Abstract:
More than 300,000 total hip replacement surgeries are performed in the United States each year to treat degenerative joint diseases that cause pain and disability. The statistical survivorship of these implants declines significantly after 15-25 years of use because wear debris causes inflammation, osteolysis, and mechanical instability of the implant. This limited longevity has unacceptable consequences, such as revision surgery to replace a worn implant, or surgery postponement, which leaves the patient in pain. Innovations such as highly cross-linked polyethylene and new materials and coatings for the femoral head have reduced wear significantly, but longevity remains an imminent problem. Another method to reduce wear is to add a patterned microtexture composed of micro-sized texture features to the smooth bearing surfaces. We critically review the literature on textured orthopedic biomaterial surfaces in the context of prosthetic hip implants. We discuss the different functions of texture features by highlighting experimental and simulated results documented by research groups active in this area. We also discuss and compare different manufacturing techniques to create texture features on orthopedic biomaterial surfaces and emphasize the key difficulties that must be overcome to produce textured prosthetic hip implants.
摘要:
在美国,每年进行超过300,000的全髋关节置换手术,以治疗引起疼痛和残疾的退行性关节疾病。这些植入物的统计存活率在使用15-25年后显著下降,因为磨损碎片会导致炎症,骨质溶解,和植入物的机械不稳定性。这种有限的寿命会带来不可接受的后果,例如翻修手术以替换磨损的植入物,或者手术推迟,这让病人很痛苦.高交联聚乙烯和股骨头新材料和涂层等创新技术大大降低了磨损,但是长寿仍然是一个迫在眉睫的问题。减少磨损的另一种方法是将由微尺寸纹理特征组成的图案化微纹理添加到光滑轴承表面。我们在假体髋关节植入物的背景下批判性地回顾了有关纹理化骨科生物材料表面的文献。我们通过突出显示活跃在该领域的研究小组记录的实验和模拟结果来讨论纹理特征的不同功能。我们还讨论和比较了不同的制造技术,以在骨科生物材料表面上创建纹理特征,并强调了生产纹理假体髋关节植入物必须克服的关键问题。