A hip joint surgical guide

Abstract

The application discloses a hip joint surgery guide plate which is arranged on a patient's acetabulum and is used for guiding acetabular reamer and cup prosthesis implantation. The hip joint surgery guide plate comprises a matching plate, a rotating arm and a guide needle. The bottom surface of the matching plate is provided with a matching surface which is attached to the rear upper end surface of the acetabulum and crosses the edge of the acetabulum. The top surface of the matching plate is provided with a positioning pin. One end of the rotating arm is provided with a positioning hole which is matched with the positioning pin. The other end of the rotating arm is provided with a guide hole. The axis of the positioning hole is parallel to the axis of the guide hole. The curvature of the edge of the acetabulum changes greatly. Therefore, the application has good matching property and is easy to find a matching position. The guide hole can rotate around the positioning pin through the cooperation of the positioning pin and the positioning hole. Therefore, the guide hole can be rotated to a flat bone surface. The guide needle can be placed along the guide hole, the interference of other instruments in the operation is reduced, the flexibility is higher, the guide needle is placed in the flat bone surface, the guide needle will not deviate when being placed, and the guiding precision is high.

Description

TECHNICAL FIELD

[0001] The present application relates to the field of medical devices, in particular to a hip joint surgery guide plate. BACKGROUND

[0002] In total hip arthroplasty, whether the cup prosthesis can be installed accurately is a key factor affecting the postoperative effect. Poor position of the cup prosthesis can cause complications such as prosthesis loosening, wear and dislocation. Due to the particularity of the acetabular anatomical structure, the placement of the cup prosthesis not only needs to consider the position and good bone coverage of the cup prosthesis, but also needs to accurately control the orientation. However, the anteversion angle and the abduction angle are difficult to accurately judge and adjust in space. At present, most doctors place the cup prosthesis manually according to experience. The uncertainty of human operation makes the postoperative effect of patients vary with the surgeon.

[0003] Therefore, how to provide a guiding device for guiding the implantation direction of the acetabular reamer and the cup prosthesis in total hip arthroplasty is a technical problem to be solved by the present application. SUMMARY

[0004] Therefore, the main purpose of the present application is to provide a hip joint surgery guide plate for guiding the implantation of the acetabular reamer and the cup prosthesis in total hip arthroplasty, and improving the placement accuracy of the cup prosthesis.

[0005] An embodiment of the present application provides a hip joint surgery guide plate arranged on the acetabulum of a patient for guiding the implantation of the acetabular reamer and the cup prosthesis, characterized in that the hip joint surgery guide plate comprises a matching plate, a rotating arm and a guide needle; wherein the bottom surface of the matching plate has a matching surface capable of fitting the upper end surface of the acetabulum and the edge of the acetabulum, and the top surface of the matching plate is provided with a positioning pin; one end of the rotating arm is provided with a positioning hole matched with the positioning pin, and the other end is provided with a guide hole, and the axis of the positioning hole is parallel to the axis of the guide hole; the guide needle is matched with the guide hole in a clearance. Since the curvature of the acetabular edge changes greatly, the matching plate can easily find the matching position during use, and the matching accuracy is high; the matching plate and the rotating arm are arranged at the back of the acetabulum, the positioning pin and the positioning hole are matched, the guide hole can rotate around the positioning pin, so that the guide hole can be rotated to the flat bone surface and the guide needle is placed along the guide hole; since the needle placement position can be selected, the interference of other instruments during the operation is reduced, the flexibility is higher, and the guide needle is placed in the flat bone surface and will not deviate during placement.

[0006] Optionally, in the embodiment of the present application, the top surface profile of the matching plate is a pentagon, the profile width is 10-60mm, and the profile length is 8-40mm.

[0007] Preferably, in the embodiments of the present application, the matching plate comprises an indicating edge, which is parallel to the acetabular notch in use, and can indicate the placement position of the matching plate.

[0008] Preferably, in the embodiments of the present application, the positioning shaft is located at the end of the top surface of the matching plate.

[0009] Preferably, in the embodiments of the present application, the taper of the positioning pin and the positioning hole is 0-50°.

[0010] Optionally, in the embodiments of the present application, the length of the rotating arm is 15-50 mm.

