CN108478250A - Femur localization method, individuation osteotomy guide plate and the prosthese of total knee arthroplasty - Google Patents
Femur localization method, individuation osteotomy guide plate and the prosthese of total knee arthroplasty Download PDFInfo
- Publication number
- CN108478250A CN108478250A CN201810304027.8A CN201810304027A CN108478250A CN 108478250 A CN108478250 A CN 108478250A CN 201810304027 A CN201810304027 A CN 201810304027A CN 108478250 A CN108478250 A CN 108478250A
- Authority
- CN
- China
- Prior art keywords
- femur
- axis
- epicondyle
- point
- peak
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1657—Bone breaking devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1675—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the knee
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1732—Guides or aligning means for drills, mills, pins or wires for bone breaking devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
-
- 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
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
-
- 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
- A61F2/3094—Designing or manufacturing processes
- A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
-
- 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
- A61F2/38—Joints for elbows or knees
- A61F2/3859—Femoral components
-
- 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
- A61F2/38—Joints for elbows or knees
- A61F2/3877—Patellae or trochleae
-
- 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
- A61F2/38—Joints for elbows or knees
- A61F2/389—Tibial components
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/102—Modelling of surgical devices, implants or prosthesis
- A61B2034/104—Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
-
- 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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
- A61F2002/30011—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in porosity
-
- 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
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30784—Plurality of holes
-
- 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
- A61F2/3094—Designing or manufacturing processes
- A61F2002/30985—Designing or manufacturing processes using three dimensional printing [3DP]
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Vascular Medicine (AREA)
- Cardiology (AREA)
- Transplantation (AREA)
- Dentistry (AREA)
- Physical Education & Sports Medicine (AREA)
- Robotics (AREA)
- Pathology (AREA)
- Physics & Mathematics (AREA)
- Geometry (AREA)
- Manufacturing & Machinery (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Abstract
The invention discloses a kind of femur localization method of total knee arthroplasty, individuation osteotomy guide plate and prostheses, are related to total knee replacement technical field, including：Whether the femur model of detection three-dimensional digital has been imported into, and the femur model of three-dimensional digital is established based on the kneed scan data of patient；When the femur model of three-dimensional digital has been imported into, the femur model of the three-dimensional digital is positioned using chromatography to obtain at least one distal femur bone mark point.Femur localization method, individuation osteotomy guide plate and the prosthese of a kind of total knee arthroplasty of the present invention, multiple bones that distal femur can be accurately positioned using chromatography indicate point, accuracy and repeatability are high, individuation osteotomy guide plate is the feature-modeling according to the distal femur surface of femur surgery epicondyle axis and three-dimensional reconstruction, prosthese is accurately matched and is created according to the feature for carrying out the distal femur after simulation osteotomy using individuation osteotomy guide plate, for realizing Individual design.
Description
Technical field
The present invention relates to total knee replacement technical fields, are positioned more particularly, to a kind of femur of total knee arthroplasty
Method, individuation osteotomy guide plate and prosthese.
Background technology
Digital orthopaedics be based on Orthopedic Clinical, combine closely with computer image processing technology and digital technology one
Door novel digital medical disciplines improve clinical orthopaedics operative treatment effect by the operation designing and surgical simulation of individuation
Fruit, to promote orthopaedic technique to develop to individuation, precision, minimally invasiveization and long-range direction.It is previous to obtain bone and joint
Image document can only be set by the imagings such as x-ray tomography of electronic computer (CT) or nuclear magnetic resonance image (MRI)
It is two-dimensional ct image for what is obtained, and such image is hardly formed an entirety and complete space structure.With number
The development of orthopaedics, medical 3 D reconstruction technique solve this problem, using the image superposition principle of computer by CT's or MRI
Bidimensional image data is overlapped, you can three-dimensional image is formed, the threedimensional model after reconstruction can arbitrarily rotate, to
The region of required observation can be adjusted the angle and image size, more intuitively, accurately show that the space of each anatomical structure is closed
System.And the application with numerous Medical Image Processing softwares such as Mimics and Geomagic Studio clinically, make more
Orthopaedics worker can enjoy caused by digital orthopaedics it is convenient with huge change.
The main purpose that digital orthopaedics is applied to total knee arthroplasty is exactly in order to promote operation precision, to help accurately
Restore the postoperative lower limb line of force, improves the accuracy of prosthese installation, reduces operating time and operation wound, so as to improve knee joint work(
It can and extend prosthese life span.Operation plan can be designed on computers using the technology of digital orthopaedics and simulates operation step
Suddenly, design surgical instrument and operation tool or even according to operation are required, clinical orthopaedics is made to be rapidly developed.Due at present for
The positioning of distal femur bone mark point does not have accurate method, critically important especially for the determining distal femur rotation line of force
The positioning of internal epicondyle of femur most concave point and external epicondyle of femur peak is the most apparent.
On the one hand, there are internal epicondyle of femur most concave point and the femur of the positioning of document report application CT or MRI tomoscan outside upper
Condyle peak is inaccurate, and recognizable rate is low.What Berger etc. was delivered earliest measures prosthese rotation in the CT film of cross section
The method of line of force position：Lead to condyle line level in femur marks measurement to lead to the line of condyle line and prosthese postartis peak respectively, this two
Angle between bar line positions femur outward turning angle.Hereafter some scholars using this measurement method and obtain in respective research
Similar conclusion is arrived, but more and more scholars think using the postoperative prosthese rotation position of two-dimensional ct assessment knee prosthesis
Method differing greatly between different observers or between the different periods of same observer, therefore this method
Repeatability is not high.Yoshino etc. has found that medial sulcus only exists in the kneed research in the 96 of 48 Human Osteoarthritis
It is detected on 33 knee joints, and thinks that osteoarthritis classification is more seriously more difficult to detect medial sulcus.This explanation is with two dimension
The recognizable rate that CT tomoscans position medial sulcus is relatively low.Garvin etc. is positioning femoral rotation axis to two-dimensional ct tomoscan
In the fail-safe analysis of line, statistics is measured by three different observer couple 502 number of cases evidences, it is believed that disconnected with reference to two-dimensional ct
Layer scanning carrys out position rotating axis and unreliable.And Hirschman etc. is in comparison X-ray, two-dimensional ct and three-dimensional reconstruction CT images
In the fail-safe analysis for positioning femoral prosthesis position, it is best to be also considered as three-dimensional reconstruction CT images credibility interval, and two-dimensional ct is credible
Section is worst.Our research also obtains similarly, as a result, in the positioning to internal epicondyle of femur most concave point, by two-dimensional ct breaking
Layer scanning can position only 73 of internal epicondyle of femur most concave point in 106, and recognizable rate only has 68.87%, and we are logical
Cross has 102 using what three-dimensional chromatography can be accurately positioned internal epicondyle of femur most concave point, and recognizable rate is up to 96.23%.Fully
Illustrate that chromatography has clear superiority in positioning internal epicondyle of femur most concave point.And we have found disconnected with two-dimensional ct under study for action
Layer Scan orientation method not only location difficulty, but also inaccuracy, this shows：Positioning distal femur on first preexisting fault section
Each bone mark point will appear deviations caused by human factor；Secondly because being selected every an example sample in the research of the past
The tomography section selected is not unified, and there is also artificial subjective factors in selection, by taking internal epicondyle of femur most concave point as an example, simulates 8
On the inside of capable of being positioned in a tomography section in the case of most concave point, the most concave point on the inside of each layer indicates, each to indicate point meeting certainly respectively
Turn is changed on 3D reconstruction models, as a result on 3D reconstruction models these mark point reflection be one inside concave point track,
The distance of this track is 5mm, and error is very big.
