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Iziganeko zotyando lwe-arthroscopic ziye zanda kwiminyaka engamashumi amabini edlulileyo, kwaye iinkqubo ze-arthroscopic shaver ziye zaba sisixhobo esisetyenziswa ngokubanzi samathambo.Nangona kunjalo, iincakuba ezininzi azibukhali ngokwaneleyo, kulula ukunxiba, njalo njalo.Injongo yeli nqaku kukuphanda iimpawu zolwakhiwo lwencakuba entsha ephindwe kabini ye-BJKMC (Bojin◊ Kinetic Medical) incakuba yearthroscopic.Inika isishwankathelo soyilo lwemveliso kunye nenkqubo yokuqinisekisa.I-razor ye-arthroscopic ye-BJKMC ibonisa idizayini ye-tube-in-tube, equka umkhono wangaphandle wensimbi engenasici kunye netyhubhu ejikelezayo engaphakathi.Iqokobhe langaphandle kunye neqokobhe langaphakathi linezibuko zokufunxa kunye nokusika ezihambelanayo, kwaye kukho iinotshi kumaqokobhe angaphakathi nangaphandle.Ukuthethelela uyilo, yathelekiswa neDyonics◊ Incisor◊ Plus Faka.Imbonakalo, ubulukhuni besixhobo, uburhabaxa betyhubhu yesinyithi, ubukhulu bodonga lwesixhobo, iprofayili yezinyo, i-angle, isakhiwo esipheleleyo, imilinganiselo ebalulekileyo, njl njl.umphezulu osebenzayo kunye nencam enzima kunye nencinci.Ke ngoko, iimveliso ze-BJKMC zinokusebenza ngokwanelisayo kutyando.
Ijoyinti emzimbeni womntu luhlobo lonxibelelwano olungathanga ngqo phakathi kwamathambo.Ziyisakhiwo esiyinkimbinkimbi kwaye sizinzile esidlala indima ebalulekileyo kubomi bethu bemihla ngemihla.Ezinye izifo ziguqula ukuhanjiswa komthwalo kwi-joint, okubangelwa ukukhawulelana nokusebenza kunye nokulahlekelwa komsebenzi1.Utyando lwendabuko lwamathambo kunzima ukunyanga ngokuchanekileyo i-invasive encinci, kwaye ixesha lokubuyisela emva kokuba unyango lude.Utyando lwe-arthroscopic luyinkqubo encinci ye-invasive efuna kuphela i-incision encinci, ibangela ukwenzakala okuncinci kunye ne-scarred, inexesha lokubuyisela ngokukhawuleza, kunye neengxaki ezimbalwa.Ngokuqulunqwa kwezixhobo zonyango, iindlela zotyando ezincinci ziye zaba yinkqubo yesiqhelo yokuxilongwa kwamathambo kunye nonyango.Kungekudala emva kokuhlinzwa kwedolo lokuqala le-arthroscopic, yamkelwa ngokusemthethweni njengendlela yokuhlinzwa nguKenji Takagi kunye noMasaki Watanabe eJapan2,3.I-arthroscopy kunye ne-endoprosthetics zimbini zezona nkqubela zibalulekileyo kwi-orthopedics4.Namhlanje, utyando oluncinci lwe-arthroscopic lusetyenziselwa ukunyanga iimeko ezahlukeneyo kunye nokulimala, kubandakanywa i-osteoarthritis, ukulimala kwe-meniscal, i-anterior and posterior cruciate ligament, i-synovitis, i-intra-articular fractures, i-patellar subluxation, i-cartilage kunye nezilonda zomzimba ezikhululekile.
Iziganeko zotyando lwe-arthroscopic ziye zanda kwiminyaka engamashumi amabini edlulileyo, kwaye iinkqubo ze-arthroscopic shaver ziye zaba sisixhobo esisetyenziswa ngokubanzi samathambo.Okwangoku, oogqirha baneendlela ezahlukeneyo zokukhetha ezifumanekayo koogqirha, kubandakanywa ukulungiswa kwe-ligament ye-cruciate, ukulungiswa kwe-meniscus, i-osteochondral grafting, i-hip arthroscopy, kunye ne-facet joint arthroscopy, kuxhomekeke kukhetho logqirha1.Njengoko iinkqubo zotyando lwe-arthroscopic zanda ukuya kumalungu amaninzi, oogqirha banokujonga amalungu e-synovial kwaye banyange ngotyando izigulane ngeendlela ebezingenakucingelwa ngaphambili.Kwangaxeshanye, kwaveliswa ezinye izixhobo.Ngokuqhelekileyo zibandakanya iyunithi yokulawula, i-handpiece enemoto enamandla kunye nesixhobo sokusika.Isixhobo sokuqhawula sivumela ukufunxa ngaxeshanye kunye nokuqhubekayo kunye nokuchithwa6.
