CN105361883A - Method for determining lower limb biological force line in three-dimensional space for total knee arthroplasty - Google Patents
Method for determining lower limb biological force line in three-dimensional space for total knee arthroplasty Download PDFInfo
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Abstract
The invention relates to a method for determining a lower limb biological force line in a three-dimensional space for total knee arthroplasty. The problem of determining a lower limb biological force line for total knee arthroplasty puzzles orthopedists, and how to overcome the defects that the total knee arthroplasty is performed in a two-dimensional plane traditionally and how to improve postoperative effects become a key study point. According to the method, three-dimensional space imaging and reverse engineering technology are combined with digital medicine, and three-dimensional reconstruction of lower limb femoral head-distal femur-proximal tibia-ankle joint is achieved by medical three-dimensional visual software Simpleware on the basis of three-segment hip-knee-ankle MRI (magnetic resonance imaging) data; space fitting of the femoral head center is completed in reverse engineering processing software Geomagic and Imageware; based on the anatomical morphology of the distal knee joint, the knee joint center is determined by means of space fitting; similarly, the tibial plateau center and the ankle joint center are determined, and connection lines of the four points from the femoral head center to the ankle joint center are established three-dimensionally to obtain the biological force line of the overall lower limb, so that precise bases are provided for the total knee arthroplasty.
Description
Technical field
Three-dimensional visualization technique combines with digital medical with reverse Engineering Technology (ReverseEngnieering) by patent of the present invention, by the Professional knowledge integrated application of computer technology and subjects of mechanical engineering to biomedical sector, solves medical science problems faced.
The modern advanced medical imaging technology of patent utilization of the present invention, the scanning of 3.0T nuclear-magnetism machine is adopted to get hip-knee joint-ankle image data, utilize medical 3 D visual software Simpleware to complete the reconstruction of lower limb syllogic data, complete the foundation of full lower-limbs biology force-line on this basis in conjunction with three dimensions such as reverse engineering software Imageware, Geomagic.
Patent of the present invention solves the drawback of traditional knee prosthesis at two dimensional surface location lower-limbs biology force-line accurately, utilizes three-dimensional medical imaging visualization technique and reverse Engineering Technology to solve a difficult problem for biologic medical field face.Demonstrate the accuracy of the descending knee prosthesis of the three-dimensional line of force by experiment, substantially increase operation precision.
Background technology
Within 1860, by Verneil, arthroplasty of knee (totalkneearthroplasty, TKA) is proposed, due in early days by the aspect factor such as material to affect operative failure rate higher.After the exploration that have passed through a century, there is artificial knee joint prosthese the earliest the 1950's.Knee replacements, increase to 150,000 examples of nineteen ninety in the U.S. by 10,000 examples of 1975, in Sweden, nearly 20 years replacements add 5 times.Someone estimates in annual about artificial replacement's 5.5 ten thousand knee joints of Germany.China enters aging society, records according to domestic newpapers and periodicals, and in the aging population of over-65s, osteoarthritis sickness rate accounts for more than 80% and has artificial knee joint replacement indication, and not yet operator estimates at 2,000,000.Total knee replacement in worldwide in 2002, the whole year, this number was now also in increase more than 600,000 examples.
The success or not of TKA and the Study on influencing factors to clinical efficacy, it is the problem that people pay close attention to always, the clinical late result obtained, for the accurate grasp of selected, the operation skill of the selection of indication, prosthese and preoperative management all very important, especially to a great extent to the requirement of operation skill, accurate osteotomy, prosthese solid should settle on three dimensions, realize copying again of knee replacements artifact mechanics.Bibliographical information is except the general complication such as infection, fat embolism, and, prosthese improper with the line of force up to the early stage overhaul technology of 50% puts that position is improper and joint destabilization is relevant.Therefore, in order to obtain better Long-term effect, Anatomical Reconstruction lower-limbs biology force-line and prosthese rotation axis are the final goals that people constantly explore and pursue.
Conventional total knee replacement operation is undertaken in marrow by mechanical guiding device in preoperative X-ray film inspection and art, marrow outside fix osteotomy patient relies on naked eyes, feel and experience to locate anatomic landmark, the lower limb line of force and prosthese rotation axis, and then manual osteotomy of ruling, prosthese are placed and soft tissue balance.This complete based on the observation of naked eyes to limbs and prosthese para-position, have very large subjectivity to line, directly affects the reliability of this locate mode and the accuracy of operation, even cause the failure of performing the operation.Although people constantly improve mechanical navigation system, improve the accuracy of Using prosthesis, but system limitation inherently determines its precision that may reach, even the mechanical navigation system that bibliographical information is the meticulousst, used by veteran doctor, femur and spinal joints are also at least 10% to the incidence rate of line error more than 3 °.And mechanical positioning measurment system is based on the dissection of imaginary standardization skeleton and geometric shape, may and be not suitable for some case-specific.Therefore, the accuracy problem of traditional surgical approaches is the subject matter of puzzlement operative doctor, how to improve the degree of accuracy of knee prosthesis, and it is crucial for setting up lower-limbs biology force-line accurately.
