本文選題：骨重建算法 + 有限元分析　； 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：全膝關(guān)節(jié)置換術(shù)是治療膝關(guān)節(jié)疾病的有效手段,隨老年人口的日益增多,在未來(lái)將有更多患者接受全膝關(guān)節(jié)置換術(shù)的治療。然而,脛骨假體植入后會(huì)造成應(yīng)力遮擋與應(yīng)力集中,從而誘發(fā)脛骨骨量分布異常,導(dǎo)致病人術(shù)后疼痛并增大假體松動(dòng)的風(fēng)險(xiǎn)。因?yàn)榧袤w的構(gòu)型以及材料等設(shè)計(jì)因素會(huì)直接影響脛骨的應(yīng)力遮擋與應(yīng)力集中情況,所以假體的設(shè)計(jì)因素一直備受關(guān)注。本文通過(guò)數(shù)值仿真的方法,研究脛骨假體的構(gòu)型與材料對(duì)脛骨骨重建行為的影響。研究分為以下兩個(gè)部分:本文第一部分建立了三維脛骨和假體的有限元模型,結(jié)合骨重建算法定量地研究了非骨水泥型脛骨假體柄的材料與長(zhǎng)度對(duì)脛骨骨重建行為的影響。采用柄的長(zhǎng)度有三組,分別為110 mm、60 mm和30 mm,每組長(zhǎng)度采用四種材料,分別為鈦合金(Ti)、理想骨材料和兩種功能梯度材料(FGM),FGM的組分分別為T(mén)i和膠原-羥基磷灰石(FGM I),及Ti和生物玻璃(FGM II)。從脛骨骨密度分布、von Mises應(yīng)力分布、柄與脛骨接觸面切應(yīng)力三方面研究柄的幾何長(zhǎng)度與材料對(duì)應(yīng)力遮擋、應(yīng)力集中,以及假體穩(wěn)定性的影響。本文的研究結(jié)果表明:在長(zhǎng)度方面,長(zhǎng)柄會(huì)比短柄造成更嚴(yán)重的應(yīng)力遮擋與應(yīng)力集中,但是長(zhǎng)柄造成的接觸面切應(yīng)力更小,會(huì)為假體提供更好的穩(wěn)定性;在材料方面,與Ti相比,FGM I可以減小宿主脛骨的應(yīng)力遮擋與應(yīng)力集中情況,并提供更小且更均勻的接觸面切應(yīng)力,減小假體松動(dòng)的風(fēng)險(xiǎn);此外,當(dāng)柄的材料屬性接近骨的材料屬性時(shí),它的彈性模量變化才會(huì)對(duì)應(yīng)力遮擋情況產(chǎn)生顯著影響;最后,與柄的長(zhǎng)度相比,材料對(duì)脛骨近端骨重建的影響更為顯著。鑒于假體長(zhǎng)度往往受限于假體的固定方式和病人脛骨的解剖結(jié)構(gòu),從材料方面對(duì)柄進(jìn)行改進(jìn)更具靈活性與可行性。從微創(chuàng)手術(shù)的角度考慮,應(yīng)減小假體對(duì)脛骨骨組織的破壞;另外,考慮到脛骨結(jié)構(gòu)以及生理載荷的非對(duì)稱(chēng)性,應(yīng)設(shè)計(jì)體積分?jǐn)?shù)較小的非對(duì)稱(chēng)假體結(jié)構(gòu)用于全膝關(guān)節(jié)置換術(shù)。本文第二部分將拓?fù)鋬?yōu)化理論與有限元分析相結(jié)合,對(duì)骨水泥型脛骨假體柄與加強(qiáng)肋區(qū)域進(jìn)行優(yōu)化設(shè)計(jì)。以設(shè)計(jì)域的高中低三種體積分?jǐn)?shù)(分別為70%、50%和30%)為約束條件,結(jié)構(gòu)的最大剛度為目標(biāo)函數(shù),分析所得結(jié)構(gòu)對(duì)脛骨力學(xué)環(huán)境的影響,并得出理想的假體構(gòu)型。結(jié)果表明:當(dāng)松質(zhì)骨區(qū)域與脛骨托盤(pán)距離小于20 mm時(shí),拓?fù)鋬?yōu)化后的三組假體均可以減緩應(yīng)力遮擋情況;當(dāng)該距離為30 mm-40 mm時(shí),拓?fù)鋬?yōu)化后的假體可以顯著地減輕應(yīng)力集中情況,其中以70%體積分?jǐn)?shù)為約束的假體減緩應(yīng)力遮擋效應(yīng)最為明顯。因此脛骨假體以較高的體積分?jǐn)?shù)(70%左右)為約束時(shí),獲得的拓?fù)鋬?yōu)化構(gòu)型更為合理。分析原始的與優(yōu)化后的假體構(gòu)型差異發(fā)現(xiàn),去除加強(qiáng)肋以及柄的前外側(cè)區(qū)域,有助于減緩脛骨前外側(cè)區(qū)域的應(yīng)力遮擋,以及底端的應(yīng)力集中情況。本文先將骨重建算法與有限元分析相結(jié)合,研究了非骨水泥型脛骨假體柄的材料與長(zhǎng)度對(duì)脛骨骨重建過(guò)程的影響;然后建立了骨水泥型脛骨假體與脛骨的有限元模型,結(jié)合拓?fù)鋬?yōu)化理論,探究體積分?jǐn)?shù)優(yōu)化后的假體結(jié)構(gòu)對(duì)脛骨力學(xué)環(huán)境的影響。為脛骨假體的設(shè)計(jì)提供了理論依據(jù),有助于提高脛骨假體使用壽命,并減輕病人疼痛。
[Abstract]:Total knee arthroplasty is an effective method for the treatment of knee joint diseases. With the increasing population of the elderly, more patients will be treated with total knee replacement in the future. However, the tibial prosthesis will cause stress occlusion and stress concentration, which leads to the abnormal distribution of the bone mass of the tibia, causing postoperative pain and increasing the prosthesis of the patients. The risk of loosening. Because the configuration of the prosthesis and the design factors such as material will directly affect the stress occlusion and stress concentration of the tibia, the design factors of the prosthesis have been paid much attention. In this paper, the effects of the configuration of the tibial prosthesis and the material on the tibial bone reconstruction are studied by numerical simulation. The study is divided into two parts. Part 1: in the first part of this paper, a finite element model of three dimensional tibia and prosthesis was established. The effect of the material and length of the non bone cement type tibial prosthesis on the reconstruction behavior of tibia was quantitatively studied with the bone reconstruction algorithm. The length of the shank was three groups of 110 mm, 60 mm and 30 mm respectively. The length of each group adopted four kinds of materials, respectively titanium alloy. (Ti), ideal bone material and two functional gradient