Synovial Metallosis After Ceramic Total Ankle Arthroplasty Treated With a Total Talar Prosthesis: A Case Report

被引：3

作者：

Kasai, Taro ^{[1
]}

Yasui, Tetsuro ^{[2
,3
]}

Matsumoto, Takumi ^{[3
]}

Tanaka, Yasuhito ^{[4
]}

Takakura, Yoshinori ^{[4
]}

Tanaka, Sakae ^{[3
]}

机构：

[1] Tokyo Metropolitan Tama Med Ctr, Dept Orthoped Sugery, Tokyo, Japan

[2] Teikyo Univ Hosp Mizonokuchi, Dept Orthoped Surg, Kawasaki, Kanagawa, Japan

[3] Univ Tokyo, Fac Med, Dept Orthoped Surg, Tokyo, Japan

[4] Nara Med Univ, Dept Orthoped Surg, Nara, Japan

来源：

JOURNAL OF FOOT & ANKLE SURGERY | 2019年 / 58卷 / 05期

关键词：

alumina-ceramic; aseptic loosening; metallosis; revision; talar prosthesis; total ankle arthroplasty; REPLACEMENT; NECROSIS; OSTEOLYSIS; BODY;

D O I：

10.1053/j.jfas.2018.12.035

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Total ankle arthroplasty is a useful surgical procedure for osteoarthritis of the ankle, but aseptic loosening of components is an issue. We report here a case of aseptic implant loosening with metallosis after total ankle arthroplasty using the TNK ankle (Kyocera, Kyoto, Japan), which occurred despite the components being ceramic. We also report favorable results from our method of treatment using a total talar prosthesis in the revision surgery. During the revision surgery, synovial metallosis was found, probably related to superficial damage to the screw affixing the tibial component to the bone. Because both the tibial and talar components were loose, all the components and the remaining talar bone were removed. A new tibial component and a custom-made alumina-ceramic total talar prosthesis was inserted. Pain relief was achieved and maintained through the latest follow-up visit at 42 months after revision surgery. Dorsiflexion of the ankle improved from 0 degrees to 5 degrees and plantarflexion remained unchanged from its preoperative range of 20 degrees. The American Orthopaedic Foot & Ankle Society ankle-hindfoot score improved from 38 to 80 points. To the best of our knowledge, this is the first reported case of an aluminaceramic total ankle prosthesis loosening caused by metallosis resulting from screw abrasion. Favorable treatment results were obtained by using a total talar prosthesis in the revision surgery. (C) 2019 by the American College of Foot and Ankle Surgeons. All rights reserved.

引用

页码：1010 / 1013

页数：4

共 18 条

[11]

Prissel MA, 2014, J FOOT ANKLE SURG, V53, P101, DOI 10.1053/j.jfas.2013.10.008

[12] Histological Analysis of Early Osteolysis in Total Ankle Arthroplasty [J].

Schipper, Oliver N. ;

Haddad, Steven L. ;

Pytel, Peter ;

Zhou, Ying .

FOOT & ANKLE INTERNATIONAL, 2017, 38 (04) :351-359

[13]

Shinomiya Fumio, 2003, Mod Rheumatol, V13, P153, DOI 10.3109/s10165-002-0215-4

[14] Ankle arthroplasty using three generations of metal and ceramic prostheses [J].

Takakura, Y ;

Tanaka, Y ;

Kumai, T ;

Sugimoto, K ;

Ohgushi, H .

CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2004, (424) :130-136

[15]

TAKAKURA Y, 1990, CLIN ORTHOP RELAT R, P209

[16] The use of a ceramic talar body prosthesis in patients with aseptic necrosis of the talus [J].

Taniguchi, A. ;

Takakura, Y. ;

Sugimoto, K. ;

Hayashi, K. ;

Ouchi, K. ;

Kumai, T. ;

Tanaka, Y. .

JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2012, 94B (11) :1529-1533

[17] An Alumina Ceramic Total Talar Prosthesis for Osteonecrosis of the Talus [J].

Taniguchi, Akira ;

Takakura, Yoshinori ;

Tanaka, Yasuhito ;

Kurokawa, Hiroaki ;

Tomiwa, Kiyonori ;

Matsuda, Takenori ;

Kumai, Tsukasa ;

Sugimoto, Kazuya .

JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2015, 97A (16) :1348-1353

[18] Total Talar Replacement Following Collapse of the Talar Body as a Complication of Total Ankle Arthroplasty A Case Report [J].

Tsukamoto, Shinji ;

Tanaka, Yasuhito ;

Maegawa, Naoki ;

Shinohara, Yasushi ;

Taniguchi, Akira ;

Kumai, Tsukasa ;

Takakura, Yoshinori .

JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2010, 92A (11) :2115-2120

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