CN104337572B - Customization operation on hip joint positioner based on medical image and supporting prosthese - Google Patents
Customization operation on hip joint positioner based on medical image and supporting prosthese Download PDFInfo
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- CN104337572B CN104337572B CN201310313544.9A CN201310313544A CN104337572B CN 104337572 B CN104337572 B CN 104337572B CN 201310313544 A CN201310313544 A CN 201310313544A CN 104337572 B CN104337572 B CN 104337572B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4609—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of acetabular cups
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Abstract
The invention discloses a kind of customization operation on hip joint positioner based on medical image and supporting prosthese and localization method, this positioner is according to preoperative planning hole, eccentric location of molding location eccentricity short handle on acetabular bone, the acetabular bone to breaking down in acetabular bone can be followed closely on the basis of the boring nail corresponding to the central shaft of acetabular component effectively to excise, it is achieved the effectiveness of acetabular component implant site and accuracy simultaneously；To improve the degree of accuracy of hands Intraoperative position, reduce use cost, simultaneously without requiring that surgeon accepts special training, it is easier that prosthese is installed in operation, and its three-dimensional coordinate position, it has been determined that decrease the times such as calibration required in operation, improves procedure efficiency when prosthese is installed.By arranging eccentric short handle on acetabular component, realize acetabular component when being installed in acetabular bone by acetabular component is circumferentially positioned, it is ensured that the pinpoint accuracy that acetabular component is installed.
Description
Technical field
The invention belongs to hip joint replacement technique field, be specifically related to a kind of customization hip joint hands based on medical image
Art positioner and supporting prosthese and localization method.
Background technology
Osteoarthritis (osteoarthritis, OA) is that a kind of degeneration, destruction and hyperosteogeny with articular cartilage is
The chronic joint disease of feature.Osteoarthritis has arthralgia, stiff lopsided and handicapped Symptoms, these symptom tables
The most just directly constitute the harm to patient, affect the healthy of patient and quality of life.The morbidity of osteoarthritis and age
Closely related, 45-64 year sickness rate less than 30%, the sickness rate more than 65 years old may be up to 68%, and this disease becomes more than 50 years old
Patient loses the second largest reason of work capacity, is only second to heart disease.
The treatment of osteoarthritis is still the significant problem that current medical circle faces, and conservative Drug therapy does not often reach effect
Really, finally remain a need for performing the operation.Prosthetic replacement performs the operation, and is by Using prosthesis human body by surgical technic, replaces ill
Function of joint, reaches to alleviate arthralgia, recovers the purpose of function of joint.Along with the aggravation of Chinese population aging, manually close
Joint market presents the trend increased rapidly, and in large-scale Grade A hospital, the displacement number of units of artificial joint, every year with 20%-30%
Above speed increases.Within 2010, Chinese artificial joint market is about 1,000,000,000 dollars, and China in 2015 will exceed Japan only to be become
World's second largest artificial joint market inferior to the U.S..The success or failure of prosthetic replacement's operation, depend not only on used people
Work joint product, can lie also in doctor implement location exactly and install according to the practical situation of patient.Prosthetic replacement
Operation require doctor according only to two-dimensional medical images and oneself clinical experience, under the narrowest and small wound, according to human bone
Bone physiology and biomechanical characterization, be precisely accomplished the displacement of patient's artificial joint.At present, become one can complete independently artificial
The qualified Orthopeadic Surgery clinician of joint replacement surgery, needs the training time of minimum 11 years, and it is famous-brand and high-quality to become one in the U.S.
Elegant doctor, needs longer practice process.Relative to the patient populations increased rapidly, the joint replacement surgery doctor that China is qualified
Raw quantity is the shortest, and traditional method is difficult to cultivate rapidly a large amount of qualified doctor.
