CN101288597A - Knee-joint prosthesis implantation process, osteotomy module thereof and device thereof - Google Patents
Knee-joint prosthesis implantation process, osteotomy module thereof and device thereof Download PDFInfo
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- CN101288597A CN101288597A CNA200810126718XA CN200810126718A CN101288597A CN 101288597 A CN101288597 A CN 101288597A CN A200810126718X A CNA200810126718X A CN A200810126718XA CN 200810126718 A CN200810126718 A CN 200810126718A CN 101288597 A CN101288597 A CN 101288597A
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Abstract
The invention discloses a kneed prosthesis implantation method, an osteotomy module used and a using device, the kneed prosthesis implantation method comprises the following steps of measuring the data of knee joint bone tissues, extracting the data of articular cartilage and the skeleton profile, establishing a three-dimensional model in an image processor, designing the osteotomy module, determining the size and the type of the used kneed prosthesis and determining an osteotomy module model and the implantation of the kneed prosthesis. The kneed prosthesis implantation method of the invention can reduce the trauma of a patient, lower the cost, shorten the implantation time, reduce the risk of complications of a user of the kneed prosthesis and have less error and higher precision.
Description
Technical field
The present invention relates to a kind of knee-joint prosthesis method for implantation, also relate to the employed osteotomy module of aforesaid knee-joint prosthesis method for implantation simultaneously, also relate to the device that uses in the aforementioned knee-joint prosthesis method for implantation in addition.
Background technology
At present, after the wearing and tearing of people's knee joint or breaking down, increasing people selects to install artificial knee joint and uses to replace original knee joint.It is most important for patient's postoperative function and prognosis how can to implant knee-joint prosthesis more accurately among the artificial knee replacement surgery.At present knee-joint prosthesis is implanted the following two kinds of methods that mainly depend on: a kind of method is to adopt art the marrow being invaded by pathogen internal medullary mass outside fix apparatus: generally locate in the femur side adopts marrow when adopting this method, locating rod in the marrow is inserted be used for locating the femur anatomical axis line in the femoral bone cavitas medullaris.Generally adopt in the marrow or the marrow outside fix is used for locating tibia and dissects axis (for example: Depuy, artificial knee joint system of Link company) in tibial side.Can provide certain reference for the doctor lays the prosthese position by such operating system, but carry out the wound that the interior location of marrow can increase patient in the operation, strengthen the risk of fat embolism, repeatable simultaneously relatively poor, there is bigger measurement error.Development along with airmanship, another kind of method has appearred, adopt navigator fix in the art exactly, adopting operation guiding system is present emerging operation method, it is to provide artificial prosthesis assembly location accurately with computer in total knee replacement, the principle of navigation is near the GPS GPS that applies on the automobile, infrared photography system in the operation guiding system is equivalent to deep space satellite and receives the signal that localizer sends on tibia and the femur, special instrument is equivalent to automobile, the tibia femur is equivalent to road conditions, change into image and data show on the fluorescent screen when the laggard row operation of computer system received signal and information, each anatomical position size of doctor's knee joint and the analysis of mechanics axis are provided.Though can increase the accuracy of prosthese riding position in theory, but this method is not considered patient's individuation difference, and present knee joint Accreditation System, localization method are still improving, so still there is certain error, and many bibliographical informations adopt operation guiding systems to carry out the medical burden that artificial knee joint replacement has increased the patient, have prolonged operating time simultaneously and have increased the risk that complication takes place the patient.These two kinds of methods that generally adopt at present all do not have well to consider patient's individuation difference and existence error in various degree in a word, can not reduce operation risk effectively.
Summary of the invention
The present invention finishes in order to solve deficiency of the prior art, the purpose of this invention is to provide a kind of patient trauma, lower, time-consuming less knee-joint prosthesis method for implantation of risk, error ratio of relatively lacking, reducing knee-joint prosthesis user generation complication of implantation of expense of reducing.
