CN113317843A - Preparation method of individualized knee joint unicondylar replacement tibia accurate osteotomy guide plate - Google Patents
Preparation method of individualized knee joint unicondylar replacement tibia accurate osteotomy guide plate Download PDFInfo
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- 210000002303 tibia Anatomy 0.000 title claims abstract description 73
- 210000000629 knee joint Anatomy 0.000 title claims abstract description 60
- 238000002360 preparation method Methods 0.000 title claims abstract description 20
- 210000003141 lower extremity Anatomy 0.000 claims abstract description 34
- 238000000034 method Methods 0.000 claims abstract description 14
- 239000007787 solid Substances 0.000 claims description 54
- 238000002591 computed tomography Methods 0.000 claims description 29
- 238000002271 resection Methods 0.000 claims description 17
- 238000003325 tomography Methods 0.000 claims description 17
- 210000000988 bone and bone Anatomy 0.000 claims description 11
- 238000000605 extraction Methods 0.000 claims description 7
- 238000012545 processing Methods 0.000 claims description 7
- 238000010146 3D printing Methods 0.000 claims description 4
- 238000002513 implantation Methods 0.000 claims description 4
- 210000004197 pelvis Anatomy 0.000 claims description 4
- 238000004088 simulation Methods 0.000 claims description 4
- 210000000689 upper leg Anatomy 0.000 claims description 4
- 238000002224 dissection Methods 0.000 claims description 3
- 238000012407 engineering method Methods 0.000 claims description 3
- 230000000877 morphologic effect Effects 0.000 claims description 3
- 238000013461 design Methods 0.000 abstract description 8
- 230000009286 beneficial effect Effects 0.000 abstract description 4
- 238000005516 engineering process Methods 0.000 abstract description 4
- 210000003127 knee Anatomy 0.000 abstract description 3
- 201000008482 osteoarthritis Diseases 0.000 description 5
- 208000003947 Knee Osteoarthritis Diseases 0.000 description 4
- 238000010586 diagram Methods 0.000 description 4
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- 208000006820 Arthralgia Diseases 0.000 description 1
- 210000001264 anterior cruciate ligament Anatomy 0.000 description 1
- 238000005452 bending Methods 0.000 description 1
- 210000004439 collateral ligament Anatomy 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 230000007850 degeneration Effects 0.000 description 1
- 230000004064 dysfunction Effects 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 208000024765 knee pain Diseases 0.000 description 1
- 238000013150 knee replacement Methods 0.000 description 1
- 238000010030 laminating Methods 0.000 description 1
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Abstract
一种个性化膝关节单髁置换胫骨精准截骨导板的制备方法,包括六个步骤。本发明有益效果包括有：1、采用了对象双下肢站立位全长片以及膝关节CT断层扫描数据作为负重位的膝关节模型三维重建基础，双下肢站立位全长片以及膝关节CT断层扫描数据的来源可靠且容易获取。2、本发明采用的逆向工程技术建模方法，反向构建出具有高度的个性化解剖匹配度的胫骨截骨导板设计，最后通过3D打印出个性化胫骨截骨导板，能在最大程度提高个体化精准度。3、本发明通过虚拟截骨，从而能准确地评估对象的截骨量，并能预先确定津单髁胫骨假体实物的型号。
A preparation method of a tibia precise osteotomy guide for personalized knee unicondylar replacement, comprising six steps. The beneficial effects of the present invention include: 1. The full-length film of the object in the standing position of the lower limbs and the CT tomographic scanning data of the knee joint are used as the basis for the three-dimensional reconstruction of the knee joint model in the weight-bearing position. The source of the data is reliable and easily accessible. 2. The reverse engineering technology modeling method adopted in the present invention reversely constructs the design of the tibial osteotomy guide plate with a high degree of personalized anatomical matching, and finally prints the personalized tibial osteotomy guide plate through 3D, which can maximize the improvement of the individual tibial osteotomy guide plate. precision. 3. The present invention can accurately evaluate the amount of osteotomy of the object through virtual osteotomy, and can predetermine the model of the actual Jin-unicondylar tibial prosthesis.
Description
Technical Field
The invention relates to the technical field of auxiliary medical instruments for knee joint unicondylar replacement tibia osteotomy operation, in particular to a preparation method of an individualized knee joint unicondylar replacement tibia accurate osteotomy guide plate.
Background
Knee Osteoarthritis (KOA) is a major cause of knee pain and dysfunction in middle and old aged people, and surgical treatment is the last approach for patients with advanced knee osteoarthritis. In patients with severe single tibiofemoral compartment degeneration without any painful discomfort to the contralateral compartment, one recommended unilateral knee replacement (UKA).
