A study for mechanism and treatment of aseptic loosening in total hip arthroplasty -Biclogical activity of wear particles, pathoicgical role of parathyroid hormone related peptide (PTHrP) and the therapeutical effect of bisphospham

全髋关节置换术中无菌性松动的机制及治疗研究——磨损颗粒的生物活性、甲状旁腺激素相关肽（PTHrP）的病理作用及双磷酰胺的治疗作用

• 批准号: 09671488
• 负责人: IDA Hirokazu
• 金额: $ 2.3万
• 依托单位: KYOTO UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09671488/
• 关键词: PTHrP; total hip arthroplasty; osteolysis; aseptic loosening; polyethylene; particles wear; aseptic looseuing

Our first year study revealed that PTHrP in joint fluid taken during revision total hip arthroplasty was concentrated ten or hundred times higher than that in normal serum and that the pseudmenbranous tissue, which have potential role for bone absorption, was stained positive by anti-PTHrP antibody. Because PTHrP has promoting function for bone absorption, it is strongly suspected that PTHrP relates to the loosening and associated osteolysis of total hip arthroplasty. Based on the results of this study, we have planned the second year experiment to investigate factors that introduce PHTrP. Although many factors are considered to be related to osteolysis associated with the loosening of total hip arthroplasty, polyethylene particle is pointed out to be the most important factor. Therefore, we have decided to investigate from this aspect. Because it was pointed out that the property of the wear particles of total hip articulation is different from that of the industrially crushed particl … More es, we made a plan of experiment using wear particles produced in the total hip articulation, and tried to extract polyethylene particles from psudomenbranous tissue. After trying various methods of extraction, the method described below was revealed to be the most practical and simple. The tissue was soaked in Xylene to solve PMMA and then soaked in HNOィイD23ィエD2 and HCL solution. The solution was neutralized by buffer. Polyethylene particles were gathered by filter. There were two types of polyethylene particles in the tissue by SEM analysis. The first type is a fibril like shape with the length of 5.3 micron in the average and the second type is a spherical shape with the diameter of 0.2 micron in the average. Although we were going to investigate whether macrophages, which had phagocytized these polyethylene particles, were stimulated and produced PTHrP, adequate amount of sample had not been collected because of the low incidence of revision arthroplasty. We are now collecting samples for investigation. Less

我们第一年的研究显示，PTHrP在翻修全髋关节置换术中的关节液中的浓度比正常血清高10倍或100倍，并且具有潜在骨吸收作用的假膜组织被抗PTHrP抗体染色阳性。由于PTHrP具有促进骨吸收的作用，因此，人们强烈怀疑PTHrP与全髋关节置换术后的松动和骨溶解有关。根据这项研究的结果，我们计划了第二年的实验，以调查引入PHTrP的因素。尽管许多因素被认为与全髋关节置换术后松动相关的骨溶解有关，但聚乙烯颗粒被指出是最重要的因素。因此，我们决定从这方面进行调查。由于人工全髋关节磨损颗粒的性质不同于工业粉碎颗粒， ...更多信息 因此，我们利用全髋关节内产生的磨损颗粒制定了一项实验计划，并试图从假膜组织中提取聚乙烯颗粒。在尝试了各种提取方法之后，下面介绍的方法被发现是最实用和简单的。将组织浸泡在二甲苯中以溶解PMMA，然后浸泡在HNO 3-D23-D2和HCL溶液中。用缓冲液中和溶液。通过过滤器收集聚乙烯颗粒。通过SEM分析，组织中有两种类型的聚乙烯颗粒。第一类是平均长度为5.3微米的纤维状形状，第二类是平均直径为0.2微米的球形形状。尽管我们打算研究吞噬这些聚乙烯颗粒的巨噬细胞是否受到刺激并产生PTHrP，但由于翻修型关节置换术的发生率较低，因此没有收集足够量的样本。我们现正收集样本进行调查。少

项目成果

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K.Kawanabe：“A-W 玻璃陶瓷作为骨水泥髋关节置换术中的骨替代品”Acta.Orthop.Scand。

Onishi,E.: "Severe metallosis caused by shaving down of the stem neck due to outer cup impingement of a bipolar endoprosthesis,Acase report" Bulletin Hosptial for Joint Diseases. 56(4). 231-217 (1997)

Onishi,E.：“由于双极内置假体的外杯撞击而导致茎颈削薄而导致严重金属沉积，案例报告”关节疾病医院通报。

H.Iida,E.Kaneda: "Metallosis Due to Impingement Between the Socket and the Femoral Neck in a Metal-on-Metal Bearing Total Hip Prosthesis"JBJS. 81-A(3). 814-820 (1999)

H.Iida，E.Kaneda：“金属对金属轴承全髋关节假体中因承窝和股骨颈之间撞击而引起的金属变性”JBJS。

H.Fujita, H.Iida: "Pressurization of Bioactive Bone Cement In vitro"J.Biomed Mater Res. 48. 43-51 (1999)

H.Fujita，H.Iida：“体外生物活性骨水泥的加压”J.Biomed Mater Res。

飯田寛和: "アルミナ製骨頭はポリエチレンソケットの摩耗の減少に役立つか" 整形外科. 48(8). 1003-1008 (1997)

Hirokazu Iida：“氧化铝股骨头可以帮助减少聚乙烯关节窝的磨损吗？”48(8) (1997)。