Knee-joint prosthesis method for implantation of the present invention may further comprise the steps:
A. knee joint osseous tissue DATA REASONING: the knee joint lower limb that need implantation joint prosthese user are carried out CT, MRI scanning, obtain the view data of limbs cross-section image and osseous tissue, wherein the view data of osseous tissue comprises that at least femur and tibia dissects in the thickness data of face before axis and mechanics axis data, articular surface morphological data, the femur, the femur ectocondyle line and the angle of postartis line, the width of the interior ectocondyle of femur, the distance of femur and tibia anteroposterior diameter, the range data of tibia transverse diameter in ectocondyle line data, the femur;
B. extract articular cartilage and bone contours data: with the view data in a step and limbs cross-section image input picture processing system successively, according to soft tissue and sclerotin at CT, the difference of gray scale is carried out image segmentation in the image that obtains among the MRI, extract outline data, obtain articular cartilage and skeleton data, described cartilage and skeleton data comprise the articular surface morphological data, femur and tibia is dissected axis and mechanics axis data, the thickness data of face before the femur, the angle of ectocondyle line and postartis line in the femur, ectocondyle width in the femur, the distance of femur and tibia anteroposterior diameter, the range data of femur transverse diameter;
C. in image processor, set up three-dimensional stereo model: with the data input picture processor that obtains in a step and the b step and utilize the drawing system that described data conversion is image, make the three-dimensional stereo model figure that meets knee-joint prosthesis user body joint surface of bone;
D. design the osteotomy module: according to the joint surface of bone shape of in image processor, making in the c step, manufacture and design femur osteotomy module and tibia osteotomy module, make femur osteotomy module and tibia osteotomy module and kneed articular surface gap less than 1.5mm, the thickness of femur osteotomy module and tibia osteotomy module is greater than 1cm simultaneously;
E. determine to use the big ting model of knee-joint prosthesis: determine to use the prosthese model according to femur, tibia data that a step measures;
F. determine the osteotomy modular model: the femur osteotomy module and the tibia osteotomy module of steps d manufacturing are offered the osteotomy groove according to prosthese shape and size that the e step is selected to determine;
G. the implantation of knee-joint prosthesis: femur osteotomy module that has the osteotomy groove and tibia osteotomy module that step f is made are sheathed on knee-joint prosthesis user knee joint femur and the tibial prosthesis face, carry out user knee joint endoprosthesis face osteotomy according to osteotomy groove position, again the knee-joint prosthesis of determining among the step e is installed on the user knee joint position.
Knee-joint prosthesis method for implantation of the present invention further can also be:
Offer amputation distal slot, front slot, back square groove, five grooves of two oblique section slot among the described step f on the femur osteotomy module, offer the proximal tibia groove on the described tibia osteotomy module.
Described femoral prosthesis femoral prosthesis and femur anatomical axis line are 6 degree that turn up, and are outward turning 3 degree with the femoral-posterior condyles line, and tibial prosthesis and tibia are dissected axis normal.
Knee-joint prosthesis method for implantation of the present invention, the advantage that has in terms of existing technologies is: because its kneed data of measuring according to knee-joint prosthesis implantation person, in picture system, reproduce the kneed articular surface of knee-joint prosthesis implantation person again, according to femur osteotomy module and tibia osteotomy module and kneed articular surface gap standard design femur osteotomy module and tibia osteotomy module less than 1.5mm, simultaneously according to knee-joint prosthesis implantation person knee joint endoprosthesis face selected shape that reappears and the big suitable finished product prosthese of ting model, then according to the finished product prosthese of choosing and the knee-joint prosthesis implantation person knee joint endoprosthesis face correspondence of reproduction, on femur osteotomy module of making and tibia osteotomy module, offer the osteotomy groove, the purpose that the osteotomy groove is offered is to guarantee in the implanting prosthetic process, can conveniently carry out osteotomy to the knee joint of prosthese user, in implantation process, directly femur osteotomy module and tibia osteotomy module are fitted on the knee joint endoprosthesis face, after according to the osteotomy groove knee joint being carried out accurate osteotomy, take off femur osteotomy module and tibia module, the knee-joint prosthesis of choosing is implanted the knee joint place of osteotomy.Such method, owing to carry out the making of osteotomy module and osteotomy groove in advance, when implanting, no longer need to measure in the art, avoiding in the marrow location must insert in the marrow of growing locating rod or navigator fix in femur, tibia must play screw and be used for fixing the wound that tracker causes on femur, tibia, the drawback that also can avoid navigating loaded down with trivial details registration process and prolong operating time, can be suitable for simultaneously different artificial knee joint prosthesis and implant, can remedy navigation like this and be used for the existence of lower limb malformation severe patient than the out of use shortcoming of mistake.