The failure rate of UKA at early stage is high, so the acceptance of UKA is not high. With the maturation of minimally invasive surgical techniques and prosthesis designs, UKA achieves satisfactory clinical results in treating a single compartment KOA. A great deal of literature at home and abroad indicates that UKA has the advantages of small wound, quick recovery and the like when used for treating knee joint antero-medial compartment osteoarthritis. However, studies have shown that premature UKA failure is closely related to poor positioning of the tibial prosthesis, and the mismatch between the morphology of the bone bed obtained from tibial osteotomies and the prosthesis is one of the major causes of poor positioning of the prosthesis. Clinically, the accuracy of UKA tibia lateral osteotomy depends on the influence of subjective factors of operators to a great extent, so that the prosthesis is implanted to a target position with great deviation, the problem of mismatch of anatomy and dynamics to lines is caused, and a series of problems such as looseness and impact are caused.
Therefore, aiming at the defects in the prior art, the preparation method of the personalized knee joint unicondylar replacement tibia accurate osteotomy guide plate is necessary to solve the defects in the prior art.
Disclosure of Invention
One of the purposes of the invention is to provide a preparation method of an accurate tibial cutting guide plate for the personalized knee joint unicondylar replacement tibia, which avoids the defects of the prior art. The preparation method of the individualized knee joint unicondylar replacement tibia accurate osteotomy guide plate can improve the osteotomy accuracy of the individualized tibia osteotomy guide plate and improve the positioning and orientation accuracy.
The above object of the present invention is achieved by the following technical measures:
the preparation method of the individualized knee joint unicondylar replacement tibia accurate osteotomy guide plate comprises the following steps:
collecting double-lower-limb standing position full-length film and double-lower-limb CT (computed tomography) tomography data of a target to obtain a target side lower limb three-dimensional geometric model in a load-bearing functional position state;
secondly, carrying out tibial force axis characteristic extraction on the target lower limb three-dimensional geometric model obtained in the first step and converting the tibial force axis characteristic into an initial solid model;
step three, rotating the initial solid model obtained in the step two by 90 degrees along a sagittal plane to obtain a knee joint flexion 90-degree body position solid model;
step four, determining a horizontal tibial osteotomy plane and a vertical tibial osteotomy plane of the solid model of the knee joint with 90-degree flexion posture obtained in the step three, performing virtual osteotomy to obtain a tibial solid model after osteotomy, and then performing simulated implantation on the tibial solid model and a tibial prosthesis of a pre-obtained oxford unicondylar tibial prosthesis model database to obtain a personalized bone-prosthesis assembly model;
fifthly, designing a bone cutting guide plate according to the personalized bone-prosthesis assembly model obtained in the fourth step to obtain a personalized unicondylar tibia bone cutting guide plate model;
and step six, carrying out 3D printing on the personalized unicondylar tibia osteotomy guide plate model obtained in the step five to obtain a personalized tibia osteotomy guide plate.
Preferably, the step one comprises the following specific steps:
step 1.1, collecting double-lower-limb standing position full-length film and double-lower-limb CT (computed tomography) tomography data of an object;
step 1.2, carrying out image processing on double-lower-limb CT (computed tomography) tomography data through three-dimensional reconstruction software to obtain a target side lower limb three-dimensional geometric model;
and step 1.3, carrying out 2D/3D registration on the target side lower limb three-dimensional geometric model and the double lower limb standing position full-length sheet through an image registration function to obtain the target side lower limb three-dimensional geometric model with an output format STL in a load-bearing function position state.
Preferably, the step two specifically includes the steps of importing the target lower limb three-dimensional geometric model obtained in the step one into reverse engineering software to perform tibial force axis feature extraction, and converting the tibial force axis feature into an initial solid model with an output format of STL.
Preferably, the third step is specifically:
3.1, importing the initial solid model obtained in the second step into CAD design software, and determining a knee joint central point;
step 3.2, rotating the femur and pelvis model by 90 degrees along the sagittal plane by using the knee joint central point to obtain a knee joint 90-degree flexion posture solid model
Preferably, the step four is specifically:
step 4.1, determining a horizontal tibial osteotomy plane and a vertical tibial osteotomy plane of the solid model of the knee joint 90-degree-of-flexion posture obtained in the step three;
step 4.2, taking the horizontal osteotomy plane and the vertical osteotomy plane of the tibia as references, and performing virtual osteotomy on the tibia side by using a Boolean algorithm to obtain a tibia solid model;
step 4.3, the tibia solid model obtained in the step 4.2 is respectively implanted in a simulation mode with tibia prostheses in a pre-obtained oxford unicondylar tibia prosthesis model database;
step 4.4, judging the matching amplitude of the prosthesis and the bone bed, returning to the step 4.2 when the matching amplitude exceeds 2mm, and otherwise, entering the step 4.5;
and 4.5, selecting a personalized bone-prosthesis assembly model consisting of the tibia prosthesis with the highest coverage rate and the tibia solid model.
