Shoulder joint replacement surgery navigation system and method

Abstract

The invention provides a shoulder joint replacement surgery navigation system and method, and relates to the technical field of computers, and the system comprises a controller and a navigation positioning device; the controller is in communication connection with the navigation positioning device; the controller comprises a preoperative planning module, a preoperative simulation module and an intra-operative execution module. According to the navigation system and method for the shoulder joint replacement surgery, by combining the preoperative medical image of the affected bone and the medical image of the healthy bone corresponding to the affected bone, the healthy form of the affected bone can be reflected more accurately under the condition that the affected bone has bone defect and / or abnormal form, and then prosthesis planning can be conducted based on the three-dimensional bone model of the affected bone, so that the patient experience is improved. The preoperative surgical planning is more objective and quantified, the movement range of the shoulder joint on the operative side of the patient after the prosthesis to be implanted is implanted into the affected bone can be simulated based on the parameter information of the prosthesis to be implanted, the accuracy and rationality of the prosthesis planning are further improved, and the accuracy and reliability of the orthopedic surgery are remarkably improved.

Description

Technical Field

[0001] The present invention relates to the field of computer technology, and in particular to a navigation system and method for shoulder replacement surgery. Background Art

[0002] Shoulder replacement surgery is an effective method for treating severe shoulder pain and dysfunction. It is suitable for treating severe shoulder pain and dysfunction caused by shoulder arthritis, shoulder fracture, rotator cuff injury, etc. The types of shoulder replacement surgery usually include hemi-shoulder replacement, total shoulder replacement and reverse total shoulder replacement, each type for different pathological conditions and patient needs. Shoulder replacement surgery mainly removes the damaged joint surface (osteotomy) and implants an artificial prosthesis to reduce pain and restore the movement function of the shoulder joint.

[0003] In the related art, before performing shoulder replacement surgery, it is difficult to accurately and objectively select the prosthesis that best matches the affected bone based on the individual characteristics of the affected bone, and it is also difficult to accurately simulate and evaluate whether the installation position of the prosthesis and the patient's shoulder joint range of motion are within a reasonable range after the prosthesis is implanted, increasing the risk of long-term pain, unstable shoulder joint movement, and loosening or dislocation of the prosthesis in patients after surgery.

[0004] Therefore, how to more accurately and objectively select a prosthesis that matches the affected bone before shoulder replacement surgery, and how to more accurately simulate and evaluate whether the installation position of the prosthesis and the patient's shoulder joint range of motion are within a reasonable range after implantation, are technical problems to be solved in this field. Summary of the invention

[0005] The present invention provides a shoulder replacement surgery navigation system and method, which are used to solve the defects in the prior art that it is difficult to accurately and objectively select a prosthesis that is compatible with the affected bone before the shoulder replacement surgery, and it is difficult to accurately simulate and evaluate whether the installation position of the prosthesis and the patient's shoulder joint motion range are within a reasonable range after the prosthesis is implanted. The system and method can more accurately and objectively select a prosthesis that is compatible with the affected bone before the shoulder replacement surgery, and more accurately simulate and evaluate whether the installation position of the prosthesis and the patient's shoulder joint motion range are within a reasonable range after the prosthesis is implanted.

[0006] The present invention provides a navigation system for shoulder replacement surgery, a controller and a navigation positioning device; the controller is communicatively connected with the navigation positioning device; the controller includes a preoperative planning module, a preoperative simulation module and an intraoperative execution module; The preoperative planning module is used to generate a three-dimensional bone model of the patient's affected bone based on the first image and the second image, perform prosthesis planning based on the three-dimensional bone model of the affected bone, and obtain parameter information of the prosthesis to be implanted in the affected bone, wherein the first image includes a medical image of the affected bone before the shoulder replacement surgery, and the second image includes a medical image of a healthy bone corresponding to the affected bone, the affected bone and the healthy bone corresponding to the affected bone are symmetrically distributed with the spine as the midline, and the parameter information includes size, posture information and installation position information; The preoperative simulation module is used to simulate the range of motion of the patient's surgical shoulder joint after the prosthesis to be implanted is implanted into the affected bone based on the parameter information of the prosthesis to be implanted, so as to obtain the maximum motion angle of the patient's surgical shoulder joint; The intraoperative execution module is used to control the navigation and positioning device to perform surgical navigation in the shoulder replacement surgery for the affected bone based on the parameter information of the prosthesis to be implanted when it is determined that the maximum active angle of the patient's surgical side shoulder joint is greater than the active angle threshold; The navigation and positioning device is used to perform surgical navigation in a shoulder joint replacement surgery on the affected bone in response to the control of the intraoperative execution module.

[0007] The present invention also provides a shoulder joint replacement surgery navigation method implemented based on any of the shoulder joint replacement surgery navigation systems described above, comprising: Based on the first image and the second image, a three-dimensional bone model of the patient's affected bone is generated, and prosthesis planning is performed based on the three-dimensional bone model of the affected bone to obtain parameter information of the prosthesis to be implanted in the affected bone, wherein the first image includes a medical image of the affected bone before shoulder replacement surgery, and the second image includes a medical image of a healthy bone corresponding to the affected bone, the affected bone and the healthy bone corresponding to the affected bone are symmetrically distributed with the spine as the midline, and the parameter information includes size, posture information, and installation position information; Based on the parameter information of the prosthesis to be implanted, simulating the range of motion of the patient's surgical shoulder joint after the prosthesis to be implanted is implanted into the affected bone, and obtaining the maximum motion angle of the patient's surgical shoulder joint; When it is determined that the maximum motion angle of the patient's surgical-side shoulder joint is greater than a motion angle threshold, based on parameter information of the prosthesis to be implanted, the navigation and positioning device is controlled to perform surgical navigation in the shoulder replacement surgery for the affected bone.

[0008] The shoulder replacement surgery navigation system and method provided by the present invention generate a three-dimensional bone model of the affected bone by combining preoperative medical images of the affected bone and medical images of the healthy bone corresponding to the affected bone. The system can more accurately reflect the healthy morphology of the affected bone when the affected bone has bone defects and / or abnormal morphology, and then perform prosthesis planning based on the three-dimensional bone model of the affected bone to obtain parameter information of the prosthesis to be implanted, so that the preoperative surgical planning is more objective and quantitative, and can simulate the range of motion of the patient's surgical side shoulder joint after the prosthesis to be implanted is implanted into the affected bone based on the parameter information of the prosthesis to be implanted, obtain the maximum motion angle of the patient's surgical side shoulder joint, and when it is determined that the maximum motion angle of the patient's surgical side shoulder joint is greater than the motion angle threshold, control the navigation positioning device to perform surgical navigation in the shoulder replacement surgery for the affected bone based on the parameter information of the prosthesis to be implanted, further improve the accuracy and rationality of prosthesis planning, reduce surgical complications and postoperative recovery time, significantly improve the accuracy and reliability of orthopedic surgery, effectively reduce surgical risks, and achieve more stable surgical results. BRIEF DESCRIPTION OF THE DRAWINGS

[0009] In order to more clearly illustrate the technical solutions in the present invention or the prior art, the following briefly introduces the drawings required for use in the embodiments or the description of the prior art. Obviously, the drawings described below are some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying creative work.

[0010] Figure 1 This is one of the structural schematic diagrams of the shoulder replacement surgery navigation system provided by the present invention.

[0011] Figure 2 This is one of the cross-sectional diagrams of the shoulder joint.

[0012] Figure 3 This is the second cross-sectional diagram of the shoulder joint.

[0013] Figure 4 This is the third cross-sectional diagram of the shoulder joint.

[0014] Figure 5 It is a three-dimensional bone model of the patient's surgical side shoulder joint in the shoulder replacement surgery navigation system provided by the present invention.

[0015] Figure 6 It is a schematic diagram of the flow of the shoulder replacement surgery navigation system provided by the present invention for prosthesis planning and preoperative simulation.

[0016] Figure 7 This is the second structural schematic diagram of the shoulder replacement surgery navigation system provided by the present invention.

[0017] Figure 8 It is a schematic flow chart of the navigation method for shoulder replacement surgery provided by the present invention. DETAILED DESCRIPTION

[0018] In order to make the purpose, technical solution and advantages of the present invention clearer, the technical solution of the present invention will be clearly and completely described below in conjunction with the drawings of the present invention. Obviously, the described embodiments are 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.

[0019] In the description of the invention, it should be noted that, unless otherwise clearly specified and limited, the terms "installed", "connected", and "connected" should be understood in a broad sense, for example, it can be a fixed connection, a detachable connection, or an integral connection; it can be a mechanical connection or an electrical connection; it can be a direct connection, or it can be indirectly connected through an intermediate medium, or it can be the internal communication of two components. For ordinary technicians in this field, the specific meanings of the above terms in the present invention can be understood according to specific circumstances.

[0020] In the description of the present application, the terms "first", "second", etc. are used to distinguish similar objects, and are not used to describe a specific order or sequence. It should be understood that the data used in this way can be interchangeable under appropriate circumstances, so that the embodiments of the present application can be implemented in an order other than those illustrated or described here, and the objects distinguished by "first", "second", etc. are usually a class, and the number of objects is not limited. For example, the first object can be one or more. In addition, in the description of the present application, "and / or" represents at least one of the connected objects, and the character " / " generally represents that the front and back associated objects are in an "or" relationship.

[0021] It should be noted that surgical navigation is a visual image-guided surgical technology developed with the help of computers, precision instruments and image processing technology, based on medical images such as ultrasound, X-rays, CT (computed tomography) and MRI (magnetic resonance imaging). Surgical navigation can achieve visualization and automation of surgical operations by digitizing the patient's lesion tissue in three dimensions and tracking the position of surgical instruments in real time, thereby assisting doctors or robots to complete surgical tasks more quickly, accurately and safely.

[0022] Shoulder replacement surgery is an orthopedic procedure used to treat severe shoulder pain and dysfunction. Shoulder replacement surgery is often performed on patients who experience persistent pain and limited function due to shoulder arthritis, shoulder fractures, rotator cuff injuries, or other conditions that have destroyed the shoulder joint.

[0023] Artificial shoulder replacement includes hemi-shoulder replacement, total shoulder replacement and reverse total shoulder replacement. Among them, hemi-shoulder replacement is mainly used for arthritis involving the humeral head and osteonecrosis not involving the labrum, and severe proximal humeral fractures. Total shoulder replacement is mainly used for osteoarthritis, inflammatory arthritis, osteonecrosis involving the labrum and postmenopausal joint degenerative diseases. Reverse total shoulder replacement is mainly used for patients with osteoarthritis and complex humeral fractures. It is different from total shoulder and hemi-shoulder replacement in that the indications are mainly accompanied by severe rotator cuff tear or loss but the biceps function is still complete. Because of its good patient recovery effect and lower revision rate than total shoulder replacement, it is currently the most widely used shoulder replacement.

[0024] Shoulder replacement surgery aims to reduce pain and restore joint motion by removing the damaged joint surface (osteotomy) and implanting an artificial prosthesis into the remaining joint to replace the damaged joint.

[0025] The general process of shoulder surgery includes preoperative examination (such as medical imaging acquisition), surgical approach, dislocation of the humeral head, osteotomy and medullary cavity expansion, prosthesis installation, rotator cuff repair and postoperative evaluation.

