A knee joint tibial high osteotomy navigation system

Abstract

The present application relates to the technical field of osteotomy navigation, and discloses a knee tibial high osteotomy navigation system, which comprises the following steps: 1) preoperative preparation, which comprises CT / DR scanning parameters, patient position and operation layout; 2) preoperative planning, which comprises CT / DR scanning preoperative image preprocessing, marking CT feature points, osteotomy line planning, planning ideal force line, steel plate pre-planning and osteotomy depth protection; 3) intraoperative procedure, which comprises tracking array installation, verification registration, bone registration, surgical approach, incision area registration, osteotomy or osteotomy positioning, distraction angle, intraoperative force line evaluation, plate implantation and fixation and verification of fixation effect; and 4) postoperative evaluation, which comprises postoperative lower limb force line verification. After osteotomy is performed by the knee tibial high osteotomy navigation system, the errors of the osteotomy plane, angle and depth are all in the sub-millimeter level, so that the body force line of the patient after the operation can be corrected to the best extent.

Description

Technical Field

[0001] This invention relates to an osteotomy navigation system, and more specifically, to a high tibial osteotomy navigation system for the knee joint. Background Technology

[0002] "High tibial osteotomy" is used to adjust joint alignment while preserving the knee joint, and is a method for treating medial knee osteoarthritis. By correcting the lower limb alignment through osteotomy, the force on the osteoarthritis-affected area of ​​the knee is redistributed to the healthy part of the knee joint, thereby slowing down degenerative changes in the knee joint and facilitating the treatment of osteoarthritis accompanied by misalignment.

[0003] Due to the limitations of surgical procedures, current high tibial osteotomy of the knee joint lacks precise means to control the force line, resulting in relatively large errors in the osteotomy plane, angle, and depth, and making it difficult for the patient's body force line to reach the optimal level after surgery. Summary of the Invention

[0004] The main technical problem solved by this invention is to provide a high tibial osteotomy navigation system for the knee joint, which solves the problems mentioned in the background art.

[0005] To solve the above-mentioned technical problems, according to one aspect of the present invention, more specifically, a high tibial osteotomy navigation system for the knee joint includes the following steps:

[0006] 1) Preoperative preparation

[0007] Preoperative preparation includes: CT / DR scan parameters, patient positioning, and surgical layout;

[0008] 2) Preoperative planning

[0009] Preoperative planning includes: CT / DR scan preoperative image preprocessing, marking CT feature points, osteotomy line planning, planning ideal force line, plate pre-planning, and osteotomy depth protection;

[0010] 3) Intraoperative procedure

[0011] The intraoperative procedure includes: tracking array installation, verification registration, bone registration, surgical approach, incision area registration, osteotomy or osteotomy positioning, distraction angle, intraoperative force line assessment, plate implantation and fixation, and verification of fixation effect.

[0012] 4) Postoperative assessment

[0013] Postoperative assessment includes verification of lower limb alignment.

[0014] Furthermore, the CT scan parameters require the patient to be in a supine position with the lower limbs in a neutral position, the patella facing forward, and the knee extended. The CT scan parameters are set to a slice thickness of less than 1 mm, continuous spiral scanning without intervals, 120-150 kV, 200-400 mA, and an image resolution of 512x512 square. The CT scan images are exported in a DICOM3 compatible format, and their range includes at least 150 mm above and below the center point of the hip, knee, and ankle joints.

[0015] Furthermore, the DR scan parameters require the patient to be in an anterior-posterior position, that is, standing facing the X-ray tube on the front of the IP frame with arms hanging naturally and feet together, in a standard human standing posture. The DR imaging uses an automatic tracking translation detector and obtains images of the entire lower limb through 2-3 exposures.