Preferably, the fifth step is specifically to design the osteotomy guide plate according to the personalized bone-prosthesis assembly model obtained in the fourth step, and obtain the personalized unicondylar tibia osteotomy guide plate model with the output format being STL format through boolean operation.
Preferably, the oxford unicondylar tibial prosthesis model database scans a plurality of oxford unicondylar tibial prosthesis real objects of different models through a laser three-dimensional scanner to obtain corresponding point cloud data, then packages and surface fits the point cloud through a reverse engineering method to obtain a plurality of corresponding three-dimensional models, and the plurality of three-dimensional models form the oxford unicondylar tibial prosthesis model database.
Preferably, the osteotomy guide plate is designed to be a horizontal osteotomy groove and a vertical osteotomy groove, a guide plate temporary fixation kirschner pin hole and a guide plate dissection attachment part.
Preferably, the image processing operation is at least one of defining denoising, a gray threshold, region growing, a morphological operation, a boolean operation, or three-dimensional editing.
Preferably, the line tibial force axis feature is extracted by fitting the tibial stem to an ideal cylinder, and taking the central axis of the ideal cylinder as the tibial force axis feature.
Preferably, the vertical osteotomy groove is connected with the horizontal osteotomy groove and forms an "L" shaped osteotomy groove.
Preferably, both ends of the vertical osteotomy groove are closed.
Preferably, the fixed kirschner wire hole is a passage through which the kirschner wire passes.
Preferably, the anatomical fit is obtained by curving a sheet of material in the osteotomy region of the tibial plateau.
Preferably, the three-dimensional reconstruction software is Mimics software, Simpleware software or 3D-doctor software.
Preferably, the reverse engineering software is Geomagic studio software or RapidForm software.
The invention discloses a preparation method of an individualized knee joint unicondylar replacement tibia accurate osteotomy guide plate, which comprises six steps. The invention has the following beneficial effects: 1. the object double-lower-limb standing position full-length film and knee joint CT tomography data are used as a three-dimensional reconstruction basis of the knee joint model of the weight bearing position, and the sources of the double-lower-limb standing position full-length film and the knee joint CT tomography data are reliable and easy to obtain. 2. According to the method, a tibial osteotomy guide plate design with high personalized anatomic matching degree is reversely constructed by adopting a reverse engineering technology modeling method, and finally, the personalized tibial osteotomy guide plate is printed out through 3D, so that the personalized precision can be improved to the greatest extent. 3. The invention can accurately evaluate the osteotomy amount of the object by virtual osteotomy, and can predetermine the model of the Jindan tibial prosthesis real object.
Drawings
The invention is further illustrated by means of the attached drawings, the content of which is not in any way limiting.
Fig. 1 is a flow chart of a personalized knee unicondylar replacement tibia accurate osteotomy guide.
Fig. 2 is a schematic diagram of a three-dimensional geometric model of the right lower limb of example 2.
FIG. 3 is a schematic diagram of an initial solid model of example 2.
Fig. 4 is a schematic view of the postural solid model of example 2 in which the right lower limb knee joint is bent by 90 °.
Fig. 5 is a schematic diagram of defining a horizontal tibial osteotomy plane of example 2.
Fig. 6 is a schematic diagram of the definition of the tibial vertical osteotomy plane of example 2.
Fig. 7 is a schematic view of the personalized bone-prosthesis assembly model of example 2.
Figure 8 is a schematic view of the personalized tibial osteotomy guide assembly of example 2.
Fig. 9 is a schematic structural view of a personalized tibial osteotomy guide.
Fig. 10 is another angle view of fig. 9.
Fig. 11 is another angle view of fig. 9.
Detailed Description
The technical solution of the present invention is further illustrated by the following examples.
Example 1.