The present invention also provides the knee-joint prosthesis method for implantation employed osteotomy module, comprise femur osteotomy module and tibia osteotomy module, offer the osteotomy groove on described femur osteotomy module and the described tibia osteotomy module, described femur osteotomy module and described tibia osteotomy module obtain by following steps: a. knee joint osseous tissue DATA REASONING: the knee joint lower limb that need implantation joint prosthese user are carried out CT, MRI scanning, obtain the view data of limbs cross-section image and osseous tissue, wherein the view data of osseous tissue comprises femur and tibia dissection axis and mechanics axis data at least, the articular surface morphological data, the thickness data of face before the femur, ectocondyle line data in the femur, the angle of ectocondyle line and postartis line in the femur, the width of ectocondyle in the femur, the distance of femur and tibia anteroposterior diameter, the range data of tibia transverse diameter;
B. extract articular cartilage and bone contours data: with the view data in a step and limbs cross-section image input picture processing system successively, according to soft tissue and sclerotin at CT, the difference of gray scale is carried out image segmentation in the image that obtains among the MRI, extract outline data, obtain articular cartilage and skeleton data, described cartilage and skeleton data comprise the articular surface morphological data, femur and tibia is dissected axis and mechanics axis data, the thickness data of face before the femur, the angle of ectocondyle line and postartis line in the femur, ectocondyle width in the femur, the distance of femur and tibia anteroposterior diameter, the range data of femur transverse diameter;
C. in image processor, set up three-dimensional stereo model: with the data input picture processor that obtains in a step and the b step and utilize the drawing system that described data conversion is image, make the three-dimensional stereo model figure that meets knee-joint prosthesis user body joint surface of bone;
D. design the osteotomy module: according to the joint surface of bone shape of in image processor, making in the c step, manufacture and design femur osteotomy module and tibia osteotomy module, make femur osteotomy module and tibia osteotomy module and kneed articular surface gap less than 1.5mm, the thickness of femur osteotomy module and tibia osteotomy module is greater than 1cm simultaneously;
E. determine to use the big ting model of knee-joint prosthesis: determine to use the prosthese model according to femur, tibia data that a step measures;
F. determine the osteotomy modular model: select the shape of definite prosthese and size that the femur osteotomy module and the tibia osteotomy module of steps d manufacturing are offered the osteotomy groove according to the e step.
The employed osteotomy module of knee-joint prosthesis method for implantation of the present invention, now for prior art, it helps in the knee-joint prosthesis implantation process, obviously shortens the implant surgery time, locatees accurately high, as to reduce wound, adaptation Different Individual difference knee joint implantation.
The present invention also provide a kind of in above-mentioned knee-joint prosthesis method for implantation employed device, it comprises data recording equipment, image processor, osteotomy modular design system and the osteotomy groove navigation system that is connected with CT, MRI scanning means, described data recording equipment passes to data and carries out the described image processor that knee joint is closed three-dimensional stereo model figure, image processor is connected with the osteotomy modular design system of design osteotomy module three-dimensional stereo model, and described osteotomy modular design system and definite osteotomy groove position are connected with big or small osteotomy groove navigation system.
The employed device of knee-joint prosthesis method for implantation of the present invention can be finished the entire making process of osteotomy module, produces degree of accuracy height, osteotomy module that individual adaptability is strong.
Description of drawings
Fig. 1 is the flow chart of knee-joint prosthesis method for implantation of the present invention.
Fig. 2 is knee-joint prosthesis method for implantation femur knee joint of the present invention and femur osteotomy module applying sketch map.
Fig. 3 is a femur osteotomy module diagram of the present invention.
Fig. 4 is a tibia osteotomy module diagram of the present invention.
Fig. 5 is the osteotomy line of rabbet joint during talipes varus in the knee joint of the present invention.
The osteotomy line of rabbet joint of Fig. 6 during for knee joint valgus deformity of the present invention.
