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Chiitiko chekuvhiyiwa kwearthroscopic chakawedzera mumakumi maviri emakore apfuura, uye arthroscopic shaver masisitimu ave chinhu chinoshandiswa zvakanyanya chemapfupa.Zvisinei, reza zhinji kazhinji hadzina kupinza zvakakwana, dziri nyore kupfeka, zvichingodaro.Chinangwa chechinyorwa chino ndechekuongorora hunhu hweiyo nyowani yakapetwa kaviri serrated blade yeBJKMC (Bojin◊ Kinetic Medical) arthroscopic razor.Inopa mhedziso yekugadzirwa kwechigadzirwa uye nzira yekusimbisa.Iyo BJKMC arthroscopic razor inoratidzira chubhu-mu-chubhu dhizaini, ine sleeve yekunze yesimbi isina tsvina uye mhango yemukati inotenderera.Iyo goko rekunze negoko remukati zvine madhishi anoyamwa uye ekucheka anoenderana, uye pane notches pamateko emukati nekunze.Kururamisa dhizaini, yakaenzaniswa neDyonics◊ Incisor◊ Plus isa.Chitarisiko, kuoma kwechishandiso, simbi chubhu roughness, mudziyo mudhuri ukobvu, mazino profile, kona, chimiro chese, zviyero zvakakosha, nezvimwe zvakatariswa nekuenzaniswa.kushanda pamusoro uye yakaoma uye yakatetepa zano.Naizvozvo, BJKMC zvigadzirwa zvinogona kushanda zvinogutsa mukuvhiya.
A join in the human body imhando yekubatana kusina kunanga pakati pemapfupa.Iyo yakaoma uye yakagadzikana chimiro chinoita basa rinokosha muhupenyu hwedu hwezuva nezuva.Zvimwe zvirwere zvinoshandura kugoverwa kwemutoro mujoini, zvichikonzera kudzikiswa kwekushanda uye kurasikirwa kwebasa1.Traditional orthopaedic surgery yakaoma kunyatsobata zvishoma, uye nguva yekudzorera mushure mekurapa yakareba.Kuvhiyiwa kweArthroscopic inzira inopinza zvishoma inongoda kuchekwa kudiki, inokonzera kushungurudza kudiki uye mavanga, ine kukurumidza kupora nguva, uye mashoma matambudziko.Nekuvandudzwa kwemichina yekurapa, nzira dzekuvhiya dzisinganyanyi kupinza zvishoma nezvishoma dzave nzira yenguva dzose yekuongororwa kwemapfupa uye kurapwa.Nguva pfupi mushure mekuvhiyiwa kwekutanga kwearthroscopic ibvi, yakagamuchirwa zviri pamutemo senzira yekuvhiya naKenji Takagi naMasaki Watanabe muJapan2,3.Arthroscopy uye endoprosthetics maviri ebudiriro yakakosha mu orthopedics4.Nhasi, kuvhiyiwa kwearthroscopic zvishoma kunoshandiswa kurapa mamiriro akasiyana-siyana uye kukuvara, kusanganisira osteoarthritis, kukuvara kwemeniscal, anterior uye posterior cruciate ligament kukuvara, synovitis, intra-articular fractures, patellar subluxation, cartilage uye maronda emuviri akasununguka.
Chiitiko chekuvhiyiwa kwearthroscopic chakawedzera mumakumi maviri emakore apfuura, uye arthroscopic shaver masisitimu ave chinhu chinoshandiswa zvakanyanya chemapfupa.Parizvino, vanachiremba vane nzira dzakasiyana-siyana dzinowanikwa kune vanovhiya, kusanganisira cruciate ligament reconstruction, meniscus kugadzirisa, osteochondral grafting, hip arthroscopy, uye facet joint arthroscopy, zvichienderana nezvinodiwa nachiremba anovhiya1.Sezvo arthroscopic yekuvhiya maitiro achiwedzera kune mamwe majoini, vanachiremba vanogona kuongorora synovial majoini uye kuvhiya varwere nenzira dzaisambofungwa.Panguva imwe cheteyo, mamwe maturusi akagadzirwa.Vanowanzo sanganisira chikwata chekutonga, handpiece ine injini ine simba uye chimbo chekucheka.Iyo dissection chiridzwa inobvumira panguva imwe chete uye inoenderera kusveta uye debridement6.
