Accurate acetabulum positioning operation guide plate for 3D printing

Abstract

The invention discloses a 3D printed acetabulum accurate positioning operation guide plate, which comprises a head part, a body part and a tail part, the body part is used for connecting the head part and the tail part, and the tail part comprises a fixing piece fixed on a residual iliac ridge of a patient and an adjusting assembly for changing the position of the head part. According to the 3D-printed acetabulum precise positioning operation guide plate, the connecting rod and the fixing ring are rotationally connected through the vertical rotating shaft, the connecting rod and the mounting ball are rotationally connected through the transverse rotating shaft, then the tail position can be rotated at will, the position of the head can be changed, a preoperative template prosthesis can be completely matched with an actual osteotomy area of a patient, and the accuracy of the acetabulum precise positioning operation guide plate is improved. In addition, adjustment is carried out according to actual conditions in the surgical operation process, accurate positioning of the original acetabulum can be achieved, and it can be guaranteed that the forward-leaning abduction angle of the original acetabulum is recovered.

Description

Technical Field

[0001] The present invention relates to the technical field, and in particular to a 3D printed acetabulum precise positioning surgical guide. Background Art

[0002] 3D printing technology, also known as rapid prototyping technology, is an emerging technology that uses computer-aided design and manufacturing based on high-quality X-ray imaging data provided by CT scans, and uses adhesive powder materials to quickly and accurately generate target models in a "layer-by-layer stacking and layer-by-layer molding" manner. As 3D printing technology becomes more mature and costs decrease, its applications in the medical field are increasing, including 3D printed prostheses, 3D printed surgical navigation templates, etc.

[0003] The acetabular precise positioning surgical guide is an auxiliary tool used in total hip replacement surgery. Its main function is to help doctors accurately place the acetabular prosthesis during surgery. The use of the positioning surgical guide can improve the accuracy of the surgery, reduce postoperative complications, and improve patient satisfaction.

[0004] For example, a 3D printed individualized acetabulum precision positioning surgical guide with publication number CN113413251B includes a head, a body and a tail. The body is used to connect the head and the tail, and the tail is a fixing unit that can be fixed to the patient's residual iliac crest. The tail includes two styles, A and B. The A style fixing unit is provided with a fixing channel, and the B style is a snap-on fixing unit.

[0005] The above-mentioned acetabular precise positioning surgical guide selects different shapes of the guide body, A and B styles, according to the patient's actual lesion size and surgical resection range. The 3D printed surgical guide needs to be customized according to the patient's actual situation. The initial design and preparation time is long and the cost is high. However, some invasive pelvic malignant tumors often progress rapidly, which may lead to the preoperative template prosthesis and the patient's actual osteotomy area. The area cannot be fully matched, and it cannot be adjusted according to the actual situation during the surgical operation. Summary of the invention

[0006] The purpose of the present invention is to provide a 3D printed acetabulum precise positioning surgical guide to solve the problem raised in the above background technology that the surgical guide currently on the market cannot be completely matched with the actual osteotomy area of ​​the patient.

[0007] To achieve the above-mentioned purpose, the present invention provides the following technical solutions: a 3D printed acetabulum precision positioning surgical guide, comprising a head, a body and a tail, the body being used to connect the head and the tail, the tail comprising a fixing part fixed to the residual iliac crest of the patient and an adjustment component for changing the position of the head.

[0008] Preferably, the adjustment assembly includes a mounting ball, a fixing ring and a connecting rod, the mounting ball is mounted on the top of the fixing member, the connecting rod is located between the mounting ball and the fixing ring, and the mounting ball is fixed to the body.

[0009] Preferably, the fixing ring and the connecting rod are rotationally connected via two vertical rotation axes, and the connecting rod and the mounting ball are rotationally connected via two horizontal rotation axes.

[0010] Preferably, the installation ball is provided with a vertical groove at an equal angle vertically on one side close to the connecting rod, and a horizontal groove is provided with an equal angle horizontally on one side close to the connecting rod.

[0011] Preferably, the fixing ring is provided with a transverse through hole, the connecting rod is provided with a vertical through hole, the vertical through hole is threadedly connected to a limiting block with one of the vertical clamping slots, and the transverse through hole is threadedly connected to a clamping block with one of the transverse clamping slots.