[0026] Among them, the steps of osteotomy and prosthesis installation are the most critical. Factors such as the amount of osteotomy, the angle of the osteotomy plane, the position of the prosthesis installation hole, and the fit of the prosthesis implant surface directly affect the success or failure of the operation. If the prosthesis is improperly positioned or the implantation technique is poor, it may cause postoperative pain, joint instability, dislocation, or prosthesis loosening. Therefore, how to complete osteotomy and prosthesis installation with high quality has become the core demand of doctors in clinical practice. If a personalized surgical plan can be made before surgery, a suitable prosthesis can be selected, and joint mobility can be simulated, and navigation technology can be used during the osteotomy process to help doctors complete the preoperative planning plan and improve the accuracy of osteotomy and prosthesis placement, postoperative complications can be reduced, thereby improving the quality of the operation. In addition, in preoperative planning, the accuracy and stability of prosthesis placement can be predicted, the range of motion of the joint can be adjusted, and postoperative rehabilitation can be planned, thereby improving surgical expectations.

[0027] Traditional surgical navigation systems in the related art are mainly suitable for trauma surgery on the pelvis, hip and limbs, full-segment spinal surgery, and joint replacement surgery for hips, knees, etc. In the related art, surgical navigation systems for shoulder joint replacement surgery have not yet been popularized.

[0028] In the related art, doctors have the following main defects in shoulder replacement surgery: First, in the related art, before performing shoulder replacement surgery, doctors can only plan the surgical plan based on the medical images of the patient's affected bone taken before the operation and based on subjective experience. When doctors plan the surgical plan based on subjective experience, they are limited to qualitatively analyzing whether the patient's affected bone is suitable for surgery. It is difficult to accurately, objectively and quantitatively plan the size of the osteotomy, the size of the implanted prosthesis and the optimal position of the prosthesis based on the individual characteristics of the affected bone.

[0029] Among them, in the related technology, during the shoulder replacement surgery, doctors lack objective and quantitative preoperative surgical planning, which results in doctors only being able to complete the shoulder replacement surgery based on subjective experience, leading to unstable surgical results, increased surgical risks, and affecting patients' postoperative recovery and final efficacy.

[0030] In addition, there are muscles, blood vessels, nerves and other tissue structures around the bones, so it is difficult for doctors to accurately judge the entire shape of the affected bones with the naked eye. When the patient's affected bones have bone defects or abnormal morphology, it is also difficult for doctors to accurately judge the extent of the bone defects or abnormal bone morphology with the naked eye, which may lead to errors in surgical operations and affect the accuracy and safety of the operation.

[0031] Thirdly, after prosthesis planning, there is a lack of effective simulation means to simulate and evaluate whether the installation position of the prosthesis and the patient's shoulder joint range of motion are within a reasonable range after prosthesis implantation. This makes it impossible to accurately evaluate whether the installation position of the prosthesis and the patient's shoulder joint range of motion are within a reasonable range, increasing the risk of long-term pain, unstable shoulder joint movement, and prosthesis loosening or dislocation in patients after surgery.

[0032] Finally, due to the limited space in the shoulder joint area and the thin scapula, the accuracy and stability of prosthesis implantation in shoulder replacement surgery are required to be high. For example, during reverse shoulder replacement surgery, screws are required to install the base, but because the glenoid bone is too thin, if the affected bone cannot be accurately calibrated and guided during the operation, the screws may penetrate the glenoid, resulting in surgical failure. The traditional surgical navigation system in the related technology is difficult to guide doctors to accurately and stably implant the prosthesis.

[0033] In this regard, the present invention provides a shoulder replacement surgery navigation system and method. The shoulder replacement surgery navigation system provided by the present invention can perform personalized prosthesis planning and surgical plan formulation based on medical images of the affected bone before the shoulder replacement surgery, simulate and evaluate the prosthesis implantation to more accurately evaluate whether the prosthesis installation position and the patient's shoulder joint range of motion are within a reasonable range, improve the accuracy and stability of prosthesis implantation during the shoulder replacement surgery, thereby improving the accuracy, stability and safety of the shoulder replacement surgery, and at the same time can reduce the operation time and radiation during the operation.

[0034] The shoulder replacement surgery navigation system provided by the present invention can provide an accurate, stable and safe surgical auxiliary means, can simulate and evaluate the patient's joint motion after prosthesis implantation, make the prosthesis model and planned position more accurate, can quickly implant prostheses such as center nails, reduce the radiation dose in traditional surgery, can automatically identify the patient's unexpected displacement, and use a following strategy to complete target tracking, further ensuring the accuracy and safety of the surgery, can significantly improve the effect of shoulder replacement surgery, reduce postoperative complications, and accelerate the patient's recovery process.

[0035] Combine the following Figure 1-Figure 7 The present invention describes a navigation system for shoulder replacement surgery.

[0036] Figure 1 This is one of the structural schematic diagrams of the shoulder replacement surgery navigation system provided by the present invention. Figure 1 The shoulder replacement surgery navigation system provided by the present invention is described. Figure 1 As shown, the shoulder replacement surgery navigation system 1000 includes: a controller 1100 and a navigation positioning device 2000; the controller 1100 is communicatively connected with the navigation positioning device 2000; the controller 1100 includes a preoperative planning module 104, a preoperative simulation module 105 and an intraoperative execution module 106.

[0037] The preoperative planning module 104 is used to generate a three-dimensional bone model of the patient's affected bone based on the first image and the second image, perform prosthesis planning based on the three-dimensional bone model of the affected bone, and obtain parameter information of the prosthesis to be implanted in the affected bone. The first image includes a medical image of the affected bone before the shoulder replacement surgery, and the second image includes a medical image of the healthy bone corresponding to the affected bone. The affected bone and the healthy bone corresponding to the affected bone are symmetrically distributed with the spine as the midline, and the parameter information includes size, posture information and installation position information.

[0038] The preoperative simulation module 105 is used to simulate the range of motion of the patient's surgical shoulder joint after the prosthesis to be implanted is implanted into the affected bone based on parameter information of the prosthesis to be implanted, and obtain the maximum motion angle of the patient's surgical shoulder joint.

[0039] The intraoperative execution module 106 is used to control the navigation and positioning device 2000 to perform surgical navigation in the shoulder replacement surgery for the affected bone based on the parameter information of the prosthesis to be implanted when it is determined that the maximum motion angle of the patient's surgical side shoulder joint is greater than the motion angle threshold.

[0040] The navigation positioning device 2000 is used to perform surgical navigation in a shoulder joint replacement surgery on an affected bone in response to the control of the intraoperative execution module 106 .

[0041] It should be noted that the controller 1100 in the embodiment of the present invention may be configured in electronic devices such as computers and servers.

[0042] Specifically, the shoulder replacement surgery system provided by the present invention can provide surgical navigation for doctors performing the shoulder replacement surgery before and during the shoulder replacement surgery on the patient's affected bone, thereby improving the accuracy, safety and efficiency of the shoulder replacement surgery.

[0043] It is understandable that in order to maintain the balance and stability of the human body, the human skeleton is symmetrically distributed with the spine as the midline. Usually, the bones of the human shoulder are also symmetrically distributed with the spine as the midline.

[0044] The affected bone and healthy bone in the embodiment of the present invention are symmetrically distributed with the spine as the midline. The affected bone is the bone on the surgical side that needs shoulder replacement surgery, and the healthy bone is the bone on the healthy side that corresponds to the affected bone and does not need shoulder replacement surgery. The surgical side is the side of the body that needs shoulder replacement surgery, and the healthy side is the side of the body that does not need shoulder replacement surgery.

[0045] In the case where the patient's affected bone has bone defects and / or abnormal morphology, it is difficult to completely and accurately generate a three-dimensional bone model of the affected bone based solely on the image of the affected bone. Therefore, in the embodiment of the present invention, the image of the healthy bone of the patient's healthy side is used for mapping, so that a complete and accurate three-dimensional bone model and bony landmarks of the affected bone can be generated, thereby improving the accuracy of preoperative surgical planning.

[0046] It is understandable that the patient and the affected bone of the patient in the embodiment of the present invention can be determined based on actual needs. The patient and the affected bone of the patient in the embodiment of the present invention are not specifically limited.

[0047] Optionally, the affected bone of the above patient may include at least one of a scapula, a humerus or a clavicle.

[0048] Before performing shoulder replacement surgery on the patient's affected bone, the preoperative planning module 104 can obtain a medical image of the patient's affected bone as a first image, and obtain a medical image of a healthy bone corresponding to the affected bone as a second image.

[0049] It should be noted that the medical images of the affected bone and the healthy bone in the embodiment of the present invention may include but are not limited to X-ray images, CT images, MRI images and other medical images of the affected bone and the healthy bone.

[0050] It is understandable that medical images such as X-ray images, CT images, and MRI images follow standardized patient positions, fixed imaging equipment, image reconstruction and positioning methods, and standardized reports and markings, so the position of the affected bone in the above medical images is relatively fixed. In the embodiment of the present invention, the horizontal direction in the above medical images can be determined as the X-axis direction, and the vertical direction in the above medical images can be determined as the Y-axis direction.

[0051] In the embodiment of the present invention, the preoperative planning module 104 can obtain the medical images of the patient's affected bone and the healthy bone corresponding to the above-mentioned affected bone before performing shoulder replacement surgery on the patient's affected bone in a variety of ways. For example, the preoperative planning module 104 can obtain the medical images of the patient's affected bone and the healthy bone corresponding to the above-mentioned affected bone by means of data query; or the preoperative planning module 104 can also obtain the medical images of the patient's affected bone and the healthy bone corresponding to the above-mentioned affected bone based on the user's input. The specific method of obtaining the medical images of the patient's affected bone and the healthy bone corresponding to the above-mentioned affected bone is not limited in the embodiment of the present invention.

[0052] After the preoperative planning module 104 obtains the medical images of the patient's affected bone and the healthy bone corresponding to the affected bone, the preoperative planning module 104 can determine the medical image of the affected bone as the first image, and the medical image of the healthy bone corresponding to the affected bone as the second image. Then, the preoperative planning module 104 can generate a three-dimensional bone model of the affected bone based on the first image and the second image through data calculation, mathematical statistics or deep learning and other technologies.

[0053] As an optional embodiment, the preoperative planning module 104 includes a data import unit, an image processing unit and a prosthesis planning unit.

[0054] The data import unit is used to obtain the first image and the second image, and send the first image and the second image to the image processing unit when the image qualities of the first image and the second image meet the preset standards.

[0055] The image processing unit is used to construct a first three-dimensional point cloud model based on the first image, construct a second three-dimensional point cloud model based on the second image, extract the centroids of the first three-dimensional point cloud model and the second three-dimensional point cloud model, mirror-reverse the second three-dimensional point cloud model in the horizontal direction based on the centroids of the first three-dimensional point cloud model and the second three-dimensional point cloud model to obtain a third three-dimensional point cloud model, align the first three-dimensional point cloud model and the third three-dimensional point cloud model based on the centroids of the first three-dimensional point cloud model and the centroid of the third three-dimensional point cloud model, obtain a feature descriptor for each point in the third three-dimensional point cloud model, and then based on the feature descriptors of each point in the third three-dimensional point cloud model, use a consistent initial registration algorithm to perform point cloud coarse registration on the third three-dimensional point cloud model and the first three-dimensional point cloud model to obtain a fourth three-dimensional point cloud model, use an iterative closest point algorithm and singular value decomposition to perform point cloud fine registration on the fourth three-dimensional point cloud model and the first three-dimensional point cloud model to obtain a three-dimensional bone model of the affected bone.

