JP7244178B2 - Guide system for supporting artificial joint placement surgery and its equipment - Google Patents

Description

TECHNICAL FIELD The present invention relates to a guide system suitable for surgical support when installing components (parts) in an artificial joint installation surgery, and particularly to a guide system for supporting an artificial joint installation surgery for installing a femoral stem, an acetabular cup, or the like. It relates to improvements in the system and its instruments.

Proper placement of prosthesis components such as femoral stems and cups in artificial joint surgery is essential to properly transmit the stresses applied to the artificial joint to the bone and to obtain an appropriate range of motion without dislocation. is important. Accurate osteotomy and placement of prosthesis components in precise locations (positions and angles) provide good load distribution and range of motion, as well as reduce component wear and loosening, resulting in improved prosthesis. It is possible to extend the service life by delaying the replacement timing, which ultimately leads to the improvement of QOL (quality of life).

In other words, placement of prosthesis components in the proper alignment position is placement that does not cause dislocation, matching the optimal size of the prosthesis component to the patient's individual bones, stabilizing it, and postoperatively. It is one of the main points of artificial joint surgery because it is a factor that influences the results. For example, in the case of total hip arthroplasty,
a, excision of the femoral head,
b, excavation of the femoral medullary cavity (excavating the bone marrow to form the medullary cavity),
c, the procedure of insertion and fixation or placement of the femoral stem. In order to insert and fix or install the femoral stem, which is the most important step c, it is necessary to perform resection of the femoral head in a, and excavation of the medullary canal in b, in an appropriate resection position and excavation direction. .

These operations are performed based on the preoperative plan, but what can be used as a reference in the actual surgery is a part of the bone developed from the skin incision directly visible in the surgical field. However, there are many cases in which expansion of the surgical site is limited due to obesity. In addition, if the bone morphology is significantly deformed, the operator may make a mistake in judgment because it is far from a normal anatomy. excavation and even placement of the femoral stem in a different location. In such cases, it is assumed that complications may occur during or after surgery, such as fracture of the femur during insertion of the femoral stem or postoperative dislocation. Currently, navigation devices have been developed that use computer technology to guide precise preoperative planning during surgery, but they are not generally popular, and installation positioning and positioning depend on the experience and intuition of the operator (doctor). It is the actual situation that alignment in the installation direction is performed, and there is a demand for simpler and easier-to-operate methods and instruments that can accurately reproduce the preoperative plan.

For example, in Patent Document 1 below, work such as bone resection, bone marrow cavity excavation, component installation, etc. is performed accurately in a short time according to a preoperative plan, and the operator intuitively grasps it. A navigation system and guide instrument are disclosed. According to this, a patient-adapted surgical support guide instrument provided with a relative angle detector is pressed against the corresponding part of the femoral neck and tightly fixed, and along the edge of the abutment and fixation part of the fixation guide Osteotomy of the femoral head is performed, and the insertion center point of the femoral stem is grasped. Next, the operator holds the grasping 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 detection device, and while the angle of the stem-side guide instrument is corrected, excavation of the medullary canal of the femur and insertion of the stem are performed in the optimum posture.

JP 2018-19813 A

By the way, in the background art described above, a wire is used, and by using this,
a, The storage section for storing the relative angle detector can be fixed to the fixed guide.
b. Since one of the orthogonal coordinate axes preset in the relative angle detector coincides with the direction of the wire, the center of the rasp becomes the stem insertion point by bringing the wire guide of the movable piece into contact with the wire. Positioning can be performed as follows.
c. By referring to the scale on the wire, the depth of excavation by the rasp and the depth of insertion of the stem can be known.
and However, in the above-described background art, although there is an advantage due to the presence of the wire, the wire may rather hinder the work of excavating the medullary cavity during excavation with the rasp, so it is necessary to remove it and operate it if necessary. be. In addition, when confirming the alignment of the center direction of the rasp with a rod-shaped wire, it is necessary to replace it vertically and horizontally with respect to each reference axis in the varus/valgus direction and the rotation direction. Furthermore, in order to accurately confirm the direction of the preoperative plan, it is necessary to visually see the reference axis from the front, and there is a problem that the direction may be misunderstood when viewed obliquely.