Traditional Man joint localization method mainly completes the location to alignment system according to mechanical apparatus, and operation is multiple
Miscellaneous, limited precision.Although and the computer navigation system used in surgical operation is thought in the past few decades and will be replaced always
Traditional mechanical location mode, brings revolutionary change for artificial operation on joint, but until today, existing surgical navigational system
System equipment is the most expensive, and positioning precision still needs to improve, and requires that surgeon accepts special training simultaneously, school required in operation
The work such as standard the most necessarily extend operating time.
Therefore, in view of problem above, it is necessary to propose a kind of navigation positioning system, to improve the accurate of hands Intraoperative position
Degree, reduces use cost, simultaneously without requiring that surgeon accepts special training, installs prosthese easier, and installs at prosthese
Time its three-dimensional coordinate position it has been determined that decrease in operation the time of required calibration etc., improve procedure efficiency.
Summary of the invention
In view of this, the present invention provides a kind of customization operation on hip joint positioner based on medical image and supporting vacation
Body and localization method, to reach to be effectively improved the degree of accuracy of acetabular component location in operation, reduce use cost, simultaneously without
Requiring that surgeon accepts special training, it is easier that prosthese is installed in operation, and its three-dimensional coordinate position is the most true when prosthese is installed
Fixed, decrease the time of calibration etc. required in operation, improve the purpose of procedure efficiency.
A kind of based on medical image the customization operation on hip joint positioner proposed according to the purpose of the present invention, is used for
Being accurately positioned acetabular component, described positioner includes the detent mechanism customized for each patient and is positioned at described detent mechanism
Guide post on inwall, the outer surface of described detent mechanism matches with the inner surface of described acetabular bone；Described guide post is at least 1
Root, including centre pilot bar, described guide post offers pilot hole along its axis direction, can be to acetabular bone by described pilot hole
Boring guides, and forms hole, location on acetabular bone, and described centre pilot bar is corresponding with the central shaft of acetabular component, and corresponding one-tenth
Type has center positioning hole.
Preferably, described guide post also includes eccentric guide post, by the corresponding molding on acetabular bone of described eccentric guide post
There is hole, eccentric location.
Preferably, described guide post also includes the multiple auxiliary guide posts being arranged in acetabular bone outer side edges, by described auxiliary
Helping guide post to carry out guiding and squeeze into boring nail with molding auxiliary positioning hole on pelvis, operation calibrating installation is permissible with bone-cutting device
Direct or indirect be fixed to hole nail on auxiliary and remove cartilaginous tissue in acetabular bone and the acetabular bone broken down, auxiliary positioning hole is for auxiliary
Helping and carry out acetabular component location, auxiliary guide post can be additionally used in the accurate direction determining drilling equipment when deep preparation acetabular bone.
Preferably, the inner side of described detent mechanism is additionally provided with datum plane, and described datum plane is fixed with final installation
The plane flush of acetabular component, for determine acetabular component install after opening direction, give operative doctor hands intuitively
The final position of acetabular component after art displacement；Or described datum plane is equal with the final plane installing fixing acetabular component
OK, but need not neat mutually, thus give doctor the displacement direction of final prosthese intuitively.
A kind of acetabular component, including acetabular component shell, is provided with eccentric short handle, described bias outside described acetabular component shell
Short handle is installed into circumferentially positioned to described acetabular component in acetabular bone.
Preferably, described eccentric short handle is detachably fixed with described acetabular component shell or becomes with described acetabular component shell one
Type.
