Goodman Stuart B, Gómez Barrena Enrique, Takagi Michiaki, Konttinen Yrjo T
The Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California 94305-5326, USA.
J Biomed Mater Res A. 2009 Aug;90(2):603-18. doi: 10.1002/jbm.a.32063.
Total joint replacement is one of the most clinically successful, cost-effective surgical procedures. These operations have been shown to improve pain, function and mobility in patients with end-stage arthritis. However, joint replacements that will allow full, unrestricted, high impact activities and last the patient's lifetime have not yet been devised. This is due to biocompatibility issues related to material science, biomechanics, and host responses. In this review, three issues that are highly pertinent to biocompatibility of joint replacements are examined. These topics include how implants initially osseointegrate within bone, potential adverse effects of byproducts of wear that can lead to aseptic loosening and periprosthetic osteolysis, and the potential for new bearing surfaces to extend the lifetime of implants. A clear understanding of these important issues will facilitate the development of novel strategies to improve the longevity and function of implants for joint replacement in the future.
全关节置换术是临床上最成功、最具成本效益的外科手术之一。这些手术已被证明可改善终末期关节炎患者的疼痛、功能和活动能力。然而，能够允许患者进行充分、不受限制的高强度活动并伴随患者一生的关节置换物尚未设计出来。这是由于与材料科学、生物力学和宿主反应相关的生物相容性问题。在本综述中，研究了与关节置换生物相容性高度相关的三个问题。这些主题包括植入物最初如何在骨内实现骨整合、磨损副产物可能导致无菌性松动和假体周围骨溶解的潜在不良影响，以及新的关节面延长植入物使用寿命的可能性。清楚地了解这些重要问题将有助于未来开发新的策略，以提高关节置换植入物的使用寿命和功能。
