{
  "abstract": "Introduction: Pigmented villonodular synovitis (PVNS) is a rare proliferative joint disease that can necessitate total joint arthroplasty. While titanium is widely regarded as a biocompatible material, this case of titanium hypersensitivity introduces an important diagnostic consideration in patients with persistent, unexplained post-operative symptoms. Case Report: A 46-year-old woman with bilateral PVNS underwent multiple arthroscopies and eventually bilateral total knee arthroplasties in 2012. Despite revision surgeries and a range of pain management interventions, she continued to experience chronic pain, recurrent inflammation, and systemic flares. Imaging and laboratory evaluations failed to show infection or mechanical failure. After multiple inconclusive diagnostic evaluations by orthopedic surgery, rheumatology, and pain management, allergy testing revealed a titanium allergy, providing a definitive diagnosis and shifting her management approach. Conclusion: This case highlights the rare but impactful phenomenon of titanium hypersensitivity and emphasizes its role in unexplained arthroplasty failure. Clinicians should consider implant allergies when standard causes have been excluded.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopaedic Surgery, Loyola University Medical Center, Maywood, Illinois, United States.",
    "Department of Physical Medicine and Rehabilitation, Northwestern Medicine Marianjoy Rehabilitation Hospital, Wheaton, Illinois, United States.",
    "Department of Molecular and Cellular Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, United States."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yianni Bakaes",
      "orcid": "0000-0003-4033-7700"
    },
    {
      "affs": [
        1
      ],
      "name": "Elisabeth P Rosen",
      "orcid": "0009-0009-8636-2099"
    },
    {
      "affs": [
        2
      ],
      "name": "Syed Eesa Nazir",
      "orcid": "0009-0001-0760-4857"
    },
    {
      "affs": [
        0
      ],
      "name": "Prempreet Singh Bajaj",
      "orcid": "0000-0002-7098-6288"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7as9jgyd4dgeq.bib",
  "cited_by": 0,
  "doi": "10.13107/jocr.2026.v16.i11.8456",
  "fulltext_url": "https://jocr.co.in/wp/2026/11/chronic-bilateral-knee-pain-following-total-knee-arthroplasty-due-to-titanium-allergy-a-case-report/",
  "id": "7as9jgyd4dgeq",
  "issns": [
    "2250-0685",
    "2321-3817"
  ],
  "landing_url": "https://doi.org/10.13107/jocr.2026.v16.i11.8456",
  "language": "en",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC925-935"
    ],
    [
      "lcc",
      "RD701-811"
    ],
    [
      "openalex",
      "2746|Orthopaedic implants and arthroplasty"
    ]
  ],
  "openalex": "W7225573362",
  "pdf_url": "https://europepmc.org/articles/PMC13740856?pdf=render",
  "pmcid": "PMC13740856",
  "pmid": "42996987",
  "published": "2026-11-01",
  "publisher": "Indian Orthopaedic Research Group",
  "ris": "https://research.draconitic.com/paper/7as9jgyd4dgeq.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T14:21:35Z",
      "native_id": "0b7003c187f9487d802d5c9b559aac35",
      "source": "doaj",
      "url": "https://doi.org/10.13107/jocr.2026.v16.i11.8456"
    },
    {
      "first_seen": "2026-11-09T15:20:34Z",
      "native_id": "MED:42996987",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42996987"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Orthopaedic implants and arthroplasty",
      "subfield": "surgery"
    }
  ],
  "title": "Chronic Bilateral Knee Pain Following Total Knee Arthroplasty Due to Titanium Allergy: A Case Report",
  "title_text": "Chronic Bilateral Knee Pain Following Total Knee Arthroplasty Due to Titanium Allergy: A Case Report",
  "type": "peer-reviewed",
  "updated_at": "2026-11-10T03:20:49Z",
  "url": "https://research.draconitic.com/paper/7as9jgyd4dgeq",
  "venue": "Journal of Orthopaedic Case Reports",
  "versions": []
}