Shanbhag A S, Jacobs J J, Black J, Galante J O, Glant T T
Department of Orthopaedic Surgery, Rush Arthritis and Orthopedics Institute, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612, USA.
Clin Orthop Relat Res. 1997 Sep(342):205-17.
An in vitro study was conducted to determine the ability of particle challenged human peripheral monocytes to modulate fibroblast proliferation and bone resorption. The effects of commercially pure titanium, titanium-aluminum-vanadium, and ultrahigh molecular weight polyethylene wear debris, either fabricated or retrieved from patients with failed total hip arthroplasties, were examined as a function of the composition, size, and dose of particles. In vitro generated particles were selected to be matched closely in particle size distribution to that found in vivo. Dosages were controlled by standardizing the ratio of particle surface area to mean monocyte surface area. The results support the hypothesis that, in vitro, challenge of monocytes by particulate wear debris results in a biphasic dose response. For the metal particles, fibrogenesis was observed over the range of 1x to 10x surface area ratio (the surface area of particles to the surface area of cells), although for metallic and polyethylene particles, saturated doses of 10x surface area ratio were required to stimulate bone resorption. In addition, metallic particles were able to stimulate fibrogenesis at doses at which simulated and retrieved polyethylene were ineffective. Although there may be a nonosteolytic chronically tolerable annual dose of ultrahigh molecular weight polyethylene wear debris corresponding to approximately 1x surface area ratio, lower doses, especially of metallic debris, may produce reactive fibroblast proliferation and fibroplasia that may contribute to implant loosening and failure.
进行了一项体外研究，以确定受颗粒刺激的人外周单核细胞调节成纤维细胞增殖和骨吸收的能力。研究了商业纯钛、钛铝钒和超高分子量聚乙烯磨损颗粒（无论是制造的还是从全髋关节置换失败患者体内取出的）对颗粒组成、大小和剂量的影响。体外生成的颗粒在粒度分布上被选择为与体内发现的颗粒紧密匹配。通过标准化颗粒表面积与单核细胞平均表面积的比例来控制剂量。结果支持这样的假设，即在体外，颗粒磨损碎片对单核细胞的刺激会导致双相剂量反应。对于金属颗粒，在1倍至10倍表面积比（颗粒表面积与细胞表面积之比）范围内观察到纤维生成，尽管对于金属和聚乙烯颗粒，需要10倍表面积比的饱和剂量来刺激骨吸收。此外，金属颗粒能够在模拟的和取出的聚乙烯无效的剂量下刺激纤维生成。虽然可能存在对应于约1倍表面积比的超高分子量聚乙烯磨损颗粒的非骨溶解慢性可耐受年剂量，但较低剂量，尤其是金属碎片剂量，可能会产生反应性成纤维细胞增殖和纤维增生，这可能导致植入物松动和失败。
