Proposal for a histopathological consensus classification of the periprosthetic interface membrane
Identifieur interne : 001473 ( Main/Exploration ); précédent : 001472; suivant : 001474Proposal for a histopathological consensus classification of the periprosthetic interface membrane
Auteurs : L. Morawietz [Allemagne] ; R-A Classen [Allemagne] ; J H Schröder [Allemagne] ; C. Dynybil [Allemagne] ; C. Perka [Allemagne] ; A. Skwara [Allemagne] ; J. Neidel [Allemagne] ; T. Gehrke [Allemagne] ; L. Frommelt [Allemagne] ; T. Hansen [Allemagne] ; M. Otto [Allemagne] ; B. Barden [Allemagne] ; T. Aigner [Allemagne] ; P. Stiehl [Allemagne] ; T. Schubert [Allemagne] ; C. Meyer-Scholten [Allemagne] ; A. König [Allemagne] ; P. Ströbel [Allemagne] ; C P Rader [Allemagne] ; S. Kirschner [Allemagne] ; F. Lintner [Autriche] ; W. Rüther [Allemagne] ; I. Bos [Allemagne] ; C. Hendrich [Allemagne] ; J. Kriegsmann [Allemagne] ; V. Krenn [Allemagne]Source :
- Journal of Clinical Pathology [ 0021-9746 ] ; 2006-06.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Classification.
English descriptors
- KwdEn :
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 inter-observer 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.
Url:
- https://api.istex.fr/document/2FC4A4CF2A090B2C2E196116455365D949E07FB1/fulltext/pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1860400
DOI: 10.1136/jcp.2005.027458
Affiliations:
- Allemagne, Autriche
- Bavière, Berlin, District de Basse-Franconie, District de Leipzig, District de Moyenne-Franconie, District de Münster, Hambourg, Rhénanie-Palatinat, Rhénanie-du-Nord-Westphalie, Saxe (Land), Vienne (Autriche)
- Berlin, Erlangen, Hambourg, Leipzig, Mayence, Münster, Vienne (Autriche), Wurtzbourg
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Le document en format XML
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Barden</name><affiliation wicri:level="1"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department for Orthopedic Surgery, St-Augustinus Hospital, Düren</wicri:regionArea><wicri:noRegion>Düren</wicri:noRegion><wicri:noRegion>Düren</wicri:noRegion></affiliation></author><author><name sortKey="Aigner, T" sort="Aigner, T" uniqKey="Aigner T" first="T" last="Aigner">T. Aigner</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute for Pathology, University Hospital, Erlangen</wicri:regionArea><placeName><settlement type="city">Erlangen</settlement><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Moyenne-Franconie</region></placeName></affiliation></author><author><name sortKey="Stiehl, P" sort="Stiehl, P" uniqKey="Stiehl P" first="P" last="Stiehl">P. 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Meyer-Scholten</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Center for Rheumapathology, Johannes-Gutenberg-University, Mainz</wicri:regionArea><placeName><region type="land" nuts="2">Rhénanie-Palatinat</region><settlement type="city">Mayence</settlement></placeName></affiliation></author><author><name sortKey="Konig, A" sort="Konig, A" uniqKey="Konig A" first="A" last="König">A. König</name><affiliation wicri:level="1"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Orthopedic Hospital, Göppingen</wicri:regionArea><wicri:noRegion>Göppingen</wicri:noRegion><wicri:noRegion>Göppingen</wicri:noRegion></affiliation></author><author><name sortKey="Strobel, P" sort="Strobel, P" uniqKey="Strobel P" first="P" last="Ströbel">P. Ströbel</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute für Pathology, University Hospital, Würzburg</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region><settlement type="city">Wurtzbourg</settlement></placeName></affiliation></author><author><name sortKey="Rader, C P" sort="Rader, C P" uniqKey="Rader C" first="C P" last="Rader">C P Rader</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Orthopedic