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解决膝关节置换术中的金属沉着病:从诊断挑战到创新治疗。

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

作者信息

Bogdonoff Yvon Maurice, Amirouche Farid

机构信息

Department of Orthopedics Surgery, University of Illinois at Chicago, Chicago, IL 60612, United States.

Department of Orthopedics Surgery, Northshore University Health System, Skokie, IL 60076, United States.

出版信息

World J Orthop. 2024 May 18;15(5):386-389. doi: 10.5312/wjo.v15.i5.386.

Abstract

In this editorial, we comment on the article by Toro published in the recent issue of . 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.

摘要

在这篇社论中,我们对托罗(Toro)发表于最近一期[期刊名称未给出]的文章进行评论。这篇社论综述全面探讨了膝关节置换金属沉着病的相关情况,重点关注从影响易感性的机制到临床意义以及先进治疗策略等关键方面。我们阐明了植入物设计、患者特异性变量以及与磨损相关的过程之间复杂的相互作用,这些因素共同导致了金属沉着病。此外,我们试图阐明诊断挑战、多学科方法的必要性以及对植入物进行密切监测的紧迫性。作为一种靶向治疗方式的单髁对单髁翻修术也被讨论,强调了其在单髁膝关节置换术(UKA)中解决金属沉着病的潜力。临床医生需要提高对金属沉着病细微表现的认识,同时了解传统成像技术的局限性。解决金属沉着病需要采取协作性的多学科方法,以有效应对与这种并发症相关的复杂性。此外,该综述强调了个性化医疗的不断发展的模式,单髁对单髁翻修术成为一种有前景的手术解决方案。总之,这篇社论概述了膝关节置换金属沉着病的动态性质及其对临床实践的多方面影响。它呼吁持续开展协作、教育并整合创新解决方案,以提高UKA领域的诊断准确性、积极管理水平以及患者的总体预后。

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本文引用的文献

1
Unicompartimental knee arthroplasty metallosis treated with uni-on-uni revision: A case report.
World J Orthop. 2023 Dec 18;14(12):889-896. doi: 10.5312/wjo.v14.i12.889.
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Metallosis after knee replacement: a review.
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