2012-11-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/650574摘要：有鑑於國內膝脛股關節退化性關節炎之臨床病理分級(X光)與關節軟骨之厚度、體積、以及軟骨特性相關性之研究缺乏；與活體膝關節應力以有限元素分析法分析，以及使用垂直正交的透視X光影像系統 (Dual Fluoroscopeimaging system, DFIS)來探討不受皮膚活動影響之動態分析研究之不足，提出本計畫。此次研究計畫有兩個目的：一、於核磁共振中量測關節軟骨之厚度、體積、以及軟骨特性來做比較分析與探討，建立較精確並以軟組織狀況為病理診斷脛股關節退化性關節炎之嚴重分級。二、以DFIS來分析脛股關節退化性關節炎病患之膝關節運動學與動力學與正常受試者之差距，建立個別膝關節模型，進行有限元素分析法計算壓力及剪力分佈。第一年，將會有三十位脛股關節退化性關節炎患者參與。試驗將以臨床嚴重分級(Kellgren-Lawrence Scale)與核磁共振中量測關節軟骨之厚度、體積、以及軟骨特性(T2 Relaxation time)來做比較分析與探討。第二年將對十位脛股關節退化性關節炎患者依第一年分級，與正常對照組進行DFIS分析，比較膝關節運動學與動力學的差異。第三年將以有限元素分析法，計算壓力及剪力分佈，比較第二年退化性關節炎患者，與正常對照組之差異。以脛股關節軟骨之形態以及特性對應精確的關節應力模型，以達建立臨床早期鑑別診斷與預防關節炎惡化之目的。<br> Abstract: Tibiofemoral joint osteoarthritis (TFJ OA) is one of the most common disordersin orthopedics and current literature comparing the commonly used clinicalseverity grading system (Kellgren-Lawrence Scale) to Magnetic ResonanceImaging (MRI) based cartilage volume, thickness, and the ability for cartilage toresist compressive and shear stress is lacking. Furthermore, tracking bonemotion without the artifacts caused by skin movement is available when utilizingDual Orthogonal Fluoroscopy Imaging System (DFIS) nowadays. Thesemethods stated above made Finite Element Analysis (FEA) more accurate andprecise when utilizing the subject-specific muscle, bone, and cartilage propertyfrom those imaging sequences. With these techniques being acquired, thepurpose of this study is to: 1) Compare the clinically used Kellgren-Lawrencescale with the MRI-based cartilage thickness, volume, and the ability to resistpressure (T2 relaxation time) between patients with different severity of TFJ OA,2) Using the DFIS approach, we can investigate the differences in kneekinematics and kinetics between TFJ OA individuals and their age, size matchedcontrols without skin movement artifact, and emphasis will be placed on frontaland transverse plane motions under weight bearing functional activities, and 3)Incorporating data acquired from study #2, we can generate subject-spefcific,imaging based tibiofemoral joint models, and investigate compressive and shearstress distribution at the surface of the TFJ. For the first year’s project, weplanned to recruit 30 individuals with the diagnosis of TFJ OA with differentseverity. Kellgren-Lawrence scale score will be compared to the MRI-measuredcartilage thickness, volume, and T2 relaxation time at the location of interest onthe TFJ cartilage surface. The second year project will utilize the DFIS approachand recruit 15 individuals with TFJ OA and 15 age, size matched controls. Thelower extremity kinematics, kinetics, and EMG will be recorded and comparedbetween groups during functional tasks such as stair descent, unilateral squat,drop jump, and treadmill gait. And for the third year’s project, we will utilizedata collected from study #2, and input these imaging-based, subject specificbone, muscle, and cartilage properties to generate FEA models for eachindividual, and the compressive stress (hydrostatic) and shear stress (Octahedral)will be simulated and compared between groups. This study will utilize the mostadvanced technology in orthopedic research and brings valuable information intibiofemoral osteoarthritis diagnosis, intervention, and prevention during clinicalpractice.