A Review of Orthopedic Implant Failures due to Metallosis and the Methods Utilized to Minimize and Address this Condition

Introduction/Purpose: Metallosis is a common cause of adverse reactions to total joint arthroplasties that result in a complicated revisional procedure and a lengthy recovery process. Through the progression of both procedures and prosthetics, the incidence of metallosis as a cause for total joint failure has markedly decreased. The prevalence of metal on metal joints has become less common, however even with the discontinuation of metal-on-metal implants, metallosis still occurs due to complications of modern OTS (on-the-shelf) implants.

Methods or Case Description: Through the review of 18 research articles regarding metallosis and total joint arthroplasty prosthetics. Three studies highlighted the incidence of metallosis in joints excluding total knees and total hips, 3 studies reviewing metallosis in total joint failures, 3 studies on adverse reactions to total joint replacements, 2 studies on diagnostic findings/complications, and 7 studies on the future of total joint procedures. Further results were reviewed within discussion with current Orthopedic surgeons.

Outcomes: Some studies attributed total joint failures to either an attributed infection only, metallosis only, or specific allergic reactions to metals causing adverse reaction. In addition a few recognized gender specific total knee replacements of importance of custom prosthetics.

Conclusion: Although metallosis incidence overall is decreasing because fewer metal on metal implants are being inserted, metallosis is still an issue in non metal implants due to the suggested increase in wear, leading to loosening prosthetics or improperly placed prosthetic pieces. The studies above highlight many reasons for why metallosis still occurs but there still lacks a body of sound and conclusive evidence as to why. This indicates the necessity for more studies to better illuminate the risk factors that can be directly traced to total joint procedures.