A kind of customization operation on hip joint localization method based on medical image, based on medical image described in employing is determined
Inhibition and generation operation on hip joint positioner, concrete positioning step is as follows:
(1), operation consent, need patient to carry out including pelvis and a series of CT of femur or MRI image, according to this be
The image of row constructs the three dimensional computer modeling of patient bone the most accurately；And according to this three dimensional computer modeling
Predetermined acetabular bone displacement position, the three-dimensional skeleton model of manufacture, and be each patient customization according to the three-dimensional skeleton model of patient
Surgery positioning device, and determine the size of acetabular component and the three-dimensional implantation position data that determine it, wherein, described positioner
The position of central locating rod and eccentric location bar determined with predetermined acetabular bone displacement position by three dimensional computer modeling；
(2), positioner is carried out sterilization processing, in order to clinical operation uses；
(3), by positioner put into acetabular bone to mate completely with acetabular bone surface to be replaced, and rapidly by described three
Dimension implantation position data are determined accurately in operation, can be used by the effect of pilot hole on acetabular bone and on pelvis limit
Drilling equipment squeezes into boring nail, hole, molding multiple location；
(4) boring, taken out on positioner and hole, eccentric location is followed closely, with the boring corresponding to acetabular component central shaft
Following closely on the basis of nail, braced frame is fixed on remaining boring and nails on, bone-cutting device is fixed on rigidity structure with operation calibrating installation
On frame, deep to carry out assisting, with the corresponding position punching of benchmark nail on braced frame, use rose drill with benchmark nail as base
Standard, cutting bone and processes, carrying out rejecting the acetabular bone broken down until exposing new bone acetabular bone；
(5), take out all of boring nail, acetabular component is put into acetabular bone so that eccentric short handle is installed into corresponding inclined
In hole, heart location fixing, acetabular component is automatically determined relative to the three-dimensional of pelvis, including acetabular bone gradient, head trim with
And the degree of depth transplanted, the position of complete and preoperative planning is matched by three-dimensional position with direction；
(6), that acetabular component is the most fixing.
Preferably, the degree of depth of acetabular bone can be determined by a regulation guide rod, or with scale/stop device operation guide rod certainly
Fixed.
Preferably, using assemble mechanism that acetabular component is put into acetabular bone in step 5, described assemble mechanism is arranged at institute
Stating inside acetabular component, the outer surface of described assemble mechanism matches with the inner surface of described acetabular component.
Preferably, in step 5, guide rod, described assemble mechanism and described guide rod are also used when the acetabular component of assembling location
Between detachable or one-body molded；When putting into acetabular component, assemble mechanism jointly acts on guide rod and being put into by acetabular component, guide rod
Insert in the hole, location of molding in advance.
Preferably, there is also the taking-up process of described assemble mechanism and guide rod after step 5.
Preferably, if three dimensional computer modeling is from CT image, also included rejecting cartilage group in acetabular bone before step 3
The step knitted.
Compared with prior art, a kind of customization operation on hip joint positioner based on medical image disclosed by the invention
And the advantage of supporting prosthese and localization method is: this positioner is according to preoperative planning molding location eccentricity short handle on acetabular bone
Hole, eccentric location, can follow closely the mortar broken down in acetabular bone on the basis of the boring nail corresponding to the central shaft of acetabular component simultaneously
Bone effectively excises, it is achieved the effectiveness of acetabular component implant site and accuracy；To improve the accurate of hands Intraoperative position
Degree, reduces use cost, and simultaneously without requiring that surgeon accepts special training, it is easier that prosthese is installed in operation, and at prosthese
Its three-dimensional coordinate position during installation, it has been determined that decrease the time of calibration etc. required in operation, improves procedure efficiency.Pass through
Arranging eccentric short handle on acetabular component, realize acetabular component when being installed in acetabular bone by acetabular component is circumferentially positioned,
Ensure the pinpoint accuracy that acetabular component is installed.
Accompanying drawing explanation
In order to be illustrated more clearly that the embodiment of the present invention or technical scheme of the prior art, below will be to embodiment or existing
In having technology to describe, the required accompanying drawing used is briefly described, it should be apparent that, the accompanying drawing in describing below is only this
Some embodiments of invention, for those of ordinary skill in the art, on the premise of not paying creative work, it is also possible to
Other accompanying drawing is obtained according to these accompanying drawings.
Fig. 1 is the structural representation of a kind of acetabular component disclosed by the invention.
Fig. 2 is the structural representation of pelvis and acetabular bone part.