[0011] Preferably, in the embodiments of the present application, the hip joint surgery guide plate further comprises a positioning needle; the matching plate comprises a first positioning through hole, the axis of which is parallel to the axis of the positioning pin; the rotating arm comprises a second positioning through hole, the axis of which is parallel to the axis of the positioning hole; the positioning hole is assembled on the positioning pin, and the first positioning through hole and the second positioning through hole form a channel for the positioning needle to pass through. The positioning needle is placed into the bone surface after passing through the first positioning through hole and the second positioning through hole, thereby assisting in fixing the matching plate and the rotating arm and increasing the stability of the hip joint surgery guide plate.

[0012] Optionally, in the embodiments of the present application, the matching plate further comprises an acetabular center marking hole, through which the center position of the acetabulum can be found, serving as the starting point of the acetabular reamer.

[0013] Optionally, in the embodiments of the present application, the hip joint surgery guide plate further comprises a mold, which has a mold inner surface matching the shape of the acetabulum, and the matching plate is placed on the mold with the rear end surface of the matching plate being coplanar with the rear end surface of the mold. Before the matching plate is placed on the acetabulum, the matching plate can be placed on the mold for matching, and the placement position of the matching plate on the acetabulum can be found by observing the relative position of the guide plate and the mold.

[0014] Optionally, in the embodiments of the present application, the bottom surface of the matching plate is stepped, the rear end thereof is a matching surface, and the front end thereof is a non-matching surface. This is mainly for the acetabular fossa with poor image data reliability or bone defect, so as to reduce the inaccurate matching surface and reduce the matching error.

[0015] The second aspect of the present application provides a method for constructing the matching plate and the rotating arm model of the hip joint surgery guide plate, which comprises the following steps:

[0016] 1) Select the pelvic region on the CT data comprising the acetabulum, and draw a three-dimensional model of the pelvis.

[0017] 2) Erase the femoral head voxels, and segment the acetabulum.

[0018] 3) Reconstruct the pelvis coordinate system with the first axis as the direction of the plane where the bilateral anterior superior iliac spine and pubic tubercle are located, the second axis as the direction of the pelvis symmetry plane, and the third axis as the direction perpendicular to the first axis and the second axis;

[0019] 4) In the pelvis coordinate system, plan the anteversion angle and abduction angle of the acetabular cup prosthesis according to the acetabular anatomical structure;

[0020] 5) Construct the contour line of the top surface of the matching plate and the center rotation track line of the guide hole in a plane perpendicular to the direction of the acetabular cup prosthesis opening;

[0021] 6) Adjust the contour of the top surface of the matching plate to cover the upper rear of the acetabulum and across the acetabular edge;

[0022] 7) Set the radius of the center rotation track line of the guide hole so that the center rotation track line of the guide hole covers the flat bone surface;

[0023] 8) Construct the matching plate and the rotating arm model, wherein the matching surface of the bottom surface of the matching plate is attached to the acetabular surface.

[0024] Preferably, the contour line of the top surface of the matching plate in step 5) further comprises a contour line of the center marking hole of the acetabulum.

[0025] As can be seen from the above technical solutions, the hip joint surgery guide plate provided by the embodiments of the present application matches the upper rear end surface of the acetabulum and the acetabular edge. Since the acetabular edge has a high curvature change, the matching precision of the hip joint surgery guide plate provided by the present application is high and the matching surface is easy to find. The matching plate and the rotating arm are arranged at the rear of the acetabulum. The rotating arm is rotated, the flat bone surface is selected, and the guide pin is placed through the guide hole. Since the needle placement site can be selected, the interference of other instruments during the operation is reduced, the flexibility is higher, and the guide pin is placed in the flat bone surface. The guide pin will not deviate when placed, and the guide precision is high. BRIEF DESCRIPTION OF DRAWINGS

[0026] In order to more clearly illustrate the technical solutions in the embodiments of the present application or the prior art, the drawings needed to be used in the embodiments or the prior art description will be briefly introduced below. Obviously, the drawings in the following description are only some embodiments described in the embodiments of the present application. Those skilled in the art can also obtain other drawings from these drawings.

[0027] Figure 1 It is a structure schematic diagram of the first embodiment of the present application and the acetabulum.

[0028] Figure 2 It is another view structure schematic diagram of the first embodiment of the present application and the acetabulum.