On the other hand, such due to needing artificially to judge medial sulcus most concave point and lateral epicondyle peak in CT tomoscans
Judge that there are subjectivities, equally causing anchor point, there are deviations.
Invention content
In view of this, the purpose of the present invention is to provide a kind of femur localization method of total knee arthroplasty, individuations
Osteotomy guide plate and prosthese indicate point, especially opponent to solve not being accurately positioned distal femur bone in Design and art
Art has a series of the technical issues of anatomic points of important references effect.
In a first aspect, an embodiment of the present invention provides a kind of femur localization methods of total knee arthroplasty, including：
Whether the femur model of detection three-dimensional digital has been imported into, and the femur model of the three-dimensional digital is based on trouble
The kneed scan data of person is established；
When detecting that the femur model of the three-dimensional digital has been imported into, using chromatography to the three-dimensional digital
Femur model position to obtain at least one distal femur bone mark point.
With reference to first aspect, an embodiment of the present invention provides the first possible embodiments of first aspect, wherein institute
Stating distal femur bone dissection mark point includes：The outer postartis of internal epicondyle of femur most concave point, external epicondyle of femur peak, femur is minimum
Postartis minimum point, femoral bone pulley minimum point and fossa intercondylaris femoris peak in point, femur.
With reference to first aspect, an embodiment of the present invention provides second of possible embodiments of first aspect, wherein institute
It states and the femur model of the three-dimensional digital is positioned using chromatography to obtain at least one distal femur bone mark point, packet
It includes：
Internal epicondyle of femur most concave point and external epicondyle of femur peak are positioned using chromatography；
Femur surgery epicondyle axis is determined according to the internal epicondyle of femur most concave point and the external epicondyle of femur peak；
World coordinate system is established according to the femur surgery epicondyle axis, obtains standard water prosposition；
On standard water prosposition, using postartis minimum point outside chromatography number positioning femur, postartis is minimum in femur
Point, femoral bone pulley minimum point and fossa intercondylaris femoris peak.
With reference to first aspect, an embodiment of the present invention provides the third possible embodiments of first aspect, wherein institute
It states and establishes world coordinate system, obtain standard water prosposition, including：
Late-segmental collapse is positioned using best centre of sphere fitting process；
Using the midpoint of the femur surgery epicondyle axis as kneed center；
Using the connecting line of the midpoint of the femur surgery epicondyle axis and the late-segmental collapse point as the Z of world coordinate system
Axis；
Using the extension line of the femur surgery epicondyle axis as the X-axis of world coordinate system；
The Y-axis of world coordinate system is determined according to the Z axis and the X-axis.
With reference to first aspect, an embodiment of the present invention provides the 4th kind of possible embodiments of first aspect, wherein also
Including：
Femoral-posterior condyles axis is determined according to postartis minimum point in postartis minimum point outside the femur and the femur；
Condyle of femur front and back axis is determined according to the femoral bone pulley minimum point and the fossa intercondylaris femoris peak；
Measure the femoral-posterior condyles axis and the femur surgery epicondyle axis angle and the condyle of femur front and back axis with
The angle of the femur surgery epicondyle axis.
With reference to first aspect, an embodiment of the present invention provides the 5th kind of possible embodiments of first aspect, wherein also
Including：
Fossa intercondyloidea vertex is determined according to the fossa intercondylaris femoris peak；
Distal femur anatomical axis is positioned using centroid method；
Locating rod entry point in marrow is determined according to the intersection point of the distal femur anatomical axis and distal femur articular surface.
With reference to first aspect, an embodiment of the present invention provides the 6th kind of possible embodiments of first aspect, wherein institute
It states and fossa intercondyloidea vertex is determined according to the fossa intercondylaris femoris peak, including：
The plane vertical with the Z axis of the world coordinate system is created according to the fossa intercondylaris femoris peak；
The fossa intercondyloidea vertex is determined according to the intersection point of the plane and fossa intercondyloidea.
Second aspect, the embodiment of the present invention also provide a kind of individuation osteotomy guide plate of total knee arthroplasty, including：Institute
State individuation osteotomy guide plate be according to the feature-modeling on the distal femur surface of the femur surgery epicondyle axis and three-dimensional reconstruction,
The femur surgery epicondyle axis is determined based on the most concave point of the internal epicondyle of femur described in first aspect and external epicondyle of femur peak.
After carrying out osteotomy of distal using the osteotomy guide plate of individuation, it can both be cut with the existing commercialization four-in-one of slitless connection
Bone conduction plate carries out the follow-up osteotomy of distal femur, and matching commercialization prosthese carries out the knee prosthesis of traditional form；It can also coordinate
Using the four-in-one osteotomy guide plate of individuation, individuation osteotomy is carried out.
The third aspect, the embodiment of the present invention also provide a kind of Custom made stem of total knee arthroplasty, including：Described
Body prosthese is according to the feature for carrying out the distal femur after simulation osteotomy using the individuation osteotomy guide plate described in second aspect
And it accurately matches and to be created.
Custom made stem is carried out on the basis of measuring the apparent size of distal femur after carrying out simulation individuation osteotomy
3D printing, which includes two major classes type, and one is bone-cement type knee-joint prosthesis, and one is bion (none-cements
Type) knee-joint prosthesis.
Fourth aspect, the embodiment of the present invention also provide a kind of electronic equipment, including memory, processor, the memory
In be stored with the computer program that can be run on the processor, the processor is realized when executing the computer program
The step of stating the method described in first aspect.
The embodiment of the present invention brings following advantageous effect：It is fixed that the invention discloses a kind of femurs of total knee arthroplasty
Position method, individuation osteotomy guide plate and prosthese, multiple bones that distal femur can be accurately positioned using chromatography indicate point, accurately
Property and repeatability it is high.
Other features and advantages of the present invention will illustrate in the following description, also, partly become from specification
It obtains it is clear that understand through the implementation of the invention.The purpose of the present invention and other advantages are in specification, claims
And specifically noted structure is realized and is obtained in attached drawing.
To enable the above objects, features and advantages of the present invention to be clearer and more comprehensible, preferred embodiment cited below particularly, and coordinate
Appended attached drawing, is described in detail below.
Description of the drawings
It, below will be to specific in order to illustrate more clearly of the specific embodiment of the invention or technical solution in the prior art
Embodiment or attached drawing needed to be used in the description of the prior art are briefly described, it should be apparent that, in being described below
Attached drawing is some embodiments of the present invention, for those of ordinary skill in the art, before not making the creative labor
It puts, other attached drawings can also be obtained according to these attached drawings.