Ngenxa yobunzima botyando lwe-arthroscopic, izixhobo ezininzi zihlala zifuneka.Ezona zixhobo zotyando zingundoqo ezisetyenziswa kutyando lwe-arthroscopic ziquka i-arthroscopes, isikere sokuphonononga, iinqindi, iiforceps, iimela ze-arthroscopic, iincakuba ze-meniscus kunye neencakuba, izixhobo zotyando lombane, iilaser, izixhobo zerediyo zamaza kunye nezinye izixhobo 7.
Incakuba sisixhobo esibalulekileyo kutyando.Kukho imigaqo emibini ephambili yepliers yotyando lwe-arthroscopic.Eyokuqala kukususa iintsalela ze-cartilage eyonakeleyo, kubandakanywa imizimba ekhululekileyo kunye ne-articular cartilage edadayo, ngokufunxa kunye nokugungxula umdibaniso nge-saline eninzi ukususa izilonda ze-intra-articular kunye nabalamli abavuthayo.Enye kukususa i-articular cartilage ehlukaniswe kwi-subchondral bone kunye nokulungisa i-cartilage defect egugile.I-meniscus ekrazukileyo iyasikwa kwaye i-meniscus egugile kwaye ephukile yenziwe.IiRazors zikwasetyenziselwa ukususa ezinye okanye zonke izicubu ze-synovial ezivuthayo, ezifana ne-hyperplasia kunye nokuqina1.
Uninzi lwee-scalpels ezincinci ezihlaselayo zinecandelo lokusika kunye ne-cannula yangaphandle engenanto kunye nombhobho wangaphakathi ongaphakathi.Abafane babe namazinyo asi-8 arhabaxa ukwenzela ukusika.Iingcebiso ezahlukeneyo ze-blade zibonelela ngamanqanaba ahlukeneyo okusika amandla kwi-razor.Amazinyo e-razor ye-arthroscopic eqhelekileyo awela kwiindidi ezintathu (Umfanekiso 1): (a) iityhubhu ezigudileyo zangaphakathi nangaphandle;(b) imibhobho yangaphandle egudileyo kunye netyhubhu engaphakathi ejikelezayo;(c) irhabaxa (esenokuba yincakuba)) imibhobho yangaphakathi nangaphandle.9. Ubukhali babo kwizicubu ezithambileyo zanda.I-avareji yamandla encopho kunye nokusebenza kakuhle kwesarha yenkcazo efanayo ingcono kune-10 bar flat.
Nangona kunjalo, kukho inani leengxaki ngeeshaver ze-arthroscopic ezikhoyo ngoku.Okokuqala, i-blade ayibukhali ngokwaneleyo, kwaye kulula ukuyivimba xa usika izicubu ezithambileyo.Okwesibini, i-razor inokunqumla kuphela izicubu ezithambileyo ze-synovial-ugqirha kufuneka asebenzise i-burr ukupholisa ithambo.Ngoko ke, ii-blades kufuneka zitshintshwe rhoqo ngexesha lokusebenza, oko kwandisa ixesha lokusebenza.Umonakalo wokusika kunye nokunxiba kwe-razor nazo ziingxaki eziqhelekileyo.Ukuchaneka komatshini kunye nolawulo lokuchaneka ngokwenene kwenze isalathiso sovavanyo olunye.
Ingxaki yokuqala kukuba i-razor blade ayigudi ngokwaneleyo ngenxa yomsantsa ogqithisileyo phakathi kweencakuba zangaphakathi nangaphandle.Isisombululo kwingxaki yesibini sinokunyusa i-angle ye-razor blade kunye nokwandisa amandla ezinto zokwakha.
