中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (35): 6498-6502.doi: 10.3969/j.issn.2095-4344.2012.35.008

• 人工假体 artificial prosthesis • 上一篇    下一篇

金属对聚乙烯与陶瓷对聚乙烯人工髋关节负重界面的抗磨损性能比较

兰 天1，史占军2，陈国奋2，卢 坤2，周亚鹏2   

  1. 1Second Department of Surgery, Guangdong Armed Police Corps Hospital, Guangzhou 510507, Guangdong Province, China;
    2Department of Orthopedic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou 510515, Guangdong Province, China
  • 收稿日期:2012-05-09 修回日期:2012-05-23 出版日期:2012-08-26 发布日期:2012-08-26
  • 通讯作者: 史占军，博士，教授，南方医科大学附属南方医院关节与骨病外科，广东省广州市510515 zhanjunshi@yahoo.com.cn
  • 作者简介:兰天★，男，1983年生，河北省平泉市人，南方医科大学在读硕士，主要从事关节外科方面的研究。 dr.latin20@gmail.com

Comparison of polyethylene wear between metal-on-polyethylene and ceramic-on-polyethylene bearing in total hip arthroplasty

Lan Tian1, Shi Zhan-jun2, Chen Guo-fen2, Lu Kun2, Zhou Ya-peng2   

  1. 1武警广东省总队医院外二科，广东省广州市510507；
    2南方医科大学附属南方医院关节与骨病外科，广东省广州市 510515
  • Received:2012-05-09 Revised:2012-05-23 Online:2012-08-26 Published:2012-08-26
  • Contact: Shi Zhan-jun, Doctor, Professor, Department of Orthopedic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou 510515, Guangdong Province, China zhanjunshi@yahoo.com.cn
  • About author:Lan Tian★, Studying for master’s degree, Second Department of Surgery, Guangdong Armed Police Corps Hospital, Guangzhou 510507, Guangdong Province, China dr.latin20@gmail.com

PDF

572

被引次数

2

摘要：

背景：人工全髋关节假体中，聚乙烯内衬假体以其稳定的质量和价格优势使用广泛，但聚乙烯磨损颗粒诱发骨溶解，进而导致假体的无菌性松动仍然是影响假体远期生存率的主要原因。
目的：以计算机辅助方法，测量金属对聚乙烯和陶瓷对聚乙烯负重界面组合假体的聚乙烯内衬线性磨损，比较2组不同负重界面组合抗磨损性能的差异。
方法：对1997/2005在南方医科大学附属南方医院行初次Zweymuller非骨水泥型假体系统人工全髋关节置换的患者48例共58髋进行随访。利用股骨头假体中心相对于髋臼杯开口平面轴线的矢量位移，来判断线性磨损的大小和方向。根据负重界面组合的不同分为金属对聚乙烯组(36髋)和陶瓷对聚乙烯组(22髋)，比较2组之间聚乙烯线性磨损率的差别。
结果与结论：金属对聚乙烯组平均随访6.3年的线性磨损率为(0.20±0.11) mm/年，陶瓷对聚乙烯组平均随访4.6年的线性磨损率为(0.11±0.03) mm/年。排除年龄、随访时间、双侧股骨偏心距差距、线性磨损方向作为混杂因素的影响后，协方差分析显示金属对聚乙烯组的线性磨损率明显高于陶瓷对聚乙烯组(P=0.017)。提示陶瓷对聚乙烯负重界面组合相比金属对聚乙烯组合，在中期临床随访中展示出更加优良的抗磨损性能。

关键词: 磨损, 关节成形, 髋关节, 假体, 聚乙烯, 测量, 骨科植入物, 组织工程

Abstract:

BACKGROUND: Total hip prosthesis with polyethylene liner has been widely applied in the total hip arthroplasty by the reason of stable quality and relatively low price. Nevertheless, polyethylene wear particles can induce periprosthetic osteolysis, and then lead to aseptic loosening, it is still the main reason influencing prosthesis survival rate.
OBJECTIVE: To measure the polyethylene linear wear of metal-on-polyethylene and ceramic-on-polyethylene bearing by computer-aided method and to compare the difference of antiwear ability.
METHODS: Forty-eight patients (58 hips) with Zweymuller uncemented total hip arthroplasty were selected from Nanfang Hospital of Southern Medical University from 1997 to 2005, and all the patients were followed-up. The migration in the femoral head center relative to the axis of acetabulum opening plane on digital consecutive radiographs were examined to determine direction and degree of polyethylene linear wear. The experiment was divided into two groups according to different weight-bearing interface combinations: metal-on-polyethylene group (36 hips) and ceramic-on-polyethylene group (22 hips), and then the liner wear rate of two groups was compared.
RESULTS AND CONCLUSION: The average polyethylene linear wear rate of metal-on-polyethylene group after 6.3 years follow-up was (0.20±0.11) mm/year, the average polyethylene linear wear rate of ceramic-on-polyethylene group after 4.6 years follow-up was (0.11±0.03) mm/year. After controlling for potential confounding factors, such as age, follow-up time, bilateral femoral eccentricity and the linear wear direction, the covariance analysis showed that the linear wear rate of ceramic-on-polyethylene group was higher than that of metal-on-polyethylene group (P = 0.017). The study showed that ceramic-on-polyethylene bearing got lower wear rate in total hip arthroplasty, and it was beneficial to long-term result.

中图分类号: