CN110495975A - The method for posting of Position Fixing Navigation System, prosthese - Google Patents
The method for posting of Position Fixing Navigation System, prosthese Download PDFInfo
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- CN110495975A CN110495975A CN201910807943.8A CN201910807943A CN110495975A CN 110495975 A CN110495975 A CN 110495975A CN 201910807943 A CN201910807943 A CN 201910807943A CN 110495975 A CN110495975 A CN 110495975A
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- acetabular fossa
- acetabular
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- pilot pin
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- 238000000034 method Methods 0.000 title claims abstract description 20
- NJPPVKZQTLUDBO-UHFFFAOYSA-N novaluron Chemical compound C1=C(Cl)C(OC(F)(F)C(OC(F)(F)F)F)=CC=C1NC(=O)NC(=O)C1=C(F)C=CC=C1F NJPPVKZQTLUDBO-UHFFFAOYSA-N 0.000 claims abstract description 50
- 238000002513 implantation Methods 0.000 abstract description 4
- 238000001356 surgical procedure Methods 0.000 abstract description 2
- 210000000988 bone and bone Anatomy 0.000 description 25
- 210000001624 hip Anatomy 0.000 description 10
- 210000004394 hip joint Anatomy 0.000 description 8
- 208000012659 Joint disease Diseases 0.000 description 4
- 238000010586 diagram Methods 0.000 description 4
- 239000004570 mortar (masonry) Substances 0.000 description 4
- 238000005259 measurement Methods 0.000 description 3
- 238000002224 dissection Methods 0.000 description 2
- 238000005516 engineering process Methods 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 238000010146 3D printing Methods 0.000 description 1
- 208000009248 Congenital Hip Dislocation Diseases 0.000 description 1
- 206010073767 Developmental hip dysplasia Diseases 0.000 description 1
- 208000025780 Protrusio acetabuli Diseases 0.000 description 1
- 206010003246 arthritis Diseases 0.000 description 1
- 238000011882 arthroplasty Methods 0.000 description 1
- 238000010009 beating Methods 0.000 description 1
- 210000000845 cartilage Anatomy 0.000 description 1
- 238000002591 computed tomography Methods 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 239000004744 fabric Substances 0.000 description 1
- 210000002391 femur head Anatomy 0.000 description 1
- 210000001981 hip bone Anatomy 0.000 description 1
- 210000001503 joint Anatomy 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 230000017074 necrotic cell death Effects 0.000 description 1
- 230000007170 pathology Effects 0.000 description 1
- 210000004197 pelvis Anatomy 0.000 description 1
- 238000004393 prognosis Methods 0.000 description 1
- 230000035939 shock Effects 0.000 description 1
- 208000024891 symptom Diseases 0.000 description 1
- 210000001685 thyroid gland Anatomy 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
Classifications
-
- 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
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
-
- 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
- A61F2/4609—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 acetabular cups
-
- 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
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2068—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis using pointers, e.g. pointers having reference marks for determining coordinates of body points
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Animal Behavior & Ethology (AREA)
- Transplantation (AREA)
- Surgery (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Physical Education & Sports Medicine (AREA)
- Robotics (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Vascular Medicine (AREA)
- Prostheses (AREA)
Abstract
The invention discloses a kind of Position Fixing Navigation Systems, for guiding prosthese to be placed in acetabular fossa, comprising: positioning pedestal, including fitting pedestal and guide rod, the fitting pedestal match with acetabular fossa, fix to fit in acetabular fossa；The guide rod is fixed on the fitting pedestal and coaxial with acetabular fossa；And locator, including sleeve and the leading arm extended to form by the sleeve, the sleeve is suitable for being sheathed on the guide rod, the leading arm is equipped with several pilot holes parallel with the axis of the sleeve, the pilot hole is suitable for squeezing into pilot pin, so that perimeter and pilot pin that pilot pin is squeezed into acetabular fossa are parallel with the axis of the acetabular fossa.In addition, the invention also discloses a kind of method for posting of prosthese.Position Fixing Navigation System of the invention, the mill for being accurately positioned acetabular fossa frustrates the implantation site of direction and acetabular cup, to be precisely placed in acetabular cup during surgery, guarantee that acetabular cup is placed in optimal location, to reduce the incidence of the complication such as prothesis dislocation, prosthetic loosening, pain.
Description
Technical field
The present invention relates to prosthese merging technical field more particularly to a kind of Position Fixing Navigation Systems.
