Metallosis in shoulder arthroplasty: an integrative review of literature

Abstract

Shoulder arthroplasty has gained popularity as an efficient means of achieving pain relief and improved function in a variety of complex shoulder disorders. Despite promising reports, given the increasing number of shoulder arthroplasty procedures, various causes that may contribute to failure of a well-functioning arthroplasty are being increasingly recognized. One such disastrous condition is metallosis, a subject which has not been much talked off with reference to shoulder arthroplasty. This article besides reviewing the existing literature intends to discuss the possible causes that contribute to metallosis and devise a protocol for its timely diagnosis and management.

The combination of Raman spectroscopy and mass spectrometry to investigate cutaneous metallosis

“…The treatment for metallosis is joint revision as chelating agents are not effective. 2 At her subsequent shoulder revision surgery, it was observed that approximately 40% of the glenoid base plate had been lost. Eight weeks postoperatively there was a noticeable reduction in the intensity of the pigmentation.…”

Metallosis‐Induced Conversion Shoulder Arthroplasty: A Unique Experience and Literature Review

“…Total shoulder arthroplasty can fail for several reasons, such as component loosening, periprosthetic fracture, instability, infection, soft tissue failure, or joint overstuffing 5,13,16,17 . Metallosis‐induced conversion arthroplasty has been reported very rarely 3,4 (Table 1).…”

“…4,15 Causative Factors of Revision Total shoulder arthroplasty can fail for several reasons, such as component loosening, periprosthetic fracture, instability, infection, soft tissue failure, or joint overstuffing. 5,13,16,17 Metallosis-induced conversion arthroplasty has been reported very rarely 3,4 (Table 1). During surgery, severe greenish metallic staining was found in the joint, confirming the diagnosis of metallosis, and diffuse wear was observed in the polyethylene insert.…”

“…This was probably due to instability due to early hypermobility, reduced tension on the deltoid muscle, inadequate liner size, downward tilt of the glenoid, and failure to lateralize the component sufficiently. 5 Loosening of the implant was suspected, and the patient required a repeat operation. In the operation field, no component loosening was identified, especially in the glenoid component.…”

Giant cell tumor formation due to metallosis after open latarjet and partial shoulder resurfacing

“…Plain radiographs have demonstrated poor sensitivity for identifying metallosis and radiographic signs are absent in over half of the cases. 11 Routine plain radiographs should be obtained to assess the glenohumeral joint space, implant positioning, and osteolysis suggestive of loosening and fracture. Characteristic CT findings of metallosis are high-density enhancement outlining the joint capsule or bursa.…”