CN115607281A - Hip joint orthopedic surgery navigation system - Google Patents
Hip joint orthopedic surgery navigation system Download PDFInfo
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- CN115607281A CN115607281A CN202211420847.6A CN202211420847A CN115607281A CN 115607281 A CN115607281 A CN 115607281A CN 202211420847 A CN202211420847 A CN 202211420847A CN 115607281 A CN115607281 A CN 115607281A
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- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2055—Optical tracking systems
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2065—Tracking using image or pattern recognition
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Abstract
The invention relates to a hip joint orthopedic surgery navigation system, which comprises an optical navigation system, a handheld power system, a computer main control system, a wireless communication system and an image registration system, wherein the image registration system is used for segmenting a model after CT scanning is carried out on a patient hip joint focus, obtaining an acetabular cup image of a patient and an acetabular cup three-dimensional model by combining the real-time position of a tracking target installed on bone tissues of the patient, tracking the relative position of an operation tool and an acetabular cup entity of the patient by taking a medical image as a carrier by adopting binocular vision, and carrying out primary registration and secondary registration based on characteristic points of the acetabular cup between the acetabular cup image of the patient and the acetabular cup three-dimensional model; the primary registration is to determine the positioning of the initial position of the pelvis and the acetabulum through CT mark points which are respectively arranged on the upper part of the acetabulum, the front part of the acetabulum and the back part of the acetabulum; the secondary registration is to determine the precise spatial position of the pelvis acetabulum through 32 misaligned CT mark points respectively arranged on the pelvis acetabulum.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a hip joint orthopedic surgery navigation system.
Background
The hip joint is the largest spherical concave joint of a human body, the acetabulum subchondral bone is similar to a spherical surface, a spherical surface structure with similar outline is arranged between the femoral head and the acetabulum joint surface, and the two curved surfaces of the acetabulum and the femoral head are always kept in tangent or parallel relation in the motion process of the acetabulum and the femoral head. The acetabulum forms different concept abduction angles and anteversion angles through a natural selection process in the development process, and the femur also forms different cervical shaft angles, so that the difference adapts to the requirements of different individual biomechanics essentially. However, the hip joint, which is a main structure capable of supporting body weight and moving lower limbs, often accompanies osteoarthritis due to wear and the like, resulting in a change in anatomical osteotomy and a decrease in joint physiological function, and further requires hip joint orthopedic surgery.
The current common hip joint orthopedic surgery includes artificial hip joint resurfacing surgery or artificial total hip joint replacement surgery. When the artificial hip joint surface replacement is used for processing the prosthesis, manual measurement and experience are usually used for grasping, and the auxiliary positioning by using a femoral neck center positioner and the like is very easily influenced by the position change in the operation. In the artificial total hip joint replacement, the acetabular cup needs to be placed at the true acetabular position as much as possible so as to avoid biomechanical change of the prosthesis in a non-physiological state after replacement, but the acetabular cup and the proximal femur often face anatomical variation and other situations when the acetabular cup prosthesis is placed clinically, so that the ideal position of how to accurately position the acetabular cup prosthesis still does not have a unified and reliable standard at present, and the actual operation depends on the personal experience of an operator to a great extent. The adoption of the orthopedic surgery navigation system can improve the surgery quality, improve the surgery efficiency and facilitate the realization of accurate medical treatment and minimally invasive operation.
