WO2023029923A1

WO2023029923A1 - Three-dimensional preoperative planning method and system for knee joint replacement

Info

Publication number: WO2023029923A1
Application number: PCT/CN2022/111537
Authority: WO
Inventors: 张逸凌; 刘星宇
Original assignee: 北京长木谷医疗科技有限公司; 张逸凌
Priority date: 2021-09-03
Filing date: 2022-08-10
Publication date: 2023-03-09
Also published as: CN113842211B; CN113842211A

Abstract

The present application discloses a three-dimensional preoperative planning method and system for knee joint replacement. The method comprises: first processing a medical image to obtain a three-dimensional skeleton model, then determining a three-dimensional skeleton prosthesis model on the basis of the three-dimensional skeleton model, and finally simulating installation of the two models. Thus, preoperative visual simulation of prosthesis replacement is achieved, thereby facilitating improvement of the precision of knee joint replacement surgery, and overcoming the defects of low surgical precision and poor safety caused by relying on manual experience in preoperative planning of knee joint replacement in the related art.

Description

Three-dimensional preoperative planning method and system for knee joint replacement

Cross References to Related Applications

This application claims the priority of the Chinese patent application with application number 202111032636.0 and titled "Method and System for Three-dimensional Preoperative Planning of Knee Joint Replacement" filed on September 03, 2021, which is incorporated herein by reference in its entirety.

technical field

The present application relates to the technical field of data processing, in particular to a three-dimensional preoperative planning method and system for knee replacement.

Background technique

Traditional TKA surgery (total knee arthroplasty) uses osteotomy plates for modular osteotomy, mainly referring to the patient’s preoperative radiographic X-ray films, measuring the bony landmarks during the operation, and manually placing the osteotomy plates for operation. Mainly rely on the technique and experience of the surgeon, and evaluate indicators such as gap balance and prosthesis position completely by subjective feeling. And because the model of the osteotomy plate is fixed, the amount of osteotomy cannot be adjusted once it is placed, which may easily lead to gap imbalance caused by improper amount of osteotomy, which has low repeatability.

Contents of the invention

The main purpose of the present application is to provide a three-dimensional preoperative planning method and system for knee replacement.

In order to achieve the above purpose, according to the first aspect of the present application, a three-dimensional preoperative planning method for knee joint replacement is provided, including: after obtaining the medical image of the knee joint, performing segmentation and three-dimensional reconstruction on the medical image, Obtain the three-dimensional bone model of the knee joint; determine the key parameters of the bone based on the three-dimensional bone model; determine the type and model of the three-dimensional bone prosthesis model based on the key parameters of the bone; implant the selected three-dimensional bone prosthesis model into the three-dimensional Skeleton model: adjust the placement position and placement angle of the three-dimensional skeleton prosthesis model based on the key parameters of the skeleton and the type and model of the three-dimensional skeleton prosthesis model.

Optionally, the three-dimensional bone model includes a three-dimensional femoral model, the three-dimensional bone prosthesis model includes a three-dimensional femoral prosthesis model, the key parameters of the bone include key parameters of the femur, and the key parameters of the femur include a femoral mechanical axis, a femoral condylar line , posterior condyle line, femur left and right diameter and femur anteroposterior diameter; The step of adjusting the placement position and placement angle of the three-dimensional skeleton prosthesis model based on the key parameters of the skeleton and the type and model of the three-dimensional skeleton prosthesis model includes: Adjust the placement position of the three-dimensional femoral prosthesis model based on the left-right diameter of the femur and the anterior-posterior diameter of the femur; adjust the varus or valgus angle of the three-dimensional femoral prosthesis model so that the transverse The section is perpendicular to the mechanical axis of the femur; the internal rotation angle or external rotation angle of the three-dimensional femoral prosthesis is adjusted so that the posterior condyle angle of the femur is within a preset range.

Optionally, the three-dimensional bone model also includes a three-dimensional tibial model, and the three-dimensional femoral prosthesis model also includes a three-dimensional tibial prosthetic model; the key bone parameters also include tibial key parameters, and the tibial key parameters include tibial mechanical axis, tibial Left and right diameters and tibial anteroposterior diameters; the step of adjusting the placement position and placement angle of the three-dimensional skeletal prosthesis model based on the bone key parameters and the type and model of the three-dimensional skeletal prosthesis model includes: based on the tibial left and right diameters and Tibial anteroposterior diameter, adjust the placement position of the three-dimensional tibial prosthesis model; adjust the varus or valgus angle of the three-dimensional tibial prosthesis, so that the tibial mechanical axis is perpendicular to the cross section of the three-dimensional tibial prosthesis

Optionally, after the step of adjusting the placement position and placement angle of the three-dimensional bone prosthesis model, the method further includes: performing a simulated osteotomy based on the matching relationship between the three-dimensional bone prosthesis model and the three-dimensional bone model to obtain a three-dimensional bone postoperative simulation model; the three-dimensional femoral postoperative simulation model is carried out to include the motion simulation of straight position and flexion position; determine the straightening gap in the straight position state, and determine the flexion gap in the flexion state; compare the straightening gap with the The buckling gap is used to verify the compatibility of the three-dimensional bone prosthesis model.