A preparation method of an individualized knee joint unicondylar replacement tibia accurate osteotomy guide plate comprises the following steps:
the method comprises the following steps:
collecting double-lower-limb standing position full-length film and double-lower-limb CT (computed tomography) tomography data of a target to obtain a target side lower limb three-dimensional geometric model in a load-bearing functional position state;
secondly, carrying out tibial force axis characteristic extraction on the target lower limb three-dimensional geometric model obtained in the first step and converting the tibial force axis characteristic into an initial solid model;
step three, rotating the initial solid model obtained in the step two by 90 degrees along a sagittal plane to obtain a knee joint flexion 90-degree body position solid model;
step four, determining a horizontal tibial osteotomy plane and a vertical tibial osteotomy plane of the solid model of the knee joint with 90-degree flexion posture obtained in the step three, performing virtual osteotomy to obtain a tibial solid model after osteotomy, and then performing simulated implantation on the tibial solid model and a tibial prosthesis of a pre-obtained oxford unicondylar tibial prosthesis model database to obtain a personalized bone-prosthesis assembly model;
fifthly, designing a bone cutting guide plate according to the personalized bone-prosthesis assembly model obtained in the fourth step to obtain a personalized unicondylar tibia bone cutting guide plate model;
and step six, carrying out 3D printing on the personalized unicondylar tibia osteotomy guide plate model obtained in the step five to obtain a personalized tibia osteotomy guide plate.
The method comprises the following specific steps:
step 1.1, collecting double-lower-limb standing position full-length film and double-lower-limb CT (computed tomography) tomography data of an object;
step 1.2, carrying out image processing on double-lower-limb CT (computed tomography) tomography data through three-dimensional reconstruction software to obtain a target side lower limb three-dimensional geometric model;
and step 1.3, carrying out 2D/3D registration on the target side lower limb three-dimensional geometric model and the double lower limb standing position full-length sheet through an image registration function to obtain the target side lower limb three-dimensional geometric model with an output format STL in a load-bearing function position state.
And step two, specifically, importing the target lower limb three-dimensional geometric model obtained in the step one into reverse engineering software to extract the tibial force axis characteristics, and converting the tibial force axis characteristics into an initial solid model with an output format of STL.
Wherein, the third step is specifically as follows:
3.1, importing the initial solid model obtained in the second step into CAD design software, and determining a knee joint central point;
and 3.2, rotating the femur and pelvis models by 90 degrees along a sagittal plane by using the knee joint central point to obtain a knee joint flexion 90-degree body position solid model.
Wherein, the step four is specifically as follows:
step 4.1, determining a horizontal tibial osteotomy plane and a vertical tibial osteotomy plane of the solid model of the knee joint 90-degree-of-flexion posture obtained in the step three;
step 4.2, taking the horizontal osteotomy plane and the vertical osteotomy plane of the tibia as references, and performing virtual osteotomy on the tibia side by using a Boolean algorithm to obtain a tibia solid model;
step 4.3, the tibia solid model obtained in the step 4.2 is respectively implanted in a simulation mode with tibia prostheses in a pre-obtained oxford unicondylar tibia prosthesis model database;
step 4.4, judging the matching amplitude of the prosthesis and the bone bed, returning to the step 4.2 when the matching amplitude exceeds 2mm, and otherwise, entering the step 4.5;
and 4.5, selecting a personalized bone-prosthesis assembly model consisting of the tibia prosthesis with the highest coverage rate and the tibia solid model.
And step five, specifically, designing a bone cutting guide plate according to the personalized bone-prosthesis assembly model obtained in the step four, and forming a personalized unicondylar tibia cutting guide plate model with an output format of STL format through Boolean operation.
The oxford unicondylar tibial prosthesis model database scans a plurality of oxford unicondylar tibial prosthesis real objects of different models through a laser three-dimensional scanner to obtain corresponding point cloud data, then packages and fits a curved surface of the point cloud through a reverse engineering method to obtain a plurality of corresponding three-dimensional models, and the oxford unicondylar tibial prosthesis model database is formed by the three-dimensional models.
The image processing operation of the present invention is to define at least one of denoising, gray level threshold, region growing, morphological operation, boolean operation, or three-dimensional editing.
The tibia force axis characteristic extraction method is characterized in that tibia is fitted into an ideal cylinder, and the central axis of the ideal cylinder is used as the tibia force axis characteristic.
The osteotomy guide plate is designed into a horizontal osteotomy groove and a vertical osteotomy groove, a guide plate temporary fixing kirschner pin hole and a guide plate dissecting and attaching part.
Wherein the fixed kirschner wire hole is a channel through which the kirschner wire passes. Wherein, the vertical osteotomy groove is connected with the horizontal osteotomy groove and forms an L-shaped osteotomy groove. Wherein both ends of the vertical osteotomy groove are closed. Wherein, dissect the laminating portion and obtain through cutting the regional curved sheet of bone to the tibial plateau.
