Brochhausen Christoph, Grevenstein David, Mamilos Andreas, Babel Maximilian, Eysel Peer
Institut für Pathologie, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
Zentrum für Rheumapathologie GmbH, Mainz, Deutschland.
Pathologe. 2020 May;41(3):271-280. doi: 10.1007/s00292-020-00768-x.
Orthopedic and trauma surgery are currently confronted with significant changes in their interventional and therapeutic strategies, especially in knee surgery. Minimally invasive and reconstructive techniques lead not only to modifications of the repertoire of interventional methods but also of the indications and questions for histopathological diagnostics. The classical problems in knee surgery remain important issues, which are traumatic, degenerative, and infectious lesions. In addition, questions regarding regeneration and integration of cell-material constructs will become more and more important in the future. Furthermore, questions regarding the regenerative potential of an implantation site for such constructs and the morphological quality of harvested tissue for the in vitro cell expansion of autologous cells are becoming increasingly important. The autologous chondrocyte transplantation is a good example of the relevance of the histopathological re-evaluation of the regenerated tissue for a better understanding of the pathophysiology of reconstructive therapies. It becomes clear that for specific aims based on reconstructive therapies, new scoring systems should be established for the histopathological routine diagnostic service. Furthermore, there is need for the definition of further histopathological criteria, which will help to optimize the differential application of reconstructive strategies via tissue engineering. The present report gives a short overview of the modifying requirements on the histopathological diagnostics in specimens from knee-surgery but does not claim to be exhaustive.
骨科与创伤外科目前在介入和治疗策略上面临重大变革，尤其是在膝关节手术方面。微创和重建技术不仅导致介入方法的改变，也使组织病理学诊断的适应症和问题发生了变化。膝关节手术中的经典问题，如创伤性、退行性和感染性病变，仍然是重要问题。此外，关于细胞-材料构建体的再生和整合问题在未来将变得越来越重要。此外，关于此类构建体植入部位的再生潜力以及用于自体细胞体外扩增的采集组织的形态质量问题也日益重要。自体软骨细胞移植是对再生组织进行组织病理学重新评估以更好地理解重建治疗病理生理学相关性的一个很好例子。很明显，为了基于重建治疗的特定目标，应该为组织病理学常规诊断服务建立新的评分系统。此外，需要定义更多的组织病理学标准，这将有助于通过组织工程优化重建策略的差异应用。本报告简要概述了膝关节手术标本对组织病理学诊断的修改要求，但并不声称详尽无遗。
