单关节膝关节翻修术治疗金属化症:病例报告

IF 2 Q2 ORTHOPEDICS World Journal of Orthopedics Pub Date : 2023-12-18 DOI:10.5312/wjo.v14.i12.889
Giuseppe Toro, A. Braile, Gianluca Conza, A. De Cicco, Assala Abu Mukh, Giacomo Placella, Vincenzo Salini
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引用次数: 0

摘要

背景 金属病是软组织中金属磨损碎片的结果,与局部和全身炎症反应有关。有报道称全髋关节和全膝关节置换术(TKA)后会出现金属病,但单侧膝关节置换术(UKA)后很少出现金属病。在UKA金属化的情况下,外科医生通常会选择使用TKA进行翻修。但在本文中,作者仅通过金属背翻修就成功治疗了UKA。病例摘要 在治疗患者之前,我们进行了文献研究,从中发现了11例UKA术后金属病变病例,其中10例(90.9%)通过TKA进行了翻修治疗。只有一个病例通过单侧膝关节翻修术进行了治疗,膝关节功能良好。我们的患者在UKA植入16个月后出现膝关节卡压,疼痛和功能均出现恶化。手术清创和单髁翻修术后 18 个月,患者的牛津膝关节评分有了明显改善,血液中的金属离子水平也有所下降。结论 我们的研究强调,如果 UKA 术后出现金属中毒,治疗方法可以是手术清创,然后对活动的组件进行翻修。
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Unicompartimental knee arthroplasty metallosis treated with uni-on-uni revision: A case report
BACKGROUND Metallosis is the result of metallic wear debris in the soft tissues and is associated to both local and systemic inflammatory response. Metallosis has been reported after total hip and total knee arthroplasty (TKA), but rarely after a unicompartimental knee arthroplasty (UKA). In the context of UKA metallosis, surgeons often opt for revision using a TKA. However, in this paper, the authors successfully treated UKA revising the metal back only. CASE SUMMARY Prior to treat our patient we conducted a literature research through which we identified eleven cases of metallosis after UKA, ten (90.9%) were treated revising using though a TKA. Only one case was managed through a uni-on-uni revision, reporting high knee function. Our patient complained worsening pain and function after a snap occurred at 16 mo after UKA implantation. At 18 mo following surgical debridment and uni-on-uni revision surgery, our patient exhibited a relevant improvement in Oxford Knee Score and a reduction of metal ion levels in the blood. CONCLUSION Our study highlights that in case of metallosis after UKA, the treatment may be based on surgical debridement and just revising the mobilized components.
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