WO2023109105A1 - 用于膝关节置换手术的手术上位机及膝关节置换手术系统 - Google Patents

用于膝关节置换手术的手术上位机及膝关节置换手术系统 Download PDF

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WO2023109105A1
WO2023109105A1 PCT/CN2022/104788 CN2022104788W WO2023109105A1 WO 2023109105 A1 WO2023109105 A1 WO 2023109105A1 CN 2022104788 W CN2022104788 W CN 2022104788W WO 2023109105 A1 WO2023109105 A1 WO 2023109105A1
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Prior art keywords
femur
tibia
thrust
joint angle
surgical
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PCT/CN2022/104788
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English (en)
French (fr)
Inventor
周一新
赵永强
史洪伟
杨德金
田野
陈波
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北京天智航医疗科技股份有限公司
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Publication of WO2023109105A1 publication Critical patent/WO2023109105A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/461—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of knees
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025—Joint distractors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/25—User interfaces for surgical systems
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/40—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
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    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
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    • A—HUMAN NECESSITIES
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4632—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using computer-controlled surgery, e.g. robotic surgery
    • A—HUMAN NECESSITIES
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A61F2002/4658—Measuring instruments used for implanting artificial joints for measuring dimensions, e.g. length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A61F2002/4666—Measuring instruments used for implanting artificial joints for measuring force, pressure or mechanical tension
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A61F2002/4668—Measuring instruments used for implanting artificial joints for measuring angles
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02P—CLIMATE CHANGE MITIGATION TECHNOLOGIES IN THE PRODUCTION OR PROCESSING OF GOODS
    • Y02P90/00—Enabling technologies with a potential contribution to greenhouse gas [GHG] emissions mitigation
    • Y02P90/02—Total factory control, e.g. smart factories, flexible manufacturing systems [FMS] or integrated manufacturing systems [IMS]

Definitions

  • the present application relates to the field of surgical equipment, in particular, to a surgical host computer for knee replacement surgery and a knee replacement surgery system.
  • Knee arthroplasty is a complex orthopedic surgery because the knee joint has complex components, including femur, tibia, and four ligaments surrounding the joint, muscles, cartilage, etc.
  • TKA is one of the main ways to treat degenerative knee diseases.
  • the goal of the operation is to restore the line of motion of the lower limbs and joint range of motion, maintain joint stability, and reduce pain.
  • Proper implant alignment and soft tissue balance are key to achieving surgical goals.
  • Ligament loosening is actually a kind of damage to the structure of human tissue. If the tension of soft tissue can be understood during the operation, so as to make appropriate adjustments according to the tension during osteotomy, the prosthesis will not loosen or loosen less after installation. Ligaments protect soft tissues.
  • This application provides a surgical host computer and a knee replacement surgery system for knee joint replacement surgery. Through different working modes, the corresponding relationship data between the force and the gap between the femur and the tibia are obtained and visualized. Or visualize the information to quickly judge whether the soft tissue is balanced and make intraoperative adjustments.
  • a surgical host computer which is used to control the soft tissue balance measurement device of the knee joint and perform data collection in knee joint replacement surgery.
  • the measurement device includes a host and accessories.
  • the operation host computer includes: a processor; and a memory, storing a plurality of computer programs, when the plurality of computer programs are processed
  • the processors are respectively executed, the processors are respectively executed with a plurality of operation modes of the surgical host computer, and the plurality of operation modes include: displaying information to be input to the user through an interactive interface, and the information to be input includes joint clips
  • the relationship between the included joint angle and the thrust applied between the femur and the tibia includes: setting the multiple value ranges corresponding to the multiple value ranges according to the dynamic change interval
  • the relationship between the joint angle and the gap formed between the femur and the tibia includes: multiple value ranges set according to the dynamic change interval, Set the data value of the gap corresponding to the plurality of value ranges, or the functional relationship between the joint angle and the gap.
  • the thrust data value applied between the femur and the tibia and the gap data value between the femur and the tibia include: the thrust data value applied between the pre-osteotomed femur and the tibia and the gap data between the femur and the tibia values; data values of the thrust applied after implantation of the prosthesis between the femur and tibia and before placement of the shim, and data values of the gap between the femur and tibia.
  • the data value of the thrust and the data value of the gap under multiple joint angles and the relationship between the data value of the thrust and the joint angle or the data of the gap The relationship between the value and the joint angle.
  • the plurality of computer programs include a first computer program, when the first computer program is executed by the processor, the processor is executed in a first operation mode of the surgical host computer, so The first operation mode includes: displaying the first information to be input to the user through the first interactive interface, the first information to be input includes the dynamic change interval of the joint angle and the femur corresponding to the dynamic change interval.
  • the data value of the thrust applied between the femur and the tibia in response to the information input by the user, during the process of dynamically adjusting the joint angle within the dynamic change interval, the abutment member and the push plate are controlled to move between the femur and the tibia applying a corresponding thrust, and collecting the data value of the gap between the femur and the tibia; and at least visually displaying the relationship between the data value of the gap and the joint angle.
  • the thrust corresponding to the different value ranges of the joint angle has different data values.
  • the plurality of computer programs includes a second computer program, when the second computer program is executed by the processor, the processor is executed in a second operation mode of the surgical host computer, so
  • the second operation mode includes: displaying the second information to be input to the user through the second interactive interface, the second information to be input includes the dynamic change interval of the joint angle and the femur corresponding to the dynamic change interval.
  • the data value of the preset gap formed between the femur and the tibia in response to the information input by the user, during the process of dynamically adjusting the joint angle within the dynamic change interval, the abutment member and the push plate are controlled to move between the femur and the tibia.
  • a corresponding gap is formed between the tibia, and the data value of the thrust between the femur and the tibia is collected; and at least a relationship between the data value of the thrust and the included angle of the joint is displayed visually.
  • gaps corresponding to different value ranges of the joint angle have different data values.
  • the plurality of computer programs includes a third computer program, when the third computer program is executed by the processor, the processor is made to perform a third operation mode of the surgical host computer, so
  • the third operation mode includes: displaying the third information to be input to the user through the third interactive interface, the third information to be input includes the dynamic range of the joint angle and the data of applying a fixed thrust between the femur and the tibia value; in response to the information input by the user, during the process of dynamically adjusting the included joint angle within the dynamic change interval, control the abutment member and the push plate to apply the fixed thrust between the femur and the tibia, and collecting data values of the gap between the femur and the tibia; and at least visually displaying the relationship between the data values of the gap and the joint angle.
  • the plurality of computer programs includes a fourth computer program, when the fourth computer program is executed by the processor, the processor is executed in a fourth operation mode of the surgical host computer, so
  • the fourth operation mode includes: displaying fourth information to be input to the user through the fourth interactive interface, the fourth information to be input includes the dynamic range of the joint angle and the data forming a fixed gap between the femur and the tibia value; in response to the information input by the user, during the process of dynamically adjusting the joint angle within the dynamic change interval, the abutting member and the push plate are controlled to form a fixed gap between the femur and the tibia, and the femur is collected The data value of the thrust between the tibia and the tibia; and at least visually display the relationship between the data value of the thrust and the included angle of the joint.
  • a knee joint replacement surgery system including the above-mentioned surgical host computer.
  • the angle, force and gap between the knee joints can be quantified and reasonably displayed to assist doctors in surgery and reduce ligament release injuries in patients.
  • Fig. 1A shows a schematic diagram of the installation of the soft tissue balance measuring device of the knee joint.
  • Fig. 1B shows a perspective schematic view of the host of the knee joint soft tissue balance measurement device.
