人工关节材料性能与运动性关节软骨损伤

背景：人工关节从开始设计到临床应用已经经历了近一个世纪的历史,人工关节的先导为人工髋关节,随着在临床上的技术应用不断娴熟,推动了腕关节、肩关节、膝关节等人工关节的设计、应用及改进。目的：总结运动性关节损伤中人工关节材料的应用进展及性能特征。方法：由第一作者检索1980至2015年PubMed数据库(http://www.ncbi.nlm.nih.gov/PubMed)、万方数据库(http://wanfangdata.com.cn/)及CNKI中国期刊全文数据库(http://www.cnki.net/),以“sports;cartilage injury; Artificial Joint”为英文检索词,“运动,关节软骨损伤,人工关节”为中文检索词,对目前国内外人工关节的研究资料进行了分析和归纳,逐一介绍并分析了国内外常用的人工关节材料,并从材料科学的角度分析了各种材料在应用时的优劣,对目前常用人工关节的表面处理方法作了阐述,并从发展的角度指出了人工关节的研究方向。结果与结论：钛合金的表面改性可获得结合性能良好的表面陶瓷层,可有效提高钛合金的耐磨损性能。超高分子量聚乙烯的填充改性,可获得耐磨损性能良好的关节复合材料,有效减少超高分子量聚乙烯磨损颗粒的产生并降低其磨损颗粒引起的生物学反应。陶瓷人工关节的进一步研究与完善将是未来人工关节的发展方向。  中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

UHMWPE髋臼的厚度对摩擦磨损的影响研究

人工关节中的髋臼大多采用耐磨损性能非常优良的超高分子量聚乙烯（UHMWPE）制作。但仍然产生部分超细磨屑造成骨溶解致使髋臼出现无菌松动。为了了解髋臼的磨损机理，尽量减少磨屑的产生，本研究用美国的ABAQUS有限元软件，对髋臼的厚度与应力，应变关系进行了计算，从应力与磨损之间关系入手，知道了超高分子量聚乙烯髋臼厚度对髋臼摩擦磨损的影响，分析了髋臼磨损机理，为合理设计人工关节提供了理论依据。     

碳增强聚醚醚酮人工关节假体材料的磨损性能研究

目的研制新型人工关节假体材料-碳纤维增强的聚醚醚酮(CFPEEK),评价其生物磨损性能.方法采用国产材料和工艺研制出CFPEEK复合材料,在模拟体液环境下对其本身以及与不同磨擦偶间的磨损性能进行测试,并与传统髋臼假体材料超高分子聚乙烯(UHMWPE)和传统金属人工关节材料的耐磨损性能进行比较.结果 1 CFPEEK的体积磨损率只为UHWMPE的1/2,耐磨损性能明显优于UHMWPE.CFPEEK与钴铬钼合金(CoCrMo)对磨将产生最少的磨屑.CFPEEK与CoCrMo对磨时的摩擦系数最低.2 CFPEEK的体积磨损率分别为钛合金(Ti)和CoCrMo的1/50和1/20 ,前者与后两者相比,均具有非常显著性差异,磨损表面形态观察显示CFPEEK磨痕细小,基质--纤维结合良好.结论 CFPEEK材料具耐磨损、生物相容性好的特点,是一种未来假体的理想材料.     

仿体条件下关节假体材料的磨损研究

作者采用国内新研制的十二道关节假体材料磨擦磨损筛选机,在模拟人工关节主要工作参数的条件下,在相当于人工关节工作15.75年的试验时间内,采用微量磨损精确测量方法,评估了现用关节假体材料的耐磨性能,比较了超高分子量聚乙烯(UHMWPE)对磨三种金属材料,Ti-6AI-4V合金,Co-Cr-Mo合金和316L不锈钢的磨损率.在试验过程中,着重阐述了UHMWPE吸水对磨损量测量的影响.试验结果表明,国产UHMWPE具有与国外产品相当的耐磨性能,UHMWPE对磨Ti-6AI-4合金和Co-Cr-Mo合金的磨损率接近.     

