Hip revision stem interference detection surgical device

Abstract

The application discloses a hip joint prosthesis revision bone interference condition detection surgical device, which is characterized by comprising a positioning module, a holding module and an interference detection module; the positioning module comprises a positioning plate and a positioning hook, the positioning plate is attached to the bone structure around a bone defect cavity, and the positioning hook is located at the edge of the positioning plate to hook the bone structure; the interference detection module is located on one end of the positioning plate and is a transparent structure, the outer surface of the interference detection module is a detection surface and is used for filling the bone defect cavity; and the holding module is connected to the back of the positioning plate through a detachable structure. The application can quickly and accurately determine the bone interference condition in operation, is convenient for bone trimming and accurate prosthesis loading into the bone defect cavity.

Description

Technical Field

[0001] This invention relates to the medical field, and in particular to a surgical device for detecting bone interference during hip joint prosthesis revision. Background Technology

[0002] Hip revision surgery is the primary treatment for patients who have undergone hip replacement surgery and experience issues such as prosthesis infection, loosening, displacement, or fracture. It is also almost the only technique that can fundamentally eliminate symptoms and improve joint function at this stage. Compared to the initial hip replacement surgery, revision surgery is often more complex. First, due to long-term micro-displacement, wear, and compression of the original prosthesis, significant bone defects may occur around the prosthesis, with some severely affected patients experiencing substantial bone loss. Second, particulate matter generated during prosthesis wear can activate inflammatory responses, leading to further dissolution of the surrounding bone, resulting in extensive and structurally complex periprosthetic bone defects.

[0003] Traditional methods such as standardized acetabular prostheses, reinforcing rings, autologous or allogeneic bone grafts, and bone cement filling have all been applied in the revision of hip joint prostheses and have achieved certain results. However, their efficacy still needs improvement, and their application in hip joint revision with large and complex bone defects is very limited. Based on this, 3D-printed personalized hip joint revision prostheses based on the concept of personalized precision medicine have been proposed and have made significant progress in recent years.

[0004] 3D-printed personalized hip revision prostheses feature a highly adaptable prosthetic structure. Their surface morphology is specifically designed to match the shape of the bone defect cavity in the patient's acetabulum, allowing for simple trimming of only a small amount of bone spurs during surgery before implantation. This avoids the extensive bone trimming and reshaping work required before implantation of traditional standardized revision prostheses. Furthermore, after implantation, the 3D-printed personalized hip revision prosthesis directly and extensively conforms to the inner surface of the bone cavity, providing strong, comprehensive, and adequate fixation. Since no additional bone grafting is required, patients do not need prolonged bed rest post-surgery.

[0005] As mentioned above, 3D-printed personalized hip revision prostheses offer numerous significant technological advantages. However, their application and promotion in actual clinical practice still face certain obstacles. The primary reason for this is the difficulty in precisely inserting the prosthesis into the bone defect cavity during surgery due to bone / prosthesis interference, thus greatly diminishing the effectiveness of the "personalized" and "precision" treatment. Specifically, the reasons for this difficulty are as follows: The structure of bone defects and cavities is complex, making it difficult for surgeons to quickly adapt them to the preoperative plan during surgery. Patients undergoing hip revision surgery who require personalized prostheses often have relatively complex conditions, with irregular shapes of acetabular bone defects and cavities that may contain diseased or dead bone. This makes it difficult for surgeons to match the chaotic surgical field with the preoperative prosthesis plan, thus hindering subsequent bone trimming, prosthesis positioning, and trial fitting.

[0006] Due to obstruction from the prosthesis and tools, surgeons often struggle to precisely locate the bone requiring modification during surgery. Even when the 3D-printed revision prosthesis structure is precisely designed based on the surface structure of the bone defect cavity, surgeons still need to perform minor modifications to the surface bone before implantation. This is because completely preserving 100% of the surface bone could result in an extremely complex and disorganized prosthesis structure, potentially creating areas of mechanical weakness. Therefore, the ideal surgical procedure is for surgeons to perform minor reshaping and modification of the small bone fragments within the bone defect cavity, based on the pre-planned prosthesis surface morphology, before smoothly implanting the prosthesis. However, this modification step faces significant obstacles in practice. Currently, the main method involves the surgeon pressing a trial prosthesis model or even the entire prosthesis into the cavity, feeling the resistance from bone interference, removing the prosthesis, reshaping the bone based on the approximate direction of the previously felt resistance, and then attempting to reinsert the prosthesis again. This process may be repeated several times, consuming not only time and the surgeon's energy, but also potentially causing soft tissue to become embedded in the reticular layer and other delicate structures on the prosthesis surface during repeated insertion. More importantly, the prosthesis itself significantly obstructs the surgeon's view during insertion, making it impossible to see the exact location of the bone interfering with the prosthesis. This greatly reduces the accuracy of bone trimming, and may even lead to repeated attempts to trim the bone without successfully inserting the prosthesis, until finally, after a successful insertion, it is discovered that there is a large amount of over-trimmed bone around the prosthesis, resulting in a prosthesis-bone gap. This is fatally detrimental to the therapeutic effect of 3D-printed personalized prostheses.

[0007] Third, the difficulty in precisely positioning personalized prostheses during surgery leads to surgeons over- or under-repairing the bone cavity, or even misaligning it: For 3D-printed personalized hip revision surgeries, the prosthesis needs to match the bone defect cavity. Therefore, surgeons need to reshape interfering bone that obstructs prosthesis placement. However, in reality, the areas of bone causing interference will vary significantly depending on the prosthesis's placement position and angle. This suggests that, theoretically, the correct placement position and angle of the prosthesis should be precisely determined before reshaping the bone defect cavity based on the prosthesis's outer surface morphology. However, due to the diverse structures of 3D-printed personalized prostheses and the lack of a standardized positioning method, the accuracy of this process is often insufficient. Summary of the Invention

[0008] To address the shortcomings of existing technologies, this invention provides a surgical device and method for detecting bone interference during hip joint prosthesis revision surgery. This device and method can quickly and accurately determine bone interference during surgery, facilitating bone reshaping and precise insertion of the prosthesis into the bone defect cavity.

[0009] To achieve the above objectives, the present invention provides the following technical solution: A surgical device for detecting bone interference in hip prosthesis revision surgery, characterized in that it includes a positioning module, a holding module, and an interference detection module; The positioning module includes a positioning plate and a positioning hook. The positioning plate fits into the bone structure around the bone defect cavity, and the positioning hook is located at the edge of the positioning plate to hook the bone structure in place. The interference detection module is located on one end of the positioning plate and is a transparent structure. The outer surface of the interference detection module is the detection surface, which is used to fill the cavity of the bone defect. The gripping module is connected to the back of the positioning plate via a detachable structure.

[0010] Preferably, the positioning plate conforms to the outer surface of the iliac crest above the acetabulum for precise positioning of the entire device.

[0011] Preferably, the positioning hook has two parts, which are respectively hooked onto the anterior superior iliac spine and below the anterior superior iliac spine to determine a unique fixation position.

[0012] Preferably, the positioning module and the interference detection module are an integrated structure, 3D printed from a transparent photocurable material.

[0013] Preferably, the gripping module is a threaded handle, and the positioning plate has a connecting sleeve for the handle to be threaded into.

[0014] Preferably, the interference detection module has a hollow internal structure.

[0015] A method for detecting bone interference in hip joint prosthesis revision surgery, characterized by the following specific steps: S1. Identify and loosen the loose femoral and acetabular prostheses, remove them and send the tissues and prostheses for intraoperative culture, assess the bone condition of the acetabulum and femur during the operation, and fully expose the inner surface of the bone defect; S2. Based on the surface structure of the bone defect cavity and the morphology of the bone structure around the bone defect cavity, a positioning module and an interference detection module with an integrated structure are 3D printed using transparent light-curing material, and a holding module is connected to the back of the positioning module. S3. Press the interference detection module into the bone defect cavity. During the pressing process, observe whether there is any bone obstructing the interference detection module. If so, observe through the transparent interference detection module to determine the position of the bone obstructing the interference detection module. Then, trim the obstructing bone and continue to press the interference detection module in. S4. After the interference detection module is fully pressed in and there is no contact or resistance between it and the inner surface of the bone defect, the interference detection module is removed. The acetabular revision prosthesis to be implanted is then fixed by pressing, and screws are added as needed to enhance stability.