[0012] Preferably, the fixing member is provided with a fixing channel for facilitating the passage of the Kirschner wire, the surgical guide is made of nylon PA2200 material, and the structures involved in the head, body and tail of the surgical guide can be prepared by 3D printing technology.

[0013] Preferably, the head is divided into two parts, the upper part is a hemispherical second guide unit that matches the size of the acetabular cup component of the modular acetabular prosthesis, and the lower part is a circular plate-shaped first guide unit with a diameter slightly larger than the upper part, which is used to determine the anteversion and abduction angle of the native acetabulum.

[0014] Compared with the prior art, the present invention has the following beneficial effects:

[0015] 1. The present invention comprises an installation ball, a connecting rod and a fixing ring, wherein the connecting rod and the fixing ring are rotationally connected via a vertical rotation axis, and the connecting rod and the installation ball are rotationally connected via a horizontal rotation axis, so that the tail portion can be rotated arbitrarily to change the position of the head portion, so that the preoperative template prosthesis can be fully matched with the actual osteotomy area of ​​the patient, and can be adjusted according to actual conditions during the surgical operation, thereby achieving accurate positioning of the original acetabulum and ensuring restoration of the anteversion and abduction angle of the original acetabulum.

[0016] 2. The present invention prepares a guide plate before the operation. Compared with the use of computer navigation technology to locate the acetabulum during the operation, the present invention can quickly locate the acetabulum during the operation, saving operation time, reducing operation risks, reducing the occurrence of postoperative complications, and alleviating the patient's pain. The surgical guide plate constructed with a three-dimensional structure greatly reduces the uncertainty compared with the traditional positioning based on experience and hand feel. It can accurately locate the position of the native acetabulum during the operation, retain the original anteversion and abduction angle, and realize the precise reduction of the hip joint rotation center, which is beneficial to the patient's postoperative functional recovery.

[0017] 3. The head, body and tail of the present invention use universal components, are easy to install and operate, and are convenient to design and manufacture during 3D printing. BRIEF DESCRIPTION OF THE DRAWINGS

[0018] Figure 1 It is a schematic diagram of the three-dimensional structure of the present invention;

[0019] Figure 2 It is a schematic diagram of the side view structure of the fixing ring of the present invention;

[0020] Figure 3 This is a schematic diagram of the connecting rod structure of the present invention;

[0021] Figure 4 It is a schematic diagram of the vertical card slot structure of the present invention;

[0022] Figure 5 This is a rear view structural diagram of the fixing ring of the present invention;

[0023] Figure 6 It is a schematic diagram of the card block structure of the present invention.

[0024] In the figure: 1, body; 2, first guide unit; 3, second guide unit; 4, fixing member; 5, fixing channel; 6, mounting ball; 7, fixing ring; 8, limit block; 9, vertical rotation axis; 10, connecting rod; 11, horizontal rotation axis; 12, vertical through hole; 13, horizontal clamping groove; 14, vertical clamping groove; 15, clamping block; 16, horizontal through hole. DETAILED DESCRIPTION

[0025] The following will be combined with the drawings in the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of the present invention.

[0026] See also Figure 1-Figure 6 , the present invention provides a technical solution:

[0027] A 3D printed acetabulum precision positioning surgical guide comprises a head, a body 1 and a tail, the body is used to connect the head and the tail, the tail comprises a fixing part 4 fixed to the residual iliac crest of the patient and an adjustment component for changing the position of the head, the fixing part 4 is provided with a fixing channel for facilitating the passage of a Kirschner wire, the surgical guide is made of nylon PA2200 material, and the structures involved in the head, body 1 and tail of the surgical guide can be prepared by 3D printing technology, the head is divided into an upper and a lower part, the upper part is a hemispherical second guide unit 3 that matches the size of the acetabular cup component of a modular acetabular prosthesis, and the lower part is a circular plate-shaped first guide unit 2 with a diameter slightly larger than the upper part, which is used to determine the anteversion and abduction angle of the native acetabulum.