Fig. 1 is the flow chart of the femur localization method of total knee arthroplasty provided in an embodiment of the present invention；
Fig. 2 is the position view of multiple distal femur bone mark points provided in an embodiment of the present invention；
Fig. 3 is the flow of measurement femur surgery epicondyle axis and the angle of condyle of femur front and back axis provided in an embodiment of the present invention
Figure；
Fig. 4 is the flow chart of positioning entry point provided in an embodiment of the present invention；
Fig. 5 (a), 5 (b), 5 (c) and 5 (d) are the position provided in an embodiment of the present invention for positioning distal femur anatomical axis FAA
Schematic diagram；
Fig. 6 is the structural schematic diagram of individuation osteotomy guide plate provided in an embodiment of the present invention；
Fig. 7 is the structural schematic diagram of four-in-one guide plate provided in an embodiment of the present invention；
Fig. 8 is the sectional view of four-in-one guide plate provided in an embodiment of the present invention；
Fig. 9 is the structural schematic diagram of the knee-joint prosthesis of the individuation of bone-cement type provided in an embodiment of the present invention；
Figure 10 is the structural schematic diagram of the knee-joint prosthesis of the individuation of cementless provided in an embodiment of the present invention.
Icon：
10- individuation osteotomy guide plates；The deep slots of 11-；12- guide pipes；20- four-in-one guide plates；Of 30- bone-cement types
Body prosthese；The Custom made stem of 40- cementless；The second binding faces of 41-；42- third binding faces；The second mounting posts of 43-；
The first binding faces of 44-；The 4th binding faces of 45-；The 5th binding faces of 46-；47- is padded；48- tibia support components；49- first is installed
Column；50- condyle of femur mounting bases.
Specific implementation mode
In order to make the object, technical scheme and advantages of the embodiment of the invention clearer, below in conjunction with attached drawing to the present invention
Technical solution be clearly and completely described, it is clear that described embodiments are some of the embodiments of the present invention, rather than
Whole embodiments.Sub based on the embodiments of the present invention, those of ordinary skill in the art are not before making creative work
Obtained every other embodiment is put, shall fall within the protection scope of the present invention.
Currently, in total knee arthroplasty (Total knee arthroplasty, TKA), for distal femur bone
Being accurately positioned for mark point lacks relevant method, especially for determining that distal femur rotates in the critically important femur of the line of force
The positioning of condyle most concave point and external epicondyle of femur peak is the most apparent.On the one hand, there is document report application CT or MRI tomoscan
Positioning internal epicondyle of femur most concave point is inaccurate, and recognizable rate is low.On the other hand, artificial due to being needed in CT tomoscans
Ground judges medial sulcus minimum point and lateral epicondyle peak, such to judge that, there are artificial subjectivity, causing positioning, there are deviations.
Based on this, a kind of femur dissection mark independent positioning method of total knee arthroplasty provided in an embodiment of the present invention, individuation are cut
Bone conduction plate and prosthese can utilize multiple bones that chromatography can be accurately positioned distal femur to indicate point, quasi- using the best centre of sphere
Legal positioning late-segmental collapse, and distal femur anatomical axis is positioned using centroid method, accuracy and repeatability are higher.
For ease of understanding the present embodiment, first to a kind of total knee arthroplasty disclosed in the embodiment of the present invention
Femur localization method describe in detail.
As shown in Figure 1, in one embodiment of the invention, providing a kind of femur positioning side of total knee arthroplasty
Method, including following steps.
Whether S101, the femur model for detecting three-dimensional digital have been imported into, and the femur model of the three-dimensional digital is
(only being illustrated below with CT data instances) established based on the kneed CT of patient or MRI scan data.
In practical applications, the DICOM file data of every CT scan can be imported PC machine with " lossless compression " format
Interior Medical Image Processing software (Materialise's interactive medical image control system,
Minics), the two dimensional image of Coronal, horizontal position and sagittal plain is shown." segmentation dish in selective medicine image processing software
" defining threshold value " (Thresholding) in list " (Segmentation Menu), given threshold create " mask ", and pass through
Region growing (region growing) removes unwanted picture, to obtain the 3-D view of femur；By the femur of acquisition
3-D view is imported with STL formats in reverse engineering software (Geomagic Studio).
S102 can utilize chromatography to described three when the femur model of the three-dimensional digital has been imported into software
The femur model of dimension word positions to obtain at least one distal femur bone mark point.Wherein, each distal femur bone mark
Show a little as shown in Figure 2：After in the outer postartis minimum point c of external epicondyle of femur peak a, internal epicondyle of femur most concave point b, femur, femur
Condyle minimum point d, femoral bone pulley minimum point e and fossa intercondylaris femoris peak f.
Specifically, determining that the detailed process of multiple distal femur bone mark points is：
External epicondyle of femur peak a and internal epicondyle of femur most concave point b is positioned using chromatography.
Femur surgery epicondyle axis is determined according to the internal epicondyle of femur most concave point b and the external epicondyle of femur peak a (i.e.
Surgical transepicondylar axis, STEA).Femur surgery epicondyle axis is considered as most reliable rotational positioning
Anatomical reference mark.
Meanwhile positioning late-segmental collapse using the method for best fit (Best Fit), i.e., femur is chosen as much as possible
The tri patch (if it once can not choose completion, can repeatedly be chosen using select tools) of head surface, with most preferably quasi-
The method of conjunction creates sphere feature, and determination can be obtained final sphere feature, and the center of sphere feature is femoral head
Center.
Specifically, using the midpoint of the femur surgery epicondyle axis STEA as kneed center, by the femur surgery
The midpoint of epicondyle axis and Z axis of the connecting line of late-segmental collapse point as world coordinate system.X-Y of the setting one perpendicular to Z axis
Plane determines generation using the extension line of the femur surgery epicondyle axis as the X-axis of world coordinate system according to the Z axis and the X-axis
The Y-axis of boundary's coordinate system, to obtain Coronal, sagittal plain and the horizontal position of standard.
On standard water prosposition, using postartis minimum point c outside chromatography number positioning femur, postartis is minimum in femur
Point d, femoral bone pulley minimum point e and fossa intercondylaris femoris peak f.And then it can quantify between each point on world coordinate system
Correlation, including distance between points and any two points are linked to be after line the angle etc. between line and line.
The invention discloses a kind of femur localization methods of total knee arthroplasty, and femur can be accurately positioned using chromatography
Multiple bone marks of distal end indicate point, very high by research and experimental verification, accuracy and repeatability.
In total knee arthroplasty, it is to realize good joint motions to obtain accurate distal femur rotation center, most
The precondition of good ligament balance and patellar tract, to obtain the satisfaction of good postoperative knee joint function and patient.
