北京生物醫(yī)學(xué)工程

一種組合式個(gè)性化人工膝關(guān)節(jié)假體數(shù)字化設(shè)計(jì)方法

A digital designing method for assembled custom knee prosthesis

作者：韋建和馬如宇顧冬云王金武趙慶輝

單位：                      上海交通大學(xué)生物醫(yī)學(xué)工程學(xué)院(上海200030)        

關(guān)鍵詞：膝關(guān)節(jié)；假體；個(gè)性化；組合式設(shè)計(jì)；數(shù)字化

分類號：

出版年·卷·期（頁碼）：2014·33·5（463-467）

摘要：

目的提出一種組合式個(gè)性化人工膝關(guān)節(jié)假體結(jié)構(gòu)，解決膝關(guān)節(jié)股骨腫瘤保肢手術(shù)由于截骨位置差異性較大，很難采用標(biāo)準(zhǔn)型人工膝關(guān)節(jié)假體滿足個(gè)性化需求的問題。方法首先將患部關(guān)節(jié)區(qū)域CT數(shù)據(jù)進(jìn)行三維重建，并利用MRI增強(qiáng)掃描技術(shù)建立腫瘤的三維模型，再通過腫瘤模型與患部關(guān)節(jié)模型進(jìn)行位置匹配，在三維模型上確定手術(shù)截骨位置，根據(jù)截骨尺寸設(shè)計(jì)個(gè)性化的股骨柄與標(biāo)準(zhǔn)股骨髁假體進(jìn)行有效組合，形成一種組合式個(gè)性化人工膝關(guān)節(jié)假體。結(jié)果根據(jù)本文設(shè)計(jì)方法的結(jié)果加工成型，骨科臨床醫(yī)生分析膝關(guān)節(jié)假體結(jié)構(gòu)與人體膝關(guān)節(jié)生理結(jié)構(gòu)相符，達(dá)到個(gè)性化假體設(shè)計(jì)要求，能夠重建患者膝關(guān)節(jié)功能。結(jié)論這種膝關(guān)節(jié)假體結(jié)構(gòu)有利于降低個(gè)性化膝關(guān)節(jié)假體設(shè)計(jì)加工成本，縮短設(shè)計(jì)加工周期，有望提高患者生命質(zhì)量。

Objective As standard knee prothesis is incompatible with the diversity of osteotomy position in limb salvage surgeries of femoral tumor, a structure of a modular personalized knee prothesis was showed in present study to meet individual requirements in such cases. Methods Firstly, three-dimensional models of the wounded joint and the tumor were reconstructed respectively based on CT data and enhanced MRI scanning technology. Position matching was performed on these two models, and the operation osteotomy position was then determined. According to the osteotomy position, the customized femoral stem and standard femoral condyle prothesis were designed and effectively combined into a personalized artificial knee prothesis. Results Certain orthopaedists analyzed the structure of this kind of assembled custom knee prosthesis. They all thought this assembled custom knee prosthesis structure was practicable. Conclusions This knee prosthesis structure helps to reduce the costs in custom knee prosthesis design and processing, and shorten the design and manufacturing time.

參考文獻(xiàn)：

［1］吳海山，吳宇黎.人工膝關(guān)節(jié)外科學(xué)：從初次置換到翻修手術(shù)［M］.北京:人民軍醫(yī)出版社，2005：26-35.
Wu Haishan, Wu Yuli. Knee Arthroplasty Primary and Revision Surgery［M］. Beijing:People’s Military Medical Press, 2005：26-35.
［2］郭世炳，馮衛(wèi)，賈燕飛等.特制假體置換在鄰關(guān)節(jié)骨巨細(xì)胞瘤治療中的應(yīng)用［J］.中國修復(fù)重建外科雜志，2008，22(1):120-122.
Guo Shibing,Feng Wei,Jia Yanfei,et al. Application of the special prosthetic replacement in treatment of giant cell tumor of bone adjacent to the joint. ［J］.Chinese Journal of Reparative and Reconstructive Surgery,2008，22(1):120-122.
［3］王小武,張衛(wèi)國,徐昕,等.特制人工假體置換治療膝關(guān)節(jié)骨巨細(xì)胞瘤［J］.臨床骨科雜志,2008,11(6):525-526.
Wang Xiaowu, Zhang Weiguo, Xu xi, et al. Custom prosthesis replacement in the treatment of patients of giant cell tumor of bone near the knee［J］.Journal of Clinical Orthopaedics, 2008,11(6):525-526.
［4］王永貴, 劉江濤.旋轉(zhuǎn)鉸鏈型膝關(guān)節(jié)置換術(shù)在膝部骨腫瘤中應(yīng)用的臨床研究［J］. 中國醫(yī)藥導(dǎo)報(bào)，2013 ,10(7)：85-87,90.
Wang Yonggui, Liu Jiangtao. Clinical research on rotating hinge prosthesis knee replacement for the treatment of bone tumors around the knee［J］. China Medical Herald，2013,10(7)：85-87,90.
［5］劉宏,范如源,曾樑,等.采用截面特征點(diǎn)云的NURBS自由曲面構(gòu)建［J］.現(xiàn)代制造工程,2012,(5):81-84.
Liu Hong, Fan Ruyuan, Zeng liang, et al. NURBS freeform surface construction from points-cloud of sectional feature［J］.Modern Manufacturing Engineering, 2012, (5):81-84.
［6］Piegl L,Tiller W. The Nurbs Book［M］.2nd ed. New York: Springer-Verlag, 1997:181-185.
［7］Pieg L A, Tiller W. The Nurbs Book［M］. 2nd ed. Berlin: Springer, 1996: 207-212.
［8］孫玉文, 吳宏基, 劉健. 基于NURBS的自由曲面精確擬合方法研究［J］. 機(jī)械工程學(xué)報(bào), 2004, 40 (3):10-14.
Sun Yuwen, Wu Hongji, Liu jian. Research on the method of accurate NURBS surface fitting to scattered points［J］. Chinese Journal of Mechanical Engineering, 2004, 40 (3):10-14.
［9］戴尅戎，倪誠，王成燾,等.定制型腫瘤假體的設(shè)計(jì)與應(yīng)用［J］.中華骨科雜志,2003：23（10）:606-610.
Dai Kerong,Ni Cheng,Wang Chengtao, et al. The design and application of custom-made tumor prostheses of knee［J］.Chinese Journal of Orthopaedics,2003：23（10）: 606-610.
［10］Beaty JH.現(xiàn)代骨科學(xué)［M］.戴尅戎譯.6版.北京:北京科學(xué)技術(shù)文獻(xiàn)出版社,2003:141-143.
Beaty J H. Modern Bone Science［M］. Dai Keirong translation. 6th ed. Beijing: Beijing Science and Technology Press,2003: 141-143.

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