Background technique
Replacement of total hip is the most common operation of Bones and joints surgery, because its efficiency-cost ratio is high, patient prognosis bona, extensively
For treating all kinds of hip joint diseases.Total hip arthroplasty mainly passes through acetabular cup, liner, femoral stem and femoral head, and this is several
A structure rebuilds the stability and joint movement function of hip joint.Need the hip treated by replacement of total hip
Joint disease includes caput femoris necrosis, hipbone arthritis, congenital dislocation of hip joint etc..The symptom of hip joint disease not only shows
It is generated for the collapse-deformation of femoral head, spur, it is also possible to show as the cartilage wear of acetabular bone, acetabular bone moves up or protrusio acetabuli etc..
Long-term hip joint disease will lead to patient's pelvic inclination, this is to bring greatly in replacement of total hip to the merging of acetabular cup
Difficulty, clinician be difficult in art determine acetabular bone specific location, in addition, the structures such as spur also will affect setting for acetabular cup
Enter angle.
The most important preoperative X-ray film template that is planned to for helping patient to position prosthese implantation site measures in the world now
Method.But the information of three-dimensional perspective is usually lost in this preoperative planning based on x-ray, can not determine prosthese from three-dimensional perspective
Implantation site, in addition, the inclination of pelvis is affected to the merging angle of prosthese.
For this reason, it may be necessary to it is a kind of for guiding the Position Fixing Navigation System of prosthese merging acetabular fossa, to be accurately placed in acetabular bone vacation
Body guarantees that prosthese is placed in optimal location, reduces the incidence of the complication such as prothesis dislocation, prosthetic loosening, pain.
Summary of the invention
For this purpose, existing above the present invention provides a kind of Position Fixing Navigation System to solve the problems, such as or at least alleviate.
According to an aspect of the invention, there is provided a kind of Position Fixing Navigation System, for guiding prosthese to be placed in acetabular fossa, packet
Include: positioning pedestal, including fitting pedestal and guide rod, the fitting pedestal matches with acetabular fossa, to fit in acetabular fossa
It is fixed；The guide rod is fixed on the fitting pedestal and coaxial with acetabular fossa；And locator, including sleeve and by described
The leading arm that sleeve extends to form, the sleeve are suitable for being sheathed on the guide rod, and the leading arm is equipped with several and institute
The parallel pilot hole of the axis of sleeve is stated, the pilot hole is suitable for squeezing into pilot pin, so that pilot pin is squeezed into the outer of acetabular fossa
Portion region and pilot pin is parallel with the axis of the acetabular fossa.
Optionally, in Position Fixing Navigation System according to the present invention, further includes: leading truck is equipped with location hole and clamping part,
The location hole is suitable for matching with the pilot pin, and the clamping part is suitable for clamping mill and frustrates bar and/or press-fitting bar；The positioning
When hole is sheathed on the pilot pin, the mill frustrates bar or press-fitting bar and acetabular fossa is coaxial.
Optionally, in Position Fixing Navigation System according to the present invention, the sleeve is rotationally sheathed on the guide rod,
Pilot pin is squeezed into after turning to predetermined position so as to the relatively described guide rod of the pilot hole.
Optionally, in Position Fixing Navigation System according to the present invention, the positioning pedestal further includes boss, the boss position
Between fitting pedestal and the guide rod；The upper surface of the boss is equipped with first gear；The lower end of the sleeve is equipped with
Suitable for the second gear engaged with the first gear.
Optionally, in Position Fixing Navigation System according to the present invention, the leading arm by the sleeve the outside water of side wall
The flat perimeter for extending to the acetabular fossa, and the pilot hole upright projection is in the perimeter of the acetabular fossa.
Optionally, in Position Fixing Navigation System according to the present invention, the model of the fitting pedestal is based on acetabular fossa
The reversed model that surface data inversely acquires.
According to a further aspect of the invention, a kind of method for posting of prosthese is provided, comprising steps of by positioning pedestal
Fitting pedestal fits in acetabular fossa and fixes, so that guide rod and acetabular fossa are coaxially disposed；The sleeve of locator is sheathed on described
Guide rod；And the pilot hole by pilot pin along locator is squeezed into, so that pilot pin is parallel with the axis of the acetabular fossa and position
In the perimeter of acetabular fossa.
Optionally, in method for posting according to the present invention, further comprise the steps of: the location hole of leading truck is sheathed on it is described
Pilot pin；Mill is frustrated into the clamping part that bar is clamped in leading truck, it is coaxial with acetabular fossa that the mill frustrates bar；And bar is frustrated by the mill
Mill is carried out to acetabular fossa to frustrate.