To obtain the rotation of good femoral prosthesis to line, commonly use equivalent osteotomy technology and gap balancing technique in clinical at present, and this two
The most important rotary reference of technology have femur surgery epicondyle axis (Surgical transepicondylar axis,
STEA), femoral-posterior condyles axis (Posterior condyles line, PCL) and condyle front and back axis (Whiteside line,
WL).But since lateral epicondyle has more soft tissue to cover in femur, cause be difficult in the course of surgery be accurately positioned STEA, therefore
The PCL of 3 ° of outward turning is empirically applied in clinical practice and simulates STEA perpendicular to WL, but the stock of this simulation STEA
Bone rotation axis is inaccurate because in the world not there are two identical knee joint, between different individuals between, different kinds
All there is the difference of different degrees of knee-joint anatomy form between race, therefore the PCL of 3 ° of unified outward turning and perpendicular to WL
Most of foreigner is may be only applicable for (because empirical 3 ° of osteotomy of outward turning are by external expert foundation white people to simulate STEA
Knee-joint anatomy morphological feature proposes), and there is no correlative studys to the applicable ratio of the knee joint of Chinese.Therefore, this whole
Neat standardized knee joint femoral surgery epicondyle axis determines that method is not particularly suited for each patient, thus be not it is exactly accurate,
To bring potential harmful effect to the postoperative patient of knee prosthesis.And as shown in figure 3, on the basis of previous embodiment
On, the femur localization method of total knee arthroplasty described in the embodiment of the present invention is further comprising the steps of.
S201 determines femoral-posterior condyles axis according to postartis minimum point d in postartis minimum point c outside the femur and the femur
(i.e. PCL).
S202 determines condyle of femur front and back axis according to the femoral bone pulley minimum point e and the fossa intercondylaris femoris peak f
(i.e. WL).
S203 measures angle (the i.e. femur of the femoral-posterior condyles axis (PCL) and the femur surgery epicondyle axis (STEA)
Postartis angle PCA) and the condyle of femur front and back axis (WL) and the femur surgery epicondyle axis (STEA) angle (WSTEA),
Its corner dimension is as shown in Figure 2.
It in the embodiment of the present invention, can utilize chromatography that can be accurately positioned STEA, PCL and WL, be individuation, precision
Total knee arthroplasty the reliable rotation line of force is provided.
It is clinically often used the reconstruction that positioning system and the outer positioning system of marrow in marrow carry out femur and shin bone the lower limb line of force,
The lower limb line of force of femur side is by the straight line of late-segmental collapse and knee joint center (fossa intercondyloidea vertex), also known as femur machinery
Axis (femoral mechanic axis, FMA).In marrow positioning be with femur anatomical axis (femoral anatomic axis,
FAA it is) positioning system referred to, femur anatomical axis is exactly the line of femoral bone cavitas medullaris central point, passes through itself and femur mechanical axis
It is formed by angle (femur valgus angle) and is used as osteotomy parameter, the method for rebuilding the femur lower limb line of force indirectly.
In addition to this, in total knee arthroplasty, accurate Anatomical orientation is extremely important, the least bit leading to great error of difference.
If there are slight deviations for the entry point of locating rod in marrow, it is possible to which leading to the positioning of femur anatomical axis, there are deviations, are based on
Deviation will also occur therewith in the lower limb line of force that anatomical axis is rebuild, so the accurate positionin of locating rod entry point is equally to obtain in marrow
The accurately key of the lower limb line of force, it will directly affect the valgus angle of distal femur and bend and stretch knee gap balance.
Therefore, in order to realize the accurate osteotomy of distal femur in total knee arthroplasty, good femoral axis power is rebuild
Line needs to be accurately positioned femur im rod entry point position, accurate to measure femur valgus angle and " femur valgus angle in art ".And such as
Shown in Fig. 4, on the basis of previous embodiment, the femur localization method of total knee arthroplasty described in the embodiment of the present invention
It is further comprising the steps of.
S301 determines fossa intercondyloidea vertex according to the fossa intercondylaris femoris peak.
Specifically, the plane vertical with the Z axis of the world coordinate system is created according to the fossa intercondylaris femoris peak,
The intersection point of the plane and fossa intercondyloidea is the fossa intercondyloidea vertex.
S302 positions distal femur anatomical axis using centroid method.
Specifically, if Fig. 5 (a), 5 (b), 5 (c) are with shown in 5 (d), closed respectively at the midpoint of femur overall length and distal femur
Two cross sections are taken above nodel line at 10cm, cortex of bone is removed, retains the Pulp chamber of plane, pass through Geomagic Studio
Centroid method (Centroid) in software is sought this (being respectively designated as A and B), and the line of point A and point B is distal femur
Anatomical axis FAA.
S303 determines locating rod inserting needle in marrow according to the intersection point of the distal femur anatomical axis and distal femur articular surface
Point.
The femur Three-dimension Reconstruction Model in Geomagic Studio softwares is saved as into IGS formats later, and imports PTC
In Creo Parametric softwares, femur valgus angle in measuring using entry point as the art of basic point, and using fossa intercondyloidea vertex as base
The femur valgus angle of point.
In yet another embodiment of the present invention, a kind of individuation osteotomy guide plate of total knee arthroplasty is additionally provided,
Including：The individuation osteotomy guide plate is according to the feature-modeling of the femur surgery epicondyle axis and distal femur surface, institute
Femur surgery epicondyle axis is stated to determine based on the most concave point of the internal epicondyle of femur in previous embodiment and external epicondyle of femur peak.
Specifically, the design process of individuation osteotomy guide plate is as follows：
1, it is reference with specific gray value, may be implemented to mark off on each layer of CT image using Mimics automatic functions
Substantially bone profile.
2, the connectivity based on bone shape, using the single layer editor of Mimics, multilayer editor, region such as increases at the functions can be with
It will substantially bone profile be optimized on each layer of CT image, and be allowed to more meet anatomical requirements.
3, the principle based on piece adult can create the triangular plate three-dimensional stock of femur using the establishment 3D functions of Mimics
Bone model.
4, three-dimensional femur model is imported into reverse engineering software (Geomagic Studio), femur is positioned using chromatography
Epicondylus medialis most concave point and external epicondyle of femur peak connect the internal epicondyle of femur most concave point and the external epicondyle of femur peak
Obtain femur surgery epicondyle axis.
5, it is based on continual curvature principle, selected by dog-ear using Magics, delete spike, function may be implemented except making an uproar
The fairing processing of threedimensional model.
6, the key features such as shaft, femoral far end face can be extracted on femur model using the correlation function of Magics.
7, these key features are imported in Proe softwares, reference is characterized as with these, it can essence using order is stretched
Threedimensional model of the true establishment with guide groove, the individuation osteotomy guide plate of guide pipe；
8, the threedimensional model of these guide grooves, guide pipe is imported in Magics softwares, using the offset of software, repairing,
Boolean calculation function can realize the establishment of individuation osteotomy guide plate.
9, the individuation osteotomy guide plate data created are exported as into stl file, osteotomy can be carried out by importing 3D printers
The individuation of guide plate prints, and is used for replacement knee in arthroplasty.
Osteotomy guide plate distal end is bonded completely in shape with distal femur.As shown in fig. 6, the individuation osteotomy is led
Deep slot 11, guide pipe 12 are provided on plate 10.Wherein, the line of the center nail hole of two guide pipes 12 and surgery epicondyle axis are flat
Row.
10, distal femur osteotomy is carried out using software and individuation osteotomy guide plate 10 later.Using two guide pipes 12
While being fixed, two 12 lines of guide pipe are parallel with STEA.After distal femur the first knife osteotomy being completed using osteotomy slot,
The line for the screw way that two fixing glues leave on osteotomy surface is i.e. parallel with STEA axis.
