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Lymphadenopathy Associated with Total Joint Prostheses. A Report of Two Cases and a Review of the Literature*
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Investigation performed at the Department of Pathology, Deaconess Hospital, and the Departments of Medicine and Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston
J Bone Joint Surg Am, 1996 Apr 01;78(4):588-93
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Local and regional lymphadenopathy that is caused by wear particles released from a joint-replacement prosthesis is becoming increasingly recognized as a possible complication of arthroplasty. Particles generated by the mechanical wear of a prosthesis can leave the site of the implant through lymphatic vessels and become engulfed by macrophages within the local and regional lymph nodes. The accumulation of cells containing particles causes the enlargement of a lymph node and the characteristic histological appearance of sinus histiocytosis8. The distention and prominence of the lymphatic sinuses are due to the presence of large numbers of either histiocytes derived from the cells that line the sinuses or macrophages derived from circulating monocytes. Multinucleated giant cells, resulting from the fusion of macrophages or histiocytes, might also be found in the dilated sinuses.
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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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