The orthopedic surgery navigation system applies computer-aided orthopedic surgery technology, and based on the intraoperative images, adopts corresponding positioning means to accurately track, display and guide the surgical position and surgical instruments in the operation in real time, so that an orthopedic doctor can perform the operation according to the navigation images. The operating principle of the orthopedic surgery navigation system is as follows: devices capable of sending signals are installed near the surgical site of a patient and on a surgical instrument, infrared rays are usually adopted as a sending source, a CCD camera is adopted as a receiver, the sent signals are utilized to track the bone position of the patient, the position and the motion track of the surgical instrument, and meanwhile, the information is displayed to a doctor through a display; during operation, X-ray fluoroscopy of the operation part of the patient is carried out, and the fluoroscopy image is combined with the obtained bone position image and the surgical instrument position image of the patient, so that a navigation image used by a doctor for operation is obtained. After adopting bone surgery navigation, the doctor at first installs the tracer near patient's operation position and surgical instruments in the operation, then shoots the perspective image at patient's operation position, at this moment, just can see the virtual image that surgical instruments got into patient's health inside on the navigation software module, just so can watch the positional relationship of surgical instruments and patient's operation position in real time on the navigation display to can accomplish whole operation according to the operation planning that navigation system made.
There is still much room for improvement in image registration in prior art orthopedic navigation systems. In the prior art, the problem of image distortion such as translation, expansion and contraction, rotation and the like easily occurs in the aspect of image registration of an orthopedic surgery navigation system, and the registration accuracy is directly influenced because medical images acquired in different batches have certain distortion on local development. In addition, in the prior art, the average time consumed for completing registration by the orthopedic operation navigation system is long, and the user experience is poor.
In addition, the orthopedic surgery navigation system in the prior art does not set safety region early warning, and the safety and effectiveness of the surgery operation cannot be guaranteed.
Disclosure of Invention
The invention aims to provide a hip joint orthopedic surgery navigation system, which at least solves the technical problems of improving the precision of image registration, shortening the registration time, improving the user experience, setting a safety region early warning and ensuring the safety and effectiveness of the surgery operation.
In order to achieve the purpose, the invention provides a hip joint orthopedic surgery navigation system which comprises an optical navigation system, a handheld power system, a computer main control system, a wireless communication system and an image registration system, wherein the image registration system is used for carrying out CT scanning on a hip joint focus of a patient and then carrying out segmentation on the model, obtaining an image of an acetabular cup of the patient and a three-dimensional model of the acetabular cup of the patient by combining the real-time position of a tracking target installed on bone tissues of the patient, taking a medical image as a carrier, tracking the relative position of a surgical tool and an acetabular cup entity of the patient by adopting binocular vision, and carrying out primary registration and secondary registration based on characteristic points of the acetabular cup between the image of the acetabular cup of the patient and the three-dimensional model of the acetabular cup; the primary registration is to determine the positioning of the initial position of the acetabulum of the pelvis through CT mark points respectively arranged on the upper part of the acetabulum, the front part of the acetabulum and the back part of the acetabulum; the secondary registration is to determine the accurate spatial position of the pelvis acetabulum through 32 misaligned CT mark points which are respectively arranged on the pelvis acetabulum; the optical navigation system is used for capturing the position of the optical target on the handheld power system and the real-time position of the tracking target installed on the bone tissue of a patient in real time in the operation implementation process, the computer main control system and the handheld power system can be in wireless communication, the computer main control system calculates the accurate spatial position of the pelvis acetabulum determined by primary registration and secondary registration according to the position of the optical target on the handheld power system captured by the optical navigation system in real time and the real-time position of the tracking target installed on the bone tissue of the patient and the image registration system, forms a real-time control signal for the handheld power system, and controls the handheld power system through wireless communication; aiming at the position of the prosthesis determined by preoperative system planning, the computer main control system can generate a control boundary and a depth boundary, perform real-time tracking response, make shutdown response to the condition exceeding the preoperative system planning, and ensure the safety and effectiveness of the bone grinding process.
Preferably, the upper part of the acetabulum is selected to be outside the upper edge of the acetabulum; the front part of the acetabulum is selected at the outer side of the upper edge of the acetabulum; the acetabulum posterior part is selected on the joint surface behind the horseshoe fossa.