  • Fig. 2 shows an operation flowchart of a surgical host computer according to an exemplary embodiment of the present application.
  • Fig. 3 shows a flow chart of the first operation mode of the surgical host computer according to an exemplary embodiment of the present application.
  • Fig. 4A is a display diagram of an interactive interface of a surgical host computer in a first operation mode according to an exemplary embodiment of the present application.
  • Fig. 4B shows a visual information presentation diagram of the first operation mode of the surgical host computer according to an exemplary embodiment of the present application.
  • Fig. 5 shows a flow chart of the second operation mode of the surgical host computer according to an exemplary embodiment of the present application.
  • Fig. 6A shows an interactive interface display diagram of the second operation mode of the surgical host computer according to an exemplary embodiment of the present application.
  • Fig. 6B shows a visual information display diagram of the second operation mode of the surgical host computer according to an exemplary embodiment of the present application.
  • Fig. 7 shows a flow chart of the third operation mode of the surgical host computer according to an exemplary embodiment of the present application.
  • Fig. 8 shows a visual information presentation diagram of the third operation mode of the surgical host computer according to an exemplary embodiment of the present application.
  • Fig. 9 shows a flow chart of the fourth operation mode of the surgical host computer according to an exemplary embodiment of the present application.
  • Fig. 10 shows a visual information presentation diagram of a fourth operation mode of the surgical host computer according to an exemplary embodiment of the present application.
  • Fig. 11 shows a block diagram of a surgical host computer according to an exemplary embodiment of the present application.
  • Example embodiments will now be described more fully with reference to the accompanying drawings.
  • Example embodiments may, however, be embodied in many forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this application will be thorough and complete, and will fully convey the concept of example embodiments to those skilled in the art.
  • the same reference numerals denote the same or similar parts in the drawings, and thus their repeated descriptions will be omitted.
  • This application provides a surgical host computer, a soft tissue balance measurement device based on the knee joint and a corresponding joint angle measurement device, which are used to collect and display the force and gap of the soft tissue in a reasonable way during knee replacement surgery, so that Help the doctor to adjust the plan, reduce the number of osteotomy adjustments or ligament damage, and reduce the operation time.
  • Fig. 1A shows a schematic diagram of the installation of the soft tissue balance measuring device of the knee joint.
  • the main body of the measuring device is placed between the patient's tibia and femur, and the attachment of the measuring device is placed on the upper surface of the patient's thigh.
  • the knee joint soft tissue balance measurement device can also be used to measure the knee joint gap and soft tissue elasticity after the prosthesis is placed between the patient's tibia and femur and before the spacer is placed.
  • the host and accessories may include gyroscopes, which may be used to determine the included angle of the patient's joints.
  • Fig. 1B shows a perspective schematic view of the host of the knee joint soft tissue balance measurement device.
  • the host of the measuring device includes a measuring module 100 and a driving module 200 .
  • the measurement module 100 includes a mount 110 , a push plate 120 for abutting against the tibia, and an abutment member 130 for abutting against the femur.
  • the push plate is fixedly connected to the mounting seat
  • the abutment member is connected to the mounting seat in a manner that can move longitudinally relative to the mounting seat
  • the upper abutment plate part of the abutting member and the lower abutment of the push plate The plate portions extend substantially parallel perpendicular to the longitudinal direction, and the upper abutment plate portion is arranged longitudinally above the lower abutment plate portion.
  • the driving module 200 includes a sealed housing 210 , a power unit and an actuator 230 .
  • the power unit is located in the sealed housing, and the actuator is located outside the sealed housing.
  • the power unit is sealed through the sealed housing and connected with the actuator in transmission.
  • the actuator is configured to be removably matched with the measurement module for pushing and abutting The member moves longitudinally relative to the push plate.
  • the abutting member acts on the medial condyle and the lateral condyle of the distal femur respectively to generate a medial thrust and a lateral thrust, thereby forming a medial gap and a lateral gap between the femur and the tibia.
  • the push plate is used to support the tibia and maintain soft tissue balance.
  • Fig. 2 shows an operation flowchart of a surgical host computer according to an exemplary embodiment of the present application.
  • the thrust data value applied between the femur and the tibia and the gap data value between the femur and the tibia include the pre-osteotomized femur and the tibia or after placing the prosthesis between the femur and the tibia and placing Thrust data values applied in front of the shim and clearance data values between the femur and tibia.
  • the pre-osteotomy includes osteotomy of the tibia and/or femur to facilitate adjustment and correction during knee prosthesis placement.
  • the prosthesis After the prosthesis is placed between the femur and the tibia and before the spacer is placed, the prosthesis can be adjusted and corrected according to the thrust data value and the gap data value between the femur and the tibia.
  • the correspondence data includes the relationship between the data value of the thrust and the included angle of the joint and/or the relationship between the data value of the clearance and the included angle of the joint.
  • the data value of the thrust further includes the data value of the fixed thrust applied according to the value range of the joint angle.
  • the gap data value also includes the data value of the fixed gap formed by applying thrust according to the value range of the joint angle.
  • the surgical planning is adjusted according to the visualized data displayed on the interactive interface.
  • the adjustment of the surgical plan includes placing the knee joint prosthesis and spacers, and adjusting the thickness of the prosthesis
  • Fig. 3 shows a flow chart of the first operation mode of the surgical host computer according to an exemplary embodiment of the present application.
  • the first information to be input is displayed to the user.
  • the first information to be input includes multiple value ranges of the joint angle and corresponding to the multiple value ranges, which have been pre-cut Data values for the thrust force applied between the femur and tibia of the bone.
  • the interactive interface is shown in Fig. 4A.
  • the first information to be input includes the value range of the preset joint angle, and the data values of the inner thrust and the outer thrust.
  • the joint angle can be set to range from 0° to 135°.
  • the included joint angle is calibrated to be 0°, and then flexed to the maximum joint included angle.
  • the data value of the thrust is set according to the value range of the joint angle:
  • the inner thrust and outer thrust are both set to 25N;
  • both the inner and outer thrusts are set to 50N;
  • the medial thrust and lateral thrust are both set to 80N.
  • the setting of the joint angle and the thrust can also be obtained according to a preset functional relationship, for example, the joint angle and the thrust have a sinusoidal function relationship.
  • the surgical host computer transmits instructions to the measuring device according to the data transmission instructions of the first interactive interface, and applies thrust through the abutting member and the push plate of the measuring device, and performs multiple measurements. And obtain the data values of the inner thrust and the outer thrust, and the corresponding data values of the inner clearance and the outer clearance.
  • the measured medial thrust and lateral thrust are both 80N, and the corresponding medial clearance is 23.22, and the lateral clearance is 17.47.
  • the left figure shows the change curve of the inner and outer gaps of the knee joint in the first operation mode of the surgical host computer.
  • the colored curve represents the outer gap
  • the purple curve represents the gap difference.
  • the figure on the right shows the change curve of the thrust between the knee joints under the first operation mode of the surgical host computer.
  • the abscissa is the data value of the thrust, and the ordinate is the angle between the joints.
  • the yellow curve represents the inner thrust, and the blue curve represents the outer thrust.
  • the purple curve represents the thrust difference.
  • Fig. 5 shows a flow chart of the second operation mode of the surgical host computer according to an exemplary embodiment of the present application.
  • the second information to be input is displayed to the user through the second interactive interface, and the second information to be input includes a plurality of value ranges of joint angles and corresponding to the plurality of value ranges, which have been pre-cut The data value of the preset gap formed between the femur and tibia of the bone.
  • the second interactive interface is shown in FIG. 6A .
