CN115607281B - Navigation system for hip joint bone surgery - Google Patents
Navigation system for hip joint bone surgery Download PDFInfo
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- CN115607281B CN115607281B CN202211420847.6A CN202211420847A CN115607281B CN 115607281 B CN115607281 B CN 115607281B CN 202211420847 A CN202211420847 A CN 202211420847A CN 115607281 B CN115607281 B CN 115607281B
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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
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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
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 carrying out CT scanning on a patient hip joint focus, then carrying out segmentation models, combining real-time positions of tracking targets arranged on bone tissues of the patient to obtain an image of an acetabular cup of the patient and a three-dimensional model of the acetabular cup, taking a medical image as a carrier, adopting a binocular vision tracking surgery tool to track relative pose of an acetabular cup entity of the patient, and carrying out primary registration and secondary registration between the image of the acetabular cup of the patient and the three-dimensional model of the acetabular cup based on characteristic points of the acetabular cup; the primary registration is to determine the positioning of the initial position of the pelvis acetabulum through 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 secondary registration is to determine the exact spatial position of the pelvic acetabulum by means of respective misaligned 32 CT landmark points disposed on the pelvic acetabulum, respectively.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a navigation system for hip joint orthopedic surgery.
Background
The hip joint is the biggest spherical concave joint of the human body, the subchondral bone of the acetabulum is similar to a spherical surface, a spherical surface structure with similar outline is arranged between the femoral head and the acetabular joint surface, and the two curved surfaces of the acetabulum and the femoral head always keep tangent or parallel relation in the movement process. The acetabulum forms abduction angles and anteversion angles of different concepts through a natural selection process in the development process, and the femur also forms different neck stem angles, so that the difference is essentially suitable for the requirements of biomechanics of different individuals. However, the hip joint is a main structure capable of functioning as a support for body weight and lower limb movement, and often causes osteoarthritis and the like due to abrasion and the like, resulting in a change in anatomical osteotomy and a decrease in physiological functions of the joint, and further requires hip joint orthopedic surgery.
Current common hip bone surgery includes artificial hip resurfacing or artificial total hip resurfacing. In artificial hip arthroplasty, the prosthesis is usually handled by manual measurement and experience, and the auxiliary positioning such as a femoral neck center positioner is extremely easy to influence by the position change in the operation. In the artificial total hip arthroplasty, the cup needs to be placed at the true acetabular position as far as possible to avoid biomechanical change of the prosthesis in the non-physiological state after replacement, but when the acetabular prosthesis is placed clinically, the conditions of acetabulum, proximal anatomical variation of femur and the like are often faced, so that no unified and reliable standard exists at present for accurately positioning the ideal azimuth of the cup prosthesis, and the practical operation depends on personal experience of an operator to a great extent. And the orthopedic operation navigation system can improve the operation quality, improve the operation efficiency and be beneficial to realizing accurate medical treatment and minimally invasive operation.
The orthopedic surgery navigation system is applied to computer-assisted orthopedic surgery technology, and based on an intraoperative image, the surgical site and surgical instruments in the surgery are accurately tracked, displayed and guided in real time by adopting corresponding positioning means, so that an orthopedic doctor can perform surgery according to the navigation image. The operating principle of the bone surgery navigation system is as follows: devices capable of sending out signals are arranged near the operation part of a patient and on the operation instrument, infrared rays are generally adopted as a transmitting source, a CCD camera is adopted as a receiver, the sent out signals are utilized to track the bone position of the patient and the position and movement track of the operation instrument, and meanwhile, the information is displayed to a doctor through a display; x-ray perspective of the operation part of the patient is carried out in the operation, and the perspective image is synthesized with the obtained bone position of the patient and the position image of the operation instrument, so that a navigation image adopted by the doctor in the operation is obtained. After the orthopedic operation navigation system is adopted, a doctor firstly installs the tracer near the operation position of the patient and on the operation instrument during operation, then shoots a perspective image of the operation position of the patient, at the moment, the virtual image of the operation instrument entering the body of the patient can be seen on the navigation software module, so that the position relation between the operation instrument and the operation position of the patient can be watched on the navigation display in real time, and the whole operation can be completed according to the operation planning formulated by the navigation system.
