Classifications

• • 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
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
• • 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
  • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
• • 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
  • A61F2/3094—Designing or manufacturing processes
  • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
• • 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
  • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
  • A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
• • 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
  • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
  • A61F2/4261—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for wrists
• • B—PERFORMING OPERATIONS; TRANSPORTING
  • B33—ADDITIVE MANUFACTURING TECHNOLOGY
  • B33Y—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
  • B33Y10/00—Processes of additive manufacturing
• • B—PERFORMING OPERATIONS; TRANSPORTING
  • B33—ADDITIVE MANUFACTURING TECHNOLOGY
  • B33Y—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
  • B33Y50/00—Data acquisition or data processing for additive manufacturing
• • B—PERFORMING OPERATIONS; TRANSPORTING
  • B33—ADDITIVE MANUFACTURING TECHNOLOGY
  • B33Y—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
  • B33Y80/00—Products made by additive manufacturing
• • G—PHYSICS
  • G05—CONTROLLING; REGULATING
  • G05B—CONTROL OR REGULATING SYSTEMS IN GENERAL; FUNCTIONAL ELEMENTS OF SUCH SYSTEMS; MONITORING OR TESTING ARRANGEMENTS FOR SUCH SYSTEMS OR ELEMENTS
  • G05B19/00—Program-control systems
  • G05B19/02—Program-control systems electric
  • G05B19/18—Numerical control [NC], i.e. automatically operating machines, in particular machine tools, e.g. in a manufacturing environment, so as to execute positioning, movement or co-ordinated operations by means of program data in numerical form
  • G05B19/4097—Numerical control [NC], i.e. automatically operating machines, in particular machine tools, e.g. in a manufacturing environment, so as to execute positioning, movement or co-ordinated operations by means of program data in numerical form characterised by using design data to control NC machines, e.g. CAD/CAM
  • G05B19/4099—Surface or curve machining, making three-dimensional [3D] objects, e.g. desktop manufacturing
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
  • A61B2017/564—Methods for bone or joint treatment
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
  • A61B2017/568—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor produced with shape and dimensions specific for an individual patient
• • 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
  • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
  • A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
• • 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
  • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
  • A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
  • A61F2002/30688—Means for allowing passage or sliding of tendons or ligaments
• • 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
  • A61F2/3094—Designing or manufacturing processes
  • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
  • A61F2002/30948—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using computerized tomography, i.e. CT scans
• • 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
  • A61F2/3094—Designing or manufacturing processes
  • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
  • A61F2002/30952—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using CAD-CAM techniques or NC-techniques
• • 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
  • A61F2/3094—Designing or manufacturing processes
  • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
  • A61F2002/30962—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using stereolithography
• • 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
  • A61F2/3094—Designing or manufacturing processes
  • A61F2002/30985—Designing or manufacturing processes using three dimensional printing [3DP]
• • 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
  • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
  • A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
  • A61F2002/4256—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for carpo-metacarpal joints, i.e. CMC joints
  • A61F2002/4258—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for carpo-metacarpal joints, i.e. CMC joints for trapezo-metacarpal joints of thumbs
• • 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
  • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
  • A61F2/4261—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for wrists
  • A61F2002/4271—Carpal bones
  • A61F2002/4274—Distal carpal row, i.e. bones adjacent the metacarpal bones
  • A61F2002/4276—Trapezium
• • B—PERFORMING OPERATIONS; TRANSPORTING
  • B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
  • B29L—INDEXING SCHEME ASSOCIATED WITH SUBCLASS B29C, RELATING TO PARTICULAR ARTICLES
  • B29L2031/00—Other particular articles
  • B29L2031/753—Medical equipment; Accessories therefor
  • B29L2031/7532—Artificial members, protheses
• • G—PHYSICS
  • G05—CONTROLLING; REGULATING
  • G05B—CONTROL OR REGULATING SYSTEMS IN GENERAL; FUNCTIONAL ELEMENTS OF SUCH SYSTEMS; MONITORING OR TESTING ARRANGEMENTS FOR SUCH SYSTEMS OR ELEMENTS
  • G05B2219/00—Program-control systems
  • G05B2219/30—Nc systems
  • G05B2219/49—Nc machine tool, till multiple
  • G05B2219/49007—Making, forming 3-D object, model, surface

Definitions

• the present invention generally relates to the manufacture of a complex substitute object for replacing or replacing a real object in a given state, potentially damaged, in particular the manufacture of a trapezio-metacarpal prosthesis to replace the trapezoid bone of a human being subject to rhizarthrosis.