It should be noted that the vertical osteotomy slots with two closed ends are used for limiting the reciprocating saw to move along the horizontal osteotomy plane of the tibia in the operation, and preventing the reciprocating saw from excessively cutting towards the outer side to cause injury to the collateral ligament. The function of the fixation kirschner pin hole is a guiding function. The anatomy fitting part is used for specifically fitting to maintain the match of the osteotomy guide plate and the tibia anatomy surface.
The three-dimensional reconstruction software is Mimics software, Simpleware software or 3D-doctor software. The reverse engineering software is Geomagic studio software or RapidForm software.
The preparation method of the individualized knee joint unicondylar replacement tibia accurate osteotomy guide plate comprises six steps. The invention has the following beneficial effects: 1. the object double-lower-limb standing position full-length film and knee joint CT tomography data are used as a three-dimensional reconstruction basis of the knee joint model of the weight bearing position, and the sources of the double-lower-limb standing position full-length film and the knee joint CT tomography data are reliable and easy to obtain. 2. According to the method, a tibial osteotomy guide plate design with high personalized anatomic matching degree is reversely constructed by adopting a reverse engineering technology modeling method, and finally, the personalized tibial osteotomy guide plate is printed out through 3D, so that the personalized precision can be improved to the greatest extent. 3. The invention can accurately evaluate the osteotomy amount of the object by virtual osteotomy, and can predetermine the model of the Jindan tibial prosthesis real object.
Example 2.
A preparation method of an individualized knee joint unicondylar replacement tibia accurate osteotomy guide plate is explained by taking a right lower limb as a target lower limb.
Step one, collecting double lower limb standing position full-length film and double lower limb CT tomoscan data of a target to obtain a target side lower limb three-dimensional geometric model in a load-bearing functional position state, as shown in figure 2.
And step two, carrying out tibia force axis feature extraction on the target lower limb three-dimensional geometric model obtained in the step one, and converting the tibia force axis feature extraction into an initial solid model, as shown in fig. 3.
And step three, rotating the initial solid model obtained in the step two by 90 degrees along the sagittal plane to obtain a knee joint flexion 90-degree body position solid model, as shown in fig. 4.
And step four, determining a horizontal tibial osteotomy plane and a vertical tibial osteotomy plane of the solid model of the knee joint in the 90-degree flexion posture obtained in the step three, performing virtual osteotomy to obtain a tibial solid model after osteotomy, and performing simulated implantation on the tibial solid model and a tibial prosthesis of a pre-obtained oxford unicondylar tibial prosthesis model database to obtain a personalized bone-prosthesis assembly model.
And step five, carrying out osteotomy guide plate design according to the personalized bone-prosthesis assembly model obtained in the step four to obtain a personalized unicondylar tibia osteotomy guide plate model.
And step six, performing 3D printing on the personalized unicondylar tibial resection guide model obtained in the step five to obtain a personalized tibial resection guide, as shown in figures 9 to 11.
Defining the tibial force axis obtained in the step two in CAD design software, projecting the tibial force axis to a sagittal plane to obtain a straight line A, and making a straight line B in the sagittal plane to be vertical to the straight line A; then stretching the straight line B along the normal direction of the sagittal plane to obtain a plane A; and then, a plane B parallel to the plane A is made through the lowest point of the inner compartment of the tibial plateau, the plane B is rotated by 7 degrees along the X-axis direction to obtain a plane C, the plane C is further moved downwards by 3mm along the direction of the straight line A to obtain a final horizontal osteotomy plane D, and the retroversion osteotomy angle and the osteotomy position of the tibial horizontal osteotomy are simulated, as shown in figure 5.
The method for determining the vertical osteotomy plane in this embodiment is to select a feature point slightly inside an anterior cruciate ligament insertion point on a 90-degree knee bending posture, approach the tibial intercondylar crest as close as possible, point the direction to the highest point of the anterior superior iliac spine, establish a vertical osteotomy plane, and simulate the vertical osteotomy of the tibia, as shown in fig. 6.
The method comprises the following specific steps:
step 1.1, collecting double-lower-limb standing position full-length film and double-lower-limb CT (computed tomography) tomography data of an object;
step 1.2, carrying out image processing on double-lower-limb CT (computed tomography) tomography data through three-dimensional reconstruction software to obtain a target side lower limb three-dimensional geometric model;
and step 1.3, carrying out 2D/3D registration on the target side lower limb three-dimensional geometric model and the double lower limb standing position full-length sheet through an image registration function to obtain the target side lower limb three-dimensional geometric model with an output format STL in a load-bearing function position state.
