聚乙烯假体致髋膝关节骨溶解差异临床研究.docVIP

聚乙烯假体致髋膝关节骨溶解差异临床研究 　　[摘要] 目的 对聚乙烯衬垫磨损后颗粒在髋和膝关节导致的骨溶解的差异进行对比研究。方法 对含有聚乙烯假体的翻修患者19例，骨溶解程度、范围及假体松动程度进行分析，按部位分成两组：全髋置换组、全膝置换组。两组聚乙烯假体最长使用年限23年，最短5年。结果 通过对比分析，髋关节聚乙烯骨溶解程度、范围远大于膝关节。 结论 聚乙烯磨损颗粒致髋膝溶解程度与颗粒大小、磨损受力方式等因素相关。 　　[关键词] 聚乙烯；人工关节；磨损；骨溶解 　　[中图分类号] R687.4[文献标识码] B[文章编号] 1673-9701（2014）16-0041-03 　　 　　The clinical research on bone dissolve differences between hip and knee joint using polyethylene prosthesis 　　HUANG Ziqiang1 ZHOU Yonggang2 JI Weiping1 ZHU Ying3CHEN Jianzhi1WANG Fei4 　　1.Department of Orthopedics，the People’s Hospital of Lishui City in Zhejiang Province，Lishui 323000，China; 2.Department of Orthopedics， the General Hospital of PLA， Beijing 100036，China；3.Department of Orthopedics，the Center Hospital of Lishui City in Zhejiang Province， Lishui 32300，China；4.Department of Orthopedics，the Affiliated Hospital of Inner Mongolia Medical University，Huhhot 010059，China 　　[Abstract] Objective To comparatively study the differences of dissolution of bones polyethylene liner wear particle in hip and knee. Methods In 19 cases of patients containing polyethylene prosthesis， we analysed the degree of dissolution of bone， the scope and loose degree of false body;According to the parts of the body， These were divided into two groups： a total hip replacement group and a total knee replacement group. The longest service life of two groups of polyethylene prosthesis were 23 years， the shortest were 5 years. Results Through the comparative analysis， both the degree and scale of dissolution of hip polyethylene were far outweigh the knee joint. Conclusion The degree of dissolution of polyethylene wear granules to hip knee is bound up with particle size， wear stress modes and so forth. 　　[Key words] Polyethylene;Artificial joint;Wear;Dissolution of bone人工关节置换为晚期关节疾患带来了福音[1]，但随着人工关节的广泛开展，其关节松动翻修成为临床关节置换的主要缺陷，给患者带来了巨大的痛苦和经济负担。人工关节磨损是造成关节面破坏的主要因素，也是导致人工关节使用时间的重要原因，其不仅导致假体本身的损伤，更重要是诱发周围组织炎性变和骨溶解，最终导致手术失败，而导致假体松动和损伤[2，3]。但其具体机制尚不清楚，因此本文通过对髋、膝关节骨溶解程度、范围及假体松动程度进行比较，分析其关系，为临床