The present invention focuses on the above-mentioned points. It is an object of the present invention to provide a guide system for supporting artificial joint placement surgery and its instruments, which can be performed accurately in a short time according to a preoperative plan.

The guide system for supporting artificial joint placement surgery according to the present invention is an artificial joint for determining the appropriate position and posture of a surgical instrument for performing a necessary surgery based on a preoperative plan when installing an artificial joint. An installation surgery support guide system, which is installed on the surgical instrument side and includes a surgical instrument side guide instrument equipped with a laser device, and is installed on the bone side and adapted to a patient on which laser light output from the laser device is projected. The surgical-instrument-side guide instrument is separated from the patient-adapted surgical-assistance guide instrument, and the optical axis of the laser beam output from the laser device is aligned with the artificial joint installation axis. The patient-adapted surgical assistance guide instrument includes a laser beam adjusting means for adjusting the position in a direction, the patient-fitting surgical assistance guide instrument includes a target onto which the laser beam is projected, and the laser beam output from the laser device is projected onto the target. Positional adjustment of the laser device with respect to the surgical instrument is performed by the laser beam adjusting means so that the surgical instrument is in a position and posture determined in the preoperative plan when projected, and the patient-adapted surgery is performed. It is characterized by setting the target in the support guide instrument.

According to one of the main forms, 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-shaped target determined in advance in a preoperative plan. and when the surgical instrument assumes the position and posture determined in the preoperative plan, the laser beam adjusting means performs adjustment so that the cross of the cross laser beam and the cross of the target match. characterized by being done.

According to another aspect, the patient-adapted surgical assist guide instrument has a shape corresponding to the shape of the bone obtained by preoperative planning, and has an abutment fixation for fixing the guide instrument against the bone. It is characterized by comprising a part.

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

According to the patient-adapted surgery support guide instrument of the present invention, the target on which the laser beam is projected is provided, and when the laser beam output from the laser device is projected onto the target, the surgical instrument: The target is set so as to have a position and posture determined in a preoperative plan.

Examples of such artificial joints include femoral stems and cup components in hip joints. As the laser beam, for example, a cross-shaped laser beam is used. Further, an example of the laser beam adjusting means is a slide-type adjusting device capable of moving the laser device in orthogonal two-dimensional or three-dimensional directions. The foregoing and other objects, features and advantages of the present invention will become apparent from the following detailed description and accompanying drawings.

According to the present invention, a laser device is attached to a guide device on the side of an artificial joint surgical instrument, such as a rasp, and a patient-adapted surgery support guide device designed and shaped based on a surgical plan for each patient is attached to the laser device. The system configuration is provided with a projection indicator that serves as a light target, and the alignment of artificial joint surgical instruments is performed by irradiating a laser beam from the side of the artificial joint surgical instrument guide instrument to the patient-adapted surgery support guide instrument. Therefore, the operation for installing the artificial joint can be performed accurately in a short period of time according to the preoperative plan.

1 is a perspective view showing a rasp-side guide instrument in Example 1 of the present invention; FIG. 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 a view from the direction of arrow F3 in the figure. FIG. 10 is a perspective view showing a state of excavation of the femoral medullary cavity by the guide instrument; 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.

EMBODIMENT OF THE INVENTION Hereinafter, the form for implementing this invention is demonstrated in detail based on an Example.

