Osteolysis and Wear Debris After Total Knee Arthroplasty Presenting With Extra-Articular Metallosis in the Calf

Tan, Gek Meng; Goh, Lynne; Singh, Sarbjit

doi:10.1016/j.arth.2007.05.031

Cited by 23 publications

(10 citation statements)

References 18 publications

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“…There has been documentation of metallosis or pseudotumor resulting from ceramic-coated total hip arthroplasty [6] and documentation of extra-articular involvement of metallosis or pseudotumor resulting from TKA [7][8][9][10][11][12][13]. There are limited data on the prevalence of metallosis resulting after TKA; however, there are extensive data on metallosis after total hip arthroplasty.…”

Section: Introductionmentioning

confidence: 99%

A Unique Case of Extra-articular Extravasation of Metal Into the Lower Leg Resulting From Oxidized Zirconium Wear Particles From Total Knee Arthroplasty

Brindley

Grimes

2020

Arthroplasty Today

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With an increasing number of joint replacements and the evolution of orthopaedic implants and hardware, there is increased occurrence and awareness of metal-related sensitivity. This has resulted in the development of devices using a variety of different materials to coat the implant. One popular option is to cover the metallic surface with a ceramic. One commercially available ceramic-coated prosthesis is coated with oxidized zirconium, with the trade name Oxinium. Although pseudotumor and metallosis resulting from ceramic joint arthroplasty implants have been documented, there is limited information on the occurrence of metallosis resulting from ceramic-coated knee implants. The purpose of this case report is to discuss a potential differential diagnosis for lower leg mass after total knee arthroplasty and to present a novel case of catastrophic failure of an Oxinium-coated total knee prosthesis (Smith and Nephew) that resulted in metallosis with extra-articular extravasation along the extensor digitorum longus tendon.

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Section: Introductionmentioning

confidence: 99%

A Unique Case of Extra-articular Extravasation of Metal Into the Lower Leg Resulting From Oxidized Zirconium Wear Particles From Total Knee Arthroplasty

Brindley

Grimes

2020

Arthroplasty Today

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“…Tan et al 21 described a case of component wear after TKA with extruded metallosis in the extra-articular tissue of the calf. Radiologic evaluation revealed severe osteolysis and loosening of prosthetic components and an intramuscular abscess communicating with the medullary canal of the tibia through an undisplaced periprosthetic fracture.…”

Section: Discussionmentioning

confidence: 99%

Paresis of the Peroneal Nerve: A Rare But Severe Long-term Complication of Polyethylene Wear in Knee Arthroplasty

Aurich¹,

Lenz²,

Best³

2017

Orthopedics

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One of the most important limiting factors in the long-term success of total knee arthroplasty is polyethylene wear. Particles of the polyethylene inserts have been shown to elicit a foreign body response, which produces bone resorption and osteolysis, ultimately leading to loosening and component failure. The authors report on a case of an elderly patient who underwent a total knee arthroplasty almost 2 decades ago. Clinical and radiological checkups of the knee had not been performed recently. He now presented with a painful and swollen knee, recurrent joint effusion and swelling of the lower leg, and paresis of the peroneal nerve. Radiological examination showed asymmetric wear of the polyethylene insert and pronounced periprosthetic osteolysis of the proximal tibia and the distal femur. Furthermore, a large ganglion on the anterolateral aspect of the lower leg, resulting in pressure on the peroneal nerve, was detected on ultrasound examination. Open excision of the ganglion was performed initially, followed by 1-stage revision knee arthroplasty using a modular system a few weeks later. This case shows a rare but severe long-term complication of total knee arthroplasty and highlights the importance of regular clinical and radiological checkups after total joint replacements, even for asymptomatic patients and especially in the long term (ie, beyond 10 years after implantation). The current case shows that wear of the polyethylene insert may also lead to ganglion formation that causes paresis of the peroneal nerve. [Orthopedics. 2017; 40(3):e538-e540.].

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“…While the effect of this phenomenon on remote organs is still controversial, local necrosis and fibrosis can be encountered [4]. Metallosis has been reported in the setting of hip and knee arthroplasties [5,6,13,14,16]. However, the prevalence of metallosis in non-weight-bearing joints is very uncommon [9,12].…”

Section: Discussionmentioning

confidence: 99%

Severe Metallosis after Total Elbow Arthroplasty—A Case Report

Sayed-Noor

Sjödén

2009

Hand (New York, N,Y.)

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We present a case of severe metallosis after total elbow arthroplasty in a female patient presenting with manifestations resembling a septic loosening. We discuss the clinical and the operative findings as well as the outcome of this uncommon complication. A review of the literature regarding the pathogenesis, radiographic appearance, and management of metallosis in prosthetic joints is presented.

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Osteolysis and Wear Debris After Total Knee Arthroplasty Presenting With Extra-Articular Metallosis in the Calf

Cited by 23 publications

References 18 publications

A Unique Case of Extra-articular Extravasation of Metal Into the Lower Leg Resulting From Oxidized Zirconium Wear Particles From Total Knee Arthroplasty

A Unique Case of Extra-articular Extravasation of Metal Into the Lower Leg Resulting From Oxidized Zirconium Wear Particles From Total Knee Arthroplasty

Paresis of the Peroneal Nerve: A Rare But Severe Long-term Complication of Polyethylene Wear in Knee Arthroplasty

Severe Metallosis after Total Elbow Arthroplasty—A Case Report

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