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Palo ea ho buuoa ha arthroscopy e eketsehile lilemong tse mashome a mabeli tse fetileng, 'me li-arthroscopic shaver systems li fetohile sesebelisoa se sebelisoang haholo sa masapo.Leha ho le joalo, hangata mahare a mangata ha a bohale ka ho lekaneng, ho bonolo ho a roala, joalo-joalo.Sepheo sa sengoloa sena ke ho batlisisa ka sebopeho sa lehare le lecha le harelaneng habeli la BJKMC (Bojin◊ Kinetic Medical) lehare la arthroscopic.E fana ka kakaretso ea moralo oa sehlahisoa le ts'ebetso ea ho netefatsa.Lehare la arthroscopic la BJKMC le na le moralo oa li-tube-in-tube, o nang le letsoho le ka ntle la tšepe e sa hloekang le lehare le pota-potileng le sekoti le kahare.Khetla e ka ntle le khetla e ka hare li na le likou tse hohelang le tse sehang, 'me ho na le likhetla tse ka hare le kantle.Ho lokafatsa moralo, o ne o bapisoa le Dyonics◊ Incisor◊ Plus kenya.Ponahalo, boima ba lisebelisoa, botenya ba li-tube tsa tšepe, botenya ba lebota la lisebelisoa, boemo ba meno, angle, sebopeho ka kakaretso, litekanyo tse mahlonoko, joalo-joalo li ile tsa hlahlojoa le ho bapisoa.bokahodimo bo sebetsang le ntlha e thata le e tshesane ho feta.Ka hona, lihlahisoa tsa BJKMC li ka sebetsa ka mokhoa o khotsofatsang ho buuoa.
Lenonyeletso 'meleng oa motho ke mofuta o mong oa khokahano e sa tobang pakeng tsa masapo.Ke mohaho o rarahaneng le o tsitsitseng o phethang karolo ea bohlokoa bophelong ba rona ba letsatsi le letsatsi.Mafu a mang a fetola kabo ea mojaro ka har'a lenonyeletso, e leng se bakang khaello ea ts'ebetso le tahlehelo ea ts'ebetso1.Ho buuoa ka mokhoa o tloaelehileng oa masapo ho thata ho phekola ka mokhoa o nepahetseng ka mokhoa o fokolang, 'me nako ea ho hlaphoheloa ka mor'a phekolo e telele.Opereishene ea Arthroscopic ke mokhoa o fokolang haholo o hlokang ho phunyeha hanyenyane feela, o bakang mahlomola a fokolang le maqeba, o na le nako ea ho hlaphoheloa ka potlako, le mathata a fokolang.Ka nts'etsopele ea lisebelisoa tsa bongaka, mekhoa e fokolang ea ho buoa butle-butle e fetohile mokhoa o tloaelehileng oa ho hlahloba masapo le phekolo.Nakoana ka mor'a ho buuoa ka lengole la pele la arthroscopic, e ile ea amoheloa ka molao e le mokhoa oa ho buuoa ke Kenji Takagi le Masaki Watanabe Japane2,3.Arthroscopy le endoprosthetics ke tse peli tsa tsoelo-pele ea bohlokoa ho lingaka tsa masapo4.Kajeno, opereishene ea "arthroscopic" e fokolang haholo e sebelisetsoa ho phekola maemo le likotsi tse sa tšoaneng, ho akarelletsa le lefu la masapo a manonyeletso, likotsi tsa meniscal, likotsi tse ka pele le tse ka morao tsa li-ligament, synovitis, fractures intra-articular, patellar subluxation, cartilage le liso tse hlephileng tsa 'mele.