Optionally, the method further includes: determining the three-dimensional coordinates of the center point of the femoral medullary cavity based on the three-dimensional femoral model; creating an intramedullary positioning analog rod by a circular fitting method; and determining a femoral pulp opening point by the intramedullary positioning analog rod.

According to the second aspect of the present application, a three-dimensional preoperative planning system for knee joint replacement is provided, including: an image preprocessing unit configured to, after obtaining the medical image of the knee joint, segment and Three-dimensional reconstruction to obtain a three-dimensional bone model of the knee joint; the prosthesis determination unit is configured to determine key parameters of the bone based on the three-dimensional bone model; determine the type and model of the three-dimensional bone prosthesis model based on the key parameters of the bone; implant A unit configured to implant the selected three-dimensional bone prosthesis model into the three-dimensional bone model; an adjustment unit configured to adjust the three-dimensional bone based on the key parameters of the bone and the type and model of the three-dimensional bone prosthesis model The placement position and placement angle of the prosthesis model.

Optionally, the three-dimensional bone model includes a three-dimensional femoral model, the three-dimensional bone prosthesis model includes a three-dimensional femoral prosthesis model, the key parameters of the bone include key parameters of the femur, and the key parameters of the femur include a femoral mechanical axis, a femoral condylar line , the connecting line of the posterior condyle, the left and right femur diameter and the anteroposterior diameter of the femur;

Adjustment units include:

The femoral prosthesis position adjustment subunit is configured to adjust the placement position of the three-dimensional femoral prosthesis model based on the left-right diameter of the femur and the anterior-posterior diameter of the femur;

The femoral prosthesis angle adjustment subunit is configured to adjust the varus angle or valgus angle of the three-dimensional femoral prosthesis model so that the cross section of the three-dimensional femoral prosthesis model is perpendicular to the femoral mechanical axis;

The femoral prosthesis angle adjustment subunit is configured to adjust the internal rotation angle or external rotation angle of the three-dimensional femoral prosthesis so that the posterior femoral condyle angle is within a preset range.

Optionally, the three-dimensional bone model also includes a three-dimensional tibial model, and the three-dimensional femoral prosthesis model also includes a three-dimensional tibial prosthetic model; the key bone parameters also include tibial key parameters, and the tibial key parameters include tibial mechanical axis, tibial Left-right diameter and tibial-posterior diameter;

The adjustment unit includes:

The tibial prosthesis position adjustment subunit is configured to adjust the placement position of the three-dimensional tibial prosthesis model based on the left and right tibial diameter and the tibial anteroposterior diameter;

The tibial prosthesis angle adjustment subunit is configured to adjust the varus angle or valgus angle of the three-dimensional tibial prosthesis so that the tibial mechanical axis is perpendicular to the cross-section of the three-dimensional tibial prosthesis.

According to the third aspect of the present application, there is provided a computer-readable storage medium, which stores computer instructions, and the computer instructions are used to make the computer execute the three-dimensional knee joint replacement described in any one of the implementation manners of the first aspect. preoperative planning approach

According to a fourth aspect of the present application, an electronic device is provided, including: at least one processor; and a memory connected to the at least one processor in communication; wherein, the memory stores information that can be used by the at least one processor Executable computer program, the computer program is executed by the at least one processor, so that the at least one processor executes the three-dimensional preoperative planning method for knee joint replacement according to any one of the first aspect.

In the 3D preoperative planning method and system for knee joint replacement in the embodiment of the present application, the medical images are firstly processed to obtain a 3D bone model, then the 3D bone prosthesis model is determined based on the 3D bone model, and finally the two models are simulated and installed to achieve The effect simulation after prosthesis replacement helps to improve the accuracy of knee replacement surgery, and solves the defects of low surgical accuracy and poor safety caused by relying on manual experience in preoperative planning of knee replacement in related technologies.

Description of drawings

In order to more clearly illustrate the specific embodiments of the present application or the technical solutions in the prior art, the following will briefly introduce the accompanying drawings that need to be used in the description of the specific embodiments or prior art. Obviously, the accompanying drawings in the following description The drawings are some implementations of the present application, and those skilled in the art can obtain other drawings based on these drawings without creative work.

