Metallosis after Motec metal-on-PEEK wrist replacement: A case report

IF 0.9 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation Pub Date : 2025-04-02 DOI:10.1016/j.hansur.2025.102154

Jannik Hinzmann , Yonca Steubing , Sonja Verena Schmidt , Enrico Fruth , Marcus Lehnhardt , Patrick S Harenberg

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引用次数: 0

Abstract

Despite its increasing popularity, total wrist arthroplasty (TWA) remains a treatment option that is often viewed critically and is still rarely used in patients with partial or complete osteoarthritis of the wrist. TWA is an appropriate alternative to total or partial wrist fusion, particularly for active patients with a high need for function. As the number of cases continues to increase, procedure-specific complications are becoming more common.

In this report, we present a 61-year-old female Caucasian patient with increasing wrist pain after TWA performed at another institution in 2016. Metallosis was suspected after clinical and radiographic examination and was confirmed intraoperatively and by histopathological analysis. Surgical management included removal of the pseudocapsule and replacement of the mobile parts of the implant. At 12 weeks post-operatively, the patient still reported limited range of motion but a significant reduction in pain. This is one of the few reports to date of metallosis following TWA, particularly with a metal-on-polymer joint. The possibility of metallosis should always be considered, especially in cases of delayed onset of pain and reduced range of motion after TWA, to ensure appropriate management.

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Motec金属- peek腕关节置换术后金属病1例报告。

尽管其越来越受欢迎，全腕部关节置换术（TWA）仍然是一种经常被批评的治疗选择，并且仍然很少用于部分或完全腕部骨关节炎患者。TWA是完全或部分腕关节融合术的合适选择，特别是对于活动量大、功能需求高的患者。随着病例数量的不断增加，特定手术的并发症变得越来越普遍。在本报告中，我们报告了一名61岁女性白人患者，2016年在另一家机构接受TWA手术后手腕疼痛加剧。临床和影像学检查后怀疑金属中毒，术中和组织病理学分析证实。手术治疗包括去除假囊和更换植入物的可移动部分。术后12周，患者仍报告活动范围有限，但疼痛明显减轻。这是迄今为止为数不多的TWA后金属病的报告之一，特别是金属对聚合物关节。应始终考虑金属病的可能性，特别是在TWA后疼痛延迟发作和活动范围缩小的情况下，以确保适当的治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hand Surgery & Rehabilitation Medicine-Surgery

CiteScore

1.70

自引率

27.30%

发文量

审稿时长

49 days

期刊介绍： As the official publication of the French, Belgian and Swiss Societies for Surgery of the Hand, as well as of the French Society of Rehabilitation of the Hand & Upper Limb, ''Hand Surgery and Rehabilitation'' - formerly named "Chirurgie de la Main" - publishes original articles, literature reviews, technical notes, and clinical cases. It is indexed in the main international databases (including Medline). Initially a platform for French-speaking hand surgeons, the journal will now publish its articles in English to disseminate its author''s scientific findings more widely. The journal also includes a biannual supplement in French, the monograph of the French Society for Surgery of the Hand, where comprehensive reviews in the fields of hand, peripheral nerve and upper limb surgery are presented. Organe officiel de la Société française de chirurgie de la main, de la Société française de Rééducation de la main (SFRM-GEMMSOR), de la Société suisse de chirurgie de la main et du Belgian Hand Group, indexée dans les grandes bases de données internationales (Medline, Embase, Pascal, Scopus), Hand Surgery and Rehabilitation - anciennement titrée Chirurgie de la main - publie des articles originaux, des revues de la littérature, des notes techniques, des cas clinique. Initialement plateforme d''expression francophone de la spécialité, la revue s''oriente désormais vers l''anglais pour devenir une référence scientifique et de formation de la spécialité en France et en Europe. Avec 6 publications en anglais par an, la revue comprend également un supplément biannuel, la monographie du GEM, où sont présentées en français, des mises au point complètes dans les domaines de la chirurgie de la main, des nerfs périphériques et du membre supérieur.