[0028] The 3D printed acetabulum precise positioning surgical guide of the present invention is prepared by the following steps: first, a spiral CT scan is used to obtain the anatomical structure of the patient's pelvis and femur before surgery, and the specific scanning parameters are: 120KV, 140mAs, pixel matrix size 512×512, slice thickness 1mm, and inter-layer spacing 1mm;

[0029] Secondly, the original DICOM data were imported into Arigin3d-Pro 3D medical reconstruction software v5.0 to perform 3D reconstruction of the pelvis and femur;

[0030] Next, the head of the surgical guide was constructed: the upper part used a hemispherical module with a diameter of 44 mm to simulate part of the femoral head in the acetabulum, and the lower part used a circular plate-shaped module with a diameter of 48 mm to simulate the anteversion and abduction angle of the acetabulum;

[0031] Construct the tail of the surgical guide: adjust the pelvic 3D reconstruction model to the optimal anatomical position, build the tail of the guide, construct the fixing part 4, the mounting ball 6, the fixing ring 7, the vertical rotation axis 9, the connecting rod 10, the horizontal rotation axis 11 and the block 15, and install them as shown in the figure. Figure 1 The tail fixing member 4 needs to fit seamlessly with the contour of the iliac crest;

[0032] Construct a module to connect the head and tail of the guide plate, namely the guide plate body 1;

[0033] Finally, the guide is printed using adhesive material according to the data of the guide constructed by the software, thereby obtaining the 3D printed acetabulum precise positioning surgical guide of the present invention. The surgical guide is made of nylon PA2200, which is cleaned using an ultrasonic spray system and sterilized by high-pressure steam (121°C, 30 minutes) before surgery.

[0034] The adjustment assembly includes a mounting ball 6, a fixing ring 7 and a connecting rod 10. The mounting ball 6 is mounted on the top of the fixing member 4. The connecting rod 10 is located between the mounting ball 6 and the fixing ring 7. The mounting ball 6 is fixed to the body 1. The fixing ring 7 and the connecting rod 10 are rotationally connected via two vertical rotation axes 9, and the connecting rod 10 and the mounting ball 6 are rotationally connected via two horizontal rotation axes 11.

[0035] The installation ball 6 is provided with a vertical slot 14 at an equal angle on one side close to the connecting rod 10 , and the connecting rod 10 is provided with a horizontal slot 13 at an equal angle on one side close to the connecting rod 10 .

[0036] The fixing ring 7 is provided with a transverse through hole 16 , the connecting rod 10 is provided with a vertical through hole 12 , the vertical through hole 12 and one of the vertical clamping grooves 14 are internally threadedly connected to the limiting block 8 , and the transverse through hole 16 and one of the transverse clamping grooves 13 are internally threadedly connected to a clamping block 15 .

[0037] All surgical operations were performed under general anesthesia. The patient was in the lateral position. The surgical incision started from the pubic symphysis of the perineum, along the groin and iliac crest, and ended at the sacroiliac joint. A second incision was made from the iliac spine to the greater trochanter and extended along the femur to the middle of the thigh. A flap was made according to the size of the tumor, and the pelvis was widely exposed for osteotomy. The surgical margin strictly complied with the system of the Musculoskeletal Tumor Society. Osteotomy was performed in the ilium, pubis, and / or sciatic bone according to the extent of the tumor.

[0038] Subsequently, the guide plate is used for hip joint reconstruction. The fixing part 4 on the tail of the guide plate is installed to make it fit tightly against the iliac crest. The fixing part 4 is in the optimal position and is tightly installed. An electric drill is used to implant 2-3 external Kirschner wires through the fixing channel 5. The guide plate is temporarily fixed on the pelvis. A modular acetabular prosthesis consisting of an iliac component with a variable length sleeve and an acetabular cup component is selected. The iliac component and the acetabular cup component are first installed on the residual bone structure. Then, the length of the iliac component and the anteversion and abduction angle of the acetabular cup are adjusted so that the acetabular cup component accurately matches the second guide unit 3 of the head and rests on the first guide unit 2.