Palo ea ho buuoa ha arthroscopy e eketsehile lilemong tse mashome a mabeli tse fetileng, 'me li-arthroscopic shaver systems li fetohile sesebelisoa se sebelisoang haholo sa masapo.Hona joale, lingaka tse buoang li na le mefuta e fapaneng ea likhetho tse fumanehang ho lingaka tse buoang, ho kenyelletsa ho tsosolosoa ha ligament, ho lokisa meniscus, osteochondral grafting, arthroscopy ea hip, le arthroscopy e kopanetsoeng ea likarolo, ho itšetlehile ka khetho ea ngaka e buoang1.Ha mekhoa ea ho buoa ea arthroscopic e ntse e eketseha ho ea ho manonyeletso a mangata, lingaka li ka hlahloba manonyeletso a synovial le ho phekola bakuli ka litsela tse neng li ke ke tsa nahanoa pele.Ka nako e tšoanang, ho ile ha etsoa lisebelisoa tse ling.Hangata li na le lisebelisoa tsa ho laola, letsoho le nang le motlakase o matla le sesebelisoa sa ho itšeha.Sesebelisoa sa ho arola se lumella ho huloa ka nako e le 'ngoe le ho tsoelang pele le ho senya6.
Ka lebaka la ho rarahana ha opereishene ea arthroscopic, hangata ho hlokahala lisebelisoa tse ngata.Lisebelisoa tse ka sehloohong tsa ho buoa tse sebelisoang ho buoa arthroscopic li kenyelletsa li-arthroscopes, scissors ea probe, punches, forceps, lithipa tsa arthroscopic, meniscus blades le mahare, lisebelisoa tsa electrosurgical, lasers, lisebelisoa tsa maqhubu a seea-le-moea le lisebelisoa tse ling 7.
Lehare ke sesebelisoa sa bohlokoa ho buuoang.Ho na le melao-motheo e 'meli ea mantlha ea pliers ea opereishene ea arthroscopic.Ea pele ke ho tlosa mesaletsa ea lefufuru le senyehileng, ho kenyelletsa le 'mele e hlephileng le lefufuru le phaphametseng la articular, ka ho monya le ho phunya lenonyeletso ka letsoai le leholo ho tlosa liso tsa intra-articular le bakena-lipakeng ba ho ruruha.E 'ngoe ke ho tlosa lefufuru la articular le arohaneng le lesapo la subchondral le ho lokisa sekoli se senyehileng sa lefufuru.Meniscus e tabohileng e khaotsoe 'me meniscus e tsofetseng le e robehileng e thehoa.Li-razors li boetse li sebelisoa ho tlosa tse ling kapa lisele tsohle tsa synovial tse ruruhileng, tse kang hyperplasia le thickening1.
Bongata ba li-scalpels tse sa hlaseleng haholo li na le karolo ea ho seha e nang le cannula e ka ntle e se nang letho le tube e ka hare e sekoti.Ha se hangata ba nang le meno a 8 a serrated bakeng sa ho itšeha.Litlhahiso tse fapaneng tsa lehare li fana ka maemo a fapaneng a matla a ho itšeha ho lehare.Meno a tloaelehileng a lehare a arthroscopic a oela likarolong tse tharo (Setšoantšo sa 1): (a) li-tubes tse boreleli tse ka hare le tsa ka ntle;(b) liphaephe tsa ka ntle tse boreleli le tse ka hare tse serrated;(c) serrated (eo e ka bang lehare)) li-tubes tse ka hare le tse ka ntle.9. Bohale ba bona ho lisele tse bonolo boa eketseha.Karolelano ea tlhōrō ea matla le bokhoni ba ho seha ba sakha ea mofuta o tšoanang e betere ho feta 10 bareng e bataletseng.
Leha ho le joalo, ho na le mathata a 'maloa ka li-shaver tsa arthroscopic tse fumanehang hajoale.Ntlha ea pele, lehare ha le bohale ka ho lekaneng, 'me ho bonolo ho thibela ha le seha lisele tse bonolo.Ea bobeli, lehare le ka khaola feela ka har'a lisele tse bonolo tsa synovial-ngaka e tlameha ho sebelisa burr ho bentša lesapo.Ka hona, li-blades li hloka ho fetoloa khafetsa nakong ea ts'ebetso, e leng ho eketsang nako ea ts'ebetso.Tšenyo e sehiloeng le ho roala ha lehare le tsona ke mathata a tloaelehileng.Ho sebetsa ka nepo le taolo ea ho nepahala ho hlile ho thehile index e le 'ngoe ea tlhahlobo.