[0016] Furthermore, the preoperative image preprocessing involves preoperative scanning of the patient's lower limbs using simulated weight-bearing CT tomography, image identification of the CT scans, and the use of third-party software Mimics for image segmentation and three-dimensional reconstruction. The marking of CT feature points involves marking femoral and tibial feature points on the reconstructed three-dimensional model of the lower limbs before surgery to calculate the mechanical axis of the lower limbs. On the femoral side, the femoral head center, medial epicondyle, and lateral epicondyle are marked, while on the tibial side, the proximal tibial medial and lateral sides, medial malleolus, and lateral epicondyle are marked. The osteotomy line planning involves a horizontal osteotomy line at least 3.5 cm below the plateau and located near the upper edge of the pes anserinus, retaining a 10 mm lateral hinge and 1.5 cm away from the lateral articular surface.

[0017] Furthermore, after the planned ideal force line, i.e., the osteotomy line, is determined, the preoperative force line is adjusted to the ideal value by planning the opening angle. After the planning is completed, an osteotomy correction simulation is performed to preview the correction effect. For the pre-planning of the steel plate, after determining the opening angle, the steel plate model is planned to a suitable position on the tibia. Then, the position of the steel plate pre-embedded screw is planned. After the position is determined, the system will mark the position of the pre-embedded screw. After the opening angle is fixed during the operation, the steel plate pre-embedded screw is placed under the guidance of the screen. The force line is evaluated by placing the steel plate on the pre-embedded screw. The osteotomy depth protection means that the osteotomy depth will be protected from over-cutting during the osteotomy. During the osteotomy, the distance value from the end of the oscillating saw to the end of the osteotomy line will be displayed on the screen in real time. The plan is that when the end of the oscillating saw touches an area outside the end of the osteotomy line, the value on the screen will issue a reminder and then stop the osteotomy.

[0018] Furthermore, the tracking array installation involves installing one tracking array on each of the femur and tibia, which is used intraoperatively to define the position of the femur and tibia. The verification registration, or power system registration, requires identification and registration of the required power tools under NDI, and the position can be displayed in real time during the operation. The probe registration involves registering the probes under NDI. The bone registration involves registering anatomical landmarks after checking the visibility of the tracking array for knee flexion and extension. For femoral registration, the thigh is rocked around the hip center until the progress bar reaches 100% to obtain the femoral head center, and the probe then clicks on the medial and lateral condyles of the distal femur. The tibial registration includes: the probe clicks on the medial and lateral sides of the tibia and the medial and lateral malleoli. After registration, the system will calculate a series of markers to obtain the lower limb mechanical axis for real-time intraoperative display.

[0019] Furthermore, the surgical approach, i.e. the incision location, can be predetermined using probe navigation. With the knee joint in a 90° flexed position, anatomical landmarks (medial joint line, pes anserine skull boundary, medial collateral ligament run-through, and tibial tuberosity) are marked on the skin in the posterior cranial direction. A 6-8 cm long skin incision is made from the anterior point of the foot to the insertion point of the foot, and the incision ends at the posteromedial angle of the tibial plateau.

[0020] Furthermore, the incision area registration involves placing a marker pin slightly above the tibial incision after the tibial incision is exposed. A probe is used to click the marker pin for proximal tibial registration. Then, the probe is used to sequentially click the registration points in the exposed incision area for precise registration, using 10 registration points. The osteotomy positioning requires muscle dissection to expose the medial tibial cortex. The leg is fully extended, two Kirschner wires are removed, and the osteotomy is guided along the osteotomy line parallel to the medial side towards the lateral side, according to the preoperatively planned osteotomy angle. The osteotomy line position is then replaced, and the osteotomy position is marked. The osteotomy includes horizontal osteotomy and ascending osteotomy. The horizontal osteotomy is the main incision for adjusting the height of the medial side of the tibia. It is performed along the osteotomy surface of the two Kirschner wires using screen guidance, up to 10 mm anterior to the lateral cortex. The hinge is retained, and the Kirschner wires are removed. For ease of operation, the Kirschner wires can be shortened. The ascending osteotomy is performed along the coronal plane in the anterior 1 / 3 of the tibia, at approximately 110 degrees to the horizontal osteotomy, which can provide stability during rotation of the first incision after surgery.

