人工关节假体的摩擦学研究进展

Current study on biotribology of artificial joint prosthesis

人工关节置换术经过近百年的发展,现已成为矫形外科/运动医学领域成熟的治疗技术,在美国以每年超过45万~60万的置换数量呈阶梯式递增。如何提高人工关节假体寿命、减轻术后并发症,是临床工作者及患者共同的期盼。既往学者关注重点多在于人工关节假体感染性/无菌性松动,近年来人工关节的摩擦学研究越来越受到重视。影响人工关节假体使用寿命的关键因素之一在于假体各组成部分之间的磨损问题,特别是由于接触表面的磨损造成表层的损耗进而导致整体/局部力学的改变。然而,假体生物摩擦学是一个复杂的综合性问题,本文将分别对膝/髋关节的摩擦学、假体材料特性、润滑、磨损变化等方面的研究现状和进展加以探讨,以期为临床和基础工作者提供有益帮助。

After nearly a century of development, arthroplasty has now become a well-established orthopedic surgical technique. It was reported that over 450,000-600,000 joint replacements had been performed in the United States each year with rapid increment in the numbers. How to increase prosthesis lifespan and reduce post-surgery complications remain to be the challenges that many clinicians and patients are hoping to solve. Although many researchers focus on the issue of septic/aseptic prosthesis loosening in the past, more emphasis is now being placed on the biotribological study of joint prosthesis. Tribological interaction between various components of the prosthesis is one of the key factors that affect the lifespan of these devices, especially when friction-induced surface damages result in overall/partial changes in the prosthetic mechanics. Given the complexity of prosthetic biotribology, this paper aims to provide helpful insights to clinicians and researchers by reviewing the current studies on knee/hip joint biotribology, prosthetic material properties, lubrication, and wear and tear.