CN114343922B - Digital total hip joint replacement device - Google Patents

Digital total hip joint replacement device Download PDF

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Publication number
CN114343922B
CN114343922B CN202210152004.6A CN202210152004A CN114343922B CN 114343922 B CN114343922 B CN 114343922B CN 202210152004 A CN202210152004 A CN 202210152004A CN 114343922 B CN114343922 B CN 114343922B
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China
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angle
module
abduction
anteversion
shaft
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CN114343922A (en
Inventor
郭楚
徐晓龙
陈一平
王聿栋
刘梦星
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Wuhan Mindray Technology Co Ltd
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Wuhan Mindray Technology 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
    • A61F2/34Acetabular cups
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/06Measuring instruments not otherwise provided for
    • 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
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4609Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of acetabular cups
    • 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
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4644Preparation of bone graft, bone plugs or bone dowels, e.g. grinding or milling bone material
    • 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
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4684Trial or dummy prostheses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/06Measuring instruments not otherwise provided for
    • A61B2090/067Measuring instruments not otherwise provided for for measuring angles
    • 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
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4632Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using computer-controlled surgery, e.g. robotic surgery
    • 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
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4632Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using computer-controlled surgery, e.g. robotic surgery
    • A61F2002/4633Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using computer-controlled surgery, e.g. robotic surgery for selection of endoprosthetic joints or for pre-operative planning

Abstract

The application provides a digital total hip replacement device and a calibration method of abduction angle and anteversion angle thereof, wherein the device comprises: a shaft having a working end and an operating end; the angle detection module is arranged on the shaft, is positioned between the working end and the operating end, and is used for determining an angle reference and detecting the abduction angle and the anteversion angle of the shaft relative to the angle reference in real time; the posture tracking module is used for being fixed on a skeleton of a patient so as to detect an angle deviation value of the patient posture relative to an angle reference in real time; the data processing module is in signal connection with the angle detection module and the body position tracking module respectively, and is used for acquiring the abduction angle and the anteversion angle, acquiring the angle deviation value, and calibrating the abduction angle and the anteversion angle based on the angle deviation value to obtain a calibrated abduction angle and a calibrated anteversion angle; and the prompting module is in signal connection with the data processing module and is used for acquiring the corrected abduction angle and anteversion angle and displaying the corrected abduction angle and anteversion angle to an operator.

Description

Digital total hip joint replacement device
Technical Field
The application relates to the field of medical instruments, in particular to a digital total hip joint replacement device and a method for calibrating an abduction angle and an anteversion angle thereof.
Background
At present, in a plurality of operation steps in a basic process of the total hip replacement surgery, such as acetabulum grinding, acetabulum outer cup test punching, acetabulum outer cup prosthesis punching and the like, the validity of results is ensured purely by means of tools of mechanical structures and subjective experiences of operators, such as whether the abduction angle and the anteversion angle of the outer cup test punching and the prosthesis are accurate, the stability of the outer cup test punching, whether the outer surface of the outer cup test punching and the acetabulum are tightly attached and the like. However, the surgical skills and subjective experiences of different operators are different, which results in different postoperative recovery effects of patients, and even results in a series of postoperative problems such as irregular limb state, limited range of motion, easy dislocation of prosthesis, shortened prosthesis life, and the like.
In recent years, surgical robot solutions and visual navigation systems for total hip replacement have appeared on the market, and the most widely used Mako robot belongs to the Stryker company. The Mako robot solution adopts binocular camera vision tracking system, utilizes the supplementary steps such as accomplishing acetabular bone polishing, putting into acetabular bone outer cup prosthesis of arm, has advantages such as control stability, angle are accurate, execution are quick, can greatly satisfy clinical demand.
However, the surgical robotic system greatly changes the daily operation habit of the operator, wherein the process of registering the vision system with the preoperative CT image is very time-consuming (the Mako robot registering step occupies 15-20 minutes of the attending operator on average), and the robot and the trolley of the navigation system greatly occupy the space of the operating room, so that the operating room with an originally tense area is extraordinarily crowded. Therefore, the surgical robot system with high price is difficult to greatly help the operator of the Chinese total hip replacement, so the surgical robot system is not widely popularized and used in China.
Disclosure of Invention
The application provides a digital total hip replacement device, aiming at solving the problem that the existing total hip replacement device can not be accurately positioned.
