The present situati on and prospect of research on artificial joint metal wear particles / 医学研究生学报

ABSTRACT

The artificial joints containing metal prosthetic components have different degrees of wear particles in the human body,which is the main reason for local osteolysis,inflammatory pseudotumor and prosthesis loosening.The metal wear debris after ar-tificial joint replacement can be derived from the normal wear of the weight-bearing interface volume,or from the edge wear of the non-weight-bearing interface.The particles produced by joint wear are mainly nano-sized particles,and their toxicity is stronger than that of micro-sized particles and ions.The wear particles can cause either local reactions by local accumulation or toxicity symptoms of multiple systems by entering the blood in various forms.Cobalt has the strongest toxicity among various metal particles.Oxidative stress,hyper-sensitivity,endoplasmic reticulum stress,autophagy,and direct destruction are the possible cytotoxic and genotoxic mechanisms,and the corresponding detoxification studies are also related to these mechanisms.There is no definite standard for the increase of the con-centration of metal particles and the clinical symptoms.At present, the main treatment is to remove the prosthesis and symptomatic treatment.Future research will focus on the improvement of prosthetic materials and finding new alternative treatment for joint diseases. Basic research will further explore the mechanism of toxicity of metal particles,especially the discovery of signal pathways and suscepti-bility genes as well as the in vivo and in vitro studies and clinical trials of new antidote.