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Diagnostic guidelines for the histological particle algorithm in the periprosthetic neo-synovial tissue
BACKGROUND: The identification of implant wear particles and non-implant related particles and the characterization of the inflammatory responses in the periprosthetic neo-synovial membrane, bone, and the synovial-like interface membrane (SLIM) play an important role for the evaluation of clinical o...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109269/ https://www.ncbi.nlm.nih.gov/pubmed/30158837 http://dx.doi.org/10.1186/s12907-018-0074-3 |
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author | Perino, G. Sunitsch, S. Huber, M. Ramirez, D. Gallo, J. Vaculova, J. Natu, S. Kretzer, J. P. Müller, S. Thomas, P. Thomsen, M. Krukemeyer, M. G. Resch, H. Hügle, T. Waldstein, W. Böettner, F. Gehrke, T. Sesselmann, S. Rüther, W. Xia, Z. Purdue, E. Krenn, V. |
author_facet | Perino, G. Sunitsch, S. Huber, M. Ramirez, D. Gallo, J. Vaculova, J. Natu, S. Kretzer, J. P. Müller, S. Thomas, P. Thomsen, M. Krukemeyer, M. G. Resch, H. Hügle, T. Waldstein, W. Böettner, F. Gehrke, T. Sesselmann, S. Rüther, W. Xia, Z. Purdue, E. Krenn, V. |
author_sort | Perino, G. |
collection | PubMed |
description | BACKGROUND: The identification of implant wear particles and non-implant related particles and the characterization of the inflammatory responses in the periprosthetic neo-synovial membrane, bone, and the synovial-like interface membrane (SLIM) play an important role for the evaluation of clinical outcome, correlation with radiological and implant retrieval studies, and understanding of the biological pathways contributing to implant failures in joint arthroplasty. The purpose of this study is to present a comprehensive histological particle algorithm (HPA) as a practical guide to particle identification at routine light microscopy examination. METHODS: The cases used for particle analysis were selected retrospectively from the archives of two institutions and were representative of the implant wear and non-implant related particle spectrum. All particle categories were described according to their size, shape, colour and properties observed at light microscopy, under polarized light, and after histochemical stains when necessary. A unified range of particle size, defined as a measure of length only, is proposed for the wear particles with five classes for polyethylene (PE) particles and four classes for conventional and corrosion metallic particles and ceramic particles. RESULTS: All implant wear and non-implant related particles were described and illustrated in detail by category. A particle scoring system for the periprosthetic tissue/SLIM is proposed as follows: 1) Wear particle identification at light microscopy with a two-step analysis at low (× 25, × 40, and × 100) and high magnification (× 200 and × 400); 2) Identification of the predominant wear particle type with size determination; 3) The presence of non-implant related endogenous and/or foreign particles. A guide for a comprehensive pathology report is also provided with sections for macroscopic and microscopic description, and diagnosis. CONCLUSIONS: The HPA should be considered a standard for the histological analysis of periprosthetic neo-synovial membrane, bone, and SLIM. It provides a basic, standardized tool for the identification of implant wear and non-implant related particles at routine light microscopy examination and aims at reducing intra-observer and inter-observer variability to provide a common platform for multicentric implant retrieval/radiological/histological studies and valuable data for the risk assessment of implant performance for regional and national implant registries and government agencies. |
format | Online Article Text |
id | pubmed-6109269 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-61092692018-08-29 Diagnostic guidelines for the histological particle algorithm in the periprosthetic neo-synovial tissue Perino, G. Sunitsch, S. Huber, M. Ramirez, D. Gallo, J. Vaculova, J. Natu, S. Kretzer, J. P. Müller, S. Thomas, P. Thomsen, M. Krukemeyer, M. G. Resch, H. Hügle, T. Waldstein, W. Böettner, F. Gehrke, T. Sesselmann, S. Rüther, W. Xia, Z. Purdue, E. Krenn, V. BMC Clin Pathol Research Article BACKGROUND: The identification of implant wear particles and non-implant related particles and the characterization of the inflammatory responses in the periprosthetic neo-synovial membrane, bone, and the synovial-like interface membrane (SLIM) play an important role for the evaluation of clinical outcome, correlation with radiological and implant retrieval studies, and understanding of the biological pathways contributing to implant failures in joint arthroplasty. The purpose of this study is to present a comprehensive histological particle algorithm (HPA) as a practical guide to particle identification at routine light microscopy examination. METHODS: The cases used for particle analysis were selected retrospectively from the archives of two institutions and were representative of the implant wear and non-implant related particle spectrum. All particle categories were described according to their size, shape, colour and properties observed at light microscopy, under polarized light, and after histochemical stains when necessary. A unified range of particle size, defined as a measure of length only, is proposed for the wear particles with five classes for polyethylene (PE) particles and four classes for conventional and corrosion metallic particles and ceramic particles. RESULTS: All implant wear and non-implant related particles were described and illustrated in detail by category. A particle scoring system for the periprosthetic tissue/SLIM is proposed as follows: 1) Wear particle identification at light microscopy with a two-step analysis at low (× 25, × 40, and × 100) and high magnification (× 200 and × 400); 2) Identification of the predominant wear particle type with size determination; 3) The presence of non-implant related endogenous and/or foreign particles. A guide for a comprehensive pathology report is also provided with sections for macroscopic and microscopic description, and diagnosis. CONCLUSIONS: The HPA should be considered a standard for the histological analysis of periprosthetic neo-synovial membrane, bone, and SLIM. It provides a basic, standardized tool for the identification of implant wear and non-implant related particles at routine light microscopy examination and aims at reducing intra-observer and inter-observer variability to provide a common platform for multicentric implant retrieval/radiological/histological studies and valuable data for the risk assessment of implant performance for regional and national implant registries and government agencies. BioMed Central 2018-08-25 /pmc/articles/PMC6109269/ /pubmed/30158837 http://dx.doi.org/10.1186/s12907-018-0074-3 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Perino, G. Sunitsch, S. Huber, M. Ramirez, D. Gallo, J. Vaculova, J. Natu, S. Kretzer, J. P. Müller, S. Thomas, P. Thomsen, M. Krukemeyer, M. G. Resch, H. Hügle, T. Waldstein, W. Böettner, F. Gehrke, T. Sesselmann, S. Rüther, W. Xia, Z. Purdue, E. Krenn, V. Diagnostic guidelines for the histological particle algorithm in the periprosthetic neo-synovial tissue |
title | Diagnostic guidelines for the histological particle algorithm in the periprosthetic neo-synovial tissue |
title_full | Diagnostic guidelines for the histological particle algorithm in the periprosthetic neo-synovial tissue |
title_fullStr | Diagnostic guidelines for the histological particle algorithm in the periprosthetic neo-synovial tissue |
title_full_unstemmed | Diagnostic guidelines for the histological particle algorithm in the periprosthetic neo-synovial tissue |
title_short | Diagnostic guidelines for the histological particle algorithm in the periprosthetic neo-synovial tissue |
title_sort | diagnostic guidelines for the histological particle algorithm in the periprosthetic neo-synovial tissue |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109269/ https://www.ncbi.nlm.nih.gov/pubmed/30158837 http://dx.doi.org/10.1186/s12907-018-0074-3 |
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