碳纤维增强聚醚醚酮复合材料生物摩擦学研究进展

碳纤维增强聚醚醚酮(CF/PEEK)复合材料具有优异的生物相容性、生物力学及生物摩擦学性能,有望成为人工关节替换材料。本文阐述了润滑介质、增强体的表面改性、功能性粒子填充、摩擦副材料及摩擦运动方式等因素对CF/PEEK复合材料生物摩擦磨损性能的影响,指出今后应加强对多因素协同作用下CF/PEEK复合材料磨损机制与润滑机制的研究。     

碳增强的聚醚醚酮人工关节假体材料的磨损性能研究

目的 研制新型人工关节假体材料-碳纤维增强的聚醚醚酮(CFPEEK)，评价其生物磨损性能。方法 采用国产材料和工艺研制出CFPEEK复合材料，在模拟体液环境下对其本身以及与不同磨擦偶间的磨损性能进行测试，并与传统髋臼假体材料超高分子聚乙烯(UHMWPE)和传统金属人工关节材料的耐磨损性能进行比较。结果 1 CFPEEK的体积磨损率只为UHWMPE的1／2，耐磨损性能明显优于UHMWPE。CFPEEK与钴铬钼合金(CoCrMo)对磨将产生最少的磨屑。CFPEEK与CoCrMo对磨时的摩擦系数最低。2CFPEEK的体积磨损率分别为钛合金(Ti)和CoCrMo的1／50和1／20，前者与后两者相比，均具有非常显著性差异，磨损表面形态观察显示CFPEEK磨痕细小，基质纤维结合良好。结论 CFPEEK材料具耐磨损、生物相容性好的特点，是一种未来假体的理想材料。     

交叉剪切对人工关节应用中PEEK和CFR-PEEK磨损的影响

磨损是人工关节置换中晚期失效的主要因素,而交叉剪切效应对于磨损性能的研究具有重要的意义。聚醚醚酮(PEEK)和碳纤维增强聚醚醚酮(CFR-PEEK)优异的耐磨性能为人工关节材料的研发提供希望。为了研究交叉剪切效应对于PEEK和CFR-PEEK磨损性能的影响,通过在一系列交叉剪切条件下进行的磨损实验测试,对PEEK和CFR-PEEK的磨损机理进行深入的研究,同时与超高分子量聚乙烯(UHMWPE)进行对比。实验结果表明,PEEK与UHMWPE具有一样的与交叉剪切相关的磨损效应,而CFR-PEEK材料在实验中并没有表现出明显的交叉剪切效应。另外,在同等条件下,与UHMWPE相比,PEEK的耐磨性能较差,其磨损系数约为UHMWPE的8倍;而CFR-PEEK的耐磨性能具有显著的优势,其磨损系数约为UHMWPE的50%。因此,CFR-PEEK材料在人工关节应用中有望成为UHMWPE合适的替代材料。     

人工髋关节超高分子量聚乙烯磨粒分析的现状及趋势

简要介绍了目前国内外分析人工髋关节磨粒的技术,评述了在各种实验方法条件下生成的人工髋关节超高分子量聚乙烯(ultra-high molecular weight polyethylene,UHMWPE)磨粒的种类及特性、人工髋关节的磨损机制以及影响其磨损机制的因素,阐述了建立人工髋关节磨粒图谱的重要作用及意义,并对未来的研究重点进行了展望。应加强磨粒形貌特性与人工髋关节磨损机制之间的相互关系研究,以及在考虑生物化学环境和力学作用等因素协同作用条件下建立合适的人工髋关节磨损预测模型的研究。这对于人工关节置换的临床应用研究以及生物摩擦学的深入发展都具有重要的理论价值和现实意义。     

氮离子注入超高分子量聚乙烯的生物摩擦学性能

用高能离子注入机对超高分子量聚乙烯(UHMWPE)进行N+注入改性,注入能量为450KeV,剂量分别为5×1014/cm2,2.5×1015/cm2和1.25×1016/cm2.以ZrO2球为上销样,UHMWPE为下盘样组成摩擦副,在销盘摩擦试验机上评价它们在干摩擦、蒸馏水和血浆润滑条件的摩擦磨损行为.结果表明,几种剂量N+注入均提高了UHMWPE的摩擦系数,增强了其在血浆润滑条件下的耐磨性.未注入UHMWPE的磨损表现为粘着、疲劳、塑性变形和犁沟,注入UHMWPE的磨损主要为磨粒磨损.     

