The Journal of Bone and Joint Surgery, Vol 77, Issue 6 877-882, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Rate of degeneration of human acetabular cartilage after hemiarthroplasty
PG Dalldorf, MP Banas, DG Hicks and VD Pellegrini
Department of Orthopaedics, University of Rochester School of Medicine, New York 14642, USA.
Biopsy specimens of cartilage and subchondral bone were obtained from the
weight-bearing dome of the acetabulum in twelve elderly patients who were
having a revision of a hemiarthroplasty of the hip because of pain. Biopsy
specimens of acetabular cartilage and subchondral bone were also obtained
from eight patients of comparable age who were having a primary
hemiarthroplasty for a displaced fracture of the femoral neck; these served
as the control specimens. The specimens were stained with hematoxylin and
eosin for the initial histological assessment of cartilage structure and
cellularity as well as the integrity of the tidemark. Safranin-O and
toluidine-blue stains were used to assess proteoglycan content. A
histological grading scale was employed for comparative analysis of
samples. The joint space of the hip was measured on the radiographs that
were made before the revision and was correlated with the histological
grade. Review of the histological specimens demonstrated considerable
degeneration of acetabular cartilage in the patients who were having a
revision of a hemiarthroplasty as compared with that in the age-matched
control patients who were having a primary hemiarthroplasty. The
progression in the severity of the degeneration correlated directly with
the duration of articulation of the implant with the acetabulum. All six of
the patients in whom the implant had been in situ for more than five years,
and in whom the femoral stem was determined to be stable at the operation,
had nearly complete loss of cartilage as seen on histological
examination.(ABSTRACT TRUNCATED AT 250 WORDS)
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