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Peer-reviewedCC BY-NCJournal of Orthopaedic Case Reports

Chronic Bilateral Knee Pain Following Total Knee Arthroplasty Due to Titanium Allergy: A Case Report

  • Yianni Bakaes1
  • Elisabeth P Rosen2
  • Syed Eesa Nazir3
  • Prempreet Singh Bajaj1
  1. 1Department of Orthopaedic Surgery, Loyola University Medical Center, Maywood, Illinois, United States.
  2. 2Department of Physical Medicine and Rehabilitation, Northwestern Medicine Marianjoy Rehabilitation Hospital, Wheaton, Illinois, United States.
  3. 3Department of Molecular and Cellular Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, United States.
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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.

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Cite

BibTeXRIS
BibTeX
@article{bakaes2026chronic,
  title = {{Chronic Bilateral Knee Pain Following Total Knee Arthroplasty Due to Titanium Allergy: A Case Report}},
  author = {Yianni Bakaes and Elisabeth P Rosen and Syed Eesa Nazir and Prempreet Singh Bajaj},
  journal = {Journal of Orthopaedic Case Reports},
  year = {2026},
  month = nov,
  doi = {10.13107/jocr.2026.v16.i11.8456},
  url = {https://doi.org/10.13107/jocr.2026.v16.i11.8456},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Chronic Bilateral Knee Pain Following Total Knee Arthroplasty Due to Titanium Allergy: A Case Report
AU  - Yianni Bakaes
AU  - Elisabeth P Rosen
AU  - Syed Eesa Nazir
AU  - Prempreet Singh Bajaj
PY  - 2026
DA  - 2026/11/01
JO  - Journal of Orthopaedic Case Reports
DO  - 10.13107/jocr.2026.v16.i11.8456
UR  - https://doi.org/10.13107/jocr.2026.v16.i11.8456
AB  - 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.
SN  - 2250-0685
SN  - 2321-3817
ER  -