Bonanni Roberto, Abbondante Lorenzo, Cariati Ida, Gasbarra Elena, Tarantino Umberto
Department of Biomedicine and Prevention, "Tor Vergata" University of Rome, Via Montpellier 1, 00133 Rome, Italy.
Department of Orthopaedics and Traumatology, "Policlinico Tor Vergata" Foundation, Viale Oxford 81, 00133 Rome, Italy.
Geriatrics (Basel). 2023 Sep 15;8(5):92. doi: 10.3390/geriatrics8050092.
Good musculoskeletal quality dramatically influences the outcome of an arthroplasty operation in geriatric patients, as well as is a key element for optimal osseointegration. In this context, metallosis is a complication associated with the type of prosthesis used, as implants with a chromium-cobalt interface are known to alter the bone microarchitecture and reduce the ratio of muscle to fat, resulting in lipid accumulation. Therefore, the aim of our study was to investigate possible muscle changes by histological, morphometric, and immunohistochemical analyses in a patient undergoing hip replacement revision with elevated blood and urinary concentrations of chromium and cobalt. Interestingly, the muscle tissue showed significant structural changes and a massive infiltration of adipose tissue between muscle fibers in association with an altered expression pattern of important biomarkers of musculoskeletal health and oxidative stress, such as myostatin and NADPH Oxidase 4. Overall, our results confirm the very serious impact of metallosis on musculoskeletal health, suggesting the need for further studies to adopt a diagnostic approach to identify the cause of metallosis early and eliminate it as part of the prosthesis revision surgery.
良好的肌肉骨骼质量对老年患者关节置换手术的结果有显著影响，也是实现最佳骨整合的关键因素。在这种情况下，金属沉着病是一种与所用假体类型相关的并发症，因为已知具有铬钴界面的植入物会改变骨微结构并降低肌肉与脂肪的比例，导致脂质堆积。因此，我们研究的目的是通过组织学、形态计量学和免疫组织化学分析，调查一名接受髋关节置换翻修手术且血液和尿液中铬和钴浓度升高的患者可能出现的肌肉变化。有趣的是，肌肉组织显示出明显的结构变化以及肌肉纤维间大量脂肪组织浸润，同时与肌肉骨骼健康和氧化应激的重要生物标志物（如肌肉生长抑制素和NADPH氧化酶4）的表达模式改变有关。总体而言，我们的结果证实了金属沉着病对肌肉骨骼健康的严重影响，表明需要进一步研究采用诊断方法，尽早识别金属沉着病的病因，并在假体翻修手术中消除该病因。