materials (FGM), FGM components are Ti and collagen hydroxyapatite (FGM I), and Ti and bioglass (FGM II). From the tibial bone density distribution, von Mises stress distribution, and the shank contact surface shear stress three aspects of the geometric length of the handle and material corresponding force occlusion, stress concentration, and prosthesis The results of the study show that the length, the long handle causes more severe stress occlusion and stress concentration than the short handle, but the long handle has smaller contact stress, which provides better stability for the prosthesis; in the material aspect, FGM I can reduce the stress occlusion and stress concentration of the host tibia compared with the Ti. A smaller and more uniform contact surface shear stress is provided to reduce the risk of prosthesis loosening; in addition, when the material property of the handle is close to the material property of the bone, the change of its modulus of elasticity will have a significant effect on the force occlusion; finally, the effect of the material on the proximal bone reconstruction of the tibia is more significant compared with the length of the handle. The length of the prosthesis is often limited to the fixation of the prosthesis and the anatomical structure of the tibia of the patient. It is more flexible and feasible to improve the handle from the material. From the point of view of minimally invasive surgery, the damage to the bone tissue of the tibia should be reduced. In addition, the volume fraction should be designed considering the dissymmetry of the tibial structure and the physiological load. The smaller asymmetric prosthesis is used for total knee arthroplasty. In this second part, the second part combines the topology optimization theory with the finite element analysis to optimize the bone cement type tibial stem and stiffening ribs. The maximum three volume fractions (70%, 50% and 30% respectively) of the design domain are constrained, and the maximum stiffness of the structure is The objective function is used to analyze the effect of the structure on the tibia mechanical environment and obtain the ideal configuration of the prosthesis. The results show that when the distance between the cancellous bone area and the tibial tray is less than 20 mm, the three components of the topology optimized can reduce the stress occlusion. When the distance is 30 MM-40 mm, the prosthesis after topology optimization can be significantly reduced. In the stress concentration condition, the 70% volume fraction of the prosthesis is most obvious in reducing the stress shielding effect. Therefore, the topologically optimized configuration of the tibial prosthesis is more reasonable when the higher volume fraction (about 70%) is restricted. Analysis of the original and optimized configuration differences of prostheses is found to remove the stiffeners and the anterolateral area of the stem. In this paper, the bone reconstruction algorithm and finite element analysis are combined to study the effect of the material and length of the non bone cement type tibial prosthesis on the reconstruction of the tibia, and then the finite element model of the bone cement type tibial prosthesis and the tibia is built. In combination with topological optimization theory, the effect of the structure of the prosthesis on the tibial mechanical environment is explored, which provides a theoretical basis for the design of the tibial prosthesis, which helps to improve the service life of the tibial prosthesis and reduce the pain of the patients.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R318.08;R68

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