1 is a flowchart of a three-dimensional preoperative planning method for knee joint replacement according to an embodiment of the present application;

2 is a schematic diagram of a three-dimensional skeleton model after key parameters are identified and marked according to an embodiment of the present application;

FIG. 3 is an application scene diagram of a three-dimensional preoperative planning method for knee joint replacement according to an embodiment of the present application;

Fig. 4 is another application scene diagram of the three-dimensional preoperative planning method for knee joint replacement according to the embodiment of the present application;

Fig. 5 is another application scene diagram of the three-dimensional preoperative planning method for knee joint replacement according to the embodiment of the present application;

Fig. 6 is a schematic structural diagram of a three-dimensional preoperative planning system for knee joint replacement according to an embodiment of the present application.

Fig. 7 is a schematic diagram of an electronic device according to an embodiment of the present application.

Detailed ways

In order to enable those skilled in the art to better understand the solution of the present application, the technical solution in the embodiment of the application will be clearly and completely described below in conjunction with the accompanying drawings in the embodiment of the application. Obviously, the described embodiment is only It is an embodiment of a part of the application, but not all of the embodiments. Based on the embodiments in this application, all other embodiments obtained by persons of ordinary skill in the art without creative efforts shall fall within the scope of protection of this application.

It should be noted that the terms "first" and "second" in the specification and claims of the present application and the above drawings are used to distinguish similar objects, but not necessarily used to describe a specific order or sequence. It should be understood that the data so used may be interchanged under appropriate circumstances for the embodiments of the application described herein. Furthermore, the terms "comprising" and "having", as well as any variations thereof, are intended to cover a non-exclusive inclusion, for example, a process, method, system, product or device comprising a sequence of steps or elements is not necessarily limited to the expressly listed instead, may include other steps or elements not explicitly listed or inherent to the process, method, product or apparatus.

It should be noted that, in the case of no conflict, the embodiments in the present application and the features in the embodiments can be combined with each other. The present application will be described in detail below with reference to the accompanying drawings and embodiments.

According to an embodiment of the present application, a three-dimensional preoperative planning method for knee joint replacement is provided, as shown in FIG. 1 , the method includes the following steps 101 to 104:

Step 101: After the medical image of the knee joint is obtained, the medical image is segmented and three-dimensionally reconstructed to obtain a three-dimensional bone model of the knee joint.

In this embodiment, after obtaining the target user's knee joint CT or MRI image data, the scanned image can be segmented by the neural network model, and can be segmented into regions of different granularities, such as the femoral region and the tibial region, Or it can be divided into femoral region, tibial region, fibula region and patella region according to needs; and then three-dimensional reconstruction can be performed on the images of each region after segmentation to obtain three-dimensional images of each bone region. Referring to Figure 2, based on CT or MRI data, the The resulting 3D bone model.

Step 102: Determine key bone parameters based on the three-dimensional bone model; determine the type and model of the three-dimensional bone prosthesis model based on the key bone parameters;

In this embodiment, after obtaining the three-dimensional bone model of each bone region, the key parameters of the bone can include key anatomical points of the bone, key axes of the bone and bone size parameters, and the key anatomical points of the bone can be based on a deep learning algorithm, such as a neural network model, Identify and mark the identified key anatomical points on the 3D bone model.

The neural network model adopted for image segmentation and reconstruction, and the neural network model adopted for the identification of key anatomical points of bones can all be known neural network models in the prior art. Regarding the establishment and training of the neural network model, no details are given here. Let me repeat.

Bone size can include left and right femur diameter, femur anteroposterior diameter, tibial left and right diameter and tibial anteroposterior diameter. The line connecting the medial and lateral borders of the tibia is determined, and the anteroposterior diameter of the tibia is determined according to the line connecting the anterior and posterior borders of the tibia.

The key axis of the bone is determined based on the key anatomical points of the bone, and the key angle of the bone is determined based on the key axis of the bone. However, based on the key axis of the bone and the key angle of the bone, it is helpful to determine the type and model of the three-dimensional bone prosthesis model. The three-dimensional skeletal prosthesis model of the knee joint generally includes a three-dimensional femoral prosthesis model, a three-dimensional tibial prosthesis model, and a spacer model connecting the three-dimensional tibial prosthesis model and the three-dimensional femoral prosthesis model.

The three-dimensional skeletal prosthesis model can be a prosthesis model for total knee replacement currently on the market. There are many types of three-dimensional bone prosthesis models, and each type of three-dimensional bone prosthesis model has multiple models. For example, the types of three-dimensional femoral prosthesis models include ATTUNE-PS, ATTUNE-CR, SIGMA-PS150, etc., and the models of ATTUNE-PS include 1, 2, 3, 3N, 4, 4N, 5, 5N, 6, 6N.

The preoperative planning system can intelligently recommend the prosthesis model from the prosthesis library, and the user can also select the type and model of the bone prosthesis model from the prosthesis library through the interactive interface based on the key axis of the bone and the key angle of the bone, and adjust the bone The placement position and placement angle of the prosthesis model.

