| Abstract [eng] |
Background: Metallosis is a rare but clinically significant complication of joint arthroplasty, defined as the accumulation of metallic debris in periprosthetic tissues and bone surrounding implant components. It is most associated with implant wear, mechanical abrasion, or corrosion, but may develop not only after metal-on-metal implants, but also in other types of arthroplasties when abnormal contact and friction between metallic surfaces occur. Metallosis may lead to soft-tissue damage, osteolysis, pseudotumor formation, implant loosening, and, in rare cases, systemic manifestations. Although improvements in implant materials have reduced the frequency of this complication, metallosis remains relevant because of the increasing number of arthroplasty procedures, the long-term use of implants, and its often-nonspecific clinical presentation. Early recognition of metallosis is important to reduce progressive bone and soft-tissue damage and to improve treatment outcomes. Aim: To analyze a clinical case of metallosis after joint arthroplasty and to provide a review of the scientific literature on the etiology, pathophysiology, clinical features, diagnosis, treatment and prevention of metallosis. Methods: A literature review was conducted using the PubMed, Google Scholar, and ScienceDirect databases, including publications from 2015 to 2025. Relevant articles were identified using the following keywords: metallosis, arthroplasty, metallosis after arthroplasty, diagnosis of metallosis, treatment of metallosis. Most of the analysed scientific sources were published between 2015 and 2025. Older sources were included when they were relevant for supporting currently used classifications or specific mechanisms of metallosis development that receive less attention in more recent literature. The clinical case description was based on retrospectively collected clinical, radiological, operative, and postoperative follow-up data. The clinical findings were compared with the latest scientific literature. Case report: This work presents the case of a 60-year-old man who developed metallosis after left hip arthroplasty. The patient presented with left hip pain and limb shortening. Radiological evaluation revealed prosthetic dislocation, signs of acetabular component loosening, and osteolysis. Metallosis was confirmed intraoperatively, and revision hip arthroplasty with debridement of the affected tissues was performed. The postoperative period was uneventful. Literature review: The scientific literature on metallosis was reviewed. The review covered the epidemiology, etiology, risk factors, pathophysiology, clinical manifestations, differential diagnosis, diagnosis, treatment and prevention of metallosis. Conclusions: Metallosis is a rare but clinically significant complication of joint arthroplasty with a multifactorial etiology and an often-nonspecific clinical presentation. Diagnosis is based on the combined assessment of clinical, laboratory, and imaging findings, particularly when differentiating metallosis from periprosthetic joint infection. Revision surgery remains the main treatment method. Proper surgical technique, regular follow-up after arthroplasty, and timely recognition of mechanical implant-related complications are essential for reducing the risk of metallosis. |
