Jazrawi L M, Kummer F J, DiCesare P E
Department of Orthopaedic Surgery, Hospital for Joint Diseases Orthopaedic Institute, New York, NY 10003, USA.
J Am Acad Orthop Surg. 1998 Jul-Aug;6(4):198-203. doi: 10.5435/00124635-199807000-00001.
The biologic response to polyethylene particulate debris generated from metal-on-polyethylene bearing surfaces is thought to be largely responsible for periprosthetic osteolysis and aseptic loosening in total joint arthroplasty. As a result, there has been an interest in developing polyethylene with improved wear characteristics, as well as a renewed interest in alternative bearing surfaces for total joint arthroplasty, including ceramic-polyethylene, metal-metal, and ceramic-ceramic articulations. These alternative surfaces have demonstrated less friction and lower wear rates than metal-on-polyethylene bearing surfaces in both clinical and laboratory experiments. Clinical results, although only short- to mid-term, have been encouraging. Alternative bearing surfaces, with lower wear rates and less particulate debris formation, may have the potential to improve total joint arthroplasty survivorship by decreasing periprosthetic osteolysis, especially in younger, high-demand patients.
金属对聚乙烯关节表面产生的聚乙烯颗粒碎片所引发的生物学反应，被认为在很大程度上是导致全关节置换术中假体周围骨溶解和无菌性松动的原因。因此，人们对开发具有更好磨损特性的聚乙烯产生了兴趣，同时也重新关注全关节置换术的替代关节表面，包括陶瓷对聚乙烯、金属对金属以及陶瓷对陶瓷关节。在临床和实验室实验中，这些替代表面均显示出比金属对聚乙烯关节表面更低的摩擦力和磨损率。临床结果虽然仅为短期至中期，但令人鼓舞。磨损率更低且颗粒碎片形成更少的替代关节表面，可能有潜力通过减少假体周围骨溶解来提高全关节置换术的生存率，尤其是在年轻、需求较高的患者中。