氧化锆金属及在人工关节中的应用

金属-超高分子量聚乙烯（UHMWPE）近半个世纪来一直是人工关节的标准配伍，被广泛地应用于人工髋关节、人工膝关节、人工肩关节、人工踝关节等。然而，随着人们期望寿命的增加、对生活质量要求的提高，这一假体配伍越来越成为制约人工关节置换术后远期效果进一步改善的重要因素。其根本原因是：这一“硬-软”配对的人工关节中，UHMWPE的磨损无法完全避免。磨损不仅限制了假体的使用寿命，而且所产生的碎屑触发了最终导致骨溶解的生物反应。两者的结果都与人工关节置换术后使用期限的有限直接相关。[第一段]     

Correlations between the in vitro and in vivo bioactivity of the Ti/HA composites fabricated by a powder metallurgy method

Ti/HA composites were successfully prepared by a powder metallurgy method and the effect of phase composition on the in vitro and in vivo bioactivity of the Ti/HA composites was investigated in the present study. The correlations between the in vitro and in vivo biological behaviors were highlighted. The results showed that the in vitro and in vivo bioactivity of the Ti/HA composites was dependent on their phase composition. The in vitro bioactivity of the Ti/HA composites was evaluated in simulated body fluid with ion concentrations similar to those of human plasma. After immersion in the simulated body fluid for a certain time, apatite precipitations formed on the surface of the composites with an initial titanium content of 50 and 70 wt.%, and no apatite was found on the surface of the composite with 30% titanium. Ti(2)O was responsible for the apatite formation on the surfaces of the composites. For in vivo analysis, Ti/HA cylinders were implanted in the metaphases of the rabbit femur. At the early stage of implantation, the new bone formed on the surface of the composite with 30% titanium was much less than that on the surfaces of the composites with 50% and 70% titanium. All the Ti/HA composites formed a chemical bone-bonding interface with the host bone by 6 months after implantation. The Ti/HA composites formed the bone-bonding interface with the surrounding bone through an apatite layer. The results in the present study suggested that the in vivo results agreed well with the in vitro results.     

类金刚石/酪蛋白磷酸肽复合薄膜修饰钛合金表面成骨细胞的增殖

背景：钛合金表面沉积类金刚石薄膜可提高其摩擦和抗腐蚀性能,但缺乏生物活性,在其表面接枝生物蛋白分子是一种新的生物化学改性途径。 目的：观察成骨细胞在类金刚石/酪蛋白磷酸肽复合薄膜修饰钛合金表面的增殖与黏附。 方法：采用非平衡磁控溅射和多步组装方法在钛合金表面制备类金刚石/酪蛋白磷酸肽复合薄膜。将对数生长期的成骨细胞悬液接种于类金刚石/酪蛋白磷酸肽复合薄膜修饰的钛合金与纯钛合金试件上。 结果与结论：类金刚石/酪蛋白磷酸肽复合薄膜修饰钛合金组细胞增殖率和黏附数量高于纯钛合金组(P < 0.05)。扫描电镜显示,类金刚石/酪蛋白磷酸肽复合薄膜修饰钛合金组成骨细胞胞体显著增大,表面粗糙,边界模糊不清,细胞呈充分的铺展状态;纯钛合金组成骨细胞胞体光滑,边界线条锐利清晰,伸展不良。表明类金刚石/酪蛋白磷酸肽复合薄膜可促进钛合金表面成骨细胞的增殖与黏附。     