[0056] The prosthesis planning unit is used to obtain the bone information of the affected bone based on the three-dimensional bone model of the affected bone, and then perform prosthesis planning based on the bone information of the affected bone to obtain parameter information of the prosthesis to be implanted.

[0057] Specifically, the data import unit can obtain the medical images of the patient's affected bone and the healthy bone corresponding to the above-mentioned affected bone in a variety of ways before performing shoulder replacement surgery on the patient's affected bone. For example, the data import unit can obtain the medical images of the patient's affected bone and the healthy bone corresponding to the above-mentioned affected bone by means of data query; or the data import unit can also obtain the medical images of the patient's affected bone and the healthy bone corresponding to the above-mentioned affected bone based on user input. The specific manner in which the data import unit obtains the medical images of the patient's affected bone and the healthy bone corresponding to the above-mentioned affected bone is not limited in the embodiment of the present invention.

[0058] It should be noted that, since it is difficult to generate a three-dimensional point cloud model based on the first image when the image quality of the first image is poor, the data import unit in the embodiment of the present invention can set a preset standard based on prior knowledge and / or actual conditions, and check the first image and the second image based on the preset standard to determine whether the image quality of the first image and the second image meets the preset standard.

[0059] When the data import unit determines that the image quality of the first image and the second image meets the preset standard, it can determine that the image quality of the first image and the second image can meet the requirements of generating a three-dimensional point cloud model, and then send the first image and the second image to the image processing unit.

[0060] After the image processing unit receives the first image and the second image sent by the data import unit, it can construct a first three-dimensional point cloud model based on the first image and a second three-dimensional point cloud model based on the second image based on numerical calculation, mathematical statistics, and deep learning.

[0061] As an optional embodiment, the image processing unit is specifically used to perform data preprocessing on the first image to obtain the first image after data preprocessing when it is determined that the image quality of the first image meets a preset standard; based on the distribution of bone blocks of the affected bone, perform image segmentation on the first image after data preprocessing to obtain multiple sub-images corresponding to the first image, each sub-image includes only one bone block of the affected bone; the sub-image of the largest bone block of the affected bone is determined as the target sub-image; and then based on the target sub-image, a three-dimensional point cloud model of the largest bone block of the affected bone is constructed as the first three-dimensional point cloud model.

[0062] Specifically, the image processing unit may perform data preprocessing on the first image to further improve the image quality of the first image, wherein the data preprocessing may include image denoising, contrast enhancement, image sharpening, and the like.

[0063] It should be noted that, considering the possibility of bone fracture in the affected bone, the image processing unit may segment the first image after data preprocessing to obtain a plurality of sub-images corresponding to the first image, wherein each sub-image corresponding to the first image includes only one bone fragment of the affected bone.

[0064] After the image processing unit obtains the sub-images corresponding to the above-mentioned first image, it can determine the sub-image including the largest bone block in the above-mentioned affected bone as the target sub-image, and then generate a three-dimensional point cloud model of the largest bone block in the above-mentioned affected bone based on the above-mentioned target sub-image as the first three-dimensional point cloud model.

[0065] It should be noted that, in the embodiment of the present invention, the image processing unit can use the MarchingCubes (MC) algorithm to generate a three-dimensional point cloud model of the largest bone block in the above-mentioned affected bone based on the above-mentioned target sub-image as the first three-dimensional point cloud model. In the embodiment of the present invention, the image processing unit can also use the marching cubes algorithm to generate a three-dimensional point cloud model of the healthy bone corresponding to the above-mentioned affected bone based on the second image as the second three-dimensional point cloud model.

[0066] Among them, the marching cube algorithm is a very mature algorithm for extracting isosurfaces. The basic idea of ​​the algorithm is to process the cubes (voxels) in the data field one by one, separate the cubes that intersect with the isosurface, and use interpolation to calculate the intersection of the isosurface and the edge of the cube. According to the relative position of each vertex of the cube and the isosurface, the intersection of the isosurface and the edge of the cube is connected in a certain way to generate an isosurface, which is an approximate representation of the isosurface in the cube. This is because the marching cube algorithm has a basic assumption: the data field along the edge of the hexahedron changes continuously. In other words, if the two vertices of an edge are respectively greater than or less than the value of the isosurface, then there is one and only one point on the edge that is the intersection of this edge and the isosurface.

[0067] The image processing unit in the embodiment of the present invention can ensure that the clarity and contrast of the image meet the preset standards for subsequent analysis or modeling by preprocessing the first image, which helps to reduce analysis errors caused by poor image quality. By determining the sub-image containing the largest bone block of the affected bone as the target sub-image and constructing a three-dimensional point cloud model based on the sub-image, it can fully take into account the possible bone fracture of the affected bone and provide a more accurate data basis for generating a three-dimensional bone model of the affected bone.

[0068] In the embodiment of the present invention, Represents the first 3D point cloud model, using Represents a second 3D point cloud model.

[0069] The image processing unit constructs the first three-dimensional point cloud model And the second 3D point cloud model Afterwards, the first 3D point cloud model can be extracted The centroid And the second 3D point cloud model The centroid .

[0070] The position information of the centroid of the 3D point cloud model can be calculated using the following formula: in, Represents the location information of the centroid of the three-dimensional point cloud model; Represents the first The location information of each point; Indicates the number of points in the 3D point cloud model; Represents the first The quality of each point, in the embodiment of the present invention The value of is 1; Represents a positive integer greater than zero.

[0071] It should be noted that in the embodiment of the present invention, the position information of any point in the three-dimensional point cloud model can be represented by a coordinate value, and the position information of the centroid of the three-dimensional point cloud model can also be represented by a coordinate value.

[0072] The image processing unit obtains the first three-dimensional point cloud model The centroid And the second 3D point cloud model The centroid Afterwards, based on the second 3D point cloud model The centroid , the second 3D point cloud model The coordinates of each point in the image are flipped horizontally to obtain a third 3D point cloud model. .

[0073] Third 3D point cloud model Middle The location information of each point can be expressed by the following formula: in, Represents the second 3D point cloud model Middle The location information of each point, Represents the second 3D point cloud model The centroid location information; Represents the second 3D point cloud model Middle The position information of the points after mirror flipping in the horizontal direction, that is, the third 3D point cloud model Middle The location information of each point; , Represents the second 3D point cloud model The number of midpoints.

[0074] The image processing unit obtains the third 3D point cloud model Afterwards, you can follow Translate the above third 3D point cloud model , complete the third 3D point cloud model And the first 3D point cloud model alignment.

[0075] It should be noted that the SPFH (Simplified Point Feature Histograms) feature vector is a feature representation method used to describe the local geometric relationship of each point in the point cloud. The dimension of the SPFH feature vector is 33. The SPFH feature is generated by calculating the geometric relationship between the point and the points in its neighborhood. The SPFH feature vector consists of three angle histograms: the angle between the normal vector of the point and its neighboring point, the angle between the normal vector of the point and the line connecting the two points, and the angle between the normal vector of the neighboring point and the line connecting the two points.

[0076] FPFH (Fast Point Feature Histograms) feature vector is a feature descriptor widely used in point cloud processing.

[0077] For the third 3D point cloud model The points, the image processing unit can calculate the third 3D point cloud model by numerical calculation The The SPFH feature vector of points. Among them, Represents a positive integer greater than zero.

[0078] The image processing unit obtains the third 3D point cloud model The After the SPFH feature vectors of the points, the third 3D point cloud model can be obtained by weighted accumulation The The SPFH features of the points in the neighborhood of points are used to obtain the third 3D point cloud model. The The FPFH feature vector of each point is calculated as follows: in, Represents the third 3D point cloud model The FPFH feature vector of points; Represents the third 3D point cloud model The SPFH feature vector of points; Represents the third 3D point cloud model Middle Point Neighborhood points; Represents the third 3D point cloud model Middle Point Neighborhood points The SPFH feature vector of Represents the third 3D point cloud model The Point and Neighborhood points The distance between represents a positive integer greater than zero; Represents the third 3D point cloud model Middle The total number of neighboring points of a point.

[0079] The image processing unit obtains the third 3D point cloud model The FPFH feature vector of the point Afterwards, the third 3D point cloud model can be The FPFH feature vector of the point Determined as a third 3D point cloud model The The feature descriptor of a point.

[0080] The image processing unit obtains the third 3D point cloud model The After the feature descriptors of the points are obtained, the image processing unit can use the Sample Consensus Initial Alignment (SAC-IA) algorithm to align the third 3D point cloud model. And the first 3D point cloud model The point cloud coarse registration includes the following steps: Select sampling points, represents a positive integer greater than zero. In order to ensure that the third 3D point cloud model The sampling points selected in the present invention have different FPFH features. In the embodiment of the present invention, the image processing unit obtains the FPFH features from the third three-dimensional point cloud model. The distance between any two sampling points selected from the .

[0081] For the third 3D point cloud model The sampling points, the image processing unit can be based on the third 3D point cloud model Middle The feature descriptor of the sampling points , the first 3D point cloud model 3D point cloud model The The sampling points have one or more points with similar FPFH features, which are determined as the third 3D point cloud model. The The similar points corresponding to the sampling points. Among them, in the first three-dimensional point cloud model The FPFH feature of any point in the third 3D point cloud model The The feature descriptor of the sampling points When the Euclidean distance between them is less than the preset value, the first three-dimensional point cloud model can be determined. Any of the above points in the third 3D point cloud model The The sampling points have similar FPFH characteristics.

[0082] In the third 3D point cloud model The When the number of similar points corresponding to the sampling points is one, the image processing unit can convert the third 3D point cloud model The The similar points corresponding to the sampling points are determined as the third 3D point cloud model The The associated points corresponding to the sampling points; in the third 3D point cloud model The When the number of similar points corresponding to the sampling points is multiple, the image processing unit can convert the third 3D point cloud model The Any one of the similar points corresponding to the sampling points is determined as the third 3D point cloud model The The associated points corresponding to the sampling points.

[0083] The image processing unit determines the third 3D point cloud model The After the associated points corresponding to the sampling points, the third 3D point cloud model can be calculated The Sampling points and the third 3D point cloud model The The rigid body transformation matrix between the associated points corresponding to the sampling points can then be used to obtain the third 3D point cloud model by solving the distance error and function. The Sampling points and the third 3D point cloud model The The matching degree between the associated points corresponding to the sampling points. Among them, the third 3D point cloud model The Sampling points and the third 3D point cloud model The The higher the matching degree between the associated points corresponding to the sampling points, the better the 3D point cloud model The Sampling points and the third 3D point cloud model The The higher the matching degree between the associated points corresponding to the sampling points.

[0084] It should be noted that the distance error and function in the embodiment of the present invention can be expressed using the Huber penalty function, which is expressed as ,in: in, represents a predefined threshold; Represents the third 3D point cloud model The Sampling points and the third 3D point cloud model The The distance difference between the diameters of the associated points corresponding to the sampling points.

[0085] The image processing unit processes the third 3D point cloud model And the first 3D point cloud model By coarse registration of the point cloud, we can find a set of optimal transformations that minimize the above Huber penalty function. Among them, the optimal transformation It can be solved by a gradient-based optimization algorithm.

[0086] The image processing unit converts the third 3D point cloud model According to the optimal transformation By transforming, we can obtain the fourth 3D point cloud model .

[0087] The image processing unit obtains the fourth 3D point cloud model After that, the iterative closest point (ICP) algorithm can be used to calculate the fourth 3D point cloud model. And the first 3D point cloud model Perform precise point cloud registration. The specific steps include: using initial transformation The fourth 3D point cloud model All points are transformed into the first 3D point cloud model Next, define the following energy function: in, represents the energy function value; Represents the fourth 3D point cloud model The After the point is transformed, The nearest point in represents the first transformation parameter; represents the second transformation parameter; Represents the fourth 3D point cloud model The points.

[0088] It should be noted that the optimization target of the energy function in the embodiment of the present invention is the energy function value Minimum.

[0089] Use the Singular Value Decomposition (SVD) algorithm to obtain the first transformation parameters and the second transformation parameter The optimal solution of Among them, the first transformation parameter in the embodiment of the present invention is and the second transformation parameter The optimal solution is The first transformation parameter is the smallest when The value of and the second transformation parameter Based on the first transformation parameter and the second transformation parameter The optimal solution of The specific method is: transform the upper left corner 3x3 matrix to the first transformation parameter The optimal solution of the right 3x1 matrix is ​​the second transformation parameter The optimal solution is to fill the bottom row with 0, 0, 0, 1, and get the transformation .

[0090] The fourth 3D point cloud model According to the optimal transformation By performing the transformation, a three-dimensional bone model of the affected bone can be obtained.

[0091] Second 3D point cloud model To the first 3D point cloud model Transformation .

[0092] After the image processing unit in the embodiment of the present invention constructs a first three-dimensional point cloud model based on the first image and a second three-dimensional point cloud model based on the second image, the image processing unit extracts the centroid of the first three-dimensional point cloud model and the second three-dimensional point cloud model, and performs mirror inversion on the second three-dimensional point cloud model in the horizontal direction based on the centroid to obtain a third three-dimensional point cloud model, thereby realizing symmetric processing of the second three-dimensional point cloud model, and performing point cloud rough registration on the first three-dimensional point cloud model and the third three-dimensional point cloud model by adopting a consistent initial registration algorithm to obtain a fourth three-dimensional point cloud model, thereby quickly finding an initial corresponding relationship between the first three-dimensional point cloud model and the third three-dimensional point cloud model, thereby helping to narrow the calculation range of subsequent precise registration and improve registration efficiency, and by iteratively optimizing the transformation relationship between the first three-dimensional point cloud model and the fourth three-dimensional point cloud model, the error between the first three-dimensional point cloud model and the fourth three-dimensional point cloud model can be gradually reduced, thereby finally realizing precise registration between the first three-dimensional point cloud model and the second three-dimensional point cloud model, and obtaining a three-dimensional bone model of the affected bone, thereby providing a more accurate data basis for subsequent surgical plan planning for the affected bone and intraoperative surgical navigation.

[0093] When the prosthesis planning unit receives the three-dimensional bone model of the affected bone sent by the image processing unit, it can obtain parameter information of the prosthesis to be implanted based on the three-dimensional bone model of the affected bone through numerical calculation, mathematical statistics, and deep learning technology.

[0094] As an optional embodiment, in the case that the affected bone is a scapula, the prosthesis planning unit is specifically used to perform spatial correction on the three-dimensional bone model of the affected bone, and after obtaining the spatially corrected three-dimensional bone model of the affected bone, calculate the bony information of the affected bone based on the spatially corrected three-dimensional bone model of the affected bone, and based on the bony information of the affected bone, obtain the size and posture information of the prosthesis to be implanted, and based on the size and posture information of the prosthesis to be implanted, use an intrusion optimization algorithm to obtain the installation position information of the prosthesis to be implanted, and then determine the size, posture information and installation position information of the prosthesis to be implanted as parameter information of the prosthesis to be implanted.

[0095] Among them, the bony information of the affected bone includes the position information of the upper pole, lower pole, front edge and rear edge of the glenoid of the affected bone, the normal direction of the glenoid plane of the affected bone, and the native posterior tilt angle and native superior tilt angle of the glenoid of the affected bone. The normal direction of the glenoid plane of the affected bone is the direction of the normal of the glenoid plane of the affected bone pointing to the humerus connected to the glenoid of the affected bone. The glenoid plane of the affected bone is obtained based on the fitting of the upper pole, lower pole, front edge and rear edge of the glenoid of the affected bone. The native posterior tilt angle of the glenoid of the affected bone is the angle between the projection line of the glenoid plane normal of the affected bone in the transverse position of the affected bone and the target auxiliary line of the affected bone. The native superior tilt angle of the glenoid of the affected bone is the angle between the projection line of the glenoid plane normal of the affected bone in the coronal position of the affected bone and the target auxiliary line of the affected bone. The target auxiliary line is the line connecting the innermost point of the scapula and the center point of the glenoid of the scapula.

[0096] Figure 2 This is one of the cross-sectional diagrams of the shoulder joint. Figure 3 This is the second cross-sectional diagram of the shoulder joint. Figure 4 This is the third cross-sectional diagram of the shoulder joint. When the affected bone is the scapula, the shape of the affected bone and its connection with other bones are as follows: Figures 2 to 4 shown.

[0097] In order to eliminate the influence of the patient's posture on prosthesis planning when taking medical images of the affected bone, the prosthesis planning unit can first perform spatial correction on the three-dimensional bone model of the affected bone when receiving the three-dimensional bone model of the affected bone sent by the image processing unit.

[0098] The specific manner in which the prosthesis planning unit spatially corrects the three-dimensional bone model of the affected bone includes: taking the center point of the glenoid cavity of the affected bone as the rotation center, rotating the target auxiliary line of the affected bone (Friedman line, i.e., the line connecting the innermost point of the scapula and the center point of the glenoid cavity of the scapula) to be parallel to the horizontal direction (X-axis direction), and then rotating the three-dimensional bone model of the affected bone around the rotated Friedman line, so that when the lower edge point of the affected bone and the target auxiliary line of the affected bone are located in the standard coronal plane (i.e., the XOZ plane), the spatial correction of the three-dimensional bone model of the affected bone is determined to be completed, and the three-dimensional bone model of the affected bone after spatial correction is obtained.

[0099] After the prosthesis planning unit obtains the spatially corrected three-dimensional bone model of the affected bone, the bone information of the affected bone can be calculated based on the spatially corrected three-dimensional bone model of the affected bone.

[0100] It should be noted that the transverse and coronal positions in the embodiments of the present invention are special terms in the medical field. The transverse position, also known as the horizontal position or the axial position, refers to a section parallel to the ground, which divides the human body into two parts: the upper (cranial side) and the lower (caudal side). The coronal position refers to the position of the human body when it is standing according to the front and back position of the human body, also known as the frontal position or the frontal position.

[0101] After the prosthesis planning unit obtains the bone information of the affected bone, it can obtain the upper and lower lengths of the glenoid cavity of the affected bone based on the position information of the upper and lower poles of the glenoid cavity of the affected bone. The anterior-posterior length of the glenoid cavity of the affected bone can also be obtained based on the position of the anterior and posterior edges of the glenoid cavity of the affected bone. .in, Indicates the position information of the upper pole of the glenoid of the affected bone; Indicates the position information of the inferior pole of the glenoid cavity of the affected bone; Indicates the position information of the front edge of the glenoid cavity of the affected bone; Indicates the position information of the posterior edge of the glenoid cavity of the affected bone.

[0102] The prosthesis planning unit obtains the upper and lower length of the glenoid cavity of the affected bone and front-to-back length After that, you can choose a prosthesis that is shorter in both its upper and lower length and its anterior-posterior length than the glenoid cavity of the affected bone. and front-to-back length The prosthesis can be used as the target prosthesis, and then the target prosthesis with the largest up-down length and front-back length among the target prostheses can be determined as the prosthesis to be implanted into the affected bone.

[0103] As an optional embodiment, the prosthesis planning unit is specifically used to determine the native posterior tilt angle and native superior tilt angle of the glenoid cavity of the affected bone as the posture information of the prosthesis to be implanted, construct a three-dimensional model of the prosthesis to be implanted based on the size and posture information of the prosthesis to be implanted, define the closest distance between any point on the base plane of the three-dimensional model of the prosthesis to be implanted and the three-dimensional bone model of the affected bone as the intrusion amount corresponding to any point, calculate the intrusion amount score corresponding to each position of the three-dimensional model of the prosthesis to be implanted within the installation range of the three-dimensional bone model of the affected bone based on a predefined ideal range of intrusion amount, and then determine the position with the highest intrusion amount score within the installation range of the three-dimensional bone model of the affected bone as the installation position of the prosthesis to be implanted, and obtain the installation position information of the prosthesis to be implanted, and the installation range of the three-dimensional bone model of the affected bone is determined based on the upper pole, lower pole, front edge and rear edge of the glenoid cavity of the affected bone.

[0104] It should be noted that in the related art, doctors usually use a posterior tilt angle of 0° and an upward tilt angle of -5° (or a downward tilt angle of -5°) as the initial angle of the prosthesis for prosthesis planning. Different from the related art, the prosthesis planning unit in the embodiment of the present invention determines the native posterior tilt angle and upward tilt angle of the affected bone as the posture information of the prosthesis to be implanted.

[0105] After the prosthesis planning unit obtains the size and posture information of the prosthesis to be implanted, it can obtain the installation position information of the prosthesis to be implanted by using the intrusion optimization algorithm based on the size and posture information of the prosthesis to be implanted. The specific steps are as follows: the prosthesis planning unit can define the closest distance between any point on the plane of the prosthesis base to be implanted and the bone surface as the intrusion corresponding to the above any point. When any point on the plane of the prosthesis base to be implanted is located outside the bone surface, the intrusion corresponding to the above any point is greater than 0. When any point on the plane of the prosthesis base to be implanted is located inside the bone surface, the intrusion corresponding to the above any point is less than 0. Among them, the intrusion can be used to represent the relationship between the prosthesis and the bone surface.

[0106] Considering the firm connection between the implanted prosthesis and the bone surface, the intrusion corresponding to the point on the plane of the implanted prosthesis base should be minimized and the proportion of points with corresponding intrusion values ​​less than 0 should be increased. However, considering the clinical principle of minimizing osteotomy to protect the affected bone, the intrusion value cannot be too small (e.g., -4mm, -6mm intrusion means too much osteotomy). Therefore, the prosthesis planning unit in the embodiment of the present invention determines the ideal intrusion range as (-2, 0) based on the above principle, and then defines the intrusion score. as follows: in, Indicates the number of points whose corresponding intrusion amount is in the interval (-2,0), Indicates the total number of points.

