Proposal for a histopathological consensus classification of the periprosthetic interface membrane
Identifieur interne : 000497 ( PascalFrancis/Curation ); précédent : 000496; suivant : 000498Proposal 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.
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.
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Proposal for a histopathological consensus classification of the periprosthetic interface membrane</title>
<author><name sortKey="Morawietz, L" sort="Morawietz, L" uniqKey="Morawietz L" first="L." last="Morawietz">L. Morawietz</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute für Pathologie, University Hospital Charité</s1>
<s2>Berlin</s2>
<s3>DEU</s3>
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<author><name sortKey="Classen, R A" sort="Classen, R A" uniqKey="Classen R" first="R.-A." last="Classen">R.-A. Classen</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute für Pathologie, University Hospital Charité</s1>
<s2>Berlin</s2>
<s3>DEU</s3>
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<author><name sortKey="Schroder, J H" sort="Schroder, J H" uniqKey="Schroder J" first="J. H." last="Schröder">J. H. Schröder</name>
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<s2>Berlin</s2>
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<author><name sortKey="Dynybil, C" sort="Dynybil, C" uniqKey="Dynybil C" first="C." last="Dynybil">C. Dynybil</name>
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<author><name sortKey="Neidel, J" sort="Neidel, J" uniqKey="Neidel J" first="J." last="Neidel">J. Neidel</name>
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<author><name sortKey="Gehrke, T" sort="Gehrke, T" uniqKey="Gehrke T" first="T." last="Gehrke">T. Gehrke</name>
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<author><name sortKey="Barden, B" sort="Barden, B" uniqKey="Barden B" first="B." last="Barden">B. Barden</name>
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<author><name sortKey="Aigner, T" sort="Aigner, T" uniqKey="Aigner T" first="T." last="Aigner">T. Aigner</name>
<affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Institute for Pathology, University Hospital</s1>
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<author><name sortKey="Stiehl, P" sort="Stiehl, P" uniqKey="Stiehl P" first="P." last="Stiehl">P. Stiehl</name>
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<author><name sortKey="Schubert, T" sort="Schubert, T" uniqKey="Schubert T" first="T." last="Schubert">T. Schubert</name>
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<author><name sortKey="Meyer Scholten, C" sort="Meyer Scholten, C" uniqKey="Meyer Scholten C" first="C." last="Meyer-Scholten">C. Meyer-Scholten</name>
<affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Center for Rheumapathology, Johannes-Gutenberg-University</s1>
<s2>Mainz</s2>
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<author><name sortKey="Konig, A" sort="Konig, A" uniqKey="Konig A" first="A." last="König">A. König</name>
<affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Orthopedic Hospital</s1>
<s2>Göppingen</s2>
<s3>DEU</s3>
<sZ>17 aut.</sZ>
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<country>Allemagne</country>
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<author><name sortKey="Strobel, P" sort="Strobel, P" uniqKey="Strobel P" first="P." last="Ströbel">P. Ströbel</name>
<affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Institute für Pathology, University Hospital</s1>
<s2>Würzburg</s2>
<s3>DEU</s3>
<sZ>18 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
</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="1"><inist:fA14 i1="15"><s1>Orthopedic Hospital König-Ludwig-Haus, University Hospital</s1>
<s2>Würzburg</s2>
<s3>DEU</s3>
<sZ>19 aut.</sZ>
<sZ>20 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
</affiliation>
</author>
<author><name sortKey="Kirschner, S" sort="Kirschner, S" uniqKey="Kirschner S" first="S." last="Kirschner">S. Kirschner</name>
<affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Orthopedic Hospital König-Ludwig-Haus, University Hospital</s1>
<s2>Würzburg</s2>
<s3>DEU</s3>
<sZ>19 aut.</sZ>
<sZ>20 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
</affiliation>
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<author><name sortKey="Lintner, F" sort="Lintner, F" uniqKey="Lintner F" first="F." last="Lintner">F. Lintner</name>
<affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Pathological-bakteriological Institute, SMZ Otto-Wagner-Spital</s1>
<s2>Wien</s2>
<s3>AUT</s3>
<sZ>21 aut.</sZ>
</inist:fA14>
<country>Autriche</country>
</affiliation>
</author>
<author><name sortKey="Ruther, W" sort="Ruther, W" uniqKey="Ruther W" first="W." last="Rüther">W. Rüther</name>
<affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Department for Orthopedic Surgery, University Hospital</s1>
<s2>Hamburg</s2>
