The value of routine histopathology during hip arthroplasty in patients with degenerative and inflammatory arthritis.
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The value of routine histopathology during hip arthroplasty in patients with degenerative and inflammatory arthritis. / Niggemeyer, Oliver; Steinhagen, Jörn; Zustin, Jozef; Rüther, Wolfgang.
In: HIP INT, Vol. 21, No. 1, 1, 2011, p. 98-106.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - The value of routine histopathology during hip arthroplasty in patients with degenerative and inflammatory arthritis.
AU - Niggemeyer, Oliver
AU - Steinhagen, Jörn
AU - Zustin, Jozef
AU - Rüther, Wolfgang
PY - 2011
Y1 - 2011
N2 - The purpose of this study was to evaluate the effectiveness of routine pathological examination of operative specimens obtained during primary total hip arthroplasty (THA) performed for osteoarthritis (OA) and rheumatoid arthritis (RA). 100 consecutive patients (50 OA, 50 RA) were prospectively evaluated. A radiological score (Kellgren-Lawrence/Larsen) and a clinical score (Harris Hip Score) were calculated in each case. Specimens of bone and cartilage from the femoral head as well as capsule were obtained intraoperatively. A histological grading (Mankin score) was obtained, and additional histological findings were also reported. In patients with RA the clinical and pathological diagnoses were concordant in 37 (74%) and discrepant in 13 patients (26%). In patients with OA there was concordance in 30 (60%) and discrepancy in 20 patients (40%). Discrepancies were additional findings such as focal osteonecrosis amyloidosis or crystal deposits. Discordance (management alteration) did not occur in any case. Histological evaluation of the capsule and the synovium was more informative than evaluation of bone. Calcium pyrophosphate (CPPD) and amyloid was frequently found in OA suggesting that these substances may contribute to joint damage, and control of their production by therapeutic means may prevent degeneration.
AB - The purpose of this study was to evaluate the effectiveness of routine pathological examination of operative specimens obtained during primary total hip arthroplasty (THA) performed for osteoarthritis (OA) and rheumatoid arthritis (RA). 100 consecutive patients (50 OA, 50 RA) were prospectively evaluated. A radiological score (Kellgren-Lawrence/Larsen) and a clinical score (Harris Hip Score) were calculated in each case. Specimens of bone and cartilage from the femoral head as well as capsule were obtained intraoperatively. A histological grading (Mankin score) was obtained, and additional histological findings were also reported. In patients with RA the clinical and pathological diagnoses were concordant in 37 (74%) and discrepant in 13 patients (26%). In patients with OA there was concordance in 30 (60%) and discrepancy in 20 patients (40%). Discrepancies were additional findings such as focal osteonecrosis amyloidosis or crystal deposits. Discordance (management alteration) did not occur in any case. Histological evaluation of the capsule and the synovium was more informative than evaluation of bone. Calcium pyrophosphate (CPPD) and amyloid was frequently found in OA suggesting that these substances may contribute to joint damage, and control of their production by therapeutic means may prevent degeneration.
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Aged, 80 and over
KW - Young Adult
KW - Severity of Illness Index
KW - Prospective Studies
KW - Health Status
KW - Reproducibility of Results
KW - Amyloid/metabolism
KW - Arthritis, Rheumatoid/pathology/physiopathology/radiography
KW - Arthroplasty, Replacement, Hip
KW - Calcium Pyrophosphate/metabolism
KW - Cartilage, Articular/metabolism/pathology
KW - Femur Head/metabolism/pathology/radiography
KW - Hip Joint/pathology/physiopathology/radiography
KW - Osteoarthritis, Hip/pathology/physiopathology/radiography
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Aged, 80 and over
KW - Young Adult
KW - Severity of Illness Index
KW - Prospective Studies
KW - Health Status
KW - Reproducibility of Results
KW - Amyloid/metabolism
KW - Arthritis, Rheumatoid/pathology/physiopathology/radiography
KW - Arthroplasty, Replacement, Hip
KW - Calcium Pyrophosphate/metabolism
KW - Cartilage, Articular/metabolism/pathology
KW - Femur Head/metabolism/pathology/radiography
KW - Hip Joint/pathology/physiopathology/radiography
KW - Osteoarthritis, Hip/pathology/physiopathology/radiography
M3 - SCORING: Journal article
VL - 21
SP - 98
EP - 106
JO - HIP INT
JF - HIP INT
SN - 1120-7000
IS - 1
M1 - 1
ER -