Nekuda kwekuoma kwekuvhiyiwa kwearthroscopic, zviridzwa zvakawanda zvinowanzodiwa.Zvishandiso zvikuru zvekuvhiya zvinoshandiswa mukuvhiya arthroscopic zvinosanganisira arthroscopes, probe scissors, punches, forceps, arthroscopic mapanga, meniscus blades uye razors, electrosurgical zviridzwa, lasers, radio frequency zviridzwa uye zvimwe zviridzwa 7.
Reza chinhu chakakosha pakuvhiya.Pane misimboti miviri mikuru yekuvhiya arthroscopic pliers.Yekutanga ndeyekubvisa zvisaririra zvecartilage yakasakara, kusanganisira miviri yakasununguka uye inoyangarara articular cartilage, nekusveta nekupuruzira mubatanidzwa nesaline yakawanda kubvisa maronda emukati-articular uye varevereri vanopisa.Imwe yacho ndeyekubvisa articular cartilage yakaparadzaniswa kubva kune subchondral bone uye kugadzirisa yakasakara cartilage defect.Iyo meniscus yakabvaruka inobviswa uye meniscus yakasakara uye yakatyoka inoumbwa.Razors anoshandiswawo kubvisa zvimwe kana zvese zvinoputika synovial tissue, senge hyperplasia uye thickening1.
Mascalpels mazhinji ane zvishoma ane chikamu chekucheka chine buri rekunze cannula uye buri remukati chubhu.Ivo havawanzove ne8 serrated mazino ekucheka kumucheto.Mazano akasiyana-siyana anopa mazinga akasiyana ekucheka simba kune razor.Mazino akajairika arthroscopic razor anowira muzvikamu zvitatu (Mufananidzo 1): (a) machubhu anotsvedzerera emukati nekunze;(b) machubhu ekunze anotsvedzerera uye machubhu emukati akatsetseka;(c) serrated (inogona kunge iri badza)) mukati nekunze machubhu.9. Kupinza kwavo kune zvinyoro zvinyoro kunowedzera.Avhareji yepamusoro peak simba uye kucheka kushanda zvakanaka kwesaha yemhando imwecheteyo iri nani pane gumi flat bar.
Nekudaro, kune akati wandei matambudziko ane parizvino aripo arthroscopic shavers.Kutanga, blade haina kupinza zvakakwana, uye zviri nyore kuvhara kana uchicheka nyama yakapfava.Chechipiri, razor inogona kungocheka kuburikidza ne-soft synovial tissue-chiremba anofanira kushandisa burr kupurisa pfupa.Nokudaro, mashizha anoda kuchinjwa kakawanda panguva yekushanda, izvo zvinowedzera nguva yekushanda.Kukuvadzwa kwekucheka uye kupfeka reza ndiwowo matambudziko akajairika.Precision machining uye kurongeka kwekutonga kwakanyatso kuumba imwechete yekuongorora index.
Dambudziko rekutanga nderekuti badza harina kutsvedzerera zvakakwana nekuda kwekunyanya mukaha pakati pemukati nekunze blades.Mhinduro yedambudziko rechipiri inogona kuwedzera kona yerazor blade uye kuwedzera simba rezvinhu zvekuvaka.
Iyo itsva BJKMC arthroscopic razor ine kaviri serrated blade inogona kugadzirisa matambudziko eakagomara ekucheka mipendero, kuvharika kuri nyore uye nekukurumidza kupfeka chishandiso.Kuti uedze kushanda kweiyo BJKMC reza dhizaini, yakaenzaniswa neyeDyonics ◊'s mumwe, iyo Incisor◊ Plus Blade.
Razo itsva yearthroscopic ine dhizaini yechubhu-mu-chubhu, inosanganisira sleeve yekunze yesimbi isina simbi uye chubhu yemukati ine mhango inotenderedza inofananidzwa uye zviteshi zvekucheka pane ruoko rwekunze nechubhu yemukati.Iyo yemukati nekunze casings haina kucherechedzwa.Panguva yekushanda, simba remagetsi rinoita kuti tube yemukati itenderere, uye yekunze chubhu inoruma nemeno, ichipindirana nekucheka.Matishu akapedzwa kuchekwa uye miviri yakasununguka inobviswa kubva pajoinhi kuburikidza nehomwe yemukati chubhu.Kuti uvandudze kushanda kwekucheka uye kushanda zvakanaka, chimiro chezino checoncave chakasarudzwa.Laser welding inoshandiswa kune zvikamu zvakasanganiswa.Chimiro cheyakajairwa mazino maviri ekuveura musoro inoratidzwa muMufananidzo 2.
