影响人工全髋关节置换稳定性的因素

Influential factors for the stability of artificial total hip replacement

背景:人工全髋关节置换后出现假体松动的现象较常见,了解影响人工全髋关节稳定性的因素对提高人工全髋关节置换疗效是十分必要的。目的:总结近年人工全髋关节置换稳定性影响因素的最新研究进展,进一步认识人工全髋关节的稳定性。方法:应用计算机检索中国期刊全文数据库1997-01/2010-12有关人工髋关节置换后假体无菌性松动的相关文章,检索词"人工关节,置换,稳定性"。检索文献量总计98篇,最终纳入符合标准的文献30篇。结果与结论:人工全髋关节置换稳定性的影响因素及发病机制较为复杂,其主要原因是力学因素,其次是生物学因素,它们共同结果是造成骨吸收、骨溶解,最终导致假体松动、骨质破坏。其过程还与许多细胞因子的参与密切相关。针对引起人工全髋关节稳定性的影响因素,可以从关节材料、安放角度、抑制磨损颗粒移动、促进成骨及抑制骨吸收等方面来防治。

BACKGROUND：Prosthesis loose appeared after artificial total hip replacement. To understand the factors that affect stability of artificial total hip joint is necessary for elevating the curative effect of artificial total hip replacement. OBJECTIVE：To summarize latest research progress of influential factors for stability of artificial total hip replacement,and to further understand the stability of artificial total hip joint. METHODS：We retrieved China National Knowledge Infrastructure（1997-01/2010-12） for articles addressing sterile prosthesis loose after artificial total hip replacement. The were ＂artificial joint,replacement,stability＂. A total of 98 articles were retrieved,and 30 articles were included in accordance with inclusion criteria. RESULTS AND CONCLUSION：Influential factor and pathogenesis of the stability of artificial total hip replacement are complicated. The major factor is mechanics,followed by biology. Their effects lead to bone resorption,osteolysis,prosthesis loose and bone destruction. The process is strongly associated with the participation of many cytokines. We can prevent and cure the influential factors for the stability of artificial total hip joint from the aspects as follows：joint material,place angle,inhibition of worn particle motion,promotion of osteogenesis,and inhibition of bone resorption.