髋假体置入后假体周围松动骨质的病理学变化

背景：磨损颗粒是导致假体周围骨质溶解的重要潜在性因素之一,但引起假体周围骨溶解的原因及其发展过程尚未完全清楚。 目的：复习人工关节置换后翻修病例的病理切片,分析病理检查在人工关节置换后感染诊断中的价值。 方法：由第一作者检索1990/2008 PubMed数据及万方数据库有关髋假体置入后假体周围松动以及假体松动周围骨质的病理学变化方面的文献。 结果与结论：人工假体与骨空隙的产生导致界膜充填,磨损微粒刺激界膜释放炎性细胞因子导致骨溶解而出现假体松动,如果尽可能地减少活动中产生的磨损碎屑可减少炎性递质的释放;减少由充填性界膜向溶骨性界膜的转变,就可从生物学角度降低人工髋关节置换后假体松动的发生率。

Pathological changes of loosening bone around the implanted hip prosthesis

BACKGROUND:Wear particles are the important potential factor leading to periprosthetic osteolysis, but the cause of periprosthetic osteolysis and its development process are still unclear. OBJECTIVE:To analyze the vale of pathological examination in the diagnosis of infection after total joint arthroplasty based on review of pathological sections after total joint arthroplasty. METHODS:The first author searched PubMed and CNKI databases (1990/2008) for articles about loosening bone around the implanted hip prosthesis and relevant pathological changes. RESULTS AND CONCLUSION:The gap between the prosthesis and bone is filled with the interface membrane, and wear particles induce the interface membrane to release inflammatory cytokines leading to loosening prosthesis. To minimize wear debris generation can reduce the release of inflammatory neurotransmitters. The incidence of loosening prosthesis after total joint arthroplasty can be reduced by decreasing the osteolytic changes of the interface membrane.