The present application is achieved as such, providing a digital total hip joint replacement device, including the axle, the axle has work end and operation end, the work end with the operation end is located respectively the relative both ends of axle, digital total hip joint replacement device still includes:
the angle detection module is arranged on the shaft, is positioned between the working end and the operating end and is used for determining an angle reference, wherein the angle reference comprises an abduction angle reference plane and an anteversion angle reference plane, and the angle detection module is also used for detecting the abduction angle and the anteversion angle of the shaft relative to the angle reference in real time;
the body position tracking module is used for fixing the body position tracking module on a bone of a patient so as to detect an angle deviation value of the body position of the patient relative to the angle reference in real time;
the data processing module is in signal connection with the angle detection module and the body position tracking module respectively, and is used for acquiring an abduction angle and an anteversion angle of the shaft relative to the angle reference, which are detected by the angle detection module in real time, and acquiring an angle deviation value of the body position of the patient relative to the angle reference, which is detected by the body position tracking module in real time; calibrating the abduction angle and the forward inclination angle based on the angle deviation value to obtain a calibrated abduction angle and a calibrated forward inclination angle; and
and the prompting module is in signal connection with the data processing module and is used for acquiring the abduction angle and the anteversion angle after calibration and displaying the abduction angle and the anteversion angle after calibration to an operator.
Optionally, in some embodiments of the present application, the angle detection module includes a first inertial sensing unit, and the first inertial sensing unit is in signal connection with the data processing module, and is configured to determine the angle reference and detect the abduction angle and the anteversion angle of the shaft relative to the angle reference in real time.
Optionally, in some embodiments of the application, the angle detection module further comprises a level gauge configured to measure an inclination angle of 0 degrees when the axis of the shaft is horizontal, for cooperating with the shaft and the first inertial sensing unit to determine the abduction angle reference plane.
Optionally, in some embodiments of the present application, the posture tracking module includes a second inertial sensing unit, and the second inertial sensing unit is configured to detect an angular deviation value of the patient posture relative to the angular reference in real time.
Optionally, in some embodiments of the present application, the digital total hip replacement device further comprises a k-wire for fixing the posture tracking module to the patient's bone.
Optionally, in some embodiments of the present application, the digital total hip replacement device is used for driving an acetabular cup trial into an acetabulum, the acetabular cup trial being detachably mounted on a working end of the shaft, and the digital total hip replacement device further comprises:
the pressure sensing module is arranged on a cup body of the acetabulum outer cup test mold and used for detecting the pressure value born by the cup body in real time;
the pressure sensing module is in signal connection with the data processing module, and the data processing module is further used for acquiring a pressure value detected by the pressure sensing module and processing the pressure value to obtain a processed pressure value;
the prompt module is further used for acquiring the processed pressure value and displaying the processed pressure value to an operator.
Optionally, in some embodiments of the present application, the pressure sensing module includes a plurality of pressure sensors, and the plurality of pressure sensors are configured to detect pressure values borne by the cup body at the position of the pressure sensor respectively;
the data processing module is in signal connection with the pressure sensors respectively and is used for acquiring a plurality of pressure values detected by the pressure sensors and processing the pressure values to obtain the maximum pressure value; the prompt module is used for acquiring the maximum pressure value and displaying the maximum pressure value; or
The data processing module is in signal connection with the pressure sensors respectively and is used for acquiring a plurality of pressure values detected by the pressure sensors and analyzing the pressure values to obtain the number of the pressure values with the same size; the prompting module is used for acquiring the number of the pressure values with the same size and displaying the number of the pressure values with the same size and the total number of the pressure sensors.
Optionally, in some embodiments of the present application, the prompting module includes:
the display screen is used for displaying the corrected abduction angle and anteversion angle or the processed pressure value; and/or
And the voice prompter is used for voice broadcasting the corrected abduction angle and anteversion angle or the processed pressure value.
Optionally, in some embodiments of the present application, the display screen is a HUD head-up display screen.
Optionally, in some embodiments of the present application, the digital total hip replacement device further includes a housing, the housing is detachably mounted on the shaft and is located between the working end and the operating end, the angle detection module and the data processing module are integrated in the housing, and the prompting module is integrated in the housing or disposed on an outer surface of the housing.
Accordingly, embodiments of the present application also provide a method for calibrating abduction and anteversion angles of a digital total hip replacement device, the device including a shaft having a working end and an operating end, the working end and the operating end being located at opposite ends of the shaft, respectively, the method including:
determining an angle reference, wherein the angle reference comprises an abduction angle reference plane and an anteversion angle reference plane;
acquiring real-time abduction and anteversion angles of the shaft relative to the angular reference;
acquiring a real-time angle deviation value of the body position of the patient relative to the angle reference;
and calibrating the abduction angle and the anteversion angle based on the angle deviation value to obtain the calibrated abduction angle and the calibrated anteversion angle.
Optionally, in some embodiments of the present application, the method for determining the angle reference includes:
and (3) putting the patient in a position that the longitudinal axis of the patient is parallel to the horizontal plane, enabling the axis of the shaft to be parallel to the longitudinal axis direction of the patient, enabling the horizontal plane where the current position of the shaft is located to be an abduction angle reference plane, and enabling the plane where the current position of the shaft is located to be a forward inclination angle reference plane, so as to obtain the angle reference.
The digital total hip joint replacement device comprises an angle detection module, a body position tracking module, a data processing module and a prompting module, wherein the angle detection module can detect the abduction angle and the anteversion angle of a shaft, or an acetabulum outer cup test mold, or an acetabulum outer cup prosthesis, or an acetabulum file in real time, so that the positioning of the acetabulum outer cup test mold, the acetabulum outer cup prosthesis and the acetabulum file is more accurate; the position tracking module can real-time detection patient position for the angle deviation value of angle basis, the data processing module can be based on the angle deviation value is right abduction angle and anteversion angle calibrate, obtain abduction angle and anteversion angle after the calibration to show for the operator through the tip module, in order to provide the reference, so, can make the operator obtain accurate abduction angle and anteversion angle in real time, be favorable to hip joint replacement operation to obtain better operation effect. In addition, the digital total hip replacement device further comprises a pressure sensing module, the pressure sensing module is matched with the data processing module, so that the original shaking force and gap detection qualitative feeling of an operator on the acetabular outer cup test mold can be converted into quantitative values, and the quantitative values are displayed to the operator through the prompting module, so that reference is provided, the operator is helped to better complete acetabular grinding effect inspection, inspection results are more accurate, and the standardization of a total hip replacement surgery process is helped to be realized.
Drawings
In order to more clearly illustrate the technical solutions in the embodiments of the present application, the drawings required to be used in the description of the embodiments are briefly introduced below, and it is obvious that the drawings in the description below are only some embodiments of the present application, and it is obvious for those skilled in the art to obtain other drawings based on these drawings without creative efforts.
FIG. 1 is a schematic diagram of a digital total hip replacement device according to an embodiment of the present application;
FIG. 2 is a schematic diagram showing the positions and connections of the angle detection module, the posture tracking module, the data processing module, the prompt module and the pressure sensing module of the digital total hip replacement device shown in FIG. 1;
FIG. 3 is a schematic view of an acetabular outer cup trial of an embodiment of the application;
fig. 4 is a flowchart of a method for calibrating abduction and anteversion angles of a digital total hip replacement device according to an embodiment of the present application.
Detailed Description
The technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are only a part of the embodiments of the present application, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present application. Furthermore, it should be understood that the detailed description and specific examples, while indicating exemplary embodiments of the invention, are given by way of illustration and explanation only, and are not intended to limit the scope of the invention.
In the description of the present application, it should be noted that the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", and the like indicate orientations or positional relationships based on orientations or positional relationships shown in the drawings, and are only for convenience of description and simplification of description, but do not indicate or imply that the device or element referred to must have a particular orientation, be constructed in a particular orientation, and operate, and thus should not be construed as limiting the present application. Furthermore, the terms "first" and "second" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance. The term "plurality" refers to two or more.
In the description of the present application, it should be noted that unless otherwise explicitly stated or limited, the terms "mounted," "connected," and "connected" are to be construed broadly, and may include, for example, a fixed connection, a detachable connection, or an integral connection; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meaning of the above terms in the present application can be understood in a specific case by those of ordinary skill in the art.
Referring to fig. 1, the present application provides a digital total hip replacement device 100 for use in total hip replacement surgery.
The digital total hip replacement device 100 includes a shaft 10. The shaft 10 has a working end 11 and an operating end 12, the working end 11 and the operating end 12 being located at opposite ends of the shaft 10, respectively. The working end 11 is used for installing an acetabular cup trial 30 (refer to fig. 3), an acetabular cup prosthesis or an acetabular file into the acetabulum of a patient, in other words, when the acetabular cup trial 30 needs to be driven into the acetabulum, the acetabular cup trial 30 is installed on the working end 11; when the acetabular outer cup prosthesis needs to be installed in the acetabulum, the acetabular outer cup prosthesis is installed at the working end 11; when the acetabulum needs to be ground, an acetabulum file is installed at the working end 11.
Referring to fig. 2, the digital total hip replacement device 100 further includes a housing 20, an angle detection module 21, a posture tracking module 22, a data processing module 23, and a prompt module 24. The housing 20 is removably mounted on the shaft 10 between the working end 11 and the operating end 12. The angle detection module 21 and the data processing module 23 are integrated in the housing 20, and the prompt module 24 is integrated in the housing 20 or disposed on an outer surface of the housing 20.
Angle detection module 21 is used for confirming an angle benchmark, the angle benchmark includes abduction angle reference surface and anteversion angle reference surface, angle detection module 21 is still used for real-time detection axle 10 is for the abduction angle and the anteversion angle of angle benchmark.
The posture tracking module 22 is configured to be fixed on a bone of a patient to detect an angular deviation value of the patient's posture relative to the angular reference in real time.
The data processing module 23 is in signal connection with the angle detection module 21 and the posture tracking module 22, and is configured to acquire an abduction angle and an anteversion angle of the shaft 10 relative to the angle reference, which are detected by the angle detection module 21 in real time, and acquire an angle deviation value of the patient posture relative to the angle reference, which is detected by the posture tracking module 22 in real time; and calibrating the abduction angle and the anteversion angle based on the angle deviation value to obtain the calibrated abduction angle and the calibrated anteversion angle.
