生物陶瓷在骨科的应用

Application of bioceramics in orthopaedics

学术背景:生物陶瓷作为植入物能满足人工骨的一般要求,而且具有亲水性、能与细胞等生物组织表现出良好的亲和性,因此具有广阔的发展前景。生物陶瓷作为生物硬组织的代用材料,可用于骨科、整形外科、牙科、口腔外科、心血管外科、眼外科、耳鼻喉科及普通外科等方面。目的:介绍生物陶瓷的分类、结构、生物学特性及其在骨科的应用,并展望生物陶瓷的发展方向。检索策略:由作者应用计算机检索Pubmed数据库和"Orthopaedics"数据库1984-01/2007-08相关文献,检索词为"Bioceramic",限定语言种类为"English";同时检索维普中文期刊数据库,万方数据库1984-01/2007-08相关文献,检索词为"生物陶瓷",限定语言种类为中文。同时手工翻阅相关书籍。纳入标准:文章内容与生物陶瓷的结构、生物学特性、临床应用有关。排除标准:较陈旧的文献和重复研究。文献评价:共收集到52篇相关文献,26篇文献符合标准,其中5篇是综述和述评类文献,其余21篇为基础研究。26篇中5篇介绍生物陶瓷的结构和生物特性,21篇介绍生物陶瓷在骨科的应用。资料综合:根据生物组织的作用机制,被用于人工关节植入体内的生物陶瓷大致可分为生物活性陶瓷、生物惰性陶瓷、可控表面活性陶瓷。生物活性陶瓷主要介绍了磷酸钙陶瓷,包括羟基磷灰石和磷酸三钙,还简单说明了生物活性玻璃和生物活性骨水泥的特性和临床应用现状。生物惰性陶瓷主要介绍了临床广泛应用的氧化铝陶瓷和氧化锆陶瓷的生物学特性和优势,并展望生物陶瓷的发展方向。结论:生物陶瓷具有良好的生物相容性,在骨科中被广泛应用,通过控制其制备过程可改变生物陶瓷的理化性能以达到不同的应用目的。

BACKGROUND： Bioceramics fits for the artificial bone as an implant, presents hydrophilicity and biological affinity, thus it is a potential material for biological sclerous tissues in terms of orthopaedics, plastic surgery, dental surgery, oral surgery, cardiovascular surgery, ophthalmic surgery, otorhinolaryngology and general surgery. OBJECTIVE： To introduce the classification, structure, biological feature and application of bioceramics on orthopaedics, and prospect the development of bioceramics. RETRIEVE STRATEGY： A computer-based online search of Pubmend database and Orthopaedics database was undertaken to identify the articles published between January 1984 and August 2007, with the key word ＂bioceramics＂ in English; Weipu Chinese Journal Database and Wanfang Database were also retrieved for the related articles from January 1984 to August 2007 by using the key word ＂bioceramics＂ in Chinese. Meanwhile, the relevant books were checked manually. Inclusive criteria： the articles related to the structure, biological feature and clinical application of bioceramics. Exclusive criteria： the outdated literatures and repeated researches. LITERATURE EVALUATION： Totally 52 articles were collected, and 26 of them met the inclusive criteria, including 5 reviews and 21 basic researches. Among 26 selected literatures, there were 5 ones referring to the structure and biological feature of bioceramics, while other 21 were the introductions of bioceramics applying in orthopaedics. DATA SYNTHESIS： According to the action mechanism of biological tissues, the bioceramics used in artificial joint can be divided into active bioceramics, unactive bioceramics and active ceramics with controlled surface. Active bioceramics mainly recommend calcium phosphate, including hydroxyapatite ceramic and tricalcium phosphate, moreover it illustrates the characteristics and clinical application of bioactive glass and bioactive cement. Unactive bioceramics mainly introduce the biological characteristics and advantages of aluminium oxide ceramics and zirconium oxide ceramics, which have been widely applied, as well as prospect the development of bioceramics. CONCLUSION： Bioceramics, with its good biocompatibility, can be widely applied in orthopaedics and its physical and chemical performance can be changed by controlling the preparation process.