11, after progress osteotomy of distal determines STEA, traditional knee prosthesis or the knee joint of individuation can be carried out
Displacement.If the traditional knee prosthesis of row, the commercialized four-in-one osteotomy guide plate that then be used directly directly match osteotomy of distal
The screw way left afterwards carries out front ankle bone cutting, then postartis osteotomy, most backward bevel bone, and installs and uses commercialized standardized
Knee-joint prosthesis completes femur side knee prosthesis.
If planning to implement the knee prosthesis of individuation, individuation simulation is carried out using the four-in-one osteotomy guide plate of individuation
Osteotomy completes front ankle bone cutting, and after postartis osteotomy, and inclination osteotomy etc. simulate osteotomy, femur after osteotomy is measured in software
The data such as the angle between the length of distal end shape, width, thickness, osteotomy surface, then according to design measurement data design individual
The data such as anteroposterior diameter, left and right diameter, the inclination angle of the knee joint femoral side prosthesis of change, the knee joint for designing printing individuation are false
Body.The concrete structure of the four-in-one osteotomy guide plate 20 of individuation is as shown in fig. 7, internal view is as shown in Figure 8.
The knee-joint prosthesis of individuation includes：Knee-joint prosthesis and the cementless (biology of the individuation of bone-cement type
Type) two kinds of the knee-joint prosthesis of individuation.Wherein, concrete structure such as Fig. 9 of the knee-joint prosthesis 30 of bone-cement type individuation
Shown, the concrete structure of the knee-joint prosthesis 40 of cementless (bion) individuation is as shown in Figure 10.
As shown in Figure 10, cementless (bion) individuation knee-joint prosthesis 40 includes 50 He of condyle of femur mounting base
Tibia support component 48；
Condyle of femur mounting base 50 is placed on tibia support component 48, and condyle of femur mounting base 50 deviates from the one of tibia support component 48
Side is equipped with femur mounting groove, and the madial wall of femur mounting groove includes the first binding face 44, the opposite two sides of the first binding face 44
It is respectively arranged with third binding face 42 and the 4th binding face 45, side connection of the third binding face 42 far from the first binding face 44
There are the second binding face 41, side of the 4th binding face 45 far from the first binding face 44 to be connected with the 5th binding face 46；
For being bonded with the first femur section, the second binding face 41 is used to paste with the second femur section first binding face 44
It closing, third binding face 42 with third femur section for being bonded, and the 4th binding face 45 with the 4th femur section for being bonded, and the 5th
Binding face 46 with the 5th femur section for being bonded；
First binding face 44 is equipped with the first mounting post 49 and the second mounting post 43, and the first mounting post 49 is used for and femur
First screw way coordinates, and the second mounting post 43 is used to coordinate with the second screw way of femur.
Further, the madial wall of the first mounting post 49, the second mounting post 43 and femur mounting groove is distributed with micropore.With
Conducive in Bone Ingrowth micropore, to make femur preferably be combined with prosthese.
Further, the micropore on the first mounting post 49, the second mounting post 43 and femur mounting groove madial wall is by extroversion
It inside tapers into, to which the elasticity modulus of the first mounting post 49, the second mounting post 43 and femur mounting groove madial wall is by outer
Inwardly gradually increase, when prosthese is installed on prosthese, avoids leading to bone-prosthese contact surface because the elasticity modulus of attachment surface is excessive
Bone injury, while being also beneficial to Bone Ingrowth.
Further, the density of the first mounting post 49, the second mounting post 43 and the micropore on femur mounting groove madial wall is equal
Ecto-entad tapers into, to which the elasticity modulus of the first mounting post 49, the second mounting post 43 and femur mounting groove madial wall is equal
Ecto-entad gradually increases, and when prosthese is installed on prosthese, can avoid causing bone-prosthese to connect because the elasticity modulus of attachment surface is excessive
The spongiosa bone injury of contacting surface.
Further, it is interconnected between micropore, is similar to the structure of bone trabecula, the first mounting post 49, the second mounting post
43 and condyle of femur mounting base 50 all have microcellular structure.To be conducive to link together inside micropore after bone tissue is grown into.
Further, knee-joint prosthesis further includes liner 47, and liner 47 is set to condyle of femur mounting base 50 and tibia support group
Between part 48.
This cementless individuation femur side prosthesis provided in an embodiment of the present invention has following advantage：Because existing
Commercialization prosthese model it is very few, size disparity is big between adjacent model, in surgical procedure often adjacent big ting model it
Between be difficult to select.If the femoral prosthesis of selection is excessive, prosthese edge is easy to cause prosthese after hanging on outside femur edge and rubs
It wipes the soft tissues such as knee ligament and causes pain after patient's knee replacements；If the knee-joint prosthesis model of selection is too small,
It can then cause prosthese that femur osteotomy surface is not completely covered, be easy to cause prosthese and do not cover hard cortex bone and cause strength poly-
Cancellous bone is combined in, prosthese sedimentation is easily caused, influences the service life of knee joint replacement prosthesis.And individuation simulation knee joint is cut
Bone after the size for measuring osteotomy, can design the knee-joint prosthesis of individuation by preoperative simulation distal femur osteotomy for patient
And 3D printing making is carried out, effectively avoid knee-joint prosthesis oversized or too small complication.
The knee prosthesis method of individuation provided by the invention can be carried out according to the knee joint morphology of each patient
The knee prosthesis of individuation.By using the knee osteotomy guide plate of individuation, the accurate of osteotomy in art is helped to improve
Degree, keeps the placement of prosthese position more accurate.Meanwhile operating time is greatly shortened, avoid positioning in marrow from opening art caused by marrow
In bleed profusely and the risk of fat embolism, contribute to the Exact Reconstruction knee joint lower limb line of force.
In another embodiment of the present invention, a kind of electronic equipment, including memory, processor, the storage are also provided
The computer program that can be run on the processor is stored in device, the processor is realized when executing the computer program
The step of femur localization method of above-mentioned total knee arthroplasty.
In another embodiment of the present invention, a kind of non-volatile program code that can perform with processor is also provided
Computer-readable medium, said program code make the processor execute the femur positioning side for stating and realizing total knee arthroplasty
Method, virtualization surgery planning, surgical simulation, individuation osteotomy guide plate and prosthetic designs etc..
The femur localization method for the total knee arthroplasty that the embodiment of the present invention is provided, the computer of device and system
Program product, including the computer readable storage medium of program code is stored, the instruction that said program code includes can be used for
The method described in previous methods embodiment is executed, specific implementation can be found in embodiment of the method, and details are not described herein.
It is apparent to those skilled in the art that for convenience and simplicity of description, the system of foregoing description
It with the specific work process of device, can refer to corresponding processes in the foregoing method embodiment, details are not described herein.
In addition, in the description of the embodiment of the present invention unless specifically defined or limited otherwise, term " installation ", " phase
Even ", " connection " shall be understood in a broad sense, for example, it may be being fixedly connected, may be a detachable connection, or be integrally connected；It can
Can also be electrical connection to be mechanical connection；It can be directly connected, can also indirectly connected through an intermediary, Ke Yishi
Connection inside two elements.For the ordinary skill in the art, above-mentioned term can be understood at this with concrete condition
Concrete meaning in invention.