Bothata ba pele ke hore lehare ha le boreleli ka ho lekaneng ka lebaka la lekhalo le feteletseng pakeng tsa mahare a ka hare le a ka ntle.Tharollo ea bothata ba bobeli e ka ba ho eketsa sekhahla sa lehare le ho eketsa matla a thepa ea kaho.
Lehare le lecha la BJKMC la arthroscopic le nang le lehare le habeli le serrated le ka rarolla mathata a ho itšeha ka mokhoa o hlabang, ho koala habonolo le ho roala lisebelisoa ka potlako.Ho leka ho sebetsa ha moralo o mocha oa lehare oa BJKMC, o ile oa bapisoa le mphato oa Dyonics◊, Incisor◊ Plus Blade.
Lehare le lecha la arthroscopic le na le moralo oa li-tube-in-tube, ho kenyeletsoa letsoho le ka ntle la tšepe e sa hloekang le tšupu e ka hare e pota-potileng e nang le likou tse monyang tse tšoanang le tse sehang letsohong le ka ntle le tšupu e ka hare.Likhase tsa ka hare le tsa ka ntle ha li koaletsoe.Nakong ea ts'ebetso, tsamaiso ea matla e etsa hore tube e ka hare e fetohe, 'me tube e ka ntle e loma ka meno, e sebelisana le ho khaola.Lithishu tse phethiloeng le 'mele o hlephileng li ntšoa lenonyeletsong ka tšupu e ka hare e sekoti.Ho ntlafatsa ts'ebetso ea ho itšeha le ho sebetsa hantle, ho ile ha khethoa sebopeho sa leino la concave.Laser welding e sebelisoa bakeng sa likarolo tse kopaneng.Sebopeho sa hlooho e tloaelehileng ea ho kuta meno a mabeli se bontšoa setšoantšong sa 2.
Ka moralo o akaretsang, bophara bo ka ntle ba pheletso e ka pele ea shaver ea arthroscopic e nyane hanyane ho feta pheletso e ka morao.Lehare ha lea lokela ho qobelloa ho kena sebakeng se kopanetsoeng, hobane ntlha le moeli oa fensetere ea ho itšeha li hlatsuoa ebe li senya bokaholimo ba articular.Ho phaella moo, bophara ba fensetere ea shaver e lokela ho ba kholo ka ho lekaneng.Ha fensetere e atoloha, ho hlophisitsoe haholoanyane ha shaver e khaola le ho monya, 'me ho molemo ho thibela ho koala fensetere.
Buisanang ka phello ea boemo ba leino holim'a matla a ho itšeha.Mohlala oa 3D oa lehare o entsoe ho sebelisoa software ea SolidWorks (SolidWorks 2016, SolidWorks Corp., Massachusetts, USA).Mefuta ea likhetla tse ka ntle tse nang le lintlha tse fapaneng tsa meno li ile tsa kengoa kantle ho lenaneo la finite element (ANSYS Workbench 16.0, ANSYS Inc., USA) bakeng sa tlhahlobo ea meshing le khatello ea maikutlo.Thepa ea mochini (modulus ea elasticity le karo-karolelano ea Poisson) ea thepa e fanoe ho Lethathamo.1. Boima ba marang-rang bo sebelisetsoang li-tissue tse bonolo e ne e le 0.05 mm, 'me re hloekisitse lifahleho tsa planer tsa 11 ka ho kopana le lisele tse bonolo (setšoantšo sa 3a).Mofuta oohle o na le li-node tse 40,522 le li-meshes tse 45,449.Litlhophisong tsa maemo a moeli, re thibela ka ho feletseng li-degree tsa 6 tsa tokoloho tse fanoeng mahlakoreng a 4 a lisele tse bonolo 'me lehare le potoloha 20 ° ho pota-pota x-axis (setšoantšo sa 3b).
