JP2020096761A - Guide system for supporting artificial joint installation surgery, and instrument for the same - Google Patents

Abstract

To provide a guide system for supporting an artificial joint installation surgery capable of appropriately installing an artificial joint in a short time along a pre-operative plan.SOLUTION: A patient-adapted surgery support guide instrument 500 is pressed by an operator's hand to a corresponding part of the femoral neck so as to bridge the intertrochanteric crest after sterilization treatment and is fixed to a bone surface airtightly. Then, the operator cuts the caput femoris along an end edge 512A of a contact part 512 of the patient-adapted surgery support guide instrument 500. Next, on the basis of a pre-operative plan, a rasp handle 10 to use is fitted to a handle 110 of a surgical instrument 100, and a posture of the surgical instrument 100 is adjusted with reference to laser beam LB so that this is projected to the center of a projection index part 520. In this state, by hitting a head 50 of the rasp handle 10 with a hammer, the medullary space of the femur TB is dug by the rasp 30.SELECTED DRAWING: Figure 4

Description

The present invention relates to a surgical assistance guide system suitable for installing components in artificial joint installation surgery, and particularly to an artificial joint installation surgical assistance guide for installing a femoral stem, an acetabular cup, or the like. The present invention relates to improvement of a system and its equipment.

In artificial joint surgery, proper placement of artificial joint components such as the femoral stem and cup is necessary to properly transfer the stress applied to the artificial joint to the bone and to obtain an appropriate range of motion without dislocation. is important. By accurately cutting the bone and installing the artificial joint component in the correct location (position/angle), good load distribution and range of motion can be obtained, and the occurrence of wear and looseness of the component is reduced, and the artificial joint component It becomes possible to delay the replacement time to prolong the service life, and ultimately to improve the quality of life (QOL).

In other words, placing the artificial joint component in an appropriate alignment position should be such that it does not cause dislocation, adapt the artificial joint component of the optimal size to allow for the individual bones of the patient, and stabilize and It is one of the main points of artificial joint surgery because it affects the results. For example, in the case of total hip arthroplasty,
a, resection of the femoral head,
b, Excavation of femoral bone marrow cavity (excavating bone marrow to form medullary cavity),
c. The procedure is performed by inserting, fixing or installing the femoral stem. In order to insert and fix or install the femoral stem in the most important item c, it is necessary to perform the excision of the femoral head of the item a and the excavation of the medullary cavity of the item b in the appropriate excision position and excavation direction. ..

These operations are performed based on a preoperative plan, but what can be referred to in actual surgery is a part of the bone deployed from the skin incision that can be seen directly in the operative field. However, due to obesity, there are many cases where the development of the surgical site is limited. In addition, when the bone morphology is significantly deformed, it is far from the usual anatomy, so the operator makes a mistake in judgment, resection of the femoral head at a height different from the preoperative plan, and medullary cavity in different directions. There is a risk that the excavation of the femur and the installation of the femoral stem at different positions may be performed. In such a case, there is a possibility that complications may occur during or after surgery, such as fracture of the femur during insertion of the femoral stem or dislocation after surgery. Currently, a navigation device that guides a precise preoperative plan during surgery is being developed by computer technology, but it is not popular in general, and the positioning and positioning based on the experience and intuition of the surgeon (doctor). The reality is that the installation direction is aligned, and there is a need for a simpler and easier-to-operate method and device that can accurately reproduce the preoperative plan.

For example, in Patent Document 1 below, an object is to perform an operation such as bone resection, bone marrow cavity excavation work, or component installation in a short time in accordance with a preoperative plan, and for an operator to intuitively grasp the work. The navigation system and the guide device are disclosed. According to this, a patient-adaptive surgical support guide instrument provided with a relative angle detector is pressed against the relevant part of the femoral neck and closely fixed, and along the edge of the contact fixing part of the fixed guide tool. Perform the osteotomy of the femoral head and grasp the insertion center point of the femoral stem. Next, the operator holds the grip portion of the stem side guide instrument provided with the relative angle detector, and stands the tip of the rasp at the insertion center point of the stem. In this state, the posture of the relative angle detector is grasped by the posture detecting device, and the medullary cavity of the femur is excavated and the stem is inserted in the optimum posture while correcting the angle of the stem side guide instrument.