Preferably, the specific method of the primary registration is as follows:
abstracting an approximate ball by taking the rotation center of a pelvis acetabulum as a circle center, taking CT mark points respectively arranged at the upper part of the acetabulum, the front part of the acetabulum and the rear part of the acetabulum as points on the surface of the abstracted approximate ball, taking the linear distance between the rotation center of the pelvis acetabulum and the CT mark points arranged at the upper part of the acetabulum, the front part of the acetabulum and the rear part of the acetabulum as radius R, completing function fitting of the approximate ball by adopting a least square method and minimizing the error of a fitting function, setting the coordinates of the circle center of the approximate ball under a world coordinate system after fitting as (alpha, beta, gamma), and setting the coordinates of any point on the surface of the approximate ball under the world coordinate system after fitting as (x) i ,y i ,z i ) Difference e between the estimated value and the actual value after each point fitting i The mathematical model (fitting function) of (α, β, γ, R) is:
e i (α,β,γ,R)=(x i –α) 2 +(y i –β) 2 +(z i –γ) 2 -R 2 ；
the mathematical model of the sum of the squares of the errors E (α, β, γ, R) of the fitting functions is:
wherein N is an integer greater than or equal to 3;
solving the numerical solutions of alpha, beta, gamma and R by solving the partial derivatives of the square sum of the errors of the fitting functions E (alpha, beta, gamma and R) on alpha, beta, gamma and R respectively and making the partial derivatives equal to 0 respectively; wherein, the coordinate values represented by alpha, beta and gamma are the positioning information of the initial position of the rotation center of the pelvis acetabulum under a world coordinate system.
Preferably, the specific method of the secondary registration is as follows:
assuming that the coordinate of each misaligned 32 CT mark points respectively arranged on the acetabulum of the pelvis under the world coordinate system is (x) j ,y j ,z j ) Calculating the average value L of the distances between the 32 CT mark points and the points represented by the coordinate values represented by alpha, beta and gamma:
replacing the radius R in primary registration by the distance mean L, and fitting each point on the surface of the approximate sphere after re-fitting to obtain a difference e between the estimated value and the actual value j The mathematical model (fitting function) of (α, β, γ, L) is:
e j (α,β,γ,L)=(x j –α) 2 +(y j –β) 2 +(z j –γ) 2 -L 2 ；
since the distance mean L is a known value obtained by calculation, the difference e j The mathematical model (fitting function) of (α, β, γ, L) collapses to a function of (α, β, γ),
the mathematical model of the sum of the squares of the errors of the fitting functions E (α, β, γ, L) is:
thirdly, respectively solving partial derivatives of the square sum E (alpha, beta, gamma, L) of the error of the fitting function on the alpha, beta and gamma, and enabling the partial derivatives to be respectively equal to 0, thereby solving the numerical solutions of the alpha, beta and gamma; establishing a virtual pelvis and acetabulum reference coordinate system by taking alpha, beta and gamma in the numerical solution as an origin; and projecting the real-time positions of the tracking targets installed on the bone tissues of the patient, CT mark points respectively arranged on the upper part of the acetabulum, the front part of the acetabulum and the back part of the acetabulum, 32 non-coincident CT mark points respectively arranged on the acetabulum of the pelvis and the positions of the optical targets on the handheld power system captured in real time by the optical navigation system in the operation implementation process into the virtual reference coordinate system of the acetabulum of the pelvis, and determining the accurate spatial position of the acetabulum of the pelvis.
Preferably, the hand-held power system comprises a power drill, a swing and/or a reciprocating machine.
Preferably, the computer main control system and the handheld power system perform data transmission and action control through wireless transmission of 2.4G low power, so that the spatial pose control of the handheld power system is realized.
Preferably, the handheld power system is provided with 3D identification points, the position of the handheld power system can be captured by capturing any space 3 points, the positioning capture control of a compound angle is further completed, and the grinding positioning of a forward-inclined abduction angle can be accurately completed.
Preferably, the hip joint orthopedic surgery navigation system sets a depth boundary early warning and an angle boundary early warning in the image after primary registration and secondary registration.
