CN106974731B - Ligament reconstructive bone road based on 3D printing technique is accurately positioned holdfast and localization method - Google Patents
Ligament reconstructive bone road based on 3D printing technique is accurately positioned holdfast and localization method Download PDFInfo
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- CN106974731B CN106974731B CN201710305655.3A CN201710305655A CN106974731B CN 106974731 B CN106974731 B CN 106974731B CN 201710305655 A CN201710305655 A CN 201710305655A CN 106974731 B CN106974731 B CN 106974731B
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B33—ADDITIVE MANUFACTURING TECHNOLOGY
- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
- B33Y10/00—Processes of additive manufacturing
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Abstract
The present invention relates to a kind of, and the Healing in Anterior Cruciate Ligament Reconstruction bone road based on 3D printing technique is accurately positioned holdfast and localization method, and steps are as follows: step 1) is needing to establish implantation positioning holdfast near bone road, carries out CT and MRI scan, obtains data；Step 2) use Mimics software processing steps 1) obtain data, establish the geometrical model in the bone with holdfast or joint, then geometrical model is transferred to Simpleware 3 d modeling software, according to predetermined bone road site and direction, the guide plate establishing virtual bone road and connecting with positioning holdfast is simulated；Step 3) manufactures the guide plate in step 2) at guide plate in kind by 3D printing technique, and guide plate is connect with positioning holdfast, according to bone preset on guide plate road direction, drills through bone road using electric drill；Step 4) removes guide plate and positioning holdfast after drilling through, and ligament is installed on bone road and fixation according to original ligament reconstructive method, completes operation.This method enormously simplifies surgical procedure, improves the accuracy of operation.
Description
Technical field
The present invention relates to a kind of localization methods in bone road, are specifically related to a kind of ligament reconstructive bone based on 3D printing technique
Road is accurately positioned holdfast and localization method.
Background technique
Anterior cruciate ligament (Anterior cruciate ligament, ACL) damage is a kind of common motion of knee joint
Damage, can lead to knee joint disorders, illness rate is about 1/3000.ACL Reconstruction controlling as standard under arthroscope
Treatment mode is by application many years, and Anatomical Reconstruction has become mainstream theory, however, advanced theory despite the use of, and use
The surgical instrument of Anatomical Reconstruction design is aimed at, clinical efficacy is not promoted accordingly, in the up to reconstruction of 10-15%
Failure case and 10-20%'s overhauls in case, and the positioning mistake in bone road inner inlet port especially femur bone road still accounts for big absolutely
It is most.
The core concept of the Anatomical Reconstruction of anterior cruciate ligament is that the implantation of ligament object after rebuilding should be extensive as accurately as possible
It answers onto the dead-centre position, ligament diameter and direction of travel of original ligamentaum cruciatum, so as to it farthest can maintain knee joint before
Stability when backward and rotation, restores the normal function in joint.Wherein it is crucial that whether the site of ligament is accurate,
The position of the road Ji Gu internal orifice.Although being furtherd investigate to ACL bone road location technology, by arthroscope imaging system vision
The influence of deviation and patient's skilled operation degree, the tunnel position prepared under Arthroscopy are sometimes unsatisfactory.According to statistics, have
10%~40% ACL Reconstruction tunnel position is bad, and the bone tunnel of all operations is difficult to ensure veteran patient
Road position is satisfied.
How objective accurate determining ACL tunnel position, be the target reached desired by each arthroscope doctor.Mesh
X-ray examination and Computer navigation surgery improve the positioning of bone road in preceding existing research application art, but due to the error of x-ray positioning compared with
Greatly, the disadvantages of computerized navigation set is expensive, complicated for operation, clinical application is restricted, and can not yet be fully solved the above problem,
And the appearance of 3D printing technique brings dawn to the solution of this problem, the present invention is by 3D printing technique Preliminary Applications in preceding friendship
It pitches ligament and dissects Single bundle reconstruction, inquire into the accuracy and feasibility of 3D printing surgical guide, provided to further apply clinic
Foundation.
