Under-reporting by surgical pathologists in tissue removed during revision surgery for metal-on-metal arthroplasties.

Although adverse local tissue reactions (ALTR) have been reported for metal-on-metal implants (MoM) requiring early revision surgery, no study has looked at the accuracy of surgical pathologists in diagnosing ALTR. This study aims to investigate the accuracy of reporting adverse local tissue reactions in tissue samples following revision surgery from metal-on-metal implants. The authors reviewed histology glass slides as well as the original pathology reports of tissue processed in revision arthroplasties in 23 cases.

Macrodystrophia Lipomatosa of the Foot: A Case Report of MRI and Histologic Findings Including Pacinian Corpuscle Abnormalities.

Case: A 37-year-old man presented with pain and macrodactyly of a toe. Imaging and histology demonstrated findings consistent with macrodystrophia lipomatosa (MDL). We compared our findings with control tissue obtained from an identical site of a fresh-frozen cadaveric foot from the same anatomical site.

A Histologic Analysis of a Retrieved Specimen 24 Years after Hemiresurfacing for Avascular Necrosis.

Reports of long-term evaluation of the viability of the femoral head after a hemiresurfacing arthroplasty (HRA) are scarce. We report the case of a 41-year-old female with lupus and right HRA (performed 24 years previously for avascular necrosis) that was revised to a total hip arthroplasty for worsening right groin pain due to chondrolysis. We present a histologic evaluation of the resurfaced femoral head retrieved 24 years after HRA.

Hyaluronan Injections Show No Histologic Evidence of Adverse Tissue Effects.

Background: The safety of hyaluronan intra-articular injections is mostly based on animal studies and clinical evidence rather than histologic studies from human administration.

Objective: This study analyzed the histologic effects of viscosupplementation with sodium hyaluronate on the synovium and articular cartilage of human knee specimen status post total knee arthroplasty within 3 years of viscosupplementation.

Methods: Twenty-four specimens from total knee arthroplasties from April 2012 to August 2016 at NYU Winthrop Hospital were selected for microscopic analysis.

Fracture of the Neck of a Lateral Flare Femoral Implant in Total Hip Arthroplasty.

We present the case of a 38-year-old man who presented 7 years after primary total hip replacement with a fracture of the neck of a lateral flare femoral stem and catastrophic polyethylene wear. The unique design of the lateral flare hip stem has been shown previously to be associated with accelerated polyethylene wear, whereas the stem remains well fixed. The resultant polyethylene wear results in the harder cobalt chrome head abrading the titanium shell generating metallic debris.

Histological Findings in Six Failed Metal-on-Metal Implants.

Although joint replacement surgery to relieve pain due to osteoarthritis is generally a successful operation, adverse local tissue reactions can occur in hip arthroplasty in patients who receive metal-on-metal (MoM) implants and lead to early failure. This has led to revisions, lawsuits, and manufacturing recalls. An understanding of the pathological process initiated by metal wear debris is essential in clinical surveillance of cases.

Atypical Tumoral Presentation of Calcium Pyrophosphate Deposition Disease: A Case Report.

Case: A 55-year-old man presented with a history of forefoot pain and swelling. Radiographs revealed a mass with internal calcifications and osseous erosion of the fifth metatarsophalangeal bone. The mass was isointense to muscle on T1-weighted magnetic resonance imaging (MRI) and hyperintense on T2-weighted MRI.

Intraosseous hibernoma: a case report and review of the literature.

Study Design: A case report and a literature review are presented.

Objective: To describe and review the clinical presentation and characteristic imaging and pathology findings of intraosseous hibernoma.

Summary Of Background Data: Hibernomas are lesions of brown fat.

Collagen scaffold meniscus implant integration in a canine model: a histological analysis.

In the situation of an irreparable meniscus tear, an implant comparable to a normal meniscus is an attractive option. Using a canine model, we assessed the early and late histologic response to a tissue engineered meniscal collagen scaffold (CS). All animals received bilateral arthrotomies, and all joints receiving the CS had an 80% resection of the meniscus.

