切换至 "中华医学电子期刊资源库"

中华关节外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (03) : 346 -351. doi: 10.3877/cma.j.issn.1674-134X.2020.03.016

所属专题: 文献

综述

人工关节置换术后假体无菌性松动的研究进展
刘鹏1, 邓亚鹏2, 曹国定1, 高余2, 封国超1, 刘军2, 甄平2,()   
  1. 1. 730000 兰州,甘肃中医药大学;730050 兰州,联勤保障部队第940医院
    2. 730050 兰州,联勤保障部队第940医院
  • 收稿日期:2019-08-27 出版日期:2020-06-01
  • 通信作者: 甄平
  • 基金资助:
    全军后勤课题面上项目(CWH17J009); 全军医学科技青年计划(19QNP047)

Research progress in aseptic loosening of prostheses after joint arthroplasty

Peng Liu1, Yapeng Deng2, Guoding Cao1, Yu Gao2, Guochao Feng1, Jun Liu2, Ping Zhen2,()   

  1. 1. Gansu University of Chinese Medical, Lanzhou 730000, China; The 940th Hospital of PLA Joint Logistics Support Force, Lanzhou 730050, China
    2. The 940th Hospital of PLA Joint Logistics Support Force, Lanzhou 730050, China
  • Received:2019-08-27 Published:2020-06-01
  • Corresponding author: Ping Zhen
  • About author:
    Corresponding author: Zhen Ping, Email:
引用本文:

刘鹏, 邓亚鹏, 曹国定, 高余, 封国超, 刘军, 甄平. 人工关节置换术后假体无菌性松动的研究进展[J]. 中华关节外科杂志(电子版), 2020, 14(03): 346-351.

Peng Liu, Yapeng Deng, Guoding Cao, Yu Gao, Guochao Feng, Jun Liu, Ping Zhen. Research progress in aseptic loosening of prostheses after joint arthroplasty[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(03): 346-351.

人工关节置换术已经作为骨科的一种标准治疗手段,用于治疗累及关节的骨折、重度骨关节炎、骨肿瘤和先天性关节发育不良等疾病,术后效果较好,但并发症也不容忽视。其中术后假体无菌性松动成为影响患者恢复的最大问题之一。本文主要从机械性因素(假体微动、应力遮挡、高液压等)及生物学因素(磨损颗粒、细胞、分子等)两方面全面阐述了关节置换术后假体发生无菌性松动的影响因素及发生机制。

Artificial arthroplasty has been used as a standard treatment in orthopaedics, which is used to treat involving joint fracture, severe osteoarthritis, bone tumors and congenital dysplasia of joint. Although artificial arthroplasty has a good postoperative effect, it’s complications also not be ignored. However, aseptic loosening of prosthesis has become one of the biggest problems affecting the recovery of patients. This paper comprehensively expounded the influencing factors and mechanism of aseptic loosening after artificial arthroplasty from mechanical factors(prosthesis fretting, stress shielding, high hydraulic pressure) and biological factors(wear particles, cells and molecular factors).

