摘要
背景:金属材料、高分子材料和陶瓷材料等制作的人工髋关节关节都已成功应用于临床,产品也已经发展到比较成熟的阶段,但是每种材料依然存在各自的优缺点。目的:评价不同材料髋关节假体的特点及临床应用。方法:采用电子检索的方式在万方数据库中检索1999-01/2011-02有关髋关节假体材料的研究,关键词为"髋关节置换"。排除重复研究、普通综述或Meta分析类文章,筛选纳入18篇文献进行评价。结果与结论:金属材料在髋关节置换中占有重要的地位,目前髋关节置换临床应用最多的是金属关节头和超高分子量聚乙烯髋臼的组合,但金属的弹性模量与人体骨骼相差甚远,导致应力遮挡效应,容易引起假体的疏松和不稳定;生物惰性陶瓷在活体内具有很高的稳定性和很好的机械强度,而生物活性陶瓷具有骨传导的特点以及与活骨整合的性能;复合材料假体因其可调的弹性模量和足够的力学强度,力学性能接近人体骨骼而逐渐被重视。但目前还缺乏生物相容性好、生物力学相容性好的理想假体材料。因此,应从改进人工髋关节设计和制造工艺,提高材料的耐磨性与力学性能,增强假体与宿主骨的结合性,减少应力遮挡,寻找新的人工髋关节假体材料等方面来提高置入物与宿主的生物相容性,从而能够更好地延长假体使用寿命。
BACKGROUND：Prostheses made of metallic materials,polymer materials and ceramic materials have been successfully used in clinic,and the products have been developed to a more mature stage,but there are still advantages and disadvantages in each material.OBJECTIVE：To evaluate the features and clinical application of different hip prostheses.METHODS：An online search of Wanfang database was performed to retrieve articles about hip prosthesis materials published from January 1999 to February 2011 with keywords of hip replacement.Repetitive articles,reviews and Meta analysis were excluded,and finally 18 articles were included. RESULTS AND CONCLUSION：Metal joint head and polyethylene acetabular combination is used most in hip replacement.However,the elastic modulus of the metal is far from that of the human skeleton,which leads to stress-shielding effect,and is likely to cause instability and loose of prostheses.Bio-inert ceramics is regarded as high stability and good mechanical strength in vivo,while bioactive ceramics have abilities of bone conduction and osseointegration in vivo.Composite prosthesis has been emphasized because of its adjustable elastic modulus and adequate mechanical strength,and similar mechanical properties with human bone.At present,there is no ideal prosthesis with good biocompatibility and biomechanical compatibility.Therefore,we should modify the design and manufacture processes of hip prosthesis to improve the wear resistance and mechanical properties,enhance integration between the prosthesis and the host bone,reduce stress shielding,and hope to find a new hip prosthesis so as to promote the biocompatibility with the host and prolong the prosthesis life.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2011年第17期3196-3199,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
