Toro G, Braile A, Conza G, De Cicco A, Abu Mukh A, Placella G, Salini V. Unicompartimental knee arthroplasty metallosis treated with uni-on-uni revision: A case report. World J Orthop 2023; 14(12): 889-896 [PMID: 38173807 DOI: 10.5312/wjo.v14.i12.889]
Corresponding Author of This Article
Giuseppe Toro, MD, PhD, Research Assistant Professor, Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli,” No. 4 Via L. De Crecchio, Naples 80138, Italy. giuseppe.toro@unicampania.it
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Dec 18, 2023; 14(12): 889-896 Published online Dec 18, 2023. doi: 10.5312/wjo.v14.i12.889
Unicompartimental knee arthroplasty metallosis treated with uni-on-uni revision: A case report
Giuseppe Toro, Adriano Braile, Gianluca Conza, Annalisa De Cicco, Assala Abu Mukh, Giacomo Placella, Vincenzo Salini
Giuseppe Toro, Adriano Braile, Gianluca Conza, Annalisa De Cicco, Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
Assala Abu Mukh, Giacomo Placella, Vincenzo Salini, Department of Orthopaedics and Traumatology, San Raffaele Hospital, Milan 20132, Italy
Author contributions: Braile A, Conza G and Salini V performed material preparation and data collection; Placella G, Toro G, Salini V performed data analysis and interpretation; Abu Mukh A and De Cicco A written the first draft of the manuscript; Placella G and Toro G revised the paper and wrote the final version of the manuscript; Toro G and Salini V supervised the entire study; all authors commented on previous versions of the manuscript; all authors read and approved the final manuscript; all authors contributed to the study conception and design.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Giuseppe Toro, MD, PhD, Research Assistant Professor, Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli,” No. 4 Via L. De Crecchio, Naples 80138, Italy. giuseppe.toro@unicampania.it
Received: August 29, 2023 Peer-review started: August 29, 2023 First decision: October 9, 2023 Revised: October 15, 2023 Accepted: November 9, 2023 Article in press: November 9, 2023 Published online: December 18, 2023
Abstract
BACKGROUND
Metallosis is the result of metallic wear debris in the soft tissues and is associated to both local and systemic inflammatory response. Metallosis has been reported after total hip and total knee arthroplasty (TKA), but rarely after a unicompartimental knee arthroplasty (UKA). In the context of UKA metallosis, surgeons often opt for revision using a TKA. However, in this paper, the authors successfully treated UKA revising the metal back only.
CASE SUMMARY
Prior to treat our patient we conducted a literature research through which we identified eleven cases of metallosis after UKA, ten (90.9%) were treated revising using though a TKA. Only one case was managed through a uni-on-uni revision, reporting high knee function. Our patient complained worsening pain and function after a snap occurred at 16 mo after UKA implantation. At 18 mo following surgical debridment and uni-on-uni revision surgery, our patient exhibited a relevant improvement in Oxford Knee Score and a reduction of metal ion levels in the blood.
CONCLUSION
Our study highlights that in case of metallosis after UKA, the treatment may be based on surgical debridement and just revising the mobilized components.
Core Tip: Metallosis is a rare but serious complication of unicompartimental knee arthroplasty. It is generally treated through surgical debridment and revision to a total knee arthroplasty. However, in case of absence of critical signs of implant malpositioning, soft tissue impairment or bone loss, it could be successfully resolved through surgical debridment and uni-on-uni revision.