[0016] The advantages of this invention are: 1. The outer surface of the interference detection module is designed to replicate the morphology of the part of the prosthesis used to fill the bone defect cavity in a 1:1 ratio. During the operation, the surgeon can use this device to directly perform the entire process of prosthesis positioning, interference detection and indentation in the surgical field without having to use their own spatial imagination to find and register. It has the characteristics of being fast, accurate and efficient. 2. Because the device is made of transparent material, the surgical device allows the surgeon to accurately locate the bone area that interferes with the prosthesis under direct vision, thereby achieving precise bone trimming; 3. The positioning module enables the surgical device to accurately position the prosthesis in one go, thereby guiding the efficient and accurate subsequent bone trimming. Attached Figure Description

[0017] Figure 1 This is a schematic diagram of the surgical device for detecting bone interference in hip prosthesis revision provided in this embodiment. Figure 2 This is a schematic diagram from another perspective of the surgical device for detecting bone interference during hip prosthesis revision provided in this embodiment. Figure 3 This is a schematic diagram showing the surgical device provided in this embodiment positioned on a bone structure. Figure 4 Another schematic diagram showing the surgical device provided in this embodiment positioned on a bone structure; Figure 5 This is a schematic diagram of the bone structure provided in this embodiment. Detailed Implementation

[0018] Combination Figures 1 to 5 The surgical device and method for detecting bone interference in hip joint prosthesis revision of the present invention will be further described.

[0019] A surgical device for detecting bone interference in hip joint prosthesis revision surgery, characterized in that it includes a positioning module 1, a holding module 2, and an interference detection module 3.

[0020] The positioning module 1 includes a positioning plate 11 and a positioning hook 12. One side of the positioning plate 11 is a contoured surface of the bone structure 4, which fits the bone structure around the bone defect cavity 41. The positioning hook 12 is located at the edge of the positioning plate 11 to hook the bone structure 4 in place.

[0021] The interference detection module 3 is located on one end of the positioning plate 11 and is a transparent structure. The outer surface of the interference detection module 3 is the detection surface 31, which is completely identical to the outer surface of the prosthesis at a 1:1 ratio. It is also the contour surface of the inner surface of the bone defect cavity 41. When the positioning plate 11 and the positioning hook 12 are in the positioning state, the interference detection module 3 fills the bone defect cavity 41.

[0022] The gripping module 2 is connected to the back of the positioning plate 11 via a detachable structure.

[0023] Specifically, the interference detection module 3 is a concave hollow curved cavity structure 32, and the detection surface 31 is the convex surface of the cavity structure 32. The cavity structure makes the wall thickness of the entire interference detection module 3 thinner, which can save the required printing material and make it easier for the surgeon to observe the fit and interference between the detection surface 31 and the inner surface of the bone defect cavity 41 through the interference detection module 3, so as to accurately and quickly find the interference site, make corrections, improve revision efficiency and reduce costs.

[0024] The positioning plate 11 is attached to the outer surface of the iliac wing above the acetabulum for precise positioning of the entire device; there are two positioning hooks 12, which are hooked on the anterior superior iliac spine and below the anterior superior iliac spine respectively, to determine the unique fixation position of the entire surgical device.

[0025] The positioning module 1 and the interference detection module 3 are an integrated structure, which is 3D printed using a transparent light-curing material such as transparent resin. The transparent material allows the surgeon to easily observe the cooperation and interference between the detection surface 31 of the interference detection module 3 and the bone through the surgical device itself.

[0026] The gripping module 2 is a threaded handle. The positioning plate 11 has a connecting sleeve for the handle to be threaded together, so that the gripping module 2 can be removed according to actual use to avoid blocking other surgical instruments or obstructing the surgical field of vision.

[0027] The specific method of using this invention is as follows: S1. The patient is placed in a supine position. The hip on the surgical side is routinely disinfected and draped. The skin and subcutaneous tissue are incised along the anterolateral landmarks of the hip joint. The tensor fasciae latae and gluteus medius muscles are separated to expose the hip joint capsule. After incising the joint capsule, the loosened femur and acetabular prosthesis are identified and released. The tissue and prosthesis are removed and sent for intraoperative culture. The bone condition of the acetabulum and femur is assessed intraoperatively, and the inner surface of the bone defect is fully exposed. S2. Based on the inner surface structure of the patient's bone defect cavity 41 and the bone structure morphology around the bone defect cavity 41, a positioning module 1 and an interference detection module 3 with an integrated structure are 3D printed using transparent light-curing material, and a holding module 2 is connected to the back of the positioning module 1. S3. Press the interference detection module 3 into the bone defect cavity 41. During the pressing process, observe whether there is any bone that obstructs the interference detection module 3. If there is, observe through the transparent interference detection module 3 to determine the position of the bone that obstructs the interference detection module 3. Then, trim the obstructing bone and press the interference detection module 3 in again. S4. After the interference detection module 3 is fully pressed in and there is no contact or resistance between it and the inner surface of the bone defect, the interference detection module 3 is removed. The acetabular revision prosthesis to be implanted is fixed by pressing in, and screws are added as needed to enhance stability. S5. After the femoral medullary cavity preparation is completed, the revised femoral stem is inserted, its position and stability are adjusted, and a trial joint reduction is performed to check the stability of the hip joint, the length of the femur and its range of motion. S6. After joint reduction, close the joint capsule, repair the gluteus medius and fascia lata, suture the subcutaneous tissue and skin in layers, place a negative pressure drain, and complete the surgery.

