Chronic Bilateral Knee Pain Following Total Knee Arthroplasty Due to Titanium Allergy: A Case Report
Year: 2026
Type: article
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.
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $250
OpenAlex ID: W7225573362
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