tailieunhanh - Vật liệu cấy ghép

Trong suy thoái cơ thể của vật liệu cấy ghép bộ phận giả ngày càng được công nhận là một nhân tố chính hạn chế độ bền của arthroplasty doanh tổng. Trong cơ thể suy thoái xảy ra chủ yếu bằng phương tiện của quá trình mài mòn có thể tạo ra số lượng lớn các mảnh vỡ hạt. | Wear Debris in Total Joint Replacements Joshua J. Jacobs MD Arun Shanbhag PhD Tibor T. Glant MD PhD Jonathan Black PhD and Jorge O. Galante MD Abstract In vivo degradation of prosthetic implant materials is increasingly recognized as a major factor limiting the durability of total joint arthroplasty. In vivo degradation occurs primarily by means of wear processes that can generate large quantities of particulate debris. This debris can stimulate an adverse local host response leading to periprosthetic bone loss which can compromise implant fixation and bone stock. The authors review the basic mechanisms of implant degradation and the host response to particulate degradation products particularly in the context of the pathogenesis of osteolysis. Submicron polyethylene particles mean size pm are the dominant type of wear particle present in periprosthetic tissues associated with uncemented hip replacements. Polyethylene wear can be minimized by improving the quality of the polyethylene avoiding use of large-diameter greater than 28 mm femoral heads in total hip arthroplasty and improving the design and fabrication of modular connections which can be important sources of three-body wear particles. Advances in the understanding of the basic mechanisms of osteolysis are critical to the development of preventive measures that will minimize the clinical impact of this phenomenon. J Am Acad Orthop Surg 1994 2 212-220 progress in understanding the tissue reaction to wear debris with regard to physical and biologic mechanisms clinical ramifications of wear debris-tissue interactions and current strategies to minimize the clinical impact of wear. Mechanisms of Debris Generation In broad terms the generation of debris from implanted materials can be conceptualized as occurring from two independent though not mutually exclusive processes wear and corrosion. Wear involves the loss of Wear debris its generation and the subsequent tissue reaction to it has emerged as a central

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