  • the second information to be input includes the value range of the preset joint angle, and the data values of the inner gap and the outer gap.
  • the joint angle can be set to range from 0° to 135°.
  • the included joint angle is calibrated to be 0°, and then flexed to the maximum joint included angle.
  • the gap data value is set according to the value range of the joint angle:
  • both the inner gap and the outer gap are set to 6;
  • both the medial and lateral gaps are set to 10;
  • both the medial and lateral gaps are set to 16.
  • the setting of the joint angle and the gap can also be obtained according to the preset functional relationship, for example, the joint angle and the gap have a sinusoidal function relationship.
  • the surgical host computer transmits instructions to the measuring device according to the data of the interactive interface, and applies thrust through the abutting member and the push plate of the measuring device, and measures and obtains it multiple times. Data values for inboard clearance and outboard clearance, and corresponding inboard thrust and outboard thrust.
  • the measured medial gap and lateral gap are both 16, and the corresponding medial thrust is 73.00N, and the lateral thrust is 93.50N.
  • the figure on the left shows the change curve of the inner and outer gaps of the knee joint under the second operation mode of the surgical host computer.
  • the colored curve represents the outer gap
  • the purple curve represents the gap difference.
  • the figure on the right shows the change curve of the thrust between the knee joints under the second operation mode of the surgical host computer.
  • the abscissa is the data value of the thrust, and the ordinate is the angle between the joints.
  • the yellow curve represents the inner thrust, and the blue curve represents the outer thrust.
  • the purple curve represents the thrust difference.
  • Fig. 7 shows a flow chart of the third operation mode of the surgical host computer according to an exemplary embodiment of the present application.
  • the third information to be input is displayed to the user through the third interactive interface, the third information to be input includes the value range of the joint angle and the data value of applying a fixed thrust between the pre-osteotomized femur and the tibia.
  • the third interactive interface can be shown in FIG. 4A .
  • the third information to be input in the third operation mode of the surgical host computer includes the value range of the preset joint angle, and the data values of the inner thrust and the outer thrust.
  • the joint angle ranges from 0° to 135°, and at any joint angle within the range, the inner thrust and outer thrust are both set to a fixed value of 18N.
  • the abutment member and the push plate are controlled to apply a fixed thrust between the femur and the tibia, and the data value of the gap between the femur and the tibia is collected.
  • the surgical host computer transmits instructions to the measuring device according to the data of the interactive interface, and applies thrust through the abutting member and the push plate of the measuring device, and measures and obtains it multiple times. Data values for inboard thrust and outboard thrust, and corresponding data values for inboard clearance and outboard clearance.
  • the measured medial thrust is 18.60N
  • the lateral thrust is 18.90N
  • the corresponding medial clearance is 13.50
  • the lateral clearance is 12.10.
  • the vibration of the measurement device due to interference factors in actual use will cause the actual measurement data (actually measured inner thrust, outer thrust) to be different from the theoretical value (set in the surgical host computer as There may be an error compared with the fixed value of inner thrust, outer thrust).
  • the left figure shows the change curve of the inner and outer gaps of the knee joint under the third operation mode of the surgical host computer.
  • the abscissa is the data value of the gap, and the ordinate is the joint angle.
  • the colored curve represents the outer gap, and the purple curve represents the gap difference.
  • the figure on the right shows the change curve of the thrust between the knee joints under the third operation mode of the surgical host computer.
  • the abscissa is the data value of the thrust, and the ordinate is the angle between the joints.
  • the yellow curve represents the inner thrust, and the blue curve represents the outer thrust.
  • the purple curve represents the thrust difference.
  • Fig. 9 shows a flow chart of the fourth operation mode of the surgical host computer according to an exemplary embodiment of the present application.
  • the fourth information to be input is displayed to the user through the fourth interactive interface.
  • the fourth information to be input includes the value range of the joint angle and the fixed gap data value formed between the pre-osteotomized femur and the tibia.
  • the fourth interactive interface can be referred to as shown in FIG. 6A .
  • the fourth information to be input in the fourth operation mode of the surgical host computer includes the value range of the preset joint angle, and the data values of the inner gap and the outer gap.
  • the joint angle ranges from 0° to 135°, and at any joint angle within the value range, the inner gap and the outer gap are both set to a fixed value of 12.
  • the abutment member and the push plate are controlled to form a fixed gap between the femur and the tibia, and the data value of the thrust between the femur and the tibia is collected.
  • the surgical host computer transmits instructions to the measuring device according to the data of the interactive interface, and applies thrust through the abutting member and the push plate of the measuring device, and measures and obtains it multiple times. Data values for inboard clearance and outboard clearance, and corresponding inboard thrust and outboard thrust.
  • the measured medial clearance and lateral clearance are both 12.00, and the corresponding medial thrust is 57.70N, and the lateral thrust is 57.70N.
  • the vibration of the measurement device due to interference factors in actual use will cause the actual measurement data (actually measured inner thrust, outer thrust) to be different from the theoretical value (according to the setting in the surgical host computer as There may be errors compared with the corresponding inner thrust and outer thrust obtained by the inner clearance and the outer clearance of the fixed value.
  • the figure on the left shows the change curve of the inner and outer gaps of the knee joint under the fourth operation mode of the surgical host computer.
  • the colored curve represents the outer gap
  • the purple curve represents the gap difference.
  • the figure on the right shows the change curve of the thrust between the knee joints under the fourth operation mode of the surgical host computer.
  • the abscissa is the data value of the thrust, and the ordinate is the angle between the joints.
  • the yellow curve represents the inner thrust, and the blue curve represents the outer thrust.
  • the purple curve represents the thrust difference.
  • Fig. 11 shows a block diagram of a surgical host computer according to an exemplary embodiment of the present application.
  • the electronic device 600 is only an example, and should not limit the functions and scope of use of this embodiment of the present application.
  • electronic device 600 takes the form of a general-purpose computing device.
  • Components of the electronic device 600 may include, but are not limited to: at least one processing unit 610, at least one storage unit 620, a bus 630 connecting different system components (including the storage unit 620 and the processing unit 610), a display unit 640, and the like.
  • the storage unit stores program codes, and the program codes can be executed by the processing unit 610, so that the processing unit 610 executes the methods described in this specification according to various exemplary embodiments of the present application.
  • the processing unit 610 may execute the method as shown in FIG. 2 .
  • the storage unit 620 may include a readable medium in the form of a volatile storage unit, such as a random access storage unit (RAM) 6201 and/or a cache storage unit 6202 , and may further include a read-only storage unit (ROM) 6203 .
  • RAM random access storage unit
  • ROM read-only storage unit
  • Storage unit 620 may also include a program/utility 6204 having a set (at least one) of program modules 6205, such program modules 6205 including but not limited to: an operating system, one or more application programs, other program modules, and program data, Implementations of networked environments may be included in each or some combination of these examples.
  • Bus 630 may represent one or more of several types of bus structures, including a memory cell bus or memory cell controller, a peripheral bus, an accelerated graphics port, a processing unit, or a local area using any of a variety of bus structures. bus.
  • the electronic device 600 can also communicate with one or more external devices 700 (such as keyboards, pointing devices, Bluetooth devices, etc.), and can also communicate with one or more devices that enable the user to interact with the electronic device 600, and/or communicate with Any device (eg, router, modem, etc.) that enables the electronic device 600 to communicate with one or more other computing devices. Such communication may occur through input/output (I/O) interface 650 .
  • the electronic device 600 can also communicate with one or more networks (such as a local area network (LAN), a wide area network (WAN) and/or a public network such as the Internet) through the network adapter 660 .