The figure number explanation
1 ... femur knee joint 2 ... femur osteotomy module 3 ... tibia osteotomy module
The specific embodiment
Below in conjunction with accompanying drawing the present invention is described in further detail.
A kind of knee-joint prosthesis method for implantation of the present invention, please refer to Fig. 1 and Fig. 2, concrete steps are: a. knee joint osseous tissue DATA REASONING: the knee joint lower limb that need implantation joint prosthese user are carried out CT, MRI scanning, obtain the view data of limbs cross-section image and osseous tissue, wherein the view data of osseous tissue comprises femur and tibia dissection axis and mechanics axis data at least, the articular surface morphological data, the thickness data of face before the femur, ectocondyle line data in the femur, the angle of ectocondyle line and postartis line in the femur, the width of ectocondyle in the femur, the distance of femur and tibia anteroposterior diameter, the range data of tibia transverse diameter;
B. extract articular cartilage and bone contours data: with the view data in a step and limbs cross-section image input picture processing system successively, according to soft tissue and sclerotin at CT, the difference of gray scale is carried out image segmentation in the image that obtains among the MRI, extract outline data, obtain articular cartilage and skeleton data, described cartilage and skeleton data comprise the articular surface morphological data, femur and tibia is dissected axis and mechanics axis data, the thickness data of face before the femur, the angle of ectocondyle line and postartis line in the femur, ectocondyle width in the femur, the distance of femur and tibia anteroposterior diameter, the range data of femur transverse diameter;
C. in image processor, set up three-dimensional stereo model: with the data input picture processor that obtains in a step and the b step and utilize the drawing system that described data conversion is image, make the three-dimensional stereo model figure of knee-joint prosthesis user body joint surface of bone;
D. design the osteotomy module: according to the joint surface of bone shape of in image processor, making in the c step, manufacture and design femur osteotomy module 2 and tibia osteotomy module 3, make femur osteotomy module 2 and tibia osteotomy module 3 and kneed articular surface gap less than 1.5mm, promptly tight the applying, the thickness of femur osteotomy module 2 and tibia osteotomy module 3 is greater than 1cm simultaneously; Be specially this applying degree and should guarantee that osteotomy module and corresponding articular surface gap can not surpass 1.5mm.If this gap surpasses the variation that 2mm will bring axis and osteotomy amount, preferably guarantee the certain thickness of osteotomy module simultaneously, approximately about 1cm, so that the direction of goose saw during the control osteotomy; Please refer to Fig. 2, femur knee joint 1 fits with femur osteotomy module;
E. determine to use the big ting model of knee-joint prosthesis: determine to use the prosthese model according to femur, tibia data that a step measures; Specifically be generally described femoral prosthesis femoral prosthesis and femur anatomical axis line and be 6 degree that turn up, be outward turning 3 degree with the femoral-posterior condyles line, tibial prosthesis and tibia are dissected axis normal;
F. determine the osteotomy modular model: the femur osteotomy module 2 and the tibia osteotomy module 3 of steps d manufacturing are offered the osteotomy groove according to prosthese shape and size that the e step is selected to determine;
G. the implantation of knee-joint prosthesis: femur osteotomy module 2 that has the osteotomy groove and tibia osteotomy module 3 that step f is made are sheathed on knee-joint prosthesis user knee joint femur and the tibial prosthesis face, carry out user knee joint endoprosthesis face osteotomy according to osteotomy groove position, again the knee-joint prosthesis of determining among the step e is installed on the user knee joint position.
Among the concrete steps e, measuring the preceding femur anteroposterior diameter of patient's art is 5.45cm, will adopt No. 2 prostheses of Genesis ‖, is 6.13cm as anteroposterior diameter, to adopt No. 5 prostheses of Genesis ‖, the design of osteotomy groove on the osteotomy module is carried out in the requirement that recovers by the osteotomy requirement and the postoperative line of force simultaneously.Generally require femoral prosthesis and dissect the axis 6 degree angles that become to turn up, be wired to outward turning 3 degree with femoral-posterior condyles and lay, tibial prosthesis and tibia dissection axis normal are laid.Simultaneously also can carry out corresponding change, adapting to operation needs, realize the purpose of navigating in advance thereby reach osteotomy direction and osteotomy amount in the art by design before the art according to specific (special) requirements before doctor's art.For example: femur osteotomy module 2 far-end osteotomy grooves and the femur anatomical axis line 8 degree angles that become to turn up can be designed in the valgus joint.
