Die Gelenkkapsel nach Alloplastik

Abstract

The Articular Capsule after Alloplastic Replacement of the Joint Summary. 1. In 48 cases of alloplastic replacement of the joint, the articular capsule was examined morphologically. Over a period of about 20 years, beginning with the first stage of restitution, the reaction of the capsule was analyzed formally and causally.2. In the first postoperative period, the reactions are typically for the healing of wounds. The new capsule is able to differentiate by functional impulses. Particularly the synovialic structures have similarities to a regenerative product. They are instable and become gradually altered. The corresponding histological manifestations are of an anabiotic and adaptive nature.3. The adaptive anabiotic process in the newly formed joint capsule securing a full function can be exhausted. Accordingly more and more catabioses will take place and the function of the joint will begin to decompensate. In the fibrosed capsule, histolyses, necroses and an abacterial exsudation of fibrin as well as the consecutive organization are caused by biomechanical factors. The resulting process is called "Arthro-Alloplastic-Arthrosis".4. The mechanical factors determine the condition of the capsule. Secondary foreign bodies as attrited prosthetic material, cartilage, bone, or cement maintain inflammatory processes and support in this way the formation of catabioses in the capsule. This development is similar to the common arthrosis.5. Enabled by special investigations the metallosis is discussed. Ceroid and endogenous iron as important staining factors of the capsule were not yet sufficiently noted.Zusammen]assung. 1. Die Gelenkkapsel nach alloplastischem Ersatz des Gelenkes wurde bei 48 Fallen eingehend morphologisch nntersucht und ihr Verhalten vonder ersten Phase der Wiederherstellung fiber einen Zeitraum bis zu rund 20 Jahren formal-und kausalgenetisch analysiert.2. Die Vorggnge in der frfihen postoperativen Phase folgen den 1%egeln der Wundheilung. Die nach der Heilung sich formierende neue Kapsel ist als reparatives Produkt offensichtlich durch funktionelle Einfifisse zu einer gewissen Differenzierung f~hig. Die einem Regenerat vor allem ghnlichen synovialen Strukturen sind instabil und werden allmghlich abgewandelt. Die entsprechenden geweblichen Erscheinungen haben einen anabiotischen Charakter und sind adaptiver Natur.3. Die eine Funktionsfghigkeit gewghrleistenden geweblichen Vorgiinge in der neuen Gelenkkapsel k6nnen sich ersch6pfen, dementsprechend Katabiosen zunehmend Platz greifen und damit die Dekompensation der Gelenkfunktion einleiten. Histolysen und Nekrosen in der

Side-Effects of Acrylic Cement Implanted into Bone: A Histological, (Micro)Angiographic, Fluorescence-Microscopic and Autoradiographic Study in the Rabbit Femur

“…After total hip arthroplasty, the movable parts of the artificial joints come to be surrounded by a new connective tissue capsule which replaces the capsule which is (usually) excised during the operation. The histopathology of this new capsule, removed in revision operations or postmortems, has been described by Cotta and Schulitz (1970), Semlitsch et al (1971), Willert (1973a), Willert andSemlitsch (1973b, 1974a), Beneke et al (1973), Charosky et al (1973), Masshoff andNeuhaus-Vogel (1974), Evans et al (1974) and Brinkmann and Heilmann (1974).…”