CN109692059B - Construction method of individual thighbone short handle - Google Patents

Construction method of individual thighbone short handle Download PDF

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Publication number
CN109692059B
CN109692059B CN201811634050.XA CN201811634050A CN109692059B CN 109692059 B CN109692059 B CN 109692059B CN 201811634050 A CN201811634050 A CN 201811634050A CN 109692059 B CN109692059 B CN 109692059B
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axis
control point
cone
constructing
femur
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CN109692059A (en
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汪轶平
程余波
李建波
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Image Medraw Technology Shanghai Co ltd
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Image Medraw Technology Shanghai Co ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3662Femoral shafts
    • A61F2/367Proximal or metaphyseal parts of shafts
    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06TIMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T17/00Three dimensional [3D] modelling, e.g. data description of 3D objects
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/3094Designing or manufacturing processes
    • A61F2/30942Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A61F2002/30943Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using mathematical models
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/3094Designing or manufacturing processes
    • A61F2/30942Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A61F2002/30948Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using computerized tomography, i.e. CT scans
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/3094Designing or manufacturing processes
    • A61F2002/30985Designing or manufacturing processes using three dimensional printing [3DP]

Abstract

The invention relates to the field of medical instruments, in particular to a construction method of an individual femur short handle. The invention provides a construction method of an individual femur short handle, which comprises the following steps: and establishing a femur 3D model, and constructing a model for obtaining the individualized femur short handle. The individual thighbone short handle constructed by the construction method provided by the invention can fully reserve bone mass, optimize stress transmission, reduce the pain of thighbone and facilitate later-stage revision.

Description

Construction method of individual thighbone short handle
Technical Field
The invention relates to the field of medical instruments, in particular to a construction method of an individual femur short handle.
Background
The individualized short femoral stem is a prosthesis commonly used in femoral operations, is mainly used in operations such as artificial total hip replacement and the like, plays a role, is a main filler for a medullary cavity, and plays a critical role in the quality of the operations. Although some methods for constructing the individual femoral short stem exist in the prior art, the problems of stress shielding, position loosening, pain and other prosthesis failures exist, so that a more advanced method for constructing the individual femoral short stem needs to be further provided.
Disclosure of Invention
In view of the above-mentioned drawbacks of the prior art, it is an object of the present invention to provide a method for constructing a personalized femoral stem, which solves the problems of the prior art.
In order to achieve the above objects and other related objects, another aspect of the present invention provides a method for constructing a personalized femoral stem, comprising the steps of:
1) establishing a femur 3D model;
2) constructing a femur mechanical axis L;
3) acquiring the section of an effective medullary cavity which is vertical to a femoral mechanical axis L and is over-small the central point of the trochanter;
4) constructing an intramedullary canal inscribed circle on the section of the effective intramedullary canal by taking the intersection point of the femur mechanical axis L and the section as the circle center;
5) establishing a three-dimensional coordinate system by taking a femoral mechanical shaft L as a first axis, taking a connection line of two condyles of a medial condyle and a lateral condyle as a second axis and taking a third axis perpendicular to the first axis and the second axis;
6) construction of control points T2And a control point T4Said control point T2And a control point T4The intersection point of the second axis direction passing through the center of the intramedullary canal inscribed circle and the intramedullary canal inscribed circle is the control point T2Located inside the mechanical axis L of the bone, T4Outside the mechanical axis L of the bone;
7) construction of control points T3And a control point T5Said control point T3And a control point T5The intersection point of the third axis direction passing through the center of the intramedullary canal inscribed circle and the intramedullary canal inscribed circle is the control point T3On the posterior side of the mechanical axis L of the bone, T5On the anterior side of the mechanical axis L of the bone;
8) construction of control points T1Said control point T1Below the section of the effective medullary cavity and on the mechanical axis L of the femur;
9) construction of control points T6Said control point T6The rotor is positioned 10-50 mm above the small rotor;
10) constructing the circle center of an upper table top of a circular table in a conical area, wherein the circle center of the upper table top is 20-60 mm away from a first axis L40, the circle center of the upper table top is 20-60 mm away from a second axis, and the distance between the circle center of the upper table top and a third axis is less than or equal to 20 mm;