Fig. 3 is a kind of customization operation on hip joint positioner embodiment 1 based on medical image disclosed by the invention
Structural representation.
Fig. 4 is a kind of customization operation on hip joint positioner based on medical image in embodiment 1 disclosed by the invention
It is fixed on supracotyloid structural representation.
Fig. 5 is a kind of customization operation on hip joint positioner embodiment 2 based on medical image disclosed by the invention
Structural representation.
Fig. 6 is a kind of customization operation on hip joint positioner based on medical image in embodiment 2 disclosed by the invention
It is fixed on supracotyloid structural representation.
Fig. 7 is that a kind of customization operation on hip joint positioner based on medical image disclosed by the invention is fixed on acetabular bone
The structural representation of upper embodiment 3.
Fig. 8 is a kind of customization operation on hip joint positioner embodiment 4 based on medical image disclosed by the invention
Structural representation.
Fig. 9 is that a kind of customization operation on hip joint positioner based on medical image disclosed by the invention is fixed on acetabular bone
The structural representation of upper embodiment 4.
Figure 10 is final installation disclosed by the invention structural representation Fig. 1 when fixing acetabular component.
Figure 11 is final installation disclosed by the invention structural representation Fig. 2 when fixing acetabular component.
Numeral in figure or the title of the corresponding component representated by letter:
100, acetabular component 101, eccentric short handle 200, detent mechanism 201, outer surface 202, eccentric guide post 203,
Centre pilot bar 204, datum plane 205, auxiliary guide post 206, pilot hole 300, pelvis 301, acetabular bone 400, assembling
Mechanism 401, guide rod
Detailed description of the invention
Traditional Man joint localization method mainly completes the realization of alignment system according to mechanical apparatus, and operation is complicated,
Limited precision.Although the computer navigation system that surgical operation uses brings revolutionary change for artificial operation on joint, but existing
Some operation guiding system equipment is the most expensive, and positioning precision has much room for improvement, and requires that surgeon accepts special training simultaneously, prolongs
Grow operating time.
The present invention is directed to deficiency of the prior art, it is provided that a kind of customization operation on hip joint based on medical image positions
Device and supporting prosthese and localization method, to improve the degree of accuracy of hands Intraoperative position, reduce operation use cost, simultaneously without
Requiring that surgeon accepts special training, it is easier that prosthese is installed in operation, and its three-dimensional coordinate position is the most true when prosthese is installed
Fixed, decrease the time of calibration etc. required in operation, improve procedure efficiency.
By detailed description of the invention, technical scheme will be clearly and completely described below.Obviously, retouched
The embodiment stated is only a part of embodiment of the present invention rather than whole embodiments.Based on the embodiment in the present invention, this
The every other embodiment that field those of ordinary skill is obtained under not making creative work premise, broadly falls into the present invention
The scope of protection.
Refer to Fig. 1, as it can be seen, a kind of acetabular component, including acetabular component shell, be provided with outside acetabular component shell partially
Heart short handle 101, eccentric short handle 101 is installed into circumferentially positioned to acetabular component 100 in acetabular bone 301, and acetabular component is the quickest
Be fixed in acetabular bone.
