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Bilateral Acute Calcium Pyrophosphate Crystal Arthritis After Bilateral Total Knee ArthroplastyA Case Report
Joshua L. Carter, MD1; Nathan K. Endres, MD1; David A. Halsey, MD2
1 Department of Orthopaedics and Rehabilitation, University of Vermont, Stafford Hall 4th Floor, 95 Carrigan Drive, Burlington, VT 05401. E-mail address for J.L. Carter: joshua.carter@vtmednet.org. E-mail address for N.K. Endres: nathan.endres@med.uvm.edu
2 Orthopedic Specialty Center, 192 Tilley Drive, South Burlington, VT 05403. E-mail address: David.Halsey@vtmednet.org
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Investigation performed at Fletcher Allen Health Care, University of Vermont, Burlington, Vermont



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2012 Oct 10;2(4):e59 1-4. doi: 10.2106/JBJS.CC.K.00167
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Extract

Calcium pyrophosphate dihydrate (CPPD) deposition disease is a well-described condition of synovial joints that frequently causes major pain and disability1,2. Acute calcium pyrophosphate (CPP) crystal arthritis, commonly called “pseudogout,” refers to the acute attacks of synovitis clinically resembling acute gouty arthropathy and was initially described nearly fifty years ago1,3. The body’s inflammatory response to the crystalline arthropathy causes painful synovitis, and it may bear all of the clinical hallmarks of septic arthritis. The incidence of the disease increases with age, and CPP crystals are commonly found in the synovial fluid aspirates of osteoarthritic knees before total joint arthroplasty4. Cases of CPPD disease, however, have rarely been reported after total joint arthroplasty5-9. To our knowledge, bilateral attacks of pseudogout after bilateral total knee arthroplasty have never been reported in the English-language literature. The patient was informed that data concerning the case would be submitted for publication, and she provided consent.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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