[0107] Based on the size and posture information of the prosthesis to be implanted, the prosthesis planning unit can construct a three-dimensional model of the prosthesis to be implanted.

[0108] After the prosthesis planning unit constructs the three-dimensional model of the prosthesis to be implanted, it can control the three-dimensional model of the prosthesis to be implanted to move within the installation range in the three-dimensional bone model of the affected bone, and based on the entry score of the three-dimensional model of the prosthesis to be implanted at each position within the installation range in the three-dimensional bone model of the affected bone, the position with the highest intrusion score within the installation range in the three-dimensional bone model of the affected bone can be determined as the installation position of the prosthesis to be implanted, thereby obtaining the installation position information of the prosthesis to be implanted.

[0109] It should be noted that the installation range in the three-dimensional bone model of the affected bone is determined based on the upper pole, lower pole, front edge and rear edge of the glenoid cavity of the affected bone.

[0110] It should be noted that the prosthesis planning unit in the embodiment of the present invention also has the functions of surgical procedure selection, prosthesis series, prosthesis model and manual adjustment of position, and can adjust the installation position and posture of the prosthesis to be implanted in two-dimensional slices (coronal, sagittal, and transverse) and three-dimensional space. The prosthesis planning unit can calculate the angle of the prosthesis to be implanted (such as the posterior tilt angle, the superior tilt angle, the anteversion angle of the humeral stem, and the neck-shaft angle, etc.) in real time, and simultaneously calculate the displacement of the affected bone after reduction, providing a basis for the doctor to manually adjust the prosthesis planning.

[0111] After the prosthesis planning unit obtains the parameter information of the prosthesis to be implanted, the parameter information of the prosthesis to be implanted can be sent to the preoperative simulation module 105 .

[0112] As an optional embodiment, the preoperative simulation module 105 is specifically used to generate a three-dimensional bone model of the patient's surgical shoulder joint after the prosthesis to be implanted is implanted into the affected bone based on parameter information of the prosthesis to be implanted; when the posture of the three-dimensional bone model of the patient's surgical shoulder joint is a preset posture, the humerus in the three-dimensional bone model of the patient's surgical shoulder joint is rotated along each preset direction until the humerus in the three-dimensional bone model of the patient's surgical shoulder joint collides with the scapula in the three-dimensional bone model of the patient's surgical shoulder joint; the rotation angle of the humerus in the three-dimensional bone model of the patient's surgical shoulder joint when the collision occurs is determined as the maximum activity angle of the three-dimensional bone model of the patient's surgical shoulder joint in each preset direction.

[0113] The intraoperative execution module 106 is used to send the maximum motion angle of the three-dimensional bone model of the patient's surgical shoulder joint in any preset direction to the prosthesis planning unit when it is determined that the maximum motion angle of the three-dimensional bone model of the patient's surgical shoulder joint in any preset direction is not greater than the motion angle threshold corresponding to any preset direction, so that the prosthesis planning unit can update the parameter information of the prosthesis to be implanted based on the maximum motion angle of the three-dimensional bone model of the patient's surgical shoulder joint in any preset direction. When it is determined that the maximum motion angle of the three-dimensional bone model of the patient's surgical shoulder joint in each preset direction is greater than the motion angle threshold corresponding to each preset direction, based on the parameter information of the prosthesis to be implanted, control the navigation and positioning device 2000 to perform surgical navigation in the shoulder replacement surgery for the affected bone.

[0114] Specifically, when the preoperative simulation module 105 receives parameter information of the prosthesis to be implanted, the preoperative simulation module 105 can generate a three-dimensional bone model of the shoulder joint on the surgical side of the affected bone after the prosthesis to be implanted is implanted into the affected bone based on the parameter information of the prosthesis to be implanted, the three-dimensional bone model of the affected bone, and the first image and the second image, according to the prosthesis transfer principle.

[0115] Figure 5 The three-dimensional bone model of the patient's surgical shoulder joint in the shoulder replacement surgery navigation system provided by the present invention. After the implanted prosthesis is implanted into the affected bone, the three-dimensional bone model of the affected bone's surgical shoulder joint is as follows: Figure 5 shown.

[0116] It should be noted that Figure 5 The orange structures in the figure represent the prosthesis implanted in the scapula, and the green structures represent the prosthesis implanted in the humerus.

[0117] It should be noted that in the embodiment of the present invention, the neutral position can be determined as a preset posture. The neutral position is defined as the flexion angle, flexion angle, internal rotation angle and external rotation angle of the shoulder joint are all 0°, and the abduction angle and adduction angle of the shoulder joint are the abduction angle and adduction angle of the shoulder joint in a natural state.

[0118] When the posture of the three-dimensional bone model of the shoulder joint on the affected side of the surgery is not the above-mentioned preset posture, the preoperative simulation module 105 may need to adjust the posture of the three-dimensional bone model of the shoulder joint on the affected side of the surgery to the preset posture.

[0119] It should be noted that in the embodiment of the present invention, the Friedman line of the patient's surgical side scapula and the lowest point of the lower edge of the patient's surgical side scapula are used to determine the standard coronal plane (i.e., the XOZ plane), and the Friedman line of the patient's surgical side scapula is used as the X-axis to establish a standard coordinate system corresponding to the patient's surgical side scapula.

[0120] After transforming the patient's surgical side humeral axis (the line connecting the center points of the proximal humeral medullary cavity and the distal humeral medullary cavity) extracted from the first image to the standard coordinate system corresponding to the patient's surgical side scapula, the transformed humeral axis is projected onto the XOZ plane in the standard coordinate system corresponding to the patient's surgical side scapula. The angle between this projected axis and the Z axis of the standard coordinate system is the initial abduction angle / adduction angle of the patient's surgical side shoulder joint.

[0121] In the embodiment of the present invention, each preset direction and the activity angle threshold corresponding to each preset direction can be determined based on prior knowledge and / or actual conditions. In the embodiment of the present invention, each preset direction and the activity angle threshold corresponding to each preset direction are not specifically limited.

[0122] Optionally, each preset direction in the embodiment of the present invention may include a flexion direction, a flexion direction, an abduction direction, an adduction direction, an internal rotation direction, and an external rotation direction. The activity angle threshold corresponding to the flexion direction is 120°, the activity angle threshold corresponding to the flexion direction is 60°, the activity angle threshold corresponding to the abduction direction is 120°, the activity angle threshold corresponding to the adduction direction is 50°, the activity angle threshold corresponding to the internal rotation direction is 90°, and the activity angle threshold corresponding to the external rotation direction is 90°.

[0123] It can be understood that when the posture of the three-dimensional bone model of the patient's surgical shoulder joint is a preset posture, the rotation angle of the humerus in the three-dimensional bone model of the patient's surgical shoulder joint is 0°.

[0124] When the posture of the three-dimensional bone model of the patient's surgical shoulder joint is a preset posture, the preoperative simulation module 105 can rotate the humerus in the three-dimensional bone model of the patient's surgical shoulder joint along each preset direction, with each rotation angle being 1°, and determine whether the humerus in the three-dimensional bone model of the patient's surgical shoulder joint collides with the scapula in the three-dimensional bone model of the patient's surgical shoulder joint.

[0125] When the preoperative simulation module 105 determines that the humerus in the three-dimensional bone model of the patient's surgical shoulder joint collides with the scapula in the three-dimensional bone model of the patient's surgical shoulder joint, the rotation angle of the humerus in the three-dimensional bone model of the patient's surgical shoulder joint when the collision occurs can be determined as the maximum motion angle of the three-dimensional bone model of the patient's surgical shoulder joint in each preset direction.

[0126] Figure 6 FIG. 1 is a flow chart of the shoulder joint replacement surgery navigation system provided by the present invention for prosthesis planning and preoperative simulation. Figure 6 As shown, after the preoperative simulation module 105 obtains the maximum motion angle of the three-dimensional bone model of the patient's surgical shoulder joint in each preset direction, the maximum motion angle of the three-dimensional bone model of the patient's surgical shoulder joint in each preset direction can be sent to the intraoperative execution module 106.

[0127] When the intraoperative execution module 106 determines that the maximum motion angle of the three-dimensional bone model of the patient's surgical shoulder joint in any preset direction is not greater than the motion angle threshold corresponding to the above preset direction, it determines that the parameter information of the prosthesis to be implanted has not passed the evaluation, and the maximum motion angle of the three-dimensional bone model of the patient's surgical shoulder joint in the above preset direction can be sent to the prosthesis planning unit.

[0128] When the prosthesis planning unit receives the maximum motion angle of the three-dimensional bone model of the patient's surgical-side shoulder joint in the above-mentioned preset direction sent by the preoperative simulation module 105, it can adjust at least one of the size, posture and installation position of the bone to be implanted based on the maximum motion angle of the three-dimensional bone model of the patient's surgical-side shoulder joint in the above-mentioned preset direction, obtain updated parameter information of the prosthesis to be implanted, and send the above-mentioned updated parameter information of the prosthesis to be implanted to the preoperative simulation module 105 again.

[0129] When the intraoperative execution module 106 determines that the maximum motion angle of the three-dimensional bone model of the patient's surgical shoulder joint in each preset direction is greater than the motion angle threshold corresponding to each preset direction, the parameter information of the prosthesis to be implanted is evaluated, and based on the parameter information of the prosthesis to be implanted, the navigation and positioning device 2000 can be controlled to perform surgical navigation in the shoulder replacement surgery for the affected bone.

[0130] The embodiment of the present invention realizes the precise planning and execution of shoulder replacement surgery through the synergistic effect of the preoperative simulation module and the intraoperative execution module, thereby improving the surgical effect, optimizing patient recovery, reducing surgical risks and complications, and improving surgical efficiency and patient satisfaction.

[0131] As an optional embodiment, the intraoperative execution module is also used to determine a number of bony landmark points at the proximal end of the three-dimensional bone model and a number of bony landmark points at the distal end of the three-dimensional bone model, and then in the shoulder replacement surgery for the affected bone, based on the correspondence between each bony landmark point on the three-dimensional bone model and each bony landmark point on the affected bone, the affected bone and the three-dimensional bone model are aligned, and a mapping relationship between the affected bone and the three-dimensional bone model and / or the first image is established. Based on the parameter information and mapping relationship of the prosthesis to be implanted, the navigation and positioning device 2000 is controlled to perform surgical navigation in the shoulder replacement surgery for the affected bone, the proximal end being the end close to the incision and the distal end being the end away from the incision.

[0132] Specifically, after receiving the three-dimensional bone model of the affected bone sent by the preoperative planning module 104, the intraoperative execution module 106 can also determine multiple bone landmarks on the three-dimensional bone model of the affected bone. Among them, bone landmarks refer to bones in certain parts of the human body, which often form obvious bulges or depressions and are often used for positioning in clinical applications, becoming bone landmarks; in the embodiment of the present invention, the bone landmarks can be determined on the three-dimensional bone model of the affected bone by interactive picking.

[0133] It should be noted that the incision refers to the skin and tissue structure cut open in orthopedic surgery to expose the surgical site and perform surgical operations. The specific location of the incision can be determined based on the first image.