医用镍钛形状记忆合金羟基磷灰石涂层的制备及其生物活性

背景：目前多采用等离子喷涂技术在钛及其合金表面涂覆羟基磷灰石涂层,制备成复合材料。但由于羟基磷灰石与钛合金基体的热膨胀系数相差较大,涂层在冷却过程中易产生脱落。 目的：在医用镍钛形状记忆合金表面制备致密、均匀的羟基磷灰石生物陶瓷涂层,利用动物实验考查镍钛/羟基磷灰石涂层材料的生物相容性。 方法：利用阴极旋转法在低温条件下从含钙、磷离子的电解水溶液中在镍钛形状记忆合金表面沉积了磷酸钙涂层,经碱处理获得羟基磷灰石涂层。分析工艺参数对涂层结构的影响。利用动物植入实验对该复合材料的生物活性进行研究,并与镍钛/羟基磷灰石与Ca₃(PO₃)₂•2H2O混合涂层复合材料、医用镍钛形状记忆合金、医用钛合金进行对比。 结果与结论：电化学沉积-碱处理方法适合在镍钛形状记忆合金表面制备羟基磷灰石生物活性陶瓷涂层,沉积电压、温度对涂层结构有强烈影响。4种不同材料植入动物体内后周围均出现不同程度的组织增生,在骨膜组织切片中都可见软骨细胞且有骨小梁形成,涂覆有羟基磷灰石涂层的植入材料组织反应较轻,相应的组织切片中所显示出的软骨细胞、骨小梁数量最多,分布均匀,表明羟基磷灰石涂层提高了医用镍钛形状记忆合金的生物活性。         

Wear‐Resistant Ultra High Molecular Weight Polyethylene/Zirconia Composites Prepared by in situ Ziegler‐Natta Polymerization

Summary: Ultra high molecular weight polyethylene (UHMWPE)/zirconia composite has been prepared by in situ polymerization of ethylene using a Ti‐based Ziegler‐Natta catalyst supported on the surface of zirconia. Comparison of mechanical and tribological properties has been carried out between the in situ polymerized and mechanically blended composites. Microscopic observations of filled composites revealed that the polymerized composite had more uniform dispersion of zirconia and enhanced interfacial properties than the mechanically blended composite. The polymerized composite showed in a tensile test a remarkable increase in elastic modulus and yield strength, in a tensile test, but a loss in elongational properties was insignificant. In a ring‐on‐block type wear test, the polymerized composite displayed superior wear resistance to the blended composite as well as to neat UHMWPE. At 43 wt.‐% of zirconia content, the polymerized composite showed about one fourth of the 1wear rate of neat UHMWPE. Observations of wear surfaces revealed that the abrasive wear, which are observed in unfilled UHMWPE, are greatly suppressed in filled composites. In polymerized composite, moreover, micro‐cracks were also significantly reduced in comparison to the blended composite, which eventually led to an additional decrease in the wear rate.

SEM image of powdery polymerized composite (zirconia content: 15%) obtained from the in situ polymerization.     

Surface roughness of retrieved CoCrMo alloy femoral components from PCA artificial total knee joints

In this study, we analyzed the surface roughness of retrieved cobalt-chromium-molybdenum (CoCrMo) femoral components of porous coated anatomic (PCA) artificial total knee joints, using a white light interference surface profilometer (WLISP). Thirty-eight PCA retrieved specimens obtained from the Anderson Clinic (Arlington, VA) were used. The artificial knees were originally implanted between 1982-1993, and the specimens were retrieved during revision surgeries between 1988-1996. We examined specimens damaged by three wear modes: femoral component against the ultra high molecular weight polyethylene (UHMWPE) articular surface (mode I), femoral component against the metal tibial tray (because of UHMWPE tibial component wear-through) (mode II), and femoral component against metal-debris-embedded-UHMWPE (with metal debris from the porous coating) (mode III). The mean surface roughness of each femoral component was the average of 80 surface roughness measurements. The in vivo alloy femoral component surfaces were rougher by an order of magnitude over controls, and the alloy surfaces were predominantly worn by the formation of parallel scratches in the direction of articulation. There was no correlation between the surface roughness of the femoral components and patient age, sex, weight, and total time of implantation. Significant surface roughness increases accompanied mode II and mode III wear. Different carbide morphologies were found on different femoral component surfaces, indicating that a variety of sintering processes, with different times and temperatures, may have been applied to the alloy femoral components during manufacture. Metal component roughness may be important to the wear of UHMWPE components and the success of total artificial knee joint.     

