title: [The cause of loosening in cemented hip joint prostheses. Light and electron microscopy study and laser microprobe mass analysis].
abstract: Aseptic loosening of joint prostheses is a quantitatively increasing problem. For evaluation of the pathogenesis of prosthesis loosening joint capsules and tissue membranes taken from the femoral and acetabular bone-cement-interface of 23 hips revised for aseptic loosening were examined. In all cases we found an excessive inflammatory histiocytic reaction with intracytoplasmatic incorporation of a small granular foreign material. This could be identified to be zirconium oxide by LAMMA-analysis. Zirconium oxide and polymethylmethacrylate (PMMA) wear particles could be shown in the cytoplasm of histiocytes by transmission electron microscopy. By quantitative grading of the histiocytic reaction and the intracellular granular wear particles we found that both were evenly distributed around the loosened prosthesis. Chronic inflammation due to bone cement abrasion is regarded as a leading cause of aseptic prosthesis loosening.
authors.affiliation: Institut für Pathologie, Medizinische Universität zu Lübeck.
authors.forename: I
authors.initials: I
authors.lastname: Bos
authors.forename: B
authors.initials: B
authors.lastname: Lindner
authors.forename: U
authors.initials: U
authors.lastname: Seydel
authors.forename: R
authors.initials: R
authors.lastname: Johannisson
authors.forename: E
authors.initials: E
authors.lastname: Dörre
authors.forename: J
authors.initials: J
authors.lastname: Henssge
authors.forename: U
authors.initials: U
authors.lastname: Löhrs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005269:Femur / Q000473:pathology*; D005500:Follow-Up Studies; D005549:Foreign-Body Reaction / Q000473:pathology*; D006622:Hip Prosthesis; D006644:Histiocytes / Q000473:pathology; D006801:Humans; D002479:Inclusion Bodies / Q000648:ultrastructure; D008297:Male; D013058:Mass Spectrometry / Q000379:methods; D008768:Methylmethacrylates / Q000032:analysis; D008854:Microscopy, Electron; D008875:Middle Aged; D010587:Phagocytosis; D011183:Postoperative Complications / Q000473:pathology*; D011475:Prosthesis Failure
chemical_list: D008768:Methylmethacrylates
vernacular_title: Untersuchungen über die Lockerungsursache bei zementierten Hüftgelenkendoprothesen. Licht- und elektronenmikroskopische Untersuchung und Laser-Mikrosonden-Massenanalyse.