Revision arthroplasty : Histopathological diagnostics in periprosthetic joint infections

Der Orthopäde
V KrennT Gehrke

Abstract

Histopathological differences in synovia and synovial-like interface membrane (SLIM) patterns can be used to differentiate periprosthetic particle-induced reactions, bacterial infections (bacterial synovitis and osteomyelitis), mechanical-induced tissue alterations, adverse reactions to implant material, and arthrofibrosis (SLIM consensus classification). Because of differences in treatment the diagnosis of a bacterial implant infection is very important. Histopathological tests and scoring systems are important diagnostic tools in identifying deep implant infections in patients with unclear clinical history as well as radiographic and laboratory studies. Modern enzyme PCR-based methods, histochemical- and immune-histopathological techniques (CD3,CD15, CD68) are useful in identifying specific and nonspecific infections, as well as differentiating postsurgical changes from recurrent infections in patients with a spacer. In all histopathological scoring systems for bacterial infection, quantifying the number of neutrophil granulocytes in a defined number of high power fields is crucial. Neutrophil granulocytes can be detected through histochemical methods and more specifically by immune-histopathological techniques and by various...Continue Reading

References

Oct 1, 1996·The Journal of Bone and Joint Surgery. American Volume·J H LonnerJ D Zuckerman
Aug 2, 2002·Clinical Orthopaedics and Related Research·Daxes M BanitJames M Hartford
Apr 6, 2006·The Journal of Bone and Joint Surgery. American Volume·Thomas W BauerViktor Krebs
Dec 18, 2008·Methods in Molecular Biology·David ErmertConstantin Urban
Jul 28, 2012·Advances in Experimental Medicine and Biology·Magdalena AraznaUrszula Demkow
Oct 24, 2013·The Bone & Joint Journal·J ParviziA F Chen
Dec 18, 2013·The Journal of Arthroplasty·Benjamin ZmistowskiEivind Witzo
May 14, 2014·Zeitschrift für Rheumatologie·V KrennM Huber
Aug 22, 2014·Zeitschrift für Orthopädie und Unfallchirurgie·H G K SchmidtU-J Gerlach
Dec 3, 2014·Pathology, Research and Practice·V KrennT Gehrke

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