基于快速成型的个体化人工半膝关节的研制——计算机辅助设计与制造  

FABRICATION OF CUSTOM-MADE ARTIFICIAL SEMI-KNEE JOINT BASED ON RAPID PROTOTYPING TECHNIQUE:COMPUTER-ASSISTED DESIGN AND MANUFACTURING

作　　者：王臻[1] 滕勇[1] 李涤尘[2] 刘非[2] 

机构地区：[1]第四军医大学西京医院骨科,西安710032 [2]西安交通大学先进制造研究所

出　　处：《中国修复重建外科杂志》2004年第5期347-351,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金资助项目 (599750 74)~~

摘　　要：目的　设计并制造一种用于复合异体半关节移植的个体化人工半膝关节 ,为解决异体骨移植关节软骨坏死和异体 -自体关节形状不匹配时提供一种方案。　方法　利用提取的股骨髁关节软骨三维轮廓数据 ,在 Surfacer9.0图像处理软件上进行个体化人工半膝关节的计算机辅助设计 ,得到三维模型 ,进行数据格式转换 ,在 L PS6 0 0快速成型机上制出快速成型树脂模 ,对树脂模进行修整、抛光获得理想的个体化人工半膝关节模型 ,经硅胶翻模、制作蜡模、成壳、浇铸 ,获得钛合金关节。将快速成型不易加工的融合笼焊接到关节上 ,抛光后即获得钛合金个体化人工半膝关节成品。并选择 1例 14岁患者 ,因右股骨下段骨肉瘤切除异体骨段保肢术后复发为临床应用。　结果　设计、制造出 1例新型复合异体半关节移植的个体化人工半膝关节 ,术中见假体与异体骨、对侧关节匹配良好。手术顺利 ,患者 5周可下地行走 ,6个月异体 -自体骨愈合 ,随访 1年患膝无不适 ,膝关节功能良好。　结论　经 CT数据获得骨骼三维轮廓信息 ,利用快速成型技术建模、熔模制造 ,可获得满意的个体化人工半膝关节假体 ,临床应用 1例明显改善膝关节功能 ,较好解决了异体Objective To design a new custom made artificial semi knee joint based on rapid prototyping(RP) technique and to explore a method to solve necroses of allocartilage in hemi joint allotransplantation. Methods Based on the extracted 3D contour image of the articular cartilage of femoral condyle, the custom made artificial semi knee joint was designed with Surfacer 9.0 image processing software. The artificial semi knee joint design used the femoral condylar 3D contour of the patient as the outer face and the subchondral bone 3D contour of allograft bone as inner face. One dado for medullary nail and two for special designing cages which were used to fix the cartilage into the allograft were added on the inner face. After being converted into RP data format, the computer assisted design was imported into the LPS600 rapid prototyping machine, and the prototype was achieved. Furthermore, the prototype could be modified by hand according to the design. Then the RP model was used as a positive mould to build up a silica gel negative mould, and the negative mould was sent to the factory to manufacture Ti 6Al 4V alloy articular cartilage through ordinary mould melted founding process. Finally, the whole metal cartilage was completed after melting two special cages on it and polishing it. Results A new custom made artificial semi knee joint was made and used to treat a 14 year old patient. The custom made artificial semi knee joint and the subchondral bone were a perfect match. The operative result was satisfactory. The patient could walk 5 weeks after operation. The bone healing of the auto bone and allo bone was achieved 6 months later. A follow up period lasting 1 year showed that the knee joint played a good function. Conclusion The artificial semi knee joint is a good match for the allograft bone and a good idea to solve necroses of allocartilage in hemi joint allotransplantation.

关 键 词：人工 膝关节功能 个体化 临床应用 异体骨 自体 关节软骨 骨骼 行走 形状 

分 类 号：R318.1[医药卫生—生物医学工程]