| 生物型髋关节假体涂层脱落的临床分期和预防 |
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Received:April 17, 2009
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| 作者 | Author | 单位 | Unit | E-Mail |
| 王峰 |
WANG Feng |
南京大学附属鼓楼医院关节疾病诊治中心,江苏 南京 210008
南京医科大学鼓楼临床医学院 |
The Center of Diagnosis and Treatment for Joint Disease,Drum Tower Hospital Affiliated to Medical College of Nanjing University,Nanjing 210008,Jiangsu,China |
qingj@nju.edu.cn |
| 陈东阳 |
CHEN Dong-yang |
南京大学附属鼓楼医院关节疾病诊治中心,江苏 南京 210008 |
The Center of Diagnosis and Treatment for Joint Disease,Drum Tower Hospital Affiliated to Medical College of Nanjing University,Nanjing 210008,Jiangsu,China |
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| 邱旭升 |
QIU Xu-sheng |
南京大学附属鼓楼医院关节疾病诊治中心,江苏 南京 210008 |
The Center of Diagnosis and Treatment for Joint Disease,Drum Tower Hospital Affiliated to Medical College of Nanjing University,Nanjing 210008,Jiangsu,China |
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| 徐志宏 |
XU Zhi-hong |
南京大学附属鼓楼医院关节疾病诊治中心,江苏 南京 210008 |
The Center of Diagnosis and Treatment for Joint Disease,Drum Tower Hospital Affiliated to Medical College of Nanjing University,Nanjing 210008,Jiangsu,China |
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| 王祖玉 |
WANG Zu-yu |
南京大学附属鼓楼医院关节疾病诊治中心,江苏 南京 210008 |
The Center of Diagnosis and Treatment for Joint Disease,Drum Tower Hospital Affiliated to Medical College of Nanjing University,Nanjing 210008,Jiangsu,China |
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| 史冬泉 |
SHI Dong-quan |
南京大学附属鼓楼医院关节疾病诊治中心,江苏 南京 210008 |
The Center of Diagnosis and Treatment for Joint Disease,Drum Tower Hospital Affiliated to Medical College of Nanjing University,Nanjing 210008,Jiangsu,China |
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| 蒋青 |
JIANG Qing |
南京大学附属鼓楼医院关节疾病诊治中心,江苏 南京 210008 |
The Center of Diagnosis and Treatment for Joint Disease,Drum Tower Hospital Affiliated to Medical College of Nanjing University,Nanjing 210008,Jiangsu,China |
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| 期刊信息：《中国骨伤》2009年22卷，第6期，第413-416页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：对于生物型髋关节长期的生物学效应是未知的，探讨生物型髋关节假体涂层脱落的原因和提出相应的预防和治疗措施具有重要临床意义。
方法：自2002年10月至2009年2月，对5例生物型髋关节假体涂层脱落进行分析，采用全髋关节翻修术治疗。男3例，女2例；年龄55～68岁。术中取出假体进行分析，探讨涂层脱落发生的原因。对照组为翻修术取下的正常假体(10例).使用组织形态学观察断面的表面形态和微结构，并用电子数显外径千分尺测量碎片厚度，维式硬度计测量涂层的维式硬度(HV),以及Push-out试验测量界面抗剪切强度。对髋关节功能进行Harris评分。
结果：对照组和试验组组织形态学观察有区别。2例HA涂层脱落患者涂层厚度分别为112、138 ?滋m;维氏硬度分别为5 843、4 524 Hv;抗剪切强度分别为12.4、11.6 MPa.3例钛珠涂层脱落患者术后Harris评分分别为82、88及87分。
结论：多种原因可同时导致假体涂层脱落，但临床上碰到的涂层脱落的病例多与假体质量有关，现有各种方法可以明显提高涂层与假体之间的结合强度，从而预防涂层的早期脱落。 |
| [关键词]:髋假体 关节成形术,置换,髋 材料试验 再手术 |
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| Clinical analysis and prevention from coating shedding of uncemented hip prosthesis |
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Abstract:
Objective: The long-term biological effects of HA-coated prostheses remain uncertain. The purpose of the study is to analyze the reasons of coating shedding of uncemented hip prothesis,so as to provide evidences for the preventions and treatment.
Methods: From 2002.10 to 2009.2,5 patients with coating shedding of uncemented hip prosthesis were treated with kip revision operation. Among the patients,3 patients were male and 2 patients were female,ranging in age from 55 to 68 years. The hip prosthesis were taken out in the operation and the cause of coating shedding was analyzed. Another ten normal prosthesis taken out from the revision operation were used as the control group. The histomorphology and microarchitecture of hip prosthesis were observed. The micrometer caliper and vickers hardness test were used to measure the thickness and hardness. The interface shearing force was measured by push-out test. The function of hip joint was evaluated by Harris score.
Results: There were difference between control and experience groups in his tomorphology observation. In the 2 patients with HA-coated shedding,the thickness of coating were 112 μm and 138 μm respectively;Vickers hardness were 5 843 Hv and 4 524 Hv respectively;and the shear strength were 12.4 MPa and 11.6 MPa respectively. In the 3 patients with Ti-coated shedding,the Harris scores were 82,88 and 87 respectively.
Conclusion: There are many reasons of coating shedding of uncemented hip prosthesis. But most reasons have relationship with the quality of hip prosthesis. Nowadays,there are many methods to enhance the binding strength between the coating and prosthesis,and to prevent the early coating shedding. |
| KEYWORDS:Hip prosthesis Arthroplasty,replacement,hip Materials testing reoperation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王峰,陈东阳,邱旭升,徐志宏,王祖玉,史冬泉,蒋青.生物型髋关节假体涂层脱落的临床分期和预防[J].中国骨伤,2009,22(6):413~416 |
| 英文格式: | WANG Feng,CHEN Dong-yang,QIU Xu-sheng,XU Zhi-hong,WANG Zu-yu,SHI Dong-quan,JIANG Qing.Clinical analysis and prevention from coating shedding of uncemented hip prosthesis[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(6):413~416 |
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