Preferably, in the depth boundary early warning, the region to be polished in the image is set to green through color management, the safety region is set to white, and the early warning region is set to red, wherein the white region has a grinding tolerance of 1mm, and the red region has a grinding tolerance of 0.5 mm.
Preferably, in the angle boundary early warning, aiming at the acetabular cup replacement, a fault-tolerant design with an anteversion angle of 15 degrees +/-5 degrees and an abduction angle of 40 degrees +/-5 degrees is designed according to the Campbell theory.
Advantageous effects
Compared with the prior art, the invention has the beneficial effects that:
the hip joint orthopedic surgery navigation system provided by the invention carries out acetabular cup registration under the guidance of a computer-aided system, takes a medical image as a carrier, adopts a binocular vision tracking surgery tool and the relative pose of a patient acetabular cup entity, and realizes registration of a lower model of a hip joint replacement surgery system and an entity affected part based on a robot technology in a mode of combining primary characteristic point registration and secondary registration, thereby improving the registration precision.
In the prior art, the average time consumed by the navigation system for completing registration is about 11-13 seconds, and the average time consumed by the hip joint orthopedic surgery navigation system is about 25 milliseconds due to the improved algorithm, so that the registration time is greatly shortened.
In addition, the hip joint orthopedic surgery navigation system is provided with a depth boundary early warning and an angle boundary early warning, in the depth boundary early warning, a region needing to be polished in an image is set to be green through color management, a safety region is set to be white, an early warning region is set to be red, the white region has a grinding tolerance of 1mm, and the red region has a grinding tolerance of 0.5 mm; in the early warning of the angle boundary, aiming at the replacement of the acetabular cup, a fault-tolerant design with an anteversion angle of 15 degrees +/-5 degrees and an abduction angle of 40 degrees +/-5 degrees is designed according to the Campbell theory, so that the safety and the effectiveness of the operation are ensured.
Drawings
The accompanying drawings are included to provide a further understanding of the present invention and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description serve to explain the principles of the invention and not to limit the invention.
Fig. 1 is a schematic structural diagram of a hip joint orthopedic surgery navigation system according to the present invention.
Detailed Description
The present invention is described in more detail below to facilitate an understanding of the present invention.
As shown in fig. 1, the hip joint orthopedic surgery navigation system of the present invention includes an optical navigation system, a handheld power system, a computer main control system, a wireless communication system and an image registration system, wherein the image registration system is used for performing a segmentation model after CT scanning on a patient hip joint focus, obtaining a patient acetabular cup image and an acetabular cup three-dimensional model by combining a real-time position of a tracking target installed on a patient bone tissue, tracking a relative pose of an operation tool and a patient acetabular cup entity by using a medical image as a carrier, and performing primary registration and secondary registration based on acetabular cup feature points between the patient acetabular cup image and the acetabular cup three-dimensional model; the primary registration is to determine the positioning of the initial position of the acetabulum of the pelvis through CT mark points respectively arranged on the upper part of the acetabulum, the front part of the acetabulum and the back part of the acetabulum; the secondary registration is to determine the accurate spatial position of the pelvis acetabulum through 32 non-coincident CT mark points which are respectively arranged on the pelvis acetabulum; the optical navigation system is used for capturing the position of the optical target on the handheld power system and the real-time position of the tracking target installed on the bone tissue of a patient in real time in the operation implementation process, the computer main control system and the handheld power system can be in wireless communication, the computer main control system calculates the accurate spatial position of the pelvis acetabulum determined by primary registration and secondary registration according to the position of the optical target on the handheld power system captured by the optical navigation system in real time and the real-time position of the tracking target installed on the bone tissue of the patient and the image registration system, forms a real-time control signal for the handheld power system, and controls the handheld power system through wireless communication; aiming at the position of the prosthesis determined by preoperative system planning, the computer main control system can generate a control boundary and a depth boundary, perform real-time tracking response, make shutdown response to the condition exceeding the preoperative system planning, and ensure the safety and effectiveness of the bone grinding process.