And step two, specifically, importing the target lower limb three-dimensional geometric model obtained in the step one into reverse engineering software to extract the tibial force axis characteristics, and converting the tibial force axis characteristics into an initial solid model with an output format of STL.
Wherein, the third step is specifically as follows:
3.1, importing the initial solid model obtained in the second step into CAD design software, and determining a knee joint central point;
and 3.2, rotating the femur and pelvis models by 90 degrees along a sagittal plane by using the knee joint central point to obtain a knee joint flexion 90-degree body position solid model.
Wherein, the step four is specifically as follows:
step 4.1, determining a horizontal tibial osteotomy plane and a vertical tibial osteotomy plane of the solid model of the knee joint 90-degree-of-flexion posture obtained in the step three;
step 4.2, taking the horizontal osteotomy plane and the vertical osteotomy plane of the tibia as references, and performing virtual osteotomy on the tibia side by using a Boolean algorithm to obtain a tibia solid model;
step 4.3, the tibia solid model obtained in the step 4.2 is respectively implanted in a simulation mode with tibia prostheses in a pre-obtained oxford unicondylar tibia prosthesis model database;
step 4.4, judging the matching amplitude of the prosthesis and the bone bed, returning to the step 4.2 when the matching amplitude exceeds 2mm, and otherwise, entering the step 4.5;
and 4.5, selecting a personalized bone-prosthesis assembly model consisting of the tibial prosthesis with the highest coverage rate and the tibial solid model, as shown in fig. 7.
The fifth step is specifically to design the osteotomy guide plate according to the personalized bone-prosthesis assembly model obtained in the fourth step, and obtain a personalized unicondylar tibia osteotomy guide plate model with an output format of STL format through Boolean operation composition, and fig. 8 is shown.
The preparation method of the individualized knee joint unicondylar replacement tibia accurate osteotomy guide plate comprises six steps. The invention has the following beneficial effects: 1. the object double-lower-limb standing position full-length film and knee joint CT tomography data are used as a three-dimensional reconstruction basis of the knee joint model of the weight bearing position, and the sources of the double-lower-limb standing position full-length film and the knee joint CT tomography data are reliable and easy to obtain. 2. According to the method, a tibial osteotomy guide plate design with high personalized anatomic matching degree is reversely constructed by adopting a reverse engineering technology modeling method, and finally, the personalized tibial osteotomy guide plate is printed out through 3D, so that the personalized precision can be improved to the greatest extent. 3. The invention can accurately evaluate the osteotomy amount of the object by virtual osteotomy, and can predetermine the model of the Jindan tibial prosthesis real object.
Finally, it should be noted that the above embodiments are only used for illustrating the technical solutions of the present invention and not for limiting the protection scope of the present invention, and although the present invention is described in detail with reference to the preferred embodiments, it should be understood by those skilled in the art that modifications or equivalent substitutions can be made on the technical solutions of the present invention without departing from the spirit and scope of the technical solutions of the present invention.
Claims (10)
1. A preparation method of an individualized knee joint unicondylar replacement tibia accurate osteotomy guide plate is characterized by comprising the following steps:
collecting double-lower-limb standing position full-length film and double-lower-limb CT (computed tomography) tomography data of a target to obtain a target side lower limb three-dimensional geometric model in a load-bearing functional position state;
secondly, carrying out tibial force axis characteristic extraction on the target lower limb three-dimensional geometric model obtained in the first step and converting the tibial force axis characteristic into an initial solid model;
step three, rotating the initial solid model obtained in the step two by 90 degrees along a sagittal plane to obtain a knee joint flexion 90-degree body position solid model;
step four, determining a horizontal tibial osteotomy plane and a vertical tibial osteotomy plane of the solid model of the knee joint with 90-degree flexion posture obtained in the step three, performing virtual osteotomy to obtain a tibial solid model after osteotomy, and then performing simulated implantation on the tibial solid model and a tibial prosthesis of a pre-obtained oxford unicondylar tibial prosthesis model database to obtain a personalized bone-prosthesis assembly model;
fifthly, designing a bone cutting guide plate according to the personalized bone-prosthesis assembly model obtained in the fourth step to obtain a personalized unicondylar tibia bone cutting guide plate model;
and step six, performing 3D printing on the personalized unicondylar tibia osteotomy guide plate model obtained in the step five to obtain the personalized tibia osteotomy guide plate.