Summary of the invention
Patent of the present invention is that the subjectivity breaking away from two dimensional surface location is random, improves the osteotomy positioning precision of knee prosthesis, improves the joint physiological function of patient in order to solve the drawback of traditional knee prosthesis process at two dimensional surface location lower-limbs biology force-line.Medical 3 D is visual, reverse Engineering Technology has combined with digital medical the foundation of the full lower-limbs biology force-line of three dimensions.
In order to solve the problems referred to above of the three dimensions determination lower limb line of force, overcoming the randomness of two dimensional surface location lower-limbs biology force-line, improving osteotomy positioning precision; The present invention, by medical 3 D visualization technique, utilizes 3.0T nuclear-magnetism machine to get lower limb syllogic hip-knee joint-ankle image data; Integrative medicine three-dimensional visualization softens the three-dimensional reconstruction that Simplware completes lower limb femoral head-distal femur-proximal tibia-ankle joint on this basis.
Then complete the three dimensions matching of late-segmental collapse in conjunction with reverse engineering software Geomagic, Imageware etc., then according to the articular morphology of patient, realize the matching of knee joint space center.In like manner, the matching at proximal tibia and ankle joint center is completed.
The line of 4 is set up at late-segmental collapse, knee joint center, tibial plateau center and ankle joint center that patent of the present invention is determined according to matching, obtains the full lower-limbs biology force-line of three dimensions human body.
Patent of the present invention is after establishing the lower limb three dimensions line of force, also needing three-dimensional to determine distal femur rotation axis to complete whole knee prosthesis, setting up the virtual pivot line of distal femur prosthese at three dimensions according to the anatomic form structure of human femur under loading far-end by MRI fault image data.On this basis according to the demand in actual operation process, in conjunction with Mimics medical image control software design, complete preoperative simulation osteotomy, verify the accuracy of the descending knee prosthesis of the three-dimensional line of force.
Patent of the present invention is carried out alternately with orthopedist in the process completing three-dimensional line of force simulation knee prosthesis osteotomy, and by different orthopedist to after the evaluation of whole simulation osteotomy process, the space completing the whole line of force is set up.
accompanying drawing illustrates:
Accompanying drawing 1, Fig. 2, Fig. 3 are syllogic femoral head, knee joint, ankle joint;
Accompanying drawing 4, Fig. 5, Fig. 6 are femoral cartilage, knee cartilage, tibial plateau cartilage;
Accompanying drawing 7, Fig. 8, Fig. 9, Figure 10 are late-segmental collapse, knee joint center, tibial plateau center, ankle joint center;
Accompanying drawing 11, Figure 12 are full lower limb biomechanics axis normotopia and side bitmap.
detailed description of the invention:
Complete the reconstruction of the three-dimensional line of force of lower limb, the medical imaging data of patient's lower limb need be obtained.Be all that doctor determines the lower limb line of force according to the lower limb two dimension X plain film line of preoperative scan patients in tradition knee prosthesis, this method is not only random with very large subjectivity, and has been difficult to the accurate location of the line of force.Occurred afterwards utilizing CT to complete the location of the lower limb line of force, but utilize the full lower limb of CT scan patient too large to the amount of radiation of patient, process of reconstruction is more complicated also, and can not show the articular cartilage of patient, and the knee prosthesis effect of articular cartilage to patient is most important.So adopt 3.0T nuclear-magnetism machine to obtain patient's lower limb syllogic hip-knee joint-ankle MRI magnetic resonance imaging data in patent of the present invention, save the three-dimensional reconstruction time, remove the radiation to patient, consider that articular cartilage is on the impact of whole knee prosthesis.
Need to carry out three-dimensional visualization after completing hip-knee joint-ankle syllogic MRI data scanning, the three-dimensional reconstruction completing femoral head, distal femur, proximal tibia, ankle joint and articular cartilage in Simplware software is preserved with STL form.The threedimensional model of bone structure and articular cartilage imports in Geomgaic and is considered as a standard ball by approximate for femoral head, and choosing partial femoral head point-cloud fitting is that a spheroid gets its centre of sphere as late-segmental collapse; Two spheroids that inside and outside matching determination distal femur, condyle the best in rear flank contains, the mid point getting the centre of sphere line of centres is knee joint center; The mid point of cristae lateralis peak line in matching determination tibia, in best fit determination ankle joint, the mid point of lateral condyle salient point line is ankle joint center.