Preferably, the upper part of the acetabulum is selected to be outside the upper edge of the acetabulum; the front part of the acetabulum is selected at the outer side of the upper edge of the acetabulum; the acetabulum posterior part is selected on the joint surface behind the horseshoe fossa.
The coordinates of the CT mark points respectively arranged on the upper part, the front part and the back part of the acetabulum are established on a real coordinate, namely a world coordinate system. The rotation center of the pelvis and the acetabulum is an abstract point, and the position coordinate of the rotation center in a world coordinate system is an unknown value. Because the hip joint orthopedic surgery navigation system needs to display a virtual image of a surgical instrument entering the body of a patient in a Virtual Reality (VR) environment, and a world coordinate system cannot be directly used, a virtual coordinate system needs to be established, and the coordinates of CT mark points respectively arranged on the upper part of an acetabulum, the front part of the acetabulum and the rear part of the acetabulum, the position information of an optical target on a handheld power system captured by the optical navigation system in real time in the implementation process of the surgery, and the real-time position information of a tracking target installed on the bone tissue of the patient are projected into the virtual coordinate system. The more the virtual coordinate system matches the world coordinate system, the higher the accuracy of the navigation procedure.
In order to establish a virtual coordinate system that matches the world coordinate system, the center of rotation of the pelvic acetabulum needs to be determined first. Since the rotation center of the pelvis acetabulum is an abstract point and is located inside the pelvis acetabulum, a CT mark point cannot be directly set at the rotation center of the pelvis acetabulum, and therefore, an effective method for determining the rotation center of the pelvis acetabulum in an engineering sense has not been provided in the field. The primary objective of the primary registration proposed in this application is to determine the center of rotation of the pelvic acetabulum and establish a virtual pelvic acetabular reference coordinate system using the center of rotation as an origin.
Preferably, the specific method of the primary registration is as follows:
abstracting an approximate ball by taking a rotation center of a pelvis acetabulum (the position coordinate of the rotation center is an unknown value) as a circle center, taking CT mark points respectively arranged at the upper part of the acetabulum, the front part of the acetabulum and the rear part of the acetabulum (the position coordinate of the CT mark points under a world coordinate system is known information) as points on the surface of the abstracted approximate ball, taking the linear distance between the rotation center of the pelvis acetabulum and the CT mark points arranged at the upper part of the acetabulum, the front part of the acetabulum and the rear part of the acetabulum as a radius R, completing function fitting of the approximate ball by adopting a least square method and minimizing the error of a fitting function, setting the coordinates of the circle center of the approximate ball under the world coordinate system after fitting as (alpha, beta, gamma), and setting the coordinates of any point on the surface of the approximate ball under the world coordinate system after fitting as (x) as the coordinates i ,y i ,z i ) Difference e between the estimated value and the actual value after each point is fitted i The mathematical model (fitting function) of (α, β, γ, R) is:
e i (α,β,γ,R)=(x i –α) 2 +(y i –β) 2 +(z i –γ) 2 -R 2 ；
the mathematical model of the sum of the squares of the errors E (α, β, γ, R) of the fitting functions is:
wherein N is an integer greater than or equal to 3;
solving the numerical solutions of alpha, beta, gamma and R by solving the partial derivatives of the square sum of the errors of the fitting functions E (alpha, beta, gamma and R) on alpha, beta, gamma and R respectively and making the partial derivatives equal to 0 respectively; the coordinate values represented by alpha, beta and gamma are the positioning information of the initial position of the rotation center of the pelvis acetabulum in the world coordinate system.
The primary registration is also called coarse registration because only 3 CT mark points (arranged on the upper part of the acetabulum, the front part of the acetabulum and the rear part of the acetabulum) are used as the basis, and the numerical solutions of alpha, beta, gamma and R are deviated from the actual coordinate values. In order to reduce the offset, the secondary registration is carried out by respectively arranging 32 misaligned CT mark points on the acetabulum of the pelvis, and the result of the primary registration is corrected, wherein the secondary registration is also called as fine registration.