Optionally, in method for posting according to the present invention, further comprise the steps of: the location hole of leading truck is sheathed on it is described
Pilot pin；Press-fitting bar is clamped in the clamping part of leading truck, the press-fitting bar and acetabular fossa are coaxial；It will be false by the press-fitting bar
Body is placed in acetabular fossa.
Optionally, it in method for posting according to the present invention, further comprises the steps of: in the pilot hole by pilot pin along locator
Before squeezing into, the relatively described guide rod swing stop, so that pilot hole turns to predetermined position.
According to the technique and scheme of the present invention, provide a kind of Position Fixing Navigation System, including positioning pedestal, with positioning pedestal phase
The locator of cooperation, fits in that acetabular fossa is fixed, the sleeve of locator is set in the guide rod of positioning pedestal by positioning pedestal
On, so that pilot hole orientation of the Kirschner wire on locator is squeezed into the perimeter of acetabular fossa and parallel with acetabular bone axis, in turn
Be accurately positioned the implantation site that the mill of acetabular fossa frustrates direction and acetabular cup by the cooperation of leading truck and Kirschner wire, so as to
It is precisely placed in acetabular cup in operation, guarantees that acetabular cup is placed in optimal location, to reduce prothesis dislocation, prosthetic loosening, pain etc.
The incidence of complication.
Further, the acetabular bone that Position Fixing Navigation System of the invention considers different crowd has different dissections or pathology
Form, and figure in conjunction with different crowd patient, gender carry out calculating design, in this way, the direction for being placed in acetabular cup more connects
The direction of the acetabular bone axis of nearly patient, and the covering acetabular region of area as big as possible, acetabular fossa is fitted in, it avoids acetabular cup and puts
The bad problem of seated position, to be effectively reduced, acetabular cup loosens, femoral head is dislocated and acetabular cup and the shock of femoral stem neck etc.
The incidence of complication ensure that the mobility of hip joint.
In addition, positioning pedestal carries out personalized designs according to the anatomic form and pathomorphism of the acetabular bone of different crowd, and
Production fitting pedestal provides more individuation more for clinician to guarantee that every patient can accurately be placed in acetabular cup
Applicable operation plan.
The above description is only an overview of the technical scheme of the present invention, in order to better understand the technical means of the present invention,
And it can be implemented in accordance with the contents of the specification, and in order to allow above and other objects of the present invention, feature and advantage can
It is clearer and more comprehensible, the followings are specific embodiments of the present invention.
Detailed description of the invention
To the accomplishment of the foregoing and related purposes, certain illustrative sides are described herein in conjunction with following description and drawings
Face, these aspects indicate the various modes that can practice principles disclosed herein, and all aspects and its equivalent aspect
It is intended to fall in the range of theme claimed.Read following detailed description in conjunction with the accompanying drawings, the disclosure it is above-mentioned
And other purposes, feature and advantage will be apparent.Throughout the disclosure, identical appended drawing reference generally refers to identical
Component or element.
Fig. 1 to Figure 11 respectively illustrates the structural schematic diagram of Position Fixing Navigation System 500 according to an embodiment of the invention,
Wherein, Fig. 1 to Figure 11 sequentially shows the step schematic diagram in acetabular fossa merging acetabular cup；
Figure 12 shows the flow chart of the method for posting 600 of prosthese according to an embodiment of the invention.
Specific embodiment
Exemplary embodiments of the present disclosure are described in more detail below with reference to accompanying drawings.Although showing the disclosure in attached drawing
Exemplary embodiment, it being understood, however, that may be realized in various forms the disclosure without should be by embodiments set forth here
It is limited.On the contrary, these embodiments are provided to facilitate a more thoroughly understanding of the present invention, and can be by the scope of the present disclosure
It is fully disclosed to those skilled in the art.
As it was noted above, the method for being placed in prosthese in replacement of total hip more or less exists in the prior art
Certain defect, therefore the invention proposes a kind of Position Fixing Navigation Systems 500, for guiding prosthese in replacement of total hip
Accurately it is placed in acetabular fossa.Prosthese is, for example, acetabular cup, but not limited to this.It is with hip in following embodiments of the invention
Position Fixing Navigation System 500 is specifically described for mortar cup, it is to be understood that, the present invention is not limited to specific kind of acetabular component
Class, Position Fixing Navigation System 500 of the invention are suitable for various acetabular components.
Fig. 1 to Figure 11 respectively illustrates the structural schematic diagram of Position Fixing Navigation System 500 according to an embodiment of the invention,
Wherein, Fig. 1 to Figure 11 sequentially shows the step schematic diagram in acetabular fossa merging acetabular cup.