11) constructing a cone-shaped area circular truncated cone axis, wherein the included angle between the cone-shaped area circular truncated cone axis and the projection of the first axis on the plane where the first axis and the second axis are located is 100-150 degrees, and the included angle between the cone-shaped area circular truncated cone axis and the projection of the second axis on the plane where the second axis and the third axis are located is 12-15 degrees;
12) constructing a cone-shaped area circular table according to the center of the upper table top of the cone-shaped area circular table and the axis of the cone-shaped area circular table, wherein the diameter of the upper table top circular surface of the cone-shaped area circular table is 11-14 mm, the height of the cone-shaped area circular table is 11-19 mm, and the taper of the cone-shaped area circular table is 5.67-5.68 mm;
13) construction of control points L1And a control point L3Said control point L1And a control point L3The control point L is the intersection point of a plane passing through the center of the upper table top of the circular truncated cone and being parallel to the plane where the first axis and the second axis are positioned and the edge of the lower table top of the circular truncated cone1Is located at the inner side of the axis of the cone area, and the control point L3The cone is positioned at the outer side of the axis of the cone area;
14) construction of control points L2And a control point L4Said control point L2And a control point L4The connecting line of the lower table top of the circular table is positioned on the lower table top of the circular table, passes through the center of the circular table top and is connected with the control point L1And a control point L3Is perpendicular to the line of the control point L2Is positioned at the rear side of the axis of the cone-shaped area of the circular truncated cone, and the control point L4The front side of the axis of the cone area;
15) respectively at control points T1And a control point T2Control point T1And a control point T3Control point T1And a control point T4Control point T1And a control point T5Constructing a Bezier curve;
16) respectively at control points L1And a control point T2Control point L2And a control point T3Control point L3And a control point T4Control point L4And a control point T5A Bezier curve is constructed in which T6Is a control point L1And a control point T2Control points on the curve in between;
17) equally dividing spline curves between the lower table top of the circular truncated cone and the section of the effective medullary cavity, and constructing a closed curve corresponding to each section of equally divided point;
18) will control point T1Equally dividing spline curves between the effective medullary cavity and the sections of the effective medullary cavity, and constructing a closed curve corresponding to each section of equally divided points;
19) and constructing a model for obtaining the individualized femur short handle.
In some embodiments of the invention, in the step 4), the intramedullary canal inscribed circle has three tangent points with the inner wall of the intramedullary canal.
In some embodiments of the invention, in the step 5), in the three-dimensional stereo coordinate system, the first axis is a z-axis, the second axis is an x-axis, and the third axis is a y-axis.
In some embodiments of the invention, in the step 8), the control point T1 is the location where the mechanical axis L of the femur is 40mm to 150mm below the cross section of the effective medullary cavity.
In some embodiments of the present invention, in the step 11), the tapered region circular truncated cone upper table is smaller than the tapered region circular truncated cone lower table.
In some embodiments of the invention, the cross-section of the individualized femoral stem varies uniformly.
In some embodiments of the invention, the individualized femoral stem is located at control point T1The end of the side is a smooth sphere.
In another aspect, the present invention provides a method for preparing a personalized femoral short stem, the method comprising: and constructing an obtained model of the individualized femur short handle according to the construction method of the individualized femur short handle, and preparing the individualized femur short handle.
The invention further provides an individual femoral short handle which is constructed by the construction method of the individual femoral short handle or prepared by the preparation method of the individual femoral short handle.
Another aspect of the present invention provides a computer readable storage medium, on which a computer program is stored, wherein the program, when executed by a processor, implements the steps of the method for constructing the personalized femoral stem or the steps of the method for preparing the personalized femoral stem.
Drawings
Fig. 1 shows a schematic view of a femoral mechanical axis L of the present invention.
FIG. 2 is a schematic diagram of the construction of an inscribed circle of the medullary cavity of the present invention.
Fig. 3 shows an axis construction diagram of the present invention.
FIG. 4 is a schematic view of a shank spline curve construction according to the present invention.
FIG. 5 is a schematic view of a shank spline curve construction according to the present invention.
FIG. 6 shows a neck control point T according to the present invention6Schematic representation.
FIG. 7 shows a schematic view of the stem construction of the present invention.
Description of the reference numerals
1 taper region of shank
2 upper region of the shank
3 small rotor center
4 lower region of the shank
Detailed Description
The inventor of the invention provides a construction method of an individual short femoral stem through long-term research, the individual short femoral stem constructed by the construction method can fully retain bone mass, optimize stress transmission, reduce the pain of the thigh and facilitate later revision, and the invention is completed on the basis.