Summary of the invention
To solve the above-mentioned problems, the ligament reconstructive bone road essence based on 3D printing technique that the object of the present invention is to provide a kind of
Determine position holdfast and localization method.This method enormously simplifies surgical procedure, bone in art caused by avoiding because of human factor
The positioning mistake in road, greatly improves the accuracy of operation, shortens operating time, reduces wound, can allow Rehabilitation faster.
The technical scheme is that a kind of Healing in Anterior Cruciate Ligament Reconstruction bone road accurate positioning side based on 3D printing technique
Method, it is characterized in that: specific step is as follows for this method:
Step 1) is needing to establish implantation positioning holdfast near bone road, carries out CT and MRI scan, obtains the section of bone
Image data；
Step 2) uses Mimics software processing steps 1) data that obtain, establish the geometry in the bone with holdfast or joint
Then geometrical model is transferred to Simpleware 3 d modeling software by model, according to predetermined bone road site and direction, mould
The proposed guide plate for founding virtual bone road and being connect with positioning holdfast；
Step 3) manufactures the guide plate in step 2) at guide plate in kind by 3D printing technique, by guide plate and positioning holdfast
Connection, according to bone preset on guide plate road direction, drills through bone road using electric drill；
Step 4) removes guide plate and positioning holdfast after drilling through, and ligament is installed on bone road according to original ligament reconstructive method
And it is fixed, complete operation.
Implantation positioning holdfast in the step 1): positioning holdfast is implanted into knee joint, implantation direction and anterior cruciate ligament weight
The direction for building the operation road Shi Gu is consistent, and implantation point is that outlet distance in the road Healing in Anterior Cruciate Ligament Reconstruction Shi Gu is at 5cm.
The basis of the step 2) predefines bone road site and direction, and simulation is established virtual bone road and connected with positioning holdfast
The guide plate connect comprises the concrete steps that:
1) choose fixed control point, which imported in Simpleware 3 d modeling software, with Threshold,
Floodfill function reconstructs the 3 D anatomical model of knee joint bone mark point and ligamentaum cruciatum respectively；Application image respectively
Boundary mark pairing in integration technology, surface are harmonious, the pairing of space torque and cross-correlation technique are merged, by CT reconstruction of bone tissue
It is assembled with the MRI ligament tissue model rebuild in Simpleware software CAD module, ligament stop can be shown simultaneously by obtaining
And the blending image of adjacent bone mark；And by image analysis, footmark central point is marked, and determine bone road direction, generate knee
Joint composite three-dimensional model；
2) virtual guide pin is established in generating compound knee joint threedimensional model, guide pin thickness is 4.5mm, according to guide pin and is determined
The relative positional relationship of position holdfast, the guide plate establishing virtual bone road and being connect with positioning holdfast.
The positioning holdfast is made of holdfast handle and holdfast bar, and the holdfast handle is by holdfast handle core, holdfast
Connector sleeve and circular enlargement body composition；The cylindrical body that the circular enlargement body is, one end are provided with axial connecting hole, holdfast
Bar is socketed in circular enlargement body by axial connecting hole；The circular enlargement body other end is connect with holdfast connector sleeve, and is integrated
Structure；Holdfast handle core is cylindrical body, and one end is socketed in holdfast connector sleeve, the horizontally-parallel setting two on holdfast connector sleeve
Side opening.
The holdfast bar is made of holdfast bar connector, holdfast polished rod and self-tapping screw, holdfast bar connector one end
It is socketed in the axial connecting hole of circular enlargement body, the other end is structure as a whole with holdfast polished rod, and the end of holdfast polished rod is fixed
It is connected with self-tapping screw.
The guide plate is resin guide plate.
Advantages of the present invention: the maximum difference of the present invention and the prior art, being exactly before surgery can be soft in computer
Tunnel position and direction have been determined in advance on part, and has established guide plate, bone road is directly established according to guide plate in art, rather than was pressed in the past
The experience of patient determines.This method enormously simplifies surgical procedure, the road Shu Zhonggu caused by avoiding because of human factor
Mistake is positioned, greatly improves the accuracy of operation, shortens operating time, reduces wound, can allow Rehabilitation faster.Meanwhile
This method can accomplish precisely and individuation, raising success rate of operation and later period can be convenient for training as a kind of operative model
Support the surgical technic of doctor.