2. The preparation method of the precise tibial resection guide for the unicondylar replacement of the knee joint according to claim 1, wherein the step one is as follows:
step 1.1, collecting double-lower-limb standing position full-length film and double-lower-limb CT (computed tomography) tomography data of an object;
step 1.2, carrying out image processing on double-lower-limb CT (computed tomography) tomography data through three-dimensional reconstruction software to obtain a target side lower limb three-dimensional geometric model;
and step 1.3, carrying out 2D/3D registration on the target side lower limb three-dimensional geometric model and the double lower limb standing position full-length sheet through an image registration function to obtain the target side lower limb three-dimensional geometric model with an output format STL in a load-bearing function position state.
3. The preparation method of the precise tibial resection guide for the unicondylar replacement of the knee joint according to claim 2, wherein the precise tibial resection guide comprises: and step two, specifically, importing the target lower limb three-dimensional geometric model obtained in the step one into reverse engineering software to extract the tibial force axis characteristics, and converting the tibial force axis characteristics into an initial solid model with an output format of STL.
4. The preparation method of the precise tibial resection guide for the unicondylar replacement of the knee joint according to claim 3, wherein the third step is specifically:
3.1, importing the initial solid model obtained in the second step into CAD design software, and determining a knee joint central point;
and 3.2, rotating the femur and pelvis models by 90 degrees along a sagittal plane by using the knee joint central point to obtain a knee joint flexion 90-degree body position solid model.
5. The preparation method of the precise tibial resection guide for the unicondylar replacement of the knee joint according to claim 4, wherein the fourth step is specifically:
step 4.1, determining a horizontal tibial osteotomy plane and a vertical tibial osteotomy plane of the solid model of the knee joint 90-degree-of-flexion posture obtained in the step three;
step 4.2, taking the horizontal osteotomy plane and the vertical osteotomy plane of the tibia as references, and performing virtual osteotomy on the tibia side by using a Boolean algorithm to obtain a tibia solid model;
step 4.3, the tibia solid model obtained in the step 4.2 is respectively implanted in a simulation mode with tibia prostheses in a pre-obtained oxford unicondylar tibia prosthesis model database;
step 4.4, judging the matching amplitude of the prosthesis and the bone bed, returning to the step 4.2 when the matching amplitude exceeds 2mm, and otherwise, entering the step 4.5;
and 4.5, selecting a personalized bone-prosthesis assembly model consisting of the tibia prosthesis with the highest coverage rate and the tibia solid model.
6. The preparation method of the precise tibial resection guide for the unicondylar replacement of the knee joint according to claim 5, wherein the precise tibial resection guide comprises: and step five specifically comprises the step of designing a bone cutting guide plate according to the personalized bone-prosthesis assembly model obtained in the step four, and obtaining a personalized unicondylar tibia cutting guide plate model with an output format of STL format through Boolean operation composition.
7. The preparation method of the precise tibial resection guide for the unicondylar replacement of the knee joint according to claim 6, wherein the precise tibial resection guide comprises: the oxford unicondylar tibial prosthesis model database scans a plurality of oxford unicondylar tibial prosthesis real objects with different models through a laser three-dimensional scanner to obtain corresponding point cloud data, then the point cloud is packaged and subjected to surface fitting through a reverse engineering method to obtain a plurality of corresponding three-dimensional models, and the oxford unicondylar tibial prosthesis model database is formed by the three-dimensional models.
8. The method for preparing the precise tibial resection guide for the unicondylar replacement of the knee joint according to claim 7, wherein the precise tibial resection guide comprises: the osteotomy guide plate is designed into a horizontal osteotomy groove and a vertical osteotomy groove, a guide plate temporary fixation kirschner pin hole and a guide plate dissection fitting part;
the image processing operation is at least one of denoising definition, gray threshold definition, region growing definition, morphological operation, Boolean operation or three-dimensional editing definition;
the tibia force axis characteristic is extracted by fitting the tibia stem to an ideal cylinder, and taking the central axis of the ideal cylinder as the tibia force axis characteristic.
9. The method for preparing the precise tibial resection guide for the unicondylar replacement of the knee joint according to claim 8, wherein the precise tibial resection guide comprises: the vertical osteotomy groove is connected with the horizontal osteotomy groove to form an L-shaped osteotomy groove;
the two ends of the vertical osteotomy groove are closed;
the fixed Kirschner wire hole is a channel through which the Kirschner wire passes;
the dissection attachment is obtained by a curved sheet for the tibial plateau osteotomy region.
10. The method for preparing the precise tibial resection guide for the unicondylar replacement of the knee joint according to claim 9, wherein the precise tibial resection guide comprises: the three-dimensional reconstruction software is Mimics software, Simpleware software or 3D-doctor software;
the reverse engineering software is Geomagic studio software or RapidForm software.