The invention provides a method for constructing an individual femur short handle, which comprises the following steps:
1) establishing a femur 3D model;
2) constructing a femur mechanical axis L;
3) acquiring the section of an effective medullary cavity which is vertical to a femoral mechanical axis L and is over-small the central point of the trochanter;
4) constructing an intramedullary canal inscribed circle on the section of the effective intramedullary canal by taking the intersection point of the femur mechanical axis L and the section as the circle center;
5) establishing a three-dimensional coordinate system by taking a femoral mechanical shaft L as a first axis, taking a connection line of two condyles of a medial condyle and a lateral condyle as a second axis and taking a third axis perpendicular to the first axis and the second axis;
6) construction of control points T2And a control point T4Said control point T2And a control point T4The intersection point of the second axis direction passing through the center of the intramedullary canal inscribed circle and the intramedullary canal inscribed circle is the control point T2Located inside the mechanical axis L of the bone, T4Outside the mechanical axis L of the bone;
7) construction of control points T3And a control point T5Said control point T3And a control point T5The intersection point of the third axis direction passing through the center of the intramedullary canal inscribed circle and the intramedullary canal inscribed circle is the control point T3On the posterior side of the mechanical axis L of the bone, T5On the anterior side of the mechanical axis L of the bone;
8) construction of control points T1Said control point T1Below the section of the effective medullary cavity and on the mechanical axis L of the femur;
9) construction of control points T6Said control point T6The rotor is positioned 10-50 mm above the small rotor;
10) constructing the circle center of an upper table top of a circular table in a conical area, wherein the circle center of the upper table top is 20-60 mm away from a first axis L40, the circle center of the upper table top is 20-60 mm away from a second axis, and the distance between the circle center of the upper table top and a third axis is less than or equal to 20 mm;
11) constructing a cone-shaped area circular truncated cone axis, wherein the included angle between the cone-shaped area circular truncated cone axis and the projection of the first axis on the plane where the first axis and the second axis are located is 100-150 degrees, and the included angle between the cone-shaped area circular truncated cone axis and the projection of the second axis on the plane where the second axis and the third axis are located is 12-15 degrees;
12) constructing a cone-shaped area circular table according to the center of the upper table top of the cone-shaped area circular table and the axis of the cone-shaped area circular table, wherein the diameter of the upper table top circular surface of the cone-shaped area circular table is 11-14 mm, the height of the cone-shaped area circular table is 11-19 mm, and the taper of the cone-shaped area circular table is 5.67-5.68 mm;
13) construction of control points L1And a control point L3Said control point L1And a control point L3The control point L is the intersection point of a plane passing through the center of the upper table top of the circular truncated cone and being parallel to the plane where the first axis and the second axis are positioned and the edge of the lower table top of the circular truncated cone1Is located at the inner side of the axis of the cone area, and the control point L3The cone is positioned at the outer side of the axis of the cone area;
14) construction of control points L2And a control point L4Said control point L2And a control point L4The connecting line of the lower table top of the circular table is positioned on the lower table top of the circular table, passes through the center of the circular table top and is connected with the control point L1And a control point L3Is perpendicular to the line of the control point L2Is positioned at the rear side of the axis of the cone-shaped area of the circular truncated cone, and the control point L4The front side of the axis of the cone area;
15) respectively at control points T1And a control point T2Control point T1And a control point T3Control point T1And a control point T4Control point T1And a control point T5Constructing a Bezier curve;
16) respectively at control points L1And a control point T2Control point L2And a control point T3Control point L3And a control point T4Control point L4And a control point T5A Bezier curve is constructed in which T6Is a control point L1And a control point T2Control points on the curve in between;
17) equally dividing spline curves between the lower table top of the circular truncated cone and the section of the effective medullary cavity, and constructing a closed curve corresponding to each section of equally divided point;
18) will control point T1Equally dividing spline curves between the effective medullary cavity and the sections of the effective medullary cavity, and constructing a closed curve corresponding to each section of equally divided points;
19) and constructing a model for obtaining the individualized femur short handle.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: and establishing a femur 3D model. One skilled in the art can select an appropriate method to build a 3D model of the femur. For example, a 3D model of the femur can be built through CT data, and for example, the 3D model of the femur can be built through mimics, medraw, 3D slicer, and other software.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: the femoral mechanical axis L is constructed. Referring to the vertical straight line in fig. 1, the femoral mechanical axis L is generally the medullary cavity axis as the centerline fitted to the medullary cavity structure between a distance above the lesser trochanter and a distance below the lesser trochanter. In one embodiment of the present invention, the femoral mechanical axis L has a centerline fitted to the medullary cavity structure 20mm above the lesser trochanter and 100mm below the lesser trochanter as the medullary cavity axis.