Because the kneed data that it is measured according to knee-joint prosthesis implantation person, in picture system, reproduce the kneed articular surface of knee-joint prosthesis implantation person again, according to femur osteotomy module 2 and tibia osteotomy module 3 and standard design femur osteotomy module 2 and the tibia osteotomy module 3 of kneed articular surface gap less than 1.5mm, simultaneously according to knee-joint prosthesis implantation person knee joint endoprosthesis face selected shape that reappears and the big suitable finished product prosthese of ting model, then according to the finished product prosthese of choosing and the knee-joint prosthesis implantation person knee joint endoprosthesis face correspondence of reproduction, on femur osteotomy module of making 2 and tibia osteotomy module 3, offer the osteotomy groove, the purpose that the osteotomy groove is offered is to guarantee in the implanting prosthetic process, can conveniently carry out osteotomy to the knee joint of prosthese user, in implantation process, directly femur osteotomy module 2 and tibia osteotomy module 3 are fitted on the knee joint endoprosthesis face, after according to the osteotomy groove knee joint being carried out accurate osteotomy, take off femur osteotomy module 2 and tibia osteotomy module 3, the knee-joint prosthesis of choosing is implanted the knee joint place of osteotomy.Such method, owing to carry out the making of osteotomy module and osteotomy groove in advance, when implanting, no longer need to measure in the art, avoiding in the marrow location must insert in the marrow of growing locating rod or navigator fix in femur, tibia must play screw and be used for fixing the wound that tracker causes on femur, tibia, the drawback that also can avoid navigating loaded down with trivial details registration process and prolong operating time, can be suitable for simultaneously different artificial knee joint prosthesis and implant, can remedy navigation like this and be used for the existence of lower limb malformation severe patient than the out of use shortcoming of mistake.The imaging data of the individuation artificial knee joint osteotomy module of pre-navigation design each patient of osteotomy modular design phase acquisition is provided in addition, and design according to corresponding data, osteotomy module and patient's knee joint surface can fit tightly to guarantee the correct of osteotomy, on the lower limb model of being set up, determine the dissection axis and the mechanics axis of femur and tibia, femur mechanics axis choose the line that can adopt femoral head center and distal femur articular surface center.Because different artificial knee joint products have different osteotomy requirements, but the position that prosthese is laid depends primarily on the tibia osteotomy, the osteotomy of face and postartis before distal femur osteotomy and the femur.In osteotomy Module Design process, can choose the big ting model of different artificial knee joint prosthesis according to imaging data and, make this method to carry out Design Treatment at different knee joints according to the osteotomy groove of face and postartis before the tibia of the requirement design osteotomy module that different osteotomy requires and the postoperative line of force is recovered, distal femur, the femur.
A kind of knee-joint prosthesis method for implantation of the present invention, please refer to Fig. 3 and Fig. 4, can also be to offer amputation distal slot, front slot, back square groove, five grooves of two oblique section slot among the step f on the femur osteotomy module 2, offer the proximal tibia groove on the tibia osteotomy module 3.Such osteotomy groove can satisfy in implantation process kneed articular surface with the knee-joint prosthesis user fully by the prosthese shape correspondence of implanting in the needs that choose, to save the implantation time.
