摘要
人工关节置换术和椎间盘置换术是目前治疗严重关节类疾病和椎间盘疾病的重要手段。人工关节和人工椎间盘在体内服役时,摩擦配副(关节头-关节臼、髓核-终板)需要往复运动数千万次,磨损产生的磨屑和腐蚀释放的有毒金属离子会导致关节假体松动、椎间盘假体下沉等临床并发症的发生。为了提高关节假体和椎间盘假体的耐磨损性能和耐腐蚀性能,研究者们采用等离子体表面改性技术在假体表面制备生物相容性好的陶瓷薄膜,希望显著延长关节和椎间盘假体寿命。文中综述了等离子体表面改性技术在提高人工关节、人工椎间盘耐磨损、耐腐蚀性能中的应用及存在的问题,总结了人工关节表面薄膜失效的主要机制,最后结合人工关节和人工椎间盘体内服役的特点,提出制备具有"体内磨损自修复功能"的薄膜来达到显著增加薄膜耐腐蚀、耐磨损性能的目的,从而延长活动金属植入假体在患者体内的服役寿命。当具有"体内磨损自修复功能"的薄膜改性假体在体内服役时,初始阶段的摩擦磨损会释放金属离子,从而促进生理介质中蛋白质等有机成分在磨痕表面沉积,在摩擦界面形成一层蛋白生物膜,这层蛋白生物膜在剪切力和金属离子催化作用下转变成为"类石墨碳润滑膜",能够对磨痕进行修复和润滑,增加假体的耐磨损特性。
Total joint replacement(TJR) and total disc replacement(TDR) are widely used for the treatment of joint disease and spine disease in clinic, respectively. The tribo-pairs of artificial joint(ball-socket) and disc(nucleus-end plate) would repeat the circulating friction more than ten million cycles when serving in the body of the patients. The wear debris produced by the friction between the tribo-pairs and the metal ions released from the corrosion of prosthesis will cause many complications, such as aseptic loosing, disc subsidence. In order to prolong the lifespan of the artificial joint and spine, many types of ceramic films, prepared by plasma technology with good biocompatibility, have been used to enhance the corrosion and wear resistance of artificial joints and discs. The application and disadvantages of plasma surface modification on artificial joint and disc were introduced. The failure mechanism of ceramic film on the artificial joint surface was summarized.Concerning the service environment of the artificial discs and joints, we proposed to deposite the "friction induced self-healing film" on the surface of tribo-pairs to prolong the lifespan of the artificial joint and disc in the body of patients. When the "friction induced self-healing film" modified artificial discs or joints serving in human body, the wear between the tribo-pairs can release the metal ions from the films. The metal ions would bond with the proteins in the body fluid and promote the formation of protein-biofilm on the surface of the wear interface. This protein-biofilm could prevent body fluid permeate from defects to corrode the interface of the film and substrate. Meanwhile, the protein-biofilm would transform to be graphite-like carbon film by the synergism of the shear force between the tribo-pairs and the catalytic abilities of metal ions. This graphitelike carbon film can heal and lubricate the friction interface. As a result, the wear resistance of the film will be enhanced and the lifetime of the artificial discs and joints will be prolonged.
作者
邓乔元
李延涛
经佩佩
龚艳丽
黄楠
冷永祥
DENG Qiaoyuan;LI Yantao;JING Peipei;GONG Yanli;HUANG Nan;LENG Yongxiang(School of Materials Science and Engineering,Southwest Jiaotong University,Chengdu 610031,China)
出处
《中国表面工程》
EI
CAS
CSCD
北大核心
2019年第5期1-12,共12页
China Surface Engineering
基金
国家自然科学基金(31570958)~~