There is still much room for improvement in image registration in prior art orthopedic navigation systems. In the prior art, the orthopedic operation navigation system is easy to generate image distortion problems such as translation, expansion and rotation in the aspect of image registration, and the accuracy of registration can be directly influenced because medical images acquired in different batches have certain distortion on local development. In addition, the orthopedic operation navigation system in the prior art has long average time consumed by finishing registration, and poor user experience.
In addition, the orthopedic surgery navigation system in the prior art is not provided with a safety area early warning, and the safety and effectiveness of surgery operation cannot be guaranteed.
Disclosure of Invention
The invention aims to provide a hip joint orthopedic surgery navigation system, which at least aims to solve the technical problems of improving the accuracy of image registration, shortening the registration time, improving the user experience, setting a safety area early warning and ensuring the safety and effectiveness of surgery operation.
In order to achieve the above 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 patient hip joint focus and then carrying out a segmentation model, obtaining an image of an acetabular cup of a patient and a three-dimensional model of the acetabular cup by combining a real-time position of a tracking target arranged on bone tissue of the patient, taking a medical image as a carrier, adopting a binocular vision tracking surgery tool to track the relative pose of an acetabular cup entity of the patient, and carrying out primary registration and secondary registration between the image of the acetabular cup of the patient and the three-dimensional model of the acetabular cup based on characteristic points of the acetabular cup; the primary registration is to determine the positioning of the initial position of the pelvis acetabulum through 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 secondary registration is to determine the accurate spatial position of the pelvis acetabulum through 32 misaligned CT mark points respectively arranged on the pelvis acetabulum; the system comprises a handheld power system, an image registration system, a computer main control system and a control system, wherein the handheld power system is provided with an optical target, 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 a tracking target arranged on bone tissue of a patient in real time in the operation implementation process, the computer main control system can wirelessly communicate with the handheld power system, and the computer main control system calculates the real-time control signal of the handheld power system according to the position of the optical target on the handheld power system captured by the optical navigation system in real time, the real-time position of the tracking target arranged on bone tissue of the patient and the accurate space position of pelvis acetabulum determined by the image registration system through primary registration and secondary registration, so as to control the handheld power system through wireless communication; aiming at the position of the prosthesis determined by the preoperative system planning, the computer main control system can generate a control boundary and a depth boundary, carry out real-time tracking response, and carry out shutdown response on the condition exceeding the preoperative system planning, thereby ensuring the safety and the effectiveness of the bone grinding process.
Preferably, the upper acetabular portion is selected outside the upper acetabular rim; the front part of the acetabulum is selected outside the upper edge of the acetabulum; the posterior aspect of the acetabulum is selected on the posterior articular surface of the horseshoe fossa.
Preferably, the specific method of the primary registration is as follows:
abstracting an approximate sphere by using the rotation center of the pelvis acetabulum as the circle center, using 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 sphere, using the straight line 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, adopting a least square method to complete the function fitting of the approximate sphere and minimize the error of the fitting function, and setting the coordinates of the circle center of the approximate sphere under the world coordinate system after the fitting as (alpha, beta)Gamma), the coordinates of any point on the surface of the approximate sphere described after fitting in the world coordinate system are (x) i ,y i ,z i ) The 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 squares of the errors E (alpha, beta, gamma, R) of the fitting function is:
wherein N is an integer greater than or equal to 3;
the square sum E (alpha, beta, gamma, R) of errors of the fitting function is used for respectively obtaining partial derivatives of alpha, beta, gamma and R, and the partial derivatives are respectively equal to 0, so that the numerical solutions of alpha, beta, gamma and R are obtained; 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 the world coordinate system.