Mukugadzirwa kwakawanda, iyo dhayamita yekunze yeanterior end of the arthroscopic shaver idiki zvishoma pane yekupedzisira.Iyo reza haifaniri kumanikidzirwa munzvimbo yakabatana, nokuti zvose zvinyorwa uye kumucheto kwehwindo rekucheka zvinoshambidzwa uye zvinokuvadza nzvimbo ye articular.Mukuwedzera, hupamhi hwehwindo rekugera hunofanira kuva rakakura zvakakwana.Iyo yakafara hwindo, iyo yakanyanya kurongeka iyo shaver inocheka uye inoyamwa, uye zviri nani inodzivirira kuvhara kwehwindo.
Kurukurai nezvemhedzisiro yezita rezino pane simba rekucheka.Iyo 3D modhi yerezo yakagadzirwa uchishandisa SolidWorks software (SolidWorks 2016, SolidWorks Corp., Massachusetts, USA).Iwo ekunze magoko mamodheru ane akasiyana mazino profiles akapinzwa kunze kune inogumira element chirongwa (ANSYS Workbench 16.0, ANSYS Inc., USA) yemeshing uye ongororo yekushushikana.Mechanical properties (modulus ye elasticity uye Poisson's ratio) yezvinhu zvinopiwa muTafura.1. Mesh density yakashandiswa kune zvinyoro zvinyoro yaiva 0.05 mm, uye isu takanatsa 11 planer zviso zvakasangana nenyoro zvinyoro (Fig. 3a).Iyo yese modhi ine 40,522 node uye 45,449 meshes.Muchigadziro chemamiriro emuganhu, tinomanikidzira zvakakwana 6 madhigirii ekusununguka anopiwa kumativi e4 ezvinyoro zvinyoro uye razor blade inotenderera 20 ° yakapoteredza x-axis (Fig. 3b).
Kuongororwa kwemhando mitatu yerazor (Fig. 4) yakaratidza kuti pfungwa yekunyanya kunetseka inoitika pakuchinja kwemaitiro, iyo inopindirana nemagetsi emagetsi.Razoro chishandiso chinoraswa4 uye pane njodzi shoma yekutsemuka kweblade panguva yekushandiswa kamwe chete.Naizvozvo, isu tinonyanya kutarisa kugona kwayo kwekucheka.Iyo yakanyanya kuenzana kushushikana inobata pane yakapfava tishu inogona kuratidza hunhu uhu.Pasi pemamiriro akafanana ekushanda, kana iyo yakanyanya kuenzana kushushikana ndiyo yakakura, inotangwa inofungidzirwa kuti zvimiro zvayo zvekucheka ndizvo zvakanakisa.Panyaya yekushushikana kwematishu akapfava, iyo 60 ° zino profilerazor yakagadzira yakanyanya kupfava tishu shear stress (39.213 MPa).
Shaver uye matishu akapfava kushushikana kwekuparadzira kana masheath ane mazino akasiyana akacheka nyama dzakapfava: (a) 50° mazino profile, (b) 60° mazino profile, (c) 70° mazino profile.
Kururamisa dhizaini yeBJKMC blade itsva, yakafananidzwa neyakaenzana Dyonics◊ Incisor◊ Plus blade (Fig. 5) ine maitiro akafanana.Mhando nhatu dzakafanana dzechigadzirwa chimwe nechimwe dzakashandiswa mukuedzwa kwese.Mareza ese akashandiswa matsva uye haana kukuvara.
