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Erweiterte Konsensusklassifikation

Histopathologische Klassifikation von Gelenkendoprothesen-assoziierten Erkrankungen

Revised consensus classification

Histopathological classification of diseases associated with joint endoprostheses

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Zusammenfassung

Die erweiterte Klassifikation der periprothetischen Membran („synovial-like interface membrane“, SLIM) umfasst die Gesamtheit der pathologischen Veränderungen, die als Folge der endoprothetischen Versorgung großer Gelenke auftreten können und zu einer Reduktion der Prothesenstandzeit führen. Hierzu gehören die etablierte Konsensusklassifikation der SLIM, mit der sich die aseptische und septische Prothesenlockerung in 4 histologische Typen einteilen lassen, sowie histopathologische Kriterien für weitere Pathologien: Endoprothesen-assoziierte Arthrofibrose, immunologische/allergische Befunde und ossäre Pathologien. Diese Erweiterung stellt eine Grundlage für die histopathologische Diagnostik des gesamten Spektrums von Gelenkendoprothesen-assoziierten Erkrankungen dar und eignet sich als Basis für eine standardisierte Diagnostik und ätiologische Abklärung des Endoprothesenversagens und auch als Datenstandard für Endoprothesenregister, insbesondere für Register, die auf Routinedaten basieren (z. B. Deutsches Endoprothesenregister).

Abstract

The revised classification of the periprosthetic membrane (synovial-like interface membrane SLIM) encompasses all pathological alterations which can occur as a result of endoprosthetic replacement of major joints and lead to a reduction in durability of prostheses. This also includes the established consensus classification of SLIM by which aseptic and septic prosthetic loosening can be subdivided into four histological types and histopathological criteria for additional pathologies: endoprosthesis-associated arthrofibrosis, immunological/allergic alterations and osseous pathologies. This revision represents the foundation for the histopathological diagnostics of the total spectrum of diseases associated with joint prostheses, is a suitable basis for a standardized diagnostic procedure and etiological clarification of endoprosthesis failure and also as a data standard for endprosthesis registers, in particular for registers based on routine data (e.g. German endoprosthesis register).

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Authors and Affiliations

  1. MVZ-Zentrum für Histologie, Zytologie und Molekulare Diagnostik, Max-Planck-Str. 5, 54296, Trier, Deutschland

    V. Krenn, C. Schuh & C. Poremba

  2. Institut für Pathologie, Klinikum Stuttgart - Katharinenhospital, Stuttgart, Deutschland

    L. Morawietz

  3. Klinik für Spez. Orthopädische Chirurgie und Unfallchirurgie, Auguste Viktoria Klinikum, Vivantes Netzwerk Berlin, Berlin, Deutschland

    H. Kienapfel

  4. Zentrum für Spezial- und Wechselendoprothetik und chirurgische Infektiologie, Zeisigwaldkliniken Bethanien, Chemnitz, Deutschland

    R. Ascherl

  5. Zentrum für muskuloskelettale Chirurgie, Charité Universitätsmedizin Berlin, Berlin, Deutschland

    G. Matziolis

  6. Klinik für Orthopädie, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland

    J. Hassenpflug

  7. Orthopädie, DRK Klinik, Baden-Baden, Deutschland

    M. Thomsen

  8. Klinik und Poliklinik für Dermatologie und Allergologie, LMU, München, Deutschland

    P. Thomas

  9. Pathologisch-bakteriologisches Institut, Otto Wagner Spital, Wien, Österreich

    M. Huber

  10. HELIOS ENDO-Klinik, Hamburg, Deutschland

    D. Kendoff & T. Gehrke

  11. Knochentumor-Referenzzentrum am Institut für Pathologie, Universitätsspital Basel, Basel, Schweiz

    D. Baumhoer

  12. Paracelsus-Kliniken Deutschland Gmbh, Osnabrück, Deutschland

    M.G. Krukemeyer

  13. Hospital for Special Surgery, New York, USA

    G. Perino

  14. Institut für Pathologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    J. Zustin

  15. Institut für Pathologie, Klinikum Kassel, Kassel, Deutschland

    I. Berger

  16. Klinik für Orthopädie, Universitätsklinikum Hamburg-Eppendorf Zentrum für Operative Medizin, Hamburg-Eppendorf, Deutschland

    W. Rüther

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  1. V. Krenn
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  2. L. Morawietz
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  3. H. Kienapfel
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  9. M. Huber
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  19. T. Gehrke
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Correspondence to V. Krenn.

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V. Krenn und L. Morawietz haben zu gleichen Teilen zu der Arbeit beigetragen.

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Krenn, V., Morawietz, L., Kienapfel, H. et al. Erweiterte Konsensusklassifikation. Z. Rheumatol. 72, 383–392 (2013). https://doi.org/10.1007/s00393-012-1099-0

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  • DOI: https://doi.org/10.1007/s00393-012-1099-0

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