As shown in Figure 1 to Figure 3, Position Fixing Navigation System 500 includes positioning pedestal 100 and guider 200, positioning pedestal 100
It is integrally formed with guider 200.Wherein, positioning pedestal 100 includes fitting pedestal 110 and guide rod 120.It is bonded pedestal 110
Lower surface match with 510 surface of acetabular bone horseshoe nest and acetabular bone inferior thyroid notch, so that acetabular bone horseshoe can be fitted in by being bonded pedestal 110
Nest 510 is fixed.Guide rod 120 is fixed on the top surface of fitting pedestal 110, and extends to the direction far from fitting pedestal 110.And
And as shown in Figure 1, guide rod 120 and acetabular fossa 510 are coaxial, are after fitting pedestal 110 is jointly mounted to acetabular fossa 510
The axis direction of guide rod 120 is identical as the axis direction of acetabular fossa 510.
As shown in Figures 2 and 3, locator 200 includes sleeve 220 and the leading arm 230 extended to form by sleeve 220.
Sleeve 220 is matched with guide rod 120, and sleeve 220 is rotatably sleeved on guide rod 120, and sleeve 220 and guide rod
120 is coaxial.Leading arm 230 is equipped with several pilot holes 235 parallel with the axis of sleeve 220.Pilot hole 235 is for squeezing into
Pilot pin 250, the position that can squeeze into acetabular bone to pilot pin 250 position.Specifically, leading arm 230 is by the side of sleeve 220
Horizontal extension is formed wall outside (being the direction far from 220 axle center of sleeve), and extends to the perimeter of acetabular fossa 510,
That is one end upright projection of the leading arm 230 far from sleeve 220 is in the perimeter of acetabular fossa 510.In addition, several are led
To 235 upright projection of hole in the perimeter of acetabular fossa 510.In this way, as shown in figure 5, by 220 sets of sleeve of locator 200
If be mounted on guide rod 120, by squeezing into pilot pin 250 along pilot hole 235, pilot pin 250 can be squeezed into acetabular fossa
510 perimeter.Pilot pin 250 is, for example, Kirschner wire, but not limited to this.
It should be noted that can guarantee pilot pin by the way that pilot pin 250 is squeezed into acetabular bone perimeter along pilot hole 235
250 is parallel with the axis of acetabular fossa 510.It should be appreciated that due to pilot hole 235 it is parallel with the axis of sleeve 220, sleeve 220 and
Guide rod 120 is coaxial, and guide rod 120 and acetabular fossa 510 are coaxial.Therefore pilot hole 235 is parallel with the axis of acetabular fossa 510, edge
The pilot pin 250 that pilot hole 235 is squeezed into is also parallel with the axis of acetabular fossa 510.
It should also be noted that the pilot hole 235 on leading arm 230 can be one or more, preferably 2~5, but this
Invention is not particularly limited the quantity of pilot hole 235.Moreover, the present invention is to one or more pilot hole 235 in leading arm
Position and arrangement mode on 230 are also with no restrictions.In addition, the present invention squeezes into 510 perimeter of acetabular fossa to along pilot hole 235
Pilot pin 250 quantity and squeeze into position and be also not particularly limited.
In addition, as shown in figure 4, after sleeve 220 is set on guide rod 120, it can be around 120 rotational positioning of guide rod
Device 200 adjusts the position of leading arm 230 and pilot hole 235 with respect to acetabular fossa 510, and pilot hole 235 is turned to predetermined
Position, predetermined position are, for example, to be located at the perimeter of acetabular fossa 510 and expose the position of bone, so as to by pilot pin 250
The perimeter of acetabular fossa 510 is squeezed into along pilot hole 235.
According to one embodiment, as depicted in figs. 1 and 2, positioning pedestal 100 further includes boss 130, and boss 130 is located at patch
It is between conjunction pedestal 110 and guide rod 120 and coaxial with guide rod 120, step surface is formed between boss 130 and guide rod 120.It is convex
The upper surface (being step surface) of platform 130 is equipped with first gear 131.The lower end surface of the sleeve 220 of locator 200 is equipped with the second tooth
Wheel 221, second gear 221 can be meshed with first gear 131.In one embodiment, first gear 131, second gear
221 be bevel gear, however, the present invention is not limited thereto.It should be appreciated that passing through first gear 131, the phase interworking of second gear 221
It closes, helps to make the sleeve of locator 200 to be more stably set on the guide rod 120 of positioning pedestal 100, and can be oppositely oriented
Bar 120 rotates.
As shown in fig. 6, just locator 200 and positioning pedestal 100 are torn open after squeezing into pilot pin 250 along pilot hole 235
It removes.In turn, direction is frustrated to the mill of acetabular cup 550 by pilot pin 250 and placing direction positions.