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: the section of the effective medullary cavity perpendicular to the mechanical axis L of the femur and passing through the central point of the lesser trochanter is obtained, so that the specific shape of the section of the effective medullary cavity can be obtained. The effective medullary cavity generally refers to the medullary cavity structure in the range of 20mm above the lesser trochanter and 20mm below the lesser trochanter.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: and constructing an intramedullary canal inscribed circle on the section of the effective intramedullary canal by taking the intersection point of the femur mechanical axis L and the section as the circle center. Referring to fig. 2, the intramedullary canal inscribed circle and the inner wall of the intramedullary canal may generally have a plurality of tangent points, for example, the intramedullary canal inscribed circle and the inner wall of the intramedullary canal may have three tangent points.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: a three-dimensional coordinate system is established by taking the femoral mechanical axis L as a first axis, taking a connection line of two condyles of the medial condyle and the lateral condyle as a second axis and taking a third axis perpendicular to the first axis and the second axis. The first and second axes are generally perpendicular, so a three-dimensional stereo coordinate system may be established with a third axis perpendicular to the first and second axes, the third axis generally passing through the intersection of the first and second axes. Referring to fig. 3, a direction of the mechanical axis L (first axis) of the femur toward the upper side of the human body may be taken as a positive z-axis direction, a direction of a connection line of two condyles (second axis) toward the femoral head may be taken as a positive x-axis direction (in fig. 3, a direction from 3 to 2 is taken as a positive direction), a y-axis (third axis) may be determined by a right-hand rule, and a three-dimensional coordinate system may be further constructed.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: construction of control points T2And a control point T4Said control point T2And a control point T4The intersection point of the second axis direction passing through the center of the intramedullary canal inscribed circle and the intramedullary canal inscribed circle is the control point T2Is positioned at the inner side of the mechanical axis L, namely, at the side of the mechanical axis L closer to the pelvic cavity when the human body is in an upright posture, and the T4Is positioned at the outer side of the mechanical axis L, namely, at the side of the mechanical axis L far away from the pelvic cavity when the human body is in an upright posture.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: construction of control points T3And a control point T5Said control point T3And a control point T5The intersection point of the third axis direction passing through the center of the intramedullary canal inscribed circle and the intramedullary canal inscribed circle is the control point T3Is positioned at the rear side of the mechanical axis L, namely, the side of the mechanical axis L close to the back of the human body when the human body is in an upright posture, and the T5Is positioned at the front side of the mechanical axis L, namely, at the side of the mechanical axis L close to the front side of the human body when the human body is in an upright posture.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: construction of control points T1Said control point T1The control point T1 is located on the mechanical axis L of femur below the cross section of the effective medullary cavity, and is 40 mm-150 mm, preferably 60 mm-100 mm, and more preferably 70 mm-90 mm below the cross section of the effective medullary cavity.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: construction of control points T6Said control point T6The rotor is 10-50 mm above the small rotor, preferably 20-40 mm, and more preferably 25-35 mm. The control point T6On the femoral cervical cortical surface (as shown in fig. 5) and tangent to the cortical surface at that point.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: the method comprises the steps of constructing the circle center of an upper table top of a circular table in a conical area, wherein the distance between the circle center of the upper table top and a first axis L40-60 mm, the distance between the circle center of the upper table top and a second axis L8920-60 mm, and the distance between the circle center of the upper table top and a third axis L is less than or equal to 20 mm.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: the method comprises the steps of constructing a cone-shaped area circular truncated cone axis, wherein the included angle between the cone-shaped area circular truncated cone axis and the projection of the first axis on the plane where the first axis and the second axis are located is 100-150 degrees, and the included angle between the cone-shaped area circular truncated cone axis and the projection of the second axis on the plane where the second axis and the third axis are located is 12-15 degrees.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: according to the circle center of the upper table top of the cone-shaped area circular truncated cone and the axis of the cone-shaped area circular truncated cone, the cone-shaped area circular truncated cone is constructed, the upper table top of the cone-shaped area circular truncated cone is usually smaller than the lower table top of the cone-shaped area circular truncated cone, the diameter of the circular surface of the upper table top of the cone-shaped area circular truncated cone is 11-14 mm, the height of the cone-shaped area circular truncated cone is 11-19 mm, and the taper of the cone-shaped.