[0021] Furthermore, the aforementioned opening angle refers to the use of a layered osteotome technique to open the osteotomy line after osteotomy to correct the deformity. The lower limb is fully extended during opening, and the opening angle is displayed in real-time. After opening to the planned angle, a retractor forceps is inserted from the last medial position of the tibia to maintain the angle. The intraoperative force line assessment requires the lower limb to be fully extended, and the pre-embedded screws of the plate are placed in the pre-marked position under navigation guided by the screen. The plate is temporarily fixed to the proximal tibia by being placed subcutaneously on the pre-embedded screws. The femoral and tibial markers are verified to check the accuracy of the force line and correct the deformity. The plate implantation... For fixation, the guide drill, in conjunction with the aiming device, is inserted into the corresponding holes A and C on the plate. A hole is drilled in hole A, and the drill bit reading is monitored to determine the screw length. Screws are then inserted into holes C and D in sequence. The pre-embedded screw is then removed from hole B and replaced with a screw for fixation. A self-tapping cortical screw is inserted into hole 1. Single cortical locking screws are inserted into the other holes of the rod through an LCP sleeve. Finally, the cortical screw in hole 1 is removed, and a hole is drilled through a locking drill sleeve to replace the double cortical locking screw. The fixation effect is verified after fixation is completed, and the femoral and tibial markers are verified again to confirm the corrective and fixation effect.

[0022] Furthermore, the postoperative lower limb alignment verification involves taking a full-length X-ray of the lower limb after surgery to measure the alignment, and comparing it with the ideal alignment planned before and during surgery. The alignment assessment benchmark, namely the mechanical axis, is the primary standard for estimating the postoperative alignment, which is within ±3° of the postoperative lower limb mechanical axis.

[0023] The beneficial effects of the high tibial osteotomy navigation system of the knee joint of the present invention are as follows:

[0024] 1. After osteotomy is performed using the high tibial osteotomy navigation system of the knee joint in this invention, the errors in the osteotomy plane, angle and depth are all within the sub-millimeter level, which can ensure that the patient's body alignment is corrected to the optimal degree after surgery.

[0025] 2. The high tibial osteotomy navigation system of the knee joint in this invention has undergone more detailed preparation and planning before the operation, which can maximize the safety of the operation. Attached Figure Description

[0026] The present invention will now be described in further detail with reference to the accompanying drawings and specific implementation methods.

[0027] Figure 1 This is a schematic diagram of the structure of the present invention. Detailed Implementation

[0028] The present invention will be described in detail below with reference to the accompanying drawings and embodiments. It should be noted that, unless otherwise specified, the embodiments and features described in the present application can be combined with each other.

[0029] like Figure 1As shown, according to one aspect of the present invention, a high tibial osteotomy navigation system for the knee joint is provided, comprising the following steps:

[0030] 1) Preoperative preparation

[0031] Preoperative preparation includes: CT / DR scan parameters, patient position and surgical layout. During the surgical layout, the surgical equipment and the surgeon can be arranged on the left or right side of the operating table.

[0032] 2) Preoperative planning

[0033] Preoperative planning includes: CT / DR scan preoperative image preprocessing, marking CT feature points, osteotomy line planning, planning ideal force line, plate pre-planning, and osteotomy depth protection;

[0034] 3) Intraoperative procedure

[0035] The intraoperative procedure includes: tracking array installation, verification registration, bone registration, surgical approach, incision area registration, osteotomy or osteotomy positioning, distraction angle, intraoperative force line assessment, plate implantation and fixation, and verification of fixation effect.

[0036] 4) Postoperative assessment

[0037] Postoperative assessment includes verification of lower limb alignment.

[0038] In this embodiment, the CT scan parameters require the patient to be in a supine position with the lower limbs in a neutral position, the patella facing forward, and the knee extended. The CT scan parameters are set to a slice thickness of less than 1 mm, continuous spiral scan without intervals, 120-150 kV, 200-400 mA, and an image resolution of 512x512 square. The CT scan image is exported in a DICOM3 compatible format, and its range includes at least 150 mm above and below the center point of the hip, knee, and ankle joints.

