Tissue reactions at the implant-bone interface of the cementless total knee prostheses with sinking (Okayama University Mark-II type).
Periprosthetic tissues of 14 revised knees of 11 patients, who had undergone Mark-II type cementless total knee prosthesis, were examined to find the relationship between tissue and sinking. Nine patients had rheumatoid arthritis and two had osteoarthritis. Two types of tissue reactions were observed at the implant-bone interface: 1) granulation-dominant tissue, composed of giant cells and macrophages phagocytizing high density polyethylene flakes and dense granules of metal, on the femoral side in six cases, and tibial side in four, 2) fibrosis-dominant tissue on the tibial side in seven, and femoral side in four. On each type, three zones were observed. In the deep zone adjacent to the bone, hyaline cartilage-like tissue was located on the tibial side in four cases, and femoral side in one. An immunohistochemical stain with S-100 proteins and transmission electron microscopy revealed chondrocyte-like features. Chondrogenesis was more frequently observed on the tibial side.
Ota
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Department of Orthopaedic Surgery, Okayama University Medical School, Japan.
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000473:pathology / Q000601:surgery*; D002356:Cartilage / Q000166:cytology; D005260:Female; D005269:Femur / Q000473:pathology*; D005355:Fibrosis; D005549:Foreign-Body Reaction; D006097:Granulation Tissue / Q000166:cytology; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects* / Q000379:methods; D008264:Macrophages; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000473:pathology / Q000601:surgery*; D010587:Phagocytosis; D012086:Reoperation; D013977:Tibia / Q000473:pathology*