Preferably, the specific method of the secondary registration is as follows:
assume that the coordinates of each of the misaligned 32 CT landmark points disposed on the pelvic acetabulum, respectively, in the world coordinate system are (x j ,y j ,z j ) Calculating the distance average value L between 32 CT mark points and points represented by coordinate values represented by alpha, beta and gamma:
replacing radius R in primary registration with distance average L, and fitting each point on the surface of the approximate sphere after re-fitting to obtain difference e between estimated value and 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 average L is a known value obtained by calculation, the difference e j The mathematical model (fitting function) of (alpha, beta, gamma, L) collapses to a function of (alpha, beta, gamma),
the mathematical model of the sum of squares of the errors E (alpha, beta, gamma, L) of the fitting function is:
thirdly, respectively obtaining partial derivatives of the sum of squares E (alpha, beta, gamma, L) of errors of the fitting function on alpha, beta and gamma, and respectively enabling the partial derivatives to be equal to 0, so as to obtain numerical solutions of alpha, beta and gamma; establishing a virtual pelvic acetabulum reference coordinate system by taking alpha, beta and gamma in the numerical solution as an origin; the real-time position of a tracking target arranged on bone tissue of a patient, CT mark points respectively arranged on the upper part of the acetabulum, the front part of the acetabulum and the rear part of the acetabulum, 32 misaligned CT mark points respectively arranged on the pelvis acetabulum and the position of an optical target on a handheld power system captured by the optical navigation system in real time in the operation implementation process are projected into the virtual pelvis acetabulum reference coordinate system, so that the accurate spatial position of the pelvis acetabulum is determined.
Preferably, the hand-held power system comprises an electric drill, a wobble and/or a reciprocating machine.
Preferably, the computer main control system and the handheld power system perform data transmission and action control by wirelessly transmitting 2.4G low power, so as to realize space pose control of the handheld power system.
Preferably, a 3D mark point is arranged in the handheld power system, position capture can be performed by capturing any 3 points in space in the handheld power system, further positioning capture control of a compound angle is completed, and grinding and positioning of a forward-leaning abduction angle can be accurately completed.
Preferably, the hip joint orthopedic surgery navigation system sets depth boundary early warning and angle boundary early warning in the images subjected to primary registration and secondary registration.
Preferably, in the depth boundary early warning, the area to be polished in the image is set to be green through color management, the safety area is set to be white, the early warning area is set to be red, wherein the white area has a grinding tolerance of 1mm, and the red area has a grinding tolerance of 0.5 mm.
Preferably, in the angle boundary early warning, the fault-tolerant design of the anteversion angle of 15 DEG + -5 DEG and the abduction angle of 40 DEG + -5 DEG is designed according to the campbell theory aiming at acetabular cup replacement.
Advantageous effects
Compared with the prior art, the invention has the beneficial effects that:
the hip joint orthopedic surgery navigation system performs acetabular cup registration under the guidance of the computer-aided system, uses medical images as carriers, adopts binocular vision to track the relative pose of a surgery tool and an acetabular cup entity of a patient, and realizes the registration of a model and an affected part of the entity under the hip joint replacement surgery system based on the robot technology by combining primary feature point registration and secondary registration, thereby improving registration accuracy.
The average time consumed by the navigation system for completing registration in the prior art is about 11-13 seconds, and the average time consumed by the navigation system for hip joint bone surgery in the invention for completing registration is about 25 milliseconds due to the improvement of the 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 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, wherein the white region has a grinding tolerance of 1mm, and the red region has a grinding tolerance of 0.5 mm; in the angle boundary early warning, aiming at acetabular cup replacement, a fault-tolerant design of a 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 effectiveness of operation are ensured.
Drawings
The accompanying drawings are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate and do not limit the invention.
Fig. 1 is a schematic structural view of a navigation system for hip bone surgery 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 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 patient hip joint focus, then carrying out a segmentation model, obtaining a patient acetabular cup image and an acetabular cup three-dimensional model by combining a real-time position of a tracking target arranged on bone tissue of the patient, adopting a binocular vision tracking surgery tool and a relative pose of the patient acetabular cup entity by taking a medical image as a carrier, and carrying out primary registration and secondary registration between the patient acetabular cup image and the acetabular cup three-dimensional model based on characteristic points of the acetabular cup; the primary registration is to determine the positioning of the initial position of the pelvis acetabulum through 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 secondary registration is to determine the accurate spatial position of the pelvis acetabulum through 32 misaligned CT mark points respectively arranged on the pelvis acetabulum; the system comprises a handheld power system, an image registration system, a computer main control system and a control system, wherein the handheld power system is provided with an optical target, 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 a tracking target arranged on bone tissue of a patient in real time in the operation implementation process, the computer main control system can wirelessly communicate with the handheld power system, and the computer main control system calculates the real-time control signal of the handheld power system according to the position of the optical target on the handheld power system captured by the optical navigation system in real time, the real-time position of the tracking target arranged on bone tissue of the patient and the accurate space position of pelvis acetabulum determined by the image registration system through primary registration and secondary registration, so as to control the handheld power system through wireless communication; aiming at the position of the prosthesis determined by the preoperative system planning, the computer main control system can generate a control boundary and a depth boundary, carry out real-time tracking response, and carry out shutdown response on the condition exceeding the preoperative system planning, thereby ensuring the safety and the effectiveness of the bone grinding process.