I-razor entsha ye-arthroscopic ye-BJKMC ene-double serrated blade inokusombulula iingxaki ze-blunt cut edges, ukuvala lula kunye nokunxiba izixhobo ezikhawulezayo.Ukuvavanya ukusebenza koyilo lwencakuba ye-BJKMC entsha, yathelekiswa neqabane likaDyonics◊, i-Incisor◊ Plus Blade.
I-razor entsha ye-arthroscopic ine-design ye-tube-in-tube, equka umkhono ongaphandle wentsimbi kunye nombhobho ojikelezayo ongaphakathi ojikelezayo kunye nezibuko ezihambelanayo kunye nokusika kumkhono ongaphandle kunye netyhubhu engaphakathi.Izingxobo zangaphakathi nangaphandle zichongiwe.Ngethuba lokusebenza, inkqubo yamandla ibangela ukuba ityhubhu yangaphakathi ijikeleze, kwaye ityhubhu yangaphandle iluma ngamazinyo, isebenzisana nokusika.Ithishu egqityiweyo yokusikwa kunye nemizimba ekhululekileyo iyasuswa kwindibaniselwano ngetyhubhu engaphakathi emngxuma.Ukuphucula ukusebenza kokusika kunye nokusebenza kakuhle, kukhethwe isakhiwo sezinyo le-concave.I-laser welding isetyenziselwa iindawo ezidibeneyo.Ubume bentloko yokucheba amazinyo aphindwe kabini buboniswe kuMfanekiso 2.
Kuyilo ngokubanzi, i-diameter yangaphandle yesiphelo sangaphambili se-arthroscopic shaver incinci kancinane kunesiphelo esingasemva.I-razor akufanele inyanzeliswe kwindawo edibeneyo, kuba zombini i-tip kunye nomda wefestile yokusika ihlanjwe kwaye yonakalise i-articular surface.Ukongezelela, ububanzi befestile ye-shaver kufuneka bube bukhulu ngokwaneleyo.Ububanzi befestile, ngakumbi ukucwangciswa kwe-shaver kunqunyulwa kunye nokufunxa, kwaye kungcono kuthintela ukuvala ifestile.
Xoxa ngefuthe leprofayili yezinyo kumandla okusika.Imodeli ye-3D ye-razor yenziwa kusetyenziswa isofthiwe ye-SolidWorks (i-SolidWorks 2016, i-SolidWorks Corp., e-Massachusetts, e-USA).Imifuziselo yeqokobhe langaphandle elineprofayile zamazinyo ezahlukeneyo zangeniswa ngaphandle kwinkqubo yezinto ezinomda (ANSYS Workbench 16.0, ANSYS Inc., USA) ukuze kuhlalutywe i-meshing kunye noxinzelelo.Iimpawu zeMechanical (imodulus ye-elasticity kunye ne-Poisson's ratio) yezixhobo zinikwe kwiThebhile.1. I-mesh density esetyenziselwa izicubu ezithambileyo yayingu-0.05 mm, kwaye sacoca ubuso beplani ye-11 ngokudibanisa nezicubu ezithambileyo (umzobo 3a).Yonke imodeli ine-40,522 nodes kunye ne-45,449 meshes.Kwimimiselo yesimo somda, sithintela ngokupheleleyo i-degrees ye-6 yenkululeko enikwe kumacala e-4 ee-tissue ezithambileyo kunye ne-razor blade ijikeleza i-20 ° malunga ne-x-axis (Umfanekiso 3b).
Uhlalutyo lweemodeli ezintathu ze-razor (umzobo 4) lubonise ukuba inqaku loxinzelelo oluphezulu lwenzeka kwinguqu ephazamisayo yesakhiwo, ehambelana neempawu zomatshini.I-razor sisixhobo esilahlwayo4 kwaye akukho mngcipheko omncinci wokuqhekeka kwe-blade ngexesha lokusetyenziswa kanye.Ngoko ke, sigxininisa ikakhulu kwisakhono sayo sokusika.Uxinzelelo oluphezulu olulinganayo olusebenza kwizicubu ezithambileyo zingabonakalisa olu phawu.Ngaphantsi kweemeko ezifanayo zokusebenza, xa uxinzelelo olulinganayo oluphezulu lukhulu kakhulu, kucatshangelwa kwangaphambili ukuba iipropati zayo zokusika zizona zilungileyo.Ngokubhekiselele kuxinzelelo lwezicubu ezithambileyo, i-razor ye-60 ° yezinyo yavelisa uxinzelelo oluphezulu lwezicubu ezithambileyo (39.213 MPa).
