Early metallosis-related failure after total knee replacement: A REPORT OF 15 CASES

• Published in: Journal of bone and joint surgery. British volume Vol. 93; no. 2; pp. 205 - 209
• Main Authors: WILLIS-OWEN, C. A, KEENE, G. C, OAKESHOTT, R. D
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01-02-2011
• Subjects: Aged; Aged, 80 and over; Arthroplasty, Replacement, Knee - adverse effects; Arthroscopy; Biological and medical sciences; Biomarkers - blood; Diseases of the osteoarticular system; Female; Foreign Bodies - diagnosis; Foreign Bodies - etiology; Humans; Inflammation Mediators - blood; Knee Prosthesis - adverse effects; Male; Medical sciences; Metals - analysis; Middle Aged; Orthopedic surgery; Postoperative Period; Prosthesis Design; Prosthesis Failure; Reoperation; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Synovial Membrane; Total knee arthroplasty; Orthopedic surgery; Treatment; Failure
• ISSN: 0301-620X; 2044-5377
• 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.