gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie
72. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 94. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und 49. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

22. - 25.10.2008, Berlin

Intraosseous lymphocytic infiltrates underneath the cemented resurfacing metal-on-metal arthroplasty suggestive of hypersensitivity reaction: A study of 157 retrieval femoral head specimen

Meeting Abstract

  • J. Zustin - Universitätsklinikum Hamburg Eppendorf, Institut für Pathologie, Hamburg, Germany
  • M. Amling - Universitätsklinikum Hamburg Eppendorf, Zentrum Biomechanik u. Skelettbiologie, Hamburg, Germany
  • M. Hahn - Universitätsklinikum Hamburg Eppendorf, Zentrum Biomechanik, Hamburg, Germany
  • M. Morlock - TU Hamburg-Harburg, Biomechanik, Hamburg, Germany
  • G. Sauter - Universitätsklinikum Hamburg Eppendorf, Institut für Pathologie, Hamburg, Germany
  • W. Rüther - Universitätsklinikum Hamburg Eppendorf, Orthopädische Klinik, Hamburg, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 94. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 49. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 22.-25.10.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocPO13-1802

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dkou2008/08dkou655.shtml

Published: October 16, 2008

© 2008 Zustin et al.
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Outline

Text

Background: Hypersensitivity induced hip pain and non-fracture failure of hip resurfacing arthroplasty is a problem of the resurfacing hip arthroplasty. Since data concerning hypersensitivity reaction to resurfacing cup are scarce and controversial the present study aimed to asses the histological criteria highly suggestive of this kind of pathological tissue reaction to cemented metal prosthesis depending on extent and character of intraosseous and synovial lymphocytic infiltrates.

Methods: One hundred fifty two femoral head remnants of failed cemented metal-on-metal resurfacing cup arthroplasties were histologicaly analysed. Intraosseous lymphocytic infiltrates were characterised depending on their localisation and amount of monocellular inflammatory cells.

Results: Histological examination of femoral head remnants showed extensive lymphocytic infiltrates underneath the bone-implant interface in 6,6% (10) cases.

Conclusion: Our findings are in agreement with those in recent publications and support the possibility that hip pain and metallosis induced aseptic loosening in hips with a cemented metal-on-metal articulation are possibly associated with hypersensitivity to cement or metal. Other prospective, comparative, randomised long-term studies are necessary to determine the pathogenesis, natural outcome and possible therapy of this phenomenon.