[0134] It should be noted that, after the intraoperative execution module 106 determines multiple bony landmark points on the three-dimensional bone model of the affected bone, the three-dimensional bone model of the affected bone marked with each bony landmark point can be sent to the preoperative planning module 104. The preoperative planning module 104 can determine the planning schemes for different surgical procedures for the affected bone based on the three-dimensional bone model of the affected bone marked with each bony landmark point, and can also provide the offset of the surgical side humerus relative to the preoperative side and relative to the contralateral side, and adjust the prosthesis planning according to the offset.

[0135] After the intraoperative execution module 106 determines multiple bony landmarks on the three-dimensional bone model of the affected bone, it can send the three-dimensional bone model of the affected bone marked with each bony landmark to the human-computer interaction device so that the human-computer interaction device can display the three-dimensional bone model of the affected bone marked with each bony landmark.

[0136] During the process of the doctor performing orthopedic surgery on the affected bone, the doctor can use a probe or other equipment to determine the bone landmarks on the affected bone based on the three-dimensional bone model of the affected bone, the bone landmarks of the three-dimensional bone model, and the prompt information displayed in the human-computer interaction device, thereby establishing a correspondence between the bone landmarks on the three-dimensional bone model of the affected bone and the bone landmarks on the affected bone.

[0137] For example, when the bony landmarks include the medial epicondyle and the lateral epicondyle at the distal end of the humerus, the probe can be used to determine the above-mentioned bony landmarks on the affected bone without piercing the patient's epidermis.

[0138] After establishing the correspondence between the bony landmark points on the three-dimensional bone model of the affected bone and the bony landmark points on the affected bone, the intraoperative execution module 106 can, based on the correspondence between the bony landmark points on the three-dimensional bone model of the affected bone and the bony landmark points on the affected bone, align the affected bone and the three-dimensional bone model of the affected bone through numerical calculation, mathematical statistics or deep learning and other technologies, and establish an imaging relationship between the affected bone and the three-dimensional bone model of the affected bone and / or the first image.

[0139] As an optional embodiment, the intraoperative execution module 106 is specifically used to establish a first registration coordinate system corresponding to the affected bone based on the positional relationship between the bony landmarks on the affected bone, establish a second registration coordinate system corresponding to the three-dimensional bone model based on the positional relationship between the bony landmarks on the three-dimensional bone model, establish a representation matrix of the first registration coordinate system and a representation matrix of the second registration coordinate system, calculate a transformation matrix between the representation matrix of the first registration coordinate system and the representation matrix of the second registration coordinate system as a target change matrix, perform spatial transformation on the bony landmarks on the affected bone based on the target change matrix, and obtain a first registration coordinate system. A spatial point set is provided. Based on each bony landmark point on the affected bone, a first transformation matrix is ​​calculated using a normal distribution transformation algorithm. Based on the first transformation matrix, the first spatial point set is spatially transformed to obtain a second spatial point set. The second spatial point set and each bony landmark point on the three-dimensional bone model are registered using an iterative nearest point algorithm and singular value decomposition to obtain a first registration matrix for describing a mapping relationship between the affected bone and the three-dimensional bone model. Based on the mapping relationship between the three-dimensional bone model and the first image and the first registration matrix, a second registration matrix for describing a mapping relationship between the affected bone and the first image is obtained.

[0140] It should be noted that in the related art, when registering two three-dimensional models, a point pair registration algorithm is used, that is, based on 4-6 points with corresponding relationships on the two three-dimensional models, a point pair registration algorithm is used to calculate the registration matrix. However, for the registration of the three-dimensional bone model of the affected bone and the affected bone, since the determination of the bony landmarks on the affected bone is easily affected by factors such as the patient's soft tissue and cartilage, the bony landmarks determined on the affected bone are not very accurate. At the same time, due to the small surgical area that can be operated on the affected bone, the error in registering the three-dimensional bone model of the affected bone and the affected bone based on the above registration algorithm is relatively large.

[0141] In this regard, an embodiment of the present invention provides an improved registration method. The intraoperative execution module 106 in the embodiment of the present invention performs two registrations on the affected bone and the three-dimensional bone model of the affected bone by establishing a registration coordinate system.

[0142] In the embodiment of the present invention, the intraoperative execution module 106 can establish a first registration coordinate system corresponding to the affected bone based on the positional relationship between the bony landmark points on the affected bone by mathematical methods, and establish a second registration coordinate system corresponding to the three-dimensional bone model based on the positional relationship between the bony landmark points on the three-dimensional bone model by mathematical methods.

[0143] It can be understood that the method of establishing the first registration coordinate system corresponding to the affected bone and the method of establishing the second registration coordinate system corresponding to the three-dimensional bone model in the embodiment of the present invention are the same.

[0144] It should be noted that the bony landmarks on the affected bone include two bony landmarks located at the inner and outer sides of the proximal end of the affected bone and two bony landmarks located at the inner and outer sides of the distal end of the affected bone.

[0145] Taking the humerus as an example, the bony landmarks on the affected bone include bony landmark 1 and bony landmark 2 located on both sides of the proximal end of the humerus, bony landmark A located at the medial epicondyle of the humerus, and bony landmark B located at the lateral epicondyle of the humerus.

[0146] The bony landmarks on the three-dimensional bone model of the affected bone include bony landmark 1 and bony landmark 2 located on both sides of the proximal end of the three-dimensional bone model of the humerus, as well as bony landmark A located at the medial epicondyle of the three-dimensional bone model of the humerus and bony landmark B located at the lateral epicondyle of the three-dimensional bone model of the humerus.

[0147] The vector from the bony landmark point A located on the medial epicondyle of the humerus to the bony landmark point B located on the lateral epicondyle of the humerus The X-axis of the first registration coordinate system is taken as the midpoint of the line connecting the bony landmark point 1 and the bony landmark point 2 located on both sides of the proximal end of the humerus as the origin O of the first registration coordinate system. The plane AOB is determined by the origin O of the first registration coordinate system and the bony landmark point A located at the medial epicondyle of the humerus pointing to the bony landmark point B located at the lateral epicondyle of the humerus. The direction passing through the origin O of the first registration coordinate system and perpendicular to the upward direction of the plane AOB is determined as the Y-axis of the first registration coordinate system, and the first registration coordinate system can be obtained.

[0148] Similarly, the vector from the bony landmark point A located at the medial epicondyle of the 3D bone model of the humerus to the bony landmark point B located at the lateral epicondyle of the humerus is The X-axis of the second registration coordinate system is taken as the midpoint of the line connecting the bony landmark point 1 and the bony landmark point 2 located on both sides of the proximal end of the three-dimensional bone model of the humerus as the origin O of the second registration coordinate system. The plane AOB is determined by the origin O of the second registration coordinate system and the bony landmark point A located at the medial epicondyle of the three-dimensional bone model of the humerus pointing to the bony landmark point B located at the lateral epicondyle of the humerus. The direction passing through the origin O of the second registration coordinate system and perpendicular to the upward direction of the plane AOB is determined as the Y-axis of the second registration coordinate system, and the second registration coordinate system can be obtained.

[0149] A representation matrix of the first registration coordinate system and a representation matrix of the second registration coordinate system are established, and a transformation matrix between the representation matrix of the first registration coordinate system and the representation matrix of the second registration coordinate system is calculated as a target change matrix.

[0150] Specifically, the representation matrix of the first registration coordinate system is established by mathematical methods: and the representation matrix of the second registration coordinate system Afterwards, the representation matrix of the first registration coordinate system can be calculated and the representation matrix of the second registration coordinate system The change matrix between , the specific calculation formula is as follows: Based on the target change matrix, each bony landmark point on the affected bone is spatially transformed to obtain a first spatial point set, and based on each bony landmark point on the affected bone, a normal distribution transformation algorithm is used to calculate a first transformation matrix.

[0151] It should be noted that the representation matrix of the first registration coordinate system is The 3x3 matrix in the upper left corner is the direction vector of the X-axis, Y-axis and Z-axis in the first registration coordinate system. The 3x1 matrix to the right of the above 3x3 matrix is ​​the origin coordinate of the first registration coordinate system. The 1x3 below the above 3x3 matrix and 3x1 matrix is ​​{0, 0, 0, 1}.

[0152] The representation matrix of the second registration coordinate system The 3x3 matrix in the upper left corner is the direction vector of the X-axis, Y-axis and Z-axis in the second registration coordinate system. The 3x1 matrix to the right of the above 3x3 matrix is ​​the origin coordinate of the second registration coordinate system. The 1x3 below the above 3x3 matrix and 3x1 matrix is ​​{0, 0, 0, 1}.

[0153] In the embodiment of the present invention, Represents the bony landmark point cloud on the affected bone, using A point cloud of bony landmarks on a 3D bone model representing the affected bone.

[0154] Based on the target change matrix Point cloud of bony landmarks on the affected bone By performing spatial transformation, the bony landmark point cloud on the affected bone can be Transform to the second registration coordinate system to obtain the first spatial point set .

[0155] Bone landmark point cloud based on the 3D bone model of the affected bone , the first change matrix can be calculated using the Normal Distribution Transform (NDT) algorithm The specific calculation steps include: Divide into multiple grids and calculate the mean in each grid. The calculation formula is as follows: in, represents the mean value in the grid; Indicates the number of bony landmarks in the mesh; Indicates the first The location information of the bony landmarks.

[0156] Calculate the covariance of each grid using the following formula: in, Indicates transpose.

[0157] Constructing a normal distribution , its probability distribution density It can be expressed as: Use Initial Transformation Transform the first space point set For all points in , establish the following evaluation function : in, Represents the first spatial point set Middle points; express According to the initial transformation The bony landmark point cloud mapped onto the 3D bone model after transformation The mean value of the grid after ; Represents the first spatial point set Middle Points According to the initial transformation The transformed value.

[0158] According to Newton optimization method, the above evaluation function is optimized, that is, to find the evaluation function The optimal transformation parameter ,The key step of optimization is to solve the Jacobian matrix and the Hessian matrix.

[0159] Repeat the above steps to optimize the evaluation function until the convergence condition is met, and obtain the first change matrix .

[0160] Get the first change matrix Afterwards, based on the first change matrix For the first set of spatial points By performing spatial transformation, we can obtain the second spatial point set .

[0161] Get the second space point set Afterwards, the iterative closest point algorithm can be used to calculate the second spatial point set. And the bone landmark point cloud on the 3D bone model of the affected bone Perform precise point cloud registration. The specific steps include: The second space point set All points in the image are transformed into the bone landmark point cloud on the 3D bone model of the affected bone. Next, define the following energy function: in, represents the energy function value; Represents the second space point set Middle points to bony landmark point cloud the closest point to the middle; represents the first transformation parameter; represents the second transformation parameter; Represents the second space point set The points.

[0162] It should be noted that the optimization target of the energy function in the embodiment of the present invention is the energy function value Minimum.

[0163] Use the Singular Value Decomposition (SVD) algorithm to obtain the first transformation parameters and the second transformation parameter The optimal solution of Among them, the first transformation parameter in the embodiment of the present invention is and the second transformation parameter The optimal solution is The first transformation parameter is the smallest when The value of and the second transformation parameter Based on the first transformation parameter and the second transformation parameter The optimal solution of The specific method is: transform the upper left corner 3x3 matrix to the first transformation parameter The optimal solution of the right 3x1 matrix is ​​the second transformation parameter The optimal solution is to fill the bottom row with 0, 0, 0, 1 to get the second change matrix .

