Grieco Preston W, Pascal Scott, Newman Jared M, Shah Neil V, Stroud Sarah G, Sheth Neil P, Maheshwari Aditya V
Department of Orthopaedic Surgery, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA.
Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, 1 Cathcart 800 Spruce Street, Philadelphia, PA 19107, USA.
J Clin Orthop Trauma. 2018 Jan-Mar;9(1):7-16. doi: 10.1016/j.jcot.2017.10.013. Epub 2017 Oct 27.
As indications for total hip arthroplasty (THA) have expanded, the incidence of THA has increased among younger patients, who live longer and tend to place more strain on implants via higher activity levels. This demographical shift accentuates the importance of advancing innovation to ensure implant longevity for younger and more active patients. Future innovation, as it pertains to THA components, is likely to focus on modifying implant designs and tribology in conjunction with identification and application of newer biomaterials. By reviewing the literature for development status of various materials and novel design advancements in THA component outside of the standard highly cross-linked polyethylene, this investigation provided an update on the current and future status of design initiatives as they pertain to THA. Though the highlighted alternative bearing surfaces have shown promising and limited, yet encouraging clinical data, they lack larger and longer-term clinical trial results. Further research and innovation is warranted to identify the optimal bearing surface to most effectively accommodate for the trend of younger and more active patients undergoing THA. Implant longevity is crucial if the clinical success of THA is to be maintained.
随着全髋关节置换术(THA)的适应证不断扩大,THA在年轻患者中的发病率有所上升,这些患者寿命更长,且由于活动水平较高,往往会给植入物带来更大的压力。这种人口结构的变化凸显了推进创新以确保年轻且活动量更大的患者的植入物使用寿命的重要性。未来与THA组件相关的创新可能会集中在修改植入物设计和摩擦学,以及识别和应用新型生物材料上。通过回顾标准高度交联聚乙烯以外的各种材料的发展现状以及THA组件的新型设计进展的文献,本研究提供了与THA相关的设计举措的当前和未来状况的最新信息。尽管所强调的替代承重表面已显示出有前景且有限但令人鼓舞的临床数据,但它们缺乏更大规模和更长期的临床试验结果。有必要进行进一步的研究和创新,以确定最有效地适应年轻且活动量更大的患者接受THA这一趋势的最佳承重表面。如果要维持THA的临床成功,植入物的使用寿命至关重要。