Morawietz, L. and Classen, R-A and Schroeder, J. H. and Dynybil, C. and Perka, C. and Skwara, A. and Neidel, J. and Gehrke, T. and Frommelt, L. and Hansen, T. and Otto, M. and Barden, B. and Aigner, T. and Stiehl, P. and Schubert, T. and Meyer-Scholten, C. and Koenig, A. and Stroebel, P. and Rader, C. P. and Kirschner, S. and Lintner, F. and Ruether, W. and Bos, I. and Hendrich, C. and Kriegsmann, J. and Krenn, Veit (2006) Proposal for a histopathological consensus classification of the periprosthetic interface membrane. JOURNAL OF CLINICAL PATHOLOGY, 59 (6). pp. 591-597. ISSN 0021-9746, 1472-4146
Full text not available from this repository. (Request a copy)Abstract
Aims: The introduction of clearly defined histopathological criteria for a standardised evaluation of the periprosthetic membrane, which can appear in cases of total joint arthroplasty revision surgery. Methods: Based on histomorphological criteria, four types of periprosthetic membrane were defined: wear particle induced type (detection of foreign body particles; macrophages and multinucleated giant cells occupy at least 20% of the area; type I); infectious type (granulation tissue with neutrophilic granulocytes, plasma cells and few, if any, wear particles; type II); combined type (aspects of type I and type II occur simultaneously; type III); and indeterminate type (neither criteria for type I nor type II are fulfilled; type IV). The periprosthetic membranes of 370 patients (217 women, 153 men; mean age 67.6 years, mean period until revision surgery 7.4 years) were analysed according to the defined criteria. Results: Frequency of histopathological membrane types was: type I 54.3%, type II 19.7%, type III 5.4%, type IV 15.4%, and not assessable 5.1%. The mean period between primary arthroplasty and revision surgery was 10.1 years for type I, 3.2 years for type II, 4.5 years for type III and 5.4 years for type IV. The correlation between histopathological and microbiological diagnosis was high (89.7%), and the interobserver reproducibility sufficient (85%). Conclusion: The classification proposed enables standardised typing of periprosthetic membranes and may serve as a tool for further research on the pathogenesis of the loosening of total joint replacement. The study highlights the importance of non-infectious, non-particle induced loosening of prosthetic devices in orthopaedic surgery (membrane type IV), which was observed in 15.4% of patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TOTAL HIP-ARTHROPLASTY; POLYETHYLENE WEAR DEBRIS; JOINT REPLACEMENTS; RAT MODEL; FOLLOW-UP; PROSTHESIS; BONE; INFECTION; MIGRATION; MACROPHAGES; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Pathologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 15 Feb 2021 09:13 |
| Last Modified: | 15 Feb 2021 09:13 |
| URI: | https://pred.uni-regensburg.de/id/eprint/34500 |
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