- 期刊
The Study of the Best-fit Designed Custom-made Hip Prostheses-A Comparison between the CT Data and x-ray Film
訂製式人工髖關節最適化設計之研究－利用電腦斷層資料及X光片資料之比較
摘要
臨床骨科醫師時常迫切的感受到訂製式人工髖關節的需求。理論上，對任何一個需要人工髖關節的病人而言，量身訂做的特製髖關節應該是最好的選擇，然而由於特製人工髖關節設計製造費時、價格昂貴，一般的病人並不能享受到它所帶來的優點，目前只有少數的病人會使用，因此，如何使用較便宜及快速的人工髖關節設計方法，是將來訂製式人工髖關節可以大量被使用的主要契機。本研究針對特製髖關節股骨柄，探討其設計流程。其中驗證股骨柄設計所需的股骨模型，利用CT影像以數位板方法建立；股骨柄設計，則根據CT影像和X光片影像分別建立，並比較不同方法其流程與結果的優缺點。在股骨柄模型建立方面，以CT影像和X光片影像分別建立的兩支股骨柄，安裝間隙(fit gap)和填滿程度(fill)的表現幾乎一致；以X光片影像建立的三支股骨柄，其輪廓差值在1mm以內，面積差異最大值為6.65%。因此，本研究建議以數位板方法建立股骨模型，也證實以X光片建立股骨柄模型是可行的。在設計參數方面，本研究發現y=ax^3模擬前傾弧度是合宜的；而y=ax^3+bx^2+cx+d模擬內傾弧度較適合。
並列摘要
The custom-made hip prostheses had strong demand by the orthopedic surgeons. How to achieve the best fit and fill with canal is the most important goal for the custom-made hip prostheses. Theoretically, the 3-dimensional model of hip stem made from CT data had the best fit and fill function than other methods. However, when compared with other factors like money and time, the model of custom-made prostheses made from x-ray film were more beneficial. An avascular necrosis femoral bone model was first established with CT scan data by using a manual digitizer. Two hip stems were then established according to the CT data and X-ray film, respectively. The difference of the results between two hip stems was then compared. The two stems established with CT data and X-ray film had the same performance in fit gap and fill. In the reliability study, the contour differences of three stems established with same X-ray film was smaller than 1mm, and the greatest difference of sectional area was 6.65%. In conclusion, the X-ray film data used to design the hip stem was a reliable and practical method. A cubic curve of y=ax^3 was good for anterior flare, and cubic curve of y=ax^3+bx^2+cx+d was good for medial flare for the best fit of hip stem prostheses in our study.
延伸閱讀
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