Zvinhu zvinokanganisa kuita badza zvinosanganisira kuoma nekukora kwebedza, kushata kwechubhu yesimbi, uye chimiro nemakona ezino.Kuyera mitsara nemakona emazino, purojekiti yekona ine sarudzo ye 0.001 mm yakasarudzwa (Starrett 400 series, Fig. 6).Mukuedza, kuveura misoro kwakaiswa pabhenji rebasa.Pima chimiro chezino uye kona inoenderana neyakachinjika pachiratidziro uye shandisa micrometer semutsauko pakati pemitsetse miviri kuona kuyerwa.Iyo chaiyo yezino profile size inowanikwa nekuiparadzanisa nekukudza kwechinangwa chakasarudzwa.Kuti uyere kona yemazino, gadzirisa mapoinzi akatarwa kudivi ripi neripi rekona yakapimwa nekachinjiro kadiki-mutsara pachiratidziro chakachochonywa uye shandisa makona ari patafura kutora kuverenga.
Nokudzokorora kuedza uku, zviyero zvakakura zvehurefu hwekushanda (mukati nekunze machubhu), anterior uye kumashure ekunze madhayamita, kureba kwehwindo nehupamhi, uye kureba kwezino zvakayerwa.
Tarisa kushata kwepamusoro nepinipointer.Musoro wechishandiso unofambiswa wakatwasuka pamusoro pesample, perpendicular kuenda kudivi rezviyo zvakagadzikiswa.Avhareji roughness Ra inowanikwa zvakananga kubva chiridzwa.Pamusoro pemuonde.7 inoratidza chiridzwa chine tsono (Mitutoyo SJ-310).
Kuoma kwereza blades kunoyerwa zvichienderana neVickers kuomarara bvunzo ISO 6507-1: 20055.Iyo indenter yedhaimani inotsikirirwa pamusoro peiyo sampuli kwenguva yakatarwa pasi peimwe simba rekuyedza.Ipapo iyo diagonal kureba kweiyo indentation yakayerwa mushure mekubviswa kweindenter.Vickers kuoma kwakaenzana nereshiyo yesimba rekuyedza kune iyo nzvimbo yekufungidzira.
Ukobvu hwemadziro emusoro wekuveura ndebvu hunoyerwa nekuisa cylindrical bhora musoro nekururama kwe 0.01 mm uye kuyerwa kwechiyero chinosvika 0-200 mm.Ukobvu hwemadziro hunotsanangurwa semusiyano pakati pekunze uye mukati madhayamita emudziyo.Nzira yekuedza yekuyera ukobvu inoratidzwa mumufananidzo 8.
Kuitwa kwechimiro cheBJKMC reza kwakafananidzwa neicho cheDyonics◊ reza yezvakatsanangurwa zvakafanana.Iyo data yekuita kwechikamu chimwe nechimwe chechigadzirwa inoyerwa nekuenzaniswa.Zvichienderana neiyo dimensional data, kugona kwekucheka kwezviviri zvigadzirwa zvinofanotaurwa.Zvigadzirwa zvese zviri zviviri zvine zvakanakisa zvimiro zvimiro, kuongororwa kwekuenzanisa kwemagetsi conductivity kubva kumativi ese kuchiri kudikanwa.
Maererano nekuedza kwekona, zvigumisiro zvinoratidzwa muTable 2 uye Tafura 3. Kurevesa uye kutsauka kwakajairwa kweprofile angle data yezvigadzirwa zviviri izvi hazvina kusiyanisa.
Kufananidzwa kwezvimwe zvipimo zvakakosha zvezvigadzirwa zviviri zvinoratidzwa muMufananidzo 9. Maererano nemukati uye kunze kwechubhu hupamhi uye urefu, Dyonics◊ mukati uye kunze mahwindo echubhu akareba zvishoma uye akafara kupfuura ayo eBJKMC.Izvi zvinoreva kuti Dyonics◊ inogona kuva nenzvimbo yakawanda yekucheka uye iyo tubing ishoma kuti ivhare.Zvigadzirwa zviviri izvi hazvina kusiyana pahuwandu mune zvimwe zvinhu.
Zvikamu zveBJKMC razor zvakabatanidzwa nelaser welding.Naizvozvo, hapana kumanikidzwa kwekunze pane weld.Chikamu chinofanira kuiswa welded hachisi pasi pekunetseka kwekupisa kana deformation yekupisa.Iyo welding chikamu chakamanikana, kupinza kwakakura, iyo mechanical simba rewelding chikamu chakakwirira, vibration yakasimba, kukanganisa kupikisa kwakakwirira.Laser-welded zvikamu zvinovimbika zvakanyanya mugungano14,15.