The prompt module 24 is in signal connection with the data processing module 23, and is configured to acquire the calibrated abduction angle and anteversion angle and display the calibrated abduction angle and anteversion angle to an operator. It is understood that the "display" and all "displays" in this application can be any means such as display or voice broadcast that can make the operator obtain the information transmitted from the data processing module 23.
In one embodiment, the housing 20 has a mounting portion 201, and the mounting portion 201 is provided with a mounting hole 2011. The shaft 10 is inserted into the mounting hole 2011, so that the housing 20 is mounted on the shaft 10.
The angle detection module 21 includes a first inertial sensing unit 212 in signal connection with the data processing module 23. The first inertial sensing unit 212 is used to determine the angular reference. The first inertial sensing unit 212 is further configured to detect the abduction angle and the anteversion angle of the current position of the shaft 10 relative to the angle reference in real time, that is, the abduction angle of the current position of the shaft 10 relative to the abduction angle reference plane and the anteversion angle relative to the anteversion angle reference plane, and transmit the abduction angle and the anteversion angle to the data processing module 23 in real time.
The angle detection module 21 further comprises a level gauge 211, and the level gauge 211 is in signal connection with the data processing module 23. The level gauge 211 may detect the angle of inclination of the shaft 10 relative to the horizontal. The data processing module 23 is further in signal connection with the level gauge 211, and is configured to acquire an inclination angle of the shaft 10 detected by the level gauge 211 relative to a horizontal plane, and transmit the inclination angle to the prompt module 24, where the prompt module 24 is configured to acquire and display the inclination angle. The level gauge 211 is configured such that the inclination angle measured when the axis of the shaft 10 is horizontal is 0 degree. The level gauge 211 is also used to cooperate with the shaft 10 and the first inertial sensing unit 212 to determine the abduction angle reference plane.
In an embodiment, the data processing module 23 is configured to set a desired abduction angle and an anteversion angle, and when the calibrated abduction angle and anteversion angle of the current position of the shaft 10 obtained by the data processing module 23 relative to the angle reference are different from the desired abduction angle and anteversion angle, the prompting module 24 is configured to display values of the abduction angle and the anteversion angle in red and/or send a warning sound to remind an operator that the shaft 10 has not rotated to the desired position (angle) and needs to rotate continuously; when the calibrated abduction and anteversion angles of the current position of the shaft 10 obtained by the data processing module 23 with respect to the angular reference are the same as the expected abduction and anteversion angles, the prompting module 24 is configured to change the displayed values of abduction and anteversion angles to green and/or emit a warning tone to alert the operator that the shaft 10 has been rotated to the expected position, and may stop the rotation for subsequent operations.
In an embodiment, the method for determining the angle reference includes: before an operation, a patient is in a lateral recumbent position on an operating table, at the moment, the longitudinal axis (head and foot direction) of the patient is in a horizontal position (namely, the longitudinal axis of the patient is parallel to a horizontal plane), the shaft 10 of the digital total hip joint replacement device 100 is adjusted to be that the axis of the shaft 10 is parallel to the longitudinal axis of the patient, the gradienter 211 measures the inclination angle of the shaft 10 in real time, when the axis of the shaft 10 is in the horizontal position, the measurement value of the gradienter 211 is 0 degree, at the moment, the prompting module 24 can remind an operator that the axis of the current shaft 10 is completely parallel to the longitudinal axis of the patient in a highlighting and/or buzzing mode, the operator can set the horizontal plane of the current position of the shaft 10 of the digital total hip joint replacement device 100 in a key pressing mode and the like to be an abduction angle reference plane, the plane of the current position of the shaft 10 is an anteversion angle reference plane parallel to the coronal plane of the patient, namely the angle reference is obtained, and at the prompting module 24 shows that the abduction angle and the anteversion angle of the current position of the shaft 10 of the digital total hip joint replacement device 100 are both 0 degree.
The body position tracking module 22 comprises a base 221, a fixation component 222 and a second inertial sensing unit 223. The second inertial sensing unit 223 is integrated within the base 221 and the fixation component 222 is configured to fix the base 221 to bone surrounding the acetabulum of the patient. The position tracking module 22 is used to fix the patient to the bone around the acetabulum of the patient before the intraoperative operation when the position of the patient has not changed. The second inertial sensing unit 223 of the posture tracking module 22 can detect an angular deviation value of the patient's posture relative to the angular reference in real time during the operation, and transmit the angular deviation value to the data processing module 23 in real time.
In at least one embodiment, the fixation component 222 is a k-wire.
As an example, the angular offset values may include 3 angular offset values (R, P, Y) of a rotation angle R of the patient about its longitudinal axis, a rotation angle P about its left-right axis, and a rotation angle Y about its anterior-posterior axis, respectively. First inertial sensing unit 212 measures abduction angle I and anteversion angle A of axle 10 current position for the angle benchmark in real time, and will abduction angle I and anteversion angle A transmit for data processing module 23 through wireless communication modes such as bluetooth or wiFi, simultaneously position tracking module 22 real-time detection (tracking) the angle deviation value (R, P, Y) of patient's position change to will through wireless communication modes such as bluetooth or wiFi the angle deviation value transmits for data processing module 23. The data processing module 23 may calculate the exact abduction angle and anteversion angle of the current position of the shaft 10 after changing relative to the patient body position based on the space geometry and the trigonometric function, and obtain the corrected abduction angle and anteversion angle. For example, if the patient posture change only includes the rotation angle R around the longitudinal axis direction thereof, the current position of the shaft 10 is calculated in a manner of I '= I, a' = a + R, respectively, with respect to the accurate abduction angle I 'and anteversion angle a' after the patient posture change; if the patient posture change includes only the rotation angle P about the left-right axis direction thereof, the current position of the shaft 10 is calculated as I '= arccos (cosIcosP) and a' = arccos (cosAcosP), respectively, with respect to the accurate abduction angle I 'and anteversion angle a' after the patient posture change; if the patient posture change only includes the rotation angle Y around the longitudinal axis direction of the patient, the calculation methods of the current position of the shaft 10 with respect to the accurate abduction angle I 'and anteversion angle a' after the patient posture change are I '= I + Y and a' = a, respectively.
It is understood that the first inertial sensing unit 212 and the second inertial sensing unit 223 may be inertial sensors.
Referring further to fig. 3, the digital total hip replacement device 100 is used to drive an acetabular cup mold 30 into an acetabulum, wherein the acetabular cup mold 30 is removably mounted to the working end 11 of the shaft 10. The digital total hip replacement device 100 further comprises a pressure sensing module 25. The pressure sensing module 25 is arranged on the cup body 301 of the acetabular outer cup test mold 30 and used for detecting the pressure value borne by the cup body 301 in real time.
The pressure sensing module 25 is in signal connection with the data processing module 23, the data processing module 23 is further configured to acquire the pressure value detected by the pressure sensing module 25, process the pressure value to obtain a processed pressure value, and the prompt module 24 is further configured to acquire the processed pressure value and display the processed pressure value to an operator.
The pressure sensing module 25 includes a plurality of pressure sensors 251, and the pressure sensors 251 are used for respectively detecting pressure values borne by the cup 301 in the positions where the pressure sensors 251 are located.
The pressure sensors 251 are arranged on the cup body 301 of the acetabular outer cup trial mold 30 at intervals, and each pressure sensor 251 is used for detecting the pressure value borne by the cup body 301 at the position of the pressure sensor 251. The data processing module 23 is in signal connection with the pressure sensors 251, and is configured to acquire a plurality of pressure values detected by the pressure sensors 251, process the pressure values to obtain processed pressure values, and the prompt module 24 is further configured to acquire the processed pressure values and display the processed pressure values to an operator.
In one embodiment, the total number of the pressure sensors 251 is 3, and the 3 pressure sensors 251 are arranged at equal intervals along the circumferential direction of the cup body 301.
It is understood that the plurality of pressure sensors 251 may be disposed on the inner wall or the outer wall of the cup 301 of the acetabular cup trial 30, or may be embedded in the cup 301 of the acetabular cup trial 30.
After the digital total hip replacement device 100 drives the outer acetabular cup test mold 30 into the acetabulum and shakes the shaft 10 of the digital total hip replacement device 100, the pressure sensing module 25 is used for detecting a plurality of pressure values borne by the cup body 301 in real time through the plurality of pressure sensors 251, the data processing module 23 is used for acquiring the plurality of pressure values and analyzing the plurality of pressure values to obtain a maximum pressure value, and the prompting module 24 is used for acquiring the maximum pressure value and displaying the maximum pressure value for reference of an operator. Therefore, the qualitative feeling of the original shaking force of the operator can be converted into a quantitative value, the operator is helped to finish the examination of the acetabular grinding effect better, the examination result is more accurate, the acetabular outer cup test model 30 is helped to be stably fixed in the acetabulum, and the standardization of the total hip replacement surgery process is helped to be realized.
After the acetabular outer cup trial mold 30 is fixed in the acetabulum, the pressure sensing module 25 is configured to detect a plurality of pressure values borne by the cup body 301 in real time through the plurality of pressure sensors 251, the data processing module 23 is configured to acquire the plurality of pressure values of the plurality of pressure sensors 251 detected by the pressure sensing module 25 in real time and analyze the plurality of pressure values to obtain the number of pressure values with the same size, and the prompting module 24 is configured to acquire the number of pressure values with the same size and display the number of pressure sensors 251 with the same pressure value (i.e., the number of pressure values with the same size) and the total number of the plurality of pressure sensors 251 for reference of an operator. If the total number of the pressure sensors 251 is different from the number of the pressure sensors 251 with the same pressure value, it indicates that there is a gap between the acetabular cup trial 30 and the acetabulum and the fit is not complete, and an operator is required to take surgical remedial measures, such as re-polishing the acetabulum. Therefore, qualitative feeling of the gap detection of the acetabular outer cup test mold 30 can be converted into quantitative values, an operator can be helped to finish the acetabular grinding effect detection better, the detection result is more accurate, the acetabular outer cup test mold 30 can be helped to be stably fixed in an acetabulum, and the standardization of a total hip replacement surgery process can be helped to be realized.
It is understood that, when the total number of the pressure sensors 251 is different from the number of the pressure sensors 251 with the same pressure value, the data displayed by the prompting module 24 may be red or the prompting module 24 may send a prompt sound to prompt a warning.
The prompting module 24 includes a display screen and/or a voice prompt. The display screen is used for displaying the calibrated abduction angle and anteversion angle transmitted by the data processing module 23, the processed pressure value and other information. The voice prompter is used for voice broadcasting the corrected abduction angle and anteversion angle transmitted by the data processing module 23, the processed pressure value and other information.
The display screen may be a HUD head-up display screen (i.e., a head-up display) disposed on the shaft, or an external (i.e., not disposed on the shaft 10) separate display screen or VR glasses connected to the data processing module 23 via wireless signals. In at least one embodiment, the prompt module 24 is a HUD head-up display screen, so that the operator can conveniently view the surgical site during the surgical procedure without obstructing the surgical field.
By way of example, in using the digital total hip replacement device 100, the procedure is as follows:
firstly, the preoperative planning of the acetabular cup prosthesis is completed based on the CT image of the pelvis of the patient, the expected abduction angle and anteversion angle of the acetabular cup prosthesis are obtained, and the expected abduction angle and anteversion angle are input into the data processing module 23 of the digital total hip replacement device 100 in a wireless mode or a manual key mode.
The patient is placed on the operation table in a lateral recumbent position, and the position tracking module 22 is fixed on the bone around the acetabulum of the patient on the affected side.
The digital total hip joint replacement device 100 is adjusted to be that the axis of the shaft 10 is parallel to the longitudinal axis direction (head and foot direction) of the patient, at this time, the longitudinal axis of the patient is in a horizontal position, the level 211 measures the inclination angle of the shaft 10 in real time, the measurement value of the level 211 changes to 0 degree when the axis of the shaft 10 is in the horizontal position, at this time, the prompt module 24 can remind an operator that the axis of the current shaft 10 is completely parallel to the longitudinal axis of the patient in a highlight and/or buzzing mode, and the like, the operator sets the horizontal plane where the current position of the shaft 10 of the digital total hip joint replacement device 100 is located as an abduction angle reference plane through a key and the like, the plane where the current position of the shaft 10 is parallel to the coronal plane of the patient is an anteversion angle reference plane, that is the angle reference of the first inertial sensing unit 212, and at this time, the prompt module 24 shows that the abduction angle and the anteversion angle of the current position of the shaft 10 of the digital total hip joint replacement device 100 are both 0 degree.
After polishing of the acetabulum is completed, the acetabulum outer cup test mold 30 is installed at the working end 11 of the shaft 10, then the acetabulum outer cup test mold 30 is placed into the acetabulum, the shaft 10 is rotated, the abduction angle and the anteversion angle of the acetabulum outer cup test mold 30 are detected in real time by the first inertia sensing unit 212 of the angle detection module 21, the data processing module 23 acquires the abduction angle and the anteversion angle in real time and calibrates the abduction angle and the anteversion angle to obtain a calibrated abduction angle and an anteversion angle, and the prompt module 24 acquires and displays the calibrated abduction angle and the calibrated anteversion angle in real time. It will be appreciated that during this process, the calibration is zero calibration since the patient position has not changed.
In this process, if the body position of the patient changes, the second inertial sensing unit 223 of the body position tracking module 22 detects an angle deviation value of the body position of the patient relative to the change of the angle reference in real time, and wirelessly transmits the angle deviation value to the data processing module 23 in real time. The data processing module 23 calculates the accurate abduction angle and anteversion angle of the current position of the shaft 10 relative to the changed body position of the patient based on the space geometry and the trigonometric function to obtain the corrected abduction angle and anteversion angle, and the prompt module 24 acquires and displays the corrected abduction angle and anteversion angle for the reference of the operator.
In this process, if the corrected abduction angle and anteversion angle of the current position of the shaft 10 obtained by the data processing module 23 relative to the angle reference are different from the expected abduction angle and anteversion angle, the numerical values of the abduction angle and the anteversion angle displayed by the prompting module 24 are red or a warning sound is emitted to remind an operator that the shaft 10 is not rotated to the expected position (angle) and needs to be rotated continuously; if the calibrated abduction and anteversion angles of the current position of the shaft 10 obtained by the data processing module 23 with respect to the angular reference are the same as the expected abduction and anteversion angles, the values of abduction and anteversion angles displayed by the prompting module 24 are changed to green and/or a warning tone is emitted to remind the operator to stop rotating and drive the acetabular cup trial 30 into the acetabulum.
Shaking the shaft 10, detecting pressure values borne by the cup body 301 at the position of the pressure sensor module 25 in real time by the pressure sensors 251 of the pressure sensor module 25, and acquiring a plurality of pressure values detected by the pressure sensors 251 and analyzing the pressure values to obtain a maximum pressure value by the data processing module 23; the prompt module 24 obtains the maximum pressure value and displays the maximum pressure value for reference by an operator.
Fixing the acetabulum outer cup test mold 30 in the acetabulum, and receiving a plurality of pressure values detected by a plurality of pressure sensors 251 of the pressure sensing module 25 in real time by the data processing module 23, and analyzing the plurality of pressure values to obtain the number of pressure values with the same size; the prompting module 24 obtains the number of pressure values with the same size, and displays the total number of the pressure sensors 251 and the number of the pressure sensors 251 with the same pressure value for reference of an operator. If the total number of the pressure sensors 251 is different from the number of the pressure sensors 251 with the same pressure value, it indicates that there is a gap between the acetabular outer cup trial 30 and the acetabulum and the gap is not completely fitted, and an operator is required to take surgical remedial measures, such as re-polishing the acetabulum.
When the acetabular outer cup trial 30 can be completely and stably fitted in the acetabulum, the grinding effect of the acetabulum is better, the acetabular outer cup trial 30 can be taken out, and the acetabular outer cup prosthesis can be driven into the acetabulum by using the same method for driving the acetabular outer cup trial 30 into the acetabulum.
The methods for calibrating the abduction angle and the anteversion angle of the digital total hip replacement device are further described below.
Referring further to fig. 4, the present application further relates to a method for calibrating abduction angle and anteversion angle of a digital total hip replacement device, comprising:
determining an angle reference, wherein the angle reference comprises an abduction angle reference plane and an anteversion angle reference plane;
acquiring real-time abduction and anteversion angles of the shaft 10 relative to the angular reference;
acquiring a real-time angle deviation value of the body position of the patient relative to the angle reference;
and calibrating the abduction angle and the anteversion angle based on the angle deviation value to obtain the calibrated abduction angle and the calibrated anteversion angle.
The angle detection module 21 determines the angle reference, and the specific method is as described above and is not described herein again.
The real-time abduction angle and anteversion angle of the shaft 10 relative to the angle reference are obtained by the angle detection module 21, and the specific method is as described above and is not described herein again.
The real-time angle deviation value of the body position of the patient relative to the angle reference is obtained by the body position tracking module 22, and the specific method is as described above and is not described herein again.
The data processing module 23 calibrates the abduction angle and the anteversion angle based on the angle deviation value to obtain a calibrated abduction angle and an anteversion angle, and the specific method is as described above and is not described herein again.
In some embodiments, after obtaining the calibrated abduction angle and anteversion angle, further comprising: displaying the calibrated abduction angle and anteversion angle to an operator.
The corrected abduction angle and anteversion angle are displayed to the operator through the prompting module 24, and the specific method is as described above and is not described herein again.
The digital total hip replacement device 100 of the present application comprises the angle detection module 21, the posture tracking module 22, the data processing module 23 and the prompt module 24. The angle detection module 21 can detect the abduction angle and the anteversion angle of the shaft 10, the acetabular cup trial 30, the acetabular cup prosthesis or the acetabular file in real time, so that the positioning of the acetabular cup trial 30, the acetabular cup prosthesis and the acetabular file is more accurate; position tracking module 22 can real-time detection patient position for the angle deviation value of angle benchmark, data processing module 23 can be based on the angle deviation value, right abduction angle and anteversion angle calibrate, obtain abduction angle and anteversion angle after the calibration to demonstrate for the operator through suggestion module 24, in order to provide the reference. In addition, the digital total hip replacement device 100 further comprises a pressure sensing module 25, the pressure sensing module 25 and the data processing module 23 are matched to convert the original shaking force and gap detection qualitative feelings of the acetabulum outer cup test mold 30 of an operator into quantitative values, and the quantitative values are displayed to the operator through the prompting module 24 so as to provide reference, help the operator to better complete the acetabulum grinding effect detection, enable the detection result to be more accurate, and help to realize the standardization of the total hip replacement surgery process.
The digital total hip replacement device and the calibration method of the abduction angle and the anteversion angle thereof provided by the embodiment of the application are described in detail above, and the principle and the implementation mode of the application are explained by applying a specific example, and the description of the embodiment is only used for helping to understand the method and the core idea of the application; meanwhile, for those skilled in the art, according to the idea of the present application, there may be variations in the specific embodiments and the application scope, and in summary, the content of the present specification should not be construed as a limitation to the present application.

Claims (10)

1. A digital total hip replacement device comprising a shaft having a working end and an operating end, the working end and the operating end being located at opposite ends of the shaft, respectively, the digital total hip replacement device further comprising:
the angle detection module is arranged on the shaft, is positioned between the working end and the operating end and is used for determining an angle reference, wherein the angle reference comprises an abduction angle reference plane and an anteversion angle reference plane, and the angle detection module is also used for detecting the abduction angle and the anteversion angle of the shaft relative to the angle reference in real time;
the body position tracking module is used for fixing the body position tracking module on a bone of a patient so as to detect an angle deviation value of the body position of the patient relative to the angle reference in real time;
the data processing module is in signal connection with the angle detection module and the body position tracking module respectively, and is used for acquiring an abduction angle and an anteversion angle of the shaft relative to the angle reference, which are detected by the angle detection module in real time, and acquiring an angle deviation value of the body position of the patient relative to the angle reference, which is detected by the body position tracking module in real time; calibrating the abduction angle and the anteversion angle based on the angle deviation value to obtain a calibrated abduction angle and a calibrated anteversion angle; and
the prompting module is in signal connection with the data processing module and is used for acquiring the calibrated abduction angle and the calibrated anteversion angle and displaying the calibrated abduction angle and the calibrated anteversion angle to an operator; the calibrated abduction and anteversion angles are used to enable an operator to determine the same or different relationship between the calibrated abduction and anteversion angles and the expected abduction and anteversion angles.
2. The digital total hip replacement device according to claim 1, wherein the angle detection module comprises a first inertial sensing unit, the first inertial sensing unit is in signal connection with the data processing module for determining the angle reference and detecting the abduction angle and the anteversion angle of the shaft relative to the angle reference in real time.
3. The digital total hip replacement device according to claim 2, wherein the angle detection module further comprises a level gauge configured to measure an inclination angle of 0 degrees when the axis of the shaft is horizontal for cooperating with the shaft and the first inertial sensing unit to determine the abduction angle reference plane.
4. The digital total hip replacement device according to claim 1 or 2, wherein the posture tracking module comprises a second inertial sensing unit for detecting an angular deviation value of the patient's posture relative to the angular reference in real time.
5. The digital total hip replacement device according to claim 1, further comprising a kirschner wire for fixing the posture tracking module to the patient's bone.
6. The digital total hip replacement device according to claim 1, wherein the digital total hip replacement device is configured to drive an acetabular cup trial into an acetabulum, the acetabular cup trial being removably mounted to a working end of the shaft, the digital total hip replacement device further comprising:
the pressure sensing module is arranged on a cup body of the acetabular outer cup test mould and used for detecting a pressure value born by the cup body in real time;
the pressure sensing module is in signal connection with the data processing module, and the data processing module is further used for acquiring a pressure value detected by the pressure sensing module and processing the pressure value to obtain a processed pressure value;
the prompt module is further used for acquiring the processed pressure value and displaying the processed pressure value to an operator.
7. The digital total hip replacement device according to claim 6, wherein the pressure sensing module comprises a plurality of pressure sensors for respectively detecting pressure values applied to the cup body at the position of the pressure sensors;
the data processing module is respectively in signal connection with the pressure sensors and is used for acquiring a plurality of pressure values detected by the pressure sensors and processing the pressure values to obtain the maximum pressure value; the prompt module is used for acquiring the maximum pressure value and displaying the maximum pressure value; or alternatively
The data processing module is in signal connection with the pressure sensors respectively and is used for acquiring a plurality of pressure values detected by the pressure sensors and analyzing the pressure values to obtain the number of the pressure values with the same size; the prompting module is used for acquiring the number of the pressure values with the same size and displaying the number of the pressure values with the same size and the total number of the pressure sensors.
8. The digital total hip replacement device according to claim 1 or 6, wherein the prompting module comprises:
the display screen is used for displaying the corrected abduction angle and anteversion angle or the processed pressure value; and/or
And the voice prompter is used for voice broadcasting the corrected abduction angle and anteversion angle or the processed pressure value.
9. The digital total hip replacement device according to claim 8, wherein the display screen is a HUD head-up display screen.
10. The digital total hip replacement device according to claim 1, further comprising a housing detachably mounted on the shaft between the working end and the operation end, wherein the angle detection module and the data processing module are integrated in the housing, and wherein the prompting module is integrated in the housing or disposed on an outer surface of the housing.
CN202210152004.6A 2022-02-18 2022-02-18 Digital total hip joint replacement device Active CN114343922B (en)

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