[0164] The first registration matrix used to describe the mapping relationship between the affected bone and the three-dimensional bone model .

[0165] Get the first registration matrix Then, based on the mapping relationship between the three-dimensional bone model of the affected bone and the first image and the first registration matrix , through numerical calculation, a second registration matrix for describing the mapping relationship between the affected bone and the first image is obtained.

[0166] In the embodiment of the present invention, the intraoperative execution module 106 establishes a first registration coordinate system corresponding to the affected bone based on the positional relationship between the bony landmarks on the affected bone, and establishes a second registration coordinate system corresponding to the three-dimensional bone model based on the positional relationship between the bony landmarks on the three-dimensional bone model. Then, a representation matrix of the first registration coordinate system and a representation matrix of the second registration coordinate system are established, and a transformation matrix between the representation matrix of the first registration coordinate system and the representation matrix of the second registration coordinate system is calculated as a target change matrix. Based on the target change matrix, each bony landmark on the affected bone is spatially transformed to obtain a first spatial point set. Based on each bony landmark on the affected bone, a normal distribution transformation algorithm is used to calculate a first transformation matrix. Based on the first transformation matrix, the first spatial point set is transformed. The point set is spatially transformed to obtain a second spatial point set, and the second spatial point set and each bony landmark point on the three-dimensional bone model are registered using an iterative closest point algorithm and singular value decomposition to obtain a first registration matrix for describing the mapping relationship between the affected bone and the three-dimensional bone model. The spatial relationship between the affected bone and the three-dimensional bone model can be more accurately described by establishing a registration coordinate system corresponding to the affected bone and the three-dimensional bone model and calculating the transformation matrix between them, thereby overcoming the limitations of the traditional point-based registration algorithm, reducing the registration error caused by inaccurate bony landmark points on the affected bone or limited surgical area, and combining the normal distribution transformation algorithm and the iterative closest point algorithm for spatial transformation and registration, which significantly improves the registration accuracy and robustness between the affected bone and the three-dimensional bone model.

[0167] When the doctor holds the navigation and positioning device 2000 to perform orthopedic surgery on the affected bone, the human-computer interaction device can display the real-time image of the affected bone during the operation and the spatial position and posture of the navigation and positioning device 2000. It can also calculate the deviations such as the distance and angle between the navigation and positioning device 2000 and any position on the affected bone to provide visual feedback.

[0168] When grinding of the affected bone is required, in order to enhance the visual feedback during the grinding process, the 3D bone model of the affected bone can be colored according to the parameter information of the prosthesis to be implanted, and red, white, and green can be used to indicate over-grinding, appropriate grinding, and under-grinding areas, respectively. During the grinding of the affected bone, the coloring information in the 3D bone model of the affected bone can be updated in real time based on the actual grinding condition of the affected bone and the position of the grinding tool to reflect the grinding condition of the affected bone in real time and ensure that the grinding area is completed.

[0169] When it is necessary to grind the center nail, fixed nail or non-fixed nail implanted in the affected bone, the center nail, fixed nail and non-fixed nail can be tracked and displayed in real time, and the three-dimensional bone model distance of the center nail penetrating the affected bone can be calculated to assist in adjusting the direction of the center nail to ensure that the center nail does not pass through the bone surface of the affected bone. At the same time, the direction of the fixed nail and non-fixed nail can be adjusted according to the patient's bone physiological structure to achieve the most stable base fixation effect.

[0170] When it is necessary to install a base for the affected bone, the real-time position and posture of the grinding tool and the installation tool can be obtained through the tracer on the affected bone side and the tracer on the navigation positioning device 2000 to calculate the distance angle deviation of the grinding reamer and the installation tool and the depth from the target position.

[0171] When the affected bone needs to be reconstructed, different types of osteotomy guides can be adapted, including standard guides, personalized guides, etc., and during the osteotomy process, the humeral tracer and the tracer installed on the guide can be used to calculate and display in real time the error between the guide plane and the planned osteotomy plane.

[0172] During the installation of the affected bone prosthesis, the position of the affected bone and the prosthesis can be obtained in real time through the tracers installed on the prosthesis and the affected bone, and compared with the planned position, and the deviation between the axis of the affected bone and the prosthesis and the anteversion angle and the plan can be provided in real time.

[0173] After the prosthesis is installed, in reverse shoulder replacement, a probe can be used to click on the liner, and the installation position and posture of the humeral stem can be used to further confirm whether the liner is installed in place. In normal shoulder and hemi-shoulder replacement, the tracer on the ball head installer can be used to determine whether the ball head on the humeral stem is installed in place.

[0174] Figure 7FIG. 2 is a second structural diagram of the navigation system for shoulder replacement surgery provided by the present invention. Figure 7 As shown, the shoulder replacement surgery navigation system 1000 also includes a human-computer interaction device 1200 and a robot 3000 .

[0175] The human-machine interaction device 1200 and the robot 3000 are respectively connected to the controller 1100 for communication.

[0176] The navigation and positioning device 2000 includes a navigation camera 2100 , a patient tracer 2200 , a robot arm end tracer 2300 , and a probe 2400 .

[0177] Specifically, the controller 1100 can communicate with the navigation and positioning device 2000 to obtain the actual spatial positions of the affected bone and the surgical tools.

[0178] The controller 1100 is respectively connected to the human-machine interaction device 1200 and the navigation camera 2100 for communication, receives information transmitted by the human-machine interaction device 1200 and the navigation camera 2100 , and sends relevant information or instructions to the human-machine interaction device 1200 and the navigation camera 2100 .

[0179] The patient tracer 2200 includes a humeral tracer and a scapula tracer, which are respectively fixed to the patient's humerus and scapula, and are used to determine the spatial position of the patient's affected side during surgery.

[0180] The end-of-arm tracer 2300 is installed at the end of the robot 3000 and is used to determine the spatial position of the end of the robot 3000. The probe 2400 is mainly used to collect bony landmarks of the patient's scapula and humerus.

[0181] The navigation camera 2100 receives signals from the patient tracer 2200, the robot end tracer 2300, and the navigation tool 2500, and determines the relative spatial position relationship between the robot 3000, the probe 2400, the patient's humerus, and the scapula in the same spatial coordinate system. On the premise that the spatial position relationship between the patient's scapula and the robot end is determined, the navigation camera 2100 receives the signal from the probe 2400 and completes the collection of the bony landmarks of the patient's scapula and humerus.

[0182] The shoulder replacement surgery navigation system in the embodiment of the present invention generates a three-dimensional bone model of the affected bone by combining the preoperative medical image of the affected bone and the medical image of the healthy bone corresponding to the affected bone. When the affected bone has bone defects and / or abnormal morphology, it can more accurately reflect the healthy morphology of the affected bone, and then perform prosthesis planning based on the three-dimensional bone model of the affected bone, obtain parameter information of the prosthesis to be implanted, and make the preoperative surgical planning more objective and quantitative. It can simulate the range of motion of the patient's surgical shoulder joint after the prosthesis to be implanted is implanted into the affected bone based on the parameter information of the prosthesis to be implanted, obtain the maximum motion angle of the patient's surgical shoulder joint, and when it is determined that the maximum motion angle of the patient's surgical shoulder joint is greater than the motion angle threshold, control the navigation and positioning device to perform surgical navigation in the shoulder replacement surgery for the affected bone based on the parameter information of the prosthesis to be implanted, further improve the accuracy and rationality of prosthesis planning, reduce surgical complications and postoperative recovery time, significantly improve the accuracy and reliability of orthopedic surgery, effectively reduce surgical risks, and achieve more stable surgical results.

[0183] Figure 8 FIG. 1 is a flow chart of the navigation method for shoulder replacement surgery provided by the present invention. Figure 8 As shown, the method includes the following: step 801, based on the first image and the second image, generating a three-dimensional bone model of the patient's affected bone, performing prosthesis planning based on the three-dimensional bone model of the affected bone, and obtaining parameter information of the prosthesis to be implanted in the affected bone, the first image includes a medical image of the affected bone before the shoulder replacement surgery, the second image includes a medical image of a healthy bone corresponding to the affected bone, the affected bone and the healthy bone corresponding to the affected bone are symmetrically distributed with the spine as the midline, and the parameter information includes size, posture information and installation position information; Step 802: Based on the parameter information of the prosthesis to be implanted, the range of motion of the patient's shoulder joint on the surgical side after the prosthesis to be implanted is simulated to obtain the maximum motion angle of the patient's shoulder joint on the surgical side; Step 803: When it is determined that the maximum motion angle of the patient's surgical-side shoulder joint is greater than the motion angle threshold, based on parameter information of the prosthesis to be implanted, control the navigation positioning device to perform surgical navigation in the shoulder replacement surgery for the affected bone.

[0184] It should be noted that the shoulder replacement surgery navigation method in the embodiment of the present invention is implemented based on the shoulder replacement surgery navigation system 1000. The specific execution steps of the shoulder replacement surgery navigation method can refer to the contents of the above embodiments, which will not be repeated in the embodiment of the present invention.

[0185] The embodiment of the present invention generates a three-dimensional bone model of the affected bone by combining the preoperative medical image of the affected bone and the medical image of the healthy bone corresponding to the affected bone. When the affected bone has bone defects and / or morphological abnormalities, the healthy morphology of the affected bone can be more accurately reflected, and then prosthesis planning can be performed based on the three-dimensional bone model of the affected bone to obtain parameter information of the prosthesis to be implanted, so that the preoperative surgical planning is more objective and quantitative. The range of motion of the patient's surgical shoulder joint after the prosthesis to be implanted is simulated based on the parameter information of the prosthesis to be implanted, and the maximum motion angle of the patient's surgical shoulder joint is obtained. When it is determined that the maximum motion angle of the patient's surgical shoulder joint is greater than the motion angle threshold, the navigation and positioning device is controlled to perform surgical navigation in the shoulder replacement surgery for the affected bone based on the parameter information of the prosthesis to be implanted, so as to further improve the accuracy and rationality of prosthesis planning, reduce surgical complications and postoperative recovery time, significantly improve the accuracy and reliability of orthopedic surgery, effectively reduce surgical risks, and achieve more stable surgical results.

[0186] Finally, it should be noted that the above embodiments are only used to illustrate the technical solutions of the present invention, rather than to limit it. Although the present invention has been described in detail with reference to the aforementioned embodiments, those skilled in the art should understand that they can still modify the technical solutions described in the aforementioned embodiments, or make equivalent replacements for some of the technical features therein. However, these modifications or replacements do not deviate the essence of the corresponding technical solutions from the spirit and scope of the technical solutions of the embodiments of the present invention.

