Guerin S, Harty J, Thompson N, Bryan K
Department of Mechanical and Manufacturing Engineering, Cork Institute of Technology, Bishopstown, Ireland.
Med Hypotheses. 2006;66(6):1142-5. doi: 10.1016/j.mehy.2005.12.027. Epub 2006 Feb 14.
The reason for revision of primary total hip arthroplasty is quoted as aseptic loosening in 60.6% of cases between 1979 and 2003 in the Swedish National Hip Arthroplasty Registry. Much research effort has been directed toward enhancing the bone-cement interface of total joint arthroplasties, in an attempt to reduce this complication. Haemostatic agents have been popularized as effective means of retarding the development of potentially harmful debris interposition adjacent to, and blood lamination patterns within, the methylmethacrylate. Such agents include hydrogen peroxide (H(2)O(2)), local freezing saline, saline at room temperature and adrenaline solution. One main concern with the use of hydrogen peroxide is whether it affects the material properties of bone cement such that in the long term it contributes to aseptic loosening. This would have enormous clinical consequences. Preliminary studies indicate that porosity increases and that the tensile strength and yield stresses are reduced by up to a factor of 10 by contaminating samples with increasing concentrations of hydrogen peroxide. We postulate that the current use of hydrogen peroxide as an irrigation solution in arthroplasty contributes to the development of aseptic loosening.
在瑞典国家髋关节置换登记处的数据显示，1979年至2003年间，60.6%的初次全髋关节置换翻修病例原因是无菌性松动。许多研究致力于增强全关节置换的骨水泥界面，以试图减少这种并发症。止血剂已作为延缓甲基丙烯酸甲酯附近潜在有害碎片形成及内部血液分层模式发展的有效手段而得到推广。此类药剂包括过氧化氢（H₂O₂）、局部冷冻生理盐水、室温生理盐水和肾上腺素溶液。使用过氧化氢的一个主要担忧是它是否会影响骨水泥的材料性能，从而长期导致无菌性松动。这将产生巨大的临床后果。初步研究表明，随着过氧化氢浓度增加而污染样本，孔隙率会增加，拉伸强度和屈服应力会降低多达10倍。我们推测，目前在关节置换术中使用过氧化氢作为冲洗液会导致无菌性松动的发生。