[0039] The position of the head is adjusted according to the final installation position of the modular acetabulum prosthesis. When the front and rear angles of the head need to be adjusted, the limit block 8 is removed to separate the limit block 8 from the vertical through hole 12 and the vertical slot 14. Then the position of the body 1 is adjusted. During adjustment, the mounting ball 6 rotates up and down on the inner side of the connecting rod 10. When the suitable angle is adjusted, the limit block 8 is installed between the vertical through hole 12 and the vertical slot 14 to fix the mounting ball 6. When the left and right angles of the head need to be adjusted, the clamping block 15 is removed to separate the clamping block 15 from the transverse through hole 16 and the transverse slot 13. Then the position of the body 1 is adjusted. During adjustment, the connecting rod 10 rotates left and right on the inner side of the fixing ring 7. When the suitable angle is adjusted, the clamping block 15 is installed between the transverse through hole 16 and the transverse slot 13 to fix the connecting rod 10.

[0040] Afterwards, the Kirschner wire can be removed with an electric drill, the surgical guide can be removed, and the femoral head prosthesis can be placed routinely to complete the hip joint reduction and reconstruction process. A drainage tube can be placed routinely, and intravenous antibiotics can be continuously applied for 2 weeks. The drainage tube can be removed when the total drainage volume is less than 50mL / day after the operation. To prevent hip dislocation, the range of motion of the affected hip is limited to the neutral abduction position for 4 weeks. About 8 weeks after the operation, weight-bearing and functional exercises can be started after bed rest.

[0041] Although the present invention has been described in detail with reference to the aforementioned embodiments, it is still possible for those skilled in the art to modify the technical solutions described in the aforementioned embodiments, or to make equivalent substitutions for some of the technical features therein. Any modifications, equivalent substitutions, improvements, etc. made within the spirit and principles of the present invention should be included in the protection scope of the present invention.

Claims

1. A 3D printed acetabular precise positioning surgical guide, characterized in that: It comprises a head, a body (1) and a tail, wherein the body is used to connect the head and the tail, and the tail comprises a fixing member (4) fixed to the residual iliac crest of the patient and an adjusting component for changing the position of the head.

2. A 3D printed acetabulum precise positioning surgical guide according to claim 1, characterized in that: The adjustment assembly comprises a mounting ball (6), a fixing ring (7) and a connecting rod (10); the mounting ball (6) is mounted on the top of the fixing member (4); the connecting rod (10) is located between the mounting ball (6) and the fixing ring (7); and the mounting ball (6) is fixed to the body (1).

3. A 3D printed acetabulum precise positioning surgical guide according to claim 2, characterized in that: The fixing ring (7) and the connecting rod (10) are rotationally connected via two vertical rotation axes (9), and the connecting rod (10) and the mounting ball (6) are rotationally connected via two horizontal rotation axes (11).

4. A 3D printed acetabulum precise positioning surgical guide according to claim 3, characterized in that: A vertical slot (14) is vertically opened at an equal angle on the side of the installation ball (6) close to the connecting rod (10), and a horizontal slot (13) is horizontally opened at an equal angle on the side of the connecting rod (10) close to the connecting rod (10).

5. A 3D printed acetabulum precise positioning surgical guide according to claim 4, characterized in that: The fixing ring (7) is provided with a transverse through hole (16), the connecting rod (10) is provided with a vertical through hole (12), the vertical through hole (12) and one of the vertical clamping grooves (14) are internally threadedly connected to a limiting block (8), and the transverse through hole (16) and one of the transverse clamping grooves (13) are internally threadedly connected to a clamping block (15).

6. The 3D printed acetabulum precise positioning surgical guide according to claim 1, characterized in that: The fixing member (4) is provided with a fixing channel for facilitating the passage of a Kirschner wire. The surgical guide is made of nylon PA2200 material. The structures involved in the head, body (1) and tail of the surgical guide can all be prepared using 3D printing technology.

7. The 3D printed acetabulum precise positioning surgical guide according to claim 1, characterized in that: The head is divided into two parts, an upper part and a lower part. The upper part is a hemispherical second guide unit (3) that matches the size of the acetabular cup component of the modular acetabular prosthesis, and the lower part is a circular plate-shaped first guide unit (2) with a diameter slightly larger than the upper part, which is used to determine the anteversion and abduction angle of the native acetabulum.

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