[0028] In practice, the present invention has the following advantages.

[0029] 1. This surgical device can directly replicate the surgical plan 1:1: The surgical device consists of a positioning module 1, a holding module 2, and an interference detection module 3. The outer surface of the interference detection module 3 is designed to replicate the morphology of the portion of the prosthesis used to fill the bone defect cavity 41 in a 1:1 scale. During the operation, the surgeon can use this device to directly perform the entire process of prosthesis positioning, interference detection, and insertion within the surgical field, without needing to rely on spatial imagination for searching and registration, making it fast, accurate, and efficient.

[0030] 2. This surgical device allows the surgeon to precisely locate the bone area interfering with the prosthesis under direct vision, thereby achieving precise bone trimming: The entire surgical device is 3D printed using a transparent light-cured material. During the procedure, as the interference detection module 3 of this device is pressed into the bone defect cavity 41, the interfering bone tip will directly scrape the outer surface of the material, forming patches and marks. The surgeon can directly and precisely observe these interfering bone areas through the transparent material and can trim the affected area directly after the device is removed, thus achieving smooth implantation of the subsequent prosthesis. This process of using this device to detect bone interference also avoids the situation where various tissues are directly embedded in the delicate structure of the prosthesis surface, and further avoids the accidental situation of hard bone tips damaging the surface mesh structure and coating of the prosthesis.

[0031] 3. This surgical device can accurately position the prosthesis in one procedure, thereby guiding efficient and accurate subsequent bone trimming: The device includes a positioning module 1, which further consists of two positioning hooks 12 and a positioning plate 11. The positioning plate 11 conforms to the bone surface surrounding the prosthesis, while the two positioning hooks 12 are anchored to anatomical landmarks, ensuring that the pre-planned position of the prosthesis is accurately reproduced in the surgical field. The device also has a holding module 2, which can manually fix the position and guide subsequent bone interference detection, facilitating rapid and accurate bone trimming.

[0032] The above description is merely a preferred embodiment of the present invention. The scope of protection of the present invention is not limited to the above embodiments. All technical solutions falling within the scope of the present invention's concept are within the scope of protection of the present invention. It should be noted that for those skilled in the art, any improvements and modifications made without departing from the principles of the present invention should also be considered within the scope of protection of the present invention.

Claims

1. A surgical device for detecting bone interference during hip joint prosthesis revision, characterized in that: It includes a positioning module, a holding module, and an interference detection module; The positioning module includes a positioning plate and a positioning hook. The positioning plate fits into the bone structure around the bone defect cavity, and the positioning hook is located at the edge of the positioning plate to hook the bone structure in place. The interference detection module is located at one end of the positioning plate and is a transparent structure. The outer surface of the interference detection module is the detection surface, which is used to fill the cavity of the bone defect. The interference detection module is used to press into the cavity of the bone defect. During the pressing process, it is observed whether there is any bone obstructing the interference detection module. If there is, the position of the bone obstructing the interference detection module is determined by observing through the transparent interference detection module. Then, the obstructing bone is adjusted, and the interference detection module is pressed in again. After the interference detection module is fully pressed in and there is no contact or resistance between it and the inner surface of the bone defect, the interference detection module is removed. The gripping module is connected to the back of the positioning plate via a detachable structure; The positioning plate conforms to the outer surface of the iliac crest above the acetabulum and is used for precise positioning of the entire device. The positioning hook has two hooks, which are respectively hooked onto the anterior superior iliac spine and below the anterior superior iliac spine to determine a unique fixation position; The positioning module and the interference detection module are an integrated structure, 3D printed from a transparent photopolymer material.

2. The surgical device for detecting bone interference in hip joint prosthesis revision according to claim 1, characterized in that: The internal structure of the interference detection module is hollow.

3. The surgical device for detecting bone interference in hip prosthesis revision according to claim 1, characterized in that: The gripping module is a threaded handle, and the positioning plate has a connecting sleeve for the handle to be threaded into.

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