Ukusasazwa koxinzelelo lwe-Shaver kunye nezicubu ezithambileyo xa iisheath zencakuba ezineeprofayili zamazinyo ezahlukileyo zisika izihlunu ezithambileyo: (a) 50° iprofayili yezinyo, (b) 60° inkangeleko yezinyo, (c) 70° inkangeleko yezinyo.
Ukuthethelela uyilo lweblade entsha ye-BJKMC, yathelekiswa ne-Dyonics◊ Incisor◊ Plus blade (Fig. 5) enomsebenzi ofanayo.Iintlobo ezintathu ezifanayo zemveliso nganye zisetyenzisiwe kuzo zonke iimfuniselo.Zonke iincakuba ezisetyenzisiweyo zintsha kwaye azonakalanga.
Izinto ezichaphazela ukusebenza kwe-razor ziquka ubunzima kunye nobukhulu be-blade, uburhabaxa betyhubhu yesinyithi, kunye neprofayili kunye ne-angle yezinyo.Ukulinganisa i-contours kunye nee-angles zamazinyo, iprojekti ye-contour enesisombululo se-0.001 mm ikhethiwe (i-Starrett 400 series, i-Fig. 6).Kwiimvavanyo, iintloko zokucheba zazibekwe kwibhentshi yokusebenza.Ukulinganisa iphrofayili yezinyo kunye ne-angle enxulumene ne-crosshairs kwisikrini sokubonisa kwaye usebenzise i-micrometer njengomahluko phakathi kwemigca emibini ukumisela umlinganiselo.Ubungakanani beprofayili yezinyo lwangempela lufumaneka ngokulwahlula ngokukhulisa injongo ekhethiweyo.Ukulinganisa i-engile yezinyo, lungelelanisa amanqaku angatshintshiyo macala omabini e-engile elinganisiweyo kunye ne-sub-line intersection kwiscreen esiqanduselweyo kwaye usebenzise ii-engile cursors kwitheyibhile ukuthatha ufundo.
Ngokuphindaphinda olu vavanyo, imilinganiselo ephambili yobude bokusebenza (imibhobho yangaphakathi nangaphandle), i-diameter yangaphambili kunye ne-posterior yangaphandle, ubude befestile kunye nobubanzi, kunye nokuphakama kwezinyo kulinganiswa.
Jonga uburhabaxa bomphezulu ngesalathisi.Incam yesixhobo ishukunyiswa ngokuthe tye ngaphezu kwesampulu, i-perpendicular ukuya kwicala lengqolowa ecutshungulwayo.Uburhabaxa obuqhelekileyo iRa ifumaneka ngokuthe ngqo kwisixhobo.Kwikhiwane.I-7 ibonisa isixhobo esinenaliti (Mitutoyo SJ-310).
Ubunzima be-razor blades bulinganiswa ngokovavanyo lobulukhuni beVickers ISO 6507-1: 20055.I-indenter yedayimane icinezelwe kumphezulu wesampuli ixesha elithile phantsi kovavanyo oluthile lwamandla.Emva koko ubude be-diagonal ye-indentation bulinganiswa emva kokususwa kwe-indenter.Ubulukhuni beVickers bulingana nomlinganiselo wamandla ovavanyo kwindawo engaphezulu yembonakalo.
Ubunzima bodonga lwentloko yokucheba bulinganiswa ngokufaka intloko yebhola ye-cylindrical ngokuchaneka kwe-0.01 mm kunye noluhlu lokulinganisa malunga ne-0-200 mm.Ubunzima bodonga buchazwa njengomahluko phakathi kweedayamitha zangaphandle nangaphakathi zesixhobo.Inkqubo yovavanyo yokulinganisa ubukhulu iboniswe kumfanekiso wesi-8.