Preferably, the upper acetabular portion is selected outside the upper acetabular rim; the front part of the acetabulum is selected outside the upper edge of the acetabulum; the posterior aspect of the acetabulum is selected on the posterior articular surface of the horseshoe fossa.
The coordinates of the CT marker points respectively disposed at the upper part of the acetabulum, the anterior part of the acetabulum and the posterior part of the acetabulum are established on a real coordinate, i.e., a world coordinate system. The rotation center of the pelvis acetabulum is an abstract point, and the position coordinate of the rotation center is unknown value under the world coordinate system. Because the hip bone surgery navigation system needs to display a virtual image of the surgical instrument entering the patient in a Virtual Reality (VR) environment, and cannot directly use a world coordinate system, it is necessary to establish a virtual coordinate system, and to project the coordinates of CT marker points respectively set on the upper portion of the acetabulum, the front portion of the acetabulum, and the rear portion of the acetabulum, the position information of an optical target on a handheld power system captured in real time by the optical navigation system during the surgery implementation, and the real-time position information of a tracking target mounted on the bone tissue of the patient into the virtual coordinate system. The more the virtual coordinate system matches the world coordinate system, the higher the accuracy of the navigational 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 center of rotation of the pelvic acetabulum itself is an abstract point and is located inside the pelvic acetabulum, CT marker points cannot be set directly at the center of rotation of the pelvic acetabulum, no effective method for determining the center of rotation of the pelvic acetabulum has been proposed in the art with engineering significance. The primary purpose 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 with the center of rotation as the origin.
Preferably, the specific method of the primary registration is as follows:
abstracting an approximate sphere by using the rotation center of the pelvis acetabulum (the position coordinate of the rotation center is an unknown value) as a circle center, enabling CT mark points (the position coordinate of the CT mark points under a world coordinate system is known information) respectively arranged at the upper part of the acetabulum, the front part of the acetabulum and the rear part of the acetabulum to be used as points on the surface of the abstracted approximate sphere, enabling the straight line 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 to be used as a radius R, completing the function fitting of the approximate sphere by adopting a least square method, minimizing the error of a fitting function, setting the coordinates of the circle center of the approximate sphere under the world coordinate system after the fitting to be (alpha, beta, gamma), and setting the coordinates of any point on the surface of the approximate sphere under the world coordinate system to be (x) i ,y i ,z i ) The 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 squares of the errors E (alpha, beta, gamma, R) of the fitting function is:
wherein N is an integer greater than or equal to 3;
the square sum E (alpha, beta, gamma, R) of errors of the fitting function is used for respectively obtaining partial derivatives of alpha, beta, gamma and R, and the partial derivatives are respectively equal to 0, so that the numerical solutions of alpha, beta, gamma and R are obtained; 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 the world coordinate system.
Since the primary registration only uses 3 CT marker points (disposed on the upper portion of the acetabulum, the anterior portion of the acetabulum, and the posterior portion of the acetabulum) as a basis, the obtained numerical solutions of α, β, γ, R are offset from the actual coordinate values, and therefore the primary registration is also called coarse registration. In order to reduce the offset, the application adopts 32 misaligned CT mark points respectively arranged on the pelvis acetabulum to carry out secondary registration, and corrects the result of the primary registration, wherein the secondary registration is also called fine registration.
