人工假体置换后的无菌性松动

Aseptic loosening after prosthetic replacement

背景:人工关节置换后无菌性松动一直是困扰外科医生的难题。目的:探讨人工假体置换后发生松动的机制,影响因素及假体松动的防治措施。方法:以"假体松动;发生机制;影响因素;治疗"为中文关键词,以:"Prosthetic loosening,Mechanism,Factors,Treatment"为英文关键词,采用计算机检索中国期刊全文数据库、PubMed数据库(1993-01/2010-11)相关文章。纳入与假体松动研究及其影响因素和防治研究相关的文章,排除重复研究或Meta分析类文章。结果与结论:共入选21篇文章进入结果分析。人工关节置换后,在假体-骨界面处的磨损碎屑颗粒以及周围的骨组织细胞相互作用所引起的一系列生物学反应是引起无菌性松动的关键环节,通过对假体设计和材料的改进,提高置换技巧及合理的防治,可以改善关节置换后假体的松动。

BACKGROUND：Aseptic loosening after total hip replacement has been a trouble for the surgeons.OBJECTIVE：To investigate the mechanism,influential factors and prevention measures of prosthetic loosening.METHODS：A computer based search of CNKI and PubMed（1993-01/2010-11） was performed for articles about the mechanism,influential factors and prevention measures of prosthetic loosening using the keywords of ＂Prosthetic loosening,Mechanism,Factors,Treatment＂ in Chinese and English.Repetitive and Meta analysis articles were excluded.RESULTS AND CONCLUSION：Finally,21 articles were included in the result analysis.After artificial joint replacement,the wear debris particles on the implant-bone interface and surrounding bone tissues can induce a series of biological reactions through the interaction.It is the key to cause aseptic loosening.However,the aseptic loosening can be improved by the improvement of prosthesis design and materials as well as promotion of implanting skill and reasonable prevention.