Revised histopathological consensus classification of joint implant related pathology

Krenn V, Morawietz L, Perino G, Kienapfel H, Ascherl R, Hassenpflug GJ, Thomsen M, Thomas P, Huber M, Kendoff D, Baumhoer D, Krukemeyer MG, Natu S, Boettner F, Zustin J, Koelbel B, Ruether W, Kretzer JP, Tiemann A, Trampuz A, Frommelt L, Tichilow R, Söder S, Mueller S, Parvizi J, Illgner U, Gehrke T (2014)

Publication Type: Journal article

Publication year: 2014

Journal

Book Volume: 210

Pages Range: 779-86

Journal Issue: 12

DOI: 10.1016/j.prp.2014.09.017

Abstract

This extended classification of joint implant related pathology is a practical histopathologic classification based on defined morphological criteria covering the complete spectrum of pathohistologic changes in periprosthetic tissues. These changes may occur as a consequence of endoprosthetic replacement of large joints and may lead to a reduction in the prosthesis survival rate. We describe the established consensus classification of the periprosthetic membrane, in which aseptic and septic prosthetic loosening can be subdivided into four histological types, as well as histopathological criteria for additional significant pathologies including endoprosthetic-associated arthrofibrosis, particle-induced immunological, inflammatory and toxic mechanisms (adverse reactions), and bone tissue pathologies. These characteristic tissue alterations and their relationships are summarized in the extended classification. Since particle heterogeneity in periprosthetic tissue is high and particle identification is a necessary part of diagnosis, the identification of different types of particles is described in the histopathological particle algorithm. The morphological qualities of prosthetic material particles and the demarcation between abrasion and non-abrasion endogenous particles are also summarized. This feasible classification which is based on low cost standard tissue processing and examination and on well-defined diagnostic criteria is a solid platform for the histological diagnosis of implant associated pathologies providing a stable and reproducible tool for the surgical pathologist. Since this classification is suitable for standardized histopathological diagnostics, it might also provide a useful data set for joint arthroplasty registers, particularly for registers based on so-called routine data.

Involved external institutions

Thomas Jefferson University United States (USA) (US) Reha-Zentrum am Sankt Josef-Stift Germany (DE) HELIOS Kliniken Germany (DE) Krankenhaus der Barmherzigen Brüder Trier Germany (DE) Klinikum Ernst von Bergmann Germany (DE) Hospital for Special Surgery (HSS) United States (USA) (US) Vivantes - Netzwerk für Gesundheit GmbH Germany (DE) Zeisigwaldkliniken Bethanien Chemnitz Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Klinikum Mittelbaden Baden-Baden Balg Germany (DE) Klinikum der Universität München (Großhadern und Innenstadt) Germany (DE) Otto-Wagner-Spital Austria (AT) Universitätsspital Basel Switzerland (CH) Paracelsus-Kliniken Deutschland Germany (DE) University Hospital of North Tees and Hartlepool NHS Foundation Trust United Kingdom (GB) Westfälische Wilhelms-Universität (WWU) Münster Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Universitätsklinikum Heidelberg Germany (DE) SRH Zentralklinikum Suhl Germany (DE) Charité - Universitätsmedizin Berlin Germany (DE) Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden Russian Federation (RU)

How to cite

APA:

Krenn, V., Morawietz, L., Perino, G., Kienapfel, H., Ascherl, R., Hassenpflug, G.J.,... Gehrke, T. (2014). Revised histopathological consensus classification of joint implant related pathology. Pathology Research and Practice, 210(12), 779-86. https://doi.org/10.1016/j.prp.2014.09.017

MLA:

Krenn, V., et al. "Revised histopathological consensus classification of joint implant related pathology." Pathology Research and Practice 210.12 (2014): 779-86.

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