Cigada Alberto, Cotogno Giulio, Chiesa Roberto
Department of Chemistry, Materials and Chemical Engineering, Politecnico di Milano, Milano, Italy.
J Appl Biomater Biomech. 2011 Jan-Apr;9(1):2-10. doi: 10.5301/JABB.2011.7730.
In the last two decades the performance of total hip replacements (THR) has constantly improved, thanks largely to advances in the field of material science and technology. Although contemporary devices are clinically very reliable, some problems still need to be addressed: the wear of ultra high molecular weight polyethylene components, the release of metal ions from metal-on-metal joints, the toughness of the ceramic cups and the possibility of squeaking for ceramic-on-ceramic couplings. All these drawbacks become particularly relevant in case of THR for young and active patients, when the life expectancy of the orthopedic device is very high and the possibility of mechanical shocks is not negligible.In the last few years an innovative ceramic-on-metal tribologic coupling has been introduced in clinical use. This novel configuration represents a very promising solution to all the aforementioned issues. Ceramic-on-metal offers both the strength points of ceramic and metal surfaces, and overcomes the limits of metal-on-metal and ceramic-on-ceramic bearings. For this reason, the ceramic-on-metal coupling has become the object of investigation for several laboratory studies and has been tested in clinical trials. This review study compares the scientific outcomes of the research on ceramic-on-metal bearings, confirming that this innovative articulation has the potential to be a suitable and attractive solution for young and active patients.
在过去二十年中，全髋关节置换术（THR）的性能不断提高，这在很大程度上要归功于材料科学和技术领域的进步。尽管当代设备在临床上非常可靠，但仍有一些问题需要解决：超高分子量聚乙烯部件的磨损、金属对金属关节中金属离子的释放、陶瓷杯的韧性以及陶瓷对陶瓷耦合产生吱吱声的可能性。对于年轻且活跃的患者进行THR时，所有这些缺点变得尤为突出，因为骨科器械的预期使用寿命很长，而且机械冲击的可能性不可忽略。在过去几年中，一种创新的陶瓷对金属摩擦学耦合已引入临床应用。这种新颖的配置是解决上述所有问题的一个非常有前景的方案。陶瓷对金属兼具陶瓷和金属表面的优点，克服了金属对金属和陶瓷对陶瓷轴承的局限性。因此，陶瓷对金属耦合已成为多项实验室研究的对象，并已在临床试验中进行了测试。本综述研究比较了陶瓷对金属轴承的研究科学成果，证实这种创新的关节连接有可能成为年轻且活跃患者的合适且有吸引力的解决方案。