  • the network adapter 660 can communicate with other modules of the electronic device 600 through the bus 630 . It should be appreciated that although not shown, other hardware and/or software modules may be used in conjunction with electronic device 600, including but not limited to: microcode, device drivers, redundant processing units, external disk drive arrays, RAID systems, tape drives And data backup storage system, etc.
  • exemplary embodiments described here can be implemented by software, or by combining software with necessary hardware.
  • the technical solutions according to the embodiments of the present application can be embodied in the form of software products, which can be stored in a non-volatile storage medium (which can be CD-ROM, U disk, mobile hard disk, etc.) or on the network, including Several instructions enable a computing device (which may be a personal computer, server, mobile terminal or network device, etc.) to execute the method according to the embodiment of the present application.
  • a software product may utilize any combination of one or more readable media.
  • the readable medium may be a readable signal medium or a readable storage medium.
  • the readable storage medium may be, for example, but not limited to, an electrical, magnetic, optical, electromagnetic, infrared, or semiconductor system, device, or device, or any combination thereof. More specific examples (non-exhaustive list) of readable storage media include: electrical connection with one or more conductors, portable disk, hard disk, random access memory (RAM), read only memory (ROM), erasable programmable read-only memory (EPROM or flash memory), optical fiber, portable compact disk read-only memory (CD-ROM), optical storage devices, magnetic storage devices, or any suitable combination of the foregoing.
  • a computer readable storage medium may include a data signal carrying readable program code in baseband or as part of a carrier wave traveling as part of a data signal. Such propagated data signals may take many forms, including but not limited to electromagnetic signals, optical signals, or any suitable combination of the foregoing.
  • a readable storage medium may also be any readable medium other than a readable storage medium that can send, propagate or transport a program for use by or in conjunction with an instruction execution system, apparatus or device.
  • the program code contained on the readable storage medium may be transmitted by any suitable medium, including but not limited to wireless, cable, optical cable, RF, etc., or any suitable combination of the above.
  • Program codes for performing the operations of the present application can be written in any combination of one or more programming languages, including object-oriented programming languages—such as Java, C++, etc., as well as conventional procedural programming Language - such as "C" or similar programming language.
  • the program code may execute entirely on the user's computing device, partly on the user's device, as a stand-alone software package, partly on the user's computing device and partly on a remote computing device, or entirely on the remote computing device or server to execute.
  • the remote computing device may be connected to the user computing device through any kind of network, including a local area network (LAN) or a wide area network (WAN), or may be connected to an external computing device (for example, using an Internet service provider). business to connect via the Internet).
  • LAN local area network
