人工关节假体周围骨溶解的发生机制及防治

综述人工关节假体周围骨溶解发生机制和防治措施的研究进展。查阅近10年有关人工关节假体周围骨溶解相关文献,并进行回顾及综合分析。发现人工关节假体周围骨溶解的形成是一个非常复杂的过程,影响因素主要涉及到假体材料、假体固定方法、界面微动、界面密封程度、假体周围高液压等;更主要的是生物学因素,包括磨损颗粒种类和大小、细胞因子释放、对磨损颗粒的致敏反应等。在防治假体周围骨溶解的措施主要有改进人工关节材料及设计、改善人工关节固定技术、注重手术操作技术。在药物防治研究领域,二膦酸盐类化合物证实具有正面效应,有望成为防治假体周围骨溶解的有效药物。随着基因治疗的研究深入,在不久的将来,基因治疗方式会成为假体周围骨吸收一种很好的治疗手段。

Mechanisms,Prevention and Treatments of Prosthesis Osteolysis

To introduce the occurrence mechanisms,prevention,and treatment measures of prosthesis osteolysis.The recent 10 years of original articles about prosthesis osteolysis were extensively reviewed and analyzed.Prosthesis osteolysis was a very complex process.The effective factors mainly came down to prosthetic materials,implant fixation methods,interface micromotion,interface integrity,and periprosthetic high hydraulic pressure,etc.;the more important biological factors included the types and sizes of wear particles,cytokine release and allergic reactions to wear particles,etc.Many measures should be adopted to effectively prevent and treat it,including improving materials and designs of prostheses,fixation techniques,surgical techniques.In the field of drug prevention and treatment,bisphosphonates compounds were proved to have positive effects,and expected to prevent and treat periprosthetic osteolysis and effective drugs.In the near future,gene therapy with depth of bone resorption around the implant will be a good treatment.