• the applicant has developed a method of manufacturing a complex substitution object having at least one functional zone and intended to replace or replace a real object, said method comprising the following steps:
• step A is performed on said real object being in a damaged state specific to a given deformation
• said method comprises between steps A and B, the following substeps:
• step B further comprises the following substeps:
• step A adaptation of the template on said three-dimensional image defined in step A, to using a drawing or CAD software, to obtain a specific model (that is, a template adapted to the damaged state);
• step b2) on the specific model, precise reconstruction of the damaged functional surfaces from the functional surfaces defined in step a'2), and approximate reconstruction, of the damaged filling surfaces from the functional surfaces defined in step a'2), to obtain a three-dimensional image reconstructed in the damaged state;
• step b3) accurately reconstructing, on the three-dimensional image reconstructed in the damaged state, functional surfaces in the undamaged state, by modifying the values of the topological and morphological parameters sensitive to the deformation defined in step a '3) of so that they correspond to an absence of deformation, to obtain a three-dimensional image reconstructed in the undamaged state;
• the first step of the method according to the invention is step A of acquiring a three-dimensional image of said real object which is digitized.
• This step can be carried out in various ways, and in particular by three-dimensional scanning (or "3D scanning") using a 3D scanner. By this technique, three-dimensional synthetic images are obtained which do not need to be segmented later.
• step A will be done in two steps, including the acquisition of three-dimensional images by techniques.
• medical imaging systems such as Magnetic Resonance Imaging (generally known by the acronym "MRI"), which are then subjected to further segmentation processing.
• MRI Magnetic Resonance Imaging
• the images are obtained by 3D scan, they are directly in the form of a scatter plot (segmentation is not necessary)
• step A of acquisition of the three-dimensional image of the object is carried out real, formatting the image into a neutral format (eg an STL file) compatible with a computer-aided drawing or design software.
• a neutral format eg an STL file
• the method according to the invention further comprises a substep a'1) of definition of invariant topological and morphological parameters of the real object, from which a template is defined.
• invariant topological and morphological parameters of the real object is meant, in the sense of the present invention, parameters which are constantly present from one real object to another, whether or not it is damaged or not and belonging to to the same category or type of object, for example from one trapezoid oz to another.
• template is understood to mean a generic model of an undamaged object (in the sense of being undeformed and undamaged by any use), which is defined by its invariant topological and morphological parameters.
• Topological and morphological invariant parameters are preferably placed on functional areas.
• Functional zones or surfaces of a given object within the meaning of the present invention, of the surfaces of the object having a given function, whether kinematic or otherwise.
• the template can be defined with joined or non-joined surfaces.
• adjoining surfaces is meant in the sense of the present invention, surfaces located side by side and defined by the same common curve. This implies that the two adjoining surfaces are dependent on each other.
• the definition of the common side is similar to both surfaces, even if they have different functions. In addition, there is no free space between the two surfaces.
• adjoining surfaces is meant, in the sense of the present invention, surfaces located side by side but which do not rest on the same curve. This implies that the two surfaces are independent of each other and there is a free space between the two surfaces. It is possible to put several surfaces facing one and the same surface.
• the method according to the invention further comprises, after sub-step a '1), a sub-step a' 2) of determining the functional (or interest) surfaces and the surfaces filling (of minor importance, including areas other than areas of interest) from the actual object to the undamaged stage.
• the method according to the invention comprises a sub-step a '3) of determining the topological and morphological parameters sensitive to the deformation of the real object (in the state damaged and identification of their variations, at the so-called functional surfaces.
• This step can be performed from a statistical database of the actual geometry of known objects similar to said real object, in order to find an object at the same time. undamaged condition, especially at so-called functional surfaces.