The present invention is described in further details below by specific embodiment, but not as a limitation of the invention.
Detailed description of the invention
Fig. 1 is positioning anchor structure schematic diagram of the invention；
Fig. 2 is the end view drawing of holdfast handle core of the present invention；
Fig. 3 is the cross-sectional view of holdfast connector sleeve of the present invention；
Fig. 4 is the structural schematic diagram of guide plate；
Fig. 5 is the structural schematic diagram of the holdfast connecting hole of guide plate；
In figure: 1, holdfast handle core；2, side opening；3, holdfast connector sleeve；4, circular enlargement body；5, holdfast bar connector；7,
Holdfast polished rod；8, self-tapping screw；9, guide plate；10, holdfast connecting hole；11, it is oriented to pin hole；12, fixation hole.
Specific embodiment
Embodiment 1
A kind of Healing in Anterior Cruciate Ligament Reconstruction bone road accurate positioning method based on 3D printing technique, the specific steps of this method are such as
Under:
Step 1) is needing to establish implantation positioning holdfast near bone road, carries out CT and MRI scan, obtains the section of bone
Image data；
Step 2) uses Mimics software processing steps 1) data that obtain, establish the geometry in the bone with holdfast or joint
Then geometrical model is transferred to Simpleware 3 d modeling software by model, according to predetermined bone road site and direction, mould
The proposed guide plate for founding virtual bone road and being connect with positioning holdfast；
Step 3) manufactures the guide plate in step 2) at guide plate in kind by 3D printing technique, by guide plate and positioning holdfast
Connection, according to bone preset on guide plate road direction, drills through bone road using electric drill；
Step 4) removes guide plate and positioning holdfast after drilling through, and ligament is installed on bone road according to original ligament reconstructive method
And it is fixed, complete operation.
Embodiment 2
A kind of Healing in Anterior Cruciate Ligament Reconstruction bone road accurate positioning method based on 3D printing technique, the specific steps of this method are such as
Under:
Step 1) is needing to establish implantation positioning holdfast near bone road, carries out CT and MRI scan, obtains the section of bone
Image data；Positioning holdfast is implanted into knee joint, implantation direction is consistent with the Healing in Anterior Cruciate Ligament Reconstruction operation direction in the road Shi Gu, plants
Access point is that outlet distance in the road Healing in Anterior Cruciate Ligament Reconstruction Shi Gu is at 5cm.
Step 2) uses Mimics software processing steps 1) data that obtain, establish the geometry in the bone with holdfast or joint
Then geometrical model is transferred to Simpleware 3 d modeling software by model, according to predetermined bone road site and direction, mould
The proposed guide plate for founding virtual bone road and being connect with positioning holdfast；
Wherein, according to predetermined bone road site and direction, simulation is established virtual bone road and is led with what positioning holdfast was connect
Plate comprises the concrete steps that:
1) choose fixed control point, which imported in Simpleware 3 d modeling software, with Threshold,
Floodfill function reconstructs the 3 D anatomical model of knee joint bone mark point and ligamentaum cruciatum respectively；Application image respectively
Boundary mark pairing in integration technology, surface are harmonious, the pairing of space torque and cross-correlation technique are merged, by CT reconstruction of bone tissue
It is assembled with the MRI ligament tissue model rebuild in Simpleware software CAD module, ligament stop can be shown simultaneously by obtaining
And the blending image of adjacent bone mark；And by image analysis, footmark central point is marked, and determine bone road direction, generate knee
Joint composite three-dimensional model；The part that the step is not described in detail is the prior art, is not just elaborated here.
2) virtual guide pin is established in generating compound knee joint threedimensional model, guide pin thickness is 4.5mm, according to guide pin and is determined
The relative positional relationship of position holdfast, the guide plate establishing virtual bone road and being connect with positioning holdfast.
