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 arthroplas...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.展开更多
Introduction: Osteoarthritis and impingement, in patellofemoral compartment after partial arthroplasty, have been rarely reported. The purpose of our study was to evaluate outcome at long-term follow-up. Methods: We h...Introduction: Osteoarthritis and impingement, in patellofemoral compartment after partial arthroplasty, have been rarely reported. The purpose of our study was to evaluate outcome at long-term follow-up. Methods: We have reviewed retrospectively twenty-five unicompartmental arthroplasties. The medial parapatellar approach was used in all cases. Patients have been evaluated with regard to patellar impingement and osteoarthritic changes revealed by radiographs. The mean follow-up was 10.4 years. The clinical scoring system of the Knee Society and specific questions regarding patellofemoral symptoms were used for functional outcome. Patellofemoral complications such as osteoarthritis, impingement and the position of the femoral component were diagnosed on X-ray views of the knee. Results: At the final follow-up, fifteen knees revealed lateral patellofemoral osteoarthritis and four knees had patellofemoral impingement. Excepted of two cases, all knees with patella impingement did not revealed degenerative modifications. Anterior pain of the knee was noted more frequently in knees with patellar complications. Patellar impingement was considered the first cause of knee pain, more than knees with degenerative modifications. Only one revision surgery was indicated in front of patellofemoral conflict. The occurrence of patellar impingement depends on the surgical procedure. The anterior position of the femoral component seems to increase the frequency of such complication. Conclusion: Several degenerative modifications may occur in the patello-femoral compartment following partial knee arthroplasty. Patellar impingement and total knee arthritis are the most reported modifications. Functional outcome may be affected progressively when these changes become obvious. Patellar impingement is the major cause of knee pain and needs revision.展开更多
文摘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.
文摘Introduction: Osteoarthritis and impingement, in patellofemoral compartment after partial arthroplasty, have been rarely reported. The purpose of our study was to evaluate outcome at long-term follow-up. Methods: We have reviewed retrospectively twenty-five unicompartmental arthroplasties. The medial parapatellar approach was used in all cases. Patients have been evaluated with regard to patellar impingement and osteoarthritic changes revealed by radiographs. The mean follow-up was 10.4 years. The clinical scoring system of the Knee Society and specific questions regarding patellofemoral symptoms were used for functional outcome. Patellofemoral complications such as osteoarthritis, impingement and the position of the femoral component were diagnosed on X-ray views of the knee. Results: At the final follow-up, fifteen knees revealed lateral patellofemoral osteoarthritis and four knees had patellofemoral impingement. Excepted of two cases, all knees with patella impingement did not revealed degenerative modifications. Anterior pain of the knee was noted more frequently in knees with patellar complications. Patellar impingement was considered the first cause of knee pain, more than knees with degenerative modifications. Only one revision surgery was indicated in front of patellofemoral conflict. The occurrence of patellar impingement depends on the surgical procedure. The anterior position of the femoral component seems to increase the frequency of such complication. Conclusion: Several degenerative modifications may occur in the patello-femoral compartment following partial knee arthroplasty. Patellar impingement and total knee arthritis are the most reported modifications. Functional outcome may be affected progressively when these changes become obvious. Patellar impingement is the major cause of knee pain and needs revision.
