【摘要】：膝關節(jié)作為人體最大且構造最復雜的關節(jié),極易受到損傷。一般采用全膝置換術對晚期的膝關節(jié)疾病進行治療。而關節(jié)置換術并非一勞永逸,很多患者術后都會出現關節(jié)失效等問題。目前,很多學者從運動生物力學的角度對骨關節(jié)炎發(fā)病機理、人工關節(jié)失效等問題進行了大量研究,但還未取得突破性成果。尤其,相對于歐美國家,我國的運動生物力學研究起步較晚,很多方面都不夠完善。因此,針對國人的運動生物力學研究意義重大。有關運動生物力學的研究中,針對人體步態(tài)的研究開展最為廣泛。正常人體步態(tài)具有周期性和穩(wěn)定性,能夠描述人體基本運動特征。本文采用三維運動捕捉、有限元分析、肌肉驅動模擬等先進的技術手段,對健康人體和接受TKA的患者進行了步態(tài)分析和仿真研究。本章所得結論揭示了健康人體下肢關節(jié)的運動規(guī)律和TKA對人體下肢關節(jié)運動的影響,對人工膝關節(jié)的設計以及TKA術后康復等都有指導作用。采用三維運動捕捉系統,對健康青年人和老年人在行走和慢跑時的時空參數和運動學參數進行研究。結果顯示與青年人相比,老年人的速度和步長都較小,而步頻相差不大。青年人和老年人之間存在的步態(tài)時空參數的年齡差異主要是老年人步長減小引起的。在行走和慢跑時,下肢關節(jié)的運動學參數也存在年齡差異。青年人和老年人下肢關節(jié)的運動范圍差異與人體運動速度有關。采用三維運動捕捉系統和測力系統,對膝關節(jié)損傷的老年女性和健康老年女性在行走時的下肢關節(jié)運動學和動力學參數進行研究。結果顯示,與健康受試者相比,TKA前患者的速度和步長較小,雙支撐期明顯變長。同時,患者更傾向于使用健康側下肢膝關節(jié),雙側髖關節(jié)和踝關節(jié)的運動會發(fā)生一定的代償性變化。TKA后,患者的時空參數基本恢復到正常水平。而與健康受試者相比,患者下肢關節(jié)運動角度仍然存在較大差異,但關節(jié)運動力矩有較大改善。采用醫(yī)學影像掃描和有限元分析技術,研究直立狀態(tài)和腳跟著地相、單肢中立相、腳尖離地相四個瞬態(tài)時,人體膝關節(jié)的股骨軟骨、脛骨軟骨的接觸應力分布情況,和人工膝關節(jié)的股骨假體、脛骨墊片和髕骨假體的接觸應力分布情況。研究結果顯示,人體膝關節(jié)中,股骨軟骨最易產生磨損和病變,并且脛骨內側軟骨比外側軟骨易發(fā)生磨損。人工膝關節(jié)中,脛骨墊片和股骨假體上應力峰值較大,為容易產生關節(jié)失效的部位。采用Open Sim軟件建立一名接受TKA患者的肌肉骨骼模型,分析四種步速下,患者手術側和健康側下肢主要肌肉的肌力和活動度的變化以及下肢主要肌肉分別引起的質心加速度。研究結果顯示,隨著步速下降,患者下肢各肌肉的肌力基本呈現逐漸減小的趨勢�；颊呤中g側和健康側肌肉力和肌肉活性基本一致,而雙側下肢肌肉對身體質心的作用完全相反。
[Abstract]:As the largest and most complicated joint of human body, knee joint is easy to be damaged. General use of total knee replacement for the treatment of late knee disease. Joint replacement is not once and for all, many patients will have joint failure and other problems. At present, many scholars have done a lot of research on the pathogenesis of osteoarthritis and artificial joint failure from the point of view of sports biomechanics, but no breakthrough results have been achieved. In particular, the study of sports biomechanics in China is relatively late compared with Europe and America, and many aspects are not perfect. Therefore, the study of sports biomechanics for Chinese is of great significance. In the research of sports biomechanics, the research on human gait is the most extensive. The gait of normal human body has periodicity and stability, and can describe the basic motion characteristics of human body. In this paper, gait analysis and simulation of healthy human body and patients receiving TKA were carried out by using advanced techniques such as 3D motion capture, finite element analysis and muscle drive simulation. The conclusions in this chapter reveal the movement law of lower extremity joint and the influence of TKA on lower extremity joint movement. It can guide the design of artificial knee joint and rehabilitation after TKA. The time and space parameters and kinematics parameters of walking and jogging of healthy young people and old people were studied by three dimensional motion capture system. The results showed that the speed and step length of the old people were smaller than that of the young people, but the step frequency was not different. The difference in gait space-time parameters between the young and the elderly is mainly caused by the decrease of the gait size. During walking and jogging, the kinematic parameters of lower extremity joints were also different in age. The range of lower extremity joint movement in young and old people is related to the movement speed of human body. The kinematic and dynamic parameters of lower extremity joints of elderly and healthy elderly women with knee joint injury were studied by means of three-dimensional motion capture system and force measuring system. The results showed that the speed and step length of the patients before TKA were smaller and the double support period was longer than that of the healthy subjects. At the same time, patients tend to use the healthy lower extremity knee joint, bilateral hip and ankle motion will have a certain compensatory change. TKA, the patient's space-time parameters are basically back to normal level. Compared with the healthy subjects, the lower extremity motion angle of the patients is still different, but the joint motion torque is improved greatly. Using medical imaging scanning and finite element analysis techniques, the contact stress distribution of femoral cartilage and tibial cartilage of human knee joint was studied under four transient conditions: vertical state and heel landing phase, neutral phase of single limb and apical phase. The contact stress distribution of femoral prosthesis, tibial pad and patellar prosthesis. The results show that femoral cartilage is the most prone to wear and lesion in human knee, and medial tibial cartilage is more prone to wear than lateral cartilage. In the artificial knee joint, the peak stress of tibial gasket and femur prosthesis is high, which is prone to joint failure. A musculoskeletal model of a patient receiving TKA was established by using Open Sim software. The changes of muscle strength and movement of the main muscles of the lower extremities and the acceleration of the center of mass caused by the main muscles of the lower extremities were analyzed under four walking speeds. The results showed that the muscle strength of lower extremity muscles decreased gradually with the decrease of walking speed. The muscle strength and muscle activity of the surgical side and the healthy side were basically the same, but the effect of bilateral lower extremity muscles on the body centroid was completely opposite.
【學位授予單位】：中國礦業(yè)大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.4;R318.1

