仿生运动条件下股骨头截骨再生实验研究

This research is aimed to observe the hip joint regeneration under the controlled bionic motion simulating normal joint, after total osteotomy inside capsule by animal experiment, in which the femoral head ligment, all of the articular cartilage and partial bone mass under the articular cartilage are cut off. So to forms a closed cavity filled with hematoma come from leukemia of the cut ends of the illiac on the top and the femur at the bottom, and surrounded by the articular capsule. .Two priciples support the idea of this resarch . One of which is the intinsic factor that come from trauma mobilization, by which the medullary stromal cells and dedifferentiated cells are activated and are transported to the articular cavity. The other one is external environment, in which the articular joint is expected to regenerate in the healing progress by functional adaptation to the motion in large arrangement after the osteotomy, different from the case of bone shaft fracture healing. .The specific improvement of this research is to get femoral head regenerated in the bionic motion environment controlled by external fixtator that consists of three ratation joint with axis of which intersected at the original center of the hip, with rigarded as the result of bone none-union after osteotomy to cancellous bone under the cartilage from both side of the hip joint. .The importance of this research is to give the damaged articuler joint a space to get itself regenerated. And the biocompatibility is naturally satisfied, which enable us to look for a new concept therapy other than internal artificial joint replacement.

本研究采用“截骨”但不“融合”，与“假关节成形术”类似的动物实验方法，通过截除关节囊内的韧带、全部关节软骨和部分软骨下骨，形成周围是关节囊，上下两面都为截骨创面的血肿腔，活体观察在模仿原有正常关节运动控制条件下，关节囊内结构再生过程。.本研究再生理论依据来自两方面。1、内因。创伤动员，截骨使骨髓基质干细胞被激活和其他组织细胞转分化，并且随着出血输运到关节腔内；2、外因。与骨干骨折愈合过程相反相成，关节截骨后，仿生功能活动使骨折愈合过程与大范围的关节功能活动相适应，再生结构是适应于运动功能的关节。.本研究创新性在于，利用带转动中心在原始股骨头中心的3自由度髋关节外固定器，创造仿生运动环境；通过关节内双侧全层截骨，从骨折不愈合的角度探讨股骨头再生。.本项目的研究意义在于，从根本上解决生物相容性问题，在内置人工关节疗法之外提供另一种治疗思路。

结题摘要：.股骨头截骨再生，主要是从损伤修复的角度说。分为功能恢复和形态生成两方面。本题的任务是创造必要的生物力学环境，让关节局部再生出必要的形态，恢复一定的关节功能。主要是生物力学功能。.研究从基本的形态解剖学开始。核心任务是在截骨愈合过程中保持关节活动，按正常规律活动。本题研究完成了共球心的三个转动自由度的仿生髋关节穿针外固定器的设计，制作。遇到的困难主要是减负重。通过观察比较兔髋骨接近长骨形态，采用髂嵴2根穿针加上坐骨一根穿针，形成稳定承重的三角固端连接结构，实现了兔后肢的悬吊减/免负重。同时，设计兔减负重车，控制兔肌肉活动，进一步保证兔相对长期稳定的创伤修复力学环境。.髋关节仿生运动生物力学环境也表现在类似球窝关节的转动。而尽量限制平动。一旦出现旋转中心偏离，仿生运动就不能与原始运动轨迹吻合配准。采用数字化的无阻力磁芯片电位器实现了2个转动自由度的角度高精度测量。而弧轨运动测量传感器采用鼠标器芯片可以方便地感知运动，但课题组研究人员未能确定其灵敏度与运动速度的关系。转而采用绝对码编码器原理继续研制。时间严重耽搁。.除了重力，项目组充分重视关节受力的另一个来源，肌肉动力。通过超声观测深层肌肉的紧张，活动，并改进了兔步态测试系统，将足底受力与兔整体活动重心轨迹同时关联测试，通过步态信号波形分辨不同的运动模式，为掌握截骨关节内再生过程中的仿生环境提供了相对无创的动态方法。.而通过X线平片与兔减负重车的结合，了解不同受力环境下关节间隙的变化，更直接反映活动对截骨断面再生的影响。.接下来课题组需要利用前面的工作基础，精心完成足够数量的动物实验，描述截骨再生的精彩。