骨科钛植入物表面改性抗感染与促进骨折愈合的研究进展

骨科内植物一旦植入体内，患者将面临发生感染的风险。感染是骨科内植物植入失败的主要原因之一，且在开放性骨折手术治疗中较为常见。临床上内固定术后骨折不愈合并不少见，通常需要二次甚至多次手术干预，对患者身心及经济造成严重负担。巨噬细胞聚集、活化使其在内植物周围局部浓度增高，可提高内植物/组织界面免疫功能，从而发挥预防或治疗感染的作用。此外，对钛及其合金表面进行改性，并负载抗生素或生物活性物质，也可发挥治疗或预防感染及骨折不愈合等作用。本文对目前国内外关于钛及钛合金植入物表面改性的抗感染与促进骨折愈合的研究现状进行综述，为构建同时具备抗感染与促进骨折愈合能力的骨科植入物材料提供参考。

Surface modification of orthopaedic titanium implant for anti-infection and promoting fracture healing: an update

Orthopaedic implants in the body brings a high risk of microbial infections. Infection is one of the main reasons for failure of implant in department of orthopaedics, and is more common in open fracture surgery. Fracture nonunion after internal fixations is not rare clinically, and reoperation or even multi-operations are required, which will be a heavy burden for the patients physically, mentally and economically. The aggregation and activation of macrophages can increase the cell count around the implants, which improves the immune function of the implant/tissue interface, thus contributing to prevention or treatment of infection. In addition, surface modification of titanium and its alloys, and loading antibiotics or bioactive substances also play a role in prevention or treatment of infection and nonunion. This review summarizes the current research on anti-infection function and fracture healing promotion in the surface modification of titanium and its alloys, so as to provide references for designing orthopaedic implants with anti-infection and fracture healing promotion functions.