[0039] To ensure consistent limb position during scanning of the hip, knee, and ankle joints and minimize the possibility of leg movement during the scan, a shoulder guard is placed over the patient's shoulder and a foot pedal is placed under their feet to simulate a weight-bearing position. If a prosthesis is installed in the opposite knee, it is elevated during the scan to reduce the influence of metal artifacts.

[0040] In this embodiment, the DR scanning parameters require the patient to be in an anterior-posterior position, that is, standing facing the X-ray tube on the front of the IP frame with arms hanging naturally and feet together, in a standard human standing posture. The DR imaging uses an automatic tracking translation detector and obtains images of the entire lower limb through 2-3 exposures.

[0041] Exposure parameters for DR scanning are determined based on the specific circumstances of each hospital. The scan area includes the hip joint, the entire length of the femur, the knee joint, the entire length of the tibia and fibula, and the ankle joint. The patient is positioned supine. A lateral support and footrest are installed on the operating table to allow easy positioning of the leg in 90° flexion and full extension. The contralateral leg is lowered at the hip joint to facilitate access to the proximal medial aspect of the tibia. A sterile suspension also exposes the iliac crest for intraoperative examination of the leg axis. A sterile tourniquet may be used, but is not mandatory. Note: Sufficient space must be left for positioning the leg in full extension when verifying the weight-bearing line during surgery.

[0042] In this embodiment, preoperative image preprocessing involves preoperative scanning of the patient's lower limbs using simulated weight-bearing CT tomography, image identification of the CT scans, and the use of third-party software Mimics for image segmentation and three-dimensional reconstruction. CT feature point marking involves marking femoral and tibial feature points on the reconstructed lower limb three-dimensional model before surgery to calculate the lower limb mechanical axis. On the femoral side, the femoral head center, medial epicondyle, and lateral epicondyle are marked; on the tibial side, the proximal tibial medial and lateral sides, medial malleolus, and lateral epicondyle are marked. Osteotomy line planning involves the horizontal osteotomy line being at least 3.5 cm below the plateau and located near the upper edge of the pes anserinus, retaining a 10 mm lateral hinge, and 1.5 cm from the lateral articular surface. The ascending osteotomy line is approximately 110 degrees to the horizontal osteotomy line and 1.5 cm from the anterior edge of the tibial tuberosity.

[0043] In this embodiment, after the ideal force line, i.e. the osteotomy line, is determined, the preoperative force line is adjusted to the ideal value by planning the opening angle. After the planning is completed, an osteotomy correction simulation is performed to preview the correction effect. For the pre-planning of the plate, after determining the opening angle, the plate model is planned to a suitable position on the tibia. Then, the position of the plate pre-embedded screw is planned. After the position is determined, the system will mark the position of the pre-embedded screw. After the opening angle is fixed during the operation, the plate pre-embedded screw is placed under the guidance of the screen. The force line is evaluated by placing the plate on the pre-embedded screw. Osteotomy depth protection means that the osteotomy depth will be protected from over-cutting during the osteotomy. During the osteotomy, the distance value from the end of the oscillating saw to the end of the osteotomy line will be displayed on the screen in real time. When the end of the oscillating saw touches an area outside the end of the osteotomy line, the value on the screen will issue a reminder and then stop the osteotomy.

[0044] In this embodiment, the tracking array installation involves installing one tracking array on each of the femur and tibia, which is used to define the position of the femur and tibia during surgery; verification registration, or power system registration, requires identification and registration of the required power tools under NDI, and the position can be displayed in real time during surgery; probe registration involves registration of probes under NDI; bone registration involves registering anatomical landmarks after checking the visibility of the tracking array for knee flexion and extension; femoral registration involves oscillating the thigh around the hip center until the progress bar reaches 100% to obtain the femoral head center, and then the probe clicks on the medial and lateral condyles of the distal femur; tibial registration includes: the probe clicks on the medial and lateral sides of the tibia, and the medial and lateral malleoli. After registration, the system will calculate a series of markers to obtain the lower limb mechanical axis for real-time display during surgery.

