Kevin Keidel1, Marc Thomsen2, Christian Dierkes1, Holger Haas3, Ingo Arnold4, Karl-Dieter Heller5, Vincent Krenn6, Martin Liebisch6, Mike Otto1, Thorsten Gehrke7, Veit Krenn8. 1. MVZ-Zentrum für Histologie, Zytologie und Molekulare Diagnostik GmbH, Max-Planck-Straße 5, 54296, Trier, Deutschland. 2. Klinik für Orthopädie und Unfallchirurgie, Baden-Baden, Deutschland. 3. Gemeinschaftskrankenhaus St. Elisabeth/St. Petrus/St. Johannes GmbH, Bonn, Deutschland. 4. Rotes Kreuz Krankenhaus Bremen gGmbH, Bremen, Deutschland. 5. Herzogin Elisabeth Hospital, Braunschweig, Deutschland. 6. Sigmund Freud Privat-Universität, Wien, Österreich. 7. Helios Endo-Klinik, Hamburg, Deutschland. 8. MVZ-Zentrum für Histologie, Zytologie und Molekulare Diagnostik GmbH, Max-Planck-Straße 5, 54296, Trier, Deutschland. krenn@patho-trier.de.
Abstract
BACKGROUND: In 2016, the AG 11 (work group for implant-material-intolerance) of the German society for Orthopaedics and Orthopaedic Surgery (DGOOC) created a histopathologic implant register (HIR). The goal was to conduct a retrospective data analysis based on the revised SLIM-consensus-classification, which defines eight different failure mechanisms. QUESTIONS: The analysis of 4000 cases of endoprosthetic joint replacements addressed the following questions: 1. What is the frequency distribution of different SLIM-types? 2. How does durability of endoprosthetic joint replacements differ among SLIM-types? 3. What kind of periprosthetic malignant neoplasia can be detected and how often? RESULTS: SLIM-type I was diagnosed in 1577 cases (n = 1577, 39.4%), SLIM-type II in 577 cases (n = 577; 14.4%), SLIM-type III in 146 cases (n = 146; 3,7%), SLIM-type IV in 1151 cases (n = 1151; 28.8%), SLIM-type V in 361 cases (n = 361; 9.0%), SLIM-type VI in 143 cases (n = 143; 3.6%), SLIM-type VII in 42 cases (n = 42; 1.0%), and SLIM-type VIII in 3 cases (n = 3; 0.075%). There was statistical significance in implant durability between the different SLIM types. Among the different reasons for endoprosthetic joint replacement failure, non-infectious causes have the biggest share at 81%, with SLIM-type I (39.5%), and SLIM-type IV (29.4%) being the predominant SLIM types. Three cases of periprosthetic malignant neoplasia (SLIM-type VIII) were detected: one case of small B lymphocytic lymphoma/BCLL (C85.9; ICD-O: 9670/3), one case of diffuse large B‑cell lymphoma/DLBCL (C83.3; ICD‑O 9680/3), and one case of anaplastic large cell lymphoma (C84.7; ICD-O: 9714/3), with the latter ones being the causes for joint replacement , which indicates that malignant neoplasia is a very rare cause of endoprosthetic joint replacement (n = 2; 0.05%). DISCUSSION: These data are complete new, especially as concerns arthrofibrosis (SLIM-type V), adverse inflammatory reactions (SLIM-type VI), and the very rare cases of periprosthetic malignant neoplasia, SLIM-type VIII, as a reason for revision. Since neither the annual review (2017) of the EPRD, nor the national evaluation report (2017) of the IQTIG provide sufficient data, this indicates the relevance of the HIR of the AG 11 of the DGOOC.
