Isaac G H, Thompson J, Williams S, Fisher J
DePuy International Ltd, Leeds, UK.
Proc Inst Mech Eng H. 2006 Feb;220(2):119-33. doi: 10.1243/095441105X68953.
When first introduced, total hip replacements offered pain relief and improved mobility in elderly patients. The success of this procedure in terms of long-term durability and restoration of function has led to its use in younger, more active patients. This has resulted in a commensurate increase in patient expectation regarding longevity and the degree to which function and lifestyle is restored. The bearing surface is a key feature of the performance of replacement joints. It is generally accepted that excessive amounts of wear debris preclude their long-term survivorship and hence there is an ongoing requirement for bearing surfaces which minimize debris generation. The purpose of this paper is to review the factors which affect the performance of so-called metal-on-metal bearings, to compare their performance with that of the other commonly used contemporary alternatives, metal and ceramic articulating against highly cross-linked polyethylene, and ceramic-on-ceramic, and finally to consider the potential solutions offered by new developments such as ceramic-on-metal and coatings applied to metal-on-metal bearings.
首次引入时，全髋关节置换术为老年患者缓解了疼痛并改善了活动能力。该手术在长期耐用性和功能恢复方面的成功促使其应用于更年轻、活动量更大的患者。这相应地提高了患者对假体使用寿命以及功能和生活方式恢复程度的期望。关节面是置换关节性能的关键特征。人们普遍认为，过多的磨损碎屑会妨碍其长期存活，因此一直需要能将碎屑产生降至最低的关节面。本文旨在综述影响所谓金属对金属关节面性能的因素，将其性能与其他常用的当代替代方案（金属与高度交联聚乙烯、陶瓷与陶瓷相互配合）进行比较，最后考虑诸如陶瓷对金属以及应用于金属对金属关节面的涂层等新进展所提供的潜在解决方案。
