Molecular identification of foreign inclusions in inflammatory tissue surrounding metal implants by Fourier transform laser microprobe mass spectrometry

Fourier transform laser microprobe mass spectrometry (FT LMMS) is a novel technique for micro-analysis of solids with a lateral resolution in the 5 microns range. One of the major advantages of the technique is the capability to perform characterisation of the molecular composition of both organic and inorganic compounds. The information is directly deduced from the signals without the aid of reference spectra. FT LMMS was applied to the characterisation of black tissue fragments in a biopsy from a patient, in which a constrained condylar nodular knee system was implanted ten years ago. The tissue contained numerous foreign giant cells with a black non-birefringent pigment in their cytoplasm. FT LMMS analysis allowed us to detect directly by means of molecular signals, that the debris consisted primarily of titanium oxide and not metallic titanium, while the implant itself only contained titanium.