前、后交叉韧带重建等长点的计算机辅助设计研究
发布时间：2019-07-06 11:00
【摘要】： 膝关节是人体中最复杂和易受损伤的负重关节。在交通事故、工矿生产事故及运动损伤等方面，膝关节的损伤机率较大。由于膝关节结构和功能的复杂性，使得对膝关节的研究受到限制。本文应用计算机技术，建立能够仿真再现无负荷状态下正常膝关节屈曲过程的运动模型，并以此模型来测量前、后交叉韧带屈曲过程中的长度变化，为临床手术提供理论依据。 目的： 利用计算机技术，对一定样本量正常膝关节进行运动模拟，得到正常膝关节计算机运动模型，根据此模型再现正常膝关节无负荷状态下的运动，测量交叉韧带在运动过程中各个状态时的长度，验证等长重建时交叉韧带附着区的位置，为交叉韧带等长重建提供理论基础。 方法： 将6例新鲜膝关节人体标本两端进行包埋并打好标记物，利用三维扫描系统对膝关节屈曲不同角度扫描(或在包埋物中加入显影剂进行CT扫描，再进行融合配准)获得扫描数据，并导入Geogemagic Studio 8软件，将得到骨干、关节面的数据进行融合成完整的膝关节各个屈曲运动状态下的模型，并对该模型进行光滑、去噪处理。把CT扫描后的图像数据导入Materialise Mimics 10.01中，经过阈值分割(Thresholding)、区域增长分割(Region growing)、编辑(Editing)、光顺(Smoothing)等操作，，对图像进行加工，重建出股骨、胫骨三维模型，将模型存储为可供分析的STL格式文件。再把此模型导入Geogemagic Studio 8中与激光三维扫描仪得到的图像进行配准，建立能反映膝关节在各个角度时胫骨与股骨相对位置的计算机模型。在模型上标记交叉韧带附着区的位置，测量膝关节不同屈曲状态时附着区上的标记物之间的距离变化，应用SPSS统计软件对数据进行统计学分析，来确定股骨及胫骨交叉韧带附着区等长重建点的位置。 结果： 1．影响ACL、PCL等长结果主要为股骨。 2．重建ACL时，最佳股骨隧道的定位应该以股骨韧带附着区的后上区，胫骨韧带附着区的前区作为等长重建的位置，长度为(30.84±4.13)mm。 3．重建PCL时，最佳骨隧道的定位应该以股骨韧带附着区的前内侧区，胫骨韧带附着区的前下区作为等长重建的位置，长度为(27.71±7.85)mm。 结论： 1．通过计算机技术能够建立可供分析测量的膝关节计算机模型，并根据标本大体解剖、参照专业书籍来确定韧带附着区的位置，并在计算机模型中标记，应用软件可对交叉韧带的长度进行测量。 2．对测量数据进行统计，可分析相对合适的等长点重建位置。
文内图片：
图片说明：标本的包埋与其标记物Fig.l一1Embededspee而enand
[Abstract]:Knee joint is the most complex and vulnerable load-bearing joint in human body. In traffic accidents, industrial and mining accidents and sports injuries, the probability of knee joint injury is high. Due to the complexity of the structure and function of the knee joint, the study of the knee joint is limited. In this paper, a motion model which can simulate and reproduce the flexion process of normal knee joint without load is established by using computer technology, and the model is used to measure the length change of anterior and posterior cruciate ligament flexion, which provides a theoretical basis for clinical surgery. Objective: to simulate the motion of normal knee joint with a certain sample of normal knee joint by computer technology, and to obtain the computer motion model of normal knee joint. According to this model, the motion of normal knee joint without load is reproduced, the length of ACL in each state is measured, and the position of attachment area of ACL during isometric reconstruction is verified, which provides a theoretical basis for isometric reconstruction of ACL. Methods: the two ends of 6 fresh knee joint specimens were embedded and marked. The knee flexion was scanned at different angles by three-dimensional scanning system (or added developer to the embedded object for CT scanning, and then fusion registration was carried out) to obtain the scanning data, and introduced into Geogemagic Studio 8 software, the backbone will be obtained. The data of the joint surface are merged into a complete model under each flexion state of the knee joint, and the model is smooth and de-noised. The image data after CT scanning are imported into Materialise Mimics 10.01. The image is processed by threshold segmentation (Thresholding), region growth segmentation (Region growing), editing (Editing), fairing (Smoothing), and the three-dimensional model of femur and tibia is reconstructed, and the model is stored as a STL format file for analysis. Then the model was introduced into Geogemagic Studio 8 for registration with the images obtained by laser three-dimensional scanner, and a computer model reflecting the relative position of tibia and femur at each angle of knee joint was established. The position of the attachment area of the cruciate ligament was marked on the model, and the distance between the markers in the attachment area of the knee joint was measured under different flexion states of the knee joint. The data were statistically analyzed by SPSS statistical software to determine the position of the equal length reconstruction point of the attachment area of the cruciate ligament of the femur and tibia. Results: 1. The main results of ACL,PCL isometric effect were femurs. 2. In the reconstruction of ACL, the best location of the femoral tunnel should be the posterior superior area of the attachment area of the thigh ligament and the anterior area of the attachment area of the tibia ligament as the position of equal length reconstruction. The length of the tunnel should be (30.84 卤4.13) mm.. 3. When reconstruction of PCL, the best location of bone tunnel should be the anterior medial area of the attachment area of the femoral ligament and the anterior inferior area of the attachment area of the tibia ligament as the position of equal length reconstruction, the length of the bone tunnel should be (27.71 卤7.85) mm.. Conclusion: 1. The computer model of knee joint can be established by computer technology, and the position of ligament attachment area can be determined according to the gross anatomy of the specimen and referring to the professional books, and marked in the computer model. The length of cruciate ligament can be measured by software. 2. Statistics of the measured data can be used to analyze the relatively appropriate reconstruction position of the equal length point.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R322;R319
