Osteoconductive coatings for total joint arthroplasty
Osteoconductive coatings for total joint arthroplasty
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DOI：
10.1097/00003086-200202000-00007
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发表时间：
2002-02-01
影响因子：
4.2
通讯作者：
Geesink, RGT
中科院分区：
文献类型：
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作者：
Geesink, RGT
用于全关节置换术的骨传导磷酸钙涂层自 20 世纪 80 年代中期以来已投入临床使用。研究了骨传导涂层功效的基本原理和基础科学证据。与多孔涂层植入物表面相比，羟基磷灰石涂层可在手术后为非骨水泥关节部件周围的间隙和空间提供一致且更好的骨填充，从而实现更好的植入物稳定性。在所有磷酸钙涂层中，羟基磷灰石涂层在髋关节置换术中应用最广泛。与更传统的植入物表面相比，它们的临床优势在初次和翻修髋关节置换术中显而易见。在作者的系列研究中，对年轻活跃患者群体（平均年龄 53 岁）的股骨部件进行至少 11 年的随访，获得了 97% 的临床存活率，且没有发生机械故障。该组的平均聚乙烯磨损率为 0.129 毫米/年。在一组类似的年轻患者中，使用羟基磷灰石涂层股骨部件进行翻修关节成形术，获得了 93% 的 11 年生存率。对尸检时取出的标本进行组织学分析证实了组件的良好骨固定。研究了最新的仿生羟基磷灰石涂层的优点。
Osteoconductive calcium phosphate coatings for total joint arthroplasty have been in clinical use since the mid1980s. The basic principles involved and basic science evidence for the efficacy of osteoconductive coatings were examined. Hydroxyapatite coatings provide consistent and better filling with bone of the gaps and spaces around cementless joint components after surgery as compared with porous-coated implant surfaces, resulting in better implant stability. Of all the calcium phosphate coatings, hydroxyapatite coatings have had the most widespread application in hip arthroplasty. Their clinical advantages over more conventional implant surfaces are evident in primary and revision hip arthroplasties. A clinical survival rate in the author's series of 97 % at a minimum of 11 years followup for the femoral component in a young active patient population (average age, 53 years) was obtained with no mechanical failures. The average polyethylene wear rate in this group was 0.129 mm/year. In a similar group of young patients with revision arthroplasty using hydroxyapatite-coated femoral components, an 11-year survival rate of 93 % was obtained. Histologic analysis of specimens retrieved at autopsy confirmed the excellent bony fixation of components. Advantages of the more recent biomimetic hydroxyapatite coatings were examined.