Exemplarily, the bone key axis and bone key angle can be determined in the following ways:

The tibial mechanical axis is determined from the tibial knee joint center (the center of the intercondylar spine) to the tibial ankle joint center (the midpoint of the line connecting the inner and outer malleolus cortices); the tibial anatomical axis is determined by the centerline of the tibial backbone, and the tibial mechanical axis and The two lines of the anatomical axis of the tibia are parallel.

One endpoint based on the anatomical axis of the femur is the center of the femoral shaft midway between the medial and lateral widths of the femoral shaft at the distal end (the uppermost point of the femoral head) and the proximal end (the portion distal to the medial femoral condyle), and the other end point is at 10cm on the knee joint surface, bisect the inner and outer cortical bone; one end of the femoral mechanical axis is located at the center of the hip joint, and the other end is located at the center of the knee joint of the femur (the apex of the intercondylar notch of the femur).

The line connecting the posterior condyle was obtained based on the connection line between the lowest points of the internal and external posterior condyles of the femur, and the line through the condyle was obtained based on the connection line between the concave of the medial femoral condyle and the highest point of the lateral femoral condyle.

The tibial angle was obtained based on the angle formed by the mechanical axis of the femur and the mechanical axis of the tibia; the distal femoral angle was obtained based on the angle formed by the mechanical axis of the femur and the anatomical axis. The posterior femoral condyle angle PCA was obtained according to the angle between the femoral condyle line and the posterior condyle line on the cross-sectional projection line.

Exemplarily, the implementation of the system determining the prosthesis model through the interactive interface may include: setting the configuration items of each three-dimensional bone prosthesis model on the interface, for example, it may be a three-dimensional femoral prosthesis model configuration item, a three-dimensional tibial prosthesis model configuration item item and the configuration item of the 3D spacer model, when a certain configuration item is triggered (for example, the selected mode triggers the configuration item), it can automatically match the corresponding prosthesis library, and then detect which phantom model in the prosthesis library is activated Trigger, the prosthesis that is triggered signals as a replacement prosthesis. For example, when the femoral prosthesis model configuration item is triggered, it can establish an association with the femoral prosthesis library, and then display the types and models of all the prosthesis models in the femoral prosthesis library on the interface, and then detect which type of femoral prosthesis model and which type of femoral prosthesis model under this type is triggered, so that the triggered femoral prosthesis model is selected as the femoral prosthesis model.

Step 103: Implant the selected three-dimensional bone prosthesis model into the three-dimensional bone model.

In this embodiment, the three-dimensional bone prosthesis model and the three-dimensional bone model can be superimposed and displayed through the three-dimensional model to realize the simulated installation of the three-dimensional bone prosthesis.

Step 104: Adjust the placement position and placement angle of the three-dimensional bone prosthesis model based on the key bone parameters and the type and model of the three-dimensional bone prosthesis model.

In this embodiment, the three-dimensional visual display of the matching adjustment process and matching effect between the three-dimensional skeleton model and the three-dimensional prosthesis model is realized. After obtaining the three-dimensional bone model after implanting the three-dimensional bone prosthesis model, the femoral prosthesis model can be determined based on the femoral valgus angle, femoral varus angle, femoral external rotation angle, femoral internal rotation angle, left and right femoral diameter, and femoral anteroposterior diameter Whether the 3D femur model has been installed and fitted.

Based on the tibial varus angle, femoral valgus angle, left and right tibial diameter, and tibial anteroposterior diameter, it can be determined whether the tibial prosthetic model has been installed and adapted to the three-dimensional tibial model.

As an optional implementation of this embodiment, the three-dimensional bone model includes a three-dimensional femoral model, the three-dimensional bone prosthesis model includes a three-dimensional femoral prosthesis model, the key bone parameters include femoral key parameters, and the femoral key parameters include Femoral mechanical axis, femoral condyle line, posterior condyle line, femur left and right diameter and femoral anteroposterior diameter; steps to adjust the placement position and placement angle of the 3D bone prosthesis model based on the key parameters of the bone and the type and model of the 3D bone prosthesis model Including: adjusting the placement position of the three-dimensional femoral prosthesis model based on the left and right diameters of the femur and the anteroposterior diameter of the femur; The axis is vertical; adjust the internal or external rotation angle of the three-dimensional femoral prosthesis so that the posterior femoral condyle angle PCA (the angle between the femoral condyle line and the posterior condyle line on the cross-sectional projection line) is within the preset range .

In this optional implementation manner, when the placement position of the femoral prosthesis model satisfies that the femoral prosthesis model can cover the left and right sides of the femur and the front and back of the femur, the installation position is appropriate.

