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The Journal of Bone and Joint Surgery 81:143-144 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Correspondence

Correspondence

S. Sugihara, M.D., Ph.D., P. J. van Diest, M.D., Ph.D., P. I. J. M. Wuisman, M.D., Ph.D., Stephen S. Raab, M.D., Daniel D. Slagel, M.D. and Robert A. Robinson, M.D., Ph.D.

TO THE EDITOR:

In "The Utility of Histological Examination of Tissue Removed during Elective Joint Replacement. A Preliminary Assessment" (80-A: 331–335, March 1998), Raab et al. stated: "The lack of case reports on so-called incidental case suggests that the risk of a clinically important disease being missed if a histological examination is not performed is low." Histopathological screening at our bone bank revealed that five (3.6 percent) of 137 femoral heads were histologically abnormal6. Three lesions were highly suspicious for low-grade B-cell lymphoma, one was a monoclonal localized plasmacytosis, and one was a nonspecific inflammatory lesion. DiCarlo et al, retrospectively studied 1794 femoral heads and found a rate of disagreement of 5.4 percent between the clinical and histological diagnoses4. Furthermore, seven morbid conditions were found histologically but not clinically. In contrast, Campbell et al, reported only a 0.84 percent rate of disagreement after 715 total joint replacements, but . . . [Full Text of this Article]


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