The human knee meniscus: a review with special focus on the collagen meniscal implant.

The human knee meniscus is important for the protection of the knee joint from degeneration. Because it is so commonly injured, several methods have been developed to replace damaged meniscal tissue with either transplanted menisci or other synthetic implants. Here we review these different approaches, with a clinical and histological focus on the collagen meniscal implant (CMI or Menaflex), a tissue-engineered bovine collagen product.

Granulomatous salmonella osteomyelitis associated with anti-tumor necrosis factor therapy in a non-sickle cell patient: a case report.

Salmonella osteomyelitis is seen most commonly in patients with sickle cell disease and in those with compromised immune systems. We report on the clinical, histological and imaging findings of salmonella osteomyelitis with intraosseous abscess formation occurring in a non-sickle cell patient receiving anti-tumor necrosis factor (TNF) alpha therapy.

Nodular skin metastasis mimicking infection in a revision total hip arthroplasty scar.

We present the case of a 60-year-old man who had metastasis of a nodular squamous cell carcinoma from a laryngeal carcinoma that mimicked an infected sinus in a 4-month postoperative revision total hip arthroplasty scar. A diagnosis was made at the time of frozen section. The patient died 3 months after tumor resection as a result of multiorgan failure.

Neovascularity in chronic posterior tibial tendon insufficiency.

Insufficient posterior tibial tendons in 28 specimens from patients with clinical Stage II or III disease were examined to clarify the etiology of adult-acquired flatfoot deformity. Hematoxylin and eosin and Masson trichrome-stained sections of formalin-fixed tissue were viewed in plain and polarized light. We performed a qualitative analysis for abnormalities in collagen orientation, degree of vascularization, tenocyte cellularity, mucinous change, and chondroid metaplasia.

Case Reports: osteosarcoma of the hand: one case and a literature review.

Osteosarcoma of the hand is rare. We present a case report and a literature review that indicates an older median age of onset than conventional osteosarcoma. The predilection for these lesions to manifest in the metacarpophalangeal joints, particularly in the second and third digits, is in contrast to the more symmetrical distribution of metastatic cancer and correlates with the sites of most active growth during development of conventional osteosarcoma.

Bone biopsy as a screening technique for bone bank allograft donation.

The objective of the study was to investigate occult abnormalities in bone bank allograft with the use of histomorphometry that may otherwise go unidentified with current screening techniques. This was a prospective pathology review in which 40 transcortical trephine bone biopsies were taken from the iliac crest of bone donors and examined by light microscopy and semiautomated histomorphometry. Current routine screening techniques for allograft bone donors include history, serology, and culture.

A quantitative histologic comparison: ACL degeneration in the osteoarthritic knee.

Newer prosthetic total knee arthroplasty (TKA) designs as well as unicondylar TKAs spare the anterior cruciate ligament (ACL). Although success of these procedures requires near normal ACL function, little has been written about the histologic features or the arthritic ACL. This study was designed to histologically evaluate the ACL for microscopic evidence of degeneration.

Ultrastructural features of giant cell tumors in Paget's disease.

Giant cell tumor is a rare complication of Paget's disease. This association is especially notable in patients originating from Avellino, Italy. Many types of evidence point to a viral etiology for Paget's disease and giant cell tumors arising in it.

Osteoclast dysfunction in the osteosclerotic variant of renal osteodystrophy.

Six iliac crest bone biopsies were obtained from five patients with renal osteodystrophy and osteosclerotic lesions to investigate the mechanism of osteosclerosis in renal osteodystrophy. Each specimen was prepared in an undecalcified fashion and measured under light microscopy for routine analysis and histomorphometry. Osteoclast resorptive lacunae were estimated by measuring the lacunar length and depth.

Ischial bursal chondromatosis.

A right ischial ulcer recurred after 6 months in a 79-year-old man with a history of recent hip fracture and Girdlestone procedure. Soft-tissue calcification was detected radiographically. The mass, hyperplastic bursal tissue with chondroid metaplasia, was excised.