新型膝關節韌帶量測裝置之開發

以作者查詢圖書館館藏

、以作者查詢臺灣博碩士

、以作者查詢全國書目

、勘誤回報

、線上人數：5

、訪客IP：18.191.216.163

姓名

許文銘(Wun-ming Syu) 查詢紙本館藏

畢業系所

光機電工程研究所

論文名稱

新型膝關節韌帶量測裝置之開發
(the development of the new knee ligament testing device)

相關論文

★ LED封裝點膠系統創新設計之研究	★ 夾治具概念設計方法之研究
★ 葡萄糖檢測電極基材之化銅電鍍鎳金製程開發研究	★ 印刷電路板蝕刻製程設計與可視化驗證實驗
★ 平行軸錐形齒輪齒根應力特性之研究	★ 漸開線直齒錐形齒輪齒根應力之量測與分析
★ 單軸押出機減速機系列產品之計算機輔助開發模式之研究	★ 漸開線直齒錐形齒輪齒根應力計算模型之初步研究
★ 非旋轉式表面電漿儀之創新設計與製作	★ 電腦輔助單軸押出機減速機系列產品之開發
★ 單軸押出機減速機箱體系列化發展模式之研究	★ 電腦輔助機械零件製造成本預估 – 以單軸押出機減速機為例
★ 直齒錐形齒輪齒根應力解析計算模式之研究	★ 具點接觸型態之歪斜軸錐形齒輪對齒面疲勞破壞之初步研究
★ 粉末冶金齒輪齒根疲勞強度之研究	★ 電腦輔助設計程式模組之建構-以齒輪減速機為例

檔案

[Endnote RIS 格式]

[Bibtex 格式]

[相關文章]

[文章引用]

[完整記錄]

[館藏目錄]

[檢視]

[下載]

本電子論文使用權限為同意立即開放。
已達開放權限電子全文僅授權使用者為學術研究之目的，進行個人非營利性質之檢索、閱讀、列印。
請遵守中華民國著作權法之相關規定，切勿任意重製、散佈、改作、轉貼、播送，以免觸法。

摘要(中)

在進行複雜的膝關節置換術時，其中ㄧ項重要工作就是利用膝關節量測裝置，迅速、準確並不破壞原有組織下評判出軟組織是否平衡。但現有量測的裝置，大多都需在大傷口的情況下使用，並無法符合現行微創手術的潮流，所以本研究從醫師對膝關節觸診的方式，藉由下肢模型的簡化力學模型，開發並製作自外部量測的新型膝關節韌帶量測裝置雛形，分析膝關節的受力情形，以改良現行量測方式。
為驗證此一概念之可行性與實用性，本研究根據醫師外部觸診的動作與姿勢，設計出對應模擬驗證系統，用以模擬韌帶組織在膝關節中作用的情形，將下肢模型與量測裝置結合進行測試，藉此了解量測裝置的效果與準確性。
藉由實驗測試的結果，可以了解外部量測對於韌帶剛性的測試具有一定的穩定度與可靠度。雖然由簡化力學模型分析的結果與實驗測試的結果並不完全吻合，本研究亦針對此點提出幾項可能產生問題的因素，以作為將來研究膝關節軟組織理論模型的基礎。

摘要(英)

In total knee replacement surgery, using the knee testing device to measure soft tissue balance without damaging the tissue in the knee is very important. Most of the current knee testing device have to use a bigger incision, and those can’t satisfy the trend of minimally invasive surgery. According to the mode of the orthopaedic test for valgus/varus stability, this research develop the prototype of the new knee ligament testing device with the simplified biomechanics model and analyze the force at the knee joint to improve the measurement of soft tissue balance test.
According to the movement of the orthopaedic test for valgus/varus stability, a experimental system was also designed to simulate the ligament in the knee and to verify the feasibility of this concept. In order to test the precision of testing device, the prototype of the new knee ligament testing device and the experimental system were combined to perform a experiment.
The results of the experiments verify that the new knee ligament testing device have great stability for ligament test. However, there are some differences between the calculated results of the simplified biomechanics model and the experimental results. Some possible reasons of the differences are proposed in this research. The biomechanics model for the further study on the soft tissue balance in knees can be based on this research in the future.