本文编号：2510962
文内图片：
图片说明：标本的包埋与其标记物Fig.l一1Embededspee而enand
[Abstract]:Knee joint is the most complex and vulnerable load-bearing joint in human body. In traffic accidents, industrial and mining accidents and sports injuries, the probability of knee joint injury is high. Due to the complexity of the structure and function of the knee joint, the study of the knee joint is limited. In this paper, a motion model which can simulate and reproduce the flexion process of normal knee joint without load is established by using computer technology, and the model is used to measure the length change of anterior and posterior cruciate ligament flexion, which provides a theoretical basis for clinical surgery. Objective: to simulate the motion of normal knee joint with a certain sample of normal knee joint by computer technology, and to obtain the computer motion model of normal knee joint. According to this model, the motion of normal knee joint without load is reproduced, the length of ACL in each state is measured, and the position of attachment area of ACL during isometric reconstruction is verified, which provides a theoretical basis for isometric reconstruction of ACL. Methods: the two ends of 6 fresh knee joint specimens were embedded and marked. The knee flexion was scanned at different angles by three-dimensional scanning system (or added developer to the embedded object for CT scanning, and then fusion registration was carried out) to obtain the scanning data, and introduced into Geogemagic Studio 8 software, the backbone will be obtained. The data of the joint surface are merged into a complete model under each flexion state of the knee joint, and the model is smooth and de-noised. The image data after CT scanning are imported into Materialise Mimics 10.01. The image is processed by threshold segmentation (Thresholding), region growth segmentation (Region growing), editing (Editing), fairing (Smoothing), and the three-dimensional model of femur and tibia is reconstructed, and the model is stored as a STL format file for analysis. Then the model was introduced into Geogemagic Studio 8 for registration with the images obtained by laser three-dimensional scanner, and a computer model reflecting the relative position of tibia and femur at each angle of knee joint was established. The position of the attachment area of the cruciate ligament was marked on the model, and the distance between the markers in the attachment area of the knee joint was measured under different flexion states of the knee joint. The data were statistically analyzed by SPSS statistical software to determine the position of the equal length reconstruction point of the attachment area of the cruciate ligament of the femur and tibia. Results: 1. The main results of ACL,PCL isometric effect were femurs. 2. In the reconstruction of ACL, the best location of the femoral tunnel should be the posterior superior area of the attachment area of the thigh ligament and the anterior area of the attachment area of the tibia ligament as the position of equal length reconstruction. The length of the tunnel should be (30.84 卤4.13) mm.. 3. When reconstruction of PCL, the best location of bone tunnel should be the anterior medial area of the attachment area of the femoral ligament and the anterior inferior area of the attachment area of the tibia ligament as the position of equal length reconstruction, the length of the bone tunnel should be (27.71 卤7.85) mm.. Conclusion: 1. The computer model of knee joint can be established by computer technology, and the position of ligament attachment area can be determined according to the gross anatomy of the specimen and referring to the professional books, and marked in the computer model. The length of cruciate ligament can be measured by software. 2. Statistics of the measured data can be used to analyze the relatively appropriate reconstruction position of the equal length point.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R322;R319
【参考文献】
相关期刊论文 前10条
1 刘雪峰,韩延龙,程振平,郝松楠,徐德恒,聂广辰;关节镜下经胫骨横钉固定前交叉韧带重建术[J];骨与关节损伤杂志;2004年03期
2 孙争鸣;膝关节前交叉韧带重建术移植物的选择[J];国外医学(骨科学分册);2002年04期
3 陈百成;人工韧带在重建膝关节交叉韧带中的应用[J];国外医学(骨科学分册);2005年02期
4 王友;前交叉韧带重建术中髁间窝成型的争议[J];国外医学(骨科学分册);2005年02期
5 刘秀梅;陶澄;肖东民;;人膝关节前、后交叉韧带解剖研究及临床意义[J];医学临床研究;2006年07期
6 李嘉,伍中庆,吴宇峰,邱桂春,付婷婷,李义凯;前交叉韧带胫骨附着处解剖学观察[J];颈腰痛杂志;2005年03期
7 张友乐,杨克非,高新生,朱伟,胡琪,王澍寰,尹大庆,韦加宁;冷冻干燥异体肌腱移植的实验研究与临床应用[J];中华骨科杂志;1997年01期
8 杨文龙,王丹,徐旭纯,金肖强,闵继康,叶光亮;95%乙醇浸泡异体肌腱移植的实验研究[J];中华手外科杂志;1997年02期
9 陈百成 ,王晓峰 ,高石军 ,聂喜增;应用双极射频治疗前交叉韧带重建术后移植物松弛[J];中华外科杂志;2005年16期
10 徐卿荣,朱振安;前交叉韧带股骨等距重建位置的比较[J];中国矫形外科杂志;2004年10期
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