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The Journal of Bone and Joint Surgery 79:1433-4 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Correspondence

Correspondence

N. A. Athanasou, Ph.D., M.R.C.P., M.R.C. Path., R. Pandey, M.S. (Orth), Dip. (Orth), R. de Steiger, F.R.A.C.S. (Orth), P. McLardy Smith, M.S., F.R.C.S., David S. Feldman, M.D., Jess H. Lonner, M.D., Panna Desai, M.D. and Joseph D. Zuckerman, M.D.

TO THE EDITOR:

We welcome the article "The Role of Intraoperative Frozen Sections in Revision Total Joint Arthroplasty" (77-A: 1807–1813, Dec. 1995), by Feldman et al., which demonstrated the diagnostic utility of histological study of intraoperative frozen sections for distinguishing septic from aseptic loosening of joint replacements. This technique has been in use for more than five years in Oxford, where more than 300 hip and knee arthroplasties have been investigated in this way. We reported our experience1 with the first 106 hips in 1995.

In our study, the main histopathological criterion for the diagnosis of highly suspected infection was the presence of an average of one neutrophilic polymorphonuclear leukocyte (neutrophil) per high-power field after examination of at least ten high-power fields. This criterion differs substantially from that of Feldman et al. and others3, who recommended more than five neutrophils per high-power field. In our study, we found that, . . . [Full Text of this Article]


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