It, can be with if the function is realized in the form of SFU software functional unit and when sold or used as an independent product
It is stored in a computer read/write memory medium.Based on this understanding, technical scheme of the present invention is substantially in other words
The part of the part that contributes to existing technology or the technical solution can be expressed in the form of software products, the meter
Calculation machine software product is stored in a storage medium, including some instructions are used so that a computer equipment (can be
People's computer, server or network equipment etc.) it performs all or part of the steps of the method described in the various embodiments of the present invention.
And storage medium above-mentioned includes：USB flash disk, mobile hard disk, read-only memory (ROM, Read-Only Memory), arbitrary access are deposited
The various media that can store program code such as reservoir (RAM, Random Access Memory), magnetic disc or CD.
In the description of the present invention, it should be noted that term "center", "upper", "lower", "left", "right", "vertical",
The orientation or positional relationship of the instructions such as "horizontal", "inner", "outside" be based on the orientation or positional relationship shown in the drawings, merely to
Convenient for the description present invention and simplify description, do not indicate or imply the indicated device or element must have a particular orientation,
With specific azimuth configuration and operation, therefore it is not considered as limiting the invention.In addition, term " first ", " second ",
" third " is used for description purposes only, and is not understood to indicate or imply relative importance.
Finally it should be noted that：Embodiment described above, only specific implementation mode of the invention, to illustrate the present invention
Technical solution, rather than its limitations, scope of protection of the present invention is not limited thereto, although with reference to the foregoing embodiments to this hair
It is bright to be described in detail, it will be understood by those of ordinary skill in the art that：Any one skilled in the art
In the technical scope disclosed by the present invention, it can still modify to the technical solution recorded in previous embodiment or can be light
It is readily conceivable that variation or equivalent replacement of some of the technical features；And these modifications, variation or replacement, do not make
The essence of corresponding technical solution is detached from the spirit and scope of technical solution of the embodiment of the present invention, should all cover the protection in the present invention
Within the scope of.Therefore, the protection scope of the present invention shall be subject to the protection scope of the claims.
Claims (10)
1. a kind of femur localization method of total knee arthroplasty, which is characterized in that including：
Whether the femur model of detection three-dimensional digital has been imported into, and the femur model of the three-dimensional digital is to be based on patient's knee
What the scan data in joint was established；
When the femur model of the three-dimensional digital has been imported into, using chromatography to the femur model of the three-dimensional digital
Positioning obtains at least one distal femur bone mark point.
2. femur localization method according to claim 1, which is characterized in that the distal femur bone indicates point and includes：
Postartis minimum point, femoral bone pulley in the outer postartis minimum point of internal epicondyle of femur most concave point, external epicondyle of femur peak, femur, femur
Minimum point and fossa intercondylaris femoris peak.
3. femur localization method according to claim 2, which is characterized in that described to utilize chromatography to the 3-dimensional digital
The femur model of change positions to obtain at least one distal femur bone mark point, including：
Internal epicondyle of femur most concave point and external epicondyle of femur peak are positioned using chromatography；
Femur surgery epicondyle axis is determined according to the internal epicondyle of femur most concave point and the external epicondyle of femur peak；
World coordinate system is established according to the femur surgery epicondyle axis, obtains standard water prosposition；
On standard water prosposition, postartis minimum point, postartis minimum point, stock in femur outside chromatography number positioning femur are utilized
Bone coaster minimum point and fossa intercondylaris femoris peak.
4. femur localization method according to claim 3, which is characterized in that it is described to establish world coordinate system, obtain standard
Horizontal position, including：
Late-segmental collapse is positioned using best centre of sphere fitting process；
Using the midpoint of the femur surgery epicondyle axis as kneed center；
Using the connecting line of the midpoint of the femur surgery epicondyle axis and the late-segmental collapse point as the Z axis of world coordinate system；
Using the extension line of the femur surgery epicondyle axis as the X-axis of world coordinate system；
The Y-axis of world coordinate system is determined according to the Z axis and the X-axis.
5. femur localization method according to claim 4, which is characterized in that further include：
Femoral-posterior condyles axis is determined according to postartis minimum point in postartis minimum point outside the femur and the femur；
Condyle of femur front and back axis is determined according to the femoral bone pulley minimum point and the fossa intercondylaris femoris peak；
Measure the femoral-posterior condyles axis and the femur surgery epicondyle axis angle and the condyle of femur front and back axis with it is described
The angle of femur surgery epicondyle axis.
6. femur localization method according to claim 5, which is characterized in that further include：
Fossa intercondyloidea vertex is determined according to the fossa intercondylaris femoris peak；
Distal femur anatomical axis is positioned using centroid method；
Locating rod entry point in marrow is determined according to the intersection point of the distal femur anatomical axis and distal femur articular surface.
7. femur localization method according to claim 6, which is characterized in that described according to the fossa intercondylaris femoris peak
Determine fossa intercondyloidea vertex, including：
The plane vertical with the Z axis of the world coordinate system is created according to the fossa intercondylaris femoris peak；
The fossa intercondyloidea vertex is determined according to the intersection point of the plane and fossa intercondyloidea.
8. a kind of individuation osteotomy guide plate of total knee arthroplasty, which is characterized in that including：The individuation osteotomy guide plate is
According to the femur surgery epicondyle axis and the feature-modeling on distal femur surface, the femur surgery epicondyle axis is wanted based on right
2 to 7 any the internal epicondyle of femur most concave points and external epicondyle of femur peak are asked to determine.
9. a kind of Custom made stem of total knee arthroplasty, it is characterised in that it includes：The Custom made stem is according to profit
The feature-modeling of distal femur after carrying out osteotomy with individuation osteotomy guide plate according to any one of claims 8.
