双动人工半膝关节假体的设计及应用

Custom-made Bipolar Hemi-knee Prosthesis Design and Clinical Application

建立一种双动人工半膝关节假体的设计方法,用于年轻病人因恶性骨肿瘤造成的股骨远端大段骨缺损的保肢手术治疗。借助于有限元分析与快速成形技术,研究并快速而有效地解决假体结构设计优化、生物力学分析、稳定性评估等技术难点,形成一种以定制化仿生大范围股骨髁部、滑动轴套系统、韧带附丽孔道为特点的附丽型定制化双动半膝关节假体。临床应用证明置换术后假体与周围组织匹配性良好,患者在完成深屈曲运动时可观察到假体的双滑动过程。该假体的研究为单侧膝关节损伤患者,特别是青少年患者术后骨生长的生物学重建及后期关节功能的良好恢复提供了有效的治疗方法。该研究也从功能化设计、性能分析与临床功能评估等方面为人工关节的研制与发展提出新的思路与方法。

A bipolar customised hemi-knee prosthesis is designed to treat maligament bone tumor on the femoral side of a young patient. Design considerations included the close match with the patients anatomy, stress optimisation of the prosthetic components, close conformity between the contacting surfaces of the prosthesis and the tibial cartilage and stability as well as reducing the development time and costs. Computational analysis based on the finite element method is employed to optimise the designs and provide pre-clinical evaluation. The optimised prosthesis was fabricated via rapid manufacture technique and tested in-vitro to evaluate its effectiveness. Clinical application of the prosthesis shows improved functional outcomes. It not only proposes a new concept of bipolar hemi-knee prosthesis, but also provides a general approach for functional design, computational analysis, rapid manufacturing and clinical application of customised prostheses.