Related Experiment Video
Updated: Jun 2, 2026
10:35
Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
[Joint endoprosthesis pathology. Histopathological diagnostics and classification]
V Krenn1, L Morawietz, M Jakobs
1Zentrum für Histologie, Zytologie und Molekulare Diagnostik Trier, Max-Planck-Str. 18 u. 20, 54296, Trier. krenn@patho-trier.de
Der Pathologe
|April 29, 2011
Summary
Understanding prosthesis failure is key to improving implant longevity. This classification system categorizes periprosthetic diseases, revealing how infection drastically reduces prosthesis durability.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Pathology
Background:
- Prosthesis durability has improved, with high 10-year survival rates.
- However, four main disease categories impact implant longevity: wear particle disease, infection, ossification, and arthrofibrosis.
Purpose of the Study:
- To introduce and validate the histopathological "extended consensus classification of periprosthetic membranes."
- To correlate membrane types with mean prosthesis durability (MPD).
Main Methods:
- Histopathological analysis of periprosthetic membranes.
- Classification into four neosynovial types (I-IV) and three arthrofibrosis grades.
- Correlation of histopathological findings with clinical data and MPD.
Main Results:
- Wear particle-induced (Type I) MPD: 12.0 years.
- Infectious (Type II) MPD: 2.5 years.
- Combined (Type III) MPD: 4.2 years.
- Indeterminate (Type IV) MPD: 5.5 years.
- Arthrofibrosis and osseous diseases can be diagnosed histopathologically or with clinical information.
Conclusions:
- The extended consensus classification provides a framework for diagnosing periprosthetic diseases.
- Infectious processes significantly compromise prosthesis durability.
- This classification may serve as a foundation for a national endoprosthesis register.
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