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Cited By (9)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113919020A (en) * | 2021-09-24 | 2022-01-11 | 北京长木谷医疗科技有限公司 | Guide plate design method for unicondylar replacement and related equipment |
| CN114073606A (en) * | 2022-01-07 | 2022-02-22 | 北京威高智慧科技有限公司 | Simulation bone cutting method |
| CN114159142A (en) * | 2021-09-30 | 2022-03-11 | 国家康复辅具研究中心 | Design method of auxiliary guide plate for tibial external fixator installation based on artificial intelligence deep learning |
| CN115624366A (en) * | 2022-09-21 | 2023-01-20 | 北京长木谷医疗科技有限公司 | Detection system, method and device for positioning tool for knee joint replacement |
| CN116747055A (en) * | 2023-08-18 | 2023-09-15 | 浙江大学 | Knee joint prosthesis and manufacturing method thereof |
| CN117017418A (en) * | 2023-08-09 | 2023-11-10 | 北京大学第三医院（北京大学第三临床医学院） | Ankle joint personalized osteotomy and bone grafting guiding device and application thereof |
| CN117017415A (en) * | 2023-10-07 | 2023-11-10 | 杭州键嘉医疗科技股份有限公司 | Tibia osteotome used in unicondylar replacement surgery navigation and application method thereof |
| WO2023231522A1 (en) * | 2022-05-31 | 2023-12-07 | 北京长木谷医疗科技有限公司 | Personalized intelligent navigation and positioning apparatus and method for unicompartmental knee arthroplasty |
| CN119112333A (en) * | 2024-11-12 | 2024-12-13 | 北京理贝尔生物工程研究所有限公司 | Method and device for determining a plate internal fixation system for bone defect reconstruction |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103860294A (en) * | 2014-03-07 | 2014-06-18 | 北京大学第三医院 | Individualized design and manufacturing system and method for full knee joint replacing prosthesis |
| TW201917611A (en) * | 2017-10-23 | 2019-05-01 | 國立虎尾科技大學 | Preoperative planning method for human knee joint repair operation for assisting the physician in simulating the cut size of the hard bone and the state of the artificial joint assembled on the human knee joint before the human knee joint repair operation |
| CN110393572A (en) * | 2019-07-30 | 2019-11-01 | 西安市红会医院 | Preparation method of a personalized 3D printed tibial high osteotomy guide plate |
-
2021
- 2021-05-08 CN CN202110499865.7A patent/CN113317843B/en active Active
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103860294A (en) * | 2014-03-07 | 2014-06-18 | 北京大学第三医院 | Individualized design and manufacturing system and method for full knee joint replacing prosthesis |
| TW201917611A (en) * | 2017-10-23 | 2019-05-01 | 國立虎尾科技大學 | Preoperative planning method for human knee joint repair operation for assisting the physician in simulating the cut size of the hard bone and the state of the artificial joint assembled on the human knee joint before the human knee joint repair operation |
| CN110393572A (en) * | 2019-07-30 | 2019-11-01 | 西安市红会医院 | Preparation method of a personalized 3D printed tibial high osteotomy guide plate |
Non-Patent Citations (1)
| Title |
|---|
| 吴碧: "3D打印个体化股骨远端截骨导板在全膝关节置换术中的应用研究", 《中国优秀硕士学位论文全文数据库 医药卫生科技辑》 * |
Cited By (14)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113919020A (en) * | 2021-09-24 | 2022-01-11 | 北京长木谷医疗科技有限公司 | Guide plate design method for unicondylar replacement and related equipment |
| CN113919020B (en) * | 2021-09-24 | 2023-12-12 | 北京长木谷医疗科技股份有限公司 | Method for designing guide plate for unicondylar replacement and related equipment |
| CN114159142A (en) * | 2021-09-30 | 2022-03-11 | 国家康复辅具研究中心 | Design method of auxiliary guide plate for tibial external fixator installation based on artificial intelligence deep learning |
| CN114073606A (en) * | 2022-01-07 | 2022-02-22 | 北京威高智慧科技有限公司 | Simulation bone cutting method |
| CN114073606B (en) * | 2022-01-07 | 2022-05-17 | 北京威高智慧科技有限公司 | Simulation bone cutting system |
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| CN116747055B (en) * | 2023-08-18 | 2023-11-07 | 浙江大学 | Knee joint prosthesis and manufacturing method thereof |
| CN116747055A (en) * | 2023-08-18 | 2023-09-15 | 浙江大学 | Knee joint prosthesis and manufacturing method thereof |
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