By arranging eccentric short handle, the placement of acetabular component will be more accurate than versatility acetabular component.Work as surgeon
Placing an acetabular component with eccentric short handle to the acetabular bone position of patient, bias short handle is inserted into pre-drilled location
Position, hole, acetabular component is just automatically determined relative to the three-dimensional of pelvis.Gradient and head trim including acetabular component
And the position of complete and preoperative planning is matched by the three-dimensional position such as the degree of depth and the direction transplanted.And, this structure also increases
The safety that acetabular component is initially fixed.Once this acetabular component is placed, the displacement of the most postoperative acetabular component in art
Risk will be minimized.Acetabular component only has one acutely to move, it is simply that bone around occurs fracture or length
The fixing failure of acetabular component self since phase.Can be by using various processing modes to strengthen bone on the surface of eccentric short handle
Growing into, such as generally operator wish that this bias short handle smoother facilitates insertion into and only for the most fixing (current
Generally initially fix acetabular component with screw, therefore, it is desirable to this eccentric short handle also has similar function).This is eccentric
Short handle will help to stablize acetabular component firmly, until the watchcase of the Bone Ingrowth acetabular component of surrounding.Hereafter, eccentric short handle except
Help doctor to monitor the tram of prosthese in real time, will no longer have that other functions.If it find that acetabular component breaks in bone
Splitting or mobile, this explanation acetabular component is fixed unsuccessfully (being similar to screw) or needs to overhaul.The long-term of acetabular component is fixed
Need to rely on the Bone Ingrowth acetabular component shell around such as acetabular bone entirety position, or rely on the fixing of bone cement.
Eccentric short handle 101 is detachably arranged on acetabular component shell.This bias short handle can be separately fabricated, then passes through
Multiple connected mode (such as threaded or clamping or interference fit) is connected with the acetabular component of other standards on market, eccentric
Short handle can apply in any one acetabular bone system, and the size of eccentric short handle can select as required, and surgeon utilizes
One Mohs cone, screw or additive method are assembled into the standardized location of acetabular component shell.Wherein, eccentric short handle also can be with
Acetabular component shell is one-body molded.
Embodiment 1
As shown in Figures 2 to 4, a kind of customization operation on hip joint positioner based on medical image, for the most fixed
Position acetabular component, this positioner includes the detent mechanism 200 customized for each patient and is positioned on detent mechanism 200 inwall
Guide post, the outer surface of detent mechanism 200 matches with the inner surface of acetabular bone 301；Guide post is at least 1, including center
Guide post 203, guide post offers pilot hole 206 along its axis direction, and drilling equipment can be enterprising to acetabular bone by pilot hole
Row drilling is followed closely, and by arranging guide post and pilot hole, can determine nailing position accurately, it is ensured that the acetabular component later stage installs
Accuracy.By acetabular bone is carried out boring process, acetabular bone forms hole, location, by the center of centre pilot bar 203 molding
Hole, location is corresponding with the central shaft of acetabular component, in order to determine the center of acetabular component.
Guide post also includes eccentric guide post 202, forms hole, eccentric location by eccentric guide post correspondence on acetabular bone.
By the hole, eccentric location of eccentric guide post 202 molding for location eccentricity short handle 101.
Centre pilot bar 203 is the central shaft of acetabular component hemisphere, and the boring nail squeezed into by centre pilot bar is deep
Time benchmark nail, doctor can be instructed the acetabular bone of patient to be boned processs, carry out skeleton for preparation setting acetabular prosthese
Cutting.
Wherein, centre pilot bar is replaced with predetermined acetabular bone by three dimensional computer modeling with the position of eccentric guide post
Position determines；Each guide post is typically parallel to the centrage of detent mechanism 200 and arranges.In particular cases, uneven between guide post
Row can also constitute individuation positioner.
The inner side of detent mechanism 200 is additionally provided with datum plane 204, and datum plane installs fixing acetabular component with final
Plane flush, for determine acetabular component install after opening direction, give hip after operative doctor operating substitution intuitively
The final position of mortar prosthese；Meanwhile, the present invention also protection group directrix plane is equal with the plane of the final acetabular component installed and fix
OK, but need not neat mutually, thus give doctor the displacement direction of final prosthese intuitively.
