Traumatology and Orthopedics of RussiaTraumatology and Orthopedics of RussiaТравматология и ортопедия России2311-29052542-0933Vreden National Medical Research Center of Traumatology and Orthopedics7410.21823/2311-2905-2014-0-3-15-27CLINICAL STUDIESКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯClinical studiesIMPLANT-ASSOCIATED PATHOLOGY: AN ALGORITHM FOR IDENTIFYING PARTICLES IN HISTOPATHOLOGIC SYNOVIALIS/SLIM DIAGNOSTICSПАТОЛОГИЯ, ВЫЗВАННАЯ ИМПЛАНТАТОМ: АЛГОРИТМ ОПРЕДЕЛЕНИЯ ЧАСТИЦ ПРИ ГИСТОПАТОЛОГИЧЕСКОМ ИССЛЕДОВАНИИ СИНОВИАЛЬНО-ПОДОБНОЙ ОКОЛОПРОТЕЗНОЙ мембраны (SLIM)KrennV.КреннВ.
Russian Federation
krenn@patho-trier.deThomasP.ТомасП.
Russian Federation
ThomsenM.ТомсенМ.
Russian Federation
UsbeckS.УсбекС.
Russian Federation
ScheuberL.ШойберЛ.
Russian Federation
BoettnerF.БоттнэрФ.
Russian Federation
RütherW.РютерВ.
Russian Federation
HopfF.ХопфФ.
Russian Federation
MüllerS.МюллерС.
Russian Federation
KrukemeyerM. G.КрукемейерМ. Г.
Russian Federation
GehrkeT.ГеркеТ.
Russian Federation
KendoffD.КендоффД.
Russian Federation
TiemannA.ТиманнА.
Russian Federation
HuberM.ХуберМ.
Russian Federation
Center for Histology, Cytology and Molecular DiagnosticsЦентр гистологии, цитологии и молекулярной диагностикиHospital and Outpatients’ Clinic for Dermatology and Allergology, Ludwig Maximilian UniversityDRK Hospital, Orthopedics and Trauma SurgeryCeramTec GmbHHospital for Special Surgery/HSSUniversity Medical Center Hamburg EppendorfCenter for Histology, Cytology and Molecular DiagnosticsParacelsus-Kliniken Deutschland GmbhHELIOS ENDO-KlinikSRH Zentralklinikum Suhl, Klinik für Orthopädie und UnfallchirurgieInstitute of Pathology and Bacteriology, Otto Wagner Hospital12102014203152712092016https://journal.rniito.org/jour/article/view/74

In histopathologic SLIM diagnostic (synovial-like interface membrane, SLIM) apart from diagnosing periprosthetic infection particle identification has an important role to play. The differences in particle pathogenesis and variability of materials in endoprosthetics explain the particle heterogeneity that hampers the diagnostic identification of particles. For this reason, a histopathological particle algorithm has been developed. With minimal methodical complexity this histopathological particle algorithm offers a guide to prosthesis material-particle identification. Light microscopic-morphological as well as enzyme-histochemical characteristics and polarization-optical proporties have set and particles are defined by size (microparticles, macroparticles and supra- macroparticles) and definitely characterized in accordance with a dichotomous principle. Based on these criteria, identification and validation of the particles was carried out in 120 joint endoprosthesis pathological cases. A histopathological particle score (HPS) is proposed that summarizes the most important information for the orthopedist, material scientist and histopathologist concerning particle identification in the SLIM.

Важную роль при гистопатологическом исследовании синовиально-подобной околопротезной мембраны (SLIM), наряду с диагностикой околопротезной инфекции, играет идентификация частиц. Различия в патогенезе частиц и разнообразии материалов для эндопротезирования объясняют ту гетерогенность, которая затрудняет диагностическую идентификацию частиц. По этой причине был разработан гистопатологический алгоритм диагностики частиц, который при минимальных методологических сложностях обеспечивает идентификацию частиц материала протеза. Простые микроскопически-морфологические и энзим-гистохимические характеристики, а также поляризационно-оптические свойства позволяют определить размер частиц (микрочастицы, макрочастицы и супер-макрочастицы) и характеризовать их по дихотомическому принципу. На основании этих критериев были выполнены идентификация и аттестация частиц в 120 случаях патологической реакции на эндопротез сустава. Предложена гистопатологическая шкала частиц (HPS), которая суммирует важнейшую информацию для ортопедов, материаловедов и гистопатологов, касающуюся идентификации частиц методом SLIM.

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