JP, 2018-198113, A

By the way, the background art described above uses a wire, and by using this,
a. The storage unit for storing the relative angle detector can be fixed to the fixed guide tool.
b. One of the orthogonal coordinate axes preset in the relative angle detector coincides with the direction of the wire. Therefore, by making the wire guide of the movable piece contact the wire, the center of the rasp becomes the stem insertion point. So that the positioning can be done.
By referring to c and the scale of the wire, it is possible to know the excavation depth by the rasp and the insertion depth of the stem.
I am trying. However, in the background art described above, although there is an advantage due to the existence of the wire, the wire may rather hinder the medullary cavity excavation work during excavation by the rasp, so that it may be necessary to remove and operate it. is there. In addition, when confirming the coincidence of the center direction of the rasp with the rod-shaped wire, it is necessary to replace the reference axes in the varus-valgus direction, the bending direction, and the rotation direction vertically and horizontally. Furthermore, in order to accurately confirm the direction of the preoperative plan, it is necessary to visually check from the front of the reference axis, and there is a problem that the direction may be mistaken when viewed obliquely.

The present invention focuses on the above points, does not hinder the installation work such as a rasp and the excavation work of the bone marrow cavity, does not need to be replaced by the reference axis, and does not mistake the direction visually. It is an object of the present invention to provide a guide system for assisting an artificial joint placement operation and an instrument thereof that can be accurately performed in a short time according to a preoperative plan.

The artificial joint installation surgery support guide system of the present invention is an artificial joint for determining an appropriate position and posture of a surgical instrument for performing a necessary operation when installing an artificial joint based on a preoperative plan. An installation surgery support guide system, which is installed on the surgical instrument side, is provided on the surgical instrument side guide instrument equipped with a laser device, and is installed on the bone side and is adapted to a patient to which a laser beam output from the laser device is projected. Type surgical support guide instrument, the surgical instrument side guide instrument is provided with a laser light adjusting means for adjusting the optical axis of the laser light output from the laser device in the artificial joint installation axial direction, The patient-adapted surgery support guide instrument comprises a target onto which the laser light is projected, and when the laser light output from the laser device is projected onto the target, the surgical instrument is in a preoperative plan. It is characterized in that the position of the laser device with respect to the surgical instrument is adjusted by the laser light adjusting means so that the position and the posture are determined, and the target in the patient-compatible surgery support guide instrument is set. ..

According to one of the main modes, the laser device of the surgical instrument side guide instrument is a laser device that outputs a cross laser beam as the laser, and the target is a cross target that is predetermined in a preoperative plan. The surgical instrument is adjusted by the laser light adjusting means so that the cross of the cross laser light and the cross of the target coincide with each other when the position and posture are determined in the preoperative plan. It is being done.

According to another aspect, the patient-adaptive surgery support guide device has a shape corresponding to the shape of the bone obtained in advance in the preoperative plan, and abutment and fixation for abutting the bone to fix the guide device. It is characterized by having a section.

According to the surgical instrument side guide instrument of the present invention, the surgical instrument side guide instrument is provided with the laser beam adjusting means for adjusting the optical axis of the laser beam output from the laser device in the axial direction of the artificial joint installation. The laser light adjusting means adjusts the position of the laser device with respect to the surgical instrument so that the surgical instrument has a position and a posture determined in a preoperative plan when the laser beam is projected onto the target. It is characterized by performing.

According to the patient-adaptive surgery support guide instrument of the present invention, the laser beam is provided with a target, when the laser beam output from the laser device is projected onto the target, the surgical instrument, It is characterized in that the target is set so as to have a position and a posture determined in the preoperative plan.

Examples of the artificial joint include a femoral stem and a cup component in a hip joint. For example, a cross-shaped laser beam is used as the laser beam. Further, an example of the laser light adjusting means corresponds to a slide type adjusting device capable of moving the laser device in two-dimensional or three-dimensional directions orthogonal to each other. The above and other objects, features and advantages of the present invention will be apparent from the following detailed description and the accompanying drawings.

