Histopathological investigations in soft tissue surrounding metallic orthopaedic implants by extravasated eosinophil leukocytes

• Published in: Zeitschrift für orthopädie und ihre grenzgebiete Vol. 140; no. 1; p. 90
• Main Authors: Gassel, F, Wagner, U A, Kraft, C, Conrads, P, Schmitt, O
• Format: Journal Article
• Language: German
• Published: Germany 01-01-2002
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy; Child; Child, Preschool; Device Removal; Eosinophilia - pathology; Eosinophils - pathology; Female; Foreign-Body Reaction - pathology; Humans; Leukocyte Count; Male; Middle Aged; Prostheses and Implants
• ISSN: 0044-3220
• DOI: 10.1055/s-2002-22097

The amount of extravasated eosinophil leukocytes in soft tissue surrounding a metallic orthopaedic implant indirectly allows conclusions about the allergenicity of the implant. As yet the implications of the distance of the biopsy from the implant have not been studied.
In a prospective study we histocytologically evaluated soft tissue biopsies gained during routine removal of orthopaedic implant material in 81 patients. By means of a quantitative and semiquantitative method, material directly adjacent to and 1 cm distant from the implant was examined for eosinophil leukocytes.
In respect to the number of eosinophil granulocytes, the two groups showed no significant discrepancies (p = 0.55). lnterestingly, correlation analysis revealed a significant difference in the number of eosinophiles between implant-adjacent and -distant tissue in some individuals. Consecutive semiquantitative analysis could show that there was no correlation concerning the number of eosinophiles between results gained at 1 cm distance from the implant and material in the direct vicinity of the biomaterial.
Our results suggest that when utilising a histocytological method to determine metal sensitivity of a biomaterial on surrounding soft tissue, not only material directly adjacent to the implant but also at a distance of approximately 1 cm should be evaluated.