CN102349843A - Method for preparing individually-customized pelvic tumor prosthesis - Google Patents
Method for preparing individually-customized pelvic tumor prosthesis Download PDFInfo
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Abstract
The invention relates to a method for preparing individually-customized pelvic tumor prosthesis. The method comprises the following steps of: reconstructing three-dimensional models of pelvises and tumors according to two-dimensional images of captive tests (CT), magnatic resonance imaging (MRI) and the like of patients before operations, demarcating a tumor excision boundary according to a tumor therapeutic principle, and determining a plane and an angle of pelvic osteotomy; and reconstructing the three-dimensional models of amputated pelvic defect parts by comparing with normal pelvises, designing and producing individually-customized prosthesis, and performing surface modification on a contacting section of a prosthesis material and bones to fulfill the aim of combining the prosthesis material and the bones stably. The pelvic tumor prosthesis designed by the method can be customized individually aiming at the tumor excision range of different patients to retain bone mass as far as possible while the tumors are excised completely, and can be matched with the original pelvic excision parts accurately to realize accurate pelvic reconstruction operations; bone integration is formed between the prosthesis and the bones to ensure the long-term stability of the prosthesis; and hip joints of the prosthesis are designed by super-radium acetabuli, so the prosthesis is stable and has a motion function.
Description
Technical field
The invention belongs to pelvic tumor excision reconstruction field, be specifically related to the method for preparing of individuation customization pelvic tumor prosthese.
Background technology
Pelvis is much more predilection site, especially II district pathological changes (tumor around the acetabular bone) good, malignant tumor see.Because the anatomical structure of pelvis is complicated, so the tumor resection at this position and reconstruction are all very difficult.The pelvic tumor cutting method depends on growth of tumor position and scope.Pelvis is positioned at the hinge position of trunk and lower limb, and to supporting trunk, keeping stablizing significant, so after the pelvis excision, in order to preserve the function of limbs, reconstruction is necessary.
Pelvic tumor excision back method for reconstructing comprises: the structural reconstruction of allograph bone, saddle prosthese (Saddle prosthese) are rebuild, adjustable semi-pelvis prosthesis is rebuild, deactivation is from the technology such as prosthese of support reconstruction, integration technology, compound reconstruction and the computer-aided design of body bone composite bone cement.Although distinct methods cuts both ways, compare with pelvis amputation or the spacious art of putting, can obtain good function result really.Wherein, prosthese is rebuild can provide the stable at once of postoperative to the patient, and operative doctor can have more selection adjustment leeway in the operation implementation process, thus prosthese to rebuild be the Therapeutic Method of comparatively generally acknowledging at present, be widely used clinically.
Though the method for pelvis prosthesis reconstruction at present is more, but still undesirable.One of major reason wherein is exactly that prosthese does not match, and the standardization prosthese can not be accomplished the individuation customization, and the pelvic tumor excision back that therefore is not suitable for making a variation more rebuilds.The individuation prosthetic designs is present developing direction.Wherein, the semi-pelvis prosthesis of customization is representative with the Vitallium prosthese of computer-aided design processing.But owing to problems such as this prosthese do not carry out that osteotomy surface stress analysis, excision and prosthese installation can not accurately be mated, its clinical effectiveness is dissatisfied, and complication is high, function is poor as a result.In addition, this prosthese manufacturing cost is higher, and the cycle is longer, and the Unpredictability of tumor resection has limited the use of this prosthese sometimes in the art.
In sum, the pelvic tumor excision changes bigger, so reconstruction mode needs individuation to consider.Accurately the individuation measure prostheses of coupling will become the ideal selection that the pelvic tumor excision is rebuild.This ideal individuation customization pelvic tumor prosthese should possess following characteristics: 1) size of prosthese and immobile interface are confirmed according to the concrete tumor resection situation of patient, and can accurately mate with the position of original pelvic tumor excision; 2) time can realize the accurate installation of prosthese by computer assisted navigation system in operation; 3) the cross section part that contacts with bone of prosthese can reach bone and integrates; 4) the cross section part that contacts with bone of prosthese meets the stress decentralization principle, is beneficial to the mechanics conduction of bone-material interface; 5) hip joint of prosthese part should be stablized, and has motor function again; 6) prosthetic material should have excellent biological compatibility, has enough mechanical strengths and anti-fatigue ability again.
In order to reach above requirement, individuation customization pelvis prosthesis becomes the new direction of research gradually.Titanium alloy is a bio-inert material, and existing enough mechanical strengths and anti-fatigue ability have excellent biological compatibility again, therefore becomes the preferred material of processing prosthese.Along with the fast development of the auxiliary precision processing technology of digitizing technique and modern computer, the individuation prosthese that the pelvis defect area of at short notice patient being estimated is carried out the accurate three-dimensional Model Reconstruction and manufactured and designed accurate coupling has become possibility.
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Summary of the invention
The object of the present invention is to provide a kind of pelvic tumor, realize excising the accurately method for preparing of the individuation customization pelvic tumor prosthese of coupling of position with former pelvis to different excision extensions.