Step 3) manufactures the guide plate in step 2) at guide plate in kind by 3D printing technique, by guide plate and positioning holdfast
Connection, according to bone preset on guide plate road direction, drills through bone road using electric drill；
Step 4) removes guide plate and positioning holdfast after drilling through, and ligament is installed on bone road according to original ligament reconstructive method
And it is fixed, complete operation.
Embodiment 3
On the basis of embodiment 1 or 2, as shown in Figure 1, the positioning holdfast is made of holdfast handle and holdfast bar,
And can dismantle, conveniently collect；The holdfast handle is made of holdfast handle core 1, holdfast connector sleeve 3 and circular enlargement body 4；
The cylindrical body that the circular enlargement body 4 is, one end are provided with axial connecting hole, and holdfast bar is socketed in by axial connecting hole
In circular enlargement body 4；4 other end of circular enlargement body is connect with holdfast connector sleeve 3, and is structure as a whole；As shown in Fig. 2, holdfast
Handle core 1 is cylindrical body, and one end is socketed in holdfast connector sleeve 3；Two side openings 2 of horizontally-parallel setting on holdfast connector sleeve 3,
As shown in figure 3, the section of the holdfast connector sleeve 3 is large semi-circular, the connection with guide plate can be facilitated, and guarantee connection
Fastness prevents guide plate from shifting, and can accurately drill through required bone road by guide plate in this way；The universal positioning anchor
Nail overall length is 20mm, the diameter 5mm of holdfast bar, is had the characteristics that in miniaturization and easily minimally invasiveization implantation bone；Holdfast handle core 1
Setting can be used for installing electric drill, enhance versatility.
The holdfast bar is made of holdfast bar connector 5, holdfast polished rod 7 and self-tapping screw 8, holdfast bar connector 5
One end is socketed in the axial connecting hole of circular enlargement body 4, and the other end is structure as a whole with holdfast polished rod 7, the end of holdfast polished rod 7
Portion is fixedly connected with self-tapping screw 8.Self-tapping screw 8 is easy to fixed after piercing convenient for piercing corresponding site, is not easy to loosen；Circle
Shape is swollen to be generally used for stopping to separate guide plate and skin soft tissue.
The holdfast handle and holdfast bar are titanium alloy paramagnetic material.Facilitate carry out CT scan, it is unlikely because of artifact caused by
Image fault.The guide plate is resin guide plate.
The application method of the positioning holdfast: the holdfast handle of holdfast being connect with holdfast bar two parts and is integral, electricity
Brill is mounted on holdfast handle core 1, is started electric drill for holdfast and is pierced scheduled position, removes holdfast handle core 1 and electricity after piercing
Bore, as shown in Figure 4 and Figure 5, by the holdfast connecting hole 10 of guide plate 9 by 9 sets of guide plate on holdfast connector sleeve 3, and with two spiral shells
Guide plate 9 is fixed on holdfast by two side openings 2 that bolt passes through on two fixation holes 12 and holdfast connector sleeve 3 in holdfast connecting hole 10
On, guide pin is packed into the guiding pin hole 11 on guide plate 9, bone road direction is preset according to holdfast, is slowly bored guide pin using electric drill
Enter knee joint, penetrates after opposite side cortical bone enters articular cavity and stop electric drill, and guide pin is taken out, and remove guide plate 9 from holdfast；
Electric drill is mounted on holdfast connector sleeve 3 by holdfast handle core 1, electric drill is started and takes out entire holdfast.
Clinical test
20, corpse knee joint that teaching and research room provides dissect in Xi'an Jiaotong University Medical College, using method of the invention to corpse
After body knee ligament rebuilds the accurate positioning of bone road, then corpse knee joint is subjected to CT and MRI scan and acquires data, by guide pin
Position is compared with preset reference point to carry out CT and MRI scan for the corpse knee joint for preparing default bone road again and acquires
Data handle the data obtained using Mimics software, the geometrical model in the bone with holdfast or joint are established, then by geometry
Model is transferred to Simpleware 3 d modeling software reconstruction of knee model again, according to the knee joint before numbering and being respective
Model is compared, and whether measurement actually drills through between bone road internal orifice position and preset reference unanimously and between measurement the two central point
Error distance.
