PMID: 9531199Apr 8, 1998Paper

The utility of histological examination of tissue removed during elective joint replacement. A preliminary assessment

The Journal of Bone and Joint Surgery. American Volume
S S RaabR A Robinson

Abstract

The utility of histological examination of tissue removed during elective joint replacement has not been determined. During a one-year period, tissue removed during 168 total joint replacements was submitted for histological examination. The clinical and histological diagnoses, the cost of the histological study, and the clinical course were determined for all joints. Degenerative joint disease, rheumatoid arthritis, and avascular necrosis accounted for 98 per cent of the histological diagnoses. There were sixteen discrepancies between the clinical and histological diagnoses. The histological diagnosis did not affect the treatment of fifteen of these joints. However, the treatment was altered for one joint that had a clinical diagnosis of degenerative joint disease and a histological diagnosis of osteomyelitis; on review, the initial histological diagnosis was determined to be incorrect. In 1996 dollars, the cost of histological examination for all 168 joints was $10,698.24. Although there would be considerable cost-savings on a population basis if histological examination were not performed, this savings must be weighed against the effect of a misdiagnosis on the management of a particular patient.

References

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Citations

Apr 8, 1998·The Journal of Bone and Joint Surgery. American Volume·P G Bullough, H D Dorfman
Jul 31, 1999·The Journal of Bone and Joint Surgery. American Volume·T LawrenceD R Diduch
May 22, 2009·BMC Musculoskeletal Disorders·Eline W ZwitserBarend J van Royen
Sep 9, 2009·Foot & Ankle International·Irvin C OhMartin J O'Malley
Feb 8, 2011·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Oliver NiggemeyerWolfgang Rüther
Dec 29, 2011·The Journal of Bone and Joint Surgery. American Volume·Katherine E MackieMing H Zheng
Jul 26, 2018·Plastic and Reconstructive Surgery·Hoyune E ChoKevin C Chung
Nov 30, 2000·Current Infectious Disease Reports·H Sax, D Lew
Oct 20, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Jason A DavisMaximino Brambila
Feb 26, 2019·Clinical Orthopaedics and Related Research·Kelly I SuchmanCalin S Moucha
Nov 8, 2011·Clinical Orthopaedics and Related Research·Michael M LinArun J Ramappa
Feb 5, 2008·The Journal of Bone and Joint Surgery. American Volume·Richard E McClainDavid A Detrisac
Mar 13, 2015·Foot & Ankle International·Dylan S SoukupScott J Ellis
Jun 5, 2014·The Journal of Bone and Joint Surgery. American Volume·Joseph W GreeneGiles R Scuderi
Apr 26, 2021·Orthopaedics & Traumatology, Surgery & Research : OTSR·Biko A SchermerRachid Mahdad

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