Skeletal Changes around Implanted Alumina Ceramic Knee Prosthesis: Histological and Radiological Studies in Three Autopsied Osteosarcoma Patients.

Abstract

We observed histologically and radiologically the skeletal changes around alumina ceramic knee prostheses used for limb salvage procedure in 3 autopsied osteosarcoma patients. Radiological findings around the prosthesis were mostly consisted of 2 zones in all the cases: clear zone of 1 to 2 mm thickness at the inner side and varying degree of sclerotic change of the bone in the outer side. In histology, a membrane formation consisting of collagenous fibrous tissue with chondroid metaplasia, was seen at the bone/prosthesis interface in all observed areas. The clear zone in radiology was considered to be relative thick fibrous tissue with occasional chondroid metaplasia. No inflammatory reaction or granulation tissue was observed in this area. Direct contact between the prosthesis and the bone was not observed. These findings in 3 patients indicated that the alumina ceramic prosthesis was a "bioinert" material. Skeletal Changes around Implanted Alumina Ceramic Knee Prosthesis months in case 1, 2, and 3, respectively. All the prosthesis used in TKR were Bioceram knee prosthesis® (Kyocera Co., Japan).