Takayanagi Satoshi, Nagase Mitsuo, Shimizu Toru, Kobayashi Toshihiko, Shirakura Kenji, Takagishi Kenji
Department of Orthopaedic Surgery, Gunma University Faculty of Medicine, 3-39-22 Showa-machi, Maebashi-shi, Gunma-ken 371-8511, Japan.
Clin Orthop Relat Res. 2003 Aug(413):183-91. doi: 10.1097/01.blo.0000073340.50837.d8.
Human leukocyte antigen phenotypes and radiographic course were studied in 70 Japanese patients (90 hips) who had Charnley low friction arthroplasty. Of the 28 hips diagnosed as radiographically loose less than 15 years after surgery, seven hips (25.0%) were in patients who had a positive human leukocyte antigen A31(19). Of the 62 hips that were radiographically stable more than 15 years, two hips (3.2%) were in patients who had a positive human leukocyte antigen A31(19). Of the nine hips in patients who were positive to human leukocyte antigen A31(19), seven hips were diagnosed as radiographically loose (loosening rate was 77.8%) 15 years after surgery. On the other hand, of the 81 hips in the patients who were negative to human leukocyte antigen A31(19), only 21 hips were diagnosed as radiographically loose (loosening rate was 25.9%) 15 years after surgery. These data suggest that individual immune response to implant materials, linked to human leukocyte antigen, may participate in the process of aseptic loosening in Charnley low friction arthroplasty.
对70例接受Charnley低摩擦关节成形术的日本患者（90髋）的人类白细胞抗原表型和影像学病程进行了研究。在术后15年以内被诊断为影像学松动的28髋中，7髋（25.0%）患者的人类白细胞抗原A31(19)呈阳性。在术后15年以上影像学稳定的62髋中，2髋（3.2%）患者的人类白细胞抗原A31(19)呈阳性。在人类白细胞抗原A31(19)呈阳性的患者的9髋中，7髋在术后15年被诊断为影像学松动（松动率为77.8%）。另一方面，在人类白细胞抗原A31(19)呈阴性的患者的81髋中，术后15年只有21髋被诊断为影像学松动（松动率为25.9%）。这些数据表明，与人类白细胞抗原相关的对植入材料的个体免疫反应可能参与了Charnley低摩擦关节成形术的无菌性松动过程。