According to the present invention, a laser device is attached to a guide instrument on the side of an artificial joint surgical instrument such as a rasp, and the laser of the laser device is added to a patient-adaptive surgery support guide instrument designed and shaped based on a surgery plan for each patient. In addition to having a system configuration with a projection index part that is a target of light, the patient-adaptive surgery support guide instrument is irradiated with laser light from the artificial joint surgery instrument guide instrument side to perform alignment (alignment) of the artificial joint surgery instrument. Since it is decided to perform the surgery, the surgery for installing the artificial joint can be accurately performed in a short time in accordance with the preoperative plan.

It is a perspective view showing a rasp side guide instrument in Example 1 of the present invention. It is the figure which looked at the said FIG. 1 from the arrow F2 direction. It is a figure which shows the femur side guide instrument in the Example of this invention. (A) is a perspective view, and (B) is seen from the direction of arrow F3 in the same figure. It is a perspective view showing a situation at the time of excavating the femoral bone marrow cavity by the guide device. It is the figure which looked at the said FIG. 4 from the arrow F5 direction. It is a perspective view showing Example 2 of the present invention.

Hereinafter, modes for carrying out the present invention will be described in detail based on Examples.

Hereinafter, with reference to FIG. 1 to FIG. 5, an embodiment will be described in which the guide system for assisting artificial joint placement surgery of the present invention is applied to a guide system for femoral stem placement. The guide system of the present invention includes a surgical instrument-side guide instrument for an artificial joint and a patient-compatible surgical assistance guide instrument. First, the surgical instrument side guide instrument will be described. FIG. 1 shows a rasp side guide instrument 100 which is a surgical instrument side guide instrument of the present embodiment, and FIG. 2 shows a state of the figure seen from the direction of arrow F2. In these drawings, a rasp handle 10 which is a surgical instrument for excavating a medullary cavity has a mechanism in which a rasp 30 corresponding to the shape size of an artificial hip joint can be attached to and detached from the distal end side of a main body 20 that is entirely bent in an arc shape. A grip portion 40 and a head portion 50 for hammering are provided on the opposite side of the main body 20. A fixing hole 42 is formed in the grip portion 40. The structure of such a rasp handle 10 is known.

Next, the rasp-side guide device 100 of the present embodiment is constructed around a handle 110 in which the grip portion 40 of the rasp handle 10 is housed. The handle 110 has an opening 112 formed on the side surface in the longitudinal direction (see FIG. 2), and the grip portion 40 of the rasp handle 10 is accommodated in the handle 110 through the opening 112. The handle 110 is provided with a fixing hole (not shown), and the fixing screw 114 is passed through the fixing hole to the fixing hole 42 of the grip portion 40 of the rasp handle 10 to tighten the rasp handle. 10 is fixed to the handle 110.

Here, assuming that the insertion direction of a stem (not shown) that is an artificial joint component to be installed in the femur is the Z direction, the arm (hereinafter, referred to as “the below” in the X direction orthogonal to the Z direction is provided below the handle 110. 200). An X slider 210 is slidably provided on the X arm 200, and the position of the X slider 210 in the X direction with respect to the X arm 200 is adjusted by moving the X slider 210 by tightening and loosening a fixing screw 212. You can do it.

The X slider 210 is provided with a Y arm 300 extending in a Y direction orthogonal to the X direction, and the Y arm 300 is fixed to the X slider 210 by tightening a fixing screw 230.

A Y slider 310 is slidably provided on the Y arm 300, and by moving the Y slider 310 by tightening and loosening a fixing screw 312, the position of the Y slider 310 in the Y direction with respect to the Y arm 300 can be adjusted. It is like this. A laser device 400 is provided on the Y slider 310, and a cross-shaped laser beam is output in the Z direction described above.

The basic operation of the rasp-side guide device 100 as described above will be described. The grip 110 of the rasp handle 10 is fitted into the opening 112 of the handle 110. Then, the rasp handle 10 is fixed to the handle 110 by fastening the fixing screw 114 from the handle 110 through the grip portion 40 of the rasp handle 10. On the other hand, the laser device 400 moves in the XY direction by the X slider 210 moving along the X arm 200 and the Y slider 310 moving along the Y arm 300. With these, the laser device 400 is moved in the XY plane, and the position is adjusted so that the laser light is in the artificial joint installation axis direction (that is, the central axis direction of the rasp handle 10=Z direction) during surgery. That is, even when the rasp 30 is replaced with another size and shape, the center of the laser beam can be adjusted to match the artificial joint installation axis.

