CONFERENCE--JOINT IMPLANT WEAR PROBLEMS 2000

全关节置换术是一种有效的治疗方法，可以减轻疼痛，恢复功能的患者的疾病或损坏的关节。 仅在美国，每年就有数十万例全关节置换术植入，随着人口继续老龄化以及关节置换术的适应症扩展到年轻患者，这些数字将增加。尽管临床上取得了成功，但许多患者需要痛苦且昂贵的翻修手术，因为他们的关节置换物继发于植入物磨损和相关的骨质溶解而松动。 形成关节植入物的人造材料的表面磨损现在被认为是长期成功的主要障碍，并且已经成为大量研究的焦点，这些研究旨在了解影响磨损过程的临床、生物、工程和材料因素。 基于这些因素的研究问题形成了1995年NIH/AAOS研讨会的议程，临床医生，生物学家，工程师和材料科学家参加了研究磨损问题。 在随后的几年中，临床关注有所增加，但幸运的是，在理解该问题的临床影响、对磨损碎屑的生物反应以及控制磨损力学的设计和材料因素方面取得了重要进展。鉴于这些发现，后续研讨会提出的目标：定义当前的研究知识基础上的磨损问题;解决干预和预防策略，涉及生物，生物力学和生物材料的解决方案;吸引新的研究人员研究磨损问题;和起草一个会议记录，快速和广泛传播研讨会的结果在互联网上。 重点将是审查什么是已知的种植体磨损，确定哪些重要方面仍然未知，并确定未来的研究方向。

Total joint arthroplasty is an effective treatment for relieving pain and restoring function for patients with diseased or damaged joints. Hundreds of thousands of total joint replacements are implanted each year in the United States alone, and these numbers will increase as the population continues to age and as the indications for joint arthroplasty extend to younger patients. Despite this clinical success, many patients require painful and costly revision surgery because their joint replacements loosen secondary to implant wear and the associated osteolysis. Wear of the surfaces of the man-made materials that form the joint implant is now recognized as the major obstacle to long-term success and has been the focus of considerable research aimed at understanding the clinical, biological, engineering and materials factors that influence the wear process. Research questions based on these factors formed the agenda of a 1995 NIH/AAOS workshop attended by clinicians, biologists, engineers, and materials scientists studying the wear problem. In the ensuing few years, clinical concern has grown, but fortunately has been accompanied by important advances in understanding the clinical impact of the problem, the biological reaction to wear debris, and design and material factors that control mechanics of wear. Given these discoveries, a follow-up workshop is proposed with the goals of: defining the current research knowledge base on the wear problem; addressing intervention and prevention strategies involving biological, biomechanical, and biomaterials solutions; attracting new investigators to research the wear issue; and drafting a proceedings for rapid and widespread dissemination of workshop findings on the internet. The emphasis will be on reviewing what is known about implant wear, defining what important aspects remain unknown, and identifying future research directions.