Tlhahlobo ea mehlala e meraro ea lehare (setšoantšo sa 4) e bontšitse hore ntlha ea khatello e phahameng ea maikutlo e etsahala ka phetoho e potlakileng ea sebopeho, e lumellanang le thepa ea mochine.Lehare ke sesebelisoa se lahloang4 mme ho na le kotsi e nyane ea ho robeha ha lehare nakong ea ts'ebeliso e le 'ngoe.Ka hona, re tsepamisa maikutlo haholo ho bokhoni ba eona ba ho itšeha.Khatello e phahameng ka ho fetisisa e lekanang le lisele tse bonolo e ka bonahatsa tšobotsi ena.Tlas'a maemo a ts'oanang a ts'ebetso, ha khatello ea maikutlo e lekanang le eona e kholo ka ho fetisisa, ho nahanoa pele hore thepa ea eona ea ho itšeha ke eona e ntle ka ho fetisisa.Mabapi le khatello ea methapo e bonolo, lehare la 60 ° leino le hlahisitse khatello e phahameng ea lithane tse bonolo (39.213 MPa).
Kabo ea khatello ea kelello ea ho kuta le lisele tse bonolo ha mahare a nang le likarolo tse fapaneng tsa leino a khaola lithane tse bonolo: (a) 50 ° profil ea meno, (b) 60 ° leino la 60 °, (c) 70 ° leino la leino.
Ho lokafatsa moralo oa lehare le lecha la BJKMC, le ne le bapisoa le Dyonics◊ Incisor◊ Plus blade (setšoantšo sa 5) se nang le ts'ebetso e tšoanang.Mefuta e meraro e ts'oanang ea sehlahisoa ka seng e sebelisitsoe litekong tsohle.Mahare ’ohle a sebelisitsoeng a macha ’me ha aa senyeha.
Lintlha tse amang ts'ebetso ea lehare li kenyelletsa ho thatafala le botenya ba lehare, ho ba thata ha tšupu ea tšepe, profil le angle ea leino.Ho lekanya li-contours le li-angles tsa meno, mochine oa contour o nang le qeto ea 0.001 mm o khethiloe (letoto la Starrett 400, setšoantšo sa 6).Litekong, lihlooho tsa ho kuta li ne li behoa holim'a benche ea mosebetsi.Lekanya boemo ba leino le angle e amanang le li-crosshair tse skrineng sa projeke 'me u sebelise micrometer e le phapang lipakeng tsa mela e' meli ho fumana tekanyo.Boholo ba boemo ba meno ba sebele bo fumanoa ka ho bo arola ka ho hōlisa sepheo se khethiloeng.Ho metha angle ea leino, beha lintlha tse tsitsitseng ka mahlakoreng ka bobeli a angle e lekantsoeng le mateano a litselana a skrineng se qhotsoang 'me u sebelise li-angcle cursor tse ka har'a tafole ho bala.
Ka ho pheta teko ena, litekanyo tse ka sehloohong tsa bolelele ba ho sebetsa (li-tubes tse ka hare le tsa ka ntle), li-diameter tse ka ntle le tse ka morao, bolelele ba lifensetere le bophara, le bophahamo ba meno li ne li lekanngoa.
Lekola bokhachane ba bokaholimo ka sesupa.Ntlheng ea sesebelisoa e tsamaisoa ka mokhoa o otlolohileng ka holim'a sampuli, ho ea ka lehlakoreng la lijo-thollo tse entsoeng.Ka karolelano roughness Ra e fumanoa ka ho toba seletsa.Ka feiga.7 e bontša sesebelisoa se nang le nale (Mitutoyo SJ-310).