Next, the patient-adaptive surgery support guide instrument 500 installed on the femur side will be described. FIG. 3(A) shows a patient-adaptive surgery support guide instrument 500, and a state seen from an arrow F3 in FIG. 3 is shown in FIG. 3(B). In these figures, the patient-compatible surgery support guide instrument 500 is
a, a contact fixing portion 510 for fixing the entire patient-compatible surgical support guide instrument 500 that abuts and closely contacts the femur,
b, a projection index portion (target) 520 for indicating the projection position of the laser light,
Is equipped with.

Of these, the abutment fixing portion 510 is similar to that in the above-mentioned patent document, and abuts on the greater trochanter and lesser trochanter of the femoral neck of the femur TB, respectively, and from the greater trochanter to the lesser trochanter. It is provided with an abutting portion 512 having a concave portion that is learned from the hook portion caught on the intertrochanteric ridge to the femoral neck. By providing the hooks that are shaped so as to straddle the intertrochanteric ridge, it is possible to stably fix them to the femoral neck with a small contact area. An edge 512A of the contact portion 512 is formed so as to indicate a bone cutting high position (cutting position) of the femoral neck. The bone cutting height is determined by a doctor at the stage of preoperative planning in consideration of the length of the patient's foot, the shape of the medullary cavity of the femur TB, the size of the femoral stem to be used, and the like.

Next, the projection index portion 520 is composed of rectangular parallelepiped blocks BA, BB, BC, and has a structure in which these blocks BA, BB, BC intersect. In other words, the blocks BA, BB, and BC are respectively extended from the intersection center in the orthogonal direction. A part of the block BB is cut off obliquely along the edge 512A of the contact portion 512 of the contact fixing portion 510. That is, when cutting the femoral neck along the edge 512A of the contact portion 512, each block of the position display unit 520 does not interfere with the cutting. Wire holding through holes QA, QB, QC are formed through these blocks BA, BB, BC, respectively, and a cross target TG is provided on the surface. These wire holding through holes QA, QB, and QC are for inserting a guide wire as shown in the above-mentioned patent document, and can also be used as a guide device using the wire. ing.

The patient-compatible surgery support guide instrument 500 having the above-described shape and structure is manufactured as follows.
(1) First, a CT (Computed Tomography) image or an MRI (Magnetic Resonance) image of the hip joint of a patient undergoing total hip arthroplasty is acquired.
(2) Next, a computer obtains a three-dimensional image of the hip joint portion, and based on the three-dimensional image, a preoperative planning of the artificial hip joint replacement is performed. As such three-dimensional preoperative planning software for artificial hip joint replacement, there is, for example, "ZedHip" manufactured by Lexy Co., Ltd. This allows
a, the shape of the patient's femur TB,
b, size of the femoral stem (implant) to be used,
c, high bone cutting position,
d, varus/valgus, anteversion/posterior torsion, flexion/extension direction,
e, the insertion center point DX of the femoral stem on the osteotomy TBC of the femur TB,
Is determined.
(3) Next, the rapid prototyping technique using a 3D printer or the like is applied to manufacture the patient-compatible surgery support guide instrument 500 with a photoresin or the like. The shape of the contact fixing part 510 of the patient-adaptive surgery support guide instrument 500 is specified by the shape of the femur TB of the patient (a) and the bone cutting height (c). The shape of the projection index portion 520 of the patient-adaptive surgery support guide instrument 500 is specified by the stem insertion center point DX on the bone cutting surface TBC in each direction of d and e. In addition, the shape of the projection index portion 520 is specified so that the directions of the wire holding through holes QA, QB, QC of the blocks BA, BB, BC coincide with the Z, X, Y directions shown in FIG. 1, respectively. It As shown in FIG. 3A, the stem insertion center point DX is located on the extension of the laser light projected on the projection index portion 520 in the X direction. The patient-compatible surgical support guide instrument 500 is manufactured for each patient because it corresponds to the bony irregularities peculiar to the patient in the hip joint portion. The above points are the same as the background art described above.