關鍵字(中)

★ 人工膝關節置換術
★ 膝關節軟組織平衡
★ 膝關節力學模型
★ 膝關節韌帶

關鍵字(英)

★ knee ligament testing device
★ Total knee replacement
★ knee biomechanics model
★ soft tissue balance in the knee

論文目次

摘要 I
Abstract III
目錄 V
圖目錄 VII
表目錄 XI
第1章緒論1
1.1 研究背景1
1.2 相關研究探討2
1.2.1 膝關節軟組織平衡之量測方法 3
1.2.2 膝關節軟組織之功能 10
1.2.3 膝關節觸診方法 12
1.2.4 膝關節韌帶負載與變形研究14
1.2.5 生物力學模型 17
1.3 研究目的 21
第2章研究方法 23
2.1 研究架構 23
2.2 膝關節內外側副帶力學模型之建立 25
2.3 膝關節韌帶量測裝置之概念設計 29
2.4 膝關節模擬驗證系統之概念設計 32
第3章膝關節韌帶量測裝置細部設計 34
3.1.1 量測平臺 34
3.1.2 量測系統架構 36
3.1.3 程式控制介面 37
第4章膝關節模擬驗證系統細部設計 40
4.1 基座 40
4.2 固定裝置40
4.3 下肢模型42
4.3.1 下肢結構43
4.3.2 關節面 45
4.3.3 韌帶模擬機構 46
第5章模擬實驗結果與討論48
5.1 實驗流程 50
5.2 數據結果與分析 51
5.2.1 量測裝置穩定性51
5.2.2 調整不同內外側副韌帶剛性 53
5.2.3 理論模型驗證 54
第6章結論與未來展望58
6.1 結論 58
6.2 未來展望58
參考文獻 60
附錄一68
附錄二70

