Abstract

MOURA, Diogo; ALEGRE, Carlos  and  FONSECA, Fernando. Metalose e sinovite em artroplastias totais do joelho: Análise de dois casos. Rev. Port. Ortop. Traum. [online]. 2016, vol.24, n.2, pp.121-130. ISSN 1646-2122.

Introduction: Metallosis is a phenomenon most commonly associated with metal-on-metal hip replacements, however it can occur in any metallic implant subject to wear. The reaction of metallic debris is that of a foreign-body reaction causing synovitis with metal infiltration of the surrounding soft tissue, pain, effusion, functional limitation, osteolysis and implant loosening. Case Study:  We present two clinical cases with severe metallosis reaction in total knee arthroplasties after wear and fracture of the polyethylene insert. Both patients underwent revision knee surgery where the stained soft tissues of the knee were debrided and both remained symptom-free at 1-year follow-up. Discussion: The metallic ions and particles can result from wear and fracture of the polyethylene insert, causing abnormal contact and wear between both metallic femoral and tibial prosthetic components. An early diagnosis suspicion and surgical intervention with revision and synovectomy can have good functional results. Conclusion: Metallosis of total knee artroplasties are becoming more referred in literature, however its true incidence is still unknown. A long term and a high level of suspicion follow-up is essential for early diagnosis and treatment, which can guarantee symptoms relief and prevent progressive articular destruction.

Keywords : Total knee arthroplasty; metallosis; synovitis; polyethylene; wear; loosening.

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