Hospital König-Ludwig-Haus, University Hospital, Würzburg</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region><settlement type="city">Wurtzbourg</settlement></placeName></affiliation></author><author><name sortKey="Kirschner, S" sort="Kirschner, S" uniqKey="Kirschner S" first="S" last="Kirschner">S. Kirschner</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Orthopedic Hospital König-Ludwig-Haus, University Hospital, Würzburg</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region><settlement type="city">Wurtzbourg</settlement></placeName></affiliation></author><author><name sortKey="Lintner, F" sort="Lintner, F" uniqKey="Lintner F" first="F" last="Lintner">F. Lintner</name><affiliation wicri:level="3"><country xml:lang="fr">Autriche</country><wicri:regionArea>Pathological-bakteriological Institute, SMZ Otto-Wagner-Spital, Wien</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Ruther, W" sort="Ruther, W" uniqKey="Ruther W" first="W" last="Rüther">W. Rüther</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department for Orthopedic Surgery, University Hospital, Hamburg</wicri:regionArea><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Bos, I" sort="Bos, I" uniqKey="Bos I" first="I" last="Bos">I. Bos</name><affiliation wicri:level="1"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute for Pathology, Medical University of Lübeck</wicri:regionArea><wicri:noRegion>Medical University of Lübeck</wicri:noRegion><wicri:noRegion>Medical University of Lübeck</wicri:noRegion></affiliation></author><author><name sortKey="Hendrich, C" sort="Hendrich, C" uniqKey="Hendrich C" first="C" last="Hendrich">C. Hendrich</name><affiliation wicri:level="1"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Orthopädisches Krankenhaus Schloss Werneck</wicri:regionArea></affiliation></author><author><name sortKey="Kriegsmann, J" sort="Kriegsmann, J" uniqKey="Kriegsmann J" first="J" last="Kriegsmann">J. Kriegsmann</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute for Pathology, University Hospital, Mainz</wicri:regionArea><placeName><region type="land" nuts="2">Rhénanie-Palatinat</region><settlement type="city">Mayence</settlement></placeName></affiliation></author><author><name sortKey="Krenn, V" sort="Krenn, V" uniqKey="Krenn V" first="V" last="Krenn">V. Krenn</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute für Pathologie, University Hospital Charité, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Clinical Pathology</title><title level="j" type="abbrev">J Clin Pathol</title><idno type="ISSN">0021-9746</idno><idno type="eISSN">1472-4146</idno><imprint><publisher>BMJ Publishing Group Ltd and Association of Clinical Pathologists</publisher><date type="published" when="2006-06">2006-06</date><biblScope unit="volume">59</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="591">591</biblScope></imprint><idno type="ISSN">0021-9746</idno></series><idno type="istex">2FC4A4CF2A090B2C2E196116455365D949E07FB1</idno><idno type="DOI">10.1136/jcp.2005.027458</idno><idno type="href">jclinpath-59-591.pdf</idno><idno type="PMID">16731601</idno><idno type="local">0590591</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0021-9746</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anatomic pathology</term><term>Classification</term><term>Consensus</term><term>Histopathology</term><term>Interface</term><term>Membrane</term><term>PE, polyethylene</term><term>PMMA, polymethyl methacrylate</term><term>Prosthesis</term><term>TJA, total joint replacement</term><term>aseptic loosening</term><term>classification</term><term>histopathology</term><term>septic loosening</term><term>total joint replacement</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Anatomopathologie</term><term>Classification</term><term>Consensus</term><term>Histopathologie</term><term>Interface</term><term>Membrane</term><term>Prothèse</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Classification</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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 inter-observer 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.