The size and shape of particulate polyethylene wear debris in total joint replacements
The size and shape of particulate polyethylene wear debris in total joint replacements
复制标题
DOI：
10.1243/0954411971534638
复制
发表时间：
1997-01-01
期刊：
影响因子：
1.8
通讯作者：
Revell, PA
中科院分区：
文献类型：
--
作者：
Kobayashi, A;Bonfield, W;Revell, PA
磨损颗粒引起的骨溶解已被认为是全关节置换长期失败的主要原因之一。然而，目前人们对颗粒的确切性质知之甚少，因为颗粒太小，无法用光学显微镜来表征。本研究采用高效超速离心法从10例Freeman型符合型全膝关节置换术(TKRs)、3例Charnley全髋关节置换术(THR)和5例帝国理工学院/伦敦医院双杯表面型人工髋关节置换术无菌松动患者中提取超高相对分子质量聚乙烯(UHMWPE)颗粒，并用扫描电子显微镜进行表征。18例患者等效环直径(ECD)为0.40~1.15微米，平均+/-SE=0.70+/-0.05微米，中位数为0.67微米。长径比为1.50~2.04(平均+/-SE=1.75+/-0.04，中位数=1.73)，圆度为1.24~2.34(平均+/-SE=1.61+/-0.07，中位数=1.65)。颗粒数为5.2×10(8)~9.17×10(10)/g组织(平均+/-SE=1.42×10(10)+/-5.41×10(9)/g组织，中位数=7.04×10(9))。TKR组每克组织中的PE颗粒数显著高于THR组(中位数分别为1.04×10(10)/g组织和2.16×10(9)/g组织)。P=0.03，Mann-Whitney U检验)。胫骨PE组分的不稳定固定可能是大量PE颗粒在界面组织中积聚的原因。
Osteolysis induced by wear particles has been recognized as one of the major causes of long-term failure in total joint replacements. However, little is currently known about the exact nature of particles, as the particles are too small to be characterized by light microscopy. In this study, ultrahigh molecular weight polyethylene (UHMWPE) particles retrieved from ten cases (six cemented and four uncemented) for Freeman type conforming tibiofemoral total knee replacements (TKRs), three Charnley total hip replacements (THRs) and five Imperial College/London Hospital double cup surface hip replacements for aseptic loosening were extracted using a high-performance method with ultracentrifugation and characterized by scanning electron microscopy. The equivalent circle diameter (ECD) of all 18 cases ranged from 0.40 to 1.15 mu m (Mean +/- SE = 0.70 +/- 0.05 mu m, median = 0.67 mu m). The aspect ratio was 1.50 to 2.04 (Mean +/- SE = 1.75 +/- 0.04, median = 1.73), and roundness was 1.24 to 2.34 (Mean +/- SE = 1.61 +/- 0.07, median = 1.65). The numbers of particles were 5.2 x 10(8) to 9.17 x 10(10)/g tissue (Mean +/- SE = 1.42 x 10(10) +/- 5.41 x 10(9)/g tissue, median = 7.04 x 10(9)). The number of polyethylene (PE) particles/g tissue in TKRs was significantly larger than that in THRs (1.04 x 10(10)/g tissue and 2.16 x 10(9)/g tissue respectively, median. p = 0.03, Mann-Whitney U test). Unstable fixation of the tibial PE component might account for the accumulation of a large number of PE particles in the interface tissue.