  • WAN wide area network
  • Internet service provider for example, using an Internet service provider
  • the above-mentioned computer-readable medium carries one or more programs, and when the above-mentioned one or more programs are executed by one device, the computer-readable medium can realize the aforementioned functions.
  • modules in the above embodiments can be distributed in the device according to the description of the embodiment, and corresponding changes can also be made in one or more devices that are only different from the embodiment.
  • the modules in the above embodiments can be combined into one module, and can also be further split into multiple sub-modules.
  • the present application can quantify and reasonably display the angle, force and gap between knee joints, assist doctors in surgery, reduce ligament release damage in patients, quickly judge whether the soft tissue is balanced, and increase the service life of the prosthesis.

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Abstract

一种用于膝关节置换手术的手术上位机及膝关节置换手术系统，涉及手术设备领域。手术上位机包括处理器以及存储器，存储器存储有多个计算机程序，当多个计算机程序被处理器分别执行时，使得处理器分别执行手术上位机的多个操作模式，多个操作模式包括：向用户展示待输入信息，待输入信息包括关节夹角的动态变化区间，以及关节夹角与股骨和胫骨间施加的推力的关系或形成的间隙的关系；在关节夹角进行动态调整的过程中施加推力，并采集推力与间隙的对应关系数据；以及可视化地展示对应关系数据。膝关节置换手术系统可将膝关节置换手术中软组织的力和间隙通过合理的方式采集和展示出来。

Description

用于膝关节置换手术的手术上位机及膝关节置换手术系统 技术领域
本申请涉及手术设备领域，具体而言，涉及一种用于膝关节置换手术的手术上位机及膝关节置换手术系统。
背景技术
膝关节置换(TKA)是一种复杂的矫形手术，是由于膝关节有复杂的组成，包括股骨、胫骨以及包围关节的4处韧带以及肌肉、软骨等。
TKA是治疗退行性膝关节疾病的主要方式之一，其手术的目标是恢复下肢力线和关节活动范围，维持关节稳定性，减少疼痛。合适的假体对位和软组织平衡是达成手术目标的关键。
传统TKA手术通常采用髓内外定位+间隙平衡法的方式进行股骨、胫骨侧截骨，再通过人工松解韧带达到张力平衡。实际操作中，多依赖于术者的感觉和经验，存在松解不足或过度松解的风险，进而导致患者关节活动受限或者关节异常活动等并发症。
韧带松解实际是对人体组织结构的一种损坏，如果在手术中能了解软组织张力的大小，从而在截骨时根据张力进行适当调整，就能在假体安装后不松解或少松解韧带，保护软组织。
发明内容
本申请提供一种用于膝关节置换手术的手术上位机及膝关节置换手术系统，通过不同工作模式，获取股骨和胫骨间的受力与间隙的对应关系数据，并进行可视化展示，医生根据数据或者可视化信息，可快速判断软组织是否平衡，并进行术中调整。
根据本申请的一方面，提供一种手术上位机，用于在膝关节置换手术中控制膝关节软组织平衡测量装置并进行数据采集，所述测量装置包括主机和附件，所述主机包括分别作用于股骨远端内髁和外髁的抵接构 件以及支撑胫骨的推板，所述手术上位机包括：处理器；以及存储器，存储有多个计算机程序，当所述多个计算机程序被所述处理器分别执行时，使得所述处理器分别执行所述手术上位机的多个操作模式，所述多个操作模式包括：通过交互界面，向用户展示待输入信息，所述待输入信息包括关节夹角的动态变化区间，以及所述关节夹角与股骨和胫骨间施加的推力的关系或所述关节夹角与股骨和胫骨间形成的间隙的关系；响应于用户输入的信息，在所述关节夹角在所述动态变化区间内进行动态调整的过程中，控制所述抵接构件和推板在股骨和胫骨间施加推力，并采集股骨和胫骨间的推力与间隙的对应关系数据；以及可视化地展示所述对应关系数据。
根据一些实施例，所述关节夹角与股骨和胫骨间施加的推力的关系包括：根据所述动态变化区间设置的多个取值范围，设置与所述多个取值范围相对应的所述推力的数据值，或所述关节夹角与所述推力的函数关系；所述关节夹角与股骨和胫骨间形成的间隙的关系包括：根据所述动态变化区间设置的多个取值范围，设置与所述多个取值范围相对应的所述间隙的数据值，或所述关节夹角与所述间隙的函数关系。
根据一些实施例，在股骨和胫骨间施加的推力数据值以及股骨和胫骨间的间隙数据值包括：在已经过预截骨的股骨和胫骨间施加的推力数据值以及股骨和胫骨间的间隙数据值；在股骨和胫骨间置入假体后及置入垫片前施加的推力数据值以及股骨和胫骨间的间隙数据值。
根据一些实施例，在多个所述关节夹角下的所述推力的数据值和所述间隙的数据值，以及所述推力的数据值与所述关节夹角的关系或所述间隙的数据值与所述关节夹角的关系。
根据一些实施例，所述多个计算机程序包括第一计算机程序，当所述第一计算机程序被所述处理器执行时，使得所述处理器执行所述手术上位机的第一操作模式，所述第一操作模式包括：通过第一交互界面，向用户展示第一待输入信息，所述第一待输入信息包括所述关节夹角的动态变化区间以及与所述动态变化区间相对应的股骨和胫骨间施加推力的数据值；响应于用户输入的信息，在所述关节夹角在所述动态变化区间内进行动态调整的过程中，控制所述抵接构件和推板在股骨和胫骨间 施加相应的推力，并采集股骨和胫骨间间隙的数据值；以及至少可视化地展示所述间隙的数据值与所述关节夹角的关系。
根据一些实施例，根据所述关节夹角的动态变化区间设置多个取值范围时，与所述关节夹角的不同取值范围相对应的推力具有不同的数据值。
根据一些实施例，所述多个计算机程序包括第二计算机程序，当所述第二计算机程序被所述处理器执行时，使得所述处理器执行所述手术上位机的第二操作模式，所述第二操作模式包括：通过第二交互界面，向用户展示第二待输入信息，所述第二待输入信息包括所述关节夹角的动态变化区间以及与所述动态变化区间相对应的股骨和胫骨间形成预设间隙的数据值；响应于用户输入的信息，在所述关节夹角在所述动态变化区间内进行动态调整的过程中，控制所述抵接构件和推板在股骨和胫骨间形成相应的间隙，并采集股骨和胫骨间的推力的数据值；以及至少可视化地展示所述推力的数据值与所述关节夹角的关系。
根据一些实施例，根据所述关节夹角的动态变化区间设置多个取值范围时，与所述关节夹角的不同取值范围相对应的间隙具有不同的数据值。
根据一些实施例，所述多个计算机程序包括第三计算机程序，当所述第三计算机程序被所述处理器执行时，使得所述处理器执行所述手术上位机的第三操作模式，所述第三操作模式包括：通过第三交互界面，向用户展示第三待输入信息，所述第三待输入信息包括所述关节夹角的动态变化区间以及在股骨和胫骨间施加固定推力的数据值；响应于用户输入的信息，在所述关节夹角在所述动态变化区间内进行动态调整的过程中，控制所述抵接构件和推板在股骨和胫骨间施加所述固定推力，并采集股骨和胫骨间的间隙的数据值；以及至少可视化地展示所述间隙的数据值与所述关节夹角的关系。
