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[Endoprosthesis failure in the ankle joint : Histopathological diagnostics and classification]
S Müller1, M Walther2, A Röser2
1Zentrum für Histologie, Zytologie und molekulare Diagnostik, Max-Planck-Straße 5, 54296, Trier, Deutschland. s.mueller@patho-trier.de.
Der Orthopade
|December 23, 2016
Summary
Ankle joint replacement failure is linked to specific tissue responses. Increased cell proliferation in pseudocysts suggests a cause for osteolysis and potential implant revision.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Histopathology
Background:
- Ankle joint replacements have high revision rates.
- Synovia-like interface membrane (SLIM) classification needs adaptation for ankle prostheses.
- Periprosthetic pseudocysts require etiological clarification.
Purpose of the Study:
- Adapt the SLIM classification for ankle periprosthetic failure.
- Investigate the causes of periprosthetic pseudocysts.
- Measure proliferative activity (Ki67) in osteolytic regions.
Main Methods:
- Applied consensus SLIM classification to 117 ankle and 42 hip/knee tissue samples.
- Utilized particle algorithm for particle identification.
- Performed Ki67 immunohistochemistry on ankle pseudocysts and controls.
Main Results:
- SLIM classification is applicable to ankle endoprosthetic failure.
- 33.3% of ankle prostheses showed pseudocysts with SLIM characteristics.
- Ankle pseudocysts exhibited increased Ki67 proliferation (mean 14%, p=0.02037).
Conclusions:
- Type 1 SLIM (abrasion-induced) was prevalent in pseudocysts (51.3%) with higher Ki67.
- This suggests destructive intraosseous synovitis as a cause of pseudocystic osteolysis.
- A simplified diagnostic scoring system for dysfunctional ankle prostheses is proposed.