Ukusebenza kolwakhiwo lwencakuba ye-BJKMC yathelekiswa naleyo ye-Dyonics◊ incakuba yolulo olufanayo.Idatha yokusebenza yecandelo ngalinye lemveliso iyalinganiswa kwaye ithelekiswe.Ngokusekelwe kwidatha ye-dimensional, amandla okusika zombini iimveliso ziqikelelwa.Zombini iimveliso zinezakhiwo ezigqwesileyo zesakhiwo, uhlalutyo oluthelekisayo lwe-conductivity yombane kuwo onke macala lusafuneka.
Ngokovavanyo lwe-angle, iziphumo ziboniswa kwiThebhile 2 kunye neThebhile 3. Intsingiselo kunye nokuphambuka okusemgangathweni kwedatha ye-angle yeprofayili yeemveliso ezimbini azizange zihluke ngokwezibalo.
Uthelekiso lwezinye iiparamitha eziphambili zeemveliso ezimbini zibonisiwe kuMfanekiso 9. Ngokobubanzi betyhubhu yangaphakathi nangaphandle nobude, iDyonics◊ iifestile zetyhubhu zangaphakathi nangaphandle zinde kancinci kwaye zibanzi kunezo ze-BJKMC.Oku kuthetha ukuba iDyonics◊ inokuba nendawo eyongezelelekileyo yokusika kwaye iityhubhu ayinakukwazi ukuvaleka.Iimveliso ezimbini azizange zihluke ngokwezibalo kwezinye iinkalo.
Amalungu e-razor ye-BJKMC axhunyiwe nge-laser welding.Ngoko ke, akukho xinzelelo lwangaphandle kwi-weld.Inxalenye ekufuneka ifakwe i-welded ayikho phantsi koxinzelelo lwe-thermal okanye i-thermal deformation.Inxalenye ye-welding incinci, ukungena kukhulu, amandla omatshini wecandelo le-welding liphezulu, i-vibration inamandla, ukuchasana kwempembelelo kuphezulu.Amacandelo e-laser-welded athembeke kakhulu kwi-assembly14,15.
Uburhabaxa bomphezulu ngumlinganiselo wokwakheka komphezulu.I-high-frequency kunye ne-short-wave components of the surface elinganisiweyo, emisela intsebenziswano phakathi kwento kunye nendawo yayo, iyaqwalaselwa.Umkhono wangaphandle wommese wangaphakathi kunye nomgangatho wangaphakathi wetyhubhu yangaphakathi yizona ndawo zisebenzayo ze-razor.Ukunciphisa uburhabaxa beendawo ezimbini kunokunciphisa ngokufanelekileyo ukunxiba kwi-razor kunye nokuphucula ukusebenza kwayo.
Uburhabaxa bomphezulu beqokobhe langaphandle, kunye nemigangatho yangaphakathi nangaphandle yencakuba yangaphakathi yeetyhubhu ezimbini zetsimbi, yafunyanwa ngovavanyo.Amaxabiso awo aphakathi aboniswa kuMzobo 10. Umphezulu wangaphakathi we-sheath yangaphandle kunye nomgangatho wangaphandle wemela yangaphakathi yizona ndawo zisebenzayo.Uburhabaxa bomphezulu wangaphakathi wescabbard kunye nomphandle we-BJKMC wangaphakathi wemela ungaphantsi kuneemveliso ezifanayo zeDyonics◊ (inkcazo efanayo).Oku kuthetha ukuba iimveliso ze-BJKMC zinokuba neziphumo ezanelisayo malunga nokusika ukusebenza.
Ngokutsho kovavanyo lobunzima be-blade, idatha yokulinga yamaqela amabini e-razor blades iboniswe kwi-Figure 11. Uninzi lwee-razors ze-arthroscopic zenziwe nge-austenitic stainless steel ngenxa yamandla aphezulu, ukuqina kunye ne-ductility efunekayo kwi-razor blades.Nangona kunjalo, iintloko zokucheba ze-BJKMC zenziwe kwi-1RK91 martensitic steel stainless steel.Iintsimbi ze-Martensitic zinamandla aphezulu kunye nokuqina kune-austenitic stainless steels17.Izinto zeekhemikhali kwiimveliso ze-BJKMC zihlangabezana neemfuno ze-S46910 (ASTM-F899 Instruments Surgical Instruments) ngexesha lenkqubo yokubumba.Izinto eziphathekayo ziye zavavanywa kwi-cytotoxicity kwaye zisetyenziswa ngokubanzi kwizixhobo zonyango.
