髋关节置换与运动性股骨头损伤

背景：体育运动中爆发性用力的跳跃动作容易造成髋关节损伤，髋关节周围的一些部位由于存在未闭合的骨骺而相对薄弱，猝然施加的暴力可以造成大块的撕脱性骨折。 目的：总结髋关节置换治疗运动性股骨头坏死技术、置换材料及并发症的研究进展，评价修复运动性股骨头损伤中所应用的髋关节置换术的各种生物材料的性能和应用。 方法：由第一作者采用电子检索的方式，在Pubmed数据库及万方数据库中检索1991-01/2010-12有关生物材料应用于组织工程肌腱支架的研究文章，中文关键词为“股骨头坏死，生物材料，髋关节置换，并发症”；英文关键词为“artificial hip joints,biomaterials,prostheses”。排除重复研究、普通综述或Meta分析类文章，筛选纳入21篇文献进行评价。 结果与结论：分析了治疗股骨头坏死的髋关节置换技术的选择、置换材料的性能评价。髋关节置换技术以及置换材料都有各自的优缺点，绝大多数还处于研究阶段。利用陶瓷股骨头假体、金属对金属的假体减少由于高分子聚乙烯磨损颗粒导致的假体松动等研究受到了人们的重视。全髋关节置换已经成为晚期髋关节疾病的有效治疗手段，因其适应证范围宽，置换效果好，目前被认为是治疗股骨头坏死中晚期的金标准。

Hip replacement and sports femoral head injury

BACKGROUND:Jumping of explosive force in sports can result in hip joint injury. Sudden force on some sites surrounding the hip joint may lead to avulsion fracture. OBJECTIVE: Tosummarize advances in hip replacement for sports necrosis of femoral head, replacement materials and complications and evaluate performance and application of biomaterials used in repairing sports femoral head injury. METHODS:A computer-based online search of Pubmed and Wanfang Database was performed for articles regarding biomaterials used in tissue engineered tendon scaffold published between January 1991 and Dember 2010, with key words “necrosis of femoral head, biomaterials, hip replacement, complication” in Chinese and “artificial hip joints, biomaterials, prostheses” in English. Repetitive studies, review articles and Meta analysis were excluded. A total of 21 articles were included and evaluated. RESULTS AND CONCLUSION:Selection of hip replacement techniques for necrosis of femoral head and evaluation of replacement materials performance were analyzed. Hip replacement techniques and replacement materials have advantages and disadvantages. Ceramics femoral head prosthesis and metal-to-metal prosthesis can reduce polymer polyethylenewearing particles induced prosthesis loosening. Total hip replacement is an effective approach for advanced stage of hip joint diseases. Moreover, it has been regarded as gold standard for middle and advanced stage of necrosis of femoral head due to wide indication range and favorable effects.