大颗粒聚乙烯对人工关节假体周围组织影响的实验研究  

THE EFFECT OF ULTRA HIGH MOLECULAR WEIGHT POLYETHYLENE PARTICLE ON THE TISSUES OF JOINT PROSTHESIS

作　　者：卢伟杰[1] 廖威明[2] 余楠生[1] 罗新乐[1] 白波[1] 林志雄[1] 顾莹莹[3] 刘慕嫦[3] 陈国勤[3] 杨通[3] 

机构地区：[1]广州医学院第一附属医院骨科,广州510120 [2]中山大学第一附属医院骨科 [3]广州医学院第一附属医院病理科,广州510120

出　　处：《中国修复重建外科杂志》2005年第1期54-57,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的　制作松动人工关节的动物模型 ,了解大颗粒聚乙烯对实验动物人工关节假体周围骨组织的影响 ,并初步探讨其作用机制。　方法　选用健康新西兰白兔 2 0只 ,雌雄各半 ,体重 2 .3～ 2 .7kg。从两侧膝关节向股骨置入钴 -铬 -钼棒 ,分别于术后 2、4、6、8及 10周向一侧膝关节腔内注射聚乙烯微粒 (直径 10 0 μm)悬液 1.5 ml(实验侧 ) ,向另一侧膝关节腔内注射生理盐水 1.5 ml(对照侧 )。术后第 10周摄双下肢 X线片 ,了解假体周围是否有骨溶解和假体松动。术后第 12周处死动物。取 13只兔检查聚乙烯颗粒在关节囊分布情况 ,假体有否松动 ,周围有无新骨及界膜形成 ;取5只兔双侧股骨、膝关节囊作组织学检查 (实验过程中有 2只动物死亡 )。　结果　 1肉眼观察 :实验侧有 4侧金属假体被新生骨组织覆盖 ,9侧被纤维膜覆盖 ;对照侧有 11侧金属假体被新生骨组织覆盖 ,2侧被纤维膜覆盖 ,差异有统计学意义(P<0 .0 5 )。2 X线片观察 :假体位于股骨髓腔远端 ,其周围未见明显新生骨组织和骨溶解征像。3组织学观察 :实验侧关节囊见大量异物颗粒被成纤维细胞和多核巨细胞包绕 ,假体近端髓腔周围见成纤维细胞和纤维组织或新生骨组织形成 ,未见异物颗粒和多核巨细胞 。Objective To study the effect of the high molecular weight polyethylene on the periprosthetic tissue in vivo as to give some reference to treatment of loosening hip arthroplasty. Methods Every lower limb of 20 New Zealand white rabbits was implanted a Co Cr Mo plug in femur by intercondylar notch. 15 mg polyethylene particles, dispersed in 1.5 ml normal saline solution, were injected into one knee joint. The other knee joint was injected 1.5 ml normal saline solution as control. This procedure was repeated 2,4,6,8 and 10 weeks after the implantation. Both of two lower limbs were given a X ray examination 10 weeks to assess if there were periprosthetic osteolysis and loosening of the plugs. All animals were killed 2 weeks afer the last injection. The distribution of polyethylene in the knee joint capsule was examined to understand if there were loosening of implants or tissue change around implants. Knee joint capsule tissues and periprosthetic tissues were examed by optical microscope. Results Nine cases formed fibrous membrane and four cases formed new bone around prostheses in experiment group. Eleven cases formed new bone and two cases formed fibrous membrane in control group( P <0.05) The X ray results indicated that the plugs were in distal medulla of femur. There was no sign of priprosthetic osteolysis, implants loosening or new bone formation. Optical microscope study indicated that there were a lot of polyethylene particles inside the capsule. The polythlene particles were surrounded by multinucleated foreign body giant cells and fibrobast. In some cases, there were fibroblasts and fibrous tissue around plug. There were no polyethylene paticles and multinucleated foreign body giant cells around plug in the marrow. There were a lot of polyehtlene particles on the joint surface. The bone surface that contacted multinucleated foreign body giant cells was coarse. Conclusion Maximing ultra high molecular weight polyethylene can restrain rabbit periprosthetic bone formation

关 键 词：假体 骨组织 新生骨 多核巨细胞 异物 人工关节 股骨 实验动物 成纤维细胞 关节面 

分 类 号：R318.1[医药卫生—生物医学工程]