根据一些实施例，所述多个计算机程序包括第四计算机程序，当所述第四计算机程序被所述处理器执行时，使得所述处理器执行所述手术上位机的第四操作模式，所述第四操作模式包括：通过第四交互界面，向用户展示第四待输入信息，所述第四待输入信息包括所述关节夹角的 动态变化区间以及在股骨和胫骨间形成固定间隙的数据值；响应于用户输入的信息，在所述关节夹角在所述动态变化区间内进行动态调整的过程中，控制所述抵接构件和推板在股骨和胫骨间形成固定间隙，并采集股骨和胫骨间的推力的数据值；以及至少可视化地展示所述推力的数据值与所述关节夹角的关系。
根据本申请的一方面，提供一种膝关节置换手术系统，包括如前所述的手术上位机。
根据本申请的实施例，可量化和合理展示膝关节间角度、力和间隙，辅助医生手术，减少患者韧带松解损伤。
应当理解的是，以上的一般描述和后文的细节描述仅是示例性的，并不能限制本申请。
附图说明
为了更清楚地说明本申请实施例中的技术方案，下面将对实施例描述中所需要使用的附图作简单地介绍，显而易见地，下面描述中的附图仅仅是本申请的一些实施例。
图1A示出膝关节软组织平衡测量装置的安装示意图。
图1B示出膝关节软组织平衡测量装置的主机立体示意图。
图2示出根据本申请示例实施例的手术上位机的操作流程图。
图3示出根据本申请示例实施例的手术上位机第一操作模式的流程图。
图4A示出根据本申请示例实施例的手术上位机第一操作模式的交互界面展示图。
图4B示出根据本申请示例实施例的手术上位机第一操作模式的可视化信息展示图。
图5示出根据本申请示例实施例的手术上位机第二操作模式的流程图。
图6A示出根据本申请示例实施例的手术上位机第二操作模式的交互界面展示图。
图6B示出根据本申请示例实施例的手术上位机第二操作模式的可 视化信息展示图。
图7示出根据本申请示例实施例的手术上位机第三操作模式的流程图。
图8示出根据本申请示例实施例的手术上位机第三操作模式的可视化信息展示图。
图9示出根据本申请示例实施例的手术上位机第四操作模式的流程图。
图10示出根据本申请示例实施例的手术上位机第四操作模式的可视化信息展示图。
图11示出根据本申请示例实施例的手术上位机的框图。
具体实施方式
现在将参考附图更全面地描述示例实施例。然而，示例实施例能够以多种形式实施，且不应被理解为限于在此阐述的实施例；相反，提供这些实施例使得本申请将全面和完整，并将示例实施例的构思全面地传达给本领域的技术人员。在图中相同的附图标记表示相同或类似的部分，因而将省略对它们的重复描述。
所描述的特征、结构或特性可以以任何合适的方式结合在一个或更多实施例中。在下面的描述中，提供许多具体细节从而给出对本公开的实施例的充分理解。然而，本领域技术人员将意识到，可以实践本公开的技术方案而没有这些特定细节中的一个或更多，或者可以采用其它的方式、组元、材料、装置或操作等。在这些情况下，将不详细示出或描述公知结构、方法、装置、实现、材料或者操作。
附图中所示的流程图仅是示例性说明，不是必须包括所有的内容和操作/步骤，也不是必须按所描述的顺序执行。例如，有的操作/步骤还可以分解，而有的操作/步骤可以合并或部分合并，因此实际执行的顺序有可能根据实际情况改变。
本申请的说明书和权利要求书及上述附图中的术语“第一”、“第一”等是用于区别不同对象，而不是用于描述特定顺序。此外，术语“包括”和“具有”以及它们任何变形，意图在于覆盖不排他的包含。例如 包含了一系列步骤或单元的过程、方法、系统、产品或设备没有限定于已列出的步骤或单元，而是可选地还包括没有列出的步骤或单元，或可选地还包括对于这些过程、方法、产品或设备固有的其他步骤或单元。
本申请提供一种手术上位机，基于膝关节的软组织平衡测量装置和相应的关节夹角测量装置，用于在膝关节置换手术中将软组织的力和间隙通过合理的方式采集和展示出来，从而帮助医生进行规划的调节，减少调整截骨的次数或者韧带的损伤，同时缩减手术时间。
下面将参照附图，对根据本申请实施例的一种用于膝关节置换手术的手术上位机及膝关节置换手术系统进行详细说明。
图1A示出膝关节软组织平衡测量装置的安装示意图。
如图1A所示，在患者完成胫骨和/或股骨的预截骨后，将测量装置的主机置于患者胫骨与股骨之间，测量装置的附件置于患者大腿上表面。
根据一些实施例，也可以在患者胫骨与股骨之间置入假体后、垫片置入前使用膝关节软组织平衡测量装置进行膝关节间隙和软组织弹力的测量。
根据一些实施例，主机和附件可包括陀螺仪，可用于测定患者的关节夹角。
图1B示出膝关节软组织平衡测量装置的主机立体示意图。
如图1B所示，测量装置的主机包括测量模块100和驱动模块200。
测量模块100包括安装座110、用于与胫骨抵接的推板120和用于与股骨抵接的抵接构件130。
参照如图1B的视角，推板与安装座固定连接，抵接构件以能够沿纵向相对于安装座移动的方式连接于安装座，抵接构件的上抵接板部分和推板的下抵接板部分大致平行地垂直于纵向延伸，并且上抵接板部分在纵向上布置在下抵接板部分的上方。
驱动模块200包括密封壳体210、动力单元和执行机构230。
动力单元位于密封壳体中，执行机构位于密封壳体外侧，动力单元密封地穿过密封壳体并与执行机构传动连接，执行机构构造为可移除地配合于测量模块，用于推动抵接构件相对于推板沿纵向移动。
根据一些实施例，抵接构件分别作用于股骨远端内髁和外髁，产生 内侧推力和外侧推力，继而形成股骨与胫骨之间的内侧间隙和外侧间隙。
推板用于支撑胫骨，保持软组织平衡。
图2示出根据本申请示例实施例的手术上位机的操作流程图。
如图2所示，在S101，通过交互界面，向用户展示关节夹角的多个取值范围、在股骨和胫骨间施加的推力数据值或股骨和胫骨间的间隙数据值。
根据一些实施例，在股骨和胫骨间施加的推力数据值以及股骨和胫骨间的间隙数据值包括在已经过预截骨的股骨和胫骨间或者在股骨和胫骨间置入假体后及置入垫片前施加的推力数据值以及股骨和胫骨间的间隙数据值。
根据一些实施例，预截骨包括对胫骨和/或股骨进行截骨，便于在膝关节假体置入过程中进行调整和纠正。
在股骨和胫骨间置入假体后及置入垫片前，可根据股骨和胫骨间施加的推力数据值以及间隙数据值对假体进行调整和纠正。
在S103，响应于用户输入的信息，根据推力数据值或间隙数据值，控制抵接构件和推板在股骨和胫骨间施加推力，并采集股骨与胫骨间的推力与间隙的对应关系数据。
根据一些实施例，对应关系数据包括推力的数据值与关节夹角的关系和/或间隙数据值与关节夹角的关系。
进一步地，推力的数据值还包括根据关节夹角的取值范围施加的固定推力的数据值。
间隙数据值还包括根据关节夹角的取值范围施加推力形成的固定的间隙的数据值。
在S105，可视化地展示对应关系数据。
根据一些实施例，根据交互界面展示的可视化的数据，调整手术规划。
进一步地，手术规划的调整包括置入膝关节假体及垫片，并调整假体的厚度
图3示出根据本申请示例实施例的手术上位机第一操作模式的流程图。
在S201，通过第一交互界面，向用户展示第一待输入信息，第一待输入信息包括关节夹角的多个取值范围以及分别与多个取值范围相对应的、在已经过预截骨的股骨和胫骨间施加推力的数据值。
交互界面如图4A所示，在手术上位机第一操作模式下，第一待输入信息包括预设的关节夹角的取值范围，以及内侧推力、外侧推力的数据值。
例如，可设置关节夹角的取值范围为0°至135°。
根据一些实施例，在患者股骨胫骨处于伸直位时，关节夹角校准为0°，后屈曲至最大关节夹角。
推力的数据值按关节夹角的取值范围设置为：
关节夹角在0°至40°时，内侧推力及外侧推力均设置为25N；
关节夹角在41°至80°时，内侧推力及外侧推力均设置为50N；
关节夹角在81°至135°时，内侧推力及外侧推力均设置为80N。
关节夹角与推力的设置也可按预设的函数关系获取，例如，关节夹角与推力呈正弦函数关系。
在S203，响应于用户输入的信息，分别在关节夹角的多个取值范围内，控制抵接构件和推板在股骨和胫骨间施加相应的推力，并采集股骨和胫骨间的间隙数据值。
根据关节夹角的取值范围多次调整患者的股骨与胫骨，手术上位机按第一交互界面的数据传输指令至测量装置，通过测量装置的抵接构件和推板施加推力，并多次测量并获取内侧推力和外侧推力的数据值，以及对应的内侧间隙和外侧间隙的数据值。
例如，在关节夹角为120°时，测得内侧推力和外侧推力均为80N，对应的内侧间隙为23.22，外侧间隙为17.47。
在S205，可视化地展示推力的数据值与关节夹角的关系和间隙数据值与关节夹角的关系。
如图4B所示，左侧图示出手术上位机第一操作模式下膝关节内外侧间隙的变化曲线，横坐标为间隙数据值，纵坐标为关节夹角，其中黄色曲线代表内侧间隙，蓝色曲线代表外侧间隙，紫色曲线代表间隙差值。
