Debski Richard E, Yamakawa Satoshi, Musahl Volker, Fujie Hiromichi
Orthopaedic Robotics Laboratory, Departments of Bioengineering and Orthopaedic Surgery, University of Pittsburgh, 408 Center for Bioengineering, 300 Technology Drive, Pittsburgh, PA 15219 e-mail:
Tokyo Metropolitan University, 6-6 Asahigaoka, Hino, Tokyo 191-0065, Japan.
J Biomech Eng. 2017 Feb 1;139(2). doi: 10.1115/1.4035644.
Diarthrodial joint function is mediated by a complex interaction between bones, ligaments, capsules, articular cartilage, and muscles. To gain a better understanding of injury mechanisms and to improve surgical procedures, an improved understanding of the structure and function of diarthrodial joints needs to be obtained. Thus, robotic testing systems have been developed to measure the resulting kinematics of diarthrodial joints as well as the in situ forces in ligaments and their replacement grafts in response to external loading conditions. These six degrees-of-freedom (DOF) testing systems can be controlled in either position or force modes to simulate physiological loading conditions or clinical exams. Recent advances allow kinematic, in situ force, and strain data to be measured continuously throughout the range of joint motion using velocity-impedance control, and in vivo kinematic data to be reproduced on cadaveric specimens to determine in situ forces during physiologic motions. The principle of superposition can also be used to determine the in situ forces carried by capsular tissue in the longitudinal direction after separation from the rest of the capsule as well as the interaction forces with the surrounding tissue. Finally, robotic testing systems can be used to simulate soft tissue injury mechanisms, and computational models can be validated using the kinematic and force data to help predict in vivo stresses and strains present in these tissues. The goal of these analyses is to help improve surgical repair procedures and postoperative rehabilitation protocols. In the future, more information is needed regarding the complex in vivo loads applied to diarthrodial joints during clinical exams and activities of daily living to serve as input to the robotic testing systems. Improving the capability to accurately reproduce in vivo kinematics with robotic testing systems should also be examined.
动关节功能由骨骼、韧带、关节囊、关节软骨和肌肉之间复杂的相互作用介导。为了更好地理解损伤机制并改进手术程序，需要对动关节的结构和功能有更深入的了解。因此，已经开发了机器人测试系统来测量动关节的运动学结果以及韧带及其替代移植物在外部加载条件下的原位力。这些六自由度（DOF）测试系统可以在位置或力模式下进行控制，以模拟生理加载条件或临床检查。最近的进展使得可以使用速度阻抗控制在关节运动范围内连续测量运动学、原位力和应变数据，并在尸体标本上再现体内运动学数据，以确定生理运动期间的原位力。叠加原理还可用于确定从关节囊其余部分分离后关节囊组织在纵向方向上承受的原位力以及与周围组织的相互作用力。最后，机器人测试系统可用于模拟软组织损伤机制，并且可以使用运动学和力数据验证计算模型，以帮助预测这些组织中存在的体内应力和应变。这些分析的目标是帮助改进手术修复程序和术后康复方案。未来，需要更多关于临床检查和日常生活活动期间施加于动关节的复杂体内负荷的信息，作为机器人测试系统的输入。还应研究提高机器人测试系统准确再现体内运动学的能力。
