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The efficiency of the Sudan-III-staining to identify wear particles of PMMA-bone cement in tissue after total endoprostheses

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Summary

On the basis of the newly-formed capsular tissue of 80 cemented (Weber-Huggler, Müller-Charnley) and uncemented (ceramic/ceramic/titanium) total hip endoprostheses which had to be reoperated on because of aseptic loosening, the efficiency of the Sudan-III-staining reported in literature to identify polymethylmethacrylate (PMMA) bone cement particles is investigated, because the quantity as well as quality of the various wear products is discussed as possible factors of prostheses loosening.

PMMA-, polyethylene and polyester particles show definite sudanophilia and orange-red coloration in the Sudan-III-stained frozen sections, so that only very large wear products utilizing the knowledge of the materials of the artificial joints used can be recognized by their forms, whereas the wear stored in the macrophages cannot be identified.

Thus, Sudan-III-staining is not suitable for guaranteeing identification and determination of the amount of PMMA-wear.

Zusammenfassung

Anhand des Regeneratkapselgewebes von 80 zementierten (Weber-Huggler, Müller-Charnley) und nicht zementierten (Keramik/Keramik/Titanium) totalen Hüftendoprothesen, die wegen aseptischer Prothesenlockerung reoperiert werden mußten, wird die Aussagekraft der in der Literatur zur Identifikation von Polymethylmethakrylat (PMMA)-Knochenzement angegebenen Sudan-III-Färbung überprüft, da sowohl die Quantität als auch die Qualität der verschiedenen Abriebfragmente als mögliche Prothesenlockerungsfaktoren diskutiert werden.

PMMA-, Polyäthylen- und Polyesterabriebteilchen zeigen im Sudan-III gefärbten Gefrierschnitt eine deutliche Sudanophilie und orangerote Färbung, so daß nur sehr große Abriebfragmente bei Kenntnis der verwendeten Werkstoffpaarungen an der Form erkannt werden können, während sich der in Makrophagen gespeicherte Abrieb der Beurteilung entzieht.

Die Sudan-III-Färbung ist somit nicht geeignet, eine Identifikation und Mengenbestimmung von PMMA-Abrieb zu gewährleisten.

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Authors and Affiliations

  1. Institute of Pathologic Anatomy, University of Vienna, Spitalgasse 4, A-1090, Vienna, Austria

    F. Lintner & G. Brand

  2. Orthopaedic University Hospital, Vienna, Garnisongasse 13, A-1090, Vienna, Austria

    P. Bösch

Authors
  1. F. Lintner
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  2. P. Bösch
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  3. G. Brand
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Lintner, F., Bösch, P. & Brand, G. The efficiency of the Sudan-III-staining to identify wear particles of PMMA-bone cement in tissue after total endoprostheses. Arch. Orth. Traum. Surg. 100, 79–81 (1982). https://doi.org/10.1007/BF00462343

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  • DOI: https://doi.org/10.1007/BF00462343

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