For achieving the above object, the technical scheme that the present invention adopts is:
1) pelvis and tumor resection position reconstructing three-dimensional model
Carry out the reconstructing three-dimensional model of pelvis and tumor according to CT and MRI scanning two dimensional image before patient's art; Press the tumor therapeutics principle and on threedimensional model, delimit the tumor resection border; Confirm the plane and the angle of pelvic osteotomy, and utilize the plane and the angle of pelvis FEM mechanics analysis correction pelvic osteotomy;
2) design of measure prostheses
According to the offside normal pelvis; To tumor resection position threedimensional model is after the defect of pelvis is revised; With data be converted to the industrial computer Aided Design with make software can recognition data, carry out the design of individuation measure prostheses, the position angle of planning fixed form and acetabular bone;
3) processing of measure prostheses
The data drawing input numerical control machining center of measure prostheses is carried out processing and preparing, obtain individuation customization pelvic tumor prosthese.
Described CT or MRI scanning bed thickness are 1-2mm.
Describedly on threedimensional model, delimit the tumor resection border and utilize mimics or the dividing function of simpleware software separates pelvic tumor amputation zone by the tumor therapeutics principle.
Described step 2) position angle of planning fixed form and acetabular bone promptly adopts screw fixation method, and according to the direction in angle of section planning nail road, screw adopts the os integumentale screw of diameter 7-9mm; Confirm the position and the angle of acetabular bone, acetabular bone adopts ultra radial design; Corresponding bulb adopts the standard bulb of diameter 28mm.
Described step 3) is carried out the surperficial cross section part that contacts with bone to the prosthese that processes and is adopted sandblast technology to process rough surface, and surface roughness Ra is 5-15 μ m.
Described prosthetic material adopts medical titanium alloy Ti-6A1-4V to process or the low titanium alloy material that plays is processed.
The individuation customization pelvic tumor prosthese of processing by designing and preparation method of the present invention has following advantage: 1) size of prosthese and immobile interface can be confirmed according to the concrete tumor resection situation of patient; And can accurately mate with the position of original pelvic tumor excision; Realized the individuation customization of prosthese, can change the design that bigger characteristics change prosthese flexibly to the pelvic tumor excision; 2) threedimensional model at art pre-neoplastic excision planning and prosthese all can import computer assisted navigation system, when operation, can realize the accurate installation of prosthese by navigation; 3) the cross section part that contacts with bone of prosthese meets the stress decentralization principle, is beneficial to the mechanics conduction of bone-material interface; 4) artificial hip joint of prosthese can keep stable, has good motor function again; 5) the cross section part that contacts with bone of prosthese can reach bone and integrates; 6) titanium alloy is as prosthetic material, and existing excellent biological compatibility has enough mechanical strengths and anti-fatigue ability again.
Description of drawings
Fig. 1 is the lateral side view of the embodiment of the invention;
The specific embodiment
Below in conjunction with accompanying drawing the present invention is done further explain.
Referring to Fig. 1, method for preparing of the present invention is following:
1) pelvis and tumor resection position reconstructing three-dimensional model
Carry out the reconstructing three-dimensional model of pelvis and tumor according to two dimensional images such as CT and MRI scannings before patient's art, the scanning bed thickness is 1-2mm; Press the tumor therapeutics principle and on threedimensional model, delimit tumor resection border 1, confirm the plane and the angle of pelvic osteotomy, utilize the dividing function of software (like mimics or simpleware software) that pelvic tumor amputation zone is separated; Utilize pelvis FEM mechanics analysis technology to revise the plane and the angle of pelvic osteotomy, make it meet the stress decentralization principle, avoid rebuilding back prosthese-synosteosis interfacial stress and concentrate, to reach the purpose of stable bond.The Cross section Design of prosthese is corresponding with above-mentioned cross section.
2) design of measure prostheses
According to the offside normal pelvis; After tumor resection position threedimensional model (being the defect of pelvis) revised, with data transaction be the industrial computer Aided Design with make software (like UG, Solideworks etc.) can recognition data; Carry out the design of individuation measure prostheses; Cut the bone scope to different patients' difference, each cross section 1 of prosthese, external form and size are variable, for individuation designs.Adopt screw fixation method, according to the direction in angle of section planning nail road 2, screw adopts the os integumentale screw of diameter 7-9mm; The direction in nail road 2 and the quantity of hold-down screw are confirmed according to the concrete bone scope of cutting, all are variable, for individuation designs.Confirm the position and the angle of acetabular bone 3, acetabular bone 3 adopts ultra radial design, can guarantee the stable of hip joint, can have good motor function again; Corresponding bulb adopts the standard bulb of diameter 28mm, is convenient to the installation of assembly type artificial hip joint femoral part.
3) processing of measure prostheses
The data drawing input numerical control machining center of measure prostheses is carried out processing and preparing, and material adopts medical titanium alloy; Prosthese to processing carries out surface modification, and the cross section part that prosthese is contacted with bone adopts sandblast technology to process rough surface, and surface roughness (Ra) parameter reaches 5-15 μ m, makes bone and material be easy to reach bone and integrates, and is beneficial to the long-term stability of prosthese.