[0029] Figure 3 It is another view structure schematic diagram of the first embodiment of the present application and the acetabulum.Figure 1 Schematic view of the embodiment group on the acetabulum;

[0030] Figure 4 Assembly view of the second embodiment;

[0031] Figure 5 Schematic view of the matching plate structure of an embodiment;

[0032] Figure 6 Schematic view of the reconstructed pelvis structure;

[0033] Figure 7 Schematic view of the pelvis divided into posterior and anterior parts;

[0034] Figure 8 Schematic view of the establishment of the first axis;

[0035] Figure 9 Schematic view of the establishment of the second axis;

[0036] Figure 10 Schematic view of the pelvis and the pelvis coordinate system;

[0037] Figure 11 Schematic view of the planned acetabular cup prosthesis installation orientation;

[0038] Figure 12 Schematic view of the matching plate top surface profile line and guide hole center rotation trajectory line;

[0039] Figure 13 Schematic view of the construction of the matching plate and the rotating arm.

[0040] Element reference

[0041] 1 hip joint surgery guide plate

[0042] 11 matching plate

[0043] 111 matching surface

[0044] 112 positioning pin

[0045] 113 first positioning through hole

[0046] 114 acetabular center marking hole

[0047] 115 indication edge

[0048] 116 rear end surface

[0049] 117 non-matching surface

[0050] 12 rotating arm

[0051] 121 positioning hole

[0052] 122 guide hole

[0053] 123 second positioning through hole

[0054] 13 guide pin

[0055] 14 positioning pin

[0056] 15 die

[0057] 151 inner surface of the die

[0058] 152 rear end surface of the die

[0059] 2 acetabulum

[0060] 21 upper rear end surface of the acetabulum

[0061] 22 acetabular rim

[0062] 23 acetabular notch

[0063] 3 pelvis

[0064] 4 pelvis coordinate system

[0065] 41 first axis

[0066] 42 second axis

[0067] 43 third axis

[0068] 5 acetabular cup prosthesis model

[0069] 6 top surface profile line of the matching plate

[0070] 61 acetabular center mark hole profile line

[0071] 7 guide hole center rotation trajectory line DETAILED DESCRIPTION

[0072] In order to make the personnel in the art better understand the technical solutions in the embodiments of the present application, the technical solutions in the embodiments of the present application will be clearly and completely described below in conjunction with the drawings in the embodiments of the present application. Obviously, the described embodiments are only some of the embodiments of the present application, not all the embodiments. Based on the embodiments in the embodiments of the present application, all other embodiments obtained by those of ordinary skill in the art should belong to the scope of protection of the embodiments of the present application.

[0073] The hip joint surgery guide plate set provided by the present application is arranged on the acetabulum of a patient, and is used for guiding the acetabular reamer and the acetabular cup prosthesis implantation. Figure 1 The hip joint surgery guide plate and the structure of the acetabulum provided by the first embodiment of the present application are shown in the structure diagram. Figure 2 The hip joint surgery guide plate and the structure of the acetabulum provided by the first embodiment of the present application are shown in the structure diagram. Figure 1 ,Figure 2 As shown in the drawings, the hip joint surgery guide plate 1 provided by the first embodiment of the present application comprises a matching plate 11, a rotating arm 12 and a guide needle 13; wherein the bottom surface of the matching plate 11 is provided with a matching surface 111, which can be attached to the posterior superior end surface 21 of the acetabulum and the acetabular edge 22, and the top surface of the matching plate is provided with a positioning pin 112; one end of the rotating arm 12 is provided with a positioning hole 121 matched with the positioning pin 112, and the other end is provided with a guide hole 122; the axis of the positioning hole 121 is parallel to the axis of the guide hole 122; the guide needle 13 is matched with the guide hole 122 in a clearance.

[0074] As shown in the drawings, Figure 1 , Figure 2 As shown in the drawings, the hip joint surgery guide plate 1 provided by the first embodiment of the present application further comprises a positioning needle 14, the matching plate 11 comprises a first positioning through hole 113, the axis of which is parallel to the axis of the positioning pin 112; the rotating arm comprises a second positioning through hole 123, the axis of which is parallel to the axis of the positioning hole 121; as shown in the drawings, Figure 3 When the positioning pin 112 is matched with the positioning hole 121, the first positioning through hole 113 and the second positioning through hole 123 are through, forming a channel through which the positioning needle 14 passes.