10. a kind of electronic equipment, including memory, processor, it is stored with and can runs on the processor in the memory
Computer program, which is characterized in that the processor realizes the claims 1 to 7 when executing the computer program
The step of method described in one.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810304027.8A CN108478250A (en) | 2018-04-04 | 2018-04-04 | Femur localization method, individuation osteotomy guide plate and the prosthese of total knee arthroplasty |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810304027.8A CN108478250A (en) | 2018-04-04 | 2018-04-04 | Femur localization method, individuation osteotomy guide plate and the prosthese of total knee arthroplasty |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN108478250A true CN108478250A (en) | 2018-09-04 |
Family
ID=63314801
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201810304027.8A Pending CN108478250A (en) | 2018-04-04 | 2018-04-04 | Femur localization method, individuation osteotomy guide plate and the prosthese of total knee arthroplasty |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN108478250A (en) |
Cited By (23)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109363682A (en) * | 2018-10-31 | 2019-02-22 | 殷晓亮 | The first preoperative plan MRI/CT of knee prosthesis is scanned and computer image processing method |
| CN110432948A (en) * | 2019-08-12 | 2019-11-12 | 中国人民解放军陆军军医大学第一附属医院 | Total knee arthroplasty osteotomy navigation device |
| CN110534175A (en) * | 2019-10-15 | 2019-12-03 | 北京爱康宜诚医疗器材有限公司 | Osteotomy measuring method, measuring device, storage medium and processor |
| CN110623702A (en) * | 2019-10-15 | 2019-12-31 | 北京爱康宜诚医疗器材有限公司 | Osteotomy amount measuring device |
| CN110960289A (en) * | 2019-12-03 | 2020-04-07 | 嘉思特华剑医疗器材(天津)有限公司 | Single-condyle bone cutting guide plate and positioning method thereof |
| CN111012470A (en) * | 2019-12-27 | 2020-04-17 | 首都医科大学宣武医院 | Movable platform single-condyle replacement medullary cavity rod insertion 3D positioning guide plate and manufacturing method thereof |
| CN111166474A (en) * | 2019-04-23 | 2020-05-19 | 艾瑞迈迪科技石家庄有限公司 | Auxiliary examination method and device before joint replacement surgery |
| CN111192498A (en) * | 2020-04-14 | 2020-05-22 | 上海龙慧医疗科技有限公司 | Multi-position hip joint artificial bone simulation operation demonstration device |
| CN111671518A (en) * | 2020-04-29 | 2020-09-18 | 北京天智航医疗科技股份有限公司 | Processing and generating method and device for hip joint femoral head spherical center and computer equipment |
| CN112138287A (en) * | 2020-07-24 | 2020-12-29 | 西安交通大学 | Positioning head die for gamma knife operation and three-dimensional imaging and forming system |
| CN112957126A (en) * | 2021-02-10 | 2021-06-15 | 北京长木谷医疗科技有限公司 | Deep learning-based unicondylar replacement preoperative planning method and related equipment |
| CN113545847A (en) * | 2021-06-08 | 2021-10-26 | 北京天智航医疗科技股份有限公司 | Femoral head center positioning system and method |
| CN113633444A (en) * | 2021-09-01 | 2021-11-12 | 湘潭市中心医院 | Auxiliary guide plate for hip joint replacement operation and using method thereof |
| CN113689406A (en) * | 2021-08-24 | 2021-11-23 | 北京长木谷医疗科技有限公司 | Knee joint femoral posterior condylar point identification method and system based on motion simulation algorithm |
| CN113679447A (en) * | 2021-07-20 | 2021-11-23 | 国家康复辅具研究中心 | Navigation template for distal femur osteotomy and design method thereof |
| CN113842211A (en) * | 2021-09-03 | 2021-12-28 | 北京长木谷医疗科技有限公司 | Three-dimensional preoperative planning method and system for knee joint replacement |
| CN113974827A (en) * | 2021-09-30 | 2022-01-28 | 杭州三坛医疗科技有限公司 | Operation reference scheme generation method and device |
| CN114366396A (en) * | 2021-12-21 | 2022-04-19 | 徐州医科大学 | Femoral condyle prosthesis binding surface design method based on bionic hand structure and application |
| WO2022142741A1 (en) * | 2020-12-31 | 2022-07-07 | 北京长木谷医疗科技有限公司 | Total knee arthroplasty preoperative planning method and device |
| CN114723897A (en) * | 2022-06-09 | 2022-07-08 | 北京长木谷医疗科技有限公司 | Planning method and device for intelligent tibial osteotomy navigation system |
| CN115830247A (en) * | 2023-02-14 | 2023-03-21 | 北京壹点灵动科技有限公司 | Fitting method and device for hip joint rotation center, processor and electronic equipment |
| CN116059016A (en) * | 2023-02-27 | 2023-05-05 | 北京壹点灵动科技有限公司 | Knee joint parameter processing method and device and electronic equipment |
| WO2023206614A1 (en) * | 2022-04-27 | 2023-11-02 | 杭州素问九州医疗科技有限公司 | Method and apparatus for determining trochlear groove curve of femur |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1488321A (en) * | 2003-08-21 | 2004-04-14 | 上海交通大学 | Thigh-bone positioning method for full knee-joint replacement operation by robot |
| CN101288597A (en) * | 2008-06-20 | 2008-10-22 | 周一新 | Knee-joint prosthesis implantation process, osteotomy module thereof and device thereof |
| CN103860293A (en) * | 2014-03-07 | 2014-06-18 | 北京大学第三医院 | Individualized reversal design and manufacturing method for full knee joint replacing prosthesis |
| CN107296651A (en) * | 2017-06-21 | 2017-10-27 | 四川大学 | It is a kind of to digitize the method that auxiliary determines distal femur Osteotomy |
-
2018
- 2018-04-04 CN CN201810304027.8A patent/CN108478250A/en active Pending
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1488321A (en) * | 2003-08-21 | 2004-04-14 | 上海交通大学 | Thigh-bone positioning method for full knee-joint replacement operation by robot |
| CN101288597A (en) * | 2008-06-20 | 2008-10-22 | 周一新 | Knee-joint prosthesis implantation process, osteotomy module thereof and device thereof |
| CN103860293A (en) * | 2014-03-07 | 2014-06-18 | 北京大学第三医院 | Individualized reversal design and manufacturing method for full knee joint replacing prosthesis |
| CN107296651A (en) * | 2017-06-21 | 2017-10-27 | 四川大学 | It is a kind of to digitize the method that auxiliary determines distal femur Osteotomy |
Non-Patent Citations (1)
| Title |
|---|
| 向柄彦: "数字技术在个性化膝关节置换中下肢力线的研究", 《中国博士学位论文全文数据库，医药卫生科技辑》 * |
Cited By (36)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109363682A (en) * | 2018-10-31 | 2019-02-22 | 殷晓亮 | The first preoperative plan MRI/CT of knee prosthesis is scanned and computer image processing method |
| CN111166474A (en) * | 2019-04-23 | 2020-05-19 | 艾瑞迈迪科技石家庄有限公司 | Auxiliary examination method and device before joint replacement surgery |
| CN111166474B (en) * | 2019-04-23 | 2021-08-27 | 艾瑞迈迪科技石家庄有限公司 | Auxiliary examination method and device before joint replacement surgery |
| CN110432948A (en) * | 2019-08-12 | 2019-11-12 | 中国人民解放军陆军军医大学第一附属医院 | Total knee arthroplasty osteotomy navigation device |
| CN110623702A (en) * | 2019-10-15 | 2019-12-31 | 北京爱康宜诚医疗器材有限公司 | Osteotomy amount measuring device |
| CN110623702B (en) * | 2019-10-15 | 2024-04-02 | 北京爱康宜诚医疗器材有限公司 | Osteotomy measuring device |
| CN110534175A (en) * | 2019-10-15 | 2019-12-03 | 北京爱康宜诚医疗器材有限公司 | Osteotomy measuring method, measuring device, storage medium and processor |
| CN110960289A (en) * | 2019-12-03 | 2020-04-07 | 嘉思特华剑医疗器材(天津)有限公司 | Single-condyle bone cutting guide plate and positioning method thereof |
| CN110960289B (en) * | 2019-12-03 | 2021-07-27 | 嘉思特华剑医疗器材(天津)有限公司 | Single-condyle bone cutting guide plate and positioning method thereof |