Preferably, the specific method of the secondary registration is as follows:
assume that the coordinates of each of the misaligned 32 CT landmark points disposed on the pelvic acetabulum, respectively, in the world coordinate system are (x j ,y j ,z j ) Calculating the distance average value L between 32 CT mark points and points represented by coordinate values represented by alpha, beta and gamma:
replacing radius R in primary registration with distance average L, and fitting each point on the surface of the approximate sphere after re-fitting to obtain difference e between estimated value and 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 average L is a known value obtained by calculation, the difference e j The mathematical model (fitting function) of (alpha, beta, gamma, L) collapses to a function of (alpha, beta, gamma),
the mathematical model of the sum of squares of the errors E (alpha, beta, gamma, L) of the fitting function is:
thirdly, respectively obtaining partial derivatives of the sum of squares E (alpha, beta, gamma, L) of errors of the fitting function on alpha, beta and gamma, and respectively enabling the partial derivatives to be equal to 0, so as to obtain numerical solutions of alpha, beta and gamma; establishing a virtual pelvic acetabulum reference coordinate system by taking alpha, beta and gamma in the numerical solution as an origin; the real-time position of a tracking target arranged on bone tissue of a patient, CT mark points respectively arranged on the upper part of the acetabulum, the front part of the acetabulum and the rear part of the acetabulum, 32 misaligned CT mark points respectively arranged on the pelvis acetabulum and the position of an optical target on a handheld power system captured by the optical navigation system in real time in the operation implementation process are projected into the virtual pelvis acetabulum reference coordinate system, so that the accurate spatial position of the pelvis acetabulum is determined.
Experimental results show that compared with the traditional registration method (the navigation system manufactured by the company of Stryker is used as a comparison example), the registration method provided by the application is reduced by 62.75% and 70.64% on the average value and standard deviation of mTRE respectively, and the registration success rate is increased by 15.3% at the minimum and 32.6% at the maximum.
In the aspect of registration time, for the same patient, the average time consumed by a navigation system manufactured by the company of Stryker and model number 240-030-900 for completing registration is about 11-13 seconds, and the average time consumed by the method for completing registration is about 25 milliseconds, so that the registration time is greatly shortened.
When the hip joint bone surgery navigation system is matched with the bone surgery robot system, in order to realize accurate cutting of an acetabular grinding area, bone tissues of a patient are not excessively ground, the bone 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 gesture fault-tolerant design according to the Canboolean theory, the grinding process meets clinical requirements, and the operation process is smooth, safe and effective.
Preferably, the hand-held power system comprises an electric drill, a wobble and/or a reciprocating machine.
Preferably, the computer main control system and the handheld power system perform data transmission and action control by wirelessly transmitting 2.4G low power, so as to realize space pose control of the handheld power system.
Preferably, a 3D mark point is arranged in the handheld power system, position capture can be performed by capturing any 3 points in space in the handheld power system, further positioning capture control of a compound angle is completed, and grinding and positioning of a forward-leaning abduction angle can be accurately completed.
Preferably, the hip joint orthopedic surgery navigation system sets depth boundary early warning and angle boundary early warning in the images subjected to primary registration and secondary registration.
Preferably, in the depth boundary early warning, the area to be polished in the image is set to be green through color management, the safety area is set to be white, the early warning area is set to be red, wherein the white area has a grinding tolerance of 1mm, and the red area has a grinding tolerance of 0.5 mm.
Preferably, in the angle boundary early warning, the fault-tolerant design of the anteversion angle of 15+/-5 degrees and the abduction angle of 40+/-5 degrees is designed according to the campbell theory aiming at acetabular cup replacement, so that the safety and the effectiveness of operation are ensured.
The foregoing describes preferred embodiments of the present invention, but is not intended to limit the invention thereto. Modifications and variations to the embodiments disclosed herein may be made by those skilled in the art without departing from the scope and spirit of the invention.
