Our Summary
This research paper looks into a condition known as metallosis, which can occur after a person has had a knee replacement surgery. Metallosis is a condition where the metal parts of a joint replacement start to wear down and release metal particles into the body. The study aims to understand why metallosis happens, how to diagnose it and how to treat it.
The researchers looked at previous studies and found that metallosis most often happens because a part of the knee replacement, known as the metal-backed patellar component, fails. They also discovered that it can take anywhere between 6 weeks and 26 years for metallosis to occur after surgery.
Common blood tests were not able to detect metallosis. Instead, it was confirmed through the examination of body tissues and by looking at the knee during surgery.
In terms of treatment, the most common method was to replace the entire knee prosthesis, which was successful and complication-free in nearly 90% of the cases. If the metallosis was caused by poor alignment of the joint, then this needed to be corrected during the surgery.
The researchers concluded that metallosis is a rare but possibly underreported complication of knee replacement surgery. They recommend a thorough approach to diagnosing and treating this condition to ensure the best possible outcome for patients.
FAQs
- What is metallosis and how does it occur after knee replacement surgery?
- How is metallosis diagnosed and treated?
- What are the common reasons for the occurrence of metallosis according to the research?
Doctor’s Tip
A doctor might advise a patient who is considering knee replacement surgery to discuss the risk of metallosis with their surgeon and to closely follow post-operative care instructions to minimize the risk of complications. It is also important for patients to attend regular follow-up appointments to monitor the health of their knee replacement and to address any potential issues promptly.
Suitable For
Patients who are typically recommended for knee replacement surgery are those who have severe knee pain and stiffness that limits their daily activities, those who have not experienced relief from other treatments such as medication or physical therapy, and those who have arthritis or other degenerative conditions that have caused significant damage to the knee joint. Additionally, patients who are generally healthy and do not have other medical conditions that would increase the risks of surgery are also good candidates for knee replacement. It is important for patients to discuss their individual circumstances with their healthcare provider to determine if knee replacement is the right option for them.
Timeline
Before knee replacement surgery: The patient experiences chronic knee pain, swelling, stiffness, and difficulty walking or performing daily activities. They may have tried non-surgical treatments such as physical therapy, medications, or injections without success.
Day of surgery: The patient undergoes knee replacement surgery, where the damaged parts of the knee joint are removed and replaced with artificial components made of metal, plastic, or ceramic.
Post-surgery recovery: The patient typically stays in the hospital for a few days to a week, followed by a period of rehabilitation and physical therapy to regain strength, flexibility, and range of motion in the knee.
Months to years after surgery: The patient experiences improved mobility and reduced pain in the knee, allowing them to return to normal activities. However, some patients may develop complications such as metallosis, where metal particles from the knee replacement components wear down and cause tissue damage.
Diagnosis of metallosis: Metallosis may be suspected if the patient experiences persistent pain, swelling, or instability in the knee, or if blood tests show elevated levels of metal ions. Diagnosis is confirmed through imaging tests, such as X-rays or MRI, and examination of the knee joint during surgery.
Treatment of metallosis: Treatment typically involves removing and replacing the entire knee prosthesis to eliminate the source of metal particles causing tissue damage. Correcting any alignment issues during surgery may also be necessary to prevent recurrence of metallosis.
Overall, the timeline of a patient before and after knee replacement surgery involves a process of preparation, surgery, recovery, and potential complications such as metallosis that may require further treatment.
What to Ask Your Doctor
- What are the potential risks and complications associated with knee replacement surgery?
- How common is metallosis as a complication of knee replacement surgery?
- What symptoms should I look out for that may indicate metallosis?
- How is metallosis diagnosed? Are there specific tests that need to be done?
- What treatment options are available for metallosis? Is revision surgery always necessary?
- What is the success rate of treating metallosis?
- Are there any specific factors that may increase my risk of developing metallosis after knee replacement surgery?
- How can metallosis be prevented during or after knee replacement surgery?
- What is the long-term outlook for someone who has had metallosis following knee replacement surgery?
- Are there any lifestyle changes or precautions I should take to prevent complications or recurrence of metallosis in the future?
Reference
Authors: Sahan I, Anagnostakos K. Journal: Arch Orthop Trauma Surg. 2020 Nov;140(11):1791-1808. doi: 10.1007/s00402-020-03560-x. Epub 2020 Jul 26. PMID: 32715399