The present invention rebuilds for pelvic tumor excision has relative adaptation disease, and its most significant advantage is to realize the individuation customization of tumor prosthese, accurately fills false accurate with prosthese with what guarantee tumor resection.Can obviously improve the shortcoming of existing pelvic tumor method for reconstructing, thereby a kind of reliable method for reconstructing is provided for guarantor's limb operation of pelvic tumor.
Claims (6)
1. the method for preparing of individuation customization pelvic tumor prosthese is characterized in that:
1) pelvis and tumor resection position reconstructing three-dimensional model
Carry out the reconstructing three-dimensional model of pelvis and tumor according to CT and MRI scanning two dimensional image before patient's art; Press the tumor therapeutics principle and on threedimensional model, delimit the tumor resection border; Confirm the plane and the angle of pelvic osteotomy, and utilize the plane and the angle of pelvis FEM mechanics analysis correction pelvic osteotomy;
2) design of measure prostheses
According to the offside normal pelvis; To tumor resection position threedimensional model is after the defect of pelvis is revised; With data be converted to the industrial computer Aided Design with make software can recognition data, carry out the design of individuation measure prostheses, the position angle of planning fixed form and acetabular bone;
3) processing of measure prostheses
The data drawing input numerical control machining center of measure prostheses is carried out processing and preparing, obtain individuation customization pelvic tumor prosthese.
2. the method for preparing of individuation customization pelvic tumor prosthese according to claim 1 is characterized in that: described CT or MRI scanning bed thickness are 1-2mm.
3. the method for preparing of individuation according to claim 1 customization pelvic tumor prosthese is characterized in that: described by the tumor therapeutics principle on threedimensional model, delimit the tumor resection border and utilize mimics or the dividing function of simpleware software with the separation of pelvic tumor amputation zone.
4. the method for preparing of individuation customization pelvic tumor prosthese according to claim 1; It is characterized in that: described step 2) position angle of planning fixed form and acetabular bone promptly adopts screw fixation method; According to the direction in angle of section planning nail road, screw adopts the os integumentale screw of diameter 7-9mm; Confirm the position and the angle of acetabular bone, acetabular bone adopts ultra radial design; Corresponding bulb adopts the standard bulb of diameter 28mm.
5. the method for preparing of individuation customization pelvic tumor prosthese according to claim 1; It is characterized in that: described step 3) is carried out the surperficial cross section part that contacts with bone to the prosthese that processes and is adopted sandblast technology to process rough surface, and surface roughness Ra is 5-15 μ m.
6. the method for preparing of individuation customization pelvic tumor prosthese according to claim 1 is characterized in that: described prosthetic material adopts medical titanium alloy Ti-6A1-4V to process or the low titanium alloy material that plays is processed.
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| CN105105838A (en) * | 2015-07-27 | 2015-12-02 | 广州中国科学院先进技术研究所 | Personalized maxillofacial surgery guide plate and manufacturing method thereof |
| CN105935320A (en) * | 2016-04-29 | 2016-09-14 | 南方医科大学第三附属医院 | Local issue structure customized reconstruction mechanism after malignant tumor around pelvis is resected |
| CN106456331A (en) * | 2014-03-04 | 2017-02-22 | 皇家墨尔本理工大学 | A method for producing a customised orthopaedic implant |
| CN107811729A (en) * | 2017-10-20 | 2018-03-20 | 赵德伟 | A kind of method for preparing acetabular bone supplementary material |
| CN109106481A (en) * | 2018-09-18 | 2019-01-01 | 北京爱康宜诚医疗器材有限公司 | The determination method and device of acetabular bone defect degree |
| CN110008506A (en) * | 2019-02-22 | 2019-07-12 | 南京航空航天大学 | A kind of bone tumour bionics prosthesis method |
| CN110478090A (en) * | 2019-07-17 | 2019-11-22 | 天津市天津医院 | CAD pelvic tumor is precisely cut off with personalized prosthese and preparation method thereof |
| CN112932744A (en) * | 2019-12-10 | 2021-06-11 | 上海昕健医疗技术有限公司 | Personalized customized pelvic prosthesis and manufacturing method thereof |
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Cited By (10)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN106456331A (en) * | 2014-03-04 | 2017-02-22 | 皇家墨尔本理工大学 | A method for producing a customised orthopaedic implant |
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| CN107811729A (en) * | 2017-10-20 | 2018-03-20 | 赵德伟 | A kind of method for preparing acetabular bone supplementary material |
| CN109106481A (en) * | 2018-09-18 | 2019-01-01 | 北京爱康宜诚医疗器材有限公司 | The determination method and device of acetabular bone defect degree |
| CN110008506A (en) * | 2019-02-22 | 2019-07-12 | 南京航空航天大学 | A kind of bone tumour bionics prosthesis method |
| CN110478090A (en) * | 2019-07-17 | 2019-11-22 | 天津市天津医院 | CAD pelvic tumor is precisely cut off with personalized prosthese and preparation method thereof |
| CN112932744A (en) * | 2019-12-10 | 2021-06-11 | 上海昕健医疗技术有限公司 | Personalized customized pelvic prosthesis and manufacturing method thereof |
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