磨损微粒在无菌性松动关节假体周围迁移聚积的实验研究

目的　观察人工髋关节假体周围界膜的超微结构 ,了解磨损微粒的形态及其在人工髋关节假体周围迁移聚积的特征。方法　临床选取 4例人工全髋关节术后发生无菌性松动病例 ,于翻修术中按照Delee Charnley髋臼分区法和Gruen Amstutz股骨分区法采取假体周围界膜组织 ,以透射电镜进行观察 ,统计各区磨损微粒数目。结果　界膜组织标本含有大量胶原纤维 ,其间可见大量黑色磨损微粒。其中髋臼分区三区磨损微粒聚积数明显高于一区和二区 (P <0 0 5 ) ,股骨分区中一区、七区中磨损微粒明显高于其余各区 (P <0 0 5 )。结论　磨损微粒的产生、迁移和局部聚积具有一定特征和规律性

Experimental Studies of the Movement and Accumulation of Wear Debris around the prostheses

Objective To observe the ultrastructural of the interface tissue around the prostheses and find out the shape and the accumulate character of the wear debris. Methods Four patients underwent revision total hip arthroplasty were eligible for this study.Interface tissue was obtained at three Delee Charnley acetabular sections and seven Gruen Amstutz femur sections in revision surgery.The tissue was prepared to be thin sections for electronic microscope for histomorphologic study of interface wear debris besides routine histomorphologic observations.Data of wear debris accumulation were compared among all sections to determine periprosthetic distribution characteristics of abrasive wear debris. Results Electronic microscopy showed that most parts of the interface sample were dense connective tissue with large amount of collagen fibers,between the cells were large amount of black metal wear debris of oval shape mainly,Data showed that the 3rd section of acetabulum had a far higher accumulating level of wear debris than the 1st and 2nd had,and black metal wear debris distributed extensively at sections 1 and 7 of femur,with a accumulating level significantly higher than the other sections of femur (P<0 05). Conclusion There were some characters of the wear debres about their producing movement and local accumulation.