參考文獻

[1] 中央健康保險局，全民健康保險專業檔案分析報告http://www.nhi.gov.tw/information/bulletin_file/724_人工關節置換抗生素使用日數分析報告_941021.doc
[2] Hinterwimmer, S. , Graichen, H. , Baumgart, R. and Plitz, W., “Influence of a mono-centric knee brace on the tension of the collateral ligaments in knee joints after sectioning of the anterior cruciate ligament─an in vitro study”, Clinical Biomechanics 19(7), 719–725, 2004
[3] Ahmed, AM. , Hyder , A, Burke , DL. and Chan , KH., “In-vitro ligament tension pattern in the flexed knee in passive loading”, Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society 5(2):217-230, 1987
[4] Hirotsugu, M. et al., “Evaluation of joint gap in TKA – A new tensor enabling the measurement without patellar eversion”, American Academy of Orthopaedic Surgeons, 2003.
[5] Yagishita, K. Muneta, T. and Ikeda, H., “Step-by-Step measurements of soft tissue balancing during total knee arthroplasty for patients with varus knees”, The Journal of Arthroplasty 18(3), 313-320, 2003.
[6] Ritschl, P., Machacek, F.J. and Fuiko, R., “Computer assisted ligament balancing in TKR using the PiGalileo System”, Poster CAOS, 2003.
[7] Asano, H., Hoshino, A. and Wilton, T.J., “Soft-Tissue Tension Total Knee Arthroplasty”, The Journal of Arthroplasty Vol. 19, No. 5, 2004, pp. 558-561.
[8] Marmignon, C., Leimnei, A. and Cinquin, P., “Robotized distraction device for knee replacement surgery”, International Congress Series 1268, 638–643, 2004.
[9] Crottet, D., Maeder,T., Fritschy, D., Bleuler, H., Nolte, L.P., and Pappas, I.P., “Development of a force amplitude and location-sensing device designed to improve the ligament balancing procedure in TKA”, IEEE Transactions on Biomedical Engineering 52(9),1609-1611, 2005.
[10] Crottet D., Maeder T. and Fritschy D., “Ligament balancing in TKA: evaluation of a force-sensing device and the influence of patellar eversion and ligament release”,Journal of Biomechanics 40(8), 147-148, 2004.
[11] Wasielewskia, R.C., Galata, D.D. and Komistek, R.D., “Correlation of compartment pressure data from an intraoperative sensing device with postoperative fluoroscopic kinematic results in TKA patients”, Journal of Biomechanics 38(2), 333–339, 2005.
[12] Kaufman, K.R., Kovacevic, N., Irby, S.E. and Colwell, C W., “Instrumented implant for measuring tibiofemoral forces”, Journal of Biomechanics 29(5), 667-671, 1996.
[13] Hsu, H.C., Luo, Z.P., Rand, J.A. and An, K.N., “Influence of patellar thickness on patellar tracking and patellofemoral contact characteristics after Total Knee Arthroplasty”, The Journal of Arthroplasty 11(1), 69-80, 1996.
[14] Argenson, J.N., Scuderi, G.R., Komistek ,R.D., Scott, W. N., Kelly, M.A. and Aubaniac, J.M. “In vivo kinematic evaluation and design considerations related to high ﬂexion in total knee arthroplasty”, Journal of Biomechanics 38(2), 277–284, 2005.
[15] Singerman, R., Heiple , K.G., Davy, D.T. and Goldberg, V.M., “Effect of tibial component position on patellar strain following total knee arthroplasty”, The Journal of Arthroplasty 10(5), 651-656, 1995.
[16] http://www.aesculapusa.com/
[17] http://www.medmetric.com/
[18] http://www.sporttech.com/
[19] http://www.nkb.com
[20] http://www.microstrain.com/
[21] http://www.novel.de
[22] http://www.kyowa-ei.co.jp/
[23] Mommersteeg, T.J., Huiskes, R., Blankevoort, L., Kooloos, J.G., Kauer, J.M. and Maathuis, P.G., “A global verification study of a quasi-static knee model with multi-bundle ligaments”, Journal of Biomechanics 29(12), 1659-1664, 1996.
[24] Zavatsky, A.B. and Wrigh, H.J., “Injury initiation and progression in the anterior cruciate ligament”, Clinical Biomechanics 16(1), 47-53, 2001.
[25] Fleming, B.C., Renstrom, P.A., Beynnon, B.D., Engstrom, B., Peura, G.D., Badger, G.J. and Johnson, R.J., “The effect of weightbearing and external loading on anterior cruciate ligament strain”, Journal of Biomechanics 34(2), 163-170, 2001.
[26] Robinson, J.R., Bull, A.M. and Amis, A.A., “Structural properties of the medial collateral ligament complex of the human knee”, Journal of Biomechanics 38(5), 1067–1074, 2005.
[27] Hull, M.L., Berns, G.S., Varma, H. and Patterson, H.A., “Strain in the medial collateral ligament of the human knee under single and combined loads”, Journal of Biomechanics 29(2), 199-206, 1996.
[28] Noyes, F.R., Grood, E.S., Butler, D.L. and Raterman, L., “Knee ligament tests: what do they really mean?”, Physical Therapy 60(12), 1578-1581, 1980.
[29] Olmstead, T.G., Wevers, H.W., Bryant, J.T. and Gouw, G.J., “Effect of muscular activity on valgus/varus laxity and stiffness of the knee”, Journal of Biomechanics 19(8), 565-577, 1986.