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: construction of control points L1And a control point L3Said control point L1And a control point L3The control point L is the intersection point of a plane passing through the center of the upper table top of the circular truncated cone and being parallel to the plane where the first axis and the second axis are positioned and the edge of the lower table top of the circular truncated cone1Is positioned at the inner side of the axis of the cone-shaped area, namely, is positioned at one side of the cone-shaped area closer to the pelvic cavity when the human body is in an upright posture, and the control point L3Is positioned at the outer side of the axis of the cone-shaped area, namely, at one side of the cone-shaped area, which is far away from the pelvic cavity, when the human body is in an upright posture.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: construction of control points L2And a control point L4Said control point L2And a control point L4The connecting line of the lower table top of the circular table is positioned on the lower table top of the circular table, passes through the center of the circular table top and is connected with the control point L1And a control point L3Is perpendicular to the line of the control point L2Is located atThe rear side of the axis of the cone-shaped area round platform, namely the side of the axis of the cone-shaped area round platform close to the back of the human body when the human body is in an upright posture, and the control point L4Is positioned at the front side of the axis of the cone-shaped area, namely at the side of the axis of the cone-shaped area close to the front of the human body when the human body is in an upright posture.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: respectively at control points T1And a control point T2Control point T1And a control point T3Control point T1And a control point T4Control point T1And a control point T5A Bezier curve is constructed in between. Those skilled in the art can construct a suitable Bezier curve according to each control point, the constructed Bezier curve generally fits the inner wall of the effective medullary cavity as much as possible, and the Bezier curve is constructed by controlling partial nodes T1The direction and magnitude of the iso-tangential vector control the local shape of the curve.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: respectively at control points L1And a control point T2Control point L2And a control point T3Control point L3And a control point T4Control point L4And a control point T5A Bezier curve is constructed in which T6Is a control point L1And a control point T2The control points on the curves in between, reference can be made to fig. 4 to 6. Those skilled in the art can construct an appropriate Bezier curve according to each control point, wherein the constructed Bezier curve generally fits the inner wall of the effective medullary cavity as much as possible and passes through the control part of the node T1The direction and magnitude of the iso-tangential vector control the local shape of the curve. Over control point T2Adjustment of the matching to the medullary cavity and the tangential orientation, T2And L1, can adjust the matching of the stem body and the medullary cavity in the coronal position. In the construction of L2And T3When the b-spline curve is obtained, two points are connected to construct the b-spline curve, and the curve passes through the T-shaped curve6When the horizontal plane has the same height, the vector direction of the curve is controlled to be parallel to the axis L, so that the curve achieves the effect of matching with the inside of the medullary cavity, and the construction is carried outL3And T4When the b-spline curve is obtained, two points are connected to construct the b-spline curve, and the curve passes through the T-shaped curve6When the height level surface is 10mm, the curve vector direction is controlled to be parallel to the axis L, so that the line can achieve the effect of matching with the inside of the medullary cavity.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: and (4) equally dividing spline curves between the lower table top of the circular truncated cone and the section of the effective medullary cavity, and constructing a closed curve corresponding to each section of equal division point. The spline curve between the lower mesa of the circular truncated cone and the cross section of the effective medullary cavity can be equally divided appropriately by those skilled in the art, for example, 15-25 equally divided can be performed with reference to fig. 7, and a closed curve can be further constructed with equally divided points at corresponding positions on various spline curves.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: will control point T1The spline curves between the effective medullary cavity and the sections of the effective medullary cavity are equally divided, and a closed curve is constructed corresponding to each section of equal division point. The person skilled in the art can set the control point T1The spline curve between the section of the effective medullary cavity and the effective medullary cavity is divided equally, for example, referring to fig. 7, the division can be divided by 5-10, and a closed curve can be further constructed by dividing points on the spline curve at corresponding positions.
The construction method of the individualized femur short handle provided by the invention can comprise the following steps: the model of the individualized femur short handle is obtained through construction, and the closed curve can be generally laid out during construction so as to obtain the model of the individualized femur short handle. The skilled person can construct a model of the individualized femur short handle with a suitable shape according to each control point and the bisector on the spline curve, the section of the model of the individualized femur short handle is generally uniform, the section is generally taken based on the cone frustum axis and the femur mechanical axis L, and the individualized femur short handle is positioned at the control point T1The ends of the sides may be smooth spheres.