After three dimensions matching determines late-segmental collapse, knee joint center, tibial plateau center and ankle joint center, the line setting up at three dimensions at 4 obtains full lower-limbs biology force-line.
Will complete knee prosthesis accurately also needs three-dimensional to set up distal femur prosthese Virtual space rotation axis, according to the anatomic form structure of distal femur, MRI scan-data is imported in Simplware, determine the most concave point of condyle and the most salient point three dimensional space coordinate of ectocondyle in distal femur, in Geomagic, set up distal femur rotation axis.
After achieving the three-dimensional foundation of lower-limbs biology force-line and distal femur rotation axis, also need to verify its accuracy.Patent of the present invention is mutual by carrying out between doctor, according to actual knee prosthesis process, needs the osteotomy requirement reached according to knee prosthesis, utilizes Mimics to complete simulation knee osteotomy process at three dimensions.
After completing simulation osteotomy, by three dimensional viewing osteotomy effect in Imageware, measure osteotomy thickness, observe the state of osteotomy surface; On this basis to equatorial projection, allow different orthopedists to consult osteotomy effect, what realize between doctor and engineer is mutual, guarantees the accuracy of the whole knee joint three dimensions line of force.
Claims (7)
1. the defining method of knee prosthesis three dimensions lower-limbs biology force-line is the error that the subjectivity randomness of locating lower-limbs biology force-line to solve traditional knee prosthesis on two-dimentional plain film is brought, 3.0TMRI nuclear-magnetism machine is utilized to obtain lower limb hip-knee joint-ankle fault image data, complete the three-dimensional visualization of data, then realize the matching at late-segmental collapse, knee joint center, tibial plateau center, ankle joint center in conjunction with reverse Engineering Technology, three-dimensional sets up full lower limb biomechanics axis.
2. the defining method of knee prosthesis three dimensions lower-limbs biology force-line according to claim 1, it is characterized in that utilizing syllogic MRI image data in Simpleware three-dimensional visualization software, realize the visual reconstruction of fault image data, complete the three-dimensional reconstruction of femoral head, distal femur, proximal tibia, ankle joint.
3. the defining method of knee prosthesis three dimensions lower-limbs biology force-line according to claim 2, it is characterized in that described three-dimensional visualization process need integrated use numeral orthopaedics and reverse Engineering Technology, integrated use reverse engineering software Imageware, Geomagic, CATIA etc., by the three dimensions matching of data, determine the articulation center of being correlated with.
4. the defining method of knee prosthesis three dimensions lower-limbs biology force-line according to claim 1, is characterized in that described lower limb biomechanics axis is that late-segmental collapse, knee joint center, tibial plateau center, 4, ankle joint center are at three-dimensional line.
5. the defining method of knee prosthesis three dimensions lower-limbs biology force-line according to claim 1, it is characterized in that described lower-limbs biology force-line is as in the basis reference process of knee prosthesis, also establish the three dimensions rotation axis of knee-joint prosthesis, guarantee the accuracy of the osteotomy of knee prosthesis.
6. the defining method of knee prosthesis three dimensions lower-limbs biology force-line according to claim 1, it is characterized in that three-dimensional establishes on the basis of lower limb biomechanics axis, MRI data is utilized to complete the three-dimensionalreconstruction of femoral cartilage and tibial plateau cartilage, then reverse engineering software Imageware and Mimics software etc. is utilized to realize the simulation osteotomy process of knee prosthesis, measure osteotomy thickness, realize whole osteotomy process.
7. the defining method of knee prosthesis three dimensions lower-limbs biology force-line according to claim 6, the orthopedist that it is characterized in that achieving the heel of spatial simulation osteotomy different carries out alternately, verifies feasibility and the effectiveness of the whole three dimensions line of force.
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CN113907774A (en) * | 2021-10-13 | 2022-01-11 | 瓴域影诺(北京)科技有限公司 | Method and device for measuring lower limb force line |
CN113870261A (en) * | 2021-12-01 | 2021-12-31 | 杭州柳叶刀机器人有限公司 | Method and system for recognizing force line by using neural network, storage medium and electronic device |
CN114052824A (en) * | 2021-12-23 | 2022-02-18 | 樊宗庆 | Preparation method and use method of 3D printing osteotomy guide device and lower limb verification device |
CN114052824B (en) * | 2021-12-23 | 2023-07-18 | 樊宗庆 | Preparation method and application method of 3D printing osteotomy guide and lower limb verification device |
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