Ho thatafala ha lehare ho lekanngoa ho latela tlhahlobo ea boima ba Vickers ISO 6507-1: 20055.Indenter ea daemane e hatelloa ka holim'a sampuli ka nako e fanoeng tlas'a matla a itseng a teko.Ebe bolelele ba diagonal ba indentation bo ile ba lekanyetsoa ka mor'a ho tlosoa ha inndenter.Boima ba Vickers bo lekana le karo-karolelano ea matla a teko sebakeng sa maikutlo.
Botenya ba lebota la hlooho ea ho kuta bo lekanngoa ka ho kenya hlooho ea bolo ea cylindrical ka ho nepahala ha 0.01 mm le tekanyo ea tekanyo e ka bang 0-200 mm.Botenya ba lerako bo hlalosoa e le phapang pakeng tsa bophara ba ka ntle le bo ka hare ba sesebelisoa.Mokhoa oa liteko oa ho lekanya botenya o bontšoa setšoantšong sa 8.
Mosebetsi oa sebopeho sa lehare la BJKMC o ne o bapisoa le oa Dyonics◊ lehare la litlhaloso tse tšoanang.Lintlha tsa ts'ebetso bakeng sa karolo ka 'ngoe ea sehlahisoa lia lekanngoa le ho bapisoa.Ho ipapisitsoe le data ea dimensional, bokhoni ba ho itšeha ba lihlahisoa ka bobeli bo ka lebelloa.Lihlahisoa tsena ka bobeli li na le thepa e ntle ea sebopeho, tlhahlobo ea papiso ea conductivity ea motlakase ho tsoa mahlakoreng 'ohle e ntse e hlokahala.
Ho latela tlhahlobo ea li-angle, liphetho li bonts'itsoe ho Lethathamo la 2 le Lethathamo la 3. Phapang e tloaelehileng le e tloaelehileng ea data ea angle angle bakeng sa lihlahisoa tse peli e ne e sa fapane ka lipalo.
Papiso ea likarolo tse ling tsa bohlokoa tsa lihlahisoa tse peli li bontšoa ho Setšoantšo sa 9. Ho ea ka bophara le bolelele ba li-tube tse ka hare le tsa ka ntle, Dyonics◊ lifensetere tsa ka hare le tsa ka ntle tsa li-tubes li telele hanyenyane le tse pharaletseng ho feta tsa BJKMC.Sena se bolela hore Dyonics ◊ e ka ba le sebaka se sengata sa ho seha 'me tubing ha e na monyetla oa ho koala.Lihlahisoa tse peli ha lia ka tsa fapana ka lipalo-palo litabeng tse ling.
Likarolo tsa lehare la BJKMC li hokahantsoe ka welding ea laser.Ka hona, ha ho na khatello ea kantle ho weld.Karolo e lokelang ho chesetsoa ha e tlas'a khatello ea mocheso kapa ho senyeha ha mocheso.Karolo ea welding e moqotetsane, ho kenella ho hoholo, matla a mochine oa karolo ea welding a phahame, ho sisinyeha ho matla, ho hanyetsa tšusumetso ho phahame.Likarolo tse entsoeng ka laser li tšepahala haholo kopanong14,15.
Bokhopo ba bokaholimo ke tekanyo ea sebopeho sa bokaholimo.Likarolo tse phahameng tsa maqhubu le maqhubu a khutšoanyane a sebaka se lekantsoeng, se khethollang ho sebelisana pakeng tsa ntho le tikoloho ea sona, li nkoa.Mokotla o ka ntle oa thipa e ka hare le bokaholimo ba ka hare ba tube e ka hare ke libaka tse ka sehloohong tse sebetsang tsa lehare.Ho fokotsa boima ba libaka tse peli ho ka fokotsa ka katleho ho apara lehare le ho ntlafatsa tshebetso ea eona.