右侧图示出手术上位机第一操作模式下膝关节间推力的变化曲线， 横坐标为推力的数据值，纵坐标为关节夹角，其中黄色曲线代表内侧推力，蓝色曲线代表外侧推力，紫色曲线代表推力差值。
图5示出根据本申请示例实施例的手术上位机第二操作模式的流程图。
在S301，通过第二交互界面，向用户展示第二待输入信息，第二待输入信息包括关节夹角的多个取值范围以及分别与多个取值范围相对应的、在已经过预截骨的股骨和胫骨间形成预设间隙的数据值。
第二交互界面如图6A所示，手术上位机第二操作模式下，第二待输入信息包括预设的关节夹角的取值范围，以及内侧间隙、外侧间隙的数据值。
例如，可设置关节夹角的取值范围为0°至135°。
根据一些实施例，在患者股骨胫骨处于伸直位时，关节夹角校准为0°，后屈曲至最大关节夹角。
间隙数据值按关节夹角的取值范围设置为：
关节夹角在0°至40°时，内侧间隙及外侧间隙均设置为6；
关节夹角在41°至80°时，内侧间隙及外侧间隙均设置为10；
关节夹角在81°至135°时，内侧间隙及外侧间隙均设置为16。
关节夹角与间隙的设置也可按预设的函数关系获取，例如，关节夹角与间隙呈正弦函数关系。
在S303，响应于用户输入的信息，分别在关节夹角的多个取值范围内，控制抵接构件和推板在股骨和胫骨间形成相应的间隙，并采集股骨和胫骨间的推力的数据值。
根据关节夹角的取值范围多次调整患者的股骨与胫骨，手术上位机按交互界面的数据传输指令至测量装置，通过测量装置的抵接构件和推板施加推力，并多次测量并获取内侧间隙和外侧间隙的数据值，以及对应的内侧推力和外侧推力的数据值。
例如，在关节夹角为120°时，测得内侧间隙和外侧间隙均为16，对应的内侧推力为73.00N，外侧推力为93.50N。
在S305，可视化地展示推力的数据值与关节夹角的关系和间隙数据值与关节夹角的关系。
如图6B所示，左侧图示出手术上位机第二操作模式下膝关节内外侧间隙的变化曲线，横坐标为间隙数据值，纵坐标为关节夹角，其中黄色曲线代表内侧间隙，蓝色曲线代表外侧间隙，紫色曲线代表间隙差值。
右侧图示出手术上位机第二操作模式下膝关节间推力的变化曲线，横坐标为推力的数据值，纵坐标为关节夹角，其中黄色曲线代表内侧推力，蓝色曲线代表外侧推力，紫色曲线代表推力差值。
图7示出根据本申请示例实施例的手术上位机第三操作模式的流程图。
在S401，通过第三交互界面，向用户展示第三待输入信息，第三待输入信息包括关节夹角的取值范围以及在已经过预截骨的股骨和胫骨间施加固定推力的数据值。
第三交互界面可参照图4A所示，手术上位机第三操作模式下第三待输入信息包括预设的关节夹角的取值范围，以及内侧推力、外侧推力的数据值。
例如，关节夹角的取值范围为0°至135°，且在取值范围内的任意关节夹角下，内侧推力及外侧推力均设置为固定值18N。
在S403，响应于用户输入的信息，在关节夹角的取值范围内，控制抵接构件和推板在股骨和胫骨间施加固定推力，并采集股骨和胫骨间的间隙数据值。
根据关节夹角的取值范围多次调整患者的股骨与胫骨，手术上位机按交互界面的数据传输指令至测量装置，通过测量装置的抵接构件和推板施加推力，并多次测量并获取内侧推力和外侧推力的数据值，以及对应的内侧间隙和外侧间隙的数据值。
例如，在关节夹角为96°时，测得内侧推力为18.60N，外侧推力为18.90N，对应的内侧间隙为13.50，外侧间隙为12.10。
一般地，测量装置在实际使用中因干扰因素(如接触面摩擦等)带来的振动，导致实际测量数据(实际测得的内侧推力、外侧推力)与理论值(在手术上位机中设置为固定值的内侧推力、外侧推力)相比可能出现误差。
在S405，可视化地展示固定推力的数据值与关节夹角的关系和间隙 数据值与关节夹角的关系。
如图8所示，左侧图示出手术上位机第三操作模式下膝关节内外侧间隙的变化曲线，横坐标为间隙数据值，纵坐标为关节夹角，其中黄色曲线代表内侧间隙，蓝色曲线代表外侧间隙，紫色曲线代表间隙差值。
右侧图示出手术上位机第三操作模式下膝关节间推力的变化曲线，横坐标为推力的数据值，纵坐标为关节夹角，其中黄色曲线代表内侧推力，蓝色曲线代表外侧推力，紫色曲线代表推力差值。
图9示出根据本申请示例实施例的手术上位机第四操作模式的流程图。
在S501，通过第四交互界面，向用户展示第四待输入信息，第四待输入信息包括关节夹角的取值范围以及在已经过预截骨的股骨和胫骨间形成固定的间隙数据值。
第四交互界面可参照图6A所示，手术上位机第四操作模式下第四待输入信息包括预设的关节夹角的取值范围，以及内侧间隙、外侧间隙的数据值。
例如，关节夹角的取值范围为0°至135°，且在取值范围内的任意关节夹角下，内侧间隙及外侧间隙均设置为固定值12。
在S503，响应于用户输入的信息，在关节夹角的取值范围内，控制抵接构件和推板在股骨和胫骨间形成固定间隙，并采集股骨和胫骨间的推力的数据值。
根据关节夹角的取值范围多次调整患者的股骨与胫骨，手术上位机按交互界面的数据传输指令至测量装置，通过测量装置的抵接构件和推板施加推力，并多次测量并获取内侧间隙和外侧间隙的数据值，以及对应的内侧推力和外侧推力的数据值。
例如，在关节夹角为120°时，测得内侧间隙和外侧间隙均为12.00，对应的内侧推力为57.70N，外侧推力为57.70N。
一般地，测量装置在实际使用中因干扰因素(如接触面摩擦等)带来的振动，导致实际测量数据(实际测得的内侧推力、外侧推力)与理论值(根据手术上位机中设置为固定值的内侧间隙、外侧间隙获取的对应的内侧推力、外侧推力)相比可能出现误差。
在S505，可视化地展示推力的数据值与关节夹角的关系和固定的间隙数据值与关节夹角的关系。
如图10所示，左侧图示出手术上位机第四操作模式下膝关节内外侧间隙的变化曲线，横坐标为间隙数据值，纵坐标为关节夹角，其中黄色曲线代表内侧间隙，蓝色曲线代表外侧间隙，紫色曲线代表间隙差值。
右侧图示出手术上位机第四操作模式下膝关节间推力的变化曲线，横坐标为推力的数据值，纵坐标为关节夹角，其中黄色曲线代表内侧推力，蓝色曲线代表外侧推力，紫色曲线代表推力差值。
图11示出根据本申请示例实施例的手术上位机的框图。
如图11所示，电子设备600仅仅是一个示例，不应对本申请实施例的功能和使用范围带来任何限制。
如图11所示，电子设备600以通用计算设备的形式表现。电子设备600的组件可以包括但不限于：至少一个处理单元610、至少一个存储单元620、连接不同系统组件(包括存储单元620和处理单元610)的总线630、显示单元640等。其中，存储单元存储有程序代码，程序代码可以被处理单元610执行，使得处理单元610执行本说明书描述的根据本申请各种示例性实施方式的方法。例如，处理单元610可以执行如图2中所示的方法。
存储单元620可以包括易失性存储单元形式的可读介质，例如随机存取存储单元(RAM)6201和/或高速缓存存储单元6202，还可以进一步包括只读存储单元(ROM)6203。
存储单元620还可以包括具有一组(至少一个)程序模块6205的程序/实用工具6204，这样的程序模块6205包括但不限于：操作系统、一个或者多个应用程序、其它程序模块以及程序数据，这些示例中的每一个或某种组合中可能包括网络环境的实现。
总线630可以为表示几类总线结构中的一种或多种，包括存储单元总线或者存储单元控制器、外围总线、图形加速端口、处理单元或者使用多种总线结构中的任意总线结构的局域总线。
电子设备600也可以与一个或多个外部设备700(例如键盘、指向设备、蓝牙设备等)通信，还可与一个或者多个使得用户能与该电子设 备600交互的设备通信，和/或与使得该电子设备600能与一个或多个其它计算设备进行通信的任何设备(例如路由器、调制解调器等等)通信。这种通信可以通过输入/输出(I/O)接口650进行。并且，电子设备600还可以通过网络适配器660与一个或者多个网络(例如局域网(LAN)，广域网(WAN)和/或公共网络，例如因特网)通信。网络适配器660可以通过总线630与电子设备600的其它模块通信。应当明白，尽管图中未示出，可以结合电子设备600使用其它硬件和/或软件模块，包括但不限于：微代码、设备驱动器、冗余处理单元、外部磁盘驱动阵列、RAID系统、磁带驱动器以及数据备份存储系统等。
