中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2014年
35期
5595-5599
,共5页
植入物%人工假体%高交联聚乙烯%陶瓷球头%全髋关节置换%磨损分析
植入物%人工假體%高交聯聚乙烯%陶瓷毬頭%全髖關節置換%磨損分析
식입물%인공가체%고교련취을희%도자구두%전관관절치환%마손분석
arthroplasty,replacement,hip%ceramics%polyethylene%dislocations
背景：假体摩擦界面是全髋关节研究的热点，然而聚乙烯的磨损微粒可诱导炎症反应使假体周围骨溶解并导致假体松动。为了减少聚乙烯的磨损，一方面选择陶瓷对陶瓷、陶瓷对聚乙烯的摩擦界面，另一方面选择更高强度的高交链聚乙烯材料。在年轻活动量大的患者中，陶瓷头的应用是一大进步。目的：评估大直径氧化铝基复合陶瓷(BIOLOX? delta)球头对第3代高交联聚乙烯(Trident X3, Stryker, Mahwah, NJ)全髋关节在年轻患者中的安全性，并在最短2年的随访后对高交联聚乙烯的磨损率进行放射学测量。方法：纳入解放军455医院2008年7月至2010年6月收治的30例(32髋)60岁以下非骨水泥全髋关节置换患者，采用36 mm BIOLOX ? delta陶瓷球头(CeramTec，Plochingen，Germany)对高交联聚乙烯的全髋关节，应用Roman软件(Robert Jones&Agnes Hunt Orthopaedic Hospital，Oswestry, United Kingdom)进行磨损分析。患者平均年龄(56.8±6.5)岁。结果与结论：随访2-3.7年，无关节脱位、球头碎裂或任何关节松动和骨溶解的影像学证据。平均 Harris评分由置换前的(19.9±7.3)分(11-36分)提高到置换后6个月的(35.3±5.4)分。置换磨合期后的平均磨损率为(0.022±0.11) mm/年。提示年轻患者使用大直径陶瓷球头对高交联聚乙烯全髋关节有更高的安全性，即出现关节脱位、假体碎裂、磨损率更低。
揹景：假體摩抆界麵是全髖關節研究的熱點，然而聚乙烯的磨損微粒可誘導炎癥反應使假體週圍骨溶解併導緻假體鬆動。為瞭減少聚乙烯的磨損，一方麵選擇陶瓷對陶瓷、陶瓷對聚乙烯的摩抆界麵，另一方麵選擇更高彊度的高交鏈聚乙烯材料。在年輕活動量大的患者中，陶瓷頭的應用是一大進步。目的：評估大直徑氧化鋁基複閤陶瓷(BIOLOX? delta)毬頭對第3代高交聯聚乙烯(Trident X3, Stryker, Mahwah, NJ)全髖關節在年輕患者中的安全性，併在最短2年的隨訪後對高交聯聚乙烯的磨損率進行放射學測量。方法：納入解放軍455醫院2008年7月至2010年6月收治的30例(32髖)60歲以下非骨水泥全髖關節置換患者，採用36 mm BIOLOX ? delta陶瓷毬頭(CeramTec，Plochingen，Germany)對高交聯聚乙烯的全髖關節，應用Roman軟件(Robert Jones&Agnes Hunt Orthopaedic Hospital，Oswestry, United Kingdom)進行磨損分析。患者平均年齡(56.8±6.5)歲。結果與結論：隨訪2-3.7年，無關節脫位、毬頭碎裂或任何關節鬆動和骨溶解的影像學證據。平均 Harris評分由置換前的(19.9±7.3)分(11-36分)提高到置換後6箇月的(35.3±5.4)分。置換磨閤期後的平均磨損率為(0.022±0.11) mm/年。提示年輕患者使用大直徑陶瓷毬頭對高交聯聚乙烯全髖關節有更高的安全性，即齣現關節脫位、假體碎裂、磨損率更低。
배경：가체마찰계면시전관관절연구적열점，연이취을희적마손미립가유도염증반응사가체주위골용해병도치가체송동。위료감소취을희적마손，일방면선택도자대도자、도자대취을희적마찰계면，령일방면선택경고강도적고교련취을희재료。재년경활동량대적환자중，도자두적응용시일대진보。목적：평고대직경양화려기복합도자(BIOLOX? delta)구두대제3대고교련취을희(Trident X3, Stryker, Mahwah, NJ)전관관절재년경환자중적안전성，병재최단2년적수방후대고교련취을희적마손솔진행방사학측량。방법：납입해방군455의원2008년7월지2010년6월수치적30례(32관)60세이하비골수니전관관절치환환자，채용36 mm BIOLOX ? delta도자구두(CeramTec，Plochingen，Germany)대고교련취을희적전관관절，응용Roman연건(Robert Jones&Agnes Hunt Orthopaedic Hospital，Oswestry, United Kingdom)진행마손분석。환자평균년령(56.8±6.5)세。결과여결론：수방2-3.7년，무관절탈위、구두쇄렬혹임하관절송동화골용해적영상학증거。평균 Harris평분유치환전적(19.9±7.3)분(11-36분)제고도치환후6개월적(35.3±5.4)분。치환마합기후적평균마손솔위(0.022±0.11) mm/년。제시년경환자사용대직경도자구두대고교련취을희전관관절유경고적안전성，즉출현관절탈위、가체쇄렬、마손솔경저。
BACKGROUND:Prosthesis friction interface is a hot focus in the study of total hip joint. Polyethylene wear particles induced inflammatory reaction, resulting in osteolysis surrounding the prosthesis and prosthesis loosening. To reduce polyethylene wear, ceramics-ceramics and ceramices-polyethylene friction interfaces were selected. High cross-linked polyethylene material with high intensity was selected. In young patients with large activity amount, the application of ceramic head is a great progress. OBJECTIVE:To assess the safety of large-diameter alumina ceramic matrix composites (BIOLOX? delta) bal on third-generation highly cross-linked polyethylene (Trident X3, Stryker, Mahwah, NJ) total hip arthroplasty in young patients, and to perform radiological measurements of high cross-linked polyethylene wear rate in the shortest two years after fol ow-up. METHODS:From July 2008 to June 2010, wear analysis of 30 cases aged less than 60 years with 32 hips with 36-mm BIOLOX ? delta ceramic femoral heads (CeramTec, Plochingen, Germany) on highly cross-linked polyethylene was performed in the 455 Hospital of Chinese PLA using Roman software (Robert Jones&Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom). The mean age of patients was 56.8 ± 6.5 years. RESULTS AND CONCLUSION:Fol ow-up was conducted from 2 to 3.7 years old. There were no imaging evidences, such as dislocation, the bal head fracture or joint loosening or osteolysis. Mean Harris score was increased from (19.9±7.3) (11-36) before replacement to (35.3±5.4) at 6 months after replacement. The mean wear rate was (0.022±0.11) mm/year after run-in period. These data indicated that large-diameter ceramic head articulation against highly cross-linked polyethylene in young patients would have high safety for joint dislocation, prosthesis fragmentation and low wear rates.