UHMWPE与钛基-TiN-TiC系梯度薄膜材料对磨的生物摩擦磨损特性

为了探索超高分子量聚乙烯（ＵＨＭＷＰＥ）与钛基－ＴｉＮ－ＴｉＣ系梯度薄膜材料组合作为人工关节置换材料的可能性,利用离子注入和等离子体化学气相沉积（ＰＣＶＤ）方法制备了Ｔｉ６Ａ１４Ｖ－ＴｉＮ－ＴｉＣ系梯度薄膜材料。通过摩擦系数和ＵＨＭＷＰＥ磨损失重的测定和用ＳＥＭ对磨损后的ＵＨＭＷＰＥ表面形貌分析,研究了ＵＨＭＷＰＥ与Ｔｉ６Ａ１４Ｖ－ＴｉＮ－ＴｉＣ系梯度薄膜材料摩擦副的生物摩擦磨损特性。研究表明：在     

Wear resistance of experimental Ti-Cu alloys

After using cast titanium prostheses in clinical dental practice, severe wear of titanium teeth has been observed. This in vitro study evaluated the wear behavior of teeth made with several cast titanium alloys containing copper (CP Ti+3.0 wt% Cu; CP Ti+5.0 wt% Cu; Ti-6Al-4V +1.0 wt% Cu; Ti-6Al-4V+4.0 wt% Cu) and compared the results with those for commercially pure (CP) titanium, Ti-6Al-4V, and gold alloy. Wear testing was performed by repeatedly grinding upper and lower teeth under flowing water in an experimental testing apparatus. Wear resistance was assessed as volume loss (mm(3)) at 5kgf (grinding force) after 50,000 strokes. Greater wear was found for the six types of titanium than for the gold alloy. The wear resistance of the experimental CP Ti+Cu and Ti-6Al-4V+Cu alloys was better than that of CP titanium and Ti-6Al-4V, respectively. Although the gold alloy had the best wear property, the 4% Cu in Ti-6Al-4V alloy exhibited the best results among the titanium metals. Alloying with copper, which introduced the alpha Ti/Ti(2)Cu eutectoid, seemed to improve the wear resistance.     

A novel ultra high molecular weight polyethylene-hyaluronan microcomposite for use in total joint replacements. II. Mechanical and tribological property evaluation

The mechanical and tribological properties of a new biomaterial, an ultra high molecular weight polyethylene-hyaluronan (UHMWPE-HA) microcomposite, were investigated in this article, which is Part II of a two-part study. Part I presented the synthesis and physical/chemical characterization of the novel microcomposites. The microcomposite was developed for bearing surfaces of total joint replacements and was designed to enhance lubrication and improve wear resistance compared to noncrosslinked UHMWPE. Pin-on-flat wear tests with cross-path motion demonstrated significant decreases for both the wear and wear rate of UHMWPE with the presence of hyaluronan (HA) within and on the microcomposite. Compared to noncrosslinked UHMWPE, a maximum decrease of 56% in wear and a maximum decrease of 31% in wear rate were observed at 1.0 million cycles. Inferior tensile properties were observed for the microcomposites when compared to noncrosslinked UHMWPE, which resulted from poor intermolecular entanglement of the UHMWPE caused by low remolding temperature throughout microcomposite manufacturing. Similar results were observed for the sham control, which was processed in the same way as the microcomposite, except for the addition of HA.     

Tribological characterization of surface-treated commercially pure titanium for femoral heads in total hip replacement: a feasibility study

Most noncemented total hip replacements combine a titanium alloy stem, a CoCrMo femoral head and an ultra-high molecular weight polyethylene (UHMWPE) acetabular cup. In spite of its nickel content of up to 1% and the resulting biocompatibility issues in some clinical situations, the higher cost and some difficulties in machining, CoCrMo alloy is preferred to titanium alloys thanks to its outstanding tribological properties, higher hardness and elastic modulus. Nowadays most of the heads of hip prostheses use CoCrMo as bearing material. The present study investigates the effect of various surface treatments and combinations of treatments, such as electrochemical oxidation (anodization), laser surface melting and barrel polishing, on the tribological properties of commercially pure grade 2 titanium. The aim of the study was to characterize surface treatments capable of improving the tribological properties of titanium surface to the same extent as CoCrMo. The tribological properties were characterized by multidirectional pin-on-flat screening wear tests, using UHMWPE pins as bearing surface. The experiments showed the possibility of improving the wear resistance of titanium to the degree of CoCrMo. Although further efforts will be required to optimize the treatments studied, the results are encouraging enough to warrant pursuing this direction of investigation.