Interface Membrane Analysis in Loose Cementless Self-cutting Titanium (CST) Total Hip Arthroplasty.
- Author:
Taek Rim YOON
1
;
Jung Tae HUR
;
Sung Man ROWE
;
Eun Sun MOON
Author Information
1. Department of Orthopedic Surgery, Chonnam University Hospital, Kwangju, Korea.
- Publication Type:Original Article
- Keywords:
Hip;
Arthroplasty;
Complication;
Histology
- MeSH:
Acetabulum;
Arthroplasty;
Arthroplasty, Replacement, Hip*;
Carbon;
Connective Tissue;
Cytoplasm;
Digestion;
Follow-Up Studies;
Foreign Bodies;
Hip;
Macrophages;
Membranes*;
Microscopy;
Osteolysis;
Phagosomes;
Polyethylene;
Titanium*
- From:Journal of Korean Orthopaedic Research Society
2000;3(1):96-118
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To analyze the characteristics of the interface membrane around loose Cementless Self-Cutting Titanium(CST) acetabular components. MATERIALS AND METHOD: The authors reviewed radiographs of one hundred and thirty-four hips which underwent total hip arthroplasty using Cementless Self-Cutting Titanium(CST) acetabular components, and performed histomorphological analysis on thirteen periprosthetic membranes which were taken out at the time of revision. RESULTS: After a mean follow-up of 82 months, thirteen hips(10%) underwent revision for acetabular loosening and migration. Histologic evaluation of the periprosthetic membranes showed evidence of abundant polyethylene and metal wear particles. The interface membrane was composed of a well vascularized loose connective tissue with macrophages. Polarized microscopy revealed numerous polyethylene wear particles. Ultrastructurally, numerous, variable-sized, irregular-shaped phagosomes containing electron-dense material were seen within the cytoplasm. Tissue digestion of the periprosthetic tissue eluted numerous polyethylene and metal particles. Energy dispersive X-ray spectroscopic analysis for these wear particles revealed high concentration of titanium and carbon component suggesting that the majority of the metal particles were titanium component and polyethylene particle. CONCLUSION: This study supports the concept that wear particles in total hip arthroplasty can be a strong stimulus for a foreign body response and that this reaction causes periprosthetic osteolysis and loosening.