• Step B of the method according to the invention consists in reconstructing from the possibly segmented three-dimensional image, a three-dimensional model of the real object using a drawing software or computer-aided design.
• Step B of the method according to the invention comprises in particular a first substep bl) of adapting the template on the digitized three-dimensional image obtained in step A, using a drawing or CAD software , to obtain a specific model, that is to say a template adapted to the damaged object.
• the sub-step b4) of reconstructing the functional surfaces in the damaged state consists in modifying, on a three-dimensional image reconstructed in the undamaged state (obtained in the sub-step b3), the Morphological parameters sensitive to deformation, so that they correspond to an absence of deformation on the basis of the information obtained during the sub-step a '3).
• step B may advantageously comprise, at the end of step b5), a step b6) of overall or localized smoothing of said closed volume model, which can be performed by a surface or volume method.
• This step is optional but strongly recommended because of the few number of points defining the template (the possibility of having sharp edges that can be harmful for the patient in fine).
• this step is strongly recommended if the creation of the closed volume model is done by voxels.
• the method according to the invention is particularly suitable for producing complex objects salts of orthopedic insoles or dental prostheses, auditory, or bone for a human or animal body.
• template in the sense of the present invention, is understood to mean the adimensional generic model of a part of a human body that one seeks to replace or supplement (by a prosthesis or a sole), which is the one a healthy subject (non-sick person) who has not been deformed or has suffered from degeneration or deformity.
• the method according to the invention is particularly suitable for manufacturing a trapezometacarpal prosthesis as a complex object of substitution of a trapezoidal bone of a human being (real object).
• a prosthesis is intended to be implanted in the hand of a patient at level of the trapeziometacarpal joint. This implantation is performed during a surgical procedure called prosthetic arthroplasty consisting in replacing, partially or totally, the diseased joint by a prosthesis. It is a therapeutic solution commonly used in the case of osteoarthritis which is a destruction or degeneration of the articular surfaces.
• the areas of interest of the trapezoid bone will be the articular surfaces, that is to say the articulation surface with the second metacarpal, the articulating surface with the scaphoid, the articulation surface with the trapezoid, and optionally the surface defining a groove for the passage of flexor carpi radialis tendon.
• the present invention also relates to a trapezio-metacarpal prosthesis obtained by the manufacturing method according to the invention as specifically defined for the manufacture of a trapezio-metacarpal prosthesis.
• Figure 1 is a top view of a skeleton of a hand with a trapezio-metacarpal prosthesis according to the invention
• Figure 2 is a detail and side view of the prosthesis of Figure 1;
• Fig. 3 is a three-dimensional view of the implantation of the prosthesis of Fig. 1, in which only the first metacarpal and trapezoid of the skeleton of the hand are shown;
• FIG. 4 shows where the trapezometacarpal joint is located in a patient's hand
• Figure 5 includes two sets of 3D images obtained by MRI and segmentation of the trapezometacarpal joint in the hands of two patients with rhizarthrosis, one for the left hand of both patients ( Figure 5a) and the other for the right hand of these two patients ( Figure 5b);
• Figure 6 shows the topological and morphological parameters constantly present from one trapezoid bone to another
• Figures 7a to 7p show the variations of these topological and morphological parameters of a trapezoidal bone
• Figures 8a to 8c show the evolution of the convex and concave curvatures of the contact surface with the 1st metacarpus according to the osteoarthritic state of the joint;
• FIGS. 9a to 9g show steps A to B6 of digital reconstruction of a trapezoid bone that has not undergone rhizarthrosis-related deformation, according to the method according to the invention, in which step b5) of reconstruction of a closed volume model of the substitution object to be manufactured is produced by a surface method (called Poisson reconstruction: see FIG. 9f) or by a voluminal method, called a voxel filling method (that is to say cubes). digital: see Figure 9g);
• FIG. 10 shows the template of a trapezoid bone and the set of points and curves defining it;
• FIG. 11 shows the evolution of a smoothing of the closed volume model until the disappearance of the sharp angles while preserving the integrity of the parameters of a previously defined healthy trapezoidal bone;
• FIG. 12 shows the various elements of the trapezio-metacarpal prosthesis to be added (1111) or extracted (1111);
• FIG. 13 shows steps C and D of the process according to the invention in the context of the manufacture of a trapezio-metacarpal prosthesis, since obtaining the closed volumic model of the trapezoid bone to be reconstructed to additive manufacturing. and the final smoothing (respectively steps 13d and 13e) leading to the prosthesis of the trapezoid bone, which is finally implanted in the hand of a patient at the trapezio-metacarpal joint (13f);
• FIG. 14 shows that the mobility properties of the hand are preserved after a prosthetic arthroplasty operation with the prosthesis of the trapezoid bone according to the invention.