【參考文獻】

相關期刊論文 前10條

1 馬青川;肖麗英;林劍浩;李志昌;董雪;;單側全膝關節(jié)置換術前兩下肢步態(tài)差異性分析[J];中國康復醫(yī)學雜志;2015年05期

2 龍術民;楊陳誠;杜勇;;單側初次人工髖關節(jié)置換患者康復期下肢關節(jié)的運動狀況研究[J];局解手術學雜志;2015年02期

3 郭媛;張緒樹;安美文;陳維毅;;日常運動時內翻人工膝關節(jié)接觸壓力的有限元分析[J];太原理工大學學報;2014年03期

4 石曉明;于占革;;骨關節(jié)炎發(fā)病機制的研究進展[J];中華臨床醫(yī)師雜志(電子版);2013年24期

5 趙江莉;毛玉tb;鄔培慧;廖威明;黃東鋒;;單側全髖關節(jié)置換術后患者下肢三維運動力學特征分析[J];中國康復醫(yī)學雜志;2013年10期

6 姜宗來;;從生物力學到力學生物學的思考[J];醫(yī)用生物力學;2013年S1期

7 馬妮;肖麗英;;基于LifeMOD的個性化人工膝關節(jié)設計中的生物力學分析[J];中國康復醫(yī)學雜志;2011年06期

8 韓亞麗;王興松;;人體行走下肢生物力學研究[J];中國科學:技術科學;2011年05期

9 曲新華;戴\戎;;金屬對金屬人工髖關節(jié)臨床應用的現狀[J];中華關節(jié)外科雜志(電子版);2010年05期

10 劉書朋;司文;嚴壯志;許昌威;;基于AnyBody~(TM)技術的人體運動建模方法[J];生物醫(yī)學工程學進展;2010年03期

相關博士學位論文 前7條

1 韓樹洋;人體關節(jié)生物力學實驗及仿真研究[D];中國礦業(yè)大學;2014年

2 周海;國人髖關節(jié)解剖與行為學特性研究及在人工關節(jié)設計中的應用[D];上海交通大學;2014年

3 王建平;膝關節(jié)力學建模與屈曲運動生物力學特性研究[D];上海交通大學;2010年

4 陳睿;基于概率模型的三維人體運動跟蹤研究[D];中國科學院研究生院（計算技術研究所）;2005年

5 何榮新;全髖關節(jié)置換術后關節(jié)穩(wěn)定性的研究[D];浙江大學;2004年

6 張正廉;CF/PEEK全髖股骨頭假體的研制與生物力學實驗研究[D];蘇州大學;2004年

7 楊年峰;人體運動協調規(guī)律及其參數化描述[D];清華大學;2001年

相關碩士學位論文 前6條

1 黃金鑫;縱跳的人體下肢運動仿真與生物力學研究[D];吉林大學;2015年

2 周唯儒;拓撲優(yōu)化方法在口腔種植體周圍松質骨結構模擬中的應用[D];吉林大學;2015年

3 皮仕蟬;基于可變形模型的人體運動跟蹤分析[D];南京理工大學;2014年

4 曹仲凱;無線步態(tài)分析系統的軟件設計與實現[D];大連理工大學;2013年

5 沈艷菲;三階拉格朗日方程兩個形式的研究[D];江西師范大學;2010年

6 汪洋;髕骨高度的測量在骨性關節(jié)炎患者行全膝關節(jié)置換手術中的意義[D];新疆醫(yī)科大學;2010年

，

本文編號：2236146