According to one embodiment, as shown in Figure 7 to 10, Position Fixing Navigation System 500 further includes leading truck 300, by leading
It is matched to frame 300 with pilot pin 250, the mill that can be accurately positioned acetabular fossa 510 in operation frustrates direction and merging acetabular cup
550 direction, and acetabular cup 550 is accurately placed in after frustrating to the mill of acetabular fossa 510.Acetabular cup 550 is being placed in acetabular fossa 510
When, it is parallel with the direction of pilot pin 250 in 510 periphery of acetabular fossa is squeezed by controlling the axis direction of acetabular cup 550,
The placing direction of acetabular cup 550 is positioned, guarantees that acetabular cup 550 is jointly mounted to acetabular fossa 510 and same with acetabular fossa 510
Axis.
Specifically, as shown in fig. 7, leading truck 300 includes location hole arm 350, location hole arm 350 is longitudinally through equipped with several
A location hole 310, and one end of location hole arm 350 is equipped with clamping part 320.Location hole 310 is suitable for matching with pilot pin 250,
Clamping part 320 can be used for clamping mill and frustrate bar 410 or press-fitting bar 420.Here, mill frustrates bar 410 for beating acetabular fossa 510
Mill；Bar 420 is press-fitted to be used for the merging acetabular fossa 510 of acetabular cup 550.2~5 location holes can be set on location hole arm 350
310, but, the present invention to the particular number of location hole 310 with no restrictions.
It should be pointed out that the present invention to the specific structure and shape of clamping part 320 also with no restrictions, as long as 320 energy of clamping part
Bar 410 is frustrated with mill, press-fitting bar 420 matches steadily clamping mill and frustrates bar 410, press-fitting bar 420, and guarantees that mill frustrates bar 410, press-fitting
The axis direction of bar 420 is parallel with 310 direction of location hole.In this way, by the way that the location hole 310 of leading truck 300 is set in
In pilot pin 250, it is parallel with the direction of pilot pin 250 to can guarantee that mill frustrates bar 410, the axis direction of press-fitting bar 420, and then guarantee
It is coaxially arranged that mill frustrates bar 410, press-fitting bar 420 and acetabular fossa 510.
It, both can be in addition, opposite grinding of the present invention frustrates bar 410, is press-fitted the specific structure of bar 420, size also with no restrictions
Using any one structure in the prior art.Based on this, the size of the clamping part 320 of leading truck 300 of the invention can root
Bar 410 is frustrated according to mill, the shape and size that are press-fitted bar 420 are determined.
It is understood that mill frustrates bar 410 and the size of press-fitting bar 420 can be consistent, it can also be inconsistent.Therefore, originally
The Position Fixing Navigation System 500 of invention may include two different leading trucks 300 of clamping part size.
In one embodiment, as shown in Figure 8 and Figure 9, it is cylinder, clamping part that mill, which frustrates bar 410 and press-fitting bar 420,
320 shape is to frustrate bar 410 with mill or the press-fitting shape of bar 420 is compatible arc-shaped such as semicircle.As shown in figure 8, leading
Bar 410 is frustrated by the clamping mill of clamping part 320 to frame 300, the lower end that mill frustrates bar 410 is equipped with the mill to match with acetabular fossa 510
First 415, it is coaxially connected that bistrique 415 and mill frustrate bar 410, carries out mill to acetabular fossa 510 by bistrique 415 and frustrates.Here, pass through guiding
The cooperation of frame 300 and pilot pin 250, so that mill is frustrated bar 410, coaxial with acetabular fossa 510 (mill frustrates the axis that bar 410 is located at acetabular fossa 510
Line direction), in this way, can guarantee that bistrique 415 and acetabular fossa 510 are coaxial, to be accurately positioned bistrique 415 to the mill of acetabular fossa 510
Frustrate direction.
In another embodiment, as shown in figure 9, leading truck 300 passes through the clamping press-fitting bar 420 of clamping part 320, press-fitting
The lower end of bar 420 is equipped with the acetabular cup 550 to match with acetabular fossa 510, and acetabular cup 550 and press-fitting bar 420 are coaxial, so as to
Acetabular cup 550 is placed in acetabular fossa 510.Here, the lower end for being press-fitted bar 420 can be connect with acetabular cup 550 by helicitic texture.
By the cooperation of leading truck 300 and pilot pin 250, making to be press-fitted bar 420 and acetabular fossa 510, coaxially arranged (press-fitting bar 420 is located at hip
The axis direction of mortar nest 510), in this way, can guarantee that the acetabular cup 550 of press-fitting 420 lower end of bar and acetabular fossa 510 are coaxial, thus right
Acetabular cup 550 is accurately positioned, and is able to achieve acetabular cup 550 being accurately placed in acetabular fossa 510.