Based on the current position of the femoral prosthesis model, the femoral valgus angle and femoral varus angle can be determined according to the relative angle between the central axis of the femoral prosthesis model in the upper and lower direction of the coronal plane and the femoral force line, and according to the transverse axis of the femoral prosthesis model The external rotation angle and internal rotation angle are determined by the relative angle to the condylar line; the femoral flexion angle is determined by the angle between the femoral mechanical axis and the central axis of the femoral prosthesis model in the sagittal front-posterior direction. By adjusting the above angles, it can be determined whether the installation angle of the three-dimensional femoral prosthesis model is appropriate, for example, when the varus/valgus angle is adjusted to 0°, and the PCA is adjusted to 3°, it is considered as the placement of the femoral prosthesis model Adjust the position and installation angle to a suitable position.

As an optional implementation of this embodiment, the three-dimensional bone model also includes a three-dimensional tibial model, and the three-dimensional femoral prosthesis model also includes a three-dimensional tibial prosthetic model; the bone key parameters also include tibial key parameters, and the tibial key parameters include tibial mechanical axis , tibia left and right diameters and tibial anteroposterior diameters; the step of adjusting the placement position and placement angle of the three-dimensional skeletal prosthesis model based on the key bone parameters and the type and model of the three-dimensional skeletal prosthesis model may also include: based on the tibial left and right diameters and the tibial anteroposterior diameters, Adjust the placement position of the three-dimensional tibial prosthesis model; adjust the varus or valgus angle of the three-dimensional tibial prosthesis so that the mechanical axis of the tibia is perpendicular to the cross-section of the three-dimensional tibial prosthesis.

In this optional implementation, in addition to determining the installation position and angle through the above methods, the posterior inclination angle of the tibial prosthesis can also be determined according to the design principles of the tibial prosthesis, and the adjustment of the flexion angle of the tibial prosthesis can be based on the patient's physiological The characteristics are determined, adjust to 0° or other, avoid notch (gap), Over.

As an optional implementation of this embodiment, after the step of adjusting the placement position and placement angle of the 3D skeletal prosthesis model, the method of this embodiment further includes: matching based on the 3D skeletal prosthesis model and the 3D prosthesis model Simulate the osteotomy based on the relationship between bone and bone to obtain a three-dimensional bone postoperative simulation model; perform motion simulation on the three-dimensional femoral postoperative simulation model including extension and flexion; determine the extension gap in the extension state, and determine the flexion gap in the flexion state; Comparing the extension gap and the flexion gap, the matching verification of the three-dimensional bone prosthesis model is carried out.

In this optional implementation, the bone osteotomy thickness is determined according to the design principle of the bone prosthesis model, and different bone prosthesis models may correspond to different osteotomy thicknesses; bone plane.

Bone osteotomy planes may include femoral osteotomy planes and tibial osteotomy planes. For tibial osteotomy planes, refer to FIG. 3 a , the number of which may be one plane area. For the femoral osteotomy plane, referring to Fig. 3b, its quantity can include 5 plane areas, and these 5 plane areas respectively include the femoral front end osteotomy plane, the femoral anterior oblique osteotomy plane, the posterior femoral condyle osteotomy plane, and the femoral posterior oblique section plane. Bone plane, tibial osteotomy plane, distal femoral osteotomy plane.

After adjusting the placement position and placement angle of the three-dimensional bone prosthesis model, simulate the osteotomy based on the matching relationship between the three-dimensional bone prosthesis model and the three-dimensional bone model, and obtain the three-dimensional bone postoperative simulation model. Referring to Figure 4(a) to Figure 4(c), the shaded part is the tibial prosthesis, and Figure 4(a) to Figure 4(c) are reference pictures of the tibial model after matching the tibial prosthesis under different viewing angles. Referring to Figure 4(d)-Figure 4(f), the shaded part is the femoral prosthesis, and Figure 4(d) to Figure 4(f) are reference images of the femoral model after matching the femoral prosthesis model under different viewing angles.

After obtaining the three-dimensional skeletal postoperative simulation model, the extension gap can be determined through the extension simulation diagram as shown in Figure 5(a); the flexion gap can be determined through the flexion simulation diagram as shown in Figure 5(b). Based on the straightening gap and the flexion gap, it is determined whether the three-dimensional bone prosthesis model fits the osteotomized three-dimensional bone model. By simulating the installation effect of the prosthesis, it can be observed from different angles whether the size and position of the prosthesis are appropriate, whether there is collision or misplacement of the prosthesis, and then it is possible to accurately determine whether the prosthesis and the bone fit. The user can determine whether the bone prosthesis model needs to be adjusted through the final simulation image. If the type and model of the bone prosthesis are changed, the prosthesis library can be called again to generate a three-dimensional replacement based on the new bone prosthesis model. Skeletal postoperative simulation model. By simulating the expected postoperative effect, the resulting bone prosthesis model can be more closely matched to the patient's knee joint.

In this embodiment, through the postoperative simulation of the bone model with the prosthesis model installed, the gap can be accurately determined, thereby overcoming the reliance on the technique and experience of the surgeon in the related art, and completely relying on the gap balance and the installation of the prosthesis position. The subjective feeling is assessed, which in turn leads to the defect of low surgical precision.