<s3>DEU</s3>
<sZ>22 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
</affiliation>
</author>
<author><name sortKey="Bos, I" sort="Bos, I" uniqKey="Bos I" first="I." last="Bos">I. Bos</name>
<affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Institute for Pathology, Medical University of Lübeck</s1>
<s3>DEU</s3>
<sZ>23 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
</affiliation>
</author>
<author><name sortKey="Hendrich, C" sort="Hendrich, C" uniqKey="Hendrich C" first="C." last="Hendrich">C. Hendrich</name>
<affiliation wicri:level="1"><inist:fA14 i1="19"><s1>Orthopädisches Krankenhaus Schloss Werneck</s1>
<s3>DEU</s3>
<sZ>24 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
</affiliation>
</author>
<author><name sortKey="Kriegsmann, J" sort="Kriegsmann, J" uniqKey="Kriegsmann J" first="J." last="Kriegsmann">J. Kriegsmann</name>
<affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Group Practice for Pathology</s1>
<s2>Trier</s2>
<s3>DEU</s3>
<sZ>11 aut.</sZ>
<sZ>25 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
</affiliation>
</author>
<author><name sortKey="Krenn, V" sort="Krenn, V" uniqKey="Krenn V" first="V." last="Krenn">V. Krenn</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute für Pathologie, University Hospital Charité</s1>
<s2>Berlin</s2>
<s3>DEU</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>26 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Journal of clinical pathology</title>
<title level="j" type="abbreviated">J. clin. pathol.</title>
<idno type="ISSN">0021-9746</idno>
<imprint><date when="2006">2006</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Journal of clinical pathology</title>
<title level="j" type="abbreviated">J. clin. pathol.</title>
<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>Prosthesis</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Anatomopathologie</term>
<term>Histopathologie</term>
<term>Consensus</term>
<term>Classification</term>
<term>Prothèse</term>
<term>Interface</term>
<term>Membrane</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Classification</term>
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<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>
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<fA08 i1="01" i2="1" l="ENG"><s1>Proposal for a histopathological consensus classification of the periprosthetic interface membrane</s1>
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<fA11 i1="26" i2="1"><s1>KRENN (V.)</s1>
</fA11>
<fA14 i1="01"><s1>Institute für Pathologie, University Hospital Charité</s1>
<s2>Berlin</s2>
<s3>DEU</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>26 aut.</sZ>
</fA14>
<fA14 i1="02"><s1>Department for Orthopedic Surgery, University Hospital Charité</s1>
<s2>Berlin</s2>
<s3>DEU</s3>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
</fA14>
<fA14 i1="03"><s1>Department for Orthopedic Surgery, University Hospital</s1>
<s2>Münster</s2>
<s3>DEU</s3>
<sZ>6 aut.</sZ>
</fA14>
<fA14 i1="04"><s1>Department for Orthopedic Surgery, Klinik Dr Guth</s1>
<s2>Hamburg</s2>
<s3>DEU</s3>
<sZ>7 aut.</sZ>
</fA14>
<fA14 i1="05"><s1>Endo-Klinik</s1>
<s2>Hamburg</s2>
<s3>DEU</s3>
<sZ>8 aut.</sZ>
<sZ>9 aut.</sZ>
</fA14>
<fA14 i1="06"><s1>Institute for Pathology, University Hospital</s1>
<s2>Mainz</s2>
<s3>DEU</s3>
<sZ>10 aut.</sZ>
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<fA14 i1="07"><s1>Group Practice for Pathology</s1>
<s2>Trier</s2>
<s3>DEU</s3>
<sZ>11 aut.</sZ>
<sZ>25 aut.</sZ>
</fA14>
<fA14 i1="08"><s1>Department for Orthopedic Surgery, St-Augustinus Hospital</s1>
<s2>Düren</s2>
<s3>DEU</s3>
<sZ>12 aut.</sZ>
</fA14>
<fA14 i1="09"><s1>Institute for Pathology, University Hospital</s1>
<s2>Erlangen</s2>
<s3>DEU</s3>
<sZ>13 aut.</sZ>
</fA14>
<fA14 i1="10"><s1>Institute for Pathology, University Hospital</s1>
<s2>Leipzig</s2>
<s3>DEU</s3>
<sZ>14 aut.</sZ>
</fA14>
<fA14 i1="11"><s1>Institute for Pathology, University Hospital</s1>
<s2>Regensburg</s2>
<s3>DEU</s3>
<sZ>15 aut.</sZ>
</fA14>
<fA14 i1="12"><s1>Center for Rheumapathology, Johannes-Gutenberg-University</s1>
<s2>Mainz</s2>
<s3>DEU</s3>
<sZ>16 aut.</sZ>
</fA14>
<fA14 i1="13"><s1>Orthopedic Hospital</s1>
<s2>Göppingen</s2>
<s3>DEU</s3>
<sZ>17 aut.</sZ>
</fA14>
<fA14 i1="14"><s1>Institute für Pathology, University Hospital</s1>
<s2>Würzburg</s2>
<s3>DEU</s3>
<sZ>18 aut.</sZ>
</fA14>
<fA14 i1="15"><s1>Orthopedic Hospital König-Ludwig-Haus, University Hospital</s1>
<s2>Würzburg</s2>
<s3>DEU</s3>
<sZ>19 aut.</sZ>
<sZ>20 aut.</sZ>
</fA14>
<fA14 i1="16"><s1>Pathological-bakteriological Institute, SMZ Otto-Wagner-Spital</s1>
<s2>Wien</s2>
<s3>AUT</s3>
<sZ>21 aut.</sZ>
</fA14>
<fA14 i1="17"><s1>Department for Orthopedic Surgery, University Hospital</s1>
<s2>Hamburg</s2>
<s3>DEU</s3>
<sZ>22 aut.</sZ>
</fA14>
<fA14 i1="18"><s1>Institute for Pathology, Medical University of Lübeck</s1>
<s3>DEU</s3>
<sZ>23 aut.</sZ>
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