Classification of acetabular changes in osteoarthritis:: a histological and radiological analysis of 122 consecutive drill biopsies routinely taken during THA

被引:2
作者
Clauss, Martin [1 ]
Ilchmann, Thomas [1 ]
Zimmermann, Peter [1 ]
Schafroth, Matthias U. [1 ,2 ]
Lueem, Martin [1 ]
Ochsner, Peter E. [1 ,3 ]
机构
[1] Kantonsspital Liestal, Dept Orthoped, CH-4410 Liestal, Switzerland
[2] Univ Amsterdam, Acad Med Ctr, Dept Orthoped, NL-1105 AZ Amsterdam, Netherlands
[3] Hirslanden St Anna Clin, Dept Orthoped, Luzern, Switzerland
关键词
THA; osteoarthritis; radiological severity; acetabular bone stock; bone quality; undecalcified histology; hip;
D O I
10.1007/s00276-008-0363-0
中图分类号
R602 [外科病理学、解剖学]; R32 [人体形态学];
学科分类号
100101 ;
摘要
Background Aseptic acetabular loosening cannot be explained with a single theory and lots of studies deal with the influence of implant design and surgical technique on implant survival. Implant registers show the effect of demographic and patient-related parameters on acetabular loosening. There is little information about the influence of the acetabular bone quality on cup loosening. Methods In a prospective study, we investigated the first 122 consecutive routinely taken biopsies out of acetabular bone stock taken during primary total hip arthroplasty (THA) before reaming of the cup. Undecalcified bone samples should be classified in respect to architecture and vitality in different histological types. Four types were defined and the primary diagnosis and the severity of the preoperative radiological changes were correlated to this classification. Results A total number of 110 (90%) out of 122 biopsies could be classified to one specific type of biopsy, nine were not classifiable and three showed special entities [rheumatoid arthritis (RA) and coxitis]. Double examination showed a high intraobserver agreement (kappa 0.972). There was a correlation between the four defined types of bone biopsies and the radiological severity of osteoarthritis (P < 0.0001) but not with the diagnosis (P = 0.104). Conclusion Histological changes during the development of osteoarthritis of the hip occur regularly, can be classified in four groups and are predictable from radiological changes on preoperative radiographs.
引用
收藏
页码:547 / 556
页数:10
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