Analysis of bone remodeling of impacted morselized chipped bone and its biological background for restoration of failed total hip arthroplasty with osteolysis.

冲击性颗粒碎骨的骨重塑分析及其对骨溶解失败的全髋关节置换术修复的生物学背景。

• 批准号: 12470300
• 负责人: TAKAGI Michiaki
• 金额: $ 7.81万
• 依托单位: Yamagata University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2003
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-12470300/
• 关键词: Total Hip Joint; Biocompatibility; Osteolysis; Loosening; Allograft bone; Impaction bone grafting; 人工関節; メカニカルストレス; 再造形; 骨吸収; 骨形成; 骨移植

To analyze bone remodeling of heated morselized allobone chips and cellular host reaction between periprosthetic bone and total hip prosthesis implant) pathologic, biomaterial, and clinical analysis were analyzed.1.Analysis of pathologic and material features.In loose total hip joints, imbalance of MMPs (MMP-1, MMP-2, MMP-3, MMP-9, MMP-13, and MMP-14) and TIMPs (TIMP 1, TIMP-2, and TIMP-3) in the tissue around loose implants was abserved. This reaction seemed to be related to pathologic increased expression of EMMPRIN, fibronectin, laminin, and PGP 9.5, which are suggested to enhance MMP production in-situ. In joint fluid retrieved from loose hip prosthesis, increased level of MMPs (MMP-1, MMP-2, MMP-3, and MMP-9)) and TIMPs (TIMP-1 and TIMP-2) was found. As well, osteolytic cytokine, IL-I beta, IL-6, and M-CSF were found to be increase as local host response to implant and their debris. Osteolytic potential was confirmed by addition of the fluid to mouse bone marrow cells, which induc … More ed marked osteoclast formation and it was inhibited by addition of osteoprotegerin. Periprosthetic bone analysis revealed that high turnover bone remodeling with fragile bone quality. Process of bone resorption was dependent both on osteoclatic and non-osteoclastic mechanism. In non-osteoclastic mechanism, acidic pH and macrophage played major role in the process. The study also showed active involvement of mechanical stress in periprosthetic bone remodeling. Micromotion combined with inflammatory mediators seemed to enhance bone remodeling process. This pathologic condition was also considered to relate to periprothetic bone remodeling after heated morselized bone chip grafting by impaction methods. In-vitro analysis of osteoblast, mechanical stretch can produce mRNA of COX-2、MMP-1、and MMP-3, transiently, after stimuli. MMP-1 and its activator MMP-3 were potent candidate of bone remodeling factors of osteoblast in mechanical stress. The process of bone remodeling was also affected by the property of materials. Stainless steel, cobalt-chromium alloy, and titanium alloy were major materials for femoral implants. Ultra-high density polyethylene, almina/zirconia ceramics, stainless steel, and cobalt-chromium alloy have been used as gliding surface. Polymethylmethacrylate and porus coating techniques have been used between bone and implants. The properties of the materials and its behaviors in each interface were suggested to be analyzed in future in point of better understanding of periprosthetic bone remodeling after morselized allo-bone grafting by impaction methods.2.Clinical analysis of the fate of heated morselized allo-bone chips after impaction technique. Clinical evaluation of periprosthetic bone remodeling and implant survival was performed. Heated morselized allo-bone chips, 2-3 mm, in diameter, after impaction technique showed favorable bone remodeling and revised THA implants functioned well. In acetabular area, rein force devidce, Kerboull and KT plate systems were so effective that they support the impacted bones and transfer, mechanical stress properly to the bone, which induced good bone remodeling in the area. In femoral side reconstruction, firm impactions and appropriate alignment technique of the stem were the decisive factor to obtain better tissue regeneration. Thus, heated morselized allo-bone chips after impaction technique revealed good biocompatibility and contribute to reconstruction of loose total hip joint with massive osteolysis, when proper support system were used in the procedure. Less

