本文選題：關節(jié)軟骨　切入點：生物摩擦學　出處：《上海交通大學》2014年博士論文　論文類型：學位論文

【摘要】：關節(jié)軟骨是一層具備優(yōu)異潤滑性能和承載能力的組織，在人體關節(jié)正常運行中起到了非常重要的作用。軟骨嚴重損傷后人工關節(jié)置換是最后的治療手段。但對于同樣的軟骨對金屬關節(jié)摩擦副，半髖人工關節(jié)置換比不置換髕骨的人工膝關節(jié)置換的術后效果差得多，所以有必要對關節(jié)磨損方式，關節(jié)軟骨損傷的形成和發(fā)展過程進行研究，從而為關節(jié)軟骨損傷的早期診斷和治療提供支持。 本課題以關節(jié)軟骨的生物力學計算作為理論工具研究了軟骨的間質(zhì)流動。其次結合同步輻射相襯成像和示蹤劑，對關節(jié)軟骨內(nèi)的間質(zhì)流動情況進行了實驗驗證。另外通過軟骨的摩擦實驗分析了軟骨的兩相潤滑模式等摩擦磨損行為。最后將上述三方面研究結果提煉成軟骨損傷的生物摩擦學機理，并運用它對半髖人工關節(jié)置換與不置換髕骨的人工膝關節(jié)置換中的生物摩擦學問題進行了分析。 本課題研究獲得的主要內(nèi)容和結論有以下幾點： 第一，以軟骨兩相力學模型為基礎，在COMSOL中建立了軟骨力學模型。結合軟骨的蠕變實驗測量了軟骨力學參數(shù)，得到的軟骨彈性模量為1MPa，滲透率為2.2×10-14m4/Ns。采用這些參數(shù)計算了靜載荷，平移載荷和循環(huán)載荷下軟骨內(nèi)部間質(zhì)流動，并建立了軟骨細胞跨尺度力學計算方法。通過軟骨流動電勢測量實驗對以上軟骨生物力學模型進行了驗證，得到的實驗結果與模型計算結果相一致。 第二，在上海光源開展了軟骨間質(zhì)流動的實驗驗證。首先篩選出合適的軟骨造影劑，測定了它在軟骨中一維擴散的擴散系數(shù)為2.28×10-11m2/s±0.71×10-11m2/s�；谝陨蠑�(shù)據(jù)和經(jīng)驗，分析了軟骨間質(zhì)流動驗證實驗面臨的難點，并提出了實驗技術方案。使用軟骨力學模型對技術方案進行了理論分析并進行了預實驗驗證，優(yōu)化了參數(shù)。最后對正常軟骨組和OA軟骨組的間質(zhì)流動進行了實驗。兩組軟骨樣本循環(huán)載荷下的間質(zhì)流動模式存在較大差異。 第三，根據(jù)軟骨對軟骨摩擦實驗和力學計算，，軟骨的摩擦系數(shù)的上升與軟骨表面間質(zhì)液承載比例的下降直接相關。載荷的移動速度對維持軟骨表面間質(zhì)液承載比例有顯著影響。另一方面，DPPC脂質(zhì)體頭部基團帶正電，軟骨的負表面電勢促進脂質(zhì)體的吸附，有利于潤滑；而正表面電勢排斥脂質(zhì)體，使?jié)櫥h(huán)境惡化。 第四，關節(jié)軟骨摩擦磨損是以軟骨潤滑機制的失效和以疲勞磨損為主的表面損傷開始的，過多間質(zhì)液滲入軟骨中，引發(fā)軟骨內(nèi)生物大分子降解的惡性循環(huán)。運用軟骨細胞跨尺度力學計算分析了正常軟骨和OA軟骨細胞周邊的力學環(huán)境，結果表明正常軟骨細胞的力學計算結果與文獻實驗中取得的結果一致。相反OA軟骨細胞的力學計算結果遠遠偏離正常范圍，嚴重影響了軟骨細胞正常生理功能，這與OA軟骨組織切片觀察到的表現(xiàn)一致。 最后，半髖人工關節(jié)置換與不置換髕骨的人工膝關節(jié)置換兩者術后結果差異主要原因是半髖置換破壞了原來的移動接觸潤滑模式，髖臼軟骨在金屬球頭固定接觸下的摩擦系數(shù)將大幅升高；其次，擠壓膜計算也顯示半髖置換后的擠壓膜持續(xù)時間比天然髖關節(jié)下降了62%。髕骨憑借自身的滑移運動保證了移動接觸的潤滑模式，能夠維持低水平的摩擦系數(shù)。半髖置換在上述摩擦磨損的情況下，軟骨細胞力學環(huán)境有惡化趨勢。不置換髕骨的人工膝關節(jié)置換術的軟骨細胞力學環(huán)境與天然髖關節(jié)的細胞力學環(huán)境基本相同。 本課題將軟骨摩擦學向軟骨生理學進行了延伸，通過軟骨生物力學模型和軟骨細胞的跨尺度力學計算，把軟骨的力學損傷與其造成的軟骨病理現(xiàn)象聯(lián)系在了一起，為以后這方面的跨學科研究提供了支持。
[Abstract]:Articular cartilage is a layer with excellent lubrication performance and bearing capacity of the organization, in the human body joint normal operation plays a very important role in cartilage. Serious injury after artificial joint replacement is the final treatment. But for the same cartilage to metal joint friction, semi hip arthroplasty than artificial knee joint replacement is not the replacement of the patella postoperative effect is much less, so it is necessary to study the abrasion of the joint, the process of formation and development of articular cartilage injury, so as to provide support for the early diagnosis and treatment of articular cartilage injury.
The biomechanics of articular cartilage interstitial flow calculation as a theoretical tool to study cartilage. Secondly combined with synchrotron radiation imaging and tracer, interstitial flow of articular cartilage in the experiment. The other two modes of lubrication friction and wear behavior of cartilage were analyzed by friction experimental cartilage. The last of the three the research results into the biotribological mechanism of cartilage injury, biotribology problem of artificial knee joint replacement and its application on hip arthroplasty and no patella replacement in were analyzed.
The main contents and conclusions of this research are as follows:
First, the mechanical model of two-phase cartilage based on COMSOL in cartilage mechanics model is established. Combining with the creep experiments of cartilage mechanics parameters were measured, the elastic modulus of cartilage was obtained 1MPa, permeability of 2.2 * 10-14m4/Ns. with these parameters of static load calculation, internal cartilage interstitial fluid flow under translational load and cycle load, and the establishment of the cartilage cells cross scale mechanical calculation method. Through the streaming potential measurement experiment to verify the cartilage cartilage biomechanics model above the experimental results obtained, the calculation results are consistent with the model.