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Autriche</li></country><region><li>Bavière</li><li>Berlin</li><li>District de Basse-Franconie</li><li>District de Leipzig</li><li>District de Moyenne-Franconie</li><li>District de Münster</li><li>Hambourg</li><li>Rhénanie-Palatinat</li><li>Rhénanie-du-Nord-Westphalie</li><li>Saxe (Land)</li><li>Vienne (Autriche)</li></region><settlement><li>Berlin</li><li>Erlangen</li><li>Hambourg</li><li>Leipzig</li><li>Mayence</li><li>Münster</li><li>Vienne (Autriche)</li><li>Wurtzbourg</li></settlement></list><tree><country name="Allemagne"><region name="Berlin"><name sortKey="Morawietz, L" sort="Morawietz, L" uniqKey="Morawietz L" first="L" last="Morawietz">L. Morawietz</name></region><name sortKey="Aigner, T" sort="Aigner, T" uniqKey="Aigner T" first="T" last="Aigner">T. Aigner</name><name sortKey="Barden, B" sort="Barden, B" uniqKey="Barden B" first="B" last="Barden">B. Barden</name><name sortKey="Bos, I" sort="Bos, I" uniqKey="Bos I" first="I" last="Bos">I. Bos</name><name sortKey="Classen, R A" sort="Classen, R A" uniqKey="Classen R" first="R-A" last="Classen">R-A Classen</name><name sortKey="Dynybil, C" sort="Dynybil, C" uniqKey="Dynybil C" first="C" last="Dynybil">C. Dynybil</name><name sortKey="Frommelt, L" sort="Frommelt, L" uniqKey="Frommelt L" first="L" last="Frommelt">L. Frommelt</name><name sortKey="Gehrke, T" sort="Gehrke, T" uniqKey="Gehrke T" first="T" last="Gehrke">T. Gehrke</name><name sortKey="Hansen, T" sort="Hansen, T" uniqKey="Hansen T" first="T" last="Hansen">T. Hansen</name><name sortKey="Hendrich, C" sort="Hendrich, C" uniqKey="Hendrich C" first="C" last="Hendrich">C. Hendrich</name><name sortKey="Kirschner, S" sort="Kirschner, S" uniqKey="Kirschner S" first="S" last="Kirschner">S. Kirschner</name><name sortKey="Konig, A" sort="Konig, A" uniqKey="Konig A" first="A" last="König">A. König</name><name sortKey="Krenn, V" sort="Krenn, V" uniqKey="Krenn V" first="V" last="Krenn">V. Krenn</name><name sortKey="Kriegsmann, J" sort="Kriegsmann, J" uniqKey="Kriegsmann J" first="J" last="Kriegsmann">J. Kriegsmann</name><name sortKey="Meyer Scholten, C" sort="Meyer Scholten, C" uniqKey="Meyer Scholten C" first="C" last="Meyer-Scholten">C. Meyer-Scholten</name><name sortKey="Neidel, J" sort="Neidel, J" uniqKey="Neidel J" first="J" last="Neidel">J. Neidel</name><name sortKey="Otto, M" sort="Otto, M" uniqKey="Otto M" first="M" last="Otto">M. Otto</name><name sortKey="Perka, C" sort="Perka, C" uniqKey="Perka C" first="C" last="Perka">C. Perka</name><name sortKey="Rader, C P" sort="Rader, C P" uniqKey="Rader C" first="C P" last="Rader">C P Rader</name><name sortKey="Ruther, W" sort="Ruther, W" uniqKey="Ruther W" first="W" last="Rüther">W. Rüther</name><name sortKey="Schroder, J H" sort="Schroder, J H" uniqKey="Schroder J" first="J H" last="Schröder">J H Schröder</name><name sortKey="Schubert, T" sort="Schubert, T" uniqKey="Schubert T" first="T" last="Schubert">T. Schubert</name><name sortKey="Skwara, A" sort="Skwara, A" uniqKey="Skwara A" first="A" last="Skwara">A. Skwara</name><name sortKey="Stiehl, P" sort="Stiehl, P" uniqKey="Stiehl P" first="P" last="Stiehl">P. Stiehl</name><name sortKey="Strobel, P" sort="Strobel, P" uniqKey="Strobel P" first="P" last="Ströbel">P. Ströbel</name></country><country name="Autriche"><region name="Vienne (Autriche)"><name sortKey="Lintner, F" sort="Lintner, F" uniqKey="Lintner F" first="F" last="Lintner">F. 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