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。 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.