Embodiment 2
As shown in Figure 5,6, remaining is same as in Example 1, and difference is, guide post also includes being arranged at outside acetabular bone
Multiple auxiliary guide posts 205 on limit, for molding auxiliary positioning hole on pelvis, by arranging auxiliary guide post, at pelvis
On stamp boring nail, operation calibrating installation can be directly anchored to boring with bone-cutting device and nails on, and follows closely auxiliary by boring and removes
Cartilaginous tissue and the acetabular bone that breaks down in acetabular bone, auxiliary positioning hole carries out acetabular component location for auxiliary, or by boring nail
On braced frame is set, operation calibrating installation and bone-cutting device are securable on braced frame indirectly fixing with boring nail, logical
Crossing boring nail auxiliary remove in acetabular bone cartilaginous tissue and carry out acetabular component location, auxiliary positioning bar can be additionally used in deep standard
The accurate direction of drilling equipment is determined during standby acetabular bone.Wherein the quantity of guide post needs according to operation and prosthese and determines.
Embodiment 3
As it is shown in fig. 7, remaining difference same as in Example 1 is, there is not datum plane 204 in positioner.
Embodiment 4
As shown in Figure 8,9, remaining is same as in Example 1, and difference is, eccentric guide post passes through with centre pilot bar
Connect assembly to fix with detent mechanism.
A kind of customization operation on hip joint localization method based on medical image, uses customization hip based on medical image
Operation on joint positioner, concrete positioning step is as follows:
(1), operation consent, need patient to carry out including pelvis and a series of CT of femur or MRI image, according to this be
The image of row constructs the three dimensional computer modeling of patient bone the most accurately；And according to this three dimensional computer modeling
Predefine acetabular bone displacement position, utilize printing type or other modes to manufacture three-dimensional skeleton model, and according to the three-dimensional of patient
Skeleton model is that each patient customizes surgery positioning device, and determines the size of acetabular component and determine its three-dimensional implantation position
Data, wherein the central locating rod of positioner and the position of eccentric location bar are by three dimensional computer modeling and predetermined hip
Mortar displacement position determines；
(2), positioner is carried out sterilization processing, in order to clinical operation uses；
(3), by positioner put into acetabular bone to mate completely with acetabular bone surface to be replaced, and rapidly three-dimensional is planted
Enter position data to be determined in operation accurately, boring can be used on acetabular bone and on pelvis limit by the effect of pilot hole
Device squeezes into boring nail, hole, molding multiple location；
(4) boring, taken out on positioner and hole, eccentric location is followed closely, with the brill corresponding to acetabular component central shaft
Following closely on the basis of Kong Ding, braced frame is fixed on remaining boring and nails on, bone-cutting device is fixed on rigidity with operation calibrating installation
On framework, deep to carry out assisting, with the corresponding position punching of benchmark nail on braced frame, use the rose drill with benchmark nail to be
Benchmark, cutting bone and processes, carrying out rejecting the acetabular bone broken down until exposing new bone acetabular bone；
(5), take out all of boring nail, acetabular component is put into acetabular bone so that eccentric short handle is installed into corresponding inclined
In hole, heart location fixing, acetabular component is automatically determined relative to the three-dimensional of pelvis, including acetabular bone gradient, head trim with
And the degree of depth transplanted, the position of complete and preoperative planning is matched by three-dimensional position with direction；
(6), acetabular component is effectively fixed.
The degree of depth of acetabular bone can be determined by a regulation guide rod, or determines with scale/stop device operation guide rod.
Using assemble mechanism that acetabular component is put into acetabular bone in step 5, it is false that assemble mechanism 400 is fixedly installed on acetabular bone
Inside body 100, the outer surface of assemble mechanism 400 matches with the inner surface of acetabular component.By arranging assemble mechanism so that
Acetabular component is put into acetabular bone.
Guide rod 401 is also used during the acetabular component of assembling location in step 5, detachable or one between assemble mechanism and guide rod
Body formed；When putting into acetabular component, assemble mechanism jointly acts on guide rod and being put into by acetabular component, and guide rod inserts molding in advance
Hole, location in.
The taking-up process of assemble mechanism and guide rod is there is also after step 5.
Such as Figure 10, assemble mechanism is one-body molded with guide rod, and such as Figure 11, assemble mechanism can be separately provided with guide rod, assembly machine
The hole passed for guide rod is offered on structure.