In addition, as shown in Figure 10, in the cooperation for passing through leading truck 300 and pilot pin 250, acetabular cup 550 is accurately placed in
After acetabular fossa 510, first press-fitting bar 420 is dismantled from acetabular cup 550, and then by the location hole of leading truck 300 310 from pilot pin
It is detached from 250, so that leading truck 300 and press-fitting bar 420 be removed.In turn, as shown in figure 11, supracotyloid pilot pin is extracted
250。
According to one embodiment, positioning pedestal 100 of the invention, locator 200, leading truck 300 are to pass through 3D printing
Technology is made.
During making 500 all parts of Position Fixing Navigation System, the hip of multiple patients is obtained by CT scan first
The surface data of mortar, and being conducted into computer software, by being split to different acetabular bone forms, MESH operation and cloth
That operation obtains the model that pedestal is closed in anti-subsidy corresponding from different acetabular bone forms.
According to a kind of embodiment, respectively to the healthy person of different BMI (Body Mass Index, body-mass index)
It is divided, is divided into the BMI group in multiple and different sections, and each BMI group is also divided into male's group and women group.By to not
With BMI group healthy person carry out CT measurement, determine healthy person acetabular bone bottom and skin on the axis direction of acetabular fossa 510 away from
From, and then specifically passed through according to determining distance parameter design suitable for the positioning pedestal 100 of the BMI group where healthy person
Distance parameter determines the length of the guide rod 120 in positioning pedestal 100, so determine the sleeve 220 of locator 200 length,
The size etc. of the clamping part 320 of leading truck 300.In addition, also the external profile diameter of the acetabular fossa of healthy person 510 is measured, and
The locator 200 and leading truck 300 suitable for the BMI group where healthy person are designed according to the diameter of measurement, specifically, according to
The diameter of measurement determines the length of the length of leading arm 230, the location hole arm 350 of leading truck 300.
Further, the pilot hole 235 and guiding on personalized designs locator 200 are carried out to the acetabular bone of different shape
Position, arrangement mode and the quantity of location hole 310 on frame 300.
It should be pointed out that the acetabular bone that Position Fixing Navigation System 500 of the invention considers different crowd have different dissection or
Pathomorphism, and figure in conjunction with different crowd patient, gender carry out calculating design, in this way, the direction for being placed in acetabular cup
Closer to the direction of the acetabular bone axis of patient, and the covering acetabular region of area as big as possible, acetabular fossa is fitted in, avoids acetabular bone
The bad problem of cup placement location, to be effectively reduced, acetabular cup loosens, femoral head dislocation and acetabular cup and femoral stem neck are hit
The incidence for the complication such as hitting, ensure that the mobility of hip joint.In addition, the hip of positioning pedestal of the invention according to different crowd
The anatomic form and pathomorphism of mortar carry out personalized designs, and make fitting pedestal, to guarantee to be ok for every patient
It is accurately placed in acetabular cup, provides more individuation more applicable operation plan for clinician.
Figure 12 shows the flow chart of the method for posting 600 of prosthese according to an embodiment of the invention.Method 600 is used for
Prosthese is placed in acetabular fossa 510, prosthese is, for example, acetabular cup 550, but the present invention is not limited to the specific types of prosthese.Method 600
Including step S610~S630.
Firstly, the fitting pedestal 110 of positioning pedestal 100 is fitted in into acetabular bone horseshoe nest 510 and is fixed in step S610,
It is coaxially disposed guide rod 120 and acetabular fossa 510.Here, the position and direction of guide rod 120 are positioned.
Then, in step S620, the sleeve 220 of locator 200 is set on guide rod 120, thus by locator
200 are mounted on the guide rod 120 of positioning pedestal 100.Here, sleeve 220 and guide rod 120 are coaxial, thus to sleeve 220 with
And the direction of the pilot hole 235 on locator 200 is positioned, and guarantees the direction of pilot hole 235 and the axis of acetabular fossa 510
In parallel.
Then, in step S630, the pilot hole 235 by pilot pin 250 along locator 200 is squeezed into, due to pilot hole 235
It is parallel with the axis of acetabular fossa 510, and 235 upright projection of pilot hole is in the perimeter of acetabular fossa 510, to can guarantee positioning
Needle 250 is parallel with the axis of acetabular fossa 510, and the position squeezed into of pilot pin 250 is located at the perimeter of acetabular fossa 510.In this way,
It can be positioned by pilot pin 250 come the direction for being placed in acetabular fossa 510 to prosthese.