Claims

1. A navigation system for shoulder replacement surgery, characterized in that: include: A controller and a navigation and positioning device; the controller is in communication connection with the navigation and positioning device; the controller comprises a preoperative planning module, a preoperative simulation module and an intraoperative execution module; The preoperative planning module is used to generate a three-dimensional bone model of the patient's affected bone based on the first image and the second image, perform prosthesis planning based on the three-dimensional bone model of the affected bone, and obtain parameter information of the prosthesis to be implanted in the affected bone, wherein the first image includes a medical image of the affected bone before the shoulder replacement surgery, and the second image includes a medical image of a healthy bone corresponding to the affected bone, the affected bone and the healthy bone corresponding to the affected bone are symmetrically distributed with the spine as the midline, and the parameter information includes size, posture information and installation position information; The preoperative simulation module is used to simulate the range of motion of the patient's surgical shoulder joint after the prosthesis to be implanted is implanted into the affected bone based on the parameter information of the prosthesis to be implanted, so as to obtain the maximum motion angle of the patient's surgical shoulder joint; The intraoperative execution module is used to control the navigation and positioning device to perform surgical navigation in the shoulder replacement surgery for the affected bone based on the parameter information of the prosthesis to be implanted when it is determined that the maximum active angle of the patient's surgical side shoulder joint is greater than the active angle threshold; The navigation and positioning device is used to perform surgical navigation in a shoulder joint replacement surgery on the affected bone in response to the control of the intraoperative execution module.

2. The shoulder replacement surgery navigation system according to claim 1, characterized in that: The preoperative planning module includes a prosthesis planning unit; In the case where the affected bone is a scapula, the prosthesis planning unit is specifically used to perform spatial correction on the three-dimensional bone model of the affected bone, and after obtaining the spatially corrected three-dimensional bone model of the affected bone, calculate the bone information of the affected bone based on the spatially corrected three-dimensional bone model of the affected bone, obtain the size and posture information of the prosthesis to be implanted based on the bone information of the affected bone, obtain the installation position information of the prosthesis to be implanted based on the size and posture information of the prosthesis to be implanted using an intrusion optimization algorithm, and then determine the size, posture information and installation position information of the prosthesis to be implanted as parameter information of the prosthesis to be implanted; Among them, the bone information of the affected bone includes the position information of the upper pole, lower pole, front edge and rear edge of the glenoid of the affected bone, the normal of the glenoid plane of the affected bone, and the native posterior tilt angle and native superior tilt angle of the glenoid of the affected bone. The normal of the glenoid plane of the affected bone is the direction of the normal of the glenoid plane of the affected bone pointing to the humerus connected to the glenoid of the affected bone. The glenoid plane of the affected bone is obtained by fitting based on the upper pole, lower pole, front edge and rear edge of the glenoid of the affected bone. The native posterior tilt angle of the glenoid of the affected bone is the angle between the projection line of the glenoid plane normal of the affected bone in the transverse position of the affected bone and the target auxiliary line of the affected bone. The native superior tilt angle of the glenoid of the affected bone is the angle between the projection line of the glenoid plane normal of the affected bone in the coronal position of the affected bone and the target auxiliary line of the affected bone. The target auxiliary line is the line connecting the innermost point of the scapula and the center point of the glenoid of the scapula.

3. The shoulder replacement surgery navigation system according to claim 2, characterized in that: The preoperative simulation module is specifically used to generate a three-dimensional bone model of the patient's surgical shoulder joint after the prosthesis to be implanted is implanted into the affected bone based on parameter information of the prosthesis to be implanted, and when the posture of the three-dimensional bone model of the patient's surgical shoulder joint is a preset posture, rotate the humerus in the three-dimensional bone model of the patient's surgical shoulder joint along each preset direction until the humerus in the three-dimensional bone model of the patient's surgical shoulder joint collides with the scapula in the three-dimensional bone model of the patient's surgical shoulder joint, and determine the rotation angle of the humerus in the three-dimensional bone model of the patient's surgical shoulder joint when the collision occurs as the maximum activity angle of the three-dimensional bone model of the patient's surgical shoulder joint in each preset direction; The intraoperative execution module is used to send the maximum activity angle of the three-dimensional bone model of the patient's surgical shoulder joint in any preset direction to the prosthesis planning unit when it is determined that the maximum activity angle of the three-dimensional bone model of the patient's surgical shoulder joint in any preset direction is not greater than the activity angle threshold corresponding to any preset direction, so that the prosthesis planning unit can update the parameter information of the prosthesis to be implanted based on the maximum activity angle of the three-dimensional bone model of the patient's surgical shoulder joint in any preset direction; when it is determined that the maximum activity angle of the three-dimensional bone model of the patient's surgical shoulder joint in each preset direction is greater than the activity angle threshold corresponding to each preset direction, based on the parameter information of the prosthesis to be implanted, control the navigation and positioning device to perform surgical navigation in the shoulder replacement surgery for the affected bone.

4. The shoulder replacement surgery navigation system according to claim 2, characterized in that: The prosthesis planning unit is specifically used to determine the native posterior tilt angle and native superior tilt angle of the glenoid cavity of the affected bone as the posture information of the prosthesis to be implanted, construct a three-dimensional model of the prosthesis to be implanted based on the size and posture information of the prosthesis to be implanted, define the closest distance between any point on the base plane of the three-dimensional model of the prosthesis to be implanted and the three-dimensional bone model of the affected bone as the intrusion amount corresponding to the any point, calculate the intrusion amount score corresponding to each position of the three-dimensional model of the prosthesis to be implanted within the installation range of the three-dimensional bone model of the affected bone based on a predefined ideal range of intrusion amount, and then determine the position with the highest intrusion amount score within the installation range of the three-dimensional bone model of the affected bone as the installation position of the prosthesis to be implanted, and obtain the installation position information of the prosthesis to be implanted, wherein the installation range of the three-dimensional bone model of the affected bone is determined based on the upper pole, lower pole, front edge and rear edge of the glenoid cavity of the affected bone.

5. The shoulder replacement surgery navigation system according to claim 1, characterized in that: The intraoperative execution module is also used to determine a plurality of bony landmark points at the proximal end of the three-dimensional bone model and a plurality of bony landmark points at the distal end of the three-dimensional bone model, and then in the shoulder joint replacement surgery for the affected bone, based on the correspondence between each bony landmark point on the three-dimensional bone model and each bony landmark point on the affected bone, the affected bone and the three-dimensional bone model are aligned, and a mapping relationship between the affected bone and the three-dimensional bone model and / or the first image is established, and based on the parameter information of the prosthesis to be implanted and the mapping relationship, the navigation and positioning device is controlled to perform surgical navigation in the shoulder joint replacement surgery for the affected bone, the proximal end being the end close to the incision, and the distal end being the end away from the incision.

6. The shoulder replacement surgery navigation system according to claim 5, characterized in that: The intraoperative execution module is specifically used to establish a first registration coordinate system corresponding to the affected bone based on the positional relationship between the bony landmarks on the affected bone, establish a second registration coordinate system corresponding to the three-dimensional bone model based on the positional relationship between the bony landmarks on the three-dimensional bone model, establish a representation matrix of the first registration coordinate system and a representation matrix of the second registration coordinate system, calculate a transformation matrix between the representation matrix of the first registration coordinate system and the representation matrix of the second registration coordinate system as a target change matrix, perform spatial transformation on the bony landmarks on the affected bone based on the target change matrix, obtain a first spatial point set, and obtain a first spatial point set based on the positional relationship between the bony landmarks on the affected bone and the three-dimensional bone model. A first transformation matrix is ​​calculated for each of the bony landmarks on the affected bone using a normal distribution transformation algorithm, the first spatial point set is spatially transformed based on the first transformation matrix to obtain a second spatial point set, an iterative closest point algorithm and a singular value decomposition are used to align the second spatial point set with each of the bony landmarks on the three-dimensional bone model to obtain a first registration matrix for describing a mapping relationship between the affected bone and the three-dimensional bone model, and a second registration matrix for describing a mapping relationship between the affected bone and the first image is obtained based on a mapping relationship between the three-dimensional bone model and the first image and the first registration matrix.

7. The shoulder replacement surgery navigation system according to claim 2, characterized in that: The preoperative planning module also includes a data import unit and an image processing unit; The data importing unit is used to acquire the first image and the second image, and send the first image and the second image to the image processing unit when the image quality of the first image and the second image meets the preset standard; The image processing unit is used to construct a first three-dimensional point cloud model based on the first image, construct a second three-dimensional point cloud model based on the second image, extract the centroids of the first three-dimensional point cloud model and the second three-dimensional point cloud model, mirror-reverse the second three-dimensional point cloud model in the horizontal direction based on the centroids of the first three-dimensional point cloud model and the second three-dimensional point cloud model to obtain a third three-dimensional point cloud model, align the first three-dimensional point cloud model with the third three-dimensional point cloud model based on the centroids of the first three-dimensional point cloud model and the centroids of the third three-dimensional point cloud model, obtain a feature descriptor of each point in the third three-dimensional point cloud model, and then, based on the feature descriptors of each point in the third three-dimensional point cloud model, use a consistent initial registration algorithm to perform point cloud coarse registration on the third three-dimensional point cloud model and the first three-dimensional point cloud model to obtain a fourth three-dimensional point cloud model, use an iterative closest point algorithm and singular value decomposition to perform point cloud fine registration on the fourth three-dimensional point cloud model and the first three-dimensional point cloud model to obtain a three-dimensional bone model of the affected bone; The prosthesis planning unit is used to obtain the bone information of the affected bone based on the three-dimensional bone model of the affected bone, and then perform prosthesis planning based on the bone information of the affected bone to obtain parameter information of the prosthesis to be implanted.

8. The shoulder replacement surgery navigation system according to claim 7, characterized in that: The image processing unit is specifically used to perform data preprocessing on the first image to obtain the first image after data preprocessing when it is determined that the image quality of the first image meets the preset standard; perform image segmentation on the first image after data preprocessing based on the distribution of the bone blocks of the affected bone to obtain multiple sub-images corresponding to the first image, each of the sub-images only includes one bone block of the affected bone; determine the sub-image of the largest bone block of the affected bone as the target sub-image; and then construct a three-dimensional point cloud model of the largest bone block of the affected bone based on the target sub-image as the first three-dimensional point cloud model.

9. The shoulder replacement surgery navigation system according to any one of claims 1 to 8, characterized in that: Also includes: Human-computer interaction devices and robots; The human-machine interaction device and the robot are respectively connected to the controller for communication; The navigation and positioning device includes a navigation camera, a patient tracer, a robot arm end tracer and a probe.

10. A shoulder replacement surgery navigation method implemented based on the shoulder replacement surgery navigation system according to any one of claims 1 to 9, characterized in that: include: Based on the first image and the second image, a three-dimensional bone model of the patient's affected bone is generated, and prosthesis planning is performed based on the three-dimensional bone model of the affected bone to obtain parameter information of the prosthesis to be implanted in the affected bone, wherein the first image includes a medical image of the affected bone before shoulder replacement surgery, and the second image includes a medical image of a healthy bone corresponding to the affected bone, the affected bone and the healthy bone corresponding to the affected bone are symmetrically distributed with the spine as the midline, and the parameter information includes size, posture information, and installation position information; Based on the parameter information of the prosthesis to be implanted, simulating the range of motion of the patient's surgical shoulder joint after the prosthesis to be implanted is implanted into the affected bone, and obtaining the maximum motion angle of the patient's surgical shoulder joint; When it is determined that the maximum motion angle of the patient's surgical-side shoulder joint is greater than a motion angle threshold, based on parameter information of the prosthesis to be implanted, the navigation and positioning device is controlled to perform surgical navigation in the shoulder replacement surgery for the affected bone.

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