人工全髋聚乙烯假体磨损及其生物学效应

目的 探讨人工关节聚乙烯磨损与假体松动的关系。方法 采用光镜与电镜对15例人工髋关节翻修病例的聚乙烯假体臼杯内表面及假体周围软组织作形态学观察。进而在动物实验中观察微小聚乙烯磨损颗粒促使骨吸收性细胞因子增加，植入物周围骨溶解以及植入物-骨整合强度下降的生物效应。结果 聚乙烯假体在人工关节松动形成时均明显磨损，聚乙烯磨损颗粒诱发机体单核-巨噬细胞增殖并分泌骨吸收性细胞因子。结论 聚乙烯磨损与假体松动密度相关。其中生物因素是引起假体松动的主要途径。

Polyethylene wear of total hip prosthesis and its biological reaction

Objective To explore the relationship between the polyethylene wear of the acetabular liner in artificial hip joint and the loosening of the prosthesis. Methods 15 polyethylene made acetabular liner together with its surrounding soft tissue retrieved from revision surgery were observed by light microscopy or electron microscopy and micron sized polyethylene debris were studied experimentally to further clarify their biological mechanism leading to the loosening of the prosthesis, such as increase in secretion of bone resorptive cytokines, induction of periimplant osteolysis and decrease in anchoring force of the implant bone interface. Results All acetabular liners revised for loosening were severely worn away and the activity of the mononuclear phagocyte induced by wear debris of polyethylene was the major biological reaction in formation of prosthetic loosening. Conclusion Close relationship between the polyethylene wear of the acetabular liner and the loosening of the prosthesis was found with mainly biological reaction of mononuclear phagocyte.