[30] 王西十與白瑞蒲“關於人膝關節生物力學模型研究現狀”,力學進展 29(2), 224-250, 1999.
[31] Liu, W. and Maitland ,M.E., “The effect of hamstring muscle compensation for anterior laxity in the ACL-deficient knee during gait”, Journal of Biomechanics 33(7), 871-879, 2000.
[32] Shelburne, K.B. and Pandy, M.G., “A musculoskeletal model of the knee for evaluating ligament forces during isometric contractions”, Journal of Biomechanics 30(2), 163-176, 1997.
[33] Yanagawa, T., Shelburne, K., Serpas, F. and Pandy, M., “Effect of hamstrings muscle action on stability of the ACL-deficient knee in isokinetic extension exercise”, Clinical Biomechanics 17(9-10), 705–712, 2002.
[34] Freeman, M. A. R., “How the knee moves”, Current Orthopaedics 15(6), 444-450, 2001.
[35] Smidt, G.L., “Biomechanical analysis of knee flexion and extension”, Journal of Biomechanics 6(1), 79-92, 1973.
[36] Norris, Christopher M., “Sports injuries : diagnosis and management / Christopher M. Norris”, Butterworth-Heinemann, Boston, 230-236, 1998
[37] Minns, R. J., “Forces at the knee joint : anatomical considerations”, Journal of Biomechanics 14(9), 633-643, 1981.
[38] 勞工安全衛生研究所人體計測資料庫http://www.iosh.gov.tw/ergo.htm
[39] Verna, W. and Eric, L.R., “Mechanics of human joints”, Marcel Dekker, New York, 167, 1993
[40] Thompson, J.C., “Netter's concise atlas of orthopaedic anatomy”, Icon Learning Systems LLC, Teterboro, NJ , 207, 2002.
[41] Fehring, T.K. and Valadie, A.L., “Knee instability after total knee arthroplasty”, Clinical Othopaedics and Related Research 299, 157-162, 1994.
[42] Korvick, D.L., Cummings, J.F., Grood, E.S., Holden, J.P., Feder, S.M. and Butler, D.L., “The use of an implantable force transducer to measure patellar tendon forces in goats ”, Journal of Biomechanics 29(4), 557-561, 1996.
[43] Siebel, T. and Käfer, W., “Modification of the posterior cruciate ligament tension following totalknee arthroplasty: comparison of the Genesis CR and LCS meniscal”, The Knee 11(3), 203–208, 2004.
[44] Herzog, W., Archambault, J.M., Leonard, T.R. and Nguyen, H.K., “Evaluation of the implantable force transducer for chronic tendon-force recordings”, Journal of Biomechanics 29(1), 103-109, 1996.
[45] Fleming, B.C., Peura, G.D. and Beynnon, B.D., “Factors influencing the output of an implantable force transducer”, Journal of Biomechanics 33(7), 889-893, 2000.
[46] West, J.R., Juncosa, N., Galloway, M.T., Boivin, G.P. and Butler, D.L., “Characterization of in vivo Achilles tendon forces in rabbits during treadmill locomotion at varying speeds and inclinations”, Journal of Biomechanics 37(11), 1647-1653, 2004.
[47] Korvick, D.L., Cummings, J.F., Grood, E.S., Holden, J.P., Feder, S.M. and Butler, D.L., “The use of an implantable force transducer to measure patellar tendon forces in goats”. Journal of Biomechanics 29(4), 557-561, 1996.
[48] Hinterwimmer, S., Graichen, H., Baumgart, R. and Plitz, W., “Influence of a mono-centric knee brace on the tension of the collateral ligaments in knee joints after sectioning of the anterior cruciate ligament––an in vitro study”,Clinical Biomechanics 19(7), 719–725, 2004.
[49] Ahmed, A.M., Hyder, A., Burke D. and Chan K.H., “In-vitro ligament tension pattern in the flexed knee in passive loading”, Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society 5(2), 217-230, 1987.
[50] Hurley, W.L. and Thompson McGuire, D., “Influences of clinician technique on performance and interpretation of the lachman test”, Journal of Athletic Training 38(1), 34–43, 2003
[51] Carcia, C.R., Shultz, S.J., Granata, K.P., Gansneder, B.M. and Perrin, D.H., “Knee ligament behavior following a controlled loading protocoldoes not differ by menstrual cycle day”, Clinical Biomechanics 19(10), 1048–1054, 2004.
[52] Shultz, S.J., Windley, T.C., Kulas, A.S., Schmitz, R.J., Valovich McLeod, T.C. and Perrin, D.H., “Low levels of anterior tibial loading enhance knee extensor reflex response characteristics”, Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology 15(1), 61–71, 2005.
[53] Thornton, G.M., Johnson, J.C., Maser, R.V., Marchuk, L.L., Shrive, N.G. and Frank, C.B., “Strength of medial structures of the knee joint are decreased by isolated injury to the medial collateral ligament and subsequent joint immobilization”, Journal of Orthopaedic Research 23(5), 1191–1198, 2005.
[54] Momersteeg, T.J., Blankevoort, L., Huiskes, R., Kooloos, J.G., Kauer, J.M. and Hendriks, J.C., “The effect of variable relative insertion orientation of human knee bone-ligament-bone complexes on the tensile stiffness”, Journal of Biomechanics 28(6), 745-752, 1995.

指導教授

蔡錫錚(Shyi-Jeng Tsai)

審核日期

2007-7-23

推文