In addition, 120 turns of bar can be oppositely oriented before squeezing into pilot pin 250 along the pilot hole 235 of locator 200
Dynamic locator 200, makes pilot hole 235 turn to predetermined position.Predetermined position be, for example, be located at acetabular fossa 510 perimeter and
The position of bone is exposed, so that pilot pin 250 to be squeezed into the perimeter of acetabular fossa 510 along pilot hole 235.
According to one embodiment, after step S630, to acetabular fossa 510 carry out mill frustrate, specifically include step S641~
S643。
In step S641, it (is to squeeze into step S630 that the location hole 310 of leading truck 300, which is set in pilot pin 250,
Pilot pin 250 in the perimeter of acetabular fossa 510) on.Here, by the cooperation of location hole 310 and pilot pin 250, to leading
It is positioned to the direction of frame 300.
Then, in step S642, mill is frustrated into the clamping part 320 that bar 410 is clamped in leading truck 300, make mill frustrate bar 410 with
Acetabular fossa 510 is coaxial, and mill frustrates the lower end of bar 410 and is equipped with the bistrique 415 to match with acetabular fossa 510.Here, mill frustrates bar
After 410 are mounted on the clamping part 320 of leading truck 300, can guarantee mill frustrate bar 410 axis direction it is parallel with location hole 310, and energy
Guarantee that mill frustrates bar 410 and acetabular fossa 510 is coaxial, the position and direction that realization opposite grinding frustrates bar 410 are accurately positioned.Moreover, mill
First 415 frustrate the coaxial arrangement of bar 410 with mill, frustrate bar 410 by opposite grinding and position, can guarantee that bistrique 415 and acetabular fossa 510 are coaxial.
Then, in step S643, mill is oriented to acetabular fossa 510 by the bistrique 415 that mill frustrates 410 lower end of bar and is frustrated.
Since bistrique 415 and acetabular fossa 510 are coaxial, direction is frustrated so as to be accurately positioned bistrique 415 to the mill of acetabular fossa 510.
According to one embodiment, after step S643, the merging of prosthese is carried out, specifically includes step S651~S653.
In step S651, it (is to squeeze into step S630 that the location hole 310 of leading truck 300, which is set in pilot pin 250,
Pilot pin 250 in the perimeter of acetabular fossa 510) on.Here, by the cooperation of location hole 310 and pilot pin 250, to leading
It is positioned to the direction of frame 300.
Then, in step S652, bar 420 will be press-fitted and be clamped in the clamping part 320 of leading truck 300, make to be press-fitted bar 420 with
Acetabular fossa 510 is coaxial, and the lower end for being press-fitted bar 420 is detachably equipped with the prosthese to match with acetabular fossa 510.Here, it is press-fitted
After bar 420 is mounted on the clamping part 320 of leading truck 300, it can guarantee that the axis direction of press-fitting bar 420 is parallel with location hole 310, and
It can guarantee that press-fitting bar 420 and acetabular fossa 510 are coaxial, realize that the position and direction to press-fitting bar 420 are accurately positioned.And prosthese
(such as acetabular cup 550) is co-axially mounted with press-fitting bar 420, in this way, can guarantee that prosthese is also coaxial with acetabular fossa 510, is realized to vacation
The accurate positioning of body.
Then, in step S653, the position of leading truck 300 is adjusted along pilot pin 250, is by leading truck 300 along fixed
Position needle 250 is slided up and down to suitable position, so that prosthese is placed in acetabular fossa 510.Here, since prosthese and acetabular fossa 510 are same
Prosthese is accurately placed in acetabular fossa 510 to can guarantee by axis, is guaranteed that prosthese is placed in optimal location, is reduced prothesis dislocation, prosthese
The incidence of the complication such as loosening, pain.
In addition, leading truck 300 and press-fitting bar 420 are removed, and extract supracotyloid pilot pin after step S653
250.It should be appreciated that since prosthese is removably mounted on the lower end of press-fitting bar 420, such as prosthese and press-fitting bar 420 pass through spiral shell
Line structure connection, in this way, can be dismantled press-fitting bar 420 from prosthese, and will lead after by Using prosthesis acetabular fossa 510
It is detached from pilot pin 250 to the location hole 310 of frame 300, removes leading truck 300, finally, extracting pilot pin 250 from acetabular bone.