As a result: all 20 corpse knee joints smoothly complete the design of guide plate, and 3D printing, at resin guide plate, guide pin is set
Enter to smoothly complete, be assessed by secondary CT and MRI scan, as a result guide pin position and preset reference point are almost the same.
Above-mentioned CT scan and MRI scan can use 64 row's CT scan of double source and 3.0T MRI scan.The present embodiment does not have
There are the component described in detail and structure and technique to belong to the well-known components and common structure or conventional means of the industry, it is different here
One narration.
Claims (2)
1. a kind of Healing in Anterior Cruciate Ligament Reconstruction bone road based on 3D printing technique is accurately positioned holdfast, it is characterized in that: the positioning holdfast
It is made of holdfast handle and holdfast bar, the holdfast handle is by holdfast handle core (1), holdfast connector sleeve (3) and circular enlargement body
(4) it forms；The cylindrical body that the circular enlargement body (4) is, one end are provided with axial connecting hole, and holdfast bar is connected by axial
Hole is connect to be socketed in circular enlargement body (4)；Circular enlargement body (4) other end is connect with holdfast connector sleeve (3), and is integrated knot
Structure；Holdfast handle core (1) is cylindrical body, and one end is socketed in holdfast connector sleeve (3), horizontally-parallel on holdfast connector sleeve (3)
Two side openings (2) are set.
2. a kind of Healing in Anterior Cruciate Ligament Reconstruction bone road based on 3D printing technique according to claim 1 is accurately positioned holdfast,
It is characterized in that: the holdfast bar is made of holdfast bar connector (5), holdfast polished rod (7) and self-tapping screw (8), holdfast bar
Connector (5) one end is socketed in the axial connecting hole of circular enlargement body (4), and the other end is structure as a whole with holdfast polished rod (7),
The end of holdfast polished rod (7) is fixedly connected with self-tapping screw (8).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710305655.3A CN106974731B (en) | 2017-05-03 | 2017-05-03 | Ligament reconstructive bone road based on 3D printing technique is accurately positioned holdfast and localization method |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710305655.3A CN106974731B (en) | 2017-05-03 | 2017-05-03 | Ligament reconstructive bone road based on 3D printing technique is accurately positioned holdfast and localization method |
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| Publication Number | Publication Date |
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| CN106974731A CN106974731A (en) | 2017-07-25 |
| CN106974731B true CN106974731B (en) | 2019-07-26 |
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| CN201710305655.3A Expired - Fee Related CN106974731B (en) | 2017-05-03 | 2017-05-03 | Ligament reconstructive bone road based on 3D printing technique is accurately positioned holdfast and localization method |
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| CN112155707B (en) * | 2020-10-29 | 2022-11-01 | 江佩师 | Femoral tunnel guiding and positioning device for reconstruction of anterior cruciate ligament |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101773404A (en) * | 2010-01-05 | 2010-07-14 | 深圳先进技术研究院 | Magnetic resonance compatible puncture needle |
| CN105997190A (en) * | 2015-03-31 | 2016-10-12 | 德普伊(爱尔兰)有限公司 | System and method for attaching surgical instrument to patient's bone |
| CN106344161A (en) * | 2016-11-22 | 2017-01-25 | 哈尔滨工业大学 | End-of-arm tooling quick replacing mechanism for minimally-invasive spine surgery robot |
-
2017
- 2017-05-03 CN CN201710305655.3A patent/CN106974731B/en not_active Expired - Fee Related
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101773404A (en) * | 2010-01-05 | 2010-07-14 | 深圳先进技术研究院 | Magnetic resonance compatible puncture needle |
| CN105997190A (en) * | 2015-03-31 | 2016-10-12 | 德普伊(爱尔兰)有限公司 | System and method for attaching surgical instrument to patient's bone |
| CN106344161A (en) * | 2016-11-22 | 2017-01-25 | 哈尔滨工业大学 | End-of-arm tooling quick replacing mechanism for minimally-invasive spine surgery robot |
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