Following table is knee-joint prosthesis method for implantation of the present invention and foregoing two kinds of method contrast tables:
| Tradition osteotomy method | The navigation osteotomy | Individuation osteotomy module | |
| The osteotomy time | 20 minutes | 30 minutes | 10 minutes |
| Operation wound | Destroy blood fortune in the marrow, cause the fat embolism possibility | Need squeeze into positioning needle respectively at femur and tibia and cause certain sclerotin injury | Increase any additional injury hardly |
| Accuracy | Usually adopt the artificial visually examine, differ greatly | Relevant with artificial registration with the femur and tibia degree of deformity | As long as guarantee strict the applying, can reach accurate osteotomy |
| Measure the knee joint time point | In the art | In the art | Before the art |
The employed osteotomy module of knee-joint prosthesis method for implantation of the present invention, comprise femur osteotomy module 2 and tibia osteotomy module 3, offer the osteotomy groove on femur osteotomy module 2 and the described tibia osteotomy module 3, described femur osteotomy module 2 and described tibia osteotomy module 3 obtain by following steps:
A. knee joint osseous tissue DATA REASONING: the knee joint lower limb that need implantation joint prosthese user are carried out CT, MRI scanning, obtain the view data of limbs cross-section image and osseous tissue, wherein the view data of osseous tissue comprises that at least femur and tibia dissects in the thickness data of face before axis and mechanics axis data, articular surface morphological data, the femur, the femur ectocondyle line and the angle of postartis line, the width of the interior ectocondyle of femur, the distance of femur and tibia anteroposterior diameter, the range data of tibia transverse diameter in ectocondyle line data, the femur;
B. extract articular cartilage and bone contours data: with the view data in a step and limbs cross-section image input picture processing system successively, according to soft tissue and sclerotin at CT, the difference of gray scale is carried out image segmentation in the image that obtains among the MRI, extract outline data, obtain articular cartilage and skeleton data, described cartilage and skeleton data comprise the articular surface morphological data, femur and tibia is dissected axis and mechanics axis data, the thickness data of face before the femur, the angle of ectocondyle line and postartis line in the femur, ectocondyle width in the femur, the distance of femur and tibia anteroposterior diameter, the range data of femur transverse diameter;
C. in image processor, set up three-dimensional stereo model: with the data input picture processor that obtains in a step and the b step and utilize the drawing system that described data conversion is image, make the three-dimensional stereo model figure that meets knee-joint prosthesis user body joint surface of bone;
D. design the osteotomy module: according to the joint surface of bone shape of in image processor, making in the c step, manufacture and design femur osteotomy module 2 and tibia osteotomy module 3, make femur osteotomy module 2 and tibia osteotomy module 3 and kneed articular surface gap less than 1.5mm, the thickness of femur osteotomy module 2 and tibia osteotomy module 3 is greater than 1cm simultaneously;
E. determine to use the big ting model of knee-joint prosthesis: determine to use the prosthese model according to femur, tibia data that a step measures;
F. determine the osteotomy modular model: select the shape of definite prosthese and size that the femur osteotomy module 2 and the tibia osteotomy module 3 of steps d manufacturing are offered the osteotomy groove according to the e step.Osteotomy module of the present invention helps in the knee-joint prosthesis implantation process, obviously shortens the implant surgery time, locatees accurately high, as to reduce wound, adaptation Different Individual difference knee joint implantation.Further, offer amputation distal slot, front slot, back square groove, five grooves of two oblique section slot on the described femur osteotomy module 2, offer the proximal tibia groove on the described tibia osteotomy module 3.So conveniently carry out osteotomy in implantation process, the osteotomy error is lower.
The employed device of knee-joint prosthesis method for implantation of the present invention, comprise the data recording equipment, image processor, osteotomy modular design system and the osteotomy groove navigation system that are connected with CT, MRI scanning means, described data recording equipment passes to data and carries out the described image processor that knee joint is closed three-dimensional stereo model figure, image processor is connected with the osteotomy modular design system of design osteotomy module three-dimensional stereo model, and described osteotomy modular design system and definite osteotomy groove position are connected with big or small osteotomy groove navigation system.Such device can be finished the entire making process of osteotomy module before implanting the operation of knee joint module, produce the strong osteotomy module of degree of accuracy height, individual adaptability for the operation use.