BACKGROUND: In 2016, the AG 11 (work group for implant-material-intolerance) of the German society for Orthopaedics and Orthopaedic Surgery (DGOOC) created a histopathologic implant register (HIR). The goal was to conduct a retrospective data analysis based on the revised SLIM-consensus-classification, which defines eight different failure mechanisms. QUESTIONS: The analysis of 4000 cases of endoprosthetic joint replacements addressed the following questions: 1. What is the frequency distribution of different SLIM-types? 2. How does durability of endoprosthetic joint replacements differ among SLIM-types? 3. What kind of periprosthetic malignant neoplasia can be detected and how often? RESULTS: SLIM-type I was diagnosed in 1577 cases (n = 1577, 39.4%), SLIM-type II in 577 cases (n = 577; 14.4%), SLIM-type III in 146 cases (n = 146; 3,7%), SLIM-type IV in 1151 cases (n = 1151; 28.8%), SLIM-type V in 361 cases (n = 361; 9.0%), SLIM-type VI in 143 cases (n = 143; 3.6%), SLIM-type VII in 42 cases (n = 42; 1.0%), and SLIM-type VIII in 3 cases (n = 3; 0.075%). There was statistical significance in implant durability between the different SLIM types. Among the different reasons for endoprosthetic joint replacement failure, non-infectious causes have the biggest share at 81%, with SLIM-type I (39.5%), and SLIM-type IV (29.4%) being the predominant SLIM types. Three cases of periprosthetic malignant neoplasia (SLIM-type VIII) were detected: one case of small B lymphocytic lymphoma/BCLL (C85.9; ICD-O: 9670/3), one case of diffuse large B‑cell lymphoma/DLBCL (C83.3; ICD‑O 9680/3), and one case of anaplastic large cell lymphoma (C84.7; ICD-O: 9714/3), with the latter ones being the causes for joint replacement , which indicates that malignant neoplasia is a very rare cause of endoprosthetic joint replacement (n = 2; 0.05%). DISCUSSION: These data are complete new, especially as concerns arthrofibrosis (SLIM-type V), adverse inflammatory reactions (SLIM-type VI), and the very rare cases of periprosthetic malignant neoplasia, SLIM-type VIII, as a reason for revision. Since neither the annual review (2017) of the EPRD, nor the national evaluation report (2017) of the IQTIG provide sufficient data, this indicates the relevance of the HIR of the AG 11 of the DGOOC.
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: L Morawietz; R-A Classen; J H Schröder; C Dynybil; C Perka; A Skwara; J Neidel; T Gehrke; L Frommelt; T Hansen; M Otto; B Barden; T Aigner; P Stiehl; T Schubert; C Meyer-Scholten; A König; P Ströbel; C P Rader; S Kirschner; F Lintner; W Rüther; I Bos; C Hendrich; J Kriegsmann; V Krenn Journal: J Clin Pathol Date: 2006-06 Impact factor: 3.411
Authors: V Krenn; L Morawietz; H Kienapfel; R Ascherl; G Matziolis; J Hassenpflug; M Thomsen; P Thomas; M Huber; C Schuh; D Kendoff; D Baumhoer; M G Krukemeyer; G Perino; J Zustin; I Berger; W Rüther; C Poremba; T Gehrke Journal: Z Rheumatol Date: 2013-05 Impact factor: 1.372
Authors: Torsten Hansen; Mike Otto; Gottfried H Buchhorn; Dieter Scharnweber; Andreas Gaumann; K Stefan Delank; Anke Eckardt; Hans G Willert; Jörg Kriegsmann; C James Kirkpatrick Journal: Acta Histochem Date: 2002 Impact factor: 2.479
Authors: Philippe Wagner; Håkan Olsson; Jonas Ranstam; Otto Robertsson; Ming Hao Zheng; Lars Lidgren Journal: Acta Orthop Date: 2012-11-09 Impact factor: 3.717
Authors: Benjamin F Ricciardi; Allina A Nocon; Seth A Jerabek; Gabrielle Wilner; Elianna Kaplowitz; Steven R Goldring; P Edward Purdue; Giorgio Perino Journal: BMC Clin Pathol Date: 2016-02-27