LIBRO DE OBSEQUIO SORPRESA 1 BREAST CANCER

Recommendations

Info

2 · Interdisciplinary Diagnosis of Joint Prosthesis Pathology21. . Fig. 17 Macroparticulate polyethylene. Polyethylene macroparticles in numerous multinucleated giant cells(H&E, ×200), birefringent under polarized light (inset, ×400)jMacroparticles (>5–100 µm)At light microscopy and polarization optical analysis, PE macroparticles are polymorphicstructures with a distinctive appearance that are localized in multinucleated foreign-bodytypegiant cells (. Fig. 17).jSupra-macroparticles (≥100 µm)The PE particles are noticeable for their large size, ranging from ≥100 µm up to more than1 mm, and are visible at low-power magnification (×10) and even with the naked eye. Theshape of the supra-macroparticulate polyethylene particles (. Fig. 18) is variable rangingfrom polygonal to long, clasp-like. The localization of the supra-macroparticulate polyethyleneparticles varies with placement in multinucleated foreign-body type giant cells and/or in viable or necrotic extracellular matrix [43]. The term “PE vacuole” has been suggestedfor supra-macroparticulate PE that is extruded from the tissue [43]. PE vacuoles can beup to several millimeters in length. The vacuole-shaped spaces corresponding to the particleshape are lined by fibroblasts and macrophagic and multinucleated foreign-body-typegiant cells. The fibroblasts in particular are aligned along the surface of the vacuole. Theyhave been observed predominantly in the periprosthetic tissue of knee joint implants. Thecause(s) of failure should be determined by combined clinical, biomechanical, and PEoxidative state analysis with histological correlation [43].
22Histological Diagnosis of Implant-Associated Pathologies. . Fig. 18 Polyethylene supra-macroparticle with adjacent multinucleated giant cells (H&E, ×400) with birefringenceunder polarized light in the inset (×400)Take-Home-Message55The analysis of PE debris is important because it is still a main cause of osteolysis,a major cause of revision of joint implants, and should be associated with the examinationand technical description of the implant, included in the pathological finalreport.55The basic subdivision of the PE debris into micro-, macro-, and supramacro-particulateis proposed to be correlated with the biomechanical analysis of the implantand the oxidative state of the material.55The occurrence of supra-macroparticles in PE degradation should be reported asa major failure of the insert; the cause of its occurrence should be determined foreach implant with detailed biomechanical analysis to differentiate among materialoxidative degradation and mechanical failures such as misalignment, impingement,dislocation, rim fractures, and third-body wear.Metallic ParticlesThe subject of metallic wear particles is complex because of the various types of reactionsthat can lead to their formation and can be subdivided into two broad categories: thenon-ferrous conventional metallic particles generated by abrasion/edge loading and thecorrosion metallic particles generated by electrochemical reactions such as tribocorrosionat the bearing surface of MoM implants and mechanically assisted crevice/fretting corrosionat the trunnion junctions.
Page 1 and 2: Clinical Management of Joint Arthro
Page 3 and 4: Veit KrennGiorgio PerinoHistologica
Page 5 and 6: VPrefaceThis guide to the histologi
Page 7 and 8: VIIAuthorVeit Krenn, MD, PhD, Profe
Page 9 and 10: IXTable of ContentHistological Diag
Page 11 and 12: 3 Clinical Approach to Synovial-Lik
Page 13 and 14: 4Histological Diagnosis of Implant-
Page 19 and 20: 10Histological Diagnosis of Implant
Page 29: 20Histological Diagnosis of Implant
Page 53: Histopathological endoprosthesis pa

LIBRO DE OBSEQUIO SORPRESA 1 BREAST CANCER

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?