摘要
目的：观察磨屑在动物体内引起的组织学反应，比较不同磨屑所致反应差别；比较磨屑在羟基磷灰石涂层钛合金棒－骨界面和光滑钛合金棒－骨界面间移动差别，探讨人工关节无菌性松动机制。方法：６４只家兔分为８组（ｎ＝８），分别将羟基磷灰石涂层钛合金棒和光滑钛合金棒经膝关节置入股骨远端，定期膝关节注入聚乙烯、钛合金及两者的混合磨屑。光镜、偏振光显微镜和电镜观察关节滑膜、两种钛合金棒－骨界面的组织学和超微结构。结果：滑膜下致密纤维组织中弥漫浸润的巨噬细胞和异物巨细胞内有大量磨屑。两种钛合金棒－骨界面间无磨屑和炎性细胞浸润，各组骨结合率和纤维组织结合率差异无显著性意义（Ｐ＞０．０５）。结论：二种磨屑均可引起相似的组织学反应；磨屑量增加，组织反应程度加重。磨屑不能在稳定的羟基磷灰石涂层钛合金棒和光滑钛合金棒－骨界面间移动。确保假体早期稳定，消除微动是防止人工关节无菌性松动的首要条件。
Purpose:Observe the histological response to wear debris in animalsin vivo,compare the difference of histological response resulted from various kinds of wear debris.and decide the difference of the migration of wear debris between theinterfaces between the bone and the types of titanium alloy plugs in an attempt to illustrate the mechanisms of aseptic loosening of prostheses.Methods:Sixty-four rabbits were divided randomly into 8 groups,each containing 8 rabbits,HA coated and smooth titanium alloy plugs were inserted into the distal femur through the knee and the wear debris of polyethylene,titanium alloy and the mixture of both were in jected.Synovial and the inter facemem branes between the bone and HA coated or smooth titanium alloy plug underwent histological examinations by light,electronic and polarized light microscopes.Results:In the dense fibrous connective tissues,there are infiltration of macrophages and foreign-body giant cells with plenty of wear debris.Most part of the surface around the two kinds of titanium alloy plugs was covered with osseous tissue.There was no infiltration of inflammatory cells and no wear debris in the interfaces between the titanium alloy plug and bone,and no hyperplasia of osteoclasts and no resorption of bonein the bonesur facearound the titanium plug.Combining rate of bone or fibrous tissues with the titanium alloy plug,showed no difference among the 8 groups,Conclusions:Two kinds of wear debris could cause similar histological responses,and the greater amount of the wear debris,the worse the foreign-body reaction in the synovial.There was no migration of wear debris at the interface between the bone and the stable,non-weight-bearing,HA coated or smooth titanium alloy plug.Assurance of the primary stability of prostheses and elimination of micromobiliazation are prerequisites to prevent aseptic loosening of prostheses.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1998年第10期606-609,I002,共5页
Chinese Journal of Orthopaedics