| CN111012470A (en) * | 2019-12-27 | 2020-04-17 | 首都医科大学宣武医院 | Movable platform single-condyle replacement medullary cavity rod insertion 3D positioning guide plate and manufacturing method thereof |
| CN111012470B (en) * | 2019-12-27 | 2024-04-30 | 首都医科大学宣武医院 | Movable platform unicondylar replacement intramedullary rod insertion 3D positioning guide plate and manufacturing method thereof |
| CN111192498A (en) * | 2020-04-14 | 2020-05-22 | 上海龙慧医疗科技有限公司 | Multi-position hip joint artificial bone simulation operation demonstration device |
| CN111192498B (en) * | 2020-04-14 | 2020-07-03 | 上海龙慧医疗科技有限公司 | Multi-position hip joint artificial bone simulation operation demonstration device |
| CN111671518A (en) * | 2020-04-29 | 2020-09-18 | 北京天智航医疗科技股份有限公司 | Processing and generating method and device for hip joint femoral head spherical center and computer equipment |
| CN111671518B (en) * | 2020-04-29 | 2021-04-16 | 北京天智航医疗科技股份有限公司 | Processing and generating method and device for hip joint femoral head spherical center and computer equipment |
| CN112138287A (en) * | 2020-07-24 | 2020-12-29 | 西安交通大学 | Positioning head die for gamma knife operation and three-dimensional imaging and forming system |
| CN112138287B (en) * | 2020-07-24 | 2022-06-07 | 西安交通大学 | Positioning head die for gamma knife operation and three-dimensional imaging and forming system |
| WO2022142741A1 (en) * | 2020-12-31 | 2022-07-07 | 北京长木谷医疗科技有限公司 | Total knee arthroplasty preoperative planning method and device |
| CN112957126A (en) * | 2021-02-10 | 2021-06-15 | 北京长木谷医疗科技有限公司 | Deep learning-based unicondylar replacement preoperative planning method and related equipment |
| CN113545847A (en) * | 2021-06-08 | 2021-10-26 | 北京天智航医疗科技股份有限公司 | Femoral head center positioning system and method |
| CN113545847B (en) * | 2021-06-08 | 2022-07-26 | 北京天智航医疗科技股份有限公司 | Femoral head center positioning system and method |
| CN113679447A (en) * | 2021-07-20 | 2021-11-23 | 国家康复辅具研究中心 | Navigation template for distal femur osteotomy and design method thereof |
| CN113679447B (en) * | 2021-07-20 | 2023-02-28 | 国家康复辅具研究中心 | Navigation template for distal femur osteotomy and design method thereof |
| CN113689406A (en) * | 2021-08-24 | 2021-11-23 | 北京长木谷医疗科技有限公司 | Knee joint femoral posterior condylar point identification method and system based on motion simulation algorithm |
| CN113633444A (en) * | 2021-09-01 | 2021-11-12 | 湘潭市中心医院 | Auxiliary guide plate for hip joint replacement operation and using method thereof |
| CN113842211A (en) * | 2021-09-03 | 2021-12-28 | 北京长木谷医疗科技有限公司 | Three-dimensional preoperative planning method and system for knee joint replacement |
| CN113974827B (en) * | 2021-09-30 | 2023-08-18 | 杭州三坛医疗科技有限公司 | Surgical reference scheme generation method and device |
| CN113974827A (en) * | 2021-09-30 | 2022-01-28 | 杭州三坛医疗科技有限公司 | Operation reference scheme generation method and device |
| CN114366396B (en) * | 2021-12-21 | 2022-11-01 | 徐州医科大学 | Femoral condyle prosthesis binding surface design method based on bionic hand structure and application |
| CN114366396A (en) * | 2021-12-21 | 2022-04-19 | 徐州医科大学 | Femoral condyle prosthesis binding surface design method based on bionic hand structure and application |
| WO2023206614A1 (en) * | 2022-04-27 | 2023-11-02 | 杭州素问九州医疗科技有限公司 | Method and apparatus for determining trochlear groove curve of femur |
| CN114723897B (en) * | 2022-06-09 | 2022-08-30 | 北京长木谷医疗科技有限公司 | Planning method and device for intelligent tibial osteotomy navigation system |
| WO2023236367A1 (en) * | 2022-06-09 | 2023-12-14 | 北京长木谷医疗科技有限公司 | Planning method and apparatus for tibia osteotomy intelligent navigation system |
| CN114723897A (en) * | 2022-06-09 | 2022-07-08 | 北京长木谷医疗科技有限公司 | Planning method and device for intelligent tibial osteotomy navigation system |
| CN115830247A (en) * | 2023-02-14 | 2023-03-21 | 北京壹点灵动科技有限公司 | Fitting method and device for hip joint rotation center, processor and electronic equipment |
| CN116059016A (en) * | 2023-02-27 | 2023-05-05 | 北京壹点灵动科技有限公司 | Knee joint parameter processing method and device and electronic equipment |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| CN108478250A (en) | Femur localization method, individuation osteotomy guide plate and the prosthese of total knee arthroplasty | |
| US10398511B2 (en) | System and method to locate soft tissue for preoperative planning | |
| US11737826B2 (en) | Systems and methods for preoperative planning and postoperative analysis of surgical procedures | |
| AU2012296556B2 (en) | Revision systems, tools and methods for revising joint arthroplasty implants | |
| CN104546060B (en) | Patella osteotomy navigation template for knee arthroplasty and manufacture method | |
| US20160331467A1 (en) | Revision Systems, Tools and Methods for Revising Joint Arthroplasty Implants | |
| TWI434675B (en) | Patient selectable joint arthroplasty devices and surgical tools | |
| Victor et al. | An experimental model for kinematic analysis of the knee | |
| CN204468186U (en) | A kind of patella osteotomy navigation template for knee prosthesis | |
| Venne et al. | Comparing conventional and computer-assisted surgery baseplate and screw placement in reverse shoulder arthroplasty | |
| Chen et al. | Research status and application prospects of digital technology in orthopaedics | |
| EP4086854A1 (en) | Surface and image integration for model evaluation and landmark determination | |
| CN102933163A (en) | Systems and methods for patient- based computer assisted surgical procedures | |
| CN107106239A (en) | Surgery is planned and method | |
| CN104622572A (en) | Individual orthopedics department positioning sheet based on medical images | |
| CN110478090A (en) | CAD pelvic tumor is precisely cut off with personalized prosthese and preparation method thereof | |
| CN104510474A (en) | Three-dimensional measurement method and system for patella osteotomy | |
| Cerveri et al. | Determination of the Whiteside line on femur surface models by fitting high-order polynomial functions to cross-section profiles of the intercondylar fossa | |
| Chang et al. | A pre‐operative approach of range of motion simulation and verification for femoroacetabular impingement | |
| CN204562290U (en) | The deep guide plate arrangement of a kind of Total knee arthroplasty distal femur | |
| Valstar et al. | Towards computer-assisted surgery in shoulder joint replacement | |
| Peters et al. | Surgical navigation improves the precision and accuracy of tibial component alignment in canine total knee replacement | |
| CA2831458C (en) | Customized orthopaedic implants and related methods | |
| Netto | The role of 3D printing in the positioning of the glenoidal component in total shoulder arthroplasty | |
| US20230111376A1 (en) | Surgical systems, anatomical models and associated methods |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| PB01 | Publication | ||
| PB01 | Publication | ||
| SE01 | Entry into force of request for substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| RJ01 | Rejection of invention patent application after publication | ||
| RJ01 | Rejection of invention patent application after publication |
Application publication date: 20180904 |