The taking-up process of guide rod is also included while assemble mechanism takes out.
If three dimensional computer modeling is from CT image, before step 3, also include the step rejecting cartilaginous tissue.Individual
Changing positioner is that three dimensional computer modeling based on patient oneself designs.If these three dimensional computer modelings are from MRI
Image, the information of cartilaginous tissue is already contained in individuation pointing device design.In operation process, after acetabular bone exposes, individual
Body surgery positioning device can be put into rapidly in acetabular bone chamber, matches with cartilage surface.But, if these three-dimensional computations
Machine model is based on CT image, and the information of cartilaginous tissue is just not included in individuation computer pointing device design,
Therefore, in operation, before positioner mates with bone, cartilaginous tissue should be rejected completely, realizes the cooperation of acetabular bone part.
It is also possible to use interpolation arithmetic calculates the cartilaginous tissue of patient, and it is contained in individual operation positioner
In design, so, operation avoids the need for cartilage is rejected.
The invention discloses a kind of customization operation on hip joint positioner based on medical image and supporting prosthese and
Localization method, this positioner is according to preoperative planning hole, eccentric location of molding location eccentricity short handle on acetabular bone, the most permissible
On the basis of the boring nail corresponding to the central shaft of acetabular component, follow closely the acetabular bone to breaking down in acetabular bone effectively excise, it is achieved
The effectiveness of acetabular component implant site and accuracy；With improve hands Intraoperative position degree of accuracy, reduce use cost, simultaneously without
Needing to ask surgeon to accept special training, it is easier that prosthese is installed in operation, and its three-dimensional coordinate position has been when prosthese is installed
Determine, decrease the times such as calibration required in operation, improve procedure efficiency.Eccentric short by arranging on acetabular component
Handle, realizes circumferentially positioned to acetabular component, it is ensured that it is high-precision that acetabular component is installed when being installed in acetabular bone by acetabular component
Exactness.
Described above to the disclosed embodiments, makes professional and technical personnel in the field be capable of or uses the present invention.
Multiple amendment to these embodiments will be apparent from for those skilled in the art, as defined herein
General Principle can realize without departing from the spirit or scope of the present invention in other embodiments.Therefore, the present invention
It is not intended to be limited to the embodiments shown herein, and is to fit to and principles disclosed herein and features of novelty phase one
The widest scope caused.
Claims (3)
1. a customization operation on hip joint positioner based on medical image, it is characterised in that be used for being accurately positioned acetabular bone
Prosthese, described positioner includes the detent mechanism customized for each patient and is positioned at the guiding on described detent mechanism inwall
Bar, the outer surface of described detent mechanism matches with the inner surface of described acetabular bone；Described guide post is at least 1, including center
Guide post, described guide post offers pilot hole along its axis direction, can be led acetabular bone boring by described pilot hole
To, acetabular bone is formed hole, location, described centre pilot bar is corresponding with the central shaft of acetabular component, and correspondence forms center and determines
Hole, position；
Described guide post also includes eccentric guide post, forms eccentric location by described eccentric guide post correspondence on acetabular bone
Hole；
Before molding surgery positioning device, need that patient is carried out CT or MRI imaging and include the one of patient's pelvis and femur to obtain
Series of CT or MRI image, construct the three-dimensional computer of patient bone the most accurately according to this series of image
Model；And predefine acetabular bone displacement position according to this three dimensional computer modeling, manufacture three-dimensional skeleton model, and according to patient's
Three-dimensional skeleton model is that each patient customizes surgery positioning device, and determines the size of acetabular component and implant with to determine it three-dimensional
Position data, wherein, the central locating rod of described positioner and bias position the position of bar by three dimensional computer modeling with pre-
The acetabular bone displacement position first determined determines.
