上海交通大学学报

上海交通大学学报 >

2023 , Vol. 57 >Issue 5: 560 - 569

DOI: https://doi.org/10.16183/j.cnki.jsjtu.2022.194

生物医学工程

定制式增材制造膝关节矫形器间室减荷效果的有限元分析

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  • 1.上海交通大学医学院附属第九人民医院 骨科, 上海 200011
    2.上海交通大学 生物医学工程学院, 上海 200030
    3.徐州医科大学 医学影像学院, 江苏 徐州 221004
    4.上海体育学院 运动科学学院, 上海 200438
    5.潍坊医学院 康复医学院, 山东 潍坊 261053
许苑晶(1993-),中级工程师,从事3D打印医疗器械研发与注册研究.

收稿日期: 2022-06-06

  修回日期: 2022-07-01

  录用日期: 2022-07-12

  网络出版日期: 2023-01-06

基金资助

国家重点研发计划(2020YFB1711505);重点专项,上海市科委项目(19441917500);重点专项,上海市科委项目(19441908700)

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Finite Element Analysis of Decompression Effect of Custom Additively Manufactured Knee Orthosis Compartments

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  • 1. Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
    2. School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China
    3. School of Medical Imaging, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
    4. School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
    5. Department of Rehabilitation Medicine, Weifang Medical University, Weifang 261053, Shandong, China

Received date: 2022-06-06

  Revised date: 2022-07-01

  Accepted date: 2022-07-12

  Online published: 2023-01-06

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摘要

通过构建膝关节与定制式增材制造膝关节矫形器有限元模型,模拟膝骨关节炎(KOA)患者佩戴矫形器前后的膝关节生物力学变化,验证矫形器的间室减荷效果,针对矫形器治疗效果开展定量化研究,可用于膝关节矫形器的临床疗效评价.实验经过上海交通大学医学院附属第九人民医院伦理委员会审批通过,招募一名膝骨关节炎的女性,对其膝关节进行光学体表及CT扫描,根据单侧减荷原理设计定制式增材制造膝关节矫形器,通过网格划分、材料赋值、边界设置等步骤,利用ANSYS等软件构建包括膝关节与定制式增材制造膝关节矫形器有限元模型,沿下肢负重轴方向对膝关节施加 1 100 N的压缩载荷,进行仿真及应力分析,研究定制式增材制造膝关节矫形器对膝关节间室的减荷效果.针对KOA特性进行有限元分析,验证软骨、韧带及下肢皮肤对膝关节承载能力的影响.相较于未佩戴任何矫形器情况,佩戴定制式膝关节矫形器后,膝关节内翻角度减少、内侧压力向外侧转移且内侧间室压力明显降低.定制式增材制造膝关节矫形器可降低早中期内侧间室型膝骨关节炎患者在步行过程中膝关节内侧间室所产生的压力,减荷效果显著.

关键词： 膝骨关节炎; 膝关节矫形器; 有限元分析; 生物力学特性; 减荷效果

本文引用格式

许苑晶, 高海峰, 吴云成, 柳毅浩, 张子砚, 黄承兰, 王赞博, 刘同有, 王彩萍, 缪伟强, 王金武 . 定制式增材制造膝关节矫形器间室减荷效果的有限元分析[J]. 上海交通大学学报, 2023 , 57(5) : 560 -569 . DOI: 10.16183/j.cnki.jsjtu.2022.194

Abstract

To simulate the biomechanical changes of knee joint before and after wearing the orthosis in patients with knee osteoarthritis (KOA) by constructing a finite element model of the knee joint and a customized additively manufactured knee orthosis, so as to verify the decompression effect of the orthosis, and aimed at orthopaedics, a quantitative research on the therapeutic effect of knee orthosis was conducted to evaluate the clinical efficacy of knee orthosis.This experiment was approved by the Ethics Committee of the Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. A woman with knee osteoarthritis was recruited, and the knee joint was subjected to optical body surface and CT scans. A custom-made additively manufactured knee orthosis was designed according to the principle of unilateral decompression. After boundary setting and other steps, software such as ANSYS was used to build a finite element model of the knee joint and a customized additively manufactured knee joint orthosis. By applying a compressive load of 1100 N to the knee joint along the direction of the lower limb load-bearing axis, a simulation and stress analysis was performed to study the deloading effect of a custom additively manufactured knee orthosis on the knee compartment. A finite element analysis of KOA characteristics was conducted for verification, considering the influence of cartilage, ligament, and lower limb skin on the bearing capacity of the knee joint. Compared with the case without wearing any orthosis, after wearing the customized knee orthosis, the varus angle of the knee joint was reduced, the medial pressure of the knee joint was shifted to the lateral side, and the pressure of the medial compartment of the knee joint was significantly reduced. The custom additively manufactured knee orthosis can reduce the pressure generated by the medial compartment of the knee joint during walking in patients with early and mid-stage medial compartment knee osteoarthritis, and the load reduction effect is significant.

Key words： knee osteoarthritis (KOA); knee orthosis; finite element analysis; biomechanical properties; deloading effect

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