Addressing metallosis in knee arthroplasty: From diagnostic challenges to innovative treatments

IF 2 Q2 ORTHOPEDICS World Journal of Orthopedics Pub Date : 2024-05-18 DOI:10.5312/wjo.v15.i5.386
Yvon Maurice Bogdonoff, Farid Amirouche
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Abstract

In this editorial, we comment on the article by Toro et al published in the recent issue of World Journal of Orthopedics . This editorial review provides a comprehensive exploration of the landscape surrounding knee arthroplasty metallosis, focusing on key aspects ranging from the mechanisms influencing susceptibility to clinical implications and advanced treatment strategies. We elucidate the complex interplay of implant design, patient-specific variables, and wear-related processes contributing to metallosis. Furthermore, we seek to shed light on diagnostic challenges, the necessity of a multidisciplinary approach, and the imperative for vigilant implant surveillance. Uni-on-uni revision, as a targeted treatment modality, is discussed, highlighting its potential to address metallosis in unicompartmental knee arthroplasty (UKA). There is a need for heightened awareness among clinicians regarding the subtle presentations of metallosis, coupled with the limitations of traditional imaging techniques. Addressing metallosis requires a collaborative, multidisciplinary approach to effectively navigate the complexities associated with this complication. Furthermore, the review emphasizes the evolving paradigm of personalized care, with uni-on-uni revision emerging as a promising surgical solution. In conclusion, the editorial outlines the dynamic nature of knee arthroplasty metallosis and its multifaceted impact on clinical practice. It calls for ongoing collaboration, education, and integration of innovative solutions to enhance diagnostic accuracy, proactive management, and overall patient outcomes in the realm of UKA.
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解决膝关节置换术中的金属中毒问题:从诊断难题到创新疗法
在这篇社论中,我们对托罗等人发表在最近一期《世界矫形外科杂志》上的文章进行了评论。这篇社论综述全面探讨了膝关节置换术金属病的相关情况,重点关注从影响易感性的机制到临床影响和先进治疗策略等关键方面。我们阐明了导致金属中毒的植入物设计、患者特异性变量和磨损相关过程之间复杂的相互作用。此外,我们还试图阐明诊断方面的挑战、多学科方法的必要性以及对种植体进行警惕性监测的必要性。作为一种有针对性的治疗方式,我们讨论了 "膝上翻修",强调了它在解决单关节膝关节置换术(UKA)中金属化病症的潜力。临床医生需要对金属化病的微妙表现以及传统成像技术的局限性提高警惕。解决金属化病问题需要多学科合作的方法,以有效地应对这一复杂的并发症。此外,这篇综述还强调了不断发展的个性化护理模式,其中 "一对一 "翻修术是一种很有前景的手术解决方案。最后,社论概述了膝关节置换术金属化的动态性质及其对临床实践的多方面影响。社论呼吁继续开展合作、教育和整合创新解决方案,以提高UKA领域的诊断准确性、前瞻性管理和患者的整体治疗效果。
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814
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