Kukasharara kwepamusoro (surface roughness) chiyereso chechimiro chepamusoro.Iyo yakakwirira-frequency uye pfupi-wave zvikamu zveyero yakayerwa, iyo inosarudza kupindirana pakati pechinhu nenzvimbo yacho, inofungidzirwa.Sleeve yekunze yebanga remukati uye nzvimbo yemukati yechubhu yemukati ndiyo inonyanya kushanda yerazo.Kuderedza kushata kwezviviri izvi kunogona kunyatso kudzikisa kupfekedzwa kwerazor uye kuvandudza kushanda kwayo.
Kushata kwepamusoro kwegoko rekunze, pamwe chete nemukati nekunze kwemukati wemukati wemachubhu maviri esimbi, akawanikwa achiyedza.Mavhareji avo maitiro anoratidzwa muMufananidzo 10. Iyo yemukati yekunze sheath uye yekunze yemukati banga ndiyo inonyanya kushanda nzvimbo.Kushata kwemukati wemukati we scabbard uye kunze kwekunze kweBJKMC banga remukati rakaderera pane zvakafanana Dyonics◊ zvigadzirwa (zvakafanana).Izvi zvinoreva kuti zvigadzirwa zveBJKMC zvinogona kuva nemigumisiro inogutsa maererano nekucheka kushanda.
Maererano nekuedza kwekuoma kweblade, data yekuedza yemapoka maviri emagetsi anoratidzwa muMufananidzo 11. Mazhinji arthroscopic razors anogadzirwa neaustenitic simbi isina tsvina nekuda kwesimba rakakwirira, kusimba uye ductility inodiwa kune razor blades.Nekudaro, BJKMC yekuveura misoro inogadzirwa kubva ku1RK91 martensitic simbi isina tsvina.Martensitic Stainless simbi dzine simba rakakwirira uye kusimba kudarika austenitic Stainless steels17.Zvinhu zvemakemikari muzvigadzirwa zveBJKMC zvinosangana nezvinodiwa zveS46910 (ASTM-F899 Surgical Instruments) panguva yekugadzira.Nyaya yacho yakaedzwa cytotoxicity uye inoshandiswa zvakanyanya mumidziyo yekurapa.
Zvinogona kuonekwa kubva pamigumisiro ye finite element analysis kuti stress concentration yerazor inonyanya kuiswa pazino profile.IRK91 ndeye yakakwirira-yakasimba supermartensitic simbi isina simbi ine kusimba kwepamusoro uye yakanaka kusimba simba patembiricha yekamuri uye tembiricha yakakwira.Kusimba kwesimba pakupisa kwekamuri kunogona kusvika kupfuura 2000 MPa, uye iyo yakanyanya kushushikana kukosha zvinoenderana neinogumira chinhu chekuongorora ndeye 130 MPa, iri kure nekuputsika kwechinhu.Isu tinotenda kuti njodzi yekuputsika kweblade idiki kwazvo.
Ukobvu hweblade hunokanganisa zvakananga kugona kwekucheka kweraza.Iyo yakaonda madziro emadziro, zviri nani kuita kwekucheka.Iyo itsva BJKMC reza inoderedza kukora kwemadziro emabhawa maviri anopokana anotenderera, uye musoro une madziro akatetepa kupfuura mamwe ayo kubva kuDyonics◊.Mapadza akaonda anogona kuwedzera simba rekucheka retip.
Iyo data iri muTable 4 inoratidza kuti kukora kwemadziro eBJKMC razor kuyerwa ne compression-kutenderera madziro ukobvu nzira yekuyera idiki pane iyo yeDyonics◊ reza yezvakatsanangurwa zvakafanana.
Zvinoenderana nekuenzanisa kuyedza, iyo itsva BJKMC arthroscopic razor yakaratidza hapana dhizaini misiyano kubva kune yakafanana Dyonics◊ modhi.Kuenzaniswa neDyonics◊ Incisor◊ Plus inoisa maererano nemidziyo yezvinhu, BJKMC kaviri mazino anoisa ane nzvimbo yekushanda yakatsetseka uye yakaoma uye yakatetepa zano.Naizvozvo, BJKMC zvigadzirwa zvinogona kushanda zvinogutsa mukuvhiya.Ichi chidzidzo chakagadzirwa zvinotarisirwa uye mashandiro chaiwo anofanirwa kuongororwa mune zviedzo zvinotevera.
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