Next, the operation of this embodiment will be described with reference to FIGS. 4 and 5. First, after the sterilization treatment, the patient-adaptive surgical support guide instrument 500 described above is pressed by an operator's hand to the corresponding portion of the femoral neck so as to straddle the intertrochanteric ridge, or a hole in the block BC. Fixing pin is fixed from QC to fix closely to the bone surface. Next, the operator cuts the femoral head along the edge 512A of the contact portion 512 of the patient-compatible surgery support guide instrument 500. 3 to 5 show the state after cutting. Subsequently, the operator grasps the insertion center point DX (see FIG. 3) of the femoral stem. As a method of grasping the insertion center point DX, for example, the stem assisting tool disclosed in JP-A-2014-42818 is used. If necessary, the pilot hole may be opened using a small-diameter drill in the insertion direction of the femoral stem at the insertion center point DX. The above cutting of the femoral head is the same as in the above-mentioned publication.

Next, the surgeon attaches the rasp handle 10 to be used to the handle 110 of the rasp-side guide instrument 100 based on the preoperative plan, and slides the Y slider 310 along the Y arm 300, whereby the laser device 400. The position of is adjusted and fixed at a position where one surface of the cross laser light is irradiated so as to pass through the central axis of the rasp 30.

Next, the operator holds the handle 110 of the rasp-side guide instrument 100, applies the tip of the rasp 30 of the rasp handle 10 to the insertion center point DX on the osteotomy surface TBC of the femur TB, and outputs from the laser device 400. The cross laser light LB hits the cross target TG, that is, it becomes the center (center of the hole QA of the block BA) of the projection index portion 520 of the patient-adaptive surgery support guide instrument 500, and each surface of the cross laser light is projected. The posture (direction or inclination) of the rasp handle 10 is adjusted so as to pass through the centers of the rectangular parallelepiped cross blocks BA, BB, and BC of the index portion 520 three-dimensionally. As described above, the cross-shaped blocks BA, BB, BC of the projection index portion 520 are preliminarily shaped so that the directions of the wire holding through holes QA, QB, QC respectively match the Z, X, Y directions shown in FIG. Is determined, and the position of the laser device 400 is set so that the cross laser light passes three-dimensionally in parallel with the center of the cross-shaped block-shaped projection index portion 520. Therefore, the surgeon refers to the cross laser beam LB and adjusts the posture of the rasp side guide instrument 100 so that this is projected on the cross target TG of the projection index portion 520, and thus the posture of the rasp handle 10 is also adjusted. The posture will be adjusted according to the preoperative plan. Note that “three-dimensionally parallel” means that the cross laser light is projected in the XY plane from the Z axis direction.

In this state, the surgeon drives the head 50 of the rasp handle 10 with a hammer (not shown) to excavate the medullary cavity of the femur TB by the rasp 30. This operation is repeated every time the size of the rasp 30 is changed on the rasp handle 10, thereby excavating the medullary cavity according to the preoperative plan. The depth of excavation depends on the operator's judgment, but as an example, the bone cutting line indicating the bone cutting high position (cutting position) of the femoral neck is a standard, and the rasp 30 is, for example, about 4 mm from the bone cutting line. If it goes deep, replace it with the next size rasp 30 and repeat until fit.

As described above, according to the present embodiment, the guide system for femoral stem installation is configured by the rasp-side guide instrument 100 and the patient-adaptive surgery support guide instrument 500, and the patient-adaptive surgery support guide instrument 500 is attached to the rasp side. Since the guide device 100 is irradiated with cross laser light to align the guide device, the following effects can be obtained.
a. The installation and excavation work of the rasp handle 10 in the medullary cavity of the femur TB can be accurately performed in a short time in accordance with the preoperative plan.
b. Since the wire is not used, the work can be smoothly performed without interfering with the excavation operation and without removing the wire or changing the direction of the wire.
c. The structure of the guide device is simplified and the operability is improved.

