Biotribological Layers in Metal-on-Metal Hip Replacement

金属对金属髋关节置换术中的生物摩擦层

• 批准号: 7942939
• 负责人: Joshua J Jacobs
• 金额: $ 66.91万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7942939
• 关键词: Address; Alloys; Area; Arthroplasty; Behavior; Cells; Chromium; Clinical; Cobalt; Complication; Corrosion; Corrosives; Couples; Delayed Hypersensitivity; Devices; Diaphyses; Engineering; Environment; Evolution; Failure; Film; Generations; Goals; Guidelines; Head; Hip region structure; Implant; In Vitro; Joint Dislocation; Joint repair; Joints; Laboratories; Lead; Marketing; Mechanics; Metallurgy; Metals; Metaphysis; Molecular Weight; Operative Surgical Procedures; Osteolysis; Particulate; Patients; Performance; Polyethylenes; Process; Property; Proteins; Reaction; Reporting; Resistance; Retrieval; Risk; Role; Running; Sampling; Surface; Surgeon; Testing; Tissues; base; bone; bone loss; design; hip replacement arthroplasty; improved; metal oxide; multidisciplinary; novel; particle; reconstruction; response; simulation; soft tissue; survivorship

DESCRIPTION (provided by applicant): Metal-on-metal (MoM) bearings for hip replacement have surged in popularity over the last several years due to lower volumetric wear (compared to conventional metal-on-ultrahigh molecular weight polyethylene) and the ability to use large femoral heads, reducing the risk of dislocation, a common complication of hip replacement necessitating revision surgery. Large femoral heads also provide the surgeon with the option of resurfacing the femoral head without breaching the femoral metaphysis or diaphysis (hip resurfacing arthroplasty) thereby preserving femoral bone stock. However, a cause for concern with MoM joint reconstruction, has recently emerged with increasing reports of early adverse local tissue responses compromising the functionality and survivorship of these reconstructions. These adverse responses, which include periprosthetic bone loss (osteolysis), delayed-type hypersensitivity and soft tissue masses (so-called pseudotumors) are governed by the local cellular reaction to particulate and ionic wear and corrosion debris. There is growing evidence that the local cell response is related to the amount of debris generated by these bearing couples. Thus, there is an urgent clinical need to delineate the mechanisms of debris generation in order to minimize these adverse local tissue responses. Unfortunately, the tribology of this bearing couple is little understood. Our laboratory has made the novel observation that metal-on-metal bearings undergo microstructural changes and tribochemical reactions with the joint environment during articulation. This behavior causes changes in the metallurgy of the upper surface and brings about the generation of a mechanically mixed zone of nanocrystalline metal (oxide) and organic constituents. Such a zone - also called tribomaterial - favorably influences the tribological properties as well as the tribocorrosive behavior, as has been shown for related boundary lubricated applications in mechanical and automotive engineering. In the present proposal, we will address the central hypothesis that the combination of metal particles and denatured proteins form a biotribological layer in metal on metal bearings that has synergistic effects in reducing wear and corrosion. We have assembled a multidisciplinary investigative team that will address the following specific aims that will likely have a significant impact of the performance of MoM bearings in hip replacement: 1) to determine the role of the biotribological layer constituents in the evolution of the near-surface region of the metal using wear simulations for accelerated testing and compare these to device retrievals obtained from patients undergoing MoM hip or surface replacement; 2) to determine the relevant properties of the mechanically mixed zone of retrievals and in-vitro samples and demonstrate the effect of embedded organic constituents; and 3) to demonstrate that the presence of a mechanically mixed zone will beneficially effect the (tribo-)corrosion behavior of the cobalt-chromium alloy

描述（由申请人提供）：在过去几年中，由于较低的体积磨损（与传统的硫磺分子金属重量聚乙烯相比，用于髋关节置换的金属（MOM）轴承均受欢迎，并且能够使用较大的股骨头，从而减少了脱位的风险，因此可以使用大量的重症机措施。大型股骨头还为外科医生提供了股骨头的选择，而无需违反股骨的冲突或隔膜（HIP重新浮力关节置换术），从而保留股骨骨骼。但是，对MOM联合重建的关注的原因最近出现了，越来越多地报告了局部不良组织反应的报告，从而损害了这些重建的功能和生存。这些不良反应包括周围的骨质流失（溶解性），延迟型超敏反应和软组织质量（所谓的假量）受局部细胞对颗粒和离子磨损和腐蚀碎屑的反应的控制。越来越多的证据表明，局部细胞反应与这些轴承夫妇产生的碎屑量有关。因此，紧急临床需要描述碎屑产生的机制，以最大程度地减少这些不良的局部组织反应。不幸的是，这对轴承夫妇的摩擦学鲜为人知。我们的实验室已经使新的观察结果表明，金属对金属轴承会在表达过程中与关节环境发生微观结构变化和贸易化学反应。这种行为导致上表面的冶金变化，并带来了纳米晶金属（氧化物）和有机成分的机械混合区域的产生。这样的区域（也称为摩托材料）有利地影响了摩擦学特性以及摩擦式行为，这对机械和汽车工程中相关边界润滑的应用显示了。在本提案中，我们将解决以下中心假设：金属颗粒和变性蛋白的组合在金属轴承上形成了金属轴承中的生物脱水层，在减少磨损和腐蚀方面具有协同作用。我们组装了一个多学科的调查团队，该团队将解决以下特定目标，该目标可能会对髋关节替换中的妈妈轴承的性能产生重大影响：1）确定生物脱生物学层成分在使用磨损模拟的近距离测试和替换患者中的磨损模拟中的近距离区域的进化中的作用，从而使这些患者从这些型号中进行了替换，从而使患者替换了这些型号或从事替换。 2）确定检索机械混合区和体外样品的相关特性，并证明嵌入式有机成分的效果； 3）证明机械混合区的存在将对钴 - 铬合金的（摩擦）腐蚀行为有益地影响