Hart R, Janecek M, Bucek B
Urazová nemocnice Brno.
Acta Chir Orthop Traumatol Cech. 2003;70(1):47-50.
The authors present a case of extensive metallosis of the knee joint resulting from the secondary abrasive wear of components of a unicompartmental alloplasty. Eight years after medial condyle replacement, an eighty-year-old patient presented with a break of the femoral component. This resulted in a rapid wear of tibial polyethylene and the development of secondary friction between two metal surfaces. The generation of a large number of metal particles produced an increase in the actual metal surface. This extensive articular metallosis affected not only intra-articular but also extraarticular tissues and the subchondral bone. Histological examination confirmed the presence of a large amount of opaque pigment in histiocytes. The condition was treated by total knee arthroplasty with resection of the posterior cruciate ligament (stabilizing plateau). The authors discuss the causes of metallosis development and its various types; they draw attention to the scarcity of literature data on this condition. Metallosis is a combined chemical and toxic reaction which, if the contact surface of a metal implant is large, may cause extensive damage to the surrounding tissue, the bone included.
作者报告了一例由于单髁置换假体部件继发性磨损导致膝关节广泛金属沉着病的病例。在内侧髁置换8年后，一名80岁患者出现股骨部件断裂。这导致胫骨聚乙烯快速磨损以及两个金属表面之间继发性摩擦的出现。大量金属颗粒的产生使实际金属表面积增加。这种广泛的关节金属沉着病不仅影响关节内组织，还影响关节外组织和软骨下骨。组织学检查证实组织细胞内存在大量不透明色素。该病症通过切除后交叉韧带（稳定平台）的全膝关节置换术进行治疗。作者讨论了金属沉着病的发病原因及其各种类型；他们提请注意关于这种病症的文献资料匮乏。金属沉着病是一种化学和毒性的联合反应，如果金属植入物的接触面积较大，可能会对包括骨骼在内的周围组织造成广泛损害。