Preferably, the specific method of the quadratic registration is as follows:
assuming that the coordinate of each misaligned 32 CT mark points respectively arranged on the acetabulum of the pelvis under the world coordinate system is (x) j ,y j ,z j ) Calculating the average value L of the distances between the 32 CT mark points and the points represented by the coordinate values represented by alpha, beta and gamma:
replacing the radius R in primary registration with the distance mean L, and fitting each point on the surface of the approximate sphere after re-fitting to obtain the difference e between the estimated value and the actual value j The mathematical model (fitting function) of (α, β, γ, L) is:
e j (α,β,γ,L)=(x j –α) 2 +(y j –β) 2 +(z j –γ) 2 -L 2 ；
since the distance mean L is a known value obtained by calculation, the difference e j The mathematical model (fitting function) of (α, β, γ, L) collapses to a function of (α, β, γ),
the mathematical model of the sum of squares of the errors E (α, β, γ, L) of the fitting functions is:
thirdly, respectively solving partial derivatives of the square sum E (alpha, beta, gamma, L) of the error of the fitting function on the alpha, beta and gamma, and enabling the partial derivatives to be respectively equal to 0, thereby solving the numerical solutions of the alpha, beta and gamma; establishing a virtual pelvis and acetabulum reference coordinate system by taking alpha, beta and gamma in the numerical solution as an origin; and projecting the real-time positions of the tracking targets installed on the bone tissues of the patient, CT mark points respectively arranged on the upper part of the acetabulum, the front part of the acetabulum and the back part of the acetabulum, 32 non-coincident CT mark points respectively arranged on the acetabulum of the pelvis and the positions of the optical targets on the handheld power system captured in real time by the optical navigation system in the operation implementation process into the virtual reference coordinate system of the acetabulum of the pelvis, and determining the accurate spatial position of the acetabulum of the pelvis.
The experimental result shows that compared with the traditional registration method (the navigation system with the model number of 240-030-900 manufactured by Stryker is taken as a comparative example), the registration method provided by the application is respectively reduced by 62.75% and 70.64% on the average value and the standard deviation of mTRE, the registration success rate is increased by 15.3% at least, and the registration success rate is increased by 32.6% at most.
In the aspect of registration time, the average time consumed for completing registration of a navigation system of a model number 240-030-900 manufactured by Stryker company for the same patient is about 11-13 seconds, and the average time consumed for completing registration of the invention is about 25 milliseconds, so that the registration time is greatly shortened.
When the hip joint orthopedic surgery navigation system is matched with the orthopedic surgery robot system, in order to realize accurate cutting of an acetabulum grinding area and prevent bone tissues of a patient from being excessively ground, the orthopedic surgery robot system accurately controls the grinding process of the handheld power system according to the real-time space position of the handheld power system calculated by the navigation system, the navigation system carries out posture fault-tolerant design according to the Ganbuer theory, the grinding process meets the clinical requirement, and the operation process is smooth, safe and effective.
Preferably, the hand-held power system comprises a power drill, a swing and/or a reciprocating machine.
Preferably, the computer main control system and the handheld power system perform data transmission and action control through wireless transmission of 2.4G low power, so that the spatial pose control of the handheld power system is realized.
Preferably, the handheld power system is provided with 3D identification points, the position capture can be carried out by capturing 3 points in any space in the handheld power system, the positioning capture control of a compound angle is further completed, and the grinding positioning of a forward-inclined abduction angle can be accurately completed.
Preferably, the hip joint orthopedic surgery navigation system sets a depth boundary early warning and an angle boundary early warning in the image after primary registration and secondary registration.
Preferably, in the depth boundary early warning, the region to be polished in the image is set to green through color management, the safety region is set to white, and the early warning region is set to red, wherein the white region has a grinding tolerance of 1mm, and the red region has a grinding tolerance of 0.5 mm.
