髕股骨人工關節之動靜態分析與測試

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駱主安(Chu-An Luo) 查詢紙本館藏

畢業系所

機械工程學系

論文名稱

髕股骨人工關節之動靜態分析與測試
(Dynamic and Static Analyses and Experimental Evaluation of Patellofemoral Prosthesis)

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摘要(中)

隨著科技進步與醫學發達，人類平均壽命逐年增加，同時也伴隨各種因老化造成的疾病；退化性關節炎即跟年齡老化有直接關係，主要病變的地方是兩骨頭的關節接觸面。目前單一退化性髕股骨關節炎，臨床治療方式有：(1)全人工膝關節置換；(2)表面置換型人工髕股骨關節。其可減少病患因關節炎產生之不適，增進髕股骨間滑動正常。表面置換型人工髕股骨關節好處在於微小骨切除量，未來關節炎若持續惡化可進行全關節置換。
本研究結合醫學影像重建技術，撰寫客製化關節曲面設計程式，自動產生與病患骨關節曲面完整貼合之植入物模型，並修改手術器械設計，有效縮減手術傷口，提高其可行性與便利性。此外，由動態模擬實際建構髕股骨關節運動分析平台，將得到膝關節運動時，植入物受力參數輸入有限元素分析模型進行分析，探討特定角度植入物受力情形及是否發生沉陷現象，以及植入物之楯的型式對本身應力分布與穩定度的影響，藉以改進客製化人工髕股骨關節之設計。

摘要(英)

Recently, human life became more and more elder because of the advancement of scientific technology and the development of medicine. But it also accompanies the disease caused by aging. Like the osteoarthritis, which the
most obvious example is. There are two kinds of treatment for isolated patellofemoral osteoarthritis. One is total knee arthroplasty, the other is surface replacement prosthesis for patellofemoral joint. Both of them can help the patients with the osteoarthritis to get rid of the uncomfortable experience, and promoting to slide normally between patella and femur. The osteotomy can resect less quality of the bone is the advantage of surface replacement prosthesis for patellofemoral joint. So it will proceed the total knee replacement even if the osteoarthritis become worse in future.
In order to produce the model of patellofemoral prosthesis that contact well with the surface of the bone from the patient automatically, this research combined the reconstruction of technology with medical image, and composing the program for the custom-made implant. Furthermore, it modified the design of the surgical instruments for reducing the wound from operation and raising the feasibility and convenience of the operating method. In addition, obtaining the contact force between patellar component and patellofemoral implant in knee motion from the dynamic simulation, which we constructed so as to find out the knee motion after the arthroplasty. Finally, using finite element analysis to get the stress distribution and stability of the implant, and bring up some principle points while designing.

關鍵字(中)

★ 關節炎
★ 客製化
★ 髕股骨植入物
★ 動態模擬
★ 有限元素分析

關鍵字(英)

★ custom-made
★ dynamic simulation
★ finite element analysis
★ patellofemoral prosthesis
★ arthritis

論文目次

摘要 i
ABSTRACT ii
致謝 iii
目錄 iv
圖目錄 vii
表目錄 xvii
一、緒論 1
1-1 研究背景 1
1-2 研究動機與目的 1
1-3 文獻回顧 2
1-3-1 膝關節之解剖學與生物力學 2
1-3-2 膝關節運動學介紹 7
1-3-3 人工髕股骨關節簡述 18
1-3-4 膝關節動態模擬 22
1-3-5 膝關節有限元素分析 24
1-4 本文架構 26
二、材料與方法 27
2-1 三維骨骼電腦模型的建立 27
2-1-1 醫學影像資料之蒐集 27
2-1-2 骨骼模型之立體重建 29
2-2 髕股骨植入物設計與打樣 33
2-2-1 植入物與手術器械之設計 33
2-2-2 手術器械銑料方式 41
2-2-3 植入物自動化設計 44
2-2-4 植入物與手術器械打樣 49
2-3 手術模擬實驗 50
2-3-1 遠端股骨模型製作 50
2-3-2 銑除手術模擬流程 54
2-4 膝關節動態模擬分析 55
2-4-1 膝關節運動學參數資料 55
2-4-2 電腦動態分析模型的建立 62
2-4-3 韌帶組織建立 66
2-4-4 肌肉力量與脛股骨關節接觸力設定 68
2-4-5 動態模擬分析參數選用 71
2-5 植入物有限元素分析 73
2-5-1 有限元素分析參數設定 73
2-5-2 有限元素分析參數選用 89
三、結果 91
3-1 手術器械模擬實驗結果 91
3-2 膝關節動態模擬分析結果 92
3-2-1 膝關節屈曲動作模擬結果 92
3-2-2 植入物受力資訊 95
3-3 植入物有限元素分析結果 97
3-3-1 不同型式的楯之應力分析結果 97
3-3-2 植入物穩定度分析結果 108
四、討論 114
4-1 手術器械模擬結果討論 114
4-2 動態模擬分析結果討論 116
4-2-1 股骨後旋(Femoral rollback) 116
4-2-2 螺旋歸位機轉(Screw-home mechanism) 120
4-2-3 髕股骨關節接觸力(Patellofemoral contact force) 122
4-3 有限元素分析結果討論 124
4-3-1 不同型式的楯之應力分析討論 124
4-3-2 植入物穩定度分析討論 126
五、結論與未來展望 134
參考文獻 136

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指導教授

林上智

審核日期

2009-7-1

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