Histological evaluation of the acetabular labrum after bipolar hip hemiarthroplasty: a case report
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CASE REPORT
Histological evaluation of the acetabular labrum after bipolar hip hemiarthroplasty: a case report Nobuhiro Kaku1 · Tatsuo Shimada2 · Ryutaro Nogami3 · Hiroaki Tagomori1 · Hiroshi Tsumura1 Received: 10 October 2019 / Accepted: 7 January 2020 © The Japanese Society for Clinical Molecular Morphology 2020
Abstract We report herein the microstructure of the acetabular labrum obtained from a patient with stem loosening but without bipolar cup migration who had undergone hemiarthroplasty for femoral neck fracture 18 years ago. We used light and scanning electron microscopy to investigate the influence of bipolar cup on acetabular labrum in vivo. Deparaffinized blocks were treated with 2 N NaOH to digest the cell matrix, allowing the collagen fibers, constituting the acetabular labrum, to be observed under scanning electron microscopy. Although chondrocyte atrophy was seen, the basic structure was not different from the normal tissue images of the elderly. However, in the deep part of the acetabular labrum, there was an area that was not stained with Alcian blue observed with light microscopy, and there was an amorphous tissue without type II collagen fibrils observed with scanning electron microscopy. These findings proved that the acetabular labrum has partially degenerated over the long term after bipolar hemiarthroplasty, and that the acetabular labrum can survive in vivo in such a condition. Given that hemiarthroplasty has a possibility to preserve the face-to-face tissue in the long term in vivo, it may be one of the valuable options for modern or future joint reconstruction surgery. Keywords Bipolar hemiarthroplasty · Acetabular labrum · Microstructure · Scanning electron microscopy · Chondrocyte · Collagen fibrils · Collagen fibers
Introduction Bipolar hip hemiarthroplasty (BHA) has been performed for femoral neck fractures and osteonecrosis of the femoral head. It is a surgical option that enables "sparing" of the acetabulum. In the hip joint, the acetabular cartilage and labrum are in contact with the artificial prosthesis and can slide and bear weight for a long time. The same can be said for the hemiarthroplasty of the shoulder joint, even if a large load is not applied to it. Although there have been reports evaluating the cartilage that has been in contact with an artificial * Nobuhiro Kaku nobuhiro@oita‑u.ac.jp 1
Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, 1‑1 Idaigaoka Hazama‑machi, Yufu City, Oita 879‑5593, Japan
2
Oita College of Judo Therapy and Acupuncture-Moxibustion, 1‑1 Chiyo‑machi, Oita City, Oita, Japan
3
Oita University Graduate School of Medicine Graduate School of Orthopedic Surgery, 1‑1 Idaigaoka Hazama‑machi, Yufu City, Oita, Japan
prosthesis for a long time after implantation [1–3], there have been no reports of changes in the acetabular labrum after BHA. We experienced a case of revision surgery for a patient with stem loosening without bipolar cup migration to the acetabulum, who had undergone BHA for a femoral neck fracture 18 ye
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