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[Hip surgery: local tissue reactions].

M Forest, J P Courpied, P Lefloch

    Annales De Pathologie
    |January 1, 1985
    PubMed
    Summary
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    Pathological studies reveal tissue reactions and bone loss following hip arthroplasty and osteotomy failures. Understanding these complex failures requires analyzing tissue responses and wear debris for improved prosthetic component longevity.

    Area of Science:

    • Orthopedic surgery
    • Biomaterials science
    • Pathology

    Background:

    • Total hip prostheses and conservative hip surgeries can lead to complex pathological tissue reactions.
    • Understanding these reactions is crucial for diagnosing failures in artificial hips and other surgical interventions.

    Purpose of the Study:

    • To investigate the pathological tissue reactions associated with the failure of various hip surgeries, including total hip prostheses, high femoral osteotomies, cup arthroplasties, and femoral metallic prostheses.
    • To identify histological factors contributing to prosthetic component loosening and failure.

    Main Methods:

    • Analysis of tissue samples obtained during surgical revisions of total hip arthroplasties.
    • Histopathological examination of newly formed capsular and synovial tissues.

    Related Experiment Videos

  • Evaluation of wear debris, corrosion products, and cellular responses (macrophages, giant cells).

    • Main Results:

    • Failures of high femoral osteotomies can result in modified osteoarthritic lesions, osteonecrosis, or bone resorption.
    • Cup arthroplasties may lead to cartilage destruction, cup dislodgement, or osteonecrosis of the femoral head.
    • Femoral metallic prostheses can cause acetabular cartilage damage and capsular tissue reactions, including histiocytic granulomas.
    • Tissue reactions in revision surgeries often resemble those found between prosthetic material and bone or cement.

    Conclusions:

    • Pathological findings in artificial hip failures are complex and dynamic, involving topographical and temporal factors.
    • Identifying infection, macrophage/giant cell response, wear debris, corrosion products, and histological factors is key for pathologists.
    • Further research is needed to fully elucidate the physiopathological mechanisms underlying artificial hip failure.