Hospital of the University of Pennsylvania, Department of Orthopaedic Surgery, 2 Silverstein, 3400 Spruce St, Philadelphia, USA.
Bone Joint J. 2014 May;96-B(5):569-73. doi: 10.1302/0301-620X.96B5.33606.
Nanotechnology is the study, production and controlled manipulation of materials with a grain size < 100 nm. At this level, the laws of classical mechanics fall away and those of quantum mechanics take over, resulting in unique behaviour of matter in terms of melting point, conductivity and reactivity. Additionally, and likely more significant, as grain size decreases, the ratio of surface area to volume drastically increases, allowing for greater interaction between implants and the surrounding cellular environment. This favourable increase in surface area plays an important role in mesenchymal cell differentiation and ultimately bone-implant interactions. Basic science and translational research have revealed important potential applications for nanotechnology in orthopaedic surgery, particularly with regard to improving the interaction between implants and host bone. Nanophase materials more closely match the architecture of native trabecular bone, thereby greatly improving the osseo-integration of orthopaedic implants. Nanophase-coated prostheses can also reduce bacterial adhesion more than conventionally surfaced prostheses. Nanophase selenium has shown great promise when used for tumour reconstructions, as has nanophase silver in the management of traumatic wounds. Nanophase silver may significantly improve healing of peripheral nerve injuries, and nanophase gold has powerful anti-inflammatory effects on tendon inflammation. Considerable advances must be made in our understanding of the potential health risks of production, implantation and wear patterns of nanophase devices before they are approved for clinical use. Their potential, however, is considerable, and is likely to benefit us all in the future.
纳米技术是研究、生产和控制操纵粒径小于 100nm 的材料的科学。在这个尺度下，经典力学的规律不再适用，量子力学的规律开始起作用，导致物质在熔点、导电性和反应性方面呈现出独特的行为。此外，可能更为重要的是，随着粒径的减小，表面积与体积的比例急剧增加，使得植入物与周围细胞环境之间的相互作用增强。这种表面积的有利增加在间充质细胞分化中起着重要作用，并最终影响骨-植入物的相互作用。基础科学和转化研究揭示了纳米技术在骨科手术中的重要潜在应用，特别是在改善植入物与宿主骨之间的相互作用方面。纳米相材料更接近天然小梁骨的结构，从而大大提高了骨科植入物的骨整合性。纳米相涂层假体也比传统表面处理的假体更能减少细菌黏附。纳米相硒在肿瘤重建中显示出巨大的应用前景，纳米相银在创伤性伤口的处理中也有应用。纳米相银可能显著改善周围神经损伤的愈合，纳米相金对肌腱炎症有强大的抗炎作用。在批准纳米相器件临床应用之前，我们必须在其生产、植入和磨损模式的潜在健康风险方面取得相当大的进展。然而，它们的潜力是巨大的，未来很可能使我们所有人受益。
