Dataset Information

A Unique Case of Extra-articular Extravasation of Metal Into the Lower Leg Resulting From Oxidized Zirconium Wear Particles From Total Knee Arthroplasty.

ABSTRACT: With an increasing number of joint replacements and the evolution of orthopaedic implants and hardware, there is increased occurrence and awareness of metal-related sensitivity. This has resulted in the development of devices using a variety of different materials to coat the implant. One popular option is to cover the metallic surface with a ceramic. One commercially available ceramic-coated prosthesis is coated with oxidized zirconium, with the trade name Oxinium. Although pseudotumor and metallosis resulting from ceramic joint arthroplasty implants have been documented, there is limited information on the occurrence of metallosis resulting from ceramic-coated knee implants. The purpose of this case report is to discuss a potential differential diagnosis for lower leg mass after total knee arthroplasty and to present a novel case of catastrophic failure of an Oxinium-coated total knee prosthesis (Smith and Nephew) that resulted in metallosis with extra-articular extravasation along the extensor digitorum longus tendon.

SUBMITTER: Purcell A

PROVIDER: S-EPMC7772447 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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A Unique Case of Extra-articular Extravasation of Metal Into the Lower Leg Resulting From Oxidized Zirconium Wear Particles From Total Knee Arthroplasty.

Purcell Amanda A Buckner Shelby S Brindley George G Grimes Jerry J

Arthroplasty today 20201120 4

With an increasing number of joint replacements and the evolution of orthopaedic implants and hardware, there is increased occurrence and awareness of metal-related sensitivity. This has resulted in the development of devices using a variety of different materials to coat the implant. One popular option is to cover the metallic surface with a ceramic. One commercially available ceramic-coated prosthesis is coated with oxidized zirconium, with the trade name Oxinium. Although pseudotumor and meta ...[more]

PMID: 33385039

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Project description:Tibial anterolateral rotary instability associated with anterior cruciate ligament (ACL) tears is a well-documented and difficult problem with a long history of solutions. The lateral extra-articular tenodesis (LET) has undergone multiple refinements in technique, largely focusing on the femoral site insertion using either an interference screw versus a staple for adequate fixation. In this article, we present an improved technique using a suture anchor as an alternative to a staple or an interference screw with secure fixation to insert the LET graft onto the femur. This technique diminishes the chance of ACL tunnel–LET drilling convergence, minimizes the footprint required for adequate graft fixation, and allows the surgeon to dial in the correct tension necessary for adequate augmentation of an ACL reconstruction. Technique Video Video 1 Onlay technique of lateral extra-articular tenodesis (LET). The lateral aspect of a right knee is shown, with the patient positioned supine. The surgeon performs an approach to the iliotibial band, removing all subcutaneous tissue for adequate exposure starting approximately at the Gerdy tubercle and extending proximally about 8 cm. A distally based strip of the iliotibial band is harvested, approximately 1 cm in width, by use of separate incisions. A double-loaded 2.3-mm Iconix all-suture suture anchor is used for LET graft insertion. The graft is whipstitched with an arm of the suture anchor that is first passed underneath the lateral collateral ligament, followed by a simple suture pass through the graft by the other end of the same arm of the suture attached to the suture anchor. The fixation with 1 arm of the double-loaded Iconix suture anchor was enough to secure the graft appropriately, and the other suture within the double-loaded 2.3-mm Iconix suture anchor was removed prior to definitive fixation of the LET graft. Once the LET graft was appropriately stitched, the graft was passed underneath the lateral collateral ligament again, from distal to proximal, and then secured to the Iconix suture anchor.

Dataset Information

A Unique Case of Extra-articular Extravasation of Metal Into the Lower Leg Resulting From Oxidized Zirconium Wear Particles From Total Knee Arthroplasty.

Publications

A Unique Case of Extra-articular Extravasation of Metal Into the Lower Leg Resulting From Oxidized Zirconium Wear Particles From Total Knee Arthroplasty.

Similar Datasets

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