• Figure 15 shows the different steps A and B of rebuilding a cup from a deformed cup.
• Image Segmentation Software OSIRIX, MATERIALIZE Segmented Image Segmentation Software: OSIRIX MATERIALIZE
• trapezium-metacarpal prosthesis trapezium schematically shown in Figures 1 to 3 and shown in the photographs of Figures 13d and 13e (Example 1),
• Trapezoid-metacarpal prosthesis trapezium bone schematically shown in Figures 1 to 3 and shown in the photographs of Figures 13d and 13e. material used for the additive manufacturing of the prosthesis: CrCoMo, TA6V.
• FIGS. 1 to 3 relating to example 1
• This trapezio-metacarpal prosthesis here comprises a prosthetic trapezium 111, a metacarpal pin 117 and an anchoring screw 113. It is intended to be placed between the first metacarpal 214 and the trapezoid 212 of a patient.
• the prosthetic trapezium 111 is anchored to the trapezoid 212 with the anchoring screw 113.
• the metacarpal peg 117 comprises two parts, here referred to one another: a base 115 and a head 116.
• the patient's hand is scanned by MRI or tomography and then transformed into point clouds (STL format).
• the technical characteristics of medical imaging and point cloud extraction are chosen so as to discretize the cortical part of the bones ( Figures 5a and 5b).
• An STL digital file is extracted and the reference points defining the template are adapted to the patient model using a CAD software or mesh editing software.
• MESHLAB software an open source software 3D mesh editing allows you to view STL files.
• the template makes it possible to eliminate the protuberances and non-anatomical roughness very present in a bone with an advanced osteoarthritis state.
• Figure 6 shows the topological and morphological parameters constantly present from one trapezoid bone to another.
• SCP o Scaphoid
• Figures 7a to 7p show all the measurements made on these landmarks in order to know their variability as a function of the osteoarthritis state.
• the parameters relating to the area of contact with the first metacarpal are very sensitive to the osteoarthritis state (431).
• FIGS. 8a to 8c show more specifically that the concave (441) and convex (442) curvatures of the surface of contact with the first metacarpal vary according to the osteoarthritis state of the joint.
• the curvatures are concave and are very pronounced for a healthy subject (4411) and weakly pronounced in the osteoarthritic state (4412).
• the convex curvatures are very pronounced in the osteoarthritic state (4422) and weakly pronounced for a healthy subject.
• Healthy concave curvatures (4411) decrease along the radioulnar line but are stable for osteoarthritis (4412).
• Healthy convex curvatures (4421) grow along the radioulnar line but decrease slightly for osteoarthritis (4412).
• Figures 9a to 9f show the different steps of reconstruction of a three-dimensional model of a trapezoid bone that has not undergone rhizarthrosis-related deformation.
• FIG. 14 shows that the mobility properties of the hand are preserved after a prosthetic arthroplasty operation with the prosthesis of the trapezoid bone according to the invention.
• the whole of the movements relative to the trapezio-metacarpal joint were correctly realized, it is about the movements of retropulsion (91), antepulsion (92), abduction (93), adduction (94) and circumduction according to their respective extent .
• EXAMPLE 2 Reconstruction using a drawing software, a three-dimensional model of a cup that has not been deformed from a deformed cup (steps A and B of the method according to the invention)
• FIG. 15 shows the sequence of steps performed for this purpose from:

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• 2018
  • 2018-02-26 FR FR1851657A patent/FR3078418B1/fr not_active Expired - Fee Related
• 2019
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