Preferably, in the angle boundary early warning, aiming at the acetabular cup replacement, a fault-tolerant design with an anteversion angle of 15 degrees +/-5 degrees and an abduction angle of 40 degrees +/-5 degrees is designed according to the Campbell theory, so that the safety and the effectiveness of the operation are ensured.
The foregoing describes preferred embodiments of the present invention, but is not intended to limit the invention thereto. Modifications and variations of the embodiments disclosed herein may be made by those skilled in the art without departing from the scope and spirit of the invention.
Claims (10)
1. The hip joint orthopedic surgery navigation system is characterized by comprising an optical navigation system, a handheld power system, a computer main control system, a wireless communication system and an image registration system, wherein the image registration system is used for segmenting a model after CT scanning is carried out on a patient hip joint focus, a patient acetabulum cup image and an acetabulum cup three-dimensional model are obtained by combining the real-time position of a tracking target installed on the bone tissue of the patient, the medical image is taken as a carrier, a binocular vision is adopted to track the relative pose of a surgical tool and a patient acetabulum cup entity, and primary registration and secondary registration based on characteristic points of the acetabulum cup are carried out between the patient acetabulum cup image and the acetabulum cup three-dimensional model; the primary registration is to determine the positioning of the initial position of the pelvis and the acetabulum through CT mark points which are respectively arranged at the upper part of the acetabulum, the front part of the acetabulum and the back part of the acetabulum; the secondary registration is to determine the accurate spatial position of the pelvis acetabulum through 32 non-coincident CT mark points which are respectively arranged on the pelvis acetabulum; the optical navigation system is used for capturing the position of the optical target on the handheld power system and the real-time position of the tracking target installed on the bone tissue of a patient in real time in the operation implementation process, the computer main control system and the handheld power system can be in wireless communication, the computer main control system calculates the accurate spatial position of the pelvis acetabulum determined by primary registration and secondary registration according to the position of the optical target on the handheld power system captured by the optical navigation system in real time and the real-time position of the tracking target installed on the bone tissue of the patient and the image registration system, forms a real-time control signal for the handheld power system, and controls the handheld power system through wireless communication; aiming at the position of the prosthesis determined by preoperative system planning, the computer main control system can generate a control boundary and a depth boundary, perform real-time tracking response, make shutdown response to the condition exceeding the preoperative system planning and ensure the safety and effectiveness of the bone grinding process.
2. The hip orthopaedic surgical navigation system according to claim 1, wherein the acetabular upper portion is selected to be outside the acetabular upper rim; the front part of the acetabulum is selected at the outer side of the upper edge of the acetabulum; the acetabulum posterior part is selected on the joint surface behind the horseshoe fossa.
3. The hip-joint orthopaedic surgery navigation system according to claim 1, characterized in that the specific method of the primary registration is:
abstracting an approximate ball by taking the rotation center of a pelvis acetabulum as a circle center, taking CT mark points respectively arranged at the upper part of the acetabulum, the front part of the acetabulum and the rear part of the acetabulum as points on the surface of the abstracted approximate ball, taking the linear distance between the rotation center of the pelvis acetabulum and the CT mark points arranged at the upper part of the acetabulum, the front part of the acetabulum and the rear part of the acetabulum as radius R, completing function fitting of the approximate ball by adopting a least square method and minimizing the error of a fitting function, setting the coordinates of the circle center of the approximate ball under a world coordinate system after fitting as (alpha, beta, gamma), and setting the coordinates of any point on the surface of the approximate ball under the world coordinate system after fitting as (x) i ,y i ,z i ) Difference e between the estimated value and the actual value after each point is fitted i The fitting function of (α, β, γ, R) is:
e i (α,β,γ,R)=(x i –α) 2 +(y i –β) 2 +(z i –γ) 2 -R 2 ；
the mathematical model of the sum of the squares of the errors E (α, β, γ, R) of the fitting functions is:
wherein N is an integer greater than or equal to 3;
calculating partial derivatives of the square sum of the errors E (alpha, beta, gamma, R) of the fitting function on alpha, beta, gamma, R respectively, and making the partial derivatives equal to 0 respectively, thereby calculating numerical solutions of alpha, beta, gamma, R; the coordinate values represented by alpha, beta and gamma are the positioning information of the initial position of the rotation center of the pelvis acetabulum in the world coordinate system.
