人工膝關節術後定位系統

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姓名

李承祖(Cheng-tzu Li) 查詢紙本館藏

畢業系所

生物醫學工程研究所

論文名稱

人工膝關節術後定位系統
(The positioning system for the post-arthroplasty)

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摘要(中)

近年來，隨著醫學技術的進步發展與老年人口的增加，人工膝關節的置換手術已經是相當普遍與常見的。人工膝關節的置換經常在手術後的數年，由於中間的塑膠墊片磨耗情況嚴重而需要做再手術之置換。然而，醫師在為病人看診時，習慣透過X 光影像來為病人體內的人工膝關節之相關情況做推測診斷，但在X 光影像中塑膠材質是無法清楚的呈現出來，再加上X 光影像所能提供給醫師的相關訊息不足，這些都會導致醫師無法明確的清楚了解人工膝關節在病人體內的真實情況。
因此，本研究希望能夠發展出人工膝關節術後的定位系統。利用視窗型程式Visual Basic 6.0 並搭配SolidWorks API 的指令，開發出一套自動化的定位平台。藉由兩張X 光影像中所提供之特徵點座標資訊，將人工膝關節之CAD 模型在軟體中完成自動定位，真實的重現出體內人工膝關節之對位情形，並對於定位後之結果進行更進一步之探討。使本研究之相關平台軟體實際的與臨床做結合，以提供未來醫師與病人在看診時有更好的依據與保障。

摘要(英)

In the recent years, within the development of medical technology and the increase of aged population, the artificial knee-joint arthroplasty has become widely adopted. A few years after the surgery, patients need
to have another surgical operation for replacing the artificial joint, due to the wastage of its tibial insert. However, when doctors examine the condition of the artificial joint through X-rays, they cannot see the tibial
insert clearly. In addition, X-rays offer little information that doctors have vague understanding about the actual condition of the artificial joint in the patients’ bodies.
Therefore, the objective of the research is to develop the positioning system for the post-arthroplasty. By using the windows program, Visual Basic 6.0, with the command of SolidWorks API, we build an automatic positioning platform. Through the characteristic point coordinate in two X-rays, the CAD model in the artificial knee-joint would automatically position itself in the system, truly reflecting the joint’s position in bodies and further probing into the result. We seek to integrate the system with the clinical practices, offering doctors and patients better information as well as assurance for diagnosis in the future.

關鍵字(中)

★ API
★ Solikworks
★ 術後定位系統
★ 全置
★ 人工膝關節

關鍵字(英)

★ API
★ Solidworks
★ positioning system for the post-arthroplasty
★ total knee arthroplasty
★ artificial knee

論文目次

摘要 ................................................... iv
Abstract .................................................v
致謝文 ................................................. vi
目錄 .................................................. vii
圖目錄 ...................................................x
表目錄 .................................................xvi
第一章緒論 ..............................................1
1-1 研究動機與目的 .......................................1
1-2 研究背景 .............................................3
1-2-1 人體解剖學之簡介 ...................................3
1-2-2 膝關節之基本構造 ...................................4
1-2-3 人工膝關節之介紹 ...................................6
1-2-4 退化性關節炎之介紹 .................................9
1-2-5 X 光機之基本構造 ................................. 13
1-3 文獻回顧 ........................................... 16
1-3-1 人工膝關節術後定位應用 ........................... 16
1-3-2 影像分析與處理 ................................... 19
1-3-3 醫用X 光影像之拍攝品質 ........................... 19
1-4 研究方法 ........................................... 24
1-5 論文架構 ........................................... 27
第二章材料與方法 ...................................... 28
2-1 建立虛擬X 光影像 ..................................................... 28
2-1-1 拍攝視角AP 與ML .................................. 28
2-1-2 虛擬X 光影像之拍攝 ............................... 30
2-2 特徵點資訊之辦識 ..................................................... 35
2-2-1 特徵點之介紹與設置限制 ........................... 35
2-2-2 定位用之人工膝關節模型 ........................... 39
2-2-3 長度比例尺之求得 ................................. 42
2-3 定位技術與方法 ..................................... 44
2-4 術後對位平台系統之建立 ............................. 47
2-5 對位結果之誤差分析 ................................. 50
2-5-1 相對位移之誤差 ................................... 50
2-5-2 相對旋轉之誤差 ................................... 52
第三章結果 ............................................ 53
3-1 術後對位系統程式平台 ............................... 53
3-1-1 特徵點三維座標搜尋平台 ........................... 55
3-1-2 人工膝關節自動化對位平台 ......................... 60
3-2 標準X 光影像拍攝夾角之對位結果 ..................... 65
3-3 實際X 光影像拍攝夾角之對位結果 ..................... 69
3-4 修正X 光影像拍攝夾角之對位結果 ..................... 75
第四章討論 ............................................ 80
4-1 特徵點對位法之誤差情形 ............................. 80
4-2 拍攝夾角非九十度之對位情形 ......................... 85
4-3 修正夾角後對位結果之改善情形 ....................... 92
第五章結論與未來展望 .................................. 99
5-1 結論 ............................................... 99
5-2 未來展望 .......................................... 100
參考文獻 .............................................. 102

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指導教授

鄔蜀威、林上智

審核日期

2009-7-14

推文