title: Histopathological and microanalytical study of zirconium dioxide and barium sulphate in bone cement.
abstract: OBJECTIVE
  To report the appearances of zirconium dioxide and barium sulphate in interface membranes, synovium, and other tissues around joint prostheses.
  
  
  METHODS
  Histological sections from 23 specimens were reviewed by light microscopy and polarisation. Scanning electron microscopy and x ray microanalysis were performed on routinely processed paraffin wax sections.
  
  
  RESULTS
  Polyethylene, metals, and polymethylmethacrylate cement debris were easily recognisable. Almost all the cement remnants contained either zirconium dioxide or barium sulphate, confirmed by microanalysis. The contrast media had characteristic light microscopic appearances. Zirconium was identified in macrophages away from cement remnants.
  
  
  CONCLUSIONS
  The presence of radiographic contrast media in tissues around prosthetic joints is common but not widely recognised.
authors.affiliation: Department of Histopathology, United Medical School, London.
authors.forename: C E
authors.initials: CE
authors.lastname: Keen
authors.forename: G
authors.initials: G
authors.lastname: Philip
authors.forename: K
authors.initials: K
authors.lastname: Brady
authors.forename: J D
authors.initials: JD
authors.lastname: Spencer
authors.forename: D A
authors.initials: DA
authors.lastname: Levison
mesh_terms: D000328:Adult; D000368:Aged; D001466:Barium Sulfate / Q000032:analysis*; D001843:Bone Cements / Q000737:chemistry*; D004577:Electron Probe Microanalysis; D006622:Hip Prosthesis; D006801:Humans; D007720:Knee Prosthesis; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D015040:Zirconium / Q000032:analysis*
chemical_list: D001843:Bone Cements; D001466:Barium Sulfate; D015040:Zirconium; C028541:zirconium oxide