Model Studies in Orthopaedic Biomechanics

人体肌肉骨骼系统疾病影响到大多数人口，是人们在积极工作期间遭受痛苦和致残的主要原因，也是社会对旷工和日益增长的医疗费用的主要关切。虽然许多此类疾病(如腰背痛、骨关节炎、骨折、关节不稳、损伤、畸形)的病因往往是不确定的，但有充分的证据支持机械因素的致病作用。确定机械因素在观察到的损伤、变形和退化过程中的作用，不仅有利于不断增长的生物医药行业，而且通过减少相关风险、提高生活质量、提高生产率和降低医疗保健成本，使社会的广泛阶层受益。这项建议提供了真实和复杂的有限元模型研究人类多余的躯干和下肢(膝关节)神经肌肉骨骼系统，椎间盘，半月板，关节软骨和韧带在完整，损伤，退化和重建条件下。这些生物力学研究包括三维耦合的非线性主动-被动稳定性、运输、弹性静力学/动力学以及在不同机械载荷、肌肉招募模式和姿势/运动学/边界条件下的多相分析。我们将使用自己开发的有限元程序以及现有的软件、数据集和模型来完成拟议的研究。硅生物力学模型研究中提出的结合体内和体外测量(由我们的团队、我们的合作者或从文献中获得)的目的是：(1)显著提高我们对人体躯干、膝关节及其组成部分在各种活动中的功能生物力学和结构稳定性的了解；(2)识别损伤、故障、故障和退变过程中的生物力学危险因素；(3)开发、检查和提出减轻伤害的方法、技术和标准，提高职业、体育和娱乐活动的安全性，并加快恢复工作；(4)研究和改进运动疗法、运动能力提高和康复管理方案；(5)分析和改进被动-主动辅助/矫正装置(外骨骼、足部佩戴、支架)、构造和假体替换系统的设计。拟议的调查涵盖了整形外科和运动生物力学的广泛的新的和复杂的应用，将培养高素质的工程师和研究人员，他们是有效应对我们的社会和生物医药行业面临的当前和未来挑战(例如，老龄化、肥胖症、更积极的生活方式、预防/治疗措施、康复、运动伤害、旷工、重返工作岗位和医疗保健成本)所急需的。

Disorders in human musculoskeletal systems affect the majority of the population and are both a leading cause of sufferance and disability in people during their active working years and a major concern for the society in terms of absenteeism and growing health care costs. Although the etiology of many of these disorders (e.g., low-back pain, osteoarthritis, fractures, joint instabilities, injuries, deformities) is often a matter of uncertainty, there is ample evidence supporting the causative role of mechanical factors. Identification of the role of mechanical factors in observed injuries, deformities and degenerative processes benefits not only the growing biomedical industry but also broad segments of the society by mitigating risks involved, improving quality of life, augmenting productivity and reducing health care costs. This proposal presents realistic and complex finite element model studies of the redundant human trunk and lower extremity (knee joint) neuro-musculoskeletal systems, intervertebral discs, menisci, articular cartilage and ligaments in intact, injured, degenerate and reconstructed conditions. These biomechanical investigations involve 3D coupled nonlinear active-passive stability, transport, elastostatic/dynamics and multi-phasic analyses under various mechanical loading, muscle recruitment patterns and postural/kinematics/boundary conditions. Our own in-house developed finite element programs as well as available software, datasets and models will be used to complete the proposed studies. The proposed in silico biomechanical model studies in combination with in vivo and in vitro measurements (carried out by our group, our collaborators or taken from the literature) are intended to : (1) markedly advance our understanding of the functional biomechanics and structural stability of the human trunk, knee joint and their constituent components in various activities; (2) identify biomechanical risk factors in injuries, failures, malfunctions and degenerative processes; (3) develop, examine and propose methods, techniques and standards to mitigate injuries, improve safety in occupational, sports and recreational activities and expedite return to work; (4) investigate and improve exercise therapies, performance enhancement and rehabilitation management programs; and finally (5) analyze and improve designs of passive-active assistive/corrective devices (exoskeletons, foot wears, braces), constructs and prosthetic replacement systems. The proposed investigations, while covering a wide range of novel and complex applications in orthopaedics and sports biomechanics, will train highly qualified engineers and researchers that are much needed to effectively respond to the current and future challenges (e.g., ageing, obesity, more active lifestyle, prevention/ treatment measures, rehabilitation, sports injuries, absenteeism, return to and stay at work, health-care cost) facing our society and the biomedical industry.