人工髋关节负重面材料的生物特性及其临床应用

Biological characteristics and clinical application of artificial hip joint weight-bearing surface materials

背景:人工髋关节假体材料对髋关节置换的成功率及对患者治愈率起到决定性作用。目的:评价不同组合方式髋关节负重面材料的性能及置入体内与机体的生物相容性。方法:以"全髋关节置换,人工髋关节,金属,陶瓷,聚乙烯,生物相容性,临床应用;totalhip replacement,Artificial hip,prosthetic materials,Biocom patibility,clinical application"为关键词,应用计算机检索2001-01/2011-12万方数据库、PubMed数据库有关人工髋关节负重面生物材料与宿主生物相容性的文章。结果与结论:金属-超高分子量聚乙烯组合是目前常用的组合,也是衡量其他组合的金标准,但其磨损颗粒引起周围组织反应导致骨溶解和无菌性假体松动;金属-高交联聚乙烯、金属-金属、陶瓷-陶瓷和陶瓷-聚乙烯组合均在一定程度上减少了磨损,但金属离子毒性、陶瓷脆性、造价高等仍然是需要解决的问题。理想的负重面材料应具有良好生物相容、耐蚀性、耐磨性、耐疲劳性、强韧性好等特点,目前人工髋关节负重面组合材料各有优缺点。因此,临床医师针对不同的患者,采取个体化治疗原则,综合患者病情和经济状况等多方面因素,选择合适假体组合类型,以期达到最佳临床疗效。

BACKGROUND： Artificial hip prosthesis materials play a decisive role in the success rates of hip replacement and the recovery rate for patients. OBJECTIVE： To evaluate the properties of hip joint weight-bearing surface materials with different combinations, as well as the biocompatibility of the materials and the host after implanted in vivo. METHODS： The key word of ＂total hip replacement, artificial hip joint, metal, ceramic, polyethylene, biocompatibility, clinical application＂ in Chinese and ＂total hip replacement, artificial hip, prosthetic materials, biocompatibility, clinical application＂ in English were used to retrieve the articles published from January 2001 to December 2011 in Wanfang and PubMed databases, respectively, by computer. Articles related to the biocompatibility of hip joint weight-bearing surface materials and their host were included. RESULTS AND CONCLUSION： Metal-ultra-high molecular weight polyethylene is commonly used in combination at present, which also measures other combinations as the gold standard. But its wear particles can induce peripheral tissue reactions, which lead to osteolysis and aseptic loosening of prosthesis. The combinations of metal-high cross linked polyethylene, metal-metal, ceramics-ceramics and ceramics-polyethylene all could reduce the attrition to a certain extent, but the metallic ion toxicity, ceramic fragility and high cost are still needed to solve. An ideal weight-bearing surface material should have good characteristics, such as biocompatibility, corrosion resistance, wear resistance, fatigue resistance and toughness. Currently, artificial hip joint bearing surface combinations have their advantages and disadvantages. Therefore, in order to achieve the best curative effect, clinicians should adopt an individualized therapeutic principle according different patients and consider patients with different illness and economic conditions to choose an appropriate prosthesis combination type.