BACKGROUND: Histopathological differences in synovia and synovial-like interface membrane (SLIM) patterns can be used to differentiate periprosthetic particle-induced reactions, bacterial infections (bacterial synovitis and osteomyelitis), mechanical-induced tissue alterations, adverse reactions to implant material, and arthrofibrosis (SLIM consensus classification). AIM: Because of differences in treatment the diagnosis of a bacterial implant infection is very important. Histopathological tests and scoring systems are important diagnostic tools in identifying deep implant infections in patients with unclear clinical history as well as radiographic and laboratory studies. RESULTS: Modern enzyme PCR-based methods, histochemical- and immune-histopathological techniques (CD3,CD15, CD68) are useful in identifying specific and nonspecific infections, as well as differentiating postsurgical changes from recurrent infections in patients with a spacer. In all histopathological scoring systems for bacterial infection, quantifying the number of neutrophil granulocytes in a defined number of high power fields is crucial. DISCUSSION: Neutrophil granulocytes can be detected through histochemical methods and more specifically by immune-histopathological techniques and by various quantification systems (histopathological scores) leading to the diagnosis of bacterial peri-implant infection. One important function of histopathology, apart from diagnosing infection, is to rule out other mechanisms of implant failure, such as tumor infiltrations, particle-induced reactions, and adverse reactions to implant materials.
BACKGROUND: Histopathological differences in synovia and synovial-like interface membrane (SLIM) patterns can be used to differentiate periprosthetic particle-induced reactions, bacterial infections (bacterial synovitis and osteomyelitis), mechanical-induced tissue alterations, adverse reactions to implant material, and arthrofibrosis (SLIM consensus classification). AIM: Because of differences in treatment the diagnosis of a bacterial implant infection is very important. Histopathological tests and scoring systems are important diagnostic tools in identifying deep implant infections in patients with unclear clinical history as well as radiographic and laboratory studies. RESULTS: Modern enzyme PCR-based methods, histochemical- and immune-histopathological techniques (CD3,CD15, CD68) are useful in identifying specific and nonspecific infections, as well as differentiating postsurgical changes from recurrent infections in patients with a spacer. In all histopathological scoring systems for bacterial infection, quantifying the number of neutrophil granulocytes in a defined number of high power fields is crucial. DISCUSSION: Neutrophil granulocytes can be detected through histochemical methods and more specifically by immune-histopathological techniques and by various quantification systems (histopathological scores) leading to the diagnosis of bacterial peri-implant infection. One important function of histopathology, apart from diagnosing infection, is to rule out other mechanisms of implant failure, such as tumor infiltrations, particle-induced reactions, and adverse reactions to implant materials.
Authors: Benjamin Zmistowski; Craig Della Valle; Thomas W Bauer; Konstantinos N Malizos; Abbas Alavi; Hani Bedair; Robert E Booth; Peter Choong; Carl Deirmengian; Garth D Ehrlich; Anil Gambir; Ronald Huang; Yair Kissin; Hideo Kobayashi; Naomi Kobayashi; Veit Krenn; Lorenzo Drago; Drago Lorenzo; S B Marston; Geert Meermans; Javier Perez; J J Ploegmakers; Aaron Rosenberg; C Simpendorfer; Peter Thomas; Stephan Tohtz; Jorge A Villafuerte; Peter Wahl; Frank-Christiaan Wagenaar; Eivind Witzo Journal: J Arthroplasty Date: 2013-12-15 Impact factor: 4.757
Authors: V Krenn; L Morawietz; G Perino; H Kienapfel; R Ascherl; G J Hassenpflug; M Thomsen; P Thomas; M Huber; D Kendoff; D Baumhoer; M G Krukemeyer; S Natu; F Boettner; J Zustin; B Kölbel; W Rüther; J P Kretzer; A Tiemann; A Trampuz; L Frommelt; R Tichilow; S Söder; S Müller; J Parvizi; U Illgner; T Gehrke Journal: Pathol Res Pract Date: 2014-10-17 Impact factor: 3.250
Authors: H G K Schmidt; M Diefenbeck; V Krenn; D Abitzsch; M Militz; A H Tiemann; N Haustedt; P Gückel; M Bühler; U-J Gerlach Journal: Z Orthop Unfall Date: 2014-08-21 Impact factor: 0.923
Authors: V Krenn; P Thomas; M Thomsen; J P Kretzer; S Usbeck; L Scheuber; G Perino; W Rüther; R v Welser; F Hopf; M Huber Journal: Z Rheumatol Date: 2014-09 Impact factor: 1.372