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Related Experiment Videos

Histopathologic evaluation in failed Gerard double cup arthroplasty.

W J Willems1, F Eulderink, P M Rozing

  • 1Department of Orthopaedics, University Hospital, Leiden, The Netherlands.

Clinical Orthopaedics and Related Research
|March 1, 1988
PubMed
Summary

Histological analysis of femoral head remnants after uncemented double cup arthroplasty revealed significant resorption in most cases. Osteonecrosis and stress protection were common causes, with one failure linked to polyethylene debris-induced synovitis.

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Histopathology

Background:

  • Uncemented double cup arthroplasty is a common procedure for hip joint replacement.
  • Femoral head resorption can occur after arthroplasty, potentially impacting long-term outcomes.
  • Understanding the histological changes in femoral head remnants is crucial for revision surgery.

Purpose of the Study:

  • To investigate the histological characteristics of femoral head remnants retrieved during revision surgery of uncemented double cup arthroplasty.
  • To identify the underlying causes of femoral head resorption and failure modes.

Main Methods:

  • Histological examination of fifteen femoral head remnants.
  • Analysis of resorption patterns, necrosis, and associated pathologies.

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  • Correlation of histological findings with clinical outcomes.

    • Main Results:

    • Nine out of fifteen femoral head remnants showed significant resorption.
    • Common causes included stress protection osteoporosis, pseudocysts, and osteonecrosis, particularly in the apicocranial region.
    • One case of failure was attributed to synovitis from polyethylene debris.
    • Formation of a collagenous membrane at interfaces and metaplasia with osteophyte development at the cup rim were observed.

    Conclusions:

    • Femoral head resorption is a frequent histological finding after uncemented double cup arthroplasty.
    • Osteonecrosis and stress-related changes are primary contributors to resorption.
    • Polyethylene debris can lead to inflammatory complications such as synovitis.