中国组织工程研究

中国组织工程研究 ›› 2013, Vol. 17 ›› Issue (17): 3148-3155.doi: 10.3969/j.issn.2095-4344.2013.17.015

• 骨与关节综述 bone and joint review • 上一篇    下一篇

陶瓷对陶瓷全髋关节置换后的异响问题

刘敬锋1，冯建民2   

  1. 1上海市伤骨科研究所，上海市  200025
    2上海交通大学医学院附属瑞金医院骨科，上海市  200025
  • 收稿日期:2012-11-03 修回日期:2012-12-17 出版日期:2013-04-23 发布日期:2013-04-23
  • 通讯作者: 冯建民，主任医师，上海交通大学医学院附属瑞金医院骨科，上海市 200025 fengjm_cn@yahoo.com
  • 作者简介:刘敬锋★，男，1977年生，上海市人，汉族，2002年上海交通大学医学院临床医学专业毕业，硕士，主治医师，主要从事人工关节方向研究。 liujingfenghm@hotmail.com

Hip squeaking after ceramic-on-ceramic total hip arthroplasty

Liu Jing-feng1, Feng Jian-min2   

  1. 1 Shanghai Institute of Traumatology and Orthopedics, Shanghai  200025, China
    2 Department of Orthopedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai  200025, China
  • Received:2012-11-03 Revised:2012-12-17 Online:2013-04-23 Published:2013-04-23
  • Contact: Feng Jian-min, Chief physician, Department of Orthopedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China fengjm_cn@yahoo.com
  • About author:Liu Jing-feng★, Master, Attending physician, Shanghai Institute of Traumatology and Orthopedics, Shanghai 200025, China liujingfenghm@hotmail.com

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943

被引次数

13

摘要：

背景：陶瓷对陶瓷界面的人工髋关节假体置换手术目前在临床上广泛开展，但是越来越多的报道显示全陶关节置换术后有些患者会出现髋关节异响，影响患者的手术满意度，严重者甚至患者的生活质量。
目的：综述目前国内外对髋关节异响问题的研究现状，阐明髋关节置换后异响的发生率和危险因素，探究髋关节异响产生的机制和临床防治路径。
方法：由第一作者检索1972年1月至2012年12月PubMed数据库，在标题和摘要中以“total hip arthroplasy，hip squeaking，hip noise”为主题词进行检索有关髋关节异响危险因素及形成原因和机制等方面的相关文献。
结果与结论：异响声在陶瓷对陶瓷界面中和金属对金属界面中都会发生，发生率报道不一。引起全髋关节置换后异响声的原因包括患者因素、手术因素和假体因素，它们间互为因果，相互影响。目前的研究认为异响产生的机制包括边缘负荷，斑纹磨损，假体撞击，第三体颗粒和润滑缺失等。髋关节置换后异响是多因素作用下产生的界面异常摩擦，从而造成假体振动产生异响。大多数患者只需临床随访，少部分患者需要手术干预。

关键词: 骨关节植入物, 骨与关节综述, 陶瓷对陶瓷界面, 金属对金属界面, 全髋关节置换, 髋关节, 髋关节异响, 假体, 磨损率, 摩擦, 第三体颗粒, 综述文献

Abstract:

BACKGROUND: Total hip arthroplasty with ceramic-on-ceramic bearings is widely used in clinic. But more and more researches report that hip squeaking may increasingly occur in some patients after ceramic-on-ceramic total hip arthroplasty which can influence not only the surgical satisfaction of patients, but also the quality of daily life severely.
OBJECTIVE: To summarize the current opinions and studies concerning hip squeaking, to elucidate the incidence and risk factors of hip squeaking, and to explore the mechanism and clinical strategy of hip squeaking.
METHODS: The PubMed database was searched for the articles on risk factors, causes and mechanisms of hip squeaking from January 1972 to December 2012 with the key words of “total hip arthroplasy, hip squeaking, and hip noise” which match titles and abstracts.
RESULTS AND CONCLUSION: Hip squeaking may occur in ceramic-on-ceramic bearing surfaces and metal-on-metal bearing surfaces with different frequencies. A number of factors may lead to hip squeaking after total hip arthroplasty, which mainly included patient factors, surgical factors and prosthesis factors, and these factors may be influenced with each other. The recent researches showed that other factors may also contribute to hip squeaking, including edge loading, stripe wear, prosthesis impingement and lack of lubrication and third-body particles. Therefore, hip squeaking after hip arthroplasty is the multiple factors caused interface abnormal friction, thus results in prosthesis vibration and generates abnormal sound. Most patients just need clinical follow-up, and few patients require surgical intervention.

Key words: bone and joint implants, review of bone and joint, ceramic-on-ceramic bearing, metal-on-metal bearing, total hip arthroplasty, hip joint, hip noise, prosthesis, wear rate, friction, third particles, review literature

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