[1]
Barg A, Wimmer MD, Wiewiorski M, et al. Total ankle replacement[J]. Dtsch Arztebl Int,2015,112(11): 177-184.
[2]
宣华兵,罗新乐,唐久阳,等.全膝关节置换治疗膝关节骨关节炎[J/CD].中华关节外科杂志(电子版),2018,12(3): 338-343.
[3]
戴尅戎,李慧武,严孟宁.我国人工关节加速发展的二十年[J/CD].中华关节外科杂志(电子版),2015,9(6): 691-694.
[4]
O′neill SC, Queally JM, Devitt BM, et al. The role of osteoblasts in peri-prosthetic osteolysis[J]. Bone Joint J, 2013, 95-B(8): 1022-1026.
[5]
巩栋,吴国泰,甄平.假体周围骨溶解动物模型的研究概况[J].中国组织工程研究,2018,22(15): 2421-2426.
[6]
Carli A, Politis A, Zukor D, et al. Clinically significant corrosion at the head-neck taper interface in total hip arthroplasty: a systematic review and case series[J]. Hip Int, 2015, 25(1): 7-14.
[7]
梁刚,张志强.髋关节置换术后假体松动的原因及机制分析[J].实用骨科杂志,2013,19(12): 1110-1113.
[8]
马玉超,田京.人工关节假体植入后无菌性松动的发病机制[J].中国组织工程研究,2012,16(26): 4892-4897.
[9]
尤田,查振刚.人工髋关节置换术后假体无菌性松动的机制及预防的研究现状[J].中国矫形外科杂志,2011,19(24): 2061-2064.
[10]
朱俊峰,张先龙,王成焘,等.股骨假体近端应力遮挡对成骨细胞增殖和凋亡的影响[J].临床骨科杂志,2009,12(3): 332-335.
[11]
鲁凡,王晶,戚仁斌.无菌性松动的病因学研究进展[J].中国病理生理杂志,2013,29(9): 1718-1724.
[12]
Mevoy A, Jeyam M, Ferrier G, et al. Synergistic effect of particles and cyclic pressure on cytokine production in human monocyte/macrophages: proposed role in periprosthetic osteolysis[J]. Bone, 2002, 30(1): 171-177.
[13]
王伟,周胜虎,刘军,等.磨损颗粒与人工关节骨溶解的相关研究[J].中国骨与关节损伤杂志,2017,32(4): 446-448.
[14]
Noble PC. CORR insights(®): Otto aufranc award: large heads do not increase damage at the head-neck taper of metal-on-polyethylene total hip arthroplasties[J]. Clin Orthop Relat Res, 2016, 474(2): 339-341.
[15]
Osman K, Panagiotidou AP, Khan M, et al. Corrosion at the head-neck interface of current designs of modular femoral components: essential questions and answers relating to corrosion in modular head-neck junctions[J]. Bone Joint J, 2016, 98-B(5): 579-584.
[16]
季锋,赵承斌.关节置换术后假体周围粒子与假体松动的研究进展[J].中国医药导报,2012,9(8): 10-12.
[17]
蒋营军,吴连国.人工关节置换术后磨损颗粒与假体周围骨溶解的研究进展[J].中国骨伤,2016,29(10): 968-972.
[18]
Valladares RD, Nich C, Zwingenberger S, et al. Toll-like receptors-2 and 4 are overexpressed in an experimental model of particle-induced osteolysis[J]. J Biomed Mater Res A, 2014, 102(9): 3004-3011.
[19]
Fujii J, Niida S, Yasunaga Y, et al. Wear debris stimulates bone-resorbing factor expression in the fibroblasts and osteoblasts[J]. Hip Int, 2011, 21(2): 231-237.
[20]
Mcgrory BJ, Mckenney BR. Revision for taper corrosion at the head-neck junction: pearls and pitfalls[J]. Curr Rev Musculoskelet Med, 2016, 9(1): 97-102.
[21]
Sagar K, Bell D, Johnson J, et al. Head and neck inflammatory pseudotumor: case series and review of the literature[J]. Neuroradiol J, 2016, 29(6): 440-446.
[22]
Chen WS, Li ZQ, Ying G, et al. Wear particles impair antimicrobial activity via suppression of reactive Oxygen species Generation and ERK1/2 phosphorylation in activated macrophages[J]. Inflammation, 2015, 38(3): 1289-1296.
[23]
王来潮,宋科官.磨损颗粒诱导假体无菌性松动的研究现状[J].中国矫形外科杂志,2013,21(18): 1837-1840.
[24]
刘丰,张超,姚振强,等.人工关节假体无菌性松动的发病机制及治疗进展[J].中国组织工程研究,2012,16(26): 4886-4891.
[25]
Song L, Zhao J, Zhang X, et al. Icariin induces osteoblast proliferation, differentiation and mineralization through estrogen receptor-mediated ERK and JNK signal activation[J]. Eur J Pharmacol, 2013, 714(1/3): 15-22.