[0075] As shown in the drawings, Figure 3 The matching plate 11 of the hip joint surgery guide plate 1 provided by the first embodiment of the present application is further provided with an acetabular center marking hole 114, through which the center position of the acetabulum can be found, serving as the starting point of the acetabular grinding.

[0076] As shown in the drawings, Figure 3 On the matching plate 11 of the hip joint surgery guide plate 1 provided by the first embodiment of the present application, there is an indication edge 115, which is placed parallel to the acetabular notch 23 during use, indicating the placement position of the matching plate 11.

[0077] As shown in the drawings, Figure 3 During use: 1) the matching position is found by the matching relationship between the matching surface 111 and the posterior superior end surface 21 of the acetabulum and the acetabular edge 22 (in this embodiment, the indication edge 115 can also be aligned with the acetabular notch 23 to assist in finding the placement position of the matching plate, reducing the operation time); 2) the rotating arm is assembled on the matching plate by matching the positioning pin 112 with the positioning hole 121 (optionally, in this embodiment, the fixed needle 14 is placed into the bone surface after passing through the first positioning through hole 113 and the second positioning through hole 123, assisting in fixing the matching plate 11 and the rotating arm 12); 3) the rotating arm 12 is rotated, and the guide needle is placed into the guide hole along the guide hole; 4) the initial grinding position is marked by the acetabular center marking hole 114; 5) the fixed needle 14, the rotating arm 12 and the matching plate 11 are sequentially removed, and the grinding and acetabular cup prosthesis implantation can be guided along the direction of the guide needle 13.

[0078] Figure 4 For the assembly drawing of the second embodiment, in the second embodiment, the hip joint surgery guide plate 1 includes a matching plate 11, a rotating arm 12, a guide needle 13, a fixed needle 14, and a matching mold 15. The structure and function of the matching plate 11, the rotating arm 12, the guide needle 13, and the fixed needle 14 are the same as those of the first embodiment, and will not be described again.

[0079] As shown in Figure 4 , the matching mold 15 has a matching mold inner surface 151 that matches the shape of the acetabulum, and the matching mold rear end surface 152 is coplanar with the matching plate rear end surface 116 when the matching plate cooperates with the matching mold. Before placing the matching plate 11 on the acetabulum 2, the matching plate 11 can be placed on the matching mold 15 for matching, and the placement position of the matching plate 11 on the acetabulum 2 can be quickly found by observing the relative position of the matching plate 11 and the matching mold 15, thereby shortening the operation time.

[0080] Figure 5 As shown in , in an embodiment, the bottom surface of the matching plate 11 is stepped, the rear end is a matching surface 111, and the front end is a non-matching surface 117. This structure is mainly aimed at image data with poor reliability or image data with bone defect acetabular fossa, reduces the matching surface, and reduces the matching error.

[0081] Figures 6-13 The model design process of the matching plate 11 and the rotating arm 12 of an embodiment of the present application.

[0082] 1) As shown in Figure 6 , select the pelvic region on the CT data containing the acetabulum, and draw a pelvic three-dimensional model 3;

[0083] 2) As shown in Figure 7 , erase the femoral head voxels and segment the acetabulum;

[0084] 3) As shown in Figure 8 , take the direction of the bilateral anterior superior iliac spine and pubic tubercle as the first axis 41; as shown in Figure 9 ; take the direction of the pelvic symmetry plane as the second axis 42, as shown in Figure 10 ; take the direction perpendicular to the first axis 41 and the second axis 42 as the third axis 43, and reconstruct the pelvic coordinate system 4;

[0085] 4) As shown in Figure 11 , under the pelvic coordinate system 4, according to the anatomical structure of the acetabulum, plan the anteversion angle and abduction angle of the acetabular cup prosthesis 5 placement;

[0086] 5) As shown in Figure 12 , construct a matching plate top surface contour line 6, a marking hole contour line 61, and a guide hole center rotation trajectory line 7 on a plane perpendicular to the direction of the acetabular cup prosthesis opening;

[0087] 6) as shown, adjust the top surface profile of the matching plate 6, cover the upper posterior acetabulum and across the acetabular edge; Figure 12

[0088] 7) as shown, set the radius of the guide hole center rotation trajectory line 7, so that the guide hole center rotation trajectory line 7 covers the bone surface flat; Figure 12

[0089] 8) as shown, construct the matching plate 11 and the rotating arm model 12, wherein the matching surface 111 of the bottom surface of the matching plate 11 is fitted with the acetabular surface. Figure 13