Second, in Shanghai to carry out light cartilage interstitial fluid flow experiment. First screening suitable cartilage contrast agent, determination of the diffusion coefficient in the cartilage in the one-dimensional diffusion is 2.28 * 10-11m2/s + 0.71 * 10-11m2/s. based on the above data and experience, analysis of the cartilage interstitial fluid flow verification the difficulties faced, and put forward the technical scheme. Using the technical scheme of cartilage mechanics model analysis and pre experiment, optimized parameters. Finally, interstitial flow of normal cartilage and OA cartilage group group in the experiment. There is a big difference between the two groups of interstitial flow pattern of cartilage samples under cyclic loading.
Third, according to the cartilage on cartilage friction test and mechanical calculation, the friction coefficient of the surface of cartilage and cartilage increased between the decreased fluid carrying ratio is directly related to the moving speed. The load has a significant impact on the maintenance of cartilage surface interstitial fluid bearing ratio. On the other hand, DPPC liposomes with the positively charged head groups, negative surface potential of cartilage to promote the adsorption of liposome, is conducive to lubrication; while the positive surface potential exclusion of liposome, the lubricating environment deterioration.
Fourth, the friction and wear of articular cartilage with cartilage lubrication mechanism and failure to start the fatigue wear surface damage, excessive infiltration of interstitial fluid in cartilage, lead to vicious spiral biological macromolecules cartilage degradation. The cartilage cells cross scale mechanical calculation analysis of mechanical environment of normal cartilage and OA cartilage cells surrounding. The results show that the normal cartilage cells made mechanical calculation results and experimental results in the literature. On the contrary mechanical chondrocyte OA results far from the normal range, seriously affected the normal physiological function of cartilage cells, cartilage tissue and the OA observed were consistent.
Finally, semi hip arthroplasty and patella replacement without artificial knee joint replacement both postoperative result difference is the main reason for hip replacement destroyed the original mode of moving contact lubrication, the friction coefficient of acetabular cartilage in contact with the fixed metal ball head under will be significantly increased; secondly, the squeeze film results also show that the squeeze film semi hip replacement after the last longer than natural hip decreased 62%. with patella sliding motion itself to ensure the lubrication mode of the mobile contact, can maintain a low coefficient of friction at the level of hip replacement in the friction and wear conditions, soft bone cell mechanics environment has deteriorated. The cell mechanical environment of chondrocyte mechanics environment artificial knee joint replacement the operation of patella replacement and natural hip joint is basically the same.
The cartilage physiology of cartilage tribology to extend through the cross scale mechanical cartilage chondrocytes biomechanical model and calculation, to cartilage pathological phenomenon of mechanical damage of cartilage and the resulting together, for future interdisciplinary research in this area provides support.

【學位授予單位】：上海交通大學
【學位級別】：博士
【學位授予年份】：2014
【分類號】：R684;R318.01

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