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[Histopathological investigations in soft tissue surrounding metallic orthopaedic implants by extravasated eosinophil
F Gassel1, U A Wagner, C Kraft
1Klinik und Poliklinik für Orthopädie der Universität Bonn, Germany.
Introduction:
The amount of extravasated eosinophil leukocytes in soft tissue surrounding a metallic orthopaedic implant indirectly allows conclusions about the allergenicity of the implant. As yet the implications of the distance of the biopsy from the implant have not been studied.
Methods:
In a prospective study we histocytologically evaluated soft tissue biopsies gained during routine removal of orthopaedic implant material in 81 patients. By means of a quantitative and semiquantitative method, material directly adjacent to and 1 cm distant from the implant was examined for eosinophil leukocytes.
Results:
In respect to the number of eosinophil granulocytes, the two groups showed no significant discrepancies (p = 0.55). lnterestingly, correlation analysis revealed a significant difference in the number of eosinophiles between implant-adjacent and -distant tissue in some individuals. Consecutive semiquantitative analysis could show that there was no correlation concerning the number of eosinophiles between results gained at 1 cm distance from the implant and material in the direct vicinity of the biomaterial.
Conclusion:
Our results suggest that when utilising a histocytological method to determine metal sensitivity of a biomaterial on surrounding soft tissue, not only material directly adjacent to the implant but also at a distance of approximately 1 cm should be evaluated.