4. The hip-joint orthopaedic surgery navigation system according to claim 3, characterized in that the secondary registration is performed by the following specific method:
let the coordinates of the 32 CT markers which are respectively arranged on the acetabulum of the pelvis and are not coincident in the world coordinate system be (x) j ,y j ,z j ) Calculating the average value L of the distances between the 32 CT mark points and the points represented by the coordinate values represented by alpha, beta and gamma:
replacing the radius R in primary registration with the distance mean L, and fitting each point on the surface of the approximate sphere after re-fitting to obtain the difference e between the estimated value and the actual value j The fitting function of (α, β, γ, L) is:
e j (α,β,γ,L)=(x j –α) 2 +(y j –β) 2 +(z j –γ) 2 -L 2 ；
since the distance mean L is a known value obtained by calculation, the difference e j The fitting function of (alpha, beta, gamma, L) collapses to a function of (alpha, beta, gamma),
the mathematical model of the sum of the squares of the errors of the fitting functions E (α, β, γ, L) is:
thirdly, respectively calculating partial derivatives of the alpha, the beta and the gamma through the square sum E (alpha, beta, gamma and L) of the errors of the fitting function, and enabling the partial derivatives to be respectively equal to 0, so as to calculate the numerical solutions of the alpha, the beta and the gamma; establishing a virtual pelvis and acetabulum reference coordinate system by taking alpha, beta and gamma in the numerical solution as an origin; and projecting the real-time positions of the tracking targets installed on the bone tissues of the patient, CT mark points respectively arranged on the upper part of the acetabulum, the front part of the acetabulum and the back part of the acetabulum, 32 non-coincident CT mark points respectively arranged on the acetabulum of the pelvis and the positions of the optical targets on the handheld power system captured in real time by the optical navigation system in the operation implementation process into the virtual reference coordinate system of the acetabulum of the pelvis, and determining the accurate spatial position of the acetabulum of the pelvis.
5. The hip-joint orthopaedic surgical navigation system of claim 1, wherein the handheld power system comprises an electric drill, a swing and/or a reciprocating machine.
6. The hip joint orthopedic surgery navigation system according to claim 1, characterized in that the computer main control system and the hand-held power system perform data transmission and motion control through wireless transmission of 2.4G low power, so as to realize space pose control of the hand-held power system.
7. The hip joint orthopedic surgery navigation system according to claim 1, characterized in that 3D identification points are provided in the handheld power system, and position capture can be performed by capturing any spatial 3 points in the handheld power system, thereby completing positioning capture control of compound angles and precisely completing grinding positioning of forward-inclined abduction angles.
8. The hip surgery navigation system according to claim 1, characterized in that the hip surgery navigation system sets a depth boundary early warning and an angle boundary early warning in the image after primary registration and secondary registration.
9. The hip joint orthopaedic surgery navigation system according to claim 8, wherein in the depth boundary early warning, the region to be ground in the image is set to green color, the safety region is set to white color, and the early warning region is set to red color through color management, wherein the white region has a grinding tolerance of 1mm, and the red region has a grinding tolerance of 0.5 mm.
10. The hip orthopaedic surgery navigation system according to claim 8, characterized in that in the angular boundary warning, a fault-tolerant design with a forward inclination of 15 ° ± 5 ° and an abduction angle of 40 ° ± 5 ° is designed in campbell theory for acetabular cup replacement.
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