Inokubonwa kwiziphumo zohlalutyo lwesici esilinganiselweyo ukuba uxinzelelo lwe-razor lugxininiswe kakhulu kwiprofayili yezinyo.I-IRK91 yintsimbi eqinileyo ephezulu yokuqina kwe-supermartensitic enokuqina okuphezulu kunye namandla okuqina aqinile kuwo omabini amaqondo obushushu begumbi kunye nobushushu obuphakamileyo.Amandla e-tensile kwiqondo lokushisa elingaphakathi angafikelela ngaphezu kwe-2000 MPa, kwaye ixabiso eliphezulu loxinzelelo ngokumalunga nohlalutyo olulinganiselweyo malunga ne-130 MPa, ekude nomda wokuqhekeka kwezinto.Sikholelwa ukuba umngcipheko wokuqhekeka kwe-blade uncinci kakhulu.
Ubunzima be-blade buchaphazela ngokuthe ngqo ukukwazi ukusika i-razor.Ubunzima bodonga oluncinci, ngcono ukusebenza kokusika.Incakuba entsha ye-BJKMC inciphisa ubukhulu bodonga lwemivalo emibini ejikelezayo echaseneyo, kwaye intloko inodonga olucekeceke kunezinye ezisuka kuDyonics◊.Iimela ezinqabileyo zinokunyusa amandla okusika kwincam.
Idatha ekwiTheyibhile yesi-4 ibonisa ukuba ubukhulu bodonga lwe-razor ye-BJKMC elinganiswa ngendlela yokulinganisa ubukhulu bodonga olucinezelayo buncinane kunobu be-Dyonics◊ incakuba yolubalulo olufanayo.
Ngokovavanyo oluthelekisayo, i-razor entsha ye-BJKMC ye-arthroscopic ibonisa ukuba akukho mahluko ucacileyo woyilo ukusuka kwimodeli efanayo yeDyonics◊.Xa kuthelekiswa ne-Dyonics◊ Incisor◊ Plus ifaka ngokweempawu zezinto eziphathekayo, i-BJKMC yokufaka izinyo eziphindwe kabini inomsebenzi osebenzayo kunye nencam enzima kunye nencinci.Ke ngoko, iimveliso ze-BJKMC zinokusebenza ngokwanelisayo kutyando.Olu phononongo luyilwe ngokulindelekileyo kwaye umsebenzi othile kufuneka uvavanywe kwimifuniselo elandelayo.
Chen, Z., Wang, C., Jiang, W., Na, T. & Chen, B. Uphononongo malunga nezixhobo zotyando lwe-knee arthroscopic debridement kunye ne-hip arthroplasty epheleleyo. Chen, Z., Wang, C., Jiang, W., Na, T. & Chen, B. Uphononongo malunga nezixhobo zotyando lwe-knee arthroscopic debridement kunye ne-hip arthroplasty epheleleyo.U-Chen Z, u-Wang K, u-Jiang W, u-Na T, kunye no-Chen B. Uphononongo lwezixhobo zotyando zokuchithwa kwamadolo e-arthroscopic kunye ne-hip arthroplasty epheleleyo. Chen, Z., Wang, C., Jiang, W., Na, T. & Chen, B. 膝关节镜清创术和全髋关节置换术手术器械综述。 Chen, Z., Wang, C., Jiang, W., Na, T. & Chen, B.U-Chen Z, u-Wang K, u-Jiang W, u-Na T, kunye no-Chen B. Uphononongo lwezixhobo zotyando zokuchithwa kwamadolo e-arthroscopic kunye nokutshintshwa kwe-hip epheleleyo.Umngcelele weSekisi.65, 291-298 (2017).
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Olu phononongo aluzange lufumane inkxaso-mali ethile kuyo nayiphi na i-arhente yenkxaso-mali kuluntu, kushishino, okanye kumacandelo angenzi nzuzo.
Isikolo seZixhobo zoNyango kunye nobuNjineli boKutya, iYunivesithi yaseShanghai yeTekhnoloji, iNombolo 516, iYungong Road, iShanghai, iRiphabhlikhi yabantu baseTshayina, ngo-2000 93