全膝關節置換手術輔助機器人之非影像式導引系統

Development of an Image-Free Guiding System for Total Knee Replacement

羅藍馥(Fu Luo-Lan)

指導教授 ： 顏炳郎

國立臺北科技大學/機電學院/自動化科技研究所/碩士(2008年)

摘要

每個人的膝蓋經過長年累月的彎曲造成的磨損，會使行動上造成疼痛，這種情況下，如果磨損程度過於嚴重，則必須進行人工膝關節置換手術(Total Knee Replacement)。在傳統人工膝關節置換手術過程，手術的切割精確度不易掌控，故有可能影響手術品質，容易造成日後植入物鬆脫的主因之一，且傳統手術在進行手術時對膝關節特徵點量測的方式繁雜且費時。
為了提升手術精確度、減少病人輻射感染以及成本考量，本研究發展一套非影像式全膝關節置換手術輔助機器人之導引系統，結合電腦導引系統與手術輔助機器人，利用手術輔助機器人量測膝關節特徵點，再經由程式精密運算之後，可以在術中提供手術輔助機器人與各個切除面之間的方位關係，且直接由手術輔助機器人進行切割，不需在錠上切割導塊，使醫生能輕易控制手術輔助機器人進行準確的削除膝關節各個切除面，達到正確安裝人工關節之目的。
經由實驗量測數據可以得知，程式所選擇的人工膝關節尺寸合適，且股骨與脛骨的誤差皆在可容許範圍之內，其量測誤差來源有可能是量測方式所造成，但此數據結果應用於手術已足夠。

關鍵字

全膝關節置換手術 ； 骨科手術 ； 非影像式 ； 手術導引 ； 手術機器人

並列摘要

After a lot of bending, our knees will be abraded, and this will bring pain to our movements. Under this situation, if the abrasion is too serious, a surgery called, Total Knee Replacement needs to be done. In traditional artificail knee replacement surgery,the accuracy of cutting is hard to be controlled, and it will affect the quality of the overall surgery and is the main reason for the looseness of the implantation. Also, the measurements of the knee characteristics in traditional surgery is complicated and tedious.
To increase the precision and to reduce the infection of radiation, and also for the sake of cost, this research develops a Image-Free of a Surgical Robot for Total Knee Replacement. With the integration of computer guiding system and robot assistant,the robot assistant measures the characterists of the knee, and after the data is calculated by computer programs, it can provide the position between the robot assistant and the part that is to be removed, and the robot assistant can directly make incisions. There is no need to cut guiding segments anymore. It brings ease to doctors to control robot assistant and to accurately remove every cutting surfaces on the knee and culminate to the presision of the installation of artificial knee. According to the experiment data, the size of the artificial knee chosen by the program is suitable, and the inaccuracies of butt bone and shin bone are within tolerance. The deviation might result from the way of measurements, but the data is sufficient to be applied in surgery.

並列關鍵字

Total Knee Replacement(TKR) ； Orthopedics surgery ； Image-Free ； Surgery guiding ； Surgical Robot

參考文獻

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