2. customization operation on hip joint positioner based on medical image as claimed in claim 1, it is characterised in that described
Guide post also includes the multiple auxiliary guide posts being arranged in acetabular bone outer side edges, carries out guiding by described auxiliary guide post and squeezes into
Boring nail is with molding auxiliary positioning hole on pelvis, and what operation calibrating installation can be direct or indirect with bone-cutting device is fixed to bore
Hole nails on auxiliary and removes cartilaginous tissue in acetabular bone and the acetabular bone broken down, and auxiliary positioning hole carries out acetabular component location for auxiliary,
Auxiliary guide post can be additionally used in the accurate direction determining drilling equipment when deep preparation acetabular bone.
3. customization operation on hip joint positioner based on medical image as claimed in claim 1, it is characterised in that described
The inner side of detent mechanism is additionally provided with datum plane, and described datum plane is equal with the plane of the final acetabular component installed and fix
Together, for determine acetabular component install after opening direction, give after operative doctor operating substitution intuitively acetabular component
Final position is put；Or described datum plane and the final plane parallel installing fixing acetabular component, but need not neat mutually, thus give
Give the displacement direction of doctor's final prosthese intuitively.
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107080607A (en) * | 2017-06-08 | 2017-08-22 | 中山大学附属第医院 | A kind of assembly type acetabular component positioner based on 3D printing technique |
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| CN104887361B (en) * | 2015-05-14 | 2017-02-22 | 青岛大学附属医院 | Fabrication template system for custom individual artificial total hip replacement operation acetabulum |
| CN105741354A (en) * | 2016-03-22 | 2016-07-06 | 陈继营 | Preoperative hip joint deformity bone model manufacturing method based on 3D printing technology |
| CN107303200B (en) * | 2016-04-21 | 2020-03-06 | 齐欣 | Femur side marking system in hip joint replacement operation and manufacturing method thereof |
| CN106780715B (en) * | 2016-11-08 | 2020-04-07 | 四川大学华西医院 | Method for establishing pelvis CT three-dimensional coordinate system |
| US11185424B2 (en) * | 2016-11-15 | 2021-11-30 | Advanced Ortho-Med Technology, Inc. | Alignment guide for acetabular implant surgery and methods for use |
| CN107115151A (en) * | 2017-04-06 | 2017-09-01 | 中国人民解放军第四军医大学 | The preparation method of pinpoint acetabular bone guide plate is aided in after a kind of half pelvis excision |
| CN110292470A (en) * | 2019-08-08 | 2019-10-01 | 北京积水潭医院 | Spherical osseous part leads to heart ancillary equipment |
| CN110522515B (en) * | 2019-09-04 | 2021-09-24 | 上海电气集团股份有限公司 | Method and system for determining coverage rate of acetabular prosthesis, electronic device and storage medium |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| JP2008188400A (en) * | 2007-02-06 | 2008-08-21 | Takehito Hananouchi | Artificial hip joint replacement assisting auxiliary member, and manufacturing method |
| ITBO20070832A1 (en) * | 2007-12-19 | 2009-06-20 | Istituti Ortopedici Rizzoli | cup |
| GB0820219D0 (en) * | 2008-11-05 | 2008-12-10 | Imp Innovations Ltd | Hip resurfacing |
| GB201007166D0 (en) * | 2010-04-29 | 2010-06-09 | Finsbury Dev Ltd | Prosthesis |
| WO2012021858A2 (en) * | 2010-08-13 | 2012-02-16 | Mason James Bettenga | Implant alignment |
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| CN107080607A (en) * | 2017-06-08 | 2017-08-22 | 中山大学附属第医院 | A kind of assembly type acetabular component positioner based on 3D printing technique |
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Effective date of registration: 20171204 Address after: 200120 room 601-15, house A, No. 3000, Longdong Avenue, Shanghai free trade test area Patentee after: Shanghai Xin Jian medical skill company limited Address before: 410001 No. 97, No. 97, No. 601, No. 601, Jiefang Road, Furong district, Changsha, Hunan Patentee before: Liu Fei |
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