In some embodiments, the three-dimensional preoperative planning method for knee joint replacement may further include: determining the three-dimensional coordinates of the center point of the femoral medullary cavity based on the three-dimensional femoral model; creating an intramedullary positioning simulation rod by a circular fitting method; The rod determines the femoral opening point.

In an optional implementation, in knee arthroplasty, it is also necessary to determine the position of the needle entry point of the femoral intramedullary positioning analog rod, wherein the apex of the intercondylar fossa can be used as the position of the needle entry point of the intramedullary positioning analog rod. The position of the point can be used as the opening point of the femur. During the operation, the intramedullary locating analog rod and the opening point of the femur are visualized on the three-dimensional bone model to guide the doctor to open the pulp.

It should be noted that the steps shown in the flowcharts of the accompanying drawings may be performed in a computer system, such as a set of computer-executable instructions, and that although a logical order is shown in the flowcharts, in some cases, The steps shown or described may be performed in an order different than here.

According to an embodiment of the present application, there is also provided a three-dimensional preoperative planning system for implementing the aforementioned knee joint replacement. As shown in FIG. 6 , the system includes: an image preprocessing unit 601 configured to After the medical image, the medical image is segmented and three-dimensionally reconstructed to obtain a three-dimensional bone model of the knee joint; the prosthesis determining unit 602 is configured to determine key bone parameters based on the three-dimensional bone model; based on the key bone parameters Determine the type and model of the three-dimensional bone prosthesis model; the implantation unit 603 is configured to implant the selected three-dimensional bone prosthesis model into the three-dimensional bone model; the adjustment unit 604 is configured to based on the bone key parameters and the selected Adjust the placement position and placement angle of the three-dimensional skeleton prosthesis model according to the type and model of the three-dimensional skeleton prosthesis model.

As an optional implementation of this embodiment, the three-dimensional bone model includes a three-dimensional femoral model, the three-dimensional bone prosthesis model includes a three-dimensional femoral prosthesis model, the key bone parameters include femoral key parameters, and the femoral key parameters include Femoral mechanical axis, femoral condyle line, posterior condyle line, femur left and right diameter and femur anteroposterior diameter.

The adjustment unit 604 includes a femoral prosthesis position adjustment subunit and a femoral prosthesis angle adjustment subunit, the femoral prosthesis position adjustment subunit is configured to adjust the placement position of the three-dimensional femoral prosthesis model based on the left and right femoral diameter and the femoral anteroposterior diameter. The femoral prosthesis angle adjustment subunit is configured to adjust the varus or valgus angle of the three-dimensional femoral prosthesis model so that the cross section of the three-dimensional femoral prosthesis model is perpendicular to the femoral mechanical axis; the femoral prosthesis angle adjustment subunit is also configured In order to adjust the internal rotation angle or external rotation angle of the three-dimensional femoral prosthesis, the posterior condyle angle of the femur is within a preset range.

As an optional implementation of this embodiment, the three-dimensional bone model also includes a three-dimensional tibial model, and the three-dimensional femoral prosthesis model also includes a three-dimensional tibial prosthetic model; the key bone parameters also include tibial key parameters, and the tibial Key parameters include the tibial mechanical axis, tibial left-right diameter, and tibial anterior-posterior diameter.

The adjustment unit also includes a tibial prosthesis position adjustment subunit and a tibial prosthesis angle adjustment subunit. The tibial prosthesis position adjustment subunit is configured to adjust the placement position of the three-dimensional tibial prosthesis model based on the tibial left and right diameters and tibial anteroposterior diameters. The prosthesis angle adjustment subunit is configured to adjust the varus angle or valgus angle of the three-dimensional tibial prosthesis so that the tibial mechanical axis is perpendicular to the cross section of the three-dimensional tibial prosthesis.

The three-dimensional preoperative planning for knee joint replacement in this embodiment also includes a motion simulation unit and an intramedullary positioning simulation rod creation unit.

The configuration of the motion simulation unit is: based on the matching relationship between the 3D skeletal prosthesis model and the 3D skeletal model, simulate osteotomy to obtain a 3D skeletal postoperative simulation model; perform motion simulation on the 3D femoral postoperative simulation model including the extension position and flexion position Determining the straightening gap in the straightened state, and determining the flexion gap in the buckled state; comparing the straightening gap with the buckling gap, and verifying the matching of the three-dimensional bone prosthesis model.

The intramedullary positioning analog rod creation unit is configured to: determine the three-dimensional coordinates of the center point of the femoral medullary cavity based on the three-dimensional femoral model; create the intramedullary positioning analog rod through a circular fitting method; determine the opening point of the femur by the intramedullary positioning analog rod.

An embodiment of the present application provides an electronic device. As shown in FIG. 7 , the electronic device includes one or more processors 71 and a memory 72 , and one processor 71 is taken as an example in FIG. 7 .