An embodiment in which a guide system for supporting artificial joint installation surgery according to the present invention is applied to a guide system for installing a femoral stem will be described below with reference to FIGS. 1 to 5. FIG. The guide system of the present invention comprises a surgical instrument-side guide instrument for an artificial joint and a patient-adapted surgery support 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 this embodiment, and FIG. In these figures, the rasp handle 10, which is a surgical instrument for excavating the medullary cavity, has a structure in which a rasp 30 corresponding to the shape and size of an artificial hip joint can be detachably fixed on the tip side of a main body 20 that is bent in an arc as a whole. On the opposite side of the main body 20 is provided a grip 40 and a head 50 for driving with a hammer. A fixing hole 42 is formed in the grip portion 40 . The construction of such a rasp handle 10 is well known.

Next, the rasp-side guide instrument 100 of this embodiment is constructed around a handle 110 in which the grasping portion 40 of the rasp handle 10 is housed. The handle 110 has an opening 112 (see FIG. 2) formed in the longitudinal side thereof, 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 a fixing screw 114 is passed through the fixing hole and passed through the fixing hole 42 of the grip portion 40 of the rasp handle 10 and tightened. 10 is fixed to the handle 110 .

Here, assuming that the direction of insertion of a stem (not shown), which is an artificial joint component to be installed in the femur, is the Z direction, an arm (hereinafter referred to as " 200 is provided. An X-slider 210 is slidably provided on the X-arm 200. By moving the X-slider 210 by tightening or loosening a fixing screw 212, the position of the X-direction of the X-slider 210 with respect to the X-arm 200 is adjusted. It is possible.

The X slider 210 is provided with a Y arm 300 extending in the Y direction perpendicular to the X direction.

A Y slider 310 is slidably provided on the Y arm 300. By moving the Y slider 310 by tightening or 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's like A laser device 400 is provided on the Y slider 310, and a cross-shaped laser beam is output in the above-described Z direction.

The basic operation of the rasp-side guide instrument 100 as described above will be described. Then, the rasp handle 10 is fixed to the handle 110 by tightening the fixing screw 114 through the grip portion 40 of the rasp handle 10 from the handle 110 . On the other hand, the laser device 400 moves in the XY direction as the X slider 210 moves along the X arm 200 and the Y slider 310 moves along the Y arm 300 . With these, the laser device 400 is moved within the XY plane, and the position is adjusted so that the laser beam is aligned with 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, it is possible to adjust the center of the laser beam to coincide with the artificial joint installation axis.

Next, the patient-adapted surgery support guide instrument 500 installed on the femur side will be described. FIG. 3(A) shows a patient-adapted surgical support guide instrument 500, and FIG. 3(B) shows a view from an arrow F3 in the same figure. In these figures, the patient-compatible surgical assist guide instrument 500 is:
a, an abutment fixation part 510 for fixing the entire patient-adapted surgical support guide instrument 500 that abuts and adheres to the femur;
b, a projection indicator (target) 520 for indicating the projected position of the laser beam;
It has

Of these, the abutment fixing part 510 is the same as that in the above-mentioned patent document, and abuts against the greater trochanter and the lesser trochanter of the femoral neck of the femur TB, and extends from the greater trochanter to the lesser trochanter. It is provided with an abutting portion 512 having a concave portion following the femoral neck from the hook portion that is caught on the intertrochanteric crest. By providing a hook portion that has a shape that spans over the intertrochanteric crest, it is possible to stably fix the femoral neck with a small contact area. An edge 512A of the abutting portion 512 is formed to indicate the osteotomy height (cutting position) of the femoral neck. The osteotomy height is determined by the doctor at the preoperative planning stage, taking into consideration the length of the patient's leg, the shape of the medullary canal of the femur TB, the size of the femoral stem to be used, and the like.

Next, the projected index portion 520 is composed of rectangular parallelepiped blocks BA, BB, and BC, and has a structure in which these blocks BA, BB, and BC intersect. In other words, the blocks BA, BB, and BC extend in orthogonal directions from the intersection center. A portion of the block BB is obliquely cut off along the edge 512A of the contact portion 512 of the contact fixing portion 510 . That is, when the femoral neck is cut along the edge 512A of the contact portion 512, each block of the position display portion 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 thereof. These wire holding through-holes QA, QB, and QC are for inserting guide wires, as shown in the above-mentioned patent document, and can be used as a guide instrument using wires. ing.