In a second aspect, the present invention provides a method for preparing a personalized femoral short stem, the method comprising: according to the construction method of the individual femur short handle provided by the first aspect of the invention, the obtained model of the individual femur short handle is constructed, and the individual femur short handle is prepared. The method for preparing the individualized femur short handle by the individualized femur short handle model is known to those skilled in the art, for example, when the individualized femur short handle is prepared, a 3D printing technology can be adopted, and more preferably, the 3D printing technology is EBM electron beam molten metal 3D printing technology, SLM selective laser melting 3D printing technology, and the like. The material used in the 3D printing technique may be any material suitable for manufacturing artificial joints in the art, for example, the material used in the 3D printing technique is selected from Titanium alloys, such as Cobalt chromium molybdenum alloys (e.g., Titanium Ti6Al4V, Titanium Ti6Al4V ELI, Titanium Grade 2, Cobalt Chrome, ASTM F75, etc.), and the like.
The invention provides a personalized short femoral stem, which is obtained by the construction method of the personalized short femoral stem provided by the first aspect or the preparation method of the personalized short femoral stem provided by the second aspect.
A fourth aspect of the invention provides a computer readable storage medium having stored thereon a computer program which, when executed by a processor, carries out the steps of the method for constructing a personalized femoral short stem provided in the first aspect of the invention or the steps of the method for preparing a personalized femoral short stem provided in the second aspect of the invention.
The individual short femoral stem constructed by the construction method of the individual short femoral stem provided by the invention can fully reserve bone mass, optimize stress transmission, reduce the pain of the thigh and facilitate later revision. Individualized thighbone short handle passes through the individuation design of handle body core region to make individualized short handle false body have better matching degree for the trabecular bone structure, thereby can avoid the false body position not hard up, make the initial stability of false body obtain improving, stress transfer obtains optimizing, thereby solved the defect that the handle body shortens probably to cause, and can compensate traditional non-bone cement handle not enough, reduce the stress and shelter from and complication such as thigh pain, improve postoperative hip joint function, the extension live time. Four contour curves are constructed on the personalized short femoral handle to realize matching of the handle body and a femoral medullary cavity, and the handle body is constructed in a manner of being tangent to the cortex of the medullary cavity, so that the personalized short femoral handle can realize transmission of a stress surface of the handle body along the direction of a femoral neck trabecular bone structure, and stress shielding of the short femoral handle and a femur can be reduced on the premise of improving excellent initial stability of the handle body.
The embodiments of the present invention are described below with reference to specific embodiments, and other advantages and effects of the present invention will be easily understood by those skilled in the art from the disclosure of the present specification. The invention is capable of other and different embodiments and of being practiced or of being carried out in various ways, and its several details are capable of modification in various respects, all without departing from the spirit and scope of the present invention.
Example 1
The construction of the individualized thighbone short handle mainly comprises 3D model reconstruction, mechanical axis establishment, handle body contour line generation, control point adjustment and entity composition. The specific method is as follows:
the surgical object was subjected to full-length CT scan of femur (siemens SOMATOM Definition Flash dual-source 128-layer CT scanner). The patient was rested on the examination table for rest within 20 minutes before scanning and was not subjected to any vigorous activity for 4 hours. Scanning parameters are as follows: 0.625mm thick, no space, 354 × 354mm field of view, 512 × 512 pixels resolution. The range is as follows: the superior iliac crest to the tibial tubercle. The creation of a 3D model of the femur from CT data using existing software is shown in figure 3. The center of the lesser trochanter is determined at the position of the lesser trochanter in the CT cross-sectional view, and the diameter of the circular ring is adjusted to be 16mm, so that the circular ring is tangent to the inner wall of the medullary cavity as shown in figure 2. A femur mechanical shaft is constructed on a femur 3D model, the position of a femoral stem in a medullary cavity is determined through the center of the mechanical shaft and the lesser trochanter, the femur mechanical shaft is constructed by adjusting and rotating a 3D model view, so that the greater trochanter at the upper end of the femur, the medial condyle and the lateral condyle at the lower end are on the same horizontal plane and are at the midpoint of the connecting line of the medial condyle and the lateral condyle, and the connecting line of the medial condyle and the lateral condyle is horizontal in the view as shown in figure 3.
In the two-dimensional CT cross section elevation handle body model, a point T is controlled at the center of the femoral medullary cavity isthmus part 60mm deep from the small trochanter1,T1Is connected with the center of the small rotorConstituting the medullary cavity axis L. .