Second Embodiment Next, a second embodiment of the present invention will be described with reference to FIG. In the above-mentioned embodiment, the case where the femoral-sided stem component of the total hip arthroplasty is installed is described as an example. However, even when the cup component is installed on the acetabular side by the cup driving device, a cross that fits the edge of the acetabulum By using a system that uses a patient-specific guide device equipped with the target and a cross laser device on the side of the cup driver, the cup component on the acetabular side is similarly adjusted so that the angle (posture or inclination) of the surgical plan is achieved. Can be installed and guided.

FIG. 6 shows a state in which the cup component 604 is installed by the cup impactor 600 on the hip joint HB of the pelvis PB. The cup impactor 600 has a cup component 604 attached to the tip of a cup impactor shaft 602, and a handle 606 provided on the opposite side. The artificial joint installation surgery assistance guide system according to the present embodiment includes a surgical instrument side guide instrument 150 installed on the cup impactor 600 side and a patient compatible surgery assistance guide instrument 550 installed on the cup component 604 side. It is composed by.

Next, the surgical instrument side guide instrument 150 will be described. The above-mentioned cup component 604 is inserted in the Z direction, and the directions orthogonal thereto are the X and Y directions. The shaft slider 152 is slidably provided on the cup impactor shaft 602 described above by tightening and loosening the fixing screw 154. A Y arm 156 is provided on the shaft slider 152 in a direction orthogonal to the shaft slider 152, and the Y arm 156 is movable by tightening and loosening a fixing screw 158. The Y arm 156 is provided with a Y slider 160, which can be moved by tightening and loosening a fixing screw 162. The Y slider 160 is provided with a holder 164 and a laser device 166. The laser device 166 outputs a cross-shaped laser beam in a direction orthogonal to the Y arm 156, that is, in the direction of the cup impactor shaft 602.

On the other hand, the patient-adaptive surgery support guide device 550 is adapted to guide the position, angle, and reaming depth of the cup component 604 by adapting to the edge of the acetabulum of the patient. It is provided with a contact fixing part 552 that abuts against the projection index part 554. The shape of the contact fixing part 552 is specified in the preoperative plan on the basis of the data such as the CT image of the hip joint of the patient, as in the above-described embodiment, and is manufactured for each patient.

The projection index portion 554 is configured by a cross-shaped block, and a cross-shaped target TG is provided on the surface. In addition, a wire holding through hole QZ is provided at the center so that it can be used as a guide device using a wire. Then, when the cup component 604 reaches an appropriate installation position, the direction of the cup impactor shaft 602 coincides with the Z direction, and the laser light is emitted from the laser device 166 on the XY plane of the projection index portion 554. In the preoperative plan, the projection index portion 554 is formed so that the cross laser light is projected, and the position of the laser device 166 in the surgical instrument side guide instrument 150 is specified.

Therefore, the operator grasps the handle 606 of the cup impactor 600 and adjusts the direction and angle of the cup impactor shaft 602 so that the cross target of the projection index portion 554 and the cross laser beam LB match. Thus, the cup component 604 can be guided and installed so that the cup component 604 has a posture or inclination according to the preoperative plan. Further, since the wire is not used, the work can be smoothly performed without disturbing the installation operation of the cup component 604.

The present invention is not limited to the above-described embodiments, and various changes can be made without departing from the scope of the present invention. For example, the following is also included.
(1) The shape and structure of each device shown in the above embodiment is an example, and may be appropriately changed so as to achieve the same action.
(2) There are cement type and cementless type artificial joints, but the present invention is applicable to any type.
(3) It does not prevent the work such as excision of the femoral neck, excavation of the femoral marrow cavity by rasp, and insertion of the femoral stem using different instruments. For example, the insertion of the femoral stem may be performed using a stem impactor or the like (not shown) different from the above-mentioned stem side guide device.
(4) In the above-described embodiment, the laser beam is emitted from the rasp-side guide instrument 100 toward the patient-adapted surgery support guide instrument 500, but the opposite is also possible in principle.