The patient-adapted surgical support guide instrument 500 having the shape and structure as described above is manufactured as follows.
(1) First, a CT (Computer Tomography) image or an MRI (Magnetic Resonance) image of the hip joint of a patient undergoing artificial hip replacement surgery is acquired.
(2) Next, a computer obtains a three-dimensional image of the hip joint, and based on this three-dimensional image, preoperative planning for total hip replacement surgery is performed. As such three-dimensional preoperative planning software for total hip arthroplasty, for example, there is "ZedHip" manufactured by Lexi Corporation. This will
a, the shape of the patient's femur TB;
b, the size of the femoral stem (implant) to be used,
c, osteotomy height,
d, varus/valgus, anteversion/retroversion, flexion/extension directions,
e, insertion center point DX of the femoral stem at the osteotomy TBC of the femur TB,
is determined.
(3) Next, a rapid prototyping technique using a 3D printer or the like is applied to fabricate a patient-adapted surgical support guide instrument 500 with optical resin or the like. The shape of the contact fixing portion 510 of the patient-adapted surgical support guide instrument 500 is specified by the shape of the patient's femur TB in the above a and the osteotomy height in the above c. The shape of the projected index portion 520 of the patient-adapted surgical support guide instrument 500 is specified by the stem insertion center point DX in each direction of d and on the osteotomy plane TBC of e. In addition, the shape of projection index portion 520 is specified so that the directions of wire holding through holes QA, QB, and QC of blocks BA, BB, and BC respectively match the Z, X, and Y directions shown in FIG. be. As shown in FIG. 3A, the stem insertion center point DX is located on the X-direction extension of the laser beam projected onto the projection index portion 520 . The patient-adapted surgical support guide instrument 500 is manufactured for each patient because it corresponds to patient-specific bony unevenness of the hip joint. 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 as well. First, after sterilization, the above-described patient-adapted surgical support guide instrument 500 is manually pressed against the relevant portion of the femoral neck so as to straddle the intertrochanteric crest, or the hole in the block BC is pressed. By driving a fixing pin from the QC, it is tightly fixed to the bone surface. Next, the operator cuts the femoral head along the edge 512A of the abutting portion 512 of the patient-adapted surgery support guide instrument 500. FIG. 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, a stem assisting tool disclosed in Japanese Patent Application Laid-Open No. 2014-42818 is used. If necessary, a small diameter drill may be used to drill a pilot hole in the femoral stem insertion direction at the insertion center point DX. The cutting of the femoral head described above is the same as in the above publication.

Next, based on the preoperative plan, the operator attaches the rasp handle 10 to be used to the handle 110 of the rasp-side guide instrument 100 and slides the Y slider 310 along the Y arm 300 to move the laser device 400. is adjusted and fixed to a position where one plane of the cross laser beam is irradiated so as to pass through the central axis of the rasp 30. As shown in FIG.