通过以上的实施方式的描述，本领域的技术人员易于理解，这里描述的示例实施例可以通过软件实现，也可以通过软件结合必要的硬件的方式来实现。根据本申请实施例的技术方案可以以软件产品的形式体现出来，该软件产品可以存储在一个非易失性存储介质(可以是CD-ROM，U盘，移动硬盘等)中或网络上，包括若干指令以使得一台计算设备(可以是个人计算机、服务器、移动终端或者网络设备等)执行根据本申请实施例的方法。
软件产品可以采用一个或多个可读介质的任意组合。可读介质可以是可读信号介质或者可读存储介质。可读存储介质例如可以为但不限于电、磁、光、电磁、红外线、或半导体的系统、装置或器件，或者任意以上的组合。可读存储介质的更具体的例子(非穷举的列表)包括：具有一个或多个导线的电连接、便携式盘、硬盘、随机存取存储器(RAM)、只读存储器(ROM)、可擦式可编程只读存储器(EPROM或闪存)、光纤、便携式紧凑盘只读存储器(CD-ROM)、光存储器件、磁存储器件、或者上述的任意合适的组合。
计算机可读存储介质可以包括在基带中或者作为载波一部分传播的数据信号，其中承载了可读程序代码。这种传播的数据信号可以采用多种形式，包括但不限于电磁信号、光信号或上述的任意合适的组合。可读存储介质还可以是可读存储介质以外的任何可读介质，该可读介质可以发送、传播或者传输用于由指令执行系统、装置或者器件使用或者与其结合使用的程序。可读存储介质上包含的程序代码可以用任何适当 的介质传输，包括但不限于无线、有线、光缆、RF等等，或者上述的任意合适的组合。
可以以一种或多种程序设计语言的任意组合来编写用于执行本申请操作的程序代码，程序设计语言包括面向对象的程序设计语言—诸如Java、C++等，还包括常规的过程式程序设计语言—诸如“C”语言或类似的程序设计语言。程序代码可以完全地在用户计算设备上执行、部分地在用户设备上执行、作为一个独立的软件包执行、部分在用户计算设备上部分在远程计算设备上执行、或者完全在远程计算设备或服务器上执行。在涉及远程计算设备的情形中，远程计算设备可以通过任意种类的网络，包括局域网(LAN)或广域网(WAN)，连接到用户计算设备，或者，可以连接到外部计算设备(例如利用因特网服务提供商来通过因特网连接)。
上述计算机可读介质承载有一个或者多个程序，当上述一个或者多个程序被一个该设备执行时，使得该计算机可读介质实现前述功能。
本领域技术人员可以理解上述各模块可以按照实施例的描述分布于装置中，也可以进行相应变化唯一不同于本实施例的一个或多个装置中。上述实施例的模块可以合并为一个模块，也可以进一步拆分成多个子模块。
根据本申请的一些实施例，本申请可量化和合理展示膝关节间角度、力和间隙，辅助医生手术，减少患者韧带松解损伤，快速判断软组织是否平衡并可增加假体使用寿命。
以上对本申请实施例进行了详细介绍，以上实施例的说明仅用于帮助理解本申请的方法及其核心思想。同时，本领域技术人员依据本申请的思想，基于本申请的具体实施方式及应用范围上做出的改变或变形之处，都属于本申请保护的范围。综上所述，本说明书内容不应理解为对本申请的限制。

Claims (10)

  1. 一种手术上位机，用于在膝关节置换手术中控制膝关节软组织平衡测量装置并进行数据采集，所述测量装置包括主机和附件，所述主机包括分别作用于股骨远端内髁和外髁的抵接构件以及支撑胫骨的推板，其特征在于，所述手术上位机包括：
    处理器；以及
    存储器，存储有多个计算机程序，当所述多个计算机程序被所述处理器分别执行时，使得所述处理器分别执行所述手术上位机的多个操作模式，所述多个操作模式包括：
    通过交互界面，向用户展示待输入信息，所述待输入信息包括关节夹角的动态变化区间，以及所述关节夹角与股骨和胫骨间施加的推力的关系或所述关节夹角与股骨和胫骨间形成的间隙的关系；
    响应于用户输入的信息，在所述关节夹角在所述动态变化区间内进行动态调整的过程中，控制所述抵接构件和推板在股骨和胫骨间施加推力，并采集股骨和胫骨间的推力与间隙的对应关系数据；以及
    可视化地展示所述对应关系数据。
  2. 根据权利要求1所述的手术上位机，其特征在于，
    所述关节夹角与股骨和胫骨间施加的推力的关系包括：
    根据所述动态变化区间设置的多个取值范围，设置与所述多个取值范围相对应的所述推力的数据值，或所述关节夹角与所述推力的函数关系；
    所述关节夹角与股骨和胫骨间形成的间隙的关系包括：
    根据所述动态变化区间设置的多个取值范围，设置与所述多个取值范围相对应的所述间隙的数据值，或所述关节夹角与所述间隙的函数关系。
  3. 根据权利要求1所述的手术上位机，其特征在于，在股骨和胫骨间施加的推力数据值以及股骨和胫骨间的间隙数据值包括：
    在已经过预截骨的股骨和胫骨间施加的推力数据值以及股骨和胫骨间的间隙数据值；
    在股骨和胫骨间置入假体后及置入垫片前施加的推力数据值以及股骨和胫骨间的间隙数据值。
  4. 根据权利要求1-3中任一项所述的手术上位机，其特征在于，所述多个计算机程序包括第一计算机程序，当所述第一计算机程序被所述处理器执行时，使得所述处理器执行所述手术上位机的第一操作模式，所述第一操作模式包括：
    通过第一交互界面，向用户展示第一待输入信息，所述第一待输入信息包括所述关节夹角的动态变化区间以及与所述动态变化区间相对应的股骨和胫骨间施加推力的数据值；
    响应于用户输入的信息，在所述关节夹角在所述动态变化区间内进行动态调整的过程中，控制所述抵接构件和推板在股骨和胫骨间施加相应的推力，并采集股骨和胫骨间间隙的数据值；以及
    至少可视化地展示所述间隙的数据值与所述关节夹角的关系。
  5. 根据权利要求4所述的手术上位机，其特征在于，根据所述关节夹角的动态变化区间设置多个取值范围时，与所述关节夹角的不同取值范围相对应的推力具有不同的数据值。
  6. 根据权利要求1-3中任一项所述的手术上位机，其特征在于，所述多个计算机程序包括第二计算机程序，当所述第二计算机程序被所述处理器执行时，使得所述处理器执行所述手术上位机的第二操作模式，所述第二操作模式包括：
    通过第二交互界面，向用户展示第二待输入信息，所述第二待输入信息包括所述关节夹角的动态变化区间以及与所述动态变化区间相对应的股骨和胫骨间形成预设间隙的数据值；
    响应于用户输入的信息，在所述关节夹角在所述动态变化区间内进行动态调整的过程中，控制所述抵接构件和推板在股骨和胫骨间形成相 应的间隙，并采集股骨和胫骨间的推力的数据值；以及
    至少可视化地展示所述推力的数据值与所述关节夹角的关系。
  7. 根据权利要求6所述的手术上位机，其特征在于，根据所述关节夹角的动态变化区间设置多个取值范围时，与所述关节夹角的不同取值范围相对应的间隙具有不同的数据值。
  8. 根据权利要求1-3中任一项所述的手术上位机，其特征在于，所述多个计算机程序包括第三计算机程序，当所述第三计算机程序被所述处理器执行时，使得所述处理器执行所述手术上位机的第三操作模式，所述第三操作模式包括：
    通过第三交互界面，向用户展示第三待输入信息，所述第三待输入信息包括所述关节夹角的动态变化区间以及在股骨和胫骨间施加固定推力的数据值；
    响应于用户输入的信息，在所述关节夹角在所述动态变化区间内进行动态调整的过程中，控制所述抵接构件和推板在股骨和胫骨间施加所述固定推力，并采集股骨和胫骨间的间隙的数据值；以及
    至少可视化地展示所述间隙的数据值与所述关节夹角的关系。
  9. 根据权利要求1-3中任一项所述的手术上位机，其特征在于，所述多个计算机程序包括第四计算机程序，当所述第四计算机程序被所述处理器执行时，使得所述处理器执行所述手术上位机的第四操作模式，所述第四操作模式包括：
    通过第四交互界面，向用户展示第四待输入信息，所述第四待输入信息包括所述关节夹角的动态变化区间以及在股骨和胫骨间形成固定间隙的数据值；
    响应于用户输入的信息，在所述关节夹角在所述动态变化区间内进行动态调整的过程中，控制所述抵接构件和推板在股骨和胫骨间形成固定间隙，并采集股骨和胫骨间的推力的数据值；以及
    至少可视化地展示所述推力的数据值与所述关节夹角的关系。
  10. 一种膝关节置换手术系统，包括如权利要求1-9中任一项所述的手术上位机。
PCT/CN2022/104788 2021-12-14 2022-07-11 用于膝关节置换手术的手术上位机及膝关节置换手术系统 WO2023109105A1 (zh)

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