腓骨截骨术治疗膝关节内侧间室骨关节炎的2D-3D影像学和在体生物力学研究

项目名称： 腓骨截骨术治疗膝关节内侧间室骨关节炎的2D-3D影像学和在体生物力学研究

项目编号： No.81501934

项目类型： 青年科学基金项目

立项/批准年度： 2016

项目学科： 医药、卫生

项目作者： 王娟

作者单位： 河北医科大学

项目金额： 18万元

中文摘要： 腓骨截骨术是治疗膝关节内侧间室骨关节炎的新手段，其有效性已得到临床验证，但其作用机理和应用指征尚不明确。针对这一问题，本研究拟以原发性膝关节内侧间室骨关节炎患者为研究对象，于腓骨截骨术前和术后6、12、24个月，应用X线显影的标定装置和统计形状建模技术实现二维X线图像采集和三维重建，精确测量二维和三维关节内外侧间隙、下肢力线、股骨胫骨解剖轴夹角等解剖参数，并进行个体化逆向动力学仿真和有限元仿真分析，获得膝关节及周围肌肉的力学分布数据。通过分析手术前后上述数据的变化及其与患者临床表现的相关性，对腓骨截骨术的功效进行量化评估和整体生物力学随访，并建立影像学改变、生物力学改变和临床转归之间的联系，从而明确腓骨截骨术治疗膝关节内侧间室骨关节炎的机理和应用指征，为该术式的推广提供科学依据。

中文关键词： 膝关节；骨性关节炎；外科手术；三维建模；有限元仿真

英文摘要： Fibulatomy is a new method for the treatment of primary medial compartment osteoarthritis (OA) of the knee joint and its validity has been clinically proved. However, the treatment mechanism and indication of this approach are still uncertain. In order to address these questions, this project intend to recruit patients with primary medial compartment osteoarthritis of the knee joint and perform fibulatomy on them as the treatment for OA. Radiographs of lower extremities of the patients will be taken while wearing radiopaque calibration devices preoperatively and 6, 12, and 24 months post-operatively. Two- and three-dimensional measurements including medial and lateral joint space, lower extremity force line and femoro-tibial anatomical axis angle will be measured on 2D X-ray images and 3D models produced by statistical shape modeling technique, and inverse dynamic simulation and finite element simulation will be performed using these measurements to obtain individual mechanical distribution information of the knee joint and its surrounding muscles. Comparison of preoperative and postoperative data will be performed, and their relevance to the clinical manifestations of the patients will be analyzed, to carry out quantitative evaluation and biomechanical follow-up of the efficacy of the surgery and establish the relation of imaging anatomical changes, biomechanical changes and clinical outcomes, in order to illustrate the mechanism and specific indication of fibulatomy in treatment of medial compartment OA of the knee joint, thereby providing scientific evidence to support the extending use of this new method.

英文关键词： knee;osteoarthitis;surgery;3D modeling;finite element simulation