TITLE

Histopathology of Femoral Head Donations: A Retrospective Review of 6161 Cases

AUTHOR(S)
Mackie, Katherine E.; Ziqiang Zhou; Robbins, Peter; Bulsara, Max; Zheng, Ming H.
PUB. DATE
August 2011
SOURCE
Journal of Bone & Joint Surgery, American Volume;8/17/2011, Vol. 93-A Issue 16, p1500
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Although total hip arthroplasty is one of the most common orthopaedic surgical procedures, it remains unclear whether histopathological examination of the excised femoral head adds to the quality of patient care. We propose that assessment of femoral heads resected during total hip arthroplasty and donated for allograft use may provide a profile of femoral head pathology that benefits total hip arthroplasty patients and bone donors. Methods: We retrospectively analyzed the histological findings reported for 6161 femoral heads donated for allograft use between 1993 and 2006. Specimens obtained during total hip arthroplasty and specimens donated at death were reviewed. Follow-up investigations that resulted from abnormal histopathological findings were also reviewed. The Western Australian Cancer Registry was used to determine whether patients with a suspected neoplasm were subsequently diagnosed with such a disease. A retrospective review of the histopathological findings was conducted to evaluate and reclassify all previous observations of abnormalities. Results: One hundred and five femoral heads demonstrated abnormal or reactive histopathological features not reported prior to surgery and were rejected for allograft use. A reactive lymphocytic infiltrate, most likely due to osteoarthritis, was the most commonly identified feature (forty-five cases). Other features observed in twenty-seven cases were also most likely due to the presence of severe osteoarthritis. Ten femoral heads demonstrated plasmacytosis, which may have been related to osteoarthritis. Two patients were diagnosed with Paget's disease, and two, with rheumatoid arthritis. Nineteen patients had a suspected neoplasm. Of these nineteen, eight cases of non-Hodgkin's lymphoma or chronic lymphocytic leukemia and one case of myelodysplastic syndrome were confirmed on further investigation. One subsequently confirmed malignancy was detected per 770 femoral heads examined. Conclusions: Our findings indicate that, even with a detailed medical history and careful physical examination, clinically important diseases including neoplasms and Paget's disease are observed in patients diagnosed with osteoarthritis prior to total hip arthroplasty. Histological examination plays an integral role in quality assurance in femoral head banking, and it also represents a possible early diagnostic test for bone and bone-marrow-related diseases in patients undergoing total hip arthroplasty.
ACCESSION #
65094498

 

Related Articles

  • Transfer of Paget's Disease from One Part of the Skeleton to Another as a Result of Autogenous Bone-Grafting. HAMADOUCHE, MOUSSA; MATHIEU, MICHEL; TOPOUCHIAN, VICKEN; PINIEUX, GONZAGUE DE; COURPIED, JEAN PIERRE // Journal of Bone & Joint Surgery, American Volume;Nov2002, Vol. 84-A Issue 11, p2056 

    Focuses on the case report of a patient in whom monostotic Paget's disease of the pelvis was transferred to the middle part of the ipsilateral femur following total hip arthroplasty. Relationship between Paget's disease and osteoarthritis of hip joints; Efficacy of total hip arthroplasty for...

  • Two-stage hip resurfacing arthroplasty in a young patient with an infected hip following internal fixation of a complex acetabular fracture. Dean, Benjamin J. F.; Noyes, David; Whitwell, Duncan // Internet Journal of Orthopedic Surgery;2009, Vol. 14 Issue 1, p14 

    The two-stage total hip arthroplasty (THA), with or without the use of a cement spacer, is a well described technique that may be employed in the treatment of septic arthritis of the native hip joint or infected hip arthroplasty. A case is presented in which a two-stage hip resurfacing...

  • Advantages of milling versus broaching the proximal femur. Deboer, David K. // Orthopedics;Sep2005 Supplement, Vol. 28, ps1041 

    Femoral canal preparation in cementless total hip arthroplasty requires either broaching or milling of the proximal femur to create an osseous envelope for component implantation. The purpose of this article is to discuss the merits of milling the proximal femur for implant placement in primary...

  • Hip resurfacing: Despite safety warnings, it remains an effective option in certain subgroups. Simpson, James M.; Villar, Richard N. // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;9/25/2010, Vol. 341 Issue 7774, p616 

    The authors ponder on the clinical efficiency of metal on metal hip resurfacing, a type of hip replacement or arthroplasty where the head of the femur is preserved and shaped to receive a metal cap or resurfacing. They highlight the benefits of hip resurfacing compared to total hip replacement....

  • Increased Anteversion of Press-fit Femoral Stems Compared With Anatomic Femur. Emerson, Roger // Clinical Orthopaedics & Related Research;Feb2012, Vol. 470 Issue 2, p477 

    Background: With contemporary canal-filling press-fit stems, there is no adjustability of stem position in the canal and therefore the canal anatomy determines stem version. Stem version will affect head/neck impingement, polyethylene wear from edge loading, and hip stability, but despite this,...

  • RETRIEVAL OF A TRIAL FEMORAL HEAD THAT DISPLACES INTO THE PERIACETABULAR SOFT TISSUE DURING MINI-INCISION TOTAL HIP ARTHROPLASTY. ALFONSO, DANIEL; IDJADI, JEREMY; LAMONT, JUSTIN G. // Journal of Bone & Joint Surgery, American Volume;Apr2006, Vol. 88-A Issue 4, p866 

    The article discusses a case of a patient in whom a trial femoral head displaced and migrated into the abdomen during a total hip arthroplasty performed with a small incision. A simple method to help prevent such an occurrence is proposed. The advantage of this technique is that it may allow for...

  • Fixation of Chevron Trochanteric Osteotomy With Two Wire Loops In Isolated Acetabular Component Revision. Panousis, Konstantinos T.; Tsifetakis, Stavros D.; Orfanos, John; Giannoulis, Philippos; Pilichos, John; Papagelopoulos, Panayiotis J. // Orthopedics;Dec2004, Vol. 27 Issue 12, p1236 

    Presents a technique used in isolated acetabular component revision, where the retained femoral stem renders passage of the wire loops more difficult than in the case of an empty medullary canal. Background on the use of greater trochanter osteotomy in total hip arthroplasty; Description of the...

  • Leg length discrepancy and lower limb alignment after total hip arthroplasty in unilateral hip osteoarthritis patients. Fujimaki, Hiroshi; Inaba, Yutaka; Kobayashi, Naomi; Tezuka, Taro; Hirata, Yasuhide; Saito, Tomoyuki // Journal of Orthopaedic Science;Nov2013, Vol. 18 Issue 6, p969 

    Background: Leg length discrepancy (LLD) following total hip arthroplasty (THA) is a leading cause of patient dissatisfaction. However, no reports have described the influence of lower limb alignment on LLD after THA. In the present study, we firstly investigated the change in lower limb...

  • Strut allograft invasion by Paget's disease of bone: a case report. Cameron, Hugh U.; Cameron, H U; Fornasier, V L; Van Zyl, D V // Canadian Journal of Surgery;Apr2000, Vol. 43 Issue 2, p140 

    Presents a case on strut allograft invasion by Paget's bone disease. Pathophysiology of Paget's disease; Patient profile and medical history; Provision of temporary strengthening of the femur by strut allografts; Preference for hip replacement with a very long stem in the management of Paget's...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics