CN114506083A - 髋关节置换翻修手术中扩髓控向模具的制作及使用方法 - Google Patents

髋关节置换翻修手术中扩髓控向模具的制作及使用方法 Download PDF

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CN114506083A
CN114506083A CN202210033432.7A CN202210033432A CN114506083A CN 114506083 A CN114506083 A CN 114506083A CN 202210033432 A CN202210033432 A CN 202210033432A CN 114506083 A CN114506083 A CN 114506083A
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prosthesis
manufacturing
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陈东阳
蒋青
秦江辉
李澜
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Nanjing Drum Tower Hospital
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Nanjing Drum Tower Hospital
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    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
    • B29C—SHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
    • B29C64/00—Additive manufacturing, i.e. manufacturing of three-dimensional [3D] objects by additive deposition, additive agglomeration or additive layering, e.g. by 3D printing, stereolithography or selective laser sintering
    • B29C64/30—Auxiliary operations or equipment
    • B29C64/386—Data acquisition or data processing for additive manufacturing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4601—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4607—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of hip femoral endoprostheses
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
    • B29C—SHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
    • B29C64/00—Additive manufacturing, i.e. manufacturing of three-dimensional [3D] objects by additive deposition, additive agglomeration or additive layering, e.g. by 3D printing, stereolithography or selective laser sintering
    • B29C64/30—Auxiliary operations or equipment
    • B29C64/379—Handling of additively manufactured objects, e.g. using robots
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B33—ADDITIVE MANUFACTURING TECHNOLOGY
    • B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
    • B33Y40/00—Auxiliary operations or equipment, e.g. for material handling
    • B33Y40/20—Post-treatment, e.g. curing, coating or polishing
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B33—ADDITIVE MANUFACTURING TECHNOLOGY
    • B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
    • B33Y50/00—Data acquisition or data processing for additive manufacturing

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Chemical & Material Sciences (AREA)
  • Materials Engineering (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Manufacturing & Machinery (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Biomedical Technology (AREA)
  • Cardiology (AREA)
  • Physics & Mathematics (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Mechanical Engineering (AREA)
  • Optics & Photonics (AREA)
  • Robotics (AREA)
  • Prostheses (AREA)

Abstract

本发明提供了髋关节置换翻修手术中扩髓控向模具的制作方法，包括以下步骤：S1：利用薄层CT对手术侧股骨假体区域进行高精度扫描；S2：利用图像处理软件对原股骨假体进行等比例三维建模；S3：后按照正确的翻修假体安装方向，在建立的模型中预留扩髓控向孔；S4：将模具利用3D打印机等比例打印并消毒备用。本发明可以定制适合患者个体的扩髓方向，术中无需扩大手术范围去除硬质骨，这样可以节约手术时间约30至60分钟，减少术中出血量至少1000ml，且术中无需透视，避免透视设备对手术区域的潜在污染可能性。

Description

髋关节置换翻修手术中扩髓控向模具的制作及使用方法
技术领域
本发明涉及髋关节置换翻修技术领域，尤其涉及髋关节置换翻修手术中扩髓控向模具的制作及使用方法。
背景技术
随着人口老龄化，髋关节置换到期病人增多，假体松动后需要进行翻修手术，翻修术中原股骨假体可能发生位移，原假体占位腔偏离正常假体植入方向，且假体周围骨质硬化，导致翻修手术时极容易将翻修假体沿原假体占位腔植入体内，导致假体位置不良。
该不良事件发生原因，主要是移位假体的占位腔周围骨质硬化，导致股骨扩髓步骤钻头沿原假体腔道行进，产生方向错误所导致的。由该错误所导致的假体安放不良，极容易使新安装假体穿出股骨，影响假体稳定，需要再次手术。
目前，解决该问题的方法是扩大手术范围，去除原骨道硬化骨，并且在手术中多次透视确定假体安装方向，这导致手术时间长、创伤大、出血多，且容易导致感染等并发症发生。而翻修手术时患者往往高龄，对以上原因耐受性更差，导致手术风险成倍增加。
发明内容
为解决上述问题，本发明公开了髋关节置换翻修手术中扩髓控向模具的制作及使用方法。
具体方案如下：
髋关节置换翻修手术中扩髓控向模具的制作方法，其特征在于，包括以下步骤：
S1：利用薄层CT对手术侧股骨假体区域进行高精度扫描；
S2：利用图像处理软件对原股骨假体进行等比例三维建模；
S3：后按照正确的翻修假体安装方向，在建立的模型中预留扩髓控向孔；
S4：将模具利用3D打印机等比例打印并消毒备用。
作为本发明的进一步改进，所述步骤S1中，扫描时在髋关节区域摆放刻度标尺，以方便后续按真实大小比例建模。
作为本发明的进一步改进，所述步骤S2中，图像处理软件包括但不限于Matalab。
作为本发明的进一步改进，所述步骤S3中，所述扩髓控向孔的直径为0.8-1.5cm。
作为本发明的进一步改进，所述步骤S4中，用低温等离子设备消毒。
髋关节置换翻修手术中扩髓控向模具的使用方法，其特征在于，采用如权利要求1-4仍以一项所述的方法所制作出的磨具，包括以下步骤：先取出原假体，再将消毒好的相同大小的模具置入原假体占位腔内，然后根据模具预留的扩髓道进行扩髓。这样无需扩大手术范围去除硬质骨，节约手术时间及出血量，且术中无需透视。
本发明的有益效果在于：可以定制适合患者个体的扩髓方向，术中无需扩大手术范围去除硬质骨，这样可以节约手术时间约30至60分钟，减少术中出血量至少1000ml，且术中无需透视，避免透视设备对手术区域的潜在污染可能性。
具体实施方式
下面结合具体实施方式，进一步阐明本发明，应理解下述具体实施方式仅用于说明本发明而不用于限制本发明的范围。
本发明提供了一种髋关节置换翻修手术中扩髓控向模具的制作方法，包括以下步骤：
S1：利用薄层CT对手术侧股骨假体区域进行高精度扫描；
S2：利用图像处理软件对原股骨假体进行等比例三维建模；
S3：后按照正确的翻修假体安装方向，在建立的模型中预留扩髓控向孔；
S4：将模具利用3D打印机等比例打印并消毒备用。
在本实施例中，所述步骤S1中，扫描时在髋关节区域摆放刻度标尺，以方便后续按真实大小比例建模。
在本实施例中，所述步骤S2中，图像处理软件包括但不限于Matalab。
在本实施例中，所述步骤S3中，所述扩髓控向孔的直径为0.8-1.5cm。
在本实施例中，所述步骤S4中，用低温等离子设备消毒。
本发明还提供了一种髋关节置换翻修手术中扩髓控向模具的使用方法，包括以下步骤：先取出原假体，再将消毒好的相同大小的模具置入原假体占位腔内，然后根据模具预留的扩髓道进行扩髓。这样无需扩大手术范围去除硬质骨，节约手术时间及出血量，且术中无需透视。
本发明方案所公开的技术手段不仅限于上述实施方式所公开的技术手段，还包括由以上技术特征任意组合所组成的技术方案。应当指出，对于本技术领域的普通技术人员来说，在不脱离本发明原理的前提下，还可以做出若干改进和润饰，这些改进和润饰也视为本发明的保护范围。

Claims (6)

1.髋关节置换翻修手术中扩髓控向模具的制作方法，其特征在于，包括以下步骤：
S1：利用薄层CT对手术侧股骨假体区域进行高精度扫描；
S2：利用图像处理软件对原股骨假体进行等比例三维建模；
S3：后按照正确的翻修假体安装方向，在建立的模型中预留扩髓控向孔；
S4：将模具利用3D打印机等比例打印并消毒备用。
2.根据权利要求1所述的髋关节置换翻修手术中扩髓控向模具的制作方法，其特征在于，所述步骤S1中，扫描时在髋关节区域摆放刻度标尺。
3.根据权利要求1所述的髋关节置换翻修手术中扩髓控向模具的制作方法，其特征在于，所述步骤S2中，图像处理软件包括但不限于Matalab。
4.根据权利要求1所述的髋关节置换翻修手术中扩髓控向模具的制作方法，其特征在于，所述步骤S3中，所述扩髓控向孔的直径为0.8-1.5cm。
5.根据权利要求1所述的髋关节置换翻修手术中扩髓控向模具的制作方法，其特征在于，所述步骤S4中，用低温等离子设备消毒。
6.髋关节置换翻修手术中扩髓控向模具的使用方法，其特征在于，采用如权利要求1-4仍以一项所述的方法所制作出的磨具，包括以下步骤：先取出原假体，再将消毒好的相同大小的模具置入原假体占位腔内，然后根据模具预留的扩髓道进行扩髓。
CN202210033432.7A 2022-01-12 2022-01-12 髋关节置换翻修手术中扩髓控向模具的制作及使用方法 Pending CN114506083A (zh)

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5607431A (en) * 1995-02-09 1997-03-04 Howmedica Inc. Prosthetic hip implantation method and apparatus
US5908423A (en) * 1993-05-27 1999-06-01 Howmedica, Inc. Flexible medullary reaming system
CN101152101A (zh) * 2006-09-29 2008-04-02 德普伊产品公司 近端扩孔钻
CN103315797A (zh) * 2013-06-14 2013-09-25 上海市第六人民医院 一种防止骨水泥型人工关节假体柄松动的扩髓器
CN213821894U (zh) * 2020-08-27 2021-07-30 安徽医科大学第二附属医院 一种股骨假体翻修术用髓腔扩髓导向装置

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5908423A (en) * 1993-05-27 1999-06-01 Howmedica, Inc. Flexible medullary reaming system
US5607431A (en) * 1995-02-09 1997-03-04 Howmedica Inc. Prosthetic hip implantation method and apparatus
CN101152101A (zh) * 2006-09-29 2008-04-02 德普伊产品公司 近端扩孔钻
CN103315797A (zh) * 2013-06-14 2013-09-25 上海市第六人民医院 一种防止骨水泥型人工关节假体柄松动的扩髓器
CN213821894U (zh) * 2020-08-27 2021-07-30 安徽医科大学第二附属医院 一种股骨假体翻修术用髓腔扩髓导向装置

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