[0045] In this embodiment, the surgical approach, i.e., the incision location, can be predetermined using probe navigation. The knee joint is in a 90° flexion position, and anatomical landmarks (medial joint line, pes anserine skull boundary, medial collateral ligament run-through, and tibial tuberosity) are marked on the skin in the posterior cranial direction. A 6-8 cm long skin incision is made from the anterior point of the foot to the insertion point of the foot, ending at the posteromedial angle of the tibial plateau.

[0046] (1) Divide the subcutaneous tissue and fascia at the cranial margin of the goose foot. Contract the arch tendon distally. The anterior edge of the superficial layer of the medial collateral ligament can now be seen;

[0047] (2) The ligament is lifted through a periosteal elevator and then from the tibia. Long fibers of the superficial portion of the ligament are removed from the tibia with a scalpel until the posterior tibial crest is exposed. A Hohmann retractor is inserted posteriorly to the tibia.

[0048] (3) Expose the patellar tendon insertion into the tibial tuberosity at the anterior edge of the incision and the medial edge of the patellar ligament.

[0049] In this embodiment, incision area registration involves placing a marker pin slightly above the tibial incision after the tibial incision is exposed. A probe is used to click the marker pin for proximal tibial registration. Then, the probe is used to click the registration points sequentially in the exposed incision area for precise registration, using 10 registration points. Osteotomy positioning requires muscle separation to expose the medial tibial cortex. The leg is fully extended, and two Kirschner wires are removed. Following the pre-planned osteotomy angle, the drill is parallel to the osteotomy line from the medial side to the lateral side, replacing the osteotomy line position and marking the osteotomy location. Osteotomy includes horizontal osteotomy and ascending osteotomy. Horizontal osteotomy is the main incision for adjusting the medial tibial height. Guided by the screen, the osteotomy is performed along the osteotomy surfaces of the two Kirschner wires, up to 10mm anterior to the lateral cortex. The hinge is retained, and the Kirschner wires are removed. For ease of operation, the Kirschner wires can be shortened. Ascending osteotomy is performed along the coronal plane in the anterior 1 / 3 of the tibia, at approximately 110 degrees to the horizontal osteotomy, providing postoperative stability during rotation of the first incision.

[0050] In this embodiment, the opening angle is achieved by using a layered osteotome technique to open the osteotomy line after osteotomy to correct the deformity. The lower limb is fully extended during opening, and the opening angle is displayed in real time during the operation. After opening to the planned angle, a retractor is inserted from the last medial position of the tibia to maintain the angle. Intraoperative force line assessment requires the lower limb to be fully extended. Under navigation guidance, the pre-embedded screws on the plate are placed at the pre-marked position. The plate is temporarily fixed to the proximal tibia by subcutaneous placement on the pre-embedded screws. The femoral and tibial markers are verified to check the accuracy of the force line, correct the deformity, and fix the plate implantation. Using a guide drill and aiming device, the screw is inserted into the corresponding holes A and C on the plate. A hole is drilled in hole A, and the drill bit reading is followed to determine the screw length. Screws are then inserted into holes C and D in sequence. The pre-embedded screw is then removed from hole B and replaced with a screw for fixation. A self-tapping cortical screw is inserted into hole 1. Single cortical locking screws are inserted into the other holes of the rod through an LCP sleeve. Finally, the cortical screw in hole 1 is removed, and a hole is drilled through a locking drill sleeve to replace the double cortical locking screw. To verify the fixation effect, the femoral and tibial markers are verified again after fixation to confirm the corrective and fixation effects.

[0051] In this embodiment, the postoperative lower limb alignment verification involves taking a full-length X-ray of the lower limb after surgery to measure the alignment, and then comparing it with the ideal alignment planned before and during surgery. The alignment assessment benchmark, namely the mechanical axis, is the primary standard for estimating the postoperative alignment, which is within ±3° of the postoperative lower limb mechanical axis.

[0052] Of course, the above description is not a limitation of the present invention, and the present invention is not limited to the examples given above. Any changes, modifications, additions or substitutions made by those skilled in the art within the scope of the present invention are also within the protection scope of the present invention.