Claims (3)
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 carrying out CT scanning on a patient hip joint focus and then carrying out a segmentation model, acquiring an image of an acetabular cup of a patient and a three-dimensional model of the acetabular cup by combining a real-time position of a tracking target arranged on bone tissue of the patient, taking a medical image as a carrier, adopting a binocular vision tracking surgery tool to track relative pose of an acetabular cup entity of the patient, and carrying out primary registration and secondary registration between the image of the acetabular cup of the patient and the three-dimensional model of the acetabular cup based on characteristic points of the acetabular cup; the primary registration is to determine the positioning of the initial position of the pelvis acetabulum through 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 secondary registration is to determine the accurate spatial position of the pelvis acetabulum through 32 misaligned CT mark points respectively arranged on the pelvis acetabulum; the system comprises a handheld power system, an image registration system, a computer main control system and a control system, wherein the handheld power system is provided with an optical target, 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 a tracking target arranged on bone tissue of a patient in real time in the operation implementation process, the computer main control system can wirelessly communicate with the handheld power system, and the computer main control system calculates the real-time control signal of the handheld power system according to the position of the optical target on the handheld power system captured by the optical navigation system in real time, the real-time position of the tracking target arranged on bone tissue of the patient and the accurate space position of pelvis acetabulum determined by the image registration system through primary registration and secondary registration, so as to control the handheld power system through wireless communication; aiming at the prosthesis position determined by the preoperative system planning, the computer main control system can generate a control boundary and a depth boundary, carry out real-time tracking response, and carry out shutdown response on the condition exceeding the preoperative system planning so as to ensure the safety and the effectiveness of the bone grinding process;
the hip joint bone surgery navigation system sets depth boundary early warning and angle boundary early warning in the images subjected to primary registration and secondary registration;
in the depth boundary early warning, a region to be polished in the 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, wherein the white region has a grinding tolerance of 1mm, and the red region has a grinding tolerance of 0.5 mm;
in the angle boundary early warning, aiming at acetabular cup replacement, a fault-tolerant design of a anteversion angle of 15 degrees+/-5 degrees and an abduction angle of 40 degrees+/-5 degrees is designed according to the campbell theory;
the specific method for one-time registration comprises the following steps:
abstracting a similar sphere by taking the rotation center of the pelvis acetabulum as the 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 similar sphere, taking the straight line 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, adopting a least square method to complete the function fitting of the similar sphere and combiningThe error of the fitting function is minimized, the coordinates of the center of the approximate sphere after fitting in the world coordinate system are (alpha, beta, gamma), and the coordinates of any point on the surface of the approximate sphere after fitting in the world coordinate system are (x) i ,y i ,z i ) The difference e between the estimated value and the actual value after each point fitting 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 squares of the errors E (alpha, beta, gamma, R) of the fitting function is:
wherein N is an integer greater than or equal to 3;
the square sum E (alpha, beta, gamma, R) of errors of the fitting function is used for respectively obtaining partial derivatives of alpha, beta, gamma and R, and the partial derivatives are respectively equal to 0, so that the numerical solutions of alpha, beta, gamma and R are obtained; 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 the world coordinate system;
the hand-held power system is provided with the 3D identification points, and position capturing can be performed by capturing any 3 points in space in the hand-held power system, so that the positioning capturing control of the compound angle is finished, and the grinding and positioning of the forward-leaning abduction angle can be accurately finished;
the specific method for the secondary registration comprises the following steps:
assume that the coordinates of each of the misaligned 32 CT landmark points disposed on the pelvic acetabulum, respectively, in the world coordinate system are (x j ,y j ,z j ) Calculating the distance average value L between 32 CT mark points and points represented by coordinate values represented by alpha, beta and gamma:
replacing radius R in primary registration with distance average L, and fitting each point on the surface of the approximate sphere after re-fitting to obtain difference e between estimated value and 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 average 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 squares of the errors E (alpha, beta, gamma, L) of the fitting function is:
thirdly, respectively obtaining partial derivatives of the sum of squares E (alpha, beta, gamma, L) of errors of the fitting function on alpha, beta and gamma, and respectively enabling the partial derivatives to be equal to 0, so as to obtain numerical solutions of alpha, beta and gamma; establishing a virtual pelvic acetabulum reference coordinate system by taking alpha, beta and gamma in the numerical solution as an origin; the real-time position of a tracking target arranged on bone tissue of a patient, CT mark points respectively arranged on the upper part of the acetabulum, the front part of the acetabulum and the rear part of the acetabulum, 32 misaligned CT mark points respectively arranged on the pelvis acetabulum and the position of an optical target on a handheld power system captured by the optical navigation system in real time in the operation implementation process are projected into the virtual pelvis acetabulum reference coordinate system, so that the accurate spatial position of the pelvis acetabulum is determined.
2. The hip orthopaedic surgical navigation system of claim 1, wherein the hand-held power system includes an electric drill, a theatre and/or a reciprocator.
3. The navigation system for hip bone surgery according to claim 1, wherein the computer main control system and the handheld power system perform data transmission and motion control by wirelessly transmitting 2.4G low power, so as to realize space pose control of the handheld power system.
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