人工全髋关节假体置换治疗运动性髋损伤的理论与实践

Theory and practice of total hip prosthesis replacement therapy for sports hip injury

背景:全髋关节表面置换尽可能保持了髋关节原有的力学性能,置换后关节稳定性及活动度好,且无明显的年龄限制。目的:探讨人工髋关节假体在髋关节运动损伤治疗中的临床应用,以及髋关节假体置换治疗的材料与方法进展。方法:应用计算机检索1998-01/2011-10PubMed数据库及中国知网数据库有关生物材料与组织工程髋关节的文献,英文检索词"hip joint injury,artificial hip joint,hip replacement,hip resurfacing arthroplasty",中文检索词"髋关节损伤,人工髋关节,人工髋关节置换,全髋关节表面置换"。最终纳入符合标准的文献41篇。结果与结论:严重髋关节运动损伤应行人工髋关节置换,以恢复患者的生活能力,甚至一定程度的运动能力。目前人工髋关节假体置换的关键因素在于假体材料,假体材料主要有金属材料、陶瓷材料高分子材料、新一代骨水泥等,各自具有一定优点与缺点,由于随访时间和临床观察周期较长,各种材料的疗效还需要进一步研究。计算机模拟髋关节的三维有限元分析成为研究的热点,将运动生物力学与材料科学结合,对新材料的研发与检验是制造满足组织工程学人工髋关节假体的要求,达到修复和重建目的的重要途径。

BACKGROUND： Total hip surface replacement can maintain the original mechanical properties of hip joints as much as possible, the stability and activity of the joint after replacement are good, and no apparent age limitations are found. OBJECTIVE： To investigate the artificial hip prosthesis in the treatment of sports hip injuries, the materials and methods of hip prosthesis. METHODS： A computer-based retrieval of PubMed database and Chinese CNKI database from January 1998 to October 2011 was conducted for documents regarding the biomaterials and tissue engineered hip joints, with the key words of ＂hip joint injury, artificial hip joint, hip replacement, hip resurfacing arthroplasty＂ in both English and Chinese. Eventually 41 papers met the inclusive criteria. RESULTS AND CONCLUSION： Severe hip joint sports injuries should be treated with artificial hip joint replacement, to restore the patient＇s life skills, and even certain athletic ability. Currently, prosthesis material is a key factor in the hip replacement treatment, including metals, ceramics, polymers and new bone cement, each has their advantages and disadvantages. Due to long period of follow-up and clinical observations, the efficacy of various materials needs further study. Computer-based three-dimensional finite element analysis for simulation of the hip is a research focus, this means is a combination of the sports biomechanics and the materials science. Research and development of new materials are essential for the manufacture of artificial hip prosthesis in tissue engineering, and for repair and reconstruction of hip joints.