Claims

1. A navigation system for high tibial osteotomy of the knee joint, characterized in that, Includes the following steps: 1) Preoperative preparation Preoperative preparation includes: CT / DR scan parameters, patient positioning, and surgical layout; 2) Preoperative planning Preoperative planning includes: CT / DR scan preoperative image preprocessing, marking CT feature points, osteotomy line planning, planning the ideal force line, plate pre-planning, and osteotomy depth protection; the planned ideal force line, i.e., after the osteotomy line is determined, the preoperative force line is adjusted to the ideal value by planning the opening angle, and after the planning is completed, osteotomy correction simulation is performed to preview the correction effect; the plate pre-planning requires determining the opening angle and planning the plate model to a suitable position on the tibia, and then planning the position of the plate pre-embedded screw. After the position is determined, the system will mark the position of the pre-embedded screw. During the operation, after the opening angle is fixed, the plate pre-embedded screw is placed under the guidance of the screen, and the force line is evaluated by placing the plate on the pre-embedded screw; 3) Intraoperative procedure The intraoperative procedure includes: tracking array installation, verification registration, probe registration, bone registration, surgical approach, incision area registration, osteotomy or osteotomy positioning, distraction angle, intraoperative force line assessment, plate implantation and fixation, and verification of fixation effect. Bone registration includes femoral and tibial registration. Incision area registration involves placing a marker pin slightly above the tibial incision after exposure, using a probe to click the marker pin for proximal tibial registration, and then sequentially clicking registration points in the exposed incision area for precise registration using 10 registration points. Intraoperative force line assessment requires full extension of the lower limb, and under navigation guidance, the pre-embedded plate pin is placed at the pre-marked position. The plate is then temporarily fixed to the proximal tibial region by subcutaneous placement on the pre-embedded pin. The femoral and tibial markers are verified, the force line is checked for accuracy, and deformities are corrected. 4) Postoperative assessment Postoperative assessment includes verification of lower limb alignment.

2. The tibial high osteotomy navigation system for the knee joint according to claim 1, characterized in that: The CT scan parameters require the patient to be in a supine position with the lower limbs in a neutral position, the patella facing forward, and the knee extended. The CT scan parameters are set as follows: slice thickness within 1 mm, continuous spiral scan, no interval, 120-150 kV, 200-400 mA, and image resolution of 512x512 square. The CT scan images are exported in DICOM3 compatible format, and their range includes at least 150 mm above and below the center point of the hip, knee, and ankle joints.

3. The tibial high osteotomy navigation system for the knee joint according to claim 1, characterized in that: The DR scan parameters require the patient to be in an anterior-posterior position, that is, standing facing the X-ray tube on the front of the IP frame with arms hanging naturally and feet together, in a standard human standing posture. The DR scan uses an automatic tracking translation detector and obtains images of the entire lower limb through 2-3 exposures.

4. The tibial high osteotomy navigation system for the knee joint according to claim 1, characterized in that: The preoperative image preprocessing involves preoperative scanning of the patient's lower limbs using simulated weight-bearing CT tomography, image identification of the CT scans, and segmentation and three-dimensional reconstruction of the images using third-party software Mimics. The marking of CT feature points involves marking femoral and tibial feature points on the reconstructed three-dimensional model of the lower limbs preoperatively to calculate the mechanical axis of the lower limb. On the femoral side, the center of the femoral head, medial epicondyle, and lateral epicondyle are marked; on the tibial side, the proximal medial and lateral tibia, medial malleolus, and lateral epicondyle are marked. The osteotomy line planning involves the horizontal osteotomy line being at least 3.5 cm below the plateau and located near the upper edge of the pes anserinus, retaining a 10 mm lateral hinge, and 1.5 cm from the lateral articular surface. The ascending osteotomy line is approximately 110 degrees to the horizontal osteotomy line and 1.5 cm from the anterior edge of the tibial tuberosity.

