基于股胫关节有限元仿真分析的膝骨关节炎生物力学改变的研究

发布时间：2019-05-22 06:09

【摘要】：膝关节是人体最重要、最复杂的关节之一，其运动量大，在日常生活中非常容易受到损伤。膝骨关节炎是一种由于正常膝关节发生病理变化而导致的慢性骨性关节炎（Osteoarthritis，OA），多发生于老龄人群。严重的膝OA患者会因剧烈疼痛而失去正常工作和生活自理能力，由此产生的各种治疗费用造成了社会和家庭的巨大经济负担。目前膝OA的发病机制尚不十分清楚，医学专家主要认为膝OA进展过程中半月板和软骨的退变是由力学和生物学因素长期相互作用所导致的。因此，膝OA进展过程中生物力学行为改变的研究有助于阐明力学因素的致病机制。本文将采集的六例志愿者的正常膝和六例志愿者的OA膝的CT和MRI影像数据导入到MIMICS软件中，对正常膝和OA膝的三维几何模型进行重构，每例模型中包含了股骨、胫骨、腓骨、半月板、股骨软骨、胫骨软骨及内外侧副韧带；将每例模型导入HYPERMESH有限元前处理软件中，对模型中各组织结构选择不同的单元形式，进行网格划分，获得三维网格模型；把每例三维网格模型的各组织结构与相应的CT或MRI影像进行对比，保证三维网格模型的精确性；将建立的每例网格模型导入ABAQUS有限元分析软件中进行材料属性、边界条件及载荷的设置；通过受力仿真分析获得每例模型的内外侧半月板的最大Mises应力、软骨的内外侧最大Mises应力和接触面积。根据仿真分析结果，，将正常膝的内侧与外侧半月板最大Mises应力的比值、软骨内侧与外侧最大Mises应力的比值、软骨内侧与外侧接触面积的比值与OA膝的相应的指标进行对比，可知OA膝半月板和软骨的最大Mises应力内侧与外侧的比值、接触面积内侧与外侧的比值基本上高于正常状态，表明了OA膝的内侧负重要高于正常状态。从生物力学层面上阐明了OA膝MRI影像观察到的内侧半月板和软骨内侧磨损严重以及CT影像观察到的股骨与胫骨内侧间隙变小的力学致病机理。
[Abstract]:Knee joint is one of the most important and complex joints in human body. It has a large amount of exercise and is very vulnerable to injury in daily life. Knee osteoarthritis is a kind of chronic osteoarthritis (Osteoarthritis,OA) caused by pathological changes of normal knee joint, which mostly occurs in the elderly population. Severe knee OA patients will lose their normal work and self-care ability due to severe pain, resulting in a huge social and family financial burden. At present, the pathogenesis of knee OA is not very clear. Medical experts mainly believe that meniscus and cartilage degeneration during the progress of knee OA is caused by the long-term interaction of mechanical and biological factors. Therefore, the study of biomechanical behavior changes during the progress of knee OA is helpful to elucidate the pathogenic mechanism of mechanical factors. In this paper, the CT and MRI images of normal knees of six volunteers and OA knees of six volunteers were imported into MIMICS software to reconstruct the three-dimensional geometric models of normal knees and OA knees. Meniscus, femoral cartilage, tibia cartilage and lateral collateral ligament; Each model is imported into HYPERMESH finite element pre-processing software, and different element forms are selected for each organization structure in the model, and the three-dimensional grid model is obtained by meshing. The organizational structure of each 3D grid model is compared with the corresponding CT or MRI images to ensure the accuracy of the 3D mesh model. Each case grid model is imported into ABAQUS finite element analysis software for material properties, boundary conditions and load settings. The maximum Mises stress of the inner and outer meniscus, the maximum Mises stress and the contact area of the inner and outer meniscus of each model were obtained by force simulation analysis. According to the results of simulation analysis, the ratio of maximum Mises stress between medial and lateral meniscus of normal knee, the ratio of maximum Mises stress between medial and lateral cartilage, and the ratio of medial to lateral contact area of cartilage were compared with the corresponding indexes of OA knee. It can be seen that the ratio of medial to lateral Mises stress of OA knee meniscus and cartilage, and the ratio of medial to lateral contact area are basically higher than those of normal state, which indicates that the medial negative value of OA knee is significantly higher than that of normal state. The mechanical pathogenesis of medial meniscus and medial cartilage wear observed by MRI images of OA knee and the decrease of medial space between femurs and tibia observed by CT images were expounded from the biomechanical level.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R318.01

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