陶瓷对陶瓷人工髋关节的磨擦界面特征

Friction interface characteristics of ceramic-on-ceramic artificial hip joint

背景:陶瓷对陶瓷人工髋关节假体在临床上已有一定的应用,在表面磨擦、磨损和润滑方面占有优势,具有很大的研发潜力。目的:评价陶瓷对陶瓷人工髋关节表面磨擦、磨损和润滑特性。方法:将金属对超高分子量聚乙烯、金属对金属以及陶瓷对陶瓷人工髋关节假体的磨损界面研究进行分析,了解氧化铝陶瓷材料的结构特点、制备工艺以及磨损参数,并分析陶瓷对陶瓷人工髋关节置换治疗的效果,与其它假体材料进行对比。结果与结论:①金属对超高分子量聚乙烯人工髋关节抗磨损性能差,使磨损颗粒进入关节和周围组织,造成骨溶解和松动。②金属对金属人工髋关节的磨损性能较金属对超高分子量聚乙烯假体有很大改善,骨溶解的发生率非常少,但由于磨损颗粒可散布于体内各脏器和体液中,使用时要注意避免发生过敏反应和毒性。③体外试验和体内试验证明陶瓷对陶瓷人工髋关节具有良好的摩擦、磨损、润滑性能,临床治疗长期随访结果显示陶瓷对陶瓷人工髋关节假体置换后无磨损颗粒,不会发生骨溶解。对于年龄较小,并且对髋关节活动度有较高要求的患者,陶瓷对陶瓷人工髋关节是治疗的首选。随着陶瓷对陶瓷人工髋关节假体设计和材料学的发展,通过改进假体的机械学特性,提高摩擦界面的耐磨性能和润滑机制,陶瓷对陶瓷人工髋关节假体的远期临床疗效将更加满意。

BACKGROUND： Ceramic-on-ceramic artificial hip joint has been applied in clinic, and has advantages in surface friction, wear and lubrication, with a great potential for research and development. OBJECTIVE：To evaluate the surface friction, wear and lubrication characteristics of ceramic-on-ceramic artificial hip joint. METHODS：The researches on metal-to-high molecular weight polyethylene, metal-on-metal and ceramic-on-ceramic artificial hip joint prostheses were analyzed to understand the structural characteristics of the alumina ceramic material, preparation process and wear parameters. The treatment effect of ceramic-on-ceramic artificial hip joint replacement was analyzed, and compared with other prosthesis materials. RESULTS AND CONCLUSION：The metal-to-ultra-high molecular weight polyethylene artificial hip joint prosthesis has the poor wear resistance, so the wear particles often go into the joint and surrounding tissue, and resulting in osteolysis and loosening. Metal-on-metal artificial hip joint prosthesis has better wear resistance than metal-to-ultra-high molecular weight polyethylene artificial hip joint prosthesis and has lower incidence of osteolysis. However, as the wear particles can be dispersed in various organs in the body and body fluids, the al ergic reactions and toxicity should be avoided. The in vitro and in vivo experiments indicate that ceramic-on-ceramic artificial hip joint prosthesis has good surface friction, wear and lubrication performance. Clinical long-term fol ow-up results show that there is no wear particle after ceramic-on-ceramic hip joint prosthesis replacement and thus no osteolysis can be observed. For the younger patients and the patients have higher requirements on hip activity, ceramic-on-ceramic artificial hip joint is preferred. With the development of the design and materials of ceramic-on-ceramic artificial hip joint prosthesis, the long-term clinical efficacy of ceramic-on-ceramic artificial hip joint prosthesis wil be more satisfactory through improving the mechanical properties of the prosthesis, as wel as the wear resistance and lubrication mechanism of friction interface.