臺灣博碩士論文加值系統

在高齡化的社會，人工膝關節之置換愈來愈普遍，但由於長期使用下會造成人工膝關節元件之磨損，進而衍生其他問題，甚至失效。本研究主要針對人工膝關節材料之磨耗進行分析並進行超冷處理對提升其耐磨耗性之可行性評估。磨耗量測分析部份主要以體內及體外磨耗為主。透過利用分析患者X光照片、逆向工程建模分析及找出特徵值等方式以預估體內磨耗量；利用AMTI Force5體外磨耗試驗機依ISO 14243規範實際量測磨耗量方式，了解體外磨耗情形；並以超冷處理之試片進行體外試驗的磨耗性能之比較。結果顯示，體內磨耗量測若以X光片輔以找出特徵值並推估磨耗量之方式，因脛骨墊片形狀不規則，現階段要訂出特徵值有其難度；另體外磨耗以AMTI Force5之機台所測得之磨耗數據，是一種較可行且為業界所接受的做法。此外，超冷處理後之試片經體外試驗結果顯示耐磨耗性有明顯提升。

In aging society, the artificial knee replacement become increasingly common, however wear of the artificial knee components will happen after long-term use, which thus gives rise to other problems, or even failure. This research mainly aims at analyzing the wear of these artificial components and evaluating the cryogenic treatment for wear resistance. Wear analysis in vivo and in vitro measurements. The in vivo measurement could be carried out by analyzing the X-ray photos, the amount of wear could be estimated by the characteristic values of X-ray photos of a tibia insert; the in-vitro measurement can be accomplished by AMTI Force5 wear testing machine in accordance with ISO 14243 standard. Then the cryogenic treatment was utilized to compare the wear performance of components with and without this treatment. The analysis of in-vivo measurement shows that it has some difficulties to find the characteristic values of X-ray photos as to estimate the amount of in-vivo wear due to the complex shape a tibia insert, the in-vitro testing results indicate that AMTI Force5 wear tester in accordance with ISO 14243 standard is more practical and widely accepted by customers, which is useful for in-vitro wear measurement. In addition, the results show that the cryogenic treatment can significantly enhance the wear resistance.

目錄
摘要.................................................................................ii
ABSTRACT...........................................................................iii
目錄.................................................................................iv
圖目錄...............................................................................vi
表目錄...............................................................................ix
第一章 緒論............................................................................1
1-1 前言..............................................................................1
1-2 研究目的及方法......................................................................4
1-3 本文架構...........................................................................5
第二章 文獻回顧.........................................................................6
2-1 人工膝關節.........................................................................6
2-2 人工膝關節磨耗分析..................................................................23
2-3 ISO14243規範簡介..................................................................29
2-4 超冷處理對人工膝關節之效益評估........................................................35
第三章 研究方法及步驟...................................................................37
3-1實驗流程圖.........................................................................37
3-2 實驗設備..........................................................................37
3-3實驗說明及方法與步驟.................................................................49
第四章 結果與討論......................................................................59
4-1 體內磨耗結果分析與討論..............................................................59
4-2 體外磨耗結果分析與討論..............................................................62
第五章 結論與未來展望...................................................................65
5-1 結論.............................................................................65
5-2 未來展望..........................................................................66
參考文獻..............................................................................67
圖目錄
圖1-1人工膝關節元件.....................................................................1
圖1-2 本文架構流程圖....................................................................5
圖2-1 膝關節各部位......................................................................6
圖2-2 膝關節各部位的機械功能..............................................................8
圖2-3 人工膝關節的基本元件之結構及機械功能..................................................18
圖2-4 人工膝關節套件....................................................................23
圖2-5 人工膝關節磨擦示意圖...............................................................24
圖2-6 運動週期內屈曲角隨時間變化的示意圖....................................................30
圖2-7 左側全膝關節置換系統................................................................32
圖2-8 左側全膝關節置換系統................................................................33
圖2-9 ISO 14243步態圖整合...............................................................34
圖3-1 實驗流程圖........................................................................37
圖3-2紅色圈選區域為灰階值判斷墊片於體內的區域.................................................38
圖3-3 以線性量測推估植入體內墊片磨損程度.....................................................38
圖3-4 SMART SCAN3D白光掃描儀.............................................................40
圖3-5 GEOMAGIC STUDIO 9軟體.............................................................41
圖3-6 SOLID WORKS 2010軟體..............................................................42
圖3-7 排水法.............................................................................42
圖3-8 重垂法.............................................................................42
圖3-9 AMTI FORCE5磨耗試驗機...............................................................43
圖3-10 DELTA D150超音波清洗機.............................................................44
圖3-11 YSC DP-40V真空乾燥機...............................................................44
圖3-12 AND GH-252電子天平.................................................................45
圖3-13 人工股骨套件........................................................................45
圖3-14 人工股骨元件........................................................................46
圖3-15 人工股骨夾治具......................................................................46
圖3-16 人工脛骨墊片........................................................................46
圖3-17 人工脛骨座套件......................................................................47
圖3-18 人工脛骨元件........................................................................47
圖3-19 包埋測試夾具........................................................................47
圖3-20 骨水泥(用於固定人工脛骨座).............................................................48
圖3-21 超冷處理設備圖.......................................................................48
圖3-22 步態週期的軸向力變化情形...............................................................50
圖3-23 步態週期的AP力變化情形................................................................50
圖3-24 步態週期的脛骨扭矩變化情形..............................................................50
圖3-25 UOC-RD-TR-2103-3011墊片.............................................................52
圖3-26脛骨墊片3D模型........................................................................52
圖3-27 GEOMAGIC STUDIO網格修補.............................................................53
圖3-28 SOLID WORKS物件特性分析..............................................................53
圖3-29實驗樣品..............................................................................55
圖3-30脛骨基座包覆組.........................................................................56
圖3-31股骨FX軸前後校正.......................................................................53
圖3-32股骨FX軸水平校正.......................................................................53
圖3-33脛骨座FY基座側邊校正....................................................................55
圖3-34脛骨座FY基座水平校正....................................................................56
圖4-1重垂法實驗示意圖(原量杯水體積為600 ml).....................................................59
圖4-2高爾夫球入水之上升水位....................................................................60
圖4-3高爾夫球綁墊片入水之上升水位...............................................................60
圖4-4物件特性分析............................................................................61
圖4-5股骨組件...............................................................................63
圖4-6脛骨墊片...............................................................................63
圖4-7未超冷股骨元件..........................................................................64
圖4-8超冷股骨元件............................................................................64
圖4-9未超冷脛骨墊片..........................................................................64
圖4-10超冷脛骨墊片...........................................................................64
表目錄
表2-1 生物醫用材料之性質比較...................................................................14
表2-2 人工膝關節組成、分類、材料及特性...........................................................15
表2-3 人工膝關節金屬材料比較...................................................................17
表2-4 常用金屬材料的機械性能...................................................................18
表2-5 參考生物醫用鈦材料及其表面改性.............................................................19
表4-1 未超冷數據表............................................................................62
表4-2 超冷數據表..............................................................................63

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