According to the present invention, a laser device is attached to a guide instrument on the side of an artificial joint surgical instrument such as a rasp, and the laser of the laser device is added to a patient-adaptive surgery support guide instrument designed and shaped based on a surgery plan for each patient. In addition to having a system configuration with a projection index part that is a target of light, the patient-adaptive surgery support guide instrument is irradiated with laser light from the artificial joint surgery instrument guide instrument side to perform alignment (alignment) of the artificial joint surgery instrument. Since it is decided to perform the surgery, the surgery for installing the artificial joint can be appropriately performed in a short time in accordance with the preoperative plan, which is suitable for the artificial joint replacement surgery.

10: Rasp handle (surgical instrument)
20: Main body 30: Rasp 40: Grip 42: Fixing hole 50: Head 100: Rasp side guide instrument (surgical instrument side guide instrument)
110: Handle 112: Opening 114: Fixing screw 150: Surgical instrument side guide instrument 152: Shaft slider 154: Fixing screw 156: Y arm 158: Fixing screw 160: Y slider 162: Fixing screw 166: Laser device 200: X arm 210: X slider 212: Fixing screw 230: Fixing screw 300: Y arm 310: Y slider 312: Fixing screw 400: Laser device 500: Patient-adaptive surgery support guide instrument 510: Contact fixing part 512: Contact part 512A: Edge 520: Projection index part 550: Patient-adaptive surgery support guide instrument 552: Contact fixing part 554: Projection index part 600: Cup impactor 602: Cup impactor shaft 604: Cup component 606: Handles BA, BB, BC : Cross block DX: Stem insertion center point LB: Cross laser light QA, QB, QC: Wire holding through hole TB: Femur TBC: Osteotomy HB: Hip joint PB: Pelvis QZ: Wire holding through hole

Claims (5)

A guide system for assisting artificial joint installation surgery for determining an appropriate position and posture of a surgical instrument for performing necessary surgery when setting an artificial joint, based on a preoperative plan,
A surgical instrument side guide instrument provided on the surgical instrument side and provided with a laser device,
A patient-adaptive surgical support guide device installed on the bone side, onto which the laser light output from the laser device is projected,
Is equipped with
The surgical instrument side guide instrument,
Laser light adjusting means for adjusting the optical axis of the laser light output from the laser device in the axial direction of the artificial joint installation,
Is equipped with
The patient-compatible surgery support guide device,
A target onto which the laser light is projected,
Is equipped with
When the laser light output from the laser device is projected onto the target, the surgical instrument is adjusted in position with respect to the surgical instrument so that the surgical instrument has a position and a posture determined in a preoperative plan. A guide system for assisting artificial joint placement surgery, which is performed by a laser light adjusting means and sets the target in the patient-compatible surgery assistance guide instrument. The laser device of the surgical instrument side guide instrument is a laser device that outputs a cross laser beam as the laser,
The target is a cross-shaped target defined in advance in a preoperative plan,
When the surgical instrument is in the position and posture determined in the preoperative plan, the laser light adjusting means performs adjustment so that the cross of the cross laser light and the cross of the target match. The guide system for assisting surgery for installing an artificial joint according to claim 1, wherein the guide system is provided. The patient-compatible surgery support guide device,
The artificial body according to claim 1 or 2, wherein the artificial body has a shape corresponding to a shape of a bone obtained in advance by a preoperative plan, and is provided with an abutment fixing portion for abutting the bone and fixing a guide device. Guide system for joint installation surgery support. A surgical instrument side guide instrument used in the artificial joint installation surgery assistance guide system according to any one of claims 1 to 3,
The optical axis of the laser light output from the laser device is provided with a laser light adjusting means for adjusting the position in the artificial joint installation axial direction,
When the laser beam output from the laser device is projected onto the target, the position of the laser device with respect to the surgical instrument is adjusted so that the surgical instrument has the position and posture defined in the preoperative plan. A surgical instrument side guide instrument, which is performed by the laser beam adjusting means. A patient-adaptive surgery support guide instrument for use in the artificial joint installation surgery support guide system according to claim 1.
A target on which the laser light is projected,
Patient targeting, characterized in that the target is set such that the surgical instrument has a position and posture defined in a preoperative plan when the laser light output from the laser device is projected onto the target. Type surgical support guide tool.

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