中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (26): 4886-4891.doi: 10.3969/j.issn.1673-8225.2012.26.027

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

人工关节假体无菌性松动的发病机制及治疗进展

刘 丰1，2，张 超1，2，姚振强1，2，杨 召1，2，孟增东1，2   

  1. 1昆明医学院附属昆华医院骨科，云南省昆明市 650032；
    2云南省第一人民医院骨科，云南省昆明市 650032
  • 收稿日期:2011-10-12 修回日期:2011-11-27 出版日期:2012-06-24 发布日期:2013-11-02
  • 通讯作者: 孟增东，云南省第一人民医院骨科，云南省昆明市 650032 menggu7119@vip.sina.com
  • 作者简介:刘丰★，男，1982年生，吉林省敦化市人，汉族，昆明医学院在读硕士，主要从事假体无菌性松动药物的治疗研究。 Jilin.liufeng@163.com

Pathogenesis and therapy progress of aseptic loosening of artificial joint prosthesis

Liu Feng1, 2, Zhang Chao1, 2, Yao Zhen-qiang1, 2, Yang Zhao1, 2, Meng Zeng-dong1, 2   

  1. 1Department of Orthopedics, Affiliated Kunhua Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China;
    2Department of Orthopedics, the First People’s Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
  • Received:2011-10-12 Revised:2011-11-27 Online:2012-06-24 Published:2013-11-02
  • Contact: Meng Zeng-dong, Department of Orthopedics, Affiliated Kunhua Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China; Department of Orthopedics, the First People’s Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China menggu7119@vip.sina.com
  • About author:Liu Feng★, Studying for master’s degree, Department of Orthopedics, Affiliated Kunhua Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China; Department of Orthopedics, the First People’s Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China Jilin.liufeng@163.com

PDF

463

被引次数

5

摘要：

背景：近年来，对炎症界膜形成、破骨细胞活化机制认识的逐渐深入，应用药物逆转人工关节无菌性松动的病理过程取得了卓有成效的进展。
目的：综述人工关节假体无菌性松动的发病机制及治疗进展。
方法：以“Artificial joints，Aseptic loosening，Osteoclast，Tumor necrosis factor-a，Interleukin-1，Drug treatment，Gene Therapy，Bone loss”为检索词检索PubMed数据库。以“人工关节，假体无菌性松动，破骨细胞，肿瘤坏死因子α，白细胞介素1，药物治疗，基因治疗，骨丢失”为检索词检索CNKI数据库。纳入假体无菌性松动的发病机制及预防假体无菌性松动药物的相关研究，排除重复文献。
结果与结论：纳入29篇文献进行分析。人工关节假体无菌性松动治疗所涉及的药物大都已被临床使用，目前研究的重点和难点是如何降低长期使用这些药物的不良反应和如何提高假体周围局部的有效药物浓度。用转基因的方法来预防和治疗人工关节假体无菌性松动是近年来研究的最新进展，虽然取得了显著的效果，但因为基因治疗的人体安全性尚未解决，所以这些研究还停留在体外试验和动物试验。

关键词: 假体无菌性松动, 人工关节, 破骨细胞, 肿瘤坏死因子α, 白细胞介素1, 药物治疗, 基因治疗, 骨丢失

Abstract:

BACKGROUND: In recent years, with gradually further understanding the mechanism of the formation of inflammatory membrane and osteoclasts and activation, application of drugs to reverse the pathology of aseptic loosening of artificial joints has achieved fruitful progress.
OBJECTIVE: To review the pathogenesis and therapy progress of aseptic loosening of artificial joint.
METHODS: PubMed database was retrieved for articles with the key words of “Artificial joints, Aseptic loosening, Osteoclast, Tumor necrosis factor-a, Interleukin-1, Drug treatment, Gene Therapy, Bone loss” in English, and CNKI database was also retrieved with the key words of “artificial joints, prosthesis aseptic loosening, osteoclasts, tumor necrosis factor-a, interleukin-1, drug therapy, gene therapy, bone loss” in Chinese. Articles related to the pathogenesis of aseptic loosening of the prosthesis and drugs for aseptic loosening of the prosthesis prevention were included, and duplicate documents were eliminated.
RESULTS AND CONCLUSION: Totally 29 articles were included for review. Drugs for aseptic loosening of artificial joint were mostly involved in clinical use. Emphasis and difficulty of the current study is how to decrease adverse reactions and increase effective local drug concentration around the prosthesis in long term use of these drugs. In recent years, transgenic approach used to prevent and treat aseptic loosening of prosthesis is the latest research progress, although significant results have been achieved, human security of gene therapy is unresolved, therefore, these studies still are in vitro and animal experiments.

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