MIGRATION OF METAL AND POLYETHYLENE PARTICLES FROM ARTICULAR PROSTHESES MAY GENERATE LYMPHADENOPATHY WITH HISTIOCYTOSIS

Wear particles released from hip or knee prostheses are known to be in volved in the fibrohistiocytic membrane interposed between bone and im plant. During surgical treatment for pelvic carcinoma (5 cases) and fo r isolated pseudomalignant lymphadenopathy (4 cases) lymph nodes in 9 patients who had had lower limb articular replacement were harvested. Light microscopy and image analysis of the nodes showed florid endosin usal histiocytosis, predominant in the cortical area. Using Oil Red O staining and polarized light, metal particles and polyethylene particl es were detected in the large histiocytes. Scanning electron microscop y with electron backscattering allowed us to localize metal particles and perform elemental microanalysis. Iron, cobalt, chromium, nickel, z irconium, and barium, known to be used in prosthetic and cementing mat erials, were identified as component of these particles. Large amounts of polyethylene particles appeared in all cases while metal particles were found to be abundant in only 2 cases. Thus, migration of polyeth ylene debris from the prosthetic site seems to be the major factor in development of the histiocytes induced in satellite lymph nodes. (C) 1 996 John Wiley & Sons, Inc.