目的构建青少年特发性脊柱侧凸的肌肉骨骼张拉整体有限元模型,模拟Chêneau支具矫正力耦合,分析骨骼、肌肉和椎间盘的力学特性。方法纳入1例Rigo A3型青少年特发性脊柱侧凸的CT数据,使用Mimics 21.0、Geomagic Studio 2017、Solid W...目的构建青少年特发性脊柱侧凸的肌肉骨骼张拉整体有限元模型,模拟Chêneau支具矫正力耦合,分析骨骼、肌肉和椎间盘的力学特性。方法纳入1例Rigo A3型青少年特发性脊柱侧凸的CT数据,使用Mimics 21.0、Geomagic Studio 2017、Solid Works 2020软件,建立包含肌肉、骨骼、椎间盘的AIS张拉整体有限元模型。使用Ansys Workbench 19.0模拟Chêneau支具经典的三点力耦合、反重力和Bengding等机制,观察张拉整体中骨骼、肌肉和椎间盘力学特性。再根据前期课题组的临床研究结果,逐渐下调腰代偿弯的矫正力,综合评价符合引导脊柱对称生长的Chêneau支具矫正力耦合。结果本研究构建了包括肌肉、椎间盘、骨骼的张拉整体的模型,经验证有效后进行模拟。模拟中发现:当Chêneau矫正力耦合达到最大矫正压力阈值时,主胸弯的Cobb矫正率、顶椎的椎间隙高度与椎间盘应力的凹凸比值最佳;然而,近胸弯Cobb角加重,肌肉的轴向力凹凸比值失衡。当腰代偿弯区域的矫正力逐步下调至25%最大阈值时,主胸弯曲线的矫正率随着之略降低,但近胸弯Cobb角未加重,椎间盘、侧肌肉的轴向力凹凸比值则更趋平衡。结论在AIS整体张拉的模型模拟中,将Chêneau支具代偿性腰弯的矫正力下调,可获得更优的张拉整体的生物力学表现,这提示对打破主胸弯进展的恶性循环模式、引导脊柱良性生长有益。展开更多
膝骨关节炎(Knee osteoarthritis, KOA)是一种常见的退行性病理改变的疾病,现已成为影响中老年群体下肢健康的重要威胁。膝关节镜手术能在极小的创口下清晰观察关节内部结构,进行必要的清创,从而有效缓解疼痛,改善关节功能。然而仅依赖...膝骨关节炎(Knee osteoarthritis, KOA)是一种常见的退行性病理改变的疾病,现已成为影响中老年群体下肢健康的重要威胁。膝关节镜手术能在极小的创口下清晰观察关节内部结构,进行必要的清创,从而有效缓解疼痛,改善关节功能。然而仅依赖手术往往难以达到最佳的长效治疗效果,引入膝关节支具能为术后的康复提供了强有力的支持。支具不仅能稳定关节,减轻因负重而加剧的疼痛,还能在一定程度上纠正关节的不良力线分布,促进关节功能的恢复和软组织的愈合。本研究的目的在于总结关节镜联合支具治疗膝骨关节炎的问题,以供医疗实践中作参考。Knee osteoarthritis (KOA) is a common degenerative disease that poses a significant threat to the lower limb health of middle-aged and elderly populations. Arthroscopic surgery allows for clear observation of the internal joint structure through minimal incisions, performing necessary debridement to effectively alleviate pain and improve joint function. However, relying solely on surgery often fails to achieve the best long-term therapeutic outcomes. The introduction of knee joint braces provides strong support for postoperative rehabilitation. Braces not only stabilize the joint and reduce pain exacerbated by weight-bearing but also correct the distribution of abnormal forces on the joint to some extent, promoting the recovery of joint function and the healing of soft tissues. The purpose of this study is to summarize the issues associated with the combined use of arthroscopy and braces in the treatment of knee osteoarthritis for reference in medical practice.展开更多
文摘目的构建青少年特发性脊柱侧凸的肌肉骨骼张拉整体有限元模型,模拟Chêneau支具矫正力耦合,分析骨骼、肌肉和椎间盘的力学特性。方法纳入1例Rigo A3型青少年特发性脊柱侧凸的CT数据,使用Mimics 21.0、Geomagic Studio 2017、Solid Works 2020软件,建立包含肌肉、骨骼、椎间盘的AIS张拉整体有限元模型。使用Ansys Workbench 19.0模拟Chêneau支具经典的三点力耦合、反重力和Bengding等机制,观察张拉整体中骨骼、肌肉和椎间盘力学特性。再根据前期课题组的临床研究结果,逐渐下调腰代偿弯的矫正力,综合评价符合引导脊柱对称生长的Chêneau支具矫正力耦合。结果本研究构建了包括肌肉、椎间盘、骨骼的张拉整体的模型,经验证有效后进行模拟。模拟中发现:当Chêneau矫正力耦合达到最大矫正压力阈值时,主胸弯的Cobb矫正率、顶椎的椎间隙高度与椎间盘应力的凹凸比值最佳;然而,近胸弯Cobb角加重,肌肉的轴向力凹凸比值失衡。当腰代偿弯区域的矫正力逐步下调至25%最大阈值时,主胸弯曲线的矫正率随着之略降低,但近胸弯Cobb角未加重,椎间盘、侧肌肉的轴向力凹凸比值则更趋平衡。结论在AIS整体张拉的模型模拟中,将Chêneau支具代偿性腰弯的矫正力下调,可获得更优的张拉整体的生物力学表现,这提示对打破主胸弯进展的恶性循环模式、引导脊柱良性生长有益。
文摘膝骨关节炎(Knee osteoarthritis, KOA)是一种常见的退行性病理改变的疾病,现已成为影响中老年群体下肢健康的重要威胁。膝关节镜手术能在极小的创口下清晰观察关节内部结构,进行必要的清创,从而有效缓解疼痛,改善关节功能。然而仅依赖手术往往难以达到最佳的长效治疗效果,引入膝关节支具能为术后的康复提供了强有力的支持。支具不仅能稳定关节,减轻因负重而加剧的疼痛,还能在一定程度上纠正关节的不良力线分布,促进关节功能的恢复和软组织的愈合。本研究的目的在于总结关节镜联合支具治疗膝骨关节炎的问题,以供医疗实践中作参考。Knee osteoarthritis (KOA) is a common degenerative disease that poses a significant threat to the lower limb health of middle-aged and elderly populations. Arthroscopic surgery allows for clear observation of the internal joint structure through minimal incisions, performing necessary debridement to effectively alleviate pain and improve joint function. However, relying solely on surgery often fails to achieve the best long-term therapeutic outcomes. The introduction of knee joint braces provides strong support for postoperative rehabilitation. Braces not only stabilize the joint and reduce pain exacerbated by weight-bearing but also correct the distribution of abnormal forces on the joint to some extent, promoting the recovery of joint function and the healing of soft tissues. The purpose of this study is to summarize the issues associated with the combined use of arthroscopy and braces in the treatment of knee osteoarthritis for reference in medical practice.