The cone area is a circular table with a certain taper on the head of the handle body, the initial position of the center of a cone surface of a short femoral handle is determined to be at the center of the femoral head through the spatial position relation and anatomical relation between the center of the femoral head of a normal person and the center of a small trochanter, wherein the distance between the center of the cone surface and the small trochanter in the mechanical axis direction is 55mm, the distance between the center of the cone surface and the small trochanter in the parallel direction of two condyles is 50mm, the distance between the center of the cone surface and the small trochanter in the vertical direction is 5mm, the axis of a neck of the femoral handle is determined through the neck angle alpha of 127 degrees between the axis of the cone area and the axis of the femur, the cone area is formed by taking the center. Constructing a neck joint area, constructing Bezier curves by respectively corresponding upper, lower, left and right four points of the conical area to corresponding positions of the small rotors, wherein the lower side of the neck of the handle body is L1The outside of the neck is L2The upper side of the neck is L3The inner side of the neck is L4,T6The control point is determined for curve L1 by determining the control point 10 above the lesser trochanter so that it is on the femoral neck cortical surface (as shown) and so that it is tangent to the cortical surface at the tangent of that point, L1The intersection point with the small rotor is T2,T2Adjusting the matching condition of the handle body and the medullary cavity in the coronary position for the curve L1 by controlling L2L4At the same height as the control point, the tangent direction is vertical downward, and at L3Upper relative T6The height of the vertical tangent direction is increased to 10, so that the handle body has a larger area on a tensile stress surface to improve the fatigue performance. Forming a Bezier curve through each control point, dividing the upper part of the handle body into 20 equal parts, forming a closed curve by dividing 4 contour lines and the like, simultaneously dividing the lower part of the handle body into 10 equal parts, respectively surrounding each section at the equidistant positions of the other three curves into sections, and then lofting to form a solid handle, thereby forming a model for obtaining the individualized short femoral handle as shown in figure 7. And printing and molding by using an EBM or SLM printer.
Carrying out femoral operation on the patient by using the constructed individualized femoral short handle, and evaluating the operation effect of the individualized femoral short handle after the operation, wherein the specific evaluation information is as follows: in the transverse position direction of the medullary cavity, the outline of the handle body below the lesser trochanter is arranged in the medullary cavity, all curves at the position 60mm below the lesser trochanter are tangent with the inner wall of the medullary cavity, the surrounded outline curves are arranged in the medullary cavity, in the coronal position direction of the medullary cavity, the sections of the two sides of the handle body at the position 60mm below the lesser trochanter are tightly jointed with the inner part of the medullary cavity, the joint with the neck of the femur is perfect at the position 20mm above the lesser trochanter, and in the sagittal position direction of the medullary cavity, the outline of the handle body at the position 60mm below the lesser trochanter is.
In conclusion, the present invention effectively overcomes various disadvantages of the prior art and has high industrial utilization value.
The foregoing embodiments are merely illustrative of the principles and utilities of the present invention and are not intended to limit the invention. Any person skilled in the art can modify or change the above-mentioned embodiments without departing from the spirit and scope of the present invention. Accordingly, it is intended that all equivalent modifications or changes which can be made by those skilled in the art without departing from the spirit and technical spirit of the present invention be covered by the claims of the present invention.

