Minoda Yukihide, Kobayashi Akio, Iwaki Hiroyoshi, Miyaguchi Masatsugu, Kadoya Yoshinori, Ohashi Hirotsugu, Yamano Yoshiki, Takaoka Kunio
Department of Orthopaedic Surgery, Osaka City University Medical School, Osaka, Japan.
Clin Orthop Relat Res. 2003 May(410):165-72. doi: 10.1097/01.blo.0000063122.39522.c2.
The aims of the current study were to examine polyethylene particles in synovial fluid at an early stage, and to compare a newly introduced medial pivot total knee prosthesis with an established posterior-stabilized total knee prosthesis. Synovial fluid was obtained 1 year after knee arthroplasty from 17 patients with well-functioning prostheses (22 knees, 11 posterior-stabilized prostheses and 11 medial pivot prostheses) under complete sterile conditions. Polyethylene particles were isolated and analyzed by scanning electron microscopy. Particle size (equivalent circle diameter) was 0.78 +/- 0.08 microm (mean +/- standard error) in posterior-stabilized prostheses and 0.67 +/- 0.06 microm in medial pivot prostheses. Particle shape (aspect ratio) was 2.30 +/- 0.22 in posterior-stabilized prostheses and 1.90 +/- 0.16 in medial pivot prostheses. The total numbers of particles were 1.16 +/- 0.57 x 10(8) in posterior-stabilized prostheses and 9.01 +/- 2.95 x 10(6) in medial pivot prostheses. Particles were smaller and rounder in medial pivot prostheses than in posterior-stabilized prostheses, but the differences were not significant. The difference in the common logarithm of particle number was significant. The medial pivot prosthesis generated less wear particles than the posteriorstabilized prosthesis, and these findings may have an impact on the incidence of osteolysis and aseptic loosening.
本研究的目的是在早期阶段检测滑液中的聚乙烯颗粒，并将一种新引入的内侧旋转平台全膝关节假体与一种成熟的后稳定型全膝关节假体进行比较。在全膝关节置换术后1年，于完全无菌条件下，从17例假体功能良好的患者（22个膝关节，其中11个为后稳定型假体，11个为内侧旋转平台假体）获取滑液。通过扫描电子显微镜分离并分析聚乙烯颗粒。后稳定型假体的颗粒大小（等效圆直径）为0.78±0.08微米（平均值±标准误），内侧旋转平台假体为0.67±0.06微米。后稳定型假体的颗粒形状（长宽比）为2.30±0.22，内侧旋转平台假体为1.90±0.16。后稳定型假体的颗粒总数为1.16±0.57×10⁸，内侧旋转平台假体为9.01±2.95×10⁶。内侧旋转平台假体的颗粒比后稳定型假体更小且更圆，但差异不显著。颗粒数量常用对数的差异具有显著性。内侧旋转平台假体产生的磨损颗粒比后稳定型假体少，这些发现可能会对骨溶解和无菌性松动的发生率产生影响。