[0090] In summary, the hip joint surgery guide plate provided by the present application has the following advantages: due to the large curvature change of the acetabular edge, the matching plate can easily find the matching position, and the matching precision is high; especially for some embodiments that can be combined with the indication edge indication and the use of the matching mold, the matching position of the matching plate can be found through various methods, further improving the correctness and accuracy of the matching; the matching plate and the rotating arm group are arranged in the posterior acetabulum, the rotating arm is rotated, the guide needle can be placed in the bone surface flat, the interference of other instruments during the operation is reduced, the flexibility is higher, and the guide needle is placed in the bone surface flat, the guide needle will not deviate when placed, and the guide precision is high.

[0091] Finally, it should be noted that: the above examples are only used to illustrate the technical solutions of the embodiments of the present application, and not to limit them; although the present application has been described in detail with reference to the foregoing embodiments, those skilled in the art should understand that: it can still modify the technical solutions recorded in the foregoing embodiments, or make equivalent replacement for part of the technical features; and these modifications or replacements do not make the essence of the corresponding technical solutions deviate from the spirit and scope of the technical solutions of the embodiments of the present application.​​​

Claims

1. A hip surgery guide plate, which is arranged on a patient's acetabulum, is used for guiding acetabular reamer and cup prosthesis implantation, characterized in that, The hip surgery guide plate comprises: a matching plate, the bottom surface of which is provided with a matching surface capable of fitting the posterior superior surface of the acetabulum and the acetabular rim, and the top surface of which is provided with a positioning pin; a rotating arm, one end of which is provided with a positioning hole matched with the positioning pin, and the other end of which is provided with a guide hole, the axis of the positioning hole being parallel to the axis of the guide hole; and a guide needle matched with the guide hole in a clearance; the matching plate is further provided with an acetabular center mark hole; the positioning pin is located at the end of the top surface of the matching plate; the rotating arm is rotated, and the guide needle is placed into the guide hole along the guide hole at the flat bone surface; the bottom surface of the matching plate is in a stepped shape, the posterior end of the bottom surface of the matching plate is a matching surface, and the anterior end is a non-matching surface; the top surface of the matching plate comprises an indicating edge parallel to the acetabular notch, which indicates the placement position of the matching plate.

2. The hip surgery guide of claim 1, wherein the taper of the positioning pin and the positioning hole is 0-50 °。 3. The hip surgery guide of claim 1, wherein the hip surgery guide plate further comprises a positioning needle; the matching plate comprises a first positioning through hole, the axis of which is parallel to the axis of the positioning pin; the rotating arm comprises a second positioning through hole, the axis of which is parallel to the axis of the positioning hole; the positioning hole is assembled on the positioning pin, and the first positioning through hole and the second positioning through hole form a channel through which the positioning needle passes.

4. The hip surgery guide of claim 1, wherein the hip surgery guide plate further comprises a mold, the inner surface of which is matched with the shape of the acetabulum; the matching plate is matched and placed on the mold, and the posterior end surface of the matching plate is coplanar with the posterior end surface of the mold.

5. The method for constructing the model of the matching plate and the rotating arm of the hip surgery guide plate according to any one of claims 1-4, comprising the following steps: 1) selecting the pelvic region on the CT data comprising the acetabulum, and drawing a three-dimensional model of the pelvis; 2) erasing the femoral head voxels, and segmenting the acetabulum; 3) taking the direction of the bilateral anterior superior iliac spines and pubic tubercles as a first axis, taking the direction of the symmetrical surface of the pelvis as a second axis, and taking the direction perpendicular to the first axis and the second axis as a third axis, and reconstructing a pelvis coordinate system; 4) in the pelvis coordinate system, planning the anteversion angle and the abduction angle of the acetabular cup prosthesis according to the anatomical structure of the acetabulum; 5) constructing the contour line of the top surface of the matching plate and the central rotation trajectory line of the guide hole on a plane perpendicular to the direction of the opening of the acetabular cup prosthesis; 6) adjusting the top surface contour of the matching plate to cover the posterior superior surface of the acetabulum and cross the acetabular rim; 7) setting the radius of the central rotation trajectory line of the guide hole; 8) constructing the model of the matching plate and the rotating arm, wherein the matching surface of the bottom surface of the matching plate is fitted with the acetabular surface.

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