To analyze bone remodeling of heated morselized allobone chips and cellular host reaction between periprosthesis implant) pathologic, biomaterial, and clinical analysis were analyzed.1.Analysis of pathologic and material features.In loose total hip joints, imbalance of MMPs (MMP-1, MMP-2, MMP-3, MMP-9, MMP-13, and MMP-14) and不存在在螺丝螺丝周围的组织中的TIMP（TIMP 1，TIMP-2和TIMP-3）。该反应似乎与EMMPRIN，纤连蛋白，层粘连蛋白和PGP 9.5的病理表达增加有关，这些反应建议在原位增强MMP产生。在从松散的假体检测到的关节流体中，发现了MMPS（MMP-1，MMP-2，MMP-3和MMP-9））和TIMP（TIMP-1和TIMP-2）的水平。同样，发现骨化细胞因子，IL-Iβ，IL-6和M-CSF随着局部宿主对植入物及其碎屑的反应而增加。通过向小鼠骨髓细胞中添加液体来证实骨质的潜能，这会诱导……更明显的破骨细胞形成，并通过添加骨蛋白蛋白蛋白抑制。周围的骨分析表明，较高的离心率骨重塑，骨质脆弱。骨骼的过程既取决于破骨斜角和非骨化的机制。在非骨碎屑机制中，酸性pH和巨噬细胞在此过程中起着重要作用。该研究还显示，机械应力在人身修饰周围的活动中有效参与。炎症介质结合使用微动物似乎可以增强骨重塑过程。该病理状况也被认为与通过撞击方法加热骨骼骨芯片后的骨膜骨重塑有关。在刺激后，机械拉伸对成骨细胞的体外分析可以产生Cox-2，MMP-1和MMP-3的mRNA。 MMP-1及其活化剂MMP-3是机械应力中成骨细胞骨重塑因子的潜在候选者。骨骼重塑的过程也受材料特性的影响。不锈钢，钴铬合金和钛合金是股骨的主要材料。超高密度聚乙烯，almina/氧化锆陶瓷，不锈钢和钴铬合金已被用作滑翔表面。多甲基丙烯酸酯和孔涂层技术已在骨头和骨架之间使用。建议将来对材料的特性及其行为在将来进行分析，以更好地理解通过撞击方法使异质骨嫁接后对周围的骨骼重塑进行更好的理解。2.2.在冲动技术之后，对加热的重量混乱的异质芯片的命运进行了分析。进行周围骨重塑和植入物存活的临床评估。撞击技术表现出良好的骨重塑，并修订了tha tha tha tha tha tha tha的功能很好地发挥作用。在髋臼区域，re绳装置，kerboull和KT板系统非常有效，以至于它们支持受影响的骨骼和转移，机械应力正常向骨骼，这会诱导该区域的良好骨重塑。股骨侧重建，企业影响和茎的适当比对技术是获得更好组织再生的决定性因素。这是在撞击技术之后加热的染色的异骨芯片，显示出良好的生物相容性，并在过程中使用了适当的支持系统时，有助于重建松散的总髋关节，并进行大量的骨溶解。较少的

项目成果

Takagi M: "Bone-Implant Interface Biology. -Foreign Body Reaction and Periprosthetic Osteolysis in Artificial Hip Joints -(review)."Journal of Clinical and Experimental Haematology. 41. 81-87 (2001)

Takagi M：“骨-植入物界面生物学。-人工髋关节中的异物反应和假体周围骨质溶解-（评论）。”临床与实验血液学杂志。

Takagi M: "Materials of total hip joints and biological host reaction. -cellular and tissue reaction to polyethylene particles."Joint Surgery(in Japanese). 22. 565-576 (2003)

Takagi M：“全髋关节材料和生物宿主反应。-聚乙烯颗粒的细胞和组织反应。”关节外科（日语）。

小林真司他: "関節リウマチに対するKTプレートを用いた人工股関節全置換術の小経験"整形外科. 53. 1429-1433 (2002)

Shinji Kobayashi 等人：“使用 KT 板治疗类风湿性关节炎的全髋关节置换术的短期经验”骨科 53. 1429-1433 (2002)

Ishii M, Hamasaki M, Kawaji H, Ida H, Takagi M, Kobayashi S, Yamakawa M, Sato T, Nitta T: "Clinical short rime result of AWGC acetabular spacer in total hip joint"Japanese Journal of Arthroplasty(in Japanese). 30. 231-232 (2000)

Ishii M、Hamasaki M、Kawaji H、Ida H、Takagi M、Kobayashi S、Yamakawa M、Sato T、Nitta T：“全髋关节 AWGC 髋臼间隔器的临床短期结果”日本关节成形术杂志（日语）。

Ishii M, Kawaji H, Hamasaki M, Ida H, Takagi M, Kobayashi S: "Surgical timing of femoral side reconstruction in loose total hip joint with impaction bone grafting technique."Bone Joint Ligament(in Japanese). 14. 75-80 (2001)

Ishii M、Kawaji H、Hamasaki M、Ida H、Takagi M、Kobayashi S：“采用压入骨移植技术进行松散全髋关节股骨侧重建的手术时机。”骨关节韧带（日语）。