https://scholars.lib.ntu.edu.tw/handle/123456789/83311
標題: | 人工全膝關節設計與評估用之膝關節三維電腦圖像生物力學模型(2/3) A 3D computer graphics-based biomechanical model of the knee joint for the design and evaluation of total knee replacements (2/3) |
作者: | 呂東武 | 關鍵字: | 膝關節生物力學;人工全膝關 節;電腦模型;knee biomechanics;total knee replacement;computer model;gait analysis | 公開日期: | 31-七月-2003 | 出版社: | 臺北市:國立臺灣大學醫學工程學研究所 | 摘要: | 人工全膝關節置換手術(total knee replacement;TKR)一直是治療退化性膝關節 炎的主要選擇。除了持續加強人工全膝關節 本身耐磨耗性與固定外,如何恢復病人術後 日常動作的功能,以提高其生活品質,是現 階段新型人工全膝關節設計一個相當重要的 課題。 本(第二)年度計畫旨在利用第一年建 立之電腦模型進行手術模擬,探討不同人工 關節設計(後十字韌帶保留型、替代型)對 膝關節力學與動作功能之影嚮。 本研究結果顯示,人工全膝關節置換 後,膝關節的穩定度明顯下降,因為韌帶及 關節面等被動受力結構被去除或改變,而目 前人工全膝關節之設計無法重建之。因此, 肌肉控制對人工全膝關節穩定度非常重要。 人工關節之被動運動因前十字韌帶之切除, 在其功能未被代償的情形下,不可能重建正 常關節運動。兩種人工關節對恢復正常運動 各有優缺點,但均不足。當正常膝關節之前 十字韌帶去除之後,其穩定性可藉由後腿肌 30-50%最大收縮力量補償之。其中人工全膝 關節(保留型、替代型)及前十字韌帶缺損 膝關節表現出的型態相似,但是前十字韌帶 缺損膝關節比人工全膝關節較接近正常膝關 節。因此,未來人工全膝關節或許應考慮如 何重建前十字韌帶之功能。 本研究除有助對現有人工全膝關節功能 表現之了解外,更可確保第三年度整合膝關 節電腦模型與己建立之下肢模型以分析功能 性動作之成功執行。 Total knee replacement (TKR) has been the main choice of treatment for advanced degenerative knee osteoarthritis over the last few decades. In developing a new prosthesis, it is essential to ensure the functional performance that the prosthesis may bring to the patient. In the present study, the 3D computer graphics-based biomechanical model of the knee joint that was developed in the first year has been used to simulate total knee replacement surgeries for the study of the effects of TKR designs (PCL retaining/substitution) on the biomechanical performance of the knee during functional activities. The results of the study showed that the stability of the knee was significantly reduced after surgery as the stabilizing structures such as ligaments and articular surfaces were removed or changed. Existing total knees were unable to reconstruct the normal stability of the joint. Therefore, muscles are important for knee stability during movement. Since the ACL was removed, normal knee kinematics cannot be recovered simply by TKR without any substituting mechanism for the ACL. Both types of TKR produced passive knee kinematics that was very different from normal. The removal of the ACL reduced significantly the stability of the knee but could be recovered by hamstrings actions with 30-50% level of its maximum force. Responses of the joint with hamstrings action were similar for the two types of TKR and the ACL-deficient knee. It seems that reconstruction of the ACL function may be considered in future TKR designs. The results of the present study will form a strong basis for the execution of the second year project in which the knee model will be incorporated into an existing lower limb model to study the mechanics of normal and prosthetic knees during functional activities. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/22376 | 其他識別: | 912320B002091 | Rights: | 國立臺灣大學醫學工程學研究所 |
顯示於: | 醫學工程學研究所 |
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912320B002091.pdf | 1.69 MB | Adobe PDF | 檢視/開啟 |
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