[Polyethylene content and cell size of foreign body giant cells in aseptic hip prosthesis loosening--a histomorphometric study].
BACKGROUND
In aseptic loosening of cementless hip arthroplasty polyethylene particles are phagocytized by macrophages and foreign-body giant cells. This initiates an osteolytic cascade. In this study, the authors investigated if there are correlations between the size of foreign-body giant cells and the polyethylene loading and number of intracellular particles as determined by light microscopy.


METHODS
Histological specimens were processed from tissues retrieved during revision surgery of 7 cases of cementless hip arthroplasty which had become aseptically loose. The specimens were analyzed by histolomorphology and histomorphometry. The cell size, polyethylene loading and intracellular particle number of 111 foreign-body giant cells were determined. A regression analysis was performed to investigate if there was a correlation between these variables.


RESULTS
The mean cell size was 1417 +/- 487 micron 2, the mean polyethylene loading was 49 +/- 42 micron 2 and the mean intracellular particle number was 10.4 +/- 5.4. The cell size correlated with both the intracellular particle number (r = 0.25) and the polyethylene loading (r = 0.39).


CONCLUSIONS
In the cellular reaction to polyethylene particles in aseptic loosening of cementless total hip arthroplasty, the size of foreign-body giant cells correlates with intracellular polyethylene loading and intracellular polyethylene particle number as determined by light microscopy. The presence of large foreign body giant cells might be associated with a high particle load of the tissue and a high osteolytic activity.
von Knoch
M
M
Orthopädische Universitätsklinik Kiel.
Plötz
G
G
Prymka
M
M
Förtsch
M
M
von Knoch
F
F
D000368:Aged; D048429:Cell Size; D005260:Female; D015743:Giant Cells, Foreign-Body / Q000473:pathology*; D006622:Hip Prosthesis; D006801:Humans; D002479:Inclusion Bodies / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000473:pathology; D010587:Phagocytosis / Q000502:physiology; D020959:Polyethylene / Q000032:analysis*; D011183:Postoperative Complications / Q000473:pathology*; D011475:Prosthesis Failure; D012086:Reoperation
D020959:Polyethylene
Polyethylenbeladung und Zellgrösse von Fremdkörperriesenzellen bei der aseptischen Hüftendoprothesenlockerung--Eine histomorphometrische Untersuchung.