5. The tibial high osteotomy navigation system for the knee joint according to claim 4, characterized in that: The osteotomy depth protection refers to the protection against overcutting during osteotomy. During osteotomy, the screen will display the distance from the end of the oscillating saw to the end of the osteotomy line in real time. The plan is to issue a warning on the screen when the end of the oscillating saw touches an area outside the end of the osteotomy line, and then stop the osteotomy.

6. The tibial high osteotomy navigation system for the knee joint according to claim 1, characterized in that: The tracking array installation involves installing one tracking array on each of the femur and tibia, which is used to define the position of the femur and tibia during the operation; the verification registration is the power system registration, which requires identification and registration of the required power tools under NDI, and the position can be displayed in real time during the operation; the probe registration is the registration of probes under NDI; the bone registration is the registration of anatomical landmarks after checking the visibility of the tracking array for knee flexion and extension; the femoral registration involves shaking the thigh around the hip center until the progress bar reaches 100% to obtain the femoral head center, and then the probe clicks on the medial and lateral condyles of the distal femur; The tibial registration process involves the probe clicking on the medial and lateral sides of the tibia and the medial and lateral malleoli. After registration, the system will calculate a series of marker points to obtain the mechanical axis of the lower limb for real-time display during surgery.

7. A tibial high osteotomy navigation system for the knee joint according to claim 6, characterized in that: The surgical approach, i.e. the incision location, can be predetermined using probe navigation. The knee joint is in a 90° flexion position, and anatomical landmarks (medial joint line, pes anserine skull boundary, medial collateral ligament run-through, and tibial tuberosity) are marked on the skin in the posterior cranial direction. A 6-8 cm long skin incision is made from the anterior point of the foot to the insertion point of the foot, and the incision ends at the posteromedial angle of the tibial plateau.

8. The tibial high osteotomy navigation system for the knee joint according to claim 7, characterized in that: The osteotomy positioning requires muscle separation, exposure of the medial tibial cortex, full extension of the leg, removal of two Kirschner wires, and drilling along the osteotomy line parallel to the medial side to the lateral side according to the preoperatively planned osteotomy angle navigation, thereby replacing the osteotomy line position and marking the osteotomy position; the osteotomy includes horizontal osteotomy and ascending osteotomy. The horizontal osteotomy is the main incision for adjusting the medial tibial height, and is performed using screen guidance along the osteotomy surfaces of the two Kirschner wires to 10mm anterior to the lateral cortex, retaining the hinge, and removing the Kirschner wires. For ease of operation, the Kirschner wires can be shortened. The ascending osteotomy is performed along the coronal plane in the anterior 1 / 3 of the tibia, at approximately 110 degrees to the horizontal osteotomy, which provides postoperative stability during rotation of the first incision.

9. A tibial high osteotomy navigation system for the knee joint according to claim 1, characterized in that: The aforementioned opening angle refers to the use of a layered osteotome to open the osteotomy line after osteotomy to correct the deformity. The lower limb is fully extended during opening, and the opening angle is displayed in real time during the operation. After opening to the planned angle, a retractor is inserted from the last medial position of the tibia to maintain the angle. For the implantation and fixation of the plate, a guide drill is used with a sight to lock into the corresponding holes A and C on the plate. A hole is drilled in hole A, and the drill bit reading is followed to determine the screw length. Screws are then inserted into holes C and D in sequence. The pre-embedded screw is then removed at hole B and replaced with a screw for fixation. A self-tapping cortical screw is implanted into one hole, and single cortical locking screws are implanted into the other holes of the rod through an LCP sleeve. Finally, the cortical screw in the last hole is removed, and a hole is drilled through a locking drill sleeve to replace the double cortical locking screw. The verification of the fixation effect requires verification of the femoral and tibial markers again after fixation is completed to confirm the correction and fixation effect.

10. A tibial high osteotomy navigation system for the knee joint according to claim 1, characterized in that: The postoperative lower limb alignment verification involves taking a full-length X-ray of the lower limb after surgery to measure the alignment, and then comparing it with the ideal alignment planned before and during surgery. The alignment assessment benchmark, namely the mechanical axis, is the primary standard for estimating the postoperative alignment, which is within ±3° of the postoperative lower limb mechanical axis.

Images