The controller may also include: an input device 73 and an output device 74 .

The processor 71 , the memory 72 , the input device 73 and the output device 74 may be connected through a bus or in other ways. In FIG. 7 , connection through a bus is taken as an example.

The processor 71 may be a central processing unit (Central Processing Unit, CPU). The processor 71 can also be other general-purpose processors, digital signal processors (Digital Signal Processor, DSP), application-specific integrated circuits (Application Specific Integrated Circuit, ASIC), field-programmable gate array (Field-Programmable Gate Array, FPGA) or other programmable logic devices, discrete Chips such as gate or transistor logic devices, discrete hardware components, or a combination of the above types of chips. A general-purpose processor may be a microprocessor, or the processor may be any conventional processor, or the like.

As a non-transitory computer-readable storage medium, the memory 72 can be used to store non-transitory software programs, non-transitory computer-executable programs and modules, such as program instructions/modules corresponding to the control method in the embodiment of the present application. The processor 71 executes various functional applications and data processing of the server by running the non-transitory software programs, instructions and modules stored in the memory 72, that is, realizes the three-dimensional preoperative planning method for knee joint replacement in the above method embodiment.

The memory 72 may include a program storage area and a data storage area, wherein the program storage area may store an operating system, an application program required by at least one function; the data storage area may store data created according to use of a processing device operated by a server, and the like. In addition, the memory 72 may include a high-speed random access memory, and may also include a non-transitory memory, such as at least one magnetic disk storage device, a flash memory device, or other non-transitory solid-state storage devices. In some embodiments, the memory 72 may optionally include memory located remotely relative to the processor 71, and these remote memories may be connected to a network connection device through a network. Examples of the aforementioned networks include, but are not limited to, the Internet, intranets, local area networks, mobile communication networks, and combinations thereof.

The input device 73 can receive input numbers or character information, and generate key signal input related to user settings and function control of the processing device of the server. The output device 74 may include a display device such as a display screen.

One or more modules are stored in the memory 72, and when executed by the one or more processors 71, perform the method shown in FIG. 1 .

Those skilled in the art can understand that all or part of the processes in the methods of the above-mentioned embodiments can be completed by instructing related hardware through computer programs, and the programs can be stored in a computer-readable storage medium. , it may include the flow of the embodiment of the above method. Wherein, the storage medium may be a magnetic disk, an optical disk, a read-only memory (Read-OnlyMemory, ROM), a random access memory (RandomAccessMemory, RAM), a flash memory (FlashMemory), a hard disk (HardDiskDrive, abbreviated: HDD) or A solid-state drive (Solid-State Drive, SSD), etc.; the storage medium may also include a combination of the above-mentioned types of memories.

Although the embodiment of the application has been described in conjunction with the accompanying drawings, those skilled in the art can make various modifications and variations without departing from the spirit and scope of the application, and such modifications and variations all fall into the scope of the appended claims. within the limited range.

Claims

A three-dimensional preoperative planning method for knee joint replacement, comprising:

After the medical image of the knee joint is obtained, the medical image is segmented and three-dimensionally reconstructed to obtain a three-dimensional bone model of the knee joint;

Determine key bone parameters based on the three-dimensional bone model; determine the type and model of the three-dimensional bone prosthesis model based on the key bone parameters;

Implanting the selected three-dimensional bone prosthesis model into the three-dimensional bone model;

Adjusting the installation position and installation angle of the three-dimensional bone prosthesis model based on the key bone parameters and the type and model of the three-dimensional bone prosthesis model.
The three-dimensional preoperative planning method for knee joint replacement according to claim 1, wherein the three-dimensional bone model includes a three-dimensional femur model, the three-dimensional bone prosthesis model includes a three-dimensional femoral prosthesis model, and the key bone parameters include a femur Key parameters, the key parameters of the femur include femoral mechanical axis, femoral condyle line, posterior condyle line, femur left and right diameter and femur anteroposterior diameter;

The step of adjusting the placement position and placement angle of the three-dimensional skeleton prosthesis model based on the key bone parameters and the type and model of the three-dimensional skeleton prosthesis model includes:

Adjust the placement position of the three-dimensional femoral prosthesis model based on the left-right diameter of the femur and the anterior-posterior diameter of the femur;

Adjusting the varus or valgus angle of the three-dimensional femoral prosthesis model so that the cross-section of the three-dimensional femoral prosthesis model is perpendicular to the mechanical axis of the femur;

The internal rotation angle or external rotation angle of the three-dimensional femoral prosthesis is adjusted so that the posterior femoral condyle angle is within a preset range.
The three-dimensional preoperative planning method for knee joint replacement according to claim 2, wherein the three-dimensional bone model also includes a three-dimensional tibial model, and the three-dimensional femoral prosthesis model also includes a three-dimensional tibial prosthetic model; the bone key parameters Also include key parameters of the tibia, the key parameters of the tibia include the mechanical axis of the tibia, the diameter of the left and right sides of the tibia, and the diameter of the front and rear of the tibia;