Next, the operator holds the handle 110 of the rasp-side guide instrument 100 and 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. The projected cross laser beam LB hits the cross target TG, that is, the center of the projection index portion 520 of the patient-fitting surgery support guide instrument 500 (the center of the hole QA of the block BA), and each surface of the cross laser beam is projected. The posture (direction or inclination) of the rasp handle 10 is adjusted so that it passes through the centers of the rectangular parallelepiped cross blocks BA, BB, and BC of the index portion 520 in three dimensions in parallel. As described above, the wire holding through holes QA, QB, and QC of the cross blocks BA, BB, and BC of the projection index portion 520 are preformed so that the directions thereof correspond to the Z, X, and Y directions shown in FIG. is determined, and the position of the laser device 400 is set so that the cross laser light three-dimensionally passes through the center of the cross-shaped block-shaped projected index portion 520 in parallel. Therefore, the operator refers to the cross-shaped laser beam LB and adjusts the posture of the rasp-side guide instrument 100 so that the cross-shaped laser beam LB is projected onto the cross-shaped target TG of the projection index section 520, so that the posture of the rasp handle 10 is also adjusted. It will be adjusted so that the posture is in line with 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 operator strikes the head 50 of the rasp handle 10 with a hammer (not shown), and the rasp 30 excavates the medullary canal of the femur TB. By repeating this operation each time the rasp handle 10 changes the size of the rasp 30, excavation of the medullary canal is performed according to the preoperative plan. The depth of excavation is determined by the operator, but as an example, the osteotomy line indicating the osteotomy height (cutting position) of the femoral neck is a guideline, and the rasp 30 is about 4 mm from the osteotomy line. If it goes too deep, replace with the next size rasp 30 and repeat until fit.

As described above, according to the present embodiment, the rasp-side guide instrument 100 and the patient-adapted surgery support guide instrument 500 form a femoral stem installation guide system, and the patient-adapted surgical support guide instrument 500 is provided with a rasp side guide system. Since the cross-shaped laser beam is emitted from the guide device 100 to align the guide device, the following effects can be obtained.
a. Installation and excavation of the rasp handle 10 in the medullary canal of the femur TB can be performed accurately in a short time according to the preoperative plan.
b. Since no wire is used, it does not interfere with the excavation operation, and the work can be performed smoothly without removing the wire in the middle or changing its direction.
c. The structure of the guide instrument is simplified, and the operability is improved.

Next, Embodiment 2 of the present invention will be described with reference to FIG. In the above-described embodiment, the case of installing the stem component on the femoral side for total hip arthroplasty was taken as an example. By using a system that uses a cross laser device on the side of the individual patient guide instrument and the cup striker side with a target of , in the same way, the acetabular side cup component is adjusted to the angle (posture or inclination) of the surgical plan The installation can be induced.

FIG. 6 shows how the cup component 604 is placed 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 distal end of a cup impactor shaft 602 and a handle 606 on the opposite side. The guide system for supporting an artificial joint placement surgery of this embodiment includes a surgical instrument-side guide instrument 150 installed on the cup impactor 600 side, and a patient-fitting surgery support 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 insertion direction of the cup component 604 described above is the Z direction, and the directions orthogonal thereto are the X and Y directions. A shaft slider 152 is slidably provided on the cup impactor shaft 602 described above by tightening or loosening a fixing screw 154 . The shaft slider 152 is provided with a Y arm 156 in a direction orthogonal to it, and is movable by tightening and loosening a fixing screw 158 . A Y slider 160 is provided on the Y arm 156 and is movable by tightening or 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 cross-shaped laser light in a direction perpendicular to the Y arm 156 , that is, in the direction of the cup impactor shaft 602 .

On the other hand, the patient-adapted surgical support guide instrument 550 is adapted to the patient's acetabulum edge to guide the position, angle, and reaming depth of the cup component 604. and a projection index portion 554. The abutting and fixing part 552 is manufactured for each patient with its shape specified in the preoperative plan based on data such as CT images of the patient's hip joint portion, as in the above-described embodiment.

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

Accordingly, 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. , the cup component 604 can be guided and installed so that the posture or inclination conforms to the preoperative plan. Moreover, since no wire is used, the installation operation of the cup component 604 is not hindered, and the operation can be performed smoothly.

The present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the gist of the present invention. For example:
(1) The shape and structure of each instrument shown in the above embodiment are examples, and may be changed as appropriate so as to achieve the same effect.
(2) There are cement type and cementless type artificial joints, and the present invention is applicable to both types.
(3) It does not preclude the use of different instruments for operations such as excision of the femoral neck, excavation of the femoral medullary cavity with a rasp, and insertion of the femoral stem. For example, the insertion of the femoral stem may be performed using a stem impactor or the like (not shown) different from the stem-side guide instrument described above.
(4) In the above embodiment, laser light is emitted from the rasp-side guide instrument 100 toward the patient-adapted surgery support guide instrument 500, but in principle, the reverse is also possible.

