球囊撑开器对儿童膝关节生物力学影响的有限元分析  

Finite element analysis of biomechanical effects of balloon expander on pediatric knee joint

作　　者：周天鹏 谷雪莲[1,2] 李海 周金成[1] 刘宇甜 赵宇轩 ZHOU Tianpeng;GU Xuelian;LI Hai;ZHOU Jincheng;LIU Yutian;ZHAO Yuxuan(School of Health Science and Engineering,University of Shanghai for Science and Technology,Shanghai 200093,China;Shanghai Engineering Research Center of Interventional Medical Device,Shanghai 200093,China;Department of Pediatric Orthopaedic Surgery,Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海理工大学健康科学与工程学院,上海200093 [2]上海介入医疗器械工程技术研究中心,上海200093 [3]上海交通大学医学院附属新华医院儿骨科,上海200092

出　　处：《中国医学物理学杂志》2023年第4期503-511,共9页Chinese Journal of Medical Physics

基　　金：上海介入医疗器械工程技术研究中心资助项目(18DZ22-50900)。

摘　　要：目的:基于儿童膝关节MRI图像建立正常膝关节三维实体模型和球囊完全撑开膝关节的三维有限元模型,采用有限元法分析两种球囊撑开器(分开设计/一体化设计)对膝关节的生物力学影响。方法:使用医学建模软件建立儿童膝关节有限元模型,模拟儿童膝关节镜手术过程。建立两种球囊撑开器模型,对球囊模型施加不同的压力,探究分开设计时3种不同形状球囊和一体化设计时不同短轴尺寸球囊与膝关节软骨相互作用的应力分布情况,获得撑开方式的最优设计。结果:当撑开器与膝关节镜分开设计时,球状球囊对软骨的峰值应力影响较小;当撑开器一体化设计时,短半轴3.0 mm逐渐增大尺寸,环状球囊的应力峰值变化较小且软骨上的应力峰值较小,环状球囊短半轴取3.0 mm是一种较优的尺寸。结论:球囊撑开器可以有效撑开一定的膝关节间隙,撑开器一体化设计相比分开设计在术中对膝关节影响较小。本研究为球囊撑开器中球囊几何结构的设计提供理论依据,提高了半月板手术治疗的安全性。Objective To establish the three-dimensional solid model of normal knee joint and the three-dimensional finite element models of knee joint treated with complete balloon distraction based on MRI images of pediatric knee joint,and to analyze the biomechanical effects of balloon expander in separate or integrated design on knee joint using finite element method.Methods The finite element model of pediatric knee joint was established using medical modeling software for simulating arthroscopic operation.Two kinds of balloon expander models were established,and different pressures were applied to the balloon expander models for exploring the stress distribution under the interaction between the different balloon expanders(3 different shapes of the balloon in the separate design and annular balloon with different short axis sizes in the integrated design)and the knee joint cartilage,thereby obtaining the optimal design for balloon expander.Results When the expander and knee arthroscope were designed separately,the peak stress of cartilage was less affected by spherical balloon.When the expander was designed in an integrated way,and the short half axis was gradually increased from 3.0 mm,the stress peak of the annular balloon changed little,and the stress peak on the cartilage was relatively small,indicating that an annular balloon with a short half axis of 3.0 mm was a better choice.Conclusion The balloon expander can effectively open certain knee space,and the integrated design of the balloon expander has less effect on the knee joint than the separate design.The study provides a theoretical basis for the geometric design of the balloon expander and improves the safety of meniscus surgery.

关 键 词：球囊撑开器 儿童膝关节 软骨 有限元分析 

分 类 号：R318[医药卫生—生物医学工程]