Specific embodiment is:
Embodiment 1: interior talipes varus patient, please refer to Fig. 5, and talipes varus in tibia, femur exist, 86 ° at femur angle is turned over 2 ° in the existence.95 ° at tibia angle is turned over 2 ° in the existence.The femur measurement data is as follows: tibia anteroposterior diameter 6.13cm.The preceding thick 0.9cm of face.Select Genesis II5 prosthese for use.The femur osteotomy module that preparation of images is the perfect design of slotting.The distal femur fluting becomes 84 ° of angles with the femur mechanical axis, be 2 ° of angles with articular surface, because turn in existing, osteotomy groove and outside far-end distance are bigger, chosen position is apart from far-end 10mm, and preceding face is parallel with the postartis line with postartis osteotomy groove, and preceding face osteotomy slot pitch is 9mm from far-end, postartis osteotomy span is 9.3mm from distal-most end, and keeping anteroposterior diameter bone amount is 43mm (to guarantee to be fit to No. 5 Genesis II prostheses).The ABCDE direction is a femur osteotomy direction among the figure, and tibia osteotomy module fluting adopts vertical with mechanical axis, is 10mm apart from the lateral condyle peak.
Embodiment 2: valgus deformity patient, please refer to Fig. 6, and by measurement such as CT, MRI and X line before the art, all there are valgus deformity in femur, tibia, and wherein the femur angle is 80 °, exists to turn up 4 °, and the tibia angle is 90 °, has the 3 ° of deformities of turning up.The femur anteroposterior diameter is 5.45cm, and preceding face is thick to be 0.6cm, adopts No. 2 prostheses of Genesis II, and carries out corresponding fluting design.The distal femur fluting becomes 84 ° of angles with the femur mechanical axis, is 4 ° of angles with articular surface, apart from articular surface distal-most end 10mm.The femoral-posterior condyles fluting is parallel with the postartis line, and postartis osteotomy span is 13.5mm from distal-most end, and keeping anteroposterior diameter bone amount is 35mm (to guarantee to be fit to No. 5 Genesis II prostheses), and ABCDE is a femur osteotomy direction.Tibia osteotomy module fluting adopts vertical with mechanical axis, is 2mm apart from medial condyle.
Above-mentionedly only several specific embodiments among the present invention are illustrated; but can not be as protection scope of the present invention; every equivalence variation of doing according to the design spirit among the present invention or modification or equal proportion are amplified or are dwindled etc., all should think to fall into protection scope of the present invention.
Claims (6)
1, knee-joint prosthesis method for implantation is characterized in that: may further comprise the steps:
A. knee joint osseous tissue DATA REASONING: the knee joint lower limb that need implantation joint prosthese user are carried out CT, MRI scanning, obtain the view data of limbs cross-section image and osseous tissue, wherein the view data of osseous tissue comprises that at least femur and tibia dissects in the thickness data of face before axis and mechanics axis data, articular surface morphological data, the femur, the femur ectocondyle line and the angle of postartis line, the width of the interior ectocondyle of femur, the distance of femur and tibia anteroposterior diameter, the range data of tibia transverse diameter in ectocondyle line data, the femur;
B. extract articular cartilage and bone contours data: with the view data in a step and limbs cross-section image input picture processing system successively, according to soft tissue and sclerotin at CT, the difference of gray scale is carried out image segmentation in the image that obtains among the MRI, extract outline data, obtain articular cartilage and skeleton data, described cartilage and skeleton data comprise the articular surface morphological data, femur and tibia is dissected axis and mechanics axis data, the thickness data of face before the femur, the angle of ectocondyle line and postartis line in the femur, ectocondyle width in the femur, the distance of femur and tibia anteroposterior diameter, the range data of femur transverse diameter;
C. in image processor, set up three-dimensional stereo model: with the data input picture processor that obtains in a step and the b step and utilize the drawing system that described data conversion is image, make the three-dimensional stereo model figure that meets knee-joint prosthesis user body joint surface of bone;
D. design the osteotomy module: according to the joint surface of bone shape of in image processor, making in the c step, manufacture and design femur osteotomy module and tibia osteotomy module, make femur osteotomy module and tibia osteotomy module and kneed articular surface gap less than 1.5mm, the thickness of femur osteotomy module and tibia osteotomy module is greater than 1cm simultaneously;
E. determine to use the big ting model of knee-joint prosthesis: determine to use the prosthese model according to femur, tibia data that a step measures;
F. determine the osteotomy modular model: the femur osteotomy module and the tibia osteotomy module of steps d manufacturing are offered the osteotomy groove according to prosthese shape and size that the e step is selected to determine;
G. the implantation of knee-joint prosthesis: femur osteotomy module that has the osteotomy groove and tibia osteotomy module that step f is made are sheathed on knee-joint prosthesis user knee joint femur and the tibial prosthesis face, carry out user knee joint endoprosthesis face osteotomy according to osteotomy groove position, again the knee-joint prosthesis of determining among the step e is installed on the user knee joint position.
