زیست‌ماده‌های مورد استفاده در پروتز مفصل ران – به روز رسانی فنی (مقاله مروری)

صادق آبادی, اصغر; حسن زاده نعمتی, ناهید; واعظی, محمد رضا; خراسانی, محمد تقی

doi:10.22034/ijos.2022.322682.1017

زیست‌ماده‌های مورد استفاده در پروتز مفصل ران – به روز رسانی فنی (مقاله مروری)

نوع مقاله : مروری

نویسندگان

اصغر صادق آبادی ¹

ناهید حسن زاده نعمتی ²

محمد رضا واعظی ³

محمد تقی خراسانی ⁴

¹ گروه مهندسی پزشکی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران. ایران.

² دستیار. گروه مهندسی پزشکی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران. ایران.

³ دانشیار، گروه نانو و مواد پیشرفته، پژوهشگاه مواد و انرژی، تهران ، ایران.

⁴ دانشیار، گروه پلیمر، پژوهشگاه پلیمر و پتروشیمی، تهران، ایران.

https://doi.org/10.22034/ijos.2022.322682.1017

چکیده

زمینه: تعویض کلی مفصل ران، THA (Total Hip Arthroplasty) یکی از موفق‌ترین جراحی‌های انجام شده در تاریخ پزشکی است. تعویض مفصل ران با استفاده از مفصل مصنوعی با اصطکاک کم (Low-Friction Arthroplasty)، توسط سر جان چارنلی (Sir John Charnley) در دهة 1960 آغاز شد. پس از آن، مواد لغزشی (Bearing surfaces)، روش‌های تثبیت و طراحی‌های جدید، بهبود یافتند و اصلاح شدند. نگرانی اصلی در مورد THA، پاسخ بیولوژیکی به ذرات تولید شده توسط سطوح لغزشی است که منجر به تخریب استخوان (Osteolysis) و از دست رفتن پروتز می‌شود. برای حل این مشکل، زیست‌ماده‌های مدرن THA توسعه یافتند.
روش‌ها: جستجوی نشریات با به کارگیری کلید واژه‌های مختلف انجام شد. مقاله‌ها و گزارش‌های فنی با بالاترین کیفیت که شامل بهترین و جدیدترین مطالب مرتبط بودند انتخاب شدند. کلیدواژه‌های جستجو شامل پروتز ران، زیست‌ماده، سایش، تیتانیم، زیرکونیا، آلومینا، UHMWPE
(Ultra-High-Molecular-Weight-Polyethylene) و کبالت-کروم بودند. در نهایت 69 منبع انتخاب و در این تحقیق از آنها استفاده شد.
نتایج: مطالعه انجام شده نشان می‌دهد که پیشرفت‌های اخیر در حوزة پروتزهای ران بر روی استحکام مکانیکی، زیست‌سازگاری، زیست‌فعالی، افزایش مقاومت سایشی و قابلیت اطمینان با استفاده از فن‌آوری‌های جدید و اصلاح ساختار و هیبرید کردن با فن‌آوری نانو، متمرکز شده‌اند. طراحی‌های هیبریدی در نانو سرامیک‌ها باعث افزایش مقاومت تا 4 برابر آلومینا شده است به طوری که امکان طراحی سر فمورال کوچک‌تر را فراهم می‌کند. به دلیل افزایش بیماران جوانی که نیازمند تعویض مفصل ران هستند و سطح فعالیت بالاتر این بیماران، به ثبات و عمر طولانی‌تر و قابلیت اطمینان بیشتر پروتز نیاز است که این فقط با روش‌های علمی و مواد جدید بهبود یافته قابل دستیابی می‌باشد.
نتیجه‌گیری: در این مقاله زیست‌ماده‌های به کار رفته در پروتز مفصل ران به خوبی معرفی شده و از جنبه های مختلف مورد بحث قرار گرفته‌اند. همچنین زیست‌ماده‌های پیشرفته‌تر برای THA که ممکن است در آینده باعث کاهش بیشتر سایش شوند و عمر پروتز را افزایش دهند بررسی شده‌اند.

کلیدواژه‌ها

آلومینا

پروتز مفصل ران

زیست‌ماده

تعویض کل مفصل ران

سرامیک‌ها

عنوان مقاله English

Hip Arthroplasty Biomaterials – A Technical Update (A review paper)

نویسندگان English

Asghar Sadeghabadi ¹

Nahid Hassanzadeh Nemati ²

Mohammad Reza Vaezi ³

Mohammad Taghi Khorasani ⁴

¹ Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran.

² Assistant Professor, Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran.

³ Associate Professor, Nano and Advanced Materials, Material and Energy Research Center, Tehran, Iran.

⁴ Associate Professor, Iran Polymer and Petrochemical Institute, Tehran, Iran.

چکیده English

Background: Total Hip prosthesis replacement is one of successful invasive procedures in medical history. Hip joint replacement started by Sir John charnley by using of low friction artificial joint on 1960s. Subsequently bearing material, fixation methods and new designs were defined and modified. The main concerns about THA are biological response due to particles produced by bearing surfaces that lead to Osteolysis and prosthesis loosening. Modern THA biomaterials were developed to remedy this problem.
Methods: A journal research strategy was performed using different terms. The highest quality technical articles and reports were selected that included the best and newest related contents. Key search words were hip, biomaterial, wear, titanium, zirconia, alumina, UHMWPE and CO-Cr. Finally 69 sources were chosen and used in this review.
Results: Recent advances in hip prostheses have focused on mechanical strength, biocompatibility, bioactivity, increasing wear resistance and reliability using new technologies, as well as structure modification and nanotechnology hybridization. A hybrid design in nano-ceramics has increased resistance up to four times that of alumina, allowing for a smaller femoral head. The prosthesis stability, longer life, and reliability are needed due to the increase in young patients who need hip arthroplasty with higher activity levels, which can be achieved with scientific methods and newly improved materials.
Conclusion: This study introduces the biomaterials used in hip joint prostheses and discussed them from different aspects. In addition, more advanced biomaterials for THA have also been investigated to further reduce wear and increase the life of the prosthesis in the future.

کلیدواژه‌ها English

Alumina

Hip prosthesis

Biomaterials

Total hip arthroplasty

Ceramics

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