In the description of this specification unless specifically defined or limited otherwise, term " connection ", " fixation " etc. should all be done extensively
Reason and good sense solution.In addition, the orientation or positional relationship of the instructions such as term " on ", "lower", "inner", "outside", "top", "bottom" is based on attached drawing
Shown in orientation or positional relationship, be merely for convenience of description of the present invention and simplification of the description, rather than indication or suggestion is signified
Equipment or unit must have specific direction, be constructed and operated in a specific orientation, it is thus impossible to be interpreted as to of the invention
Limitation.
In the description of this specification, the description of term " one embodiment ", " some embodiments ", " specific embodiment " etc.
Mean that particular features, structures, materials, or characteristics described in conjunction with this embodiment or example are contained at least one reality of the invention
It applies in example or example.In the present specification, schematic expression of the above terms are not necessarily referring to identical embodiment or show
Example.Moreover, description particular features, structures, materials, or characteristics can in any one or more of the embodiments or examples with
Suitable mode combines.
In the instructions provided here, numerous specific details are set forth.It is to be appreciated, however, that implementation of the invention
Example can be practiced without these specific details.In some instances, well known method, knot is not been shown in detail
Structure and technology, so as not to obscure the understanding of this specification.
Claims (10)
1. a kind of Position Fixing Navigation System, for guiding prosthese to be placed in acetabular fossa, comprising:
Positioning pedestal, including fitting pedestal and guide rod, the fitting pedestal matches with acetabular fossa, to fit in acetabular fossa
It is fixed；The guide rod is fixed on the fitting pedestal and coaxial with acetabular fossa；And
Locator, including sleeve and the leading arm extended to form by the sleeve, the sleeve is suitable for being sheathed on the guiding
Bar, the leading arm are equipped with several pilot holes parallel with the axis of the sleeve, and the pilot hole is suitable for squeezing into positioning
Needle, so that perimeter and pilot pin that pilot pin is squeezed into acetabular fossa are parallel with the axis of the acetabular fossa.
2. Position Fixing Navigation System as described in claim 1, wherein further include:
Leading truck is equipped with location hole and clamping part, and the location hole is suitable for matching with the pilot pin, and the clamping part is suitable for
Clamping mill frustrates bar and/or press-fitting bar；
When the location hole is sheathed on the pilot pin, the mill frustrates bar or press-fitting bar and acetabular fossa is coaxial.
3. such as the described in any item Position Fixing Navigation Systems of claim 1-2, in which:
The sleeve is rotationally sheathed on the guide rod, so that the relatively described guide rod of the pilot hole turns to pre-determined bit
It postpones and squeezes into pilot pin.
4. Position Fixing Navigation System as claimed in claim 3, in which:
The positioning pedestal further includes boss, and the boss is between fitting pedestal and the guide rod；The boss it is upper
End face is equipped with first gear；
The lower end of the sleeve is equipped with the second gear for being suitable for engaging with the first gear.
5. Position Fixing Navigation System according to any one of claims 1-4, in which:
The leading arm is extended horizontally to the perimeter of the acetabular fossa, and the pilot hole by the side wall of the sleeve outward
Upright projection is in the perimeter of the acetabular fossa.
6. Position Fixing Navigation System as described in any one in claim 1-5, in which:
The model of the fitting pedestal is the reversed model that the surface data based on acetabular fossa inversely acquires.
7. a kind of method for posting of prosthese, comprising steps of
The fitting pedestal of positioning pedestal is fitted in acetabular fossa to fix, so that guide rod and acetabular fossa are coaxially disposed；
The sleeve of locator is sheathed on the guide rod；And
Pilot hole by pilot pin along locator is squeezed into, so that pilot pin is parallel with the axis of the acetabular fossa and is located at acetabular fossa
Perimeter.
8. the method for claim 7, further comprising the steps of:
The location hole of leading truck is sheathed on the pilot pin；
Mill is frustrated into the clamping part that bar is clamped in leading truck, it is coaxial with acetabular fossa that the mill frustrates bar；And
By it is described mill frustrate bar to acetabular fossa carry out mill frustrate.
9. method as claimed in claim 7 or 8, further comprises the steps of:
The location hole of leading truck is sheathed on the pilot pin；
Press-fitting bar is clamped in the clamping part of leading truck, the press-fitting bar and acetabular fossa are coaxial；
Prosthese is placed in acetabular fossa by the press-fitting bar.
10. being further comprised the steps of: such as the described in any item methods of claim 7-9
Before pilot pin is squeezed into along the pilot hole of locator, the relatively described guide rod swing stop, so that pilot hole turns
It moves to predetermined position.
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| CN201910807943.8A CN110495975B (en) | 2019-08-29 | 2019-08-29 | Positioning navigation system and prosthesis implantation method |
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