Bokaholimo ba khetla e ka ntle, hammoho le bokaholimo ba kahare le kantle ba lehare le ka hare la li-tubes tse peli tsa tšepe, li ile tsa fumanoa ka liteko.Litekanyetso tsa bona tse tloaelehileng li bontšoa ho Setšoantšo sa 10. Sebaka se ka hare sa sekoahelo se ka ntle le bokantle ba ka ntle ba thipa e ka hare ke libaka tse ka sehloohong tse sebetsang.Bokhopo ba karolo e ka hare ea scabbard le bokantle ba ka ntle ba thipa ea ka hare ea BJKMC e tlaase ho feta lihlahisoa tse tšoanang tsa Dyonics◊ (litlhaloso tse tšoanang).Sena se bolela hore lihlahisoa tsa BJKMC li ka ba le liphello tse khotsofatsang mabapi le ts'ebetso ea ho itšeha.
Ho ea ka teko ea boima ba lehare, lintlha tsa liteko tsa lihlopha tse peli tsa lehare li bontšoa ho Setšoantšo sa 11. Mahare a mangata a arthroscopic a entsoe ka tšepe e sa hloekang ea austenitic ka lebaka la matla a phahameng, boima le ductility tse hlokahalang bakeng sa mahare.Leha ho le joalo, lihlooho tsa ho kuta tsa BJKMC li entsoe ka tšepe e sa hloekang ea 1RK91 martensitic.Litšepe tse sa hloekang tsa martensitic li na le matla a phahameng le ho tiea ho feta litšepe tse sa hloekang tsa austenitic17.Lintho tsa lik'hemik'hale lihlahisoa tsa BJKMC li finyella litlhoko tsa S46910 (ASTM-F899 Surgical Instruments) nakong ea ts'ebetso ea ho qhekella.Thepa e lekoa bakeng sa cytotoxicity mme e sebelisoa haholo lisebelisoa tsa bongaka.
Ho ka bonoa ho tsoa ho liphetho tsa tlhahlobo ea lintlha tse fokolang hore khatello ea maikutlo ea lehare e tsepamisitsoe haholo ponong ea leino.IRK91 ke tšepe e sa hloekang e matla haholo e nang le matla a holimo e thata haholo le matla a matle a ho tsitsa mocheso oa kamore le mocheso o phahameng.Matla a tsitsitseng mocheso oa kamore a ka fihla ho feta 2000 MPa, 'me boleng bo phahameng ba khatello ea maikutlo ho latela tlhahlobo ea lintlha tse fokolang ke hoo e ka bang 130 MPa, e leng hole le moeli oa ho robeha ha thepa.Re lumela hore kotsi ea ho robeha ha lehare e nyane haholo.
Botenya ba lehare bo ama ka ho toba bokhoni ba ho itšeha ba lehare.Ha lerako le le lesesaane, le na le ts'ebetso e ntle ea ho itšeha.Lehare le lecha la BJKMC le fokotsa botenya ba lerako la mekoallo e 'meli e bilikang, 'me hlooho e na le lebota le lesesaane ho feta balekane ba eona ba Dyonics◊.Lithipa tse tšesaane li ka eketsa matla a ho seha ha ntlha.
Lintlha tse ho Lethathamo la 4 li bontša hore botenya ba lebota la lehare la BJKMC bo lekantsoeng ka mokhoa oa ho lekanya lerako la ho potoloha ha boima bo nyane ho feta ba Dyonics◊ lehare la litlhaloso tse tšoanang.
Ho ea ka liteko tsa ho bapisa, lehare le lecha la BJKMC la arthroscopic ha lea bontša phapang e hlakileng ea moralo ho tsoa ho mofuta o tšoanang oa Dyonics◊.Ha ho bapisoa le Dyonics◊ Incisor◊ Plus e kenyang ho latela thepa ea thepa, BJKMC meno a mabeli a kenngoa a na le sebaka se sebetsang hantle le ntlha e thata le e fokolang.Ka hona, lihlahisoa tsa BJKMC li ka sebetsa ka mokhoa o khotsofatsang ho buuoa.Boithuto bona bo entsoe ka mokhoa o lebelletsoeng, 'me ts'ebetso e ikhethileng e lokela ho lekoa litekong tse latelang.
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