The step of adjusting the placement position and placement angle of the three-dimensional skeleton prosthesis model based on the key bone parameters and the type and model of the three-dimensional skeleton prosthesis model includes:

Adjust the placement position of the three-dimensional tibial prosthesis model based on the tibial left-right diameter and tibial-posterior diameter;

The varus angle or valgus angle of the three-dimensional tibial prosthesis is adjusted so that the tibial mechanical axis is perpendicular to the cross-section of the three-dimensional tibial prosthesis.
According to the three-dimensional preoperative planning method of knee joint replacement according to claim 3, after the step of adjusting the placement position and placement angle of the three-dimensional bone prosthesis model, the method further comprises:

Based on the matching relationship between the three-dimensional bone prosthesis model and the three-dimensional bone model, the osteotomy is simulated, and the three-dimensional bone postoperative simulation model is obtained;

Carry out motion simulation including straight position and flexion position to described three-dimensional femoral postoperative simulation model;

The extension gap is determined in the state of extension, and the flexion gap is determined in the flexion state;

Comparing the straightening gap and the flexion gap, the compatibility of the three-dimensional bone prosthesis model is verified.
The three-dimensional preoperative planning method for knee joint replacement according to claim 2, said method further comprising:

Determine the three-dimensional coordinates of the center point of the femoral medullary cavity based on the three-dimensional femoral model;

Create intramedullary positioning analog rods by circular fitting;

The opening point of the femur is determined by the intramedullary positioning analog rod.
A three-dimensional preoperative planning system for knee replacement, including:

The image preprocessing unit is configured to, after acquiring the medical image of the knee joint, perform segmentation and three-dimensional reconstruction on the medical image to obtain a three-dimensional bone model of the knee joint;

The prosthesis determination unit is configured to determine key bone parameters based on the three-dimensional bone model; determine the type and model of the three-dimensional bone prosthesis model based on the key bone parameters;

an implant unit configured to implant the selected three-dimensional bone prosthesis model into the three-dimensional bone model;

The adjustment unit is configured to adjust the installation position and installation angle of the three-dimensional bone prosthesis model based on the key bone parameters and the type and model of the three-dimensional bone prosthesis model.
The three-dimensional preoperative planning system for knee joint replacement according to claim 6, wherein the three-dimensional bone model includes a three-dimensional femur model, the three-dimensional bone prosthesis model includes a three-dimensional femoral prosthesis model, and the key bone parameters include a femur Key parameters, the key parameters of the femur include femoral mechanical axis, femoral condyle line, posterior condyle line, femur left and right diameter and femur anteroposterior diameter;

The adjustment unit includes:

The femoral prosthesis position adjustment subunit is configured to adjust the placement position of the three-dimensional femoral prosthesis model based on the left-right diameter of the femur and the anterior-posterior diameter of the femur;

The femoral prosthesis angle adjustment subunit is configured to adjust the varus angle or valgus angle of the three-dimensional femoral prosthesis model so that the cross section of the three-dimensional femoral prosthesis model is perpendicular to the femoral mechanical axis;

The femoral prosthesis angle adjustment subunit is further configured to adjust the internal rotation angle or external rotation angle of the three-dimensional femoral prosthesis, so that the posterior femoral condyle angle is within a preset range.
According to the three-dimensional preoperative planning system of knee joint replacement according to claim 6, the three-dimensional bone model also includes a three-dimensional tibial model, and the three-dimensional femoral prosthesis model also includes a three-dimensional tibial prosthesis model; the key bone parameters also include The key parameters of the tibia, the key parameters of the tibia include the mechanical axis of the tibia, the diameter of the left and right sides of the tibia, and the diameter of the front and rear of the tibia;

The adjustment unit also includes:

The tibial prosthesis position adjustment subunit is configured to adjust the placement position of the three-dimensional tibial prosthesis model based on the left and right tibial diameter and the tibial anteroposterior diameter;

The tibial prosthesis angle adjustment subunit is configured to adjust the varus angle or valgus angle of the three-dimensional tibial prosthesis so that the tibial mechanical axis is perpendicular to the cross section of the three-dimensional tibial prosthesis.
A computer-readable storage medium, the computer-readable storage medium stores computer instructions, and the computer instructions are used to make the computer perform the three-dimensional preoperative planning of knee joint replacement according to any one of claims 1-5 method.
An electronic device, comprising: at least one processor; and a memory communicatively connected to the at least one processor; wherein, the memory stores a computer program executable by the at least one processor, and the computer program is The at least one processor executes, so that the at least one processor executes the three-dimensional preoperative planning method for knee joint replacement according to any one of claims 1-5.