Claims (10)

1. A construction method of an individualized femur short handle comprises the following steps:
1) establishing a femur 3D model;
2) constructing a femur mechanical axis L;
3) acquiring the section of an effective medullary cavity which is vertical to a femoral mechanical axis L and is over-small the central point of the trochanter;
4) constructing an intramedullary canal inscribed circle on the section of the effective intramedullary canal by taking the intersection point of the femur mechanical axis L and the section as the circle center;
5) establishing a three-dimensional coordinate system by taking a femoral mechanical shaft L as a first axis, taking a connection line of two condyles of a medial condyle and a lateral condyle as a second axis and taking a third axis perpendicular to the first axis and the second axis;
6) construction of control points T2And a control point T4Said control point T2And a control point T4The intersection point of the second axis direction passing through the center of the intramedullary canal inscribed circle and the intramedullary canal inscribed circle is the control point T2Located inside the mechanical axis L of the bone, T4Outside the mechanical axis L of the bone;
7) construction of control points T3And a control point T5Said control point T3And a control point T5The intersection point of the third axis direction passing through the center of the intramedullary canal inscribed circle and the intramedullary canal inscribed circle is the control point T3On the posterior side of the mechanical axis L of the bone, T5On the anterior side of the mechanical axis L of the bone;
8) construction of control points T1Said control point T1Below the section of the effective medullary cavity and on the mechanical axis L of the femur;
9) construction of control points T6Said control point T6The rotor is positioned 10-50 mm above the small rotor;
10) constructing the circle center of an upper table top of a circular table in a conical area, wherein the circle center of the upper table top is 20-60 mm away from a first axis L40, the circle center of the upper table top is 20-60 mm away from a second axis, and the distance between the circle center of the upper table top and a third axis is less than or equal to 20 mm;
11) constructing a cone-shaped area circular truncated cone axis, wherein the included angle between the cone-shaped area circular truncated cone axis and the projection of the first axis on the plane where the first axis and the second axis are located is 100-150 degrees, and the included angle between the cone-shaped area circular truncated cone axis and the projection of the second axis on the plane where the second axis and the third axis are located is 12-15 degrees;
12) constructing a cone-shaped area circular table according to the center of the upper table top of the cone-shaped area circular table and the axis of the cone-shaped area circular table, wherein the diameter of the upper table top circular surface of the cone-shaped area circular table is 11-14 mm, the height of the cone-shaped area circular table is 11-19 mm, and the taper of the cone-shaped area circular table is 5.67-5.68 mm;
13) construction of control points L1And a control point L3Said control point L1And a control point L3The control point L is the intersection point of a plane passing through the center of the upper table top of the circular truncated cone and being parallel to the plane where the first axis and the second axis are positioned and the edge of the lower table top of the circular truncated cone1Is located at the inner side of the axis of the cone area, and the control point L3The cone is positioned at the outer side of the axis of the cone area;
14) construction of control points L2And a control point L4Said control point L2And a control point L4The connecting line is positioned on the lower table-board of the circular table andpassing through the center of the lower table top of the circular truncated cone and connecting with a control point L1And a control point L3Is perpendicular to the line of the control point L2Is positioned at the rear side of the axis of the cone-shaped area of the circular truncated cone, and the control point L4The front side of the axis of the cone area;
15) respectively at control points T1And a control point T2Control point T1And a control point T3Control point T1And a control point T4Control point T1And a control point T5Constructing a Bezier curve;
16) respectively at control points L1And a control point T2Control point L2And a control point T3Control point L3And a control point T4Control point L4And a control point T5A Bezier curve is constructed in which T6Is a control point L1And a control point T2Control points on the curve in between;
17) equally dividing spline curves between the lower table top of the circular truncated cone and the section of the effective medullary cavity, and constructing a closed curve corresponding to each section of equally divided point;
18) will control point T1Equally dividing spline curves between the effective medullary cavity and the sections of the effective medullary cavity, and constructing a closed curve corresponding to each section of equally divided points;
19) and constructing a model for obtaining the individualized femur short handle.
2. The method for constructing an individualized femoral stem according to claim 1, wherein in the step 4), the intramedullary canal inscribed circle has three tangent points with the inner wall of the intramedullary canal.
3. The method for constructing an individualized femoral stem according to claim 1, wherein in the step 5), the first axis is a z-axis, the second axis is an x-axis, and the third axis is a y-axis in the three-dimensional stereo coordinate system.
4. The method for constructing an individualized femoral stem according to claim 1, wherein in the step 8), the control point T1 is that the mechanical axis L of the femur is 40 mm-150 mm below the section of the effective medullary cavity.
5. The method for constructing an individualized femoral stem insert according to claim 1, wherein in step 11), the tapered region frustoconical upper table is smaller than the tapered region frustoconical lower table.
6. The method of claim 1, wherein the cross-section of the individual femoral stem is uniformly varied.
7. The method of claim 1, wherein the individualized femoral stem is located at a control point T1The end of the side is a smooth sphere.
8. A method of preparing a personalized femoral stem, the method comprising: constructing a model of the obtained individualized femur short handle according to the construction method of the individualized femur short handle as claimed in any one of claims 1-7, and preparing the individualized femur short handle.
9. A personalized femoral short handle, which is obtained by the construction method of the personalized femoral short handle as claimed in any one of claims 1 to 7 or the preparation method of the personalized femoral short handle as claimed in claim 8.
10. A computer-readable storage medium, on which a computer program is stored, which program, when being executed by a processor, carries out the steps of the method for constructing a personalized femoral short stem according to any one of claims 1 to 7 or the steps of the method for preparing a personalized femoral short stem according to claim 8.
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