According to the present invention, a laser device is attached to a guide device on the side of an artificial joint surgical instrument, such as a rasp, and a patient-adapted surgery support guide device designed and shaped based on a surgical plan for each patient is attached to the laser device. The system configuration is provided with a projection indicator that serves as a light target, and the alignment of artificial joint surgical instruments is performed by irradiating a laser beam from the side of the artificial joint surgical instrument guide instrument to the patient-adapted surgery support guide instrument. Therefore, the operation for installing the artificial joint can be accurately performed in a short period of time according to the preoperative plan, which is suitable for artificial joint replacement.

10: Rasp handle (surgical instrument)
20: Main body 30: Rasp 40: Grasping part 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-adapted surgery support guide instrument 510: Abutting fixing part 512: Abutting part 512A: Edge 520: Projected index part 550: Patient-compatible surgical support guide instrument 552: Abutment fixing part 554: Projected 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 beams QA, QB, QC: Wire holding through hole TB: Femur TBC: Osteotomy surface HB: Hip joint PB: Pelvis QZ: Wire holding through hole

Claims (5)

A guide system for supporting an artificial joint installation surgery for determining the appropriate position and posture of a surgical instrument for performing a necessary surgery based on a preoperative plan when installing an artificial joint,
a surgical instrument-side guide instrument installed on the surgical instrument side and equipped with a laser device;
A patient-adapted surgery assisting guide instrument installed on the bone side and onto which the laser beam output from the laser device is projected,
and
The surgical instrument side guide instrument,
It is spaced apart from the patient-compatible surgical support guide instrument,
laser beam adjustment means for adjusting the position of the optical axis of the laser beam output from the laser device in the direction of the artificial joint installation axis;
and
The patient-adapted surgical support guide instrument,
a target onto which the laser light is projected;
and
The position adjustment of the laser device with respect to the surgical instrument is performed so that the surgical instrument assumes the position and posture determined in the preoperative plan when the laser beam output from the laser device is projected onto the target. A guide system for supporting an artificial joint placement surgery, characterized in that the operation is performed by a laser beam adjustment means and the target is set in the patient-adapted surgery support 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 determined in advance by preoperative planning,
Adjustment is performed by the laser beam adjustment means so that the cross of the cross laser beam and the cross of the target match when the surgical instrument assumes the position and posture determined in the preoperative plan. 2. The guide system for supporting artificial joint placement surgery according to claim 1, wherein the guide system comprises: The patient-adapted surgical support guide instrument,
3. The prosthesis according to claim 1 or 2, wherein the prosthesis has a shape corresponding to the shape of the bone obtained by preoperative planning, and is provided with an abutment fixation part for abutting the bone and fixing the guide instrument. A guide system for assisting joint placement surgery. A surgical instrument-side guide instrument used in the guide system for supporting artificial joint placement surgery according to any one of claims 1 to 3,
A laser beam adjusting means for adjusting the position of the optical axis of the laser beam output from the laser device in the direction of the artificial joint installation axis,
Adjusting the position of the laser device with respect to the surgical instrument so that the surgical instrument assumes the position and posture determined in the preoperative plan when the laser beam output from the laser device is projected onto the target. A surgical-instrument-side guide instrument, characterized in that the operation is performed by the laser beam adjusting means. A patient-adapted surgery support guide instrument used in the guide system for artificial joint placement surgery support according to any one of claims 1 to 3,
A target onto which the laser beam is projected is provided,
The patient adaptation characterized in that the target is set so that the surgical instrument assumes a position and posture determined in a preoperative plan when the laser beam output from the laser device is projected onto the target. type surgery support guide instrument.

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