[26]
林绵辉,史占军.淫羊藿苷对钛颗粒作用下成骨细胞增殖和分化的影响[J].中国矫形外科杂志,2014,22(10): 923-928.
[27]
李海亚,查振刚.磨损颗粒引起人工关节无菌性松动的研究与进展[J].中国组织工程研究,2012,16(48): 9059-9063.
[28]
Mandelin J, Li TF, Hukkanen M, et al. Interface tissue fibroblasts from loose total hip replacement prosthesis produce receptor activator of nuclear factor-kappaB ligand, osteoprotegerin, and cathepsin K[J]. J Rheumatol, 2005, 32(4): 713-720.
[29]
刘国印,赵建宁,王瑞.磨损微粒诱导细胞凋亡与无菌性松动的研究进展[J].中国骨伤,2013,26(9): 791-796.
[30]
Blankenhorn EP, Butterfield R, Laure KC, et al. Genetics of experimental allergic encephalomyelitis supports the role of T helper cells in multiple sclerosis pathogenesis[J]. Ann Neurol, 2011, 70(6): 887-896.
[31]
Rego I, Fernández-Moreno M, Fernández-López C, et al. Role of European mitochondrial DNA haplogroups in the prevalence of hip osteoarthritis in Galicia, Northern Spain[J]. Ann Rheum Dis, 2010, 69(1): 210-213.
[32]
Valdes AM, Spector TD. The clinical relevance of genetic susceptibility to osteoarthritis[J]. Best Pract Res Clin Rheumatol, 2010, 24(1): 3-14.
[33]
朱书涛,刘洋,张明辉,等.去卵巢大鼠骨组织中肿瘤坏死因子α、白细胞介素1β及白细胞介素6水平与骨质疏松的关系[J].中国组织工程研究,2016,20(15): 2206-2211.
[34]
刘国印,王瑞,赵建宁. MicroRNA在无菌性松动中的研究进展[J]. 中国骨伤,2014, 27(3): 232-236.
[35]
钱叶斌,张先龙,王琦,等.P物质和PMMA颗粒对成纤维细胞分泌PGE2和IL-6的影响[J].中国矫形外科杂志,2013,21(14): 1442-1445.
[36]
孟庆阳,郑嵘,朱阳,等.破骨细胞分化因子及其信号转导通路[J].国际口腔医学杂志,2015,42(2): 189-193.
[37]
Xue JB, Zhan XL, Wang WJ, et al. OPG rs2073617 polymorphism is associated with upregulated OPG protein expression and an increased risk of intervertebral disc degeneration[J]. Exp Ther Med, 2016, 12(2): 702-710.
[38]
陈瀚宇,徐颖鹏,李鼎鹏,等.RANK/RANKL/OPG系统在骨性关节炎与骨质疏松相关性中的作用机制[J].中国中医骨伤科杂志,2019,27(1): 86-88.
[1] 丁莹莹, 宋恺, 金姬延, 田华. 机器人辅助膝髋关节置换术后精细化临床护理[J]. 中华关节外科杂志(电子版), 2024, 18(04): 553-557.
[2] 孔德铭, 刘铮, 李睿, 钱文伟, 王飞, 蔡道章, 柴伟. 人工智能辅助全髋关节置换三维术前规划准确性评价[J]. 中华关节外科杂志(电子版), 2024, 18(04): 431-438.
[3] 赵飞鸿, 陈颖杰, 林静芳, 郑晓春, 廖燕凌. 超声引导下周围神经阻滞对髋膝关节置换术后恢复的影响[J]. 中华关节外科杂志(电子版), 2024, 18(04): 457-468.
[4] 任俊筱, 浦路桥, 王志豪, 施洪鑫, 刘爱峰, 齐保闯, 徐永清, 李川. 机器人辅助全膝关节置换术的临床疗效对照研究[J]. 中华关节外科杂志(电子版), 2024, 18(04): 469-476.
[5] 许亚龙, 巩栋, 陈晓涛. 超前镇痛在全膝关节置换术中的研究进展[J]. 中华关节外科杂志(电子版), 2024, 18(04): 517-523.
[6] 刘晓凡. 老年股骨头坏死髋关节置换术后康复应用多维度干预[J]. 中华关节外科杂志(电子版), 2024, 18(03): 314-319.
[7] 沈建成, 阮安民, 刘壮. 两种关节评分联用评价两种手术治疗老年股骨粗隆间骨折[J]. 中华关节外科杂志(电子版), 2024, 18(03): 329-336.
[8] 王冰, 孙海宁, 于秀淳, 周珂, 翟凯, 苗族康. 膝骨关节炎的活动衬垫型单髁置换疗效与假体生存率[J]. 中华关节外科杂志(电子版), 2024, 18(03): 337-345.
[9] 张江礼, 刘金辉, 潘西庆, 刘光源, 范虓. 全膝关节置换应用智能辅助手术导航系统治疗膝骨关节炎[J]. 中华关节外科杂志(电子版), 2024, 18(03): 346-351.
[10] 杨士慷, 曹光磊. 膝骨关节炎三种术式患者满意度的术前影响因素[J]. 中华关节外科杂志(电子版), 2024, 18(03): 390-397.
[11] 刘正宇, 刘春风, 王振. 改良后外侧入路半髋置换治疗股骨颈骨折的早期疗效[J]. 中华关节外科杂志(电子版), 2024, 18(03): 409-413.
[12] 阿卜杜萨拉木·图尔荪麦麦提, 吐尔洪江·吐逊, 温浩. 肝脏缺血-再灌注损伤与cGAS-STING信号通路[J]. 中华肝脏外科手术学电子杂志, 2024, 13(03): 394-397.
[13] 茹江英, 廖启宇, 温国洪, 潘思华, 刘栋, 张皓琛, 牛云飞. 直接前方入路和后外侧入路半髋关节置换治疗老年痴呆股骨颈骨折的疗效比较[J]. 中华老年骨科与康复电子杂志, 2024, 10(05): 287-293.
[14] 丛黎, 马林, 陈旭, 李文文, 张亮亮, 周华亭. 改良CT严重指数联合炎症指标在重症急性胰腺炎患者胰腺感染预测及预后评估中的研究[J]. 中华消化病与影像杂志(电子版), 2024, 14(05): 432-436.
[15] 冯盼, 梁秋华. 细胞间相互作用及代谢微环境在动脉钙化中的作用机制研究进展[J]. 中华诊断学电子杂志, 2024, 12(03): 193-198.
阅读次数
全文


摘要