Willis-Owen C A, Keene G C, Oakeshott R D
Sportsmed SA, 32 Payenham Road, Adelaide, South Australia 5069, Australia.
J Bone Joint Surg Br. 2011 Feb;93(2):205-9. doi: 10.1302/0301-620X.93B2.25150.
Metallosis is a rare cause of failure after total knee replacement and has only previously been reported when there has been abnormal metal-on-metal contact. We describe 14 patients (15 knees) whose total knee replacement required revision for a new type of early failure caused by extensive metallosis. A modification of a cementless rotating platform implant, which had previously had excellent long-term survival, had been used in each case. The change was in the form of a new porous-beaded surface on the femoral component to induce cementless fixation, which had been used successfully in the fixation of acetabular and tibial components. This modification appeared to have resulted in metallosis due to abrasive two-body wear. The component has subsequently been recalled and is no longer in use. The presentation, investigation, and findings at revision are described and a possible aetiology and its implications are discussed.
金属沉着病是全膝关节置换术后失败的罕见原因，此前仅在金属对金属接触异常时才有报道。我们描述了14例患者（15个膝关节），他们的全膝关节置换因广泛金属沉着病导致的新型早期失败而需要翻修。在每例病例中均使用了一种非骨水泥旋转平台植入物的改良型，该植入物此前长期生存率良好。改变之处在于股骨部件上有新的多孔珠面以诱导非骨水泥固定，这种表面已成功用于髋臼和胫骨部件的固定。这种改良似乎因磨料性双体磨损导致了金属沉着病。该部件随后被召回，不再使用。本文描述了翻修时的表现、检查及结果，并讨论了可能的病因及其影响。