2, knee-joint prosthesis method for implantation according to claim 1, it is characterized in that: offer amputation distal slot, front slot, back square groove, five grooves of two oblique section slot among the described step f on the femur osteotomy module, offer the proximal tibia groove on the described tibia osteotomy module.
3, knee-joint prosthesis method for implantation according to claim 1 and 2 is characterized in that: described femoral prosthesis femoral prosthesis and femur anatomical axis line are 6 degree that turn up, and are outward turning 3 degree with the femoral-posterior condyles line, and tibial prosthesis and tibia are dissected axis normal.
4, a kind of claim 1 or the employed osteotomy module of 2 described knee-joint prosthesis method for implantation, it is characterized in that: comprise femur osteotomy module and tibia osteotomy module, offer the osteotomy groove on described femur osteotomy module and the described tibia osteotomy module, described femur osteotomy module and described tibia osteotomy module obtain by following steps: a. knee joint osseous tissue DATA REASONING: the knee joint lower limb that need implantation joint prosthese user are carried out CT, MRI scanning, obtain the view data of limbs cross-section image and osseous tissue, wherein the view data of osseous tissue comprises femur and tibia dissection axis and mechanics axis data at least, the articular surface morphological data, the thickness data of face before the femur, ectocondyle line data in the femur, the angle of ectocondyle line and postartis line in the femur, the width of ectocondyle in the femur, the distance of femur and tibia anteroposterior diameter, the range data of tibia transverse diameter;
B. extract articular cartilage and bone contours data: with the view data in a step and limbs cross-section image input picture processing system successively, according to soft tissue and sclerotin at CT, the difference of gray scale is carried out image segmentation in the image that obtains among the MRI, extract outline data, obtain articular cartilage and skeleton data, described cartilage and skeleton data comprise the articular surface morphological data, femur and tibia is dissected axis and mechanics axis data, the thickness data of face before the femur, the angle of ectocondyle line and postartis line in the femur, ectocondyle width in the femur, the distance of femur and tibia anteroposterior diameter, the range data of femur transverse diameter;
C. in image processor, set up three-dimensional stereo model: with the data input picture processor that obtains in a step and the b step and utilize the drawing system that described data conversion is image, make the three-dimensional stereo model figure that meets knee-joint prosthesis user body joint surface of bone;
D. design the osteotomy module: according to the joint surface of bone shape of in image processor, making in the c step, manufacture and design femur osteotomy module and tibia osteotomy module, make femur osteotomy module and tibia osteotomy module and kneed articular surface gap less than 1.5mm, the thickness of femur osteotomy module and tibia osteotomy module is greater than 1cm simultaneously;
E. determine to use the big ting model of knee-joint prosthesis: determine to use the prosthese model according to femur, tibia data that a step measures;
F. determine the osteotomy modular model: the femur osteotomy module and the tibia osteotomy module of steps d manufacturing are offered the osteotomy groove according to prosthese shape and size that the e step is selected to determine.
5, the osteotomy module of using in the knee-joint prosthesis method for implantation according to claim 4, it is characterized in that: offer amputation distal slot, front slot, back square groove, five grooves of two oblique section slot on the described femur osteotomy module, offer the proximal tibia groove on the described tibia osteotomy module.
6, a kind of claim 1 or the employed device of 2 described knee-joint prosthesis method for implantation, it is characterized in that: comprise and CT, the data recording equipment that the MRI scanning means connects, image processor, osteotomy modular design system and osteotomy groove navigation system, described data recording equipment passes to data and carries out the described image processor that knee joint is closed three-dimensional stereo model figure, image processor is connected with the osteotomy modular design system of design osteotomy module three-dimensional stereo model, and described osteotomy modular design system and definite osteotomy groove position are connected with big or small osteotomy groove navigation system.
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| CN200810126718A CN100581490C (en) | 2008-06-20 | 2008-06-20 | Knee-joint prosthesis implantation process, osteotomy module thereof and device thereof |
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