【摘要】： 膝關(guān)節(jié)是人體中最復(fù)雜和易受損傷的負(fù)重關(guān)節(jié)。在交通事故、工礦生產(chǎn)事故及運(yùn)動(dòng)損傷等方面，膝關(guān)節(jié)的損傷機(jī)率較大。由于膝關(guān)節(jié)結(jié)構(gòu)和功能的復(fù)雜性，使得對(duì)膝關(guān)節(jié)的研究受到限制。本文應(yīng)用計(jì)算機(jī)技術(shù)，建立能夠仿真再現(xiàn)無負(fù)荷狀態(tài)下正常膝關(guān)節(jié)屈曲過程的運(yùn)動(dòng)模型，并以此模型來測量前、后交叉韌帶屈曲過程中的長度變化，為臨床手術(shù)提供理論依據(jù)。 目的： 利用計(jì)算機(jī)技術(shù)，對(duì)一定樣本量正常膝關(guān)節(jié)進(jìn)行運(yùn)動(dòng)模擬，得到正常膝關(guān)節(jié)計(jì)算機(jī)運(yùn)動(dòng)模型，根據(jù)此模型再現(xiàn)正常膝關(guān)節(jié)無負(fù)荷狀態(tài)下的運(yùn)動(dòng)，測量交叉韌帶在運(yùn)動(dòng)過程中各個(gè)狀態(tài)時(shí)的長度，驗(yàn)證等長重建時(shí)交叉韌帶附著區(qū)的位置，為交叉韌帶等長重建提供理論基礎(chǔ)。 方法： 將6例新鮮膝關(guān)節(jié)人體標(biāo)本兩端進(jìn)行包埋并打好標(biāo)記物，利用三維掃描系統(tǒng)對(duì)膝關(guān)節(jié)屈曲不同角度掃描(或在包埋物中加入顯影劑進(jìn)行CT掃描，再進(jìn)行融合配準(zhǔn))獲得掃描數(shù)據(jù)，并導(dǎo)入Geogemagic Studio 8軟件，將得到骨干、關(guān)節(jié)面的數(shù)據(jù)進(jìn)行融合成完整的膝關(guān)節(jié)各個(gè)屈曲運(yùn)動(dòng)狀態(tài)下的模型，并對(duì)該模型進(jìn)行光滑、去噪處理。把CT掃描后的圖像數(shù)據(jù)導(dǎo)入Materialise Mimics 10.01中，經(jīng)過閾值分割(Thresholding)、區(qū)域增長分割(Region growing)、編輯(Editing)、光順(Smoothing)等操作，，對(duì)圖像進(jìn)行加工，重建出股骨、脛骨三維模型，將模型存儲(chǔ)為可供分析的STL格式文件。再把此模型導(dǎo)入Geogemagic Studio 8中與激光三維掃描儀得到的圖像進(jìn)行配準(zhǔn)，建立能反映膝關(guān)節(jié)在各個(gè)角度時(shí)脛骨與股骨相對(duì)位置的計(jì)算機(jī)模型。在模型上標(biāo)記交叉韌帶附著區(qū)的位置，測量膝關(guān)節(jié)不同屈曲狀態(tài)時(shí)附著區(qū)上的標(biāo)記物之間的距離變化，應(yīng)用SPSS統(tǒng)計(jì)軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析，來確定股骨及脛骨交叉韌帶附著區(qū)等長重建點(diǎn)的位置。 結(jié)果： 1．影響ACL、PCL等長結(jié)果主要為股骨。 2．重建ACL時(shí)，最佳股骨隧道的定位應(yīng)該以股骨韌帶附著區(qū)的后上區(qū)，脛骨韌帶附著區(qū)的前區(qū)作為等長重建的位置，長度為(30.84±4.13)mm。 3．重建PCL時(shí)，最佳骨隧道的定位應(yīng)該以股骨韌帶附著區(qū)的前內(nèi)側(cè)區(qū)，脛骨韌帶附著區(qū)的前下區(qū)作為等長重建的位置，長度為(27.71±7.85)mm。 結(jié)論： 1．通過計(jì)算機(jī)技術(shù)能夠建立可供分析測量的膝關(guān)節(jié)計(jì)算機(jī)模型，并根據(jù)標(biāo)本大體解剖、參照專業(yè)書籍來確定韌帶附著區(qū)的位置，并在計(jì)算機(jī)模型中標(biāo)記，應(yīng)用軟件可對(duì)交叉韌帶的長度進(jìn)行測量。 2．對(duì)測量數(shù)據(jù)進(jìn)行統(tǒng)計(jì)，可分析相對(duì)合適的等長點(diǎn)重建位置。
文內(nèi)圖片：
圖片說明：標(biāo)本的包埋與其標(biāo)記物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 鹵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 鹵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.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2007
【分類號(hào)】：R322;R319

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