臨床取得與體外模擬磨耗殘屑之產生型態與成分研究

Study of Morphologies and Compositions of Wear Debris Generated from Peri-prostheses and a Cup-on-ball Simulator

廖峻德(J. D. Liao) ； 賴育誠(Y. C. Lai) ； 楊文一(W. E Yang) ； 邱耀慶(Y. C. Chiu) ； 王明誠(M. C. Wang)

《Journal of Medical and Biological Engineering》 20卷3期 (2000/09) Pp. 31-39

摘要

為評估可能導致人工髖關節鬆脫原因中，有關磨耗殘屑造成骨溶解的問題、及相對機械性質造成材質磨損的程度。本研究以模擬磨耗機試著趨近髖關節之動態生物力學方式，並取其最大步態值；加速負荷磨損表面的磨耗變化，以收集磨耗屑；評估殘屑釋出的速率、形態、做定性及定量分析，並與人體內取出之失敗人工髖關節周圍組織的殘留殘屑做比較。以掃描式電子顯微鏡、感應耦合電漿質譜儀、電子能譜化學分析儀分別對人體取出的殘留殘屑、及在30萬、60萬、100萬及130萬測試次對濾片或循環液做磨耗殘屑分析，結果顯示：殘屑形態會隨測試次，依序形成小泡狀聚集，而後呈較巨觀的片狀結構；殘屑成份包括：金屬氧化物、聚乙烯殘屑及可能由兩者所形成之化合物等。磨耗殘屑的增量與測試次呈同一趨勢，但因片狀物質產生，隨測試次增加而使增率呈上升關係。由人體取得的磨耗殘屑呈泛綠白色與紫黑色兩類，大小約為1μm左右，其成份無法明確測得兩種常用人工髖關節產品的各主要金屬元素；但呈紫黑色的殘留殘屑含有大量的鈦氧化物，可能來自於臼杯外襯。此與模擬測試結果比較：因外觀設計與厚度不同，除了殘屑釋出速率不等外，在形態方面，初期皆成泡狀結構且皆由小泡狀磨耗屑聚集而成；磨耗後期則因超高分子聚乙烯髖臼杯產生應變硬化，導致片狀磨耗屑陸續釋出。循環液經過分析則含有主要的金屬元素，釋出的時間也因產品及測試時間的不同而異。此結果與臨床取出之殘屑，雖在產生機制的時期與方法有不同，但均發現有微米級顆粒聚集的現象，因而其產生過程對其周圍組織的影響值得再進一步探討。

關鍵字

磨耗殘屑 ； 去組織的殘留殘屑 ； 形態 ； 顆粒聚集

並列摘要

This study approaches to predict factors leading to failure of hip joint prosthesis. In particular, wear-associated debris probably provokes bone tissue resorption and relative diversity in mechanical properties at the articulating surfaces, which also cause different degrees of wear. This work assumes an accelerated condition for a cup-on-ball simulator, tried to interpret the occurrence of wear debris generation and collected the released species. Wear species are characterized by estimating the released sequences, morphologies and by doing qualitative and quantitative analyses. Experimental results were also compared with tissue-detached particles obtained from peri-prosthesis. Scanning Electron Microscope, Inductively Coupled Plasma Mass Spectrometer and Electron Spectroscopy for Chemical Analysis were used for identifying the tissue-detached particles, filtered samples and circulated liquid, at 300K, 600K, 1.0 M and 1.3 M testing cycles, respectively. Analytical results revealed that morphologies and concentrations of wear debris varied with testing cycles, which generated in sequence: initial agglomerates, e.g. carbonates from scissioned polyethylene in spherical foam, and then delaminated to plate-like debris. The composition likely includes: metallic oxides, carbonates and mixed compounds. Accumulation of released mass increased with the testing cycles, they showed an upward relationship, probably due to gradual delamination at the load-bearing acetabular cup. The tissue-detached particles exhibited as green-in-white and purple-in-black colors with the dimensions of ca. 1 m in length. The compositions were comprised of main elements from two types of the prosthetic components. The black-like particles were identified as titanium oxide-rich species. Although generations of wear species were different in running mechanics, agglomeration of micron-scale species into particles was observed. This work may provide practical data, as a reference for further osteolysis study as well as loosening evolution occurred at the articulating surfaces.

並列關鍵字

Wear debris ； tissues-detached particles ； morphology ； agglomeration