Preoperative planning method and device for hip preservation surgery

Abstract

This application provides a method and apparatus for preoperative planning of hip-preserving surgery. The method includes: acquiring a three-dimensional skeletal model of the hip joint; generating at least two alternative osteotomy schemes based on the three-dimensional skeletal model of the hip joint; the alternative osteotomy schemes are one of the following: periacetabular osteotomy, femoral rotational osteotomy, combined acetabular-femoral rotational osteotomy, proximal femoral osteotomy, and combined acetabular-femoral rotational osteotomy; and selecting the optimal alternative osteotomy scheme as the preoperative planning scheme for hip-preserving surgery. In this application, by generating preoperative planning schemes for different surgical types separately and comparing them horizontally, optimization can be achieved not only for individual surgical types but also for different surgical types.

Description

TECHNICAL FIELD

[0001] The present application relates to the technical field of medical image processing, in particular to a preoperative planning method and device for hip-preserving surgery. BACKGROUND

[0002] Hip-preserving surgery is a knee-preserving surgery for treating unilateral compartmental lesions of the knee joint. By replacing the damaged femoral or tibial articular surface, the healthy cartilage, ligament and other structures are preserved to achieve precise repair and rapid functional recovery.

[0003] The current preoperative planning for hip-preserving surgery is the preoperative planning of a single surgery type, such as the preoperative planning of periacetabular osteotomy or the preoperative planning of femoral rotational osteotomy. Such preoperative planning scheme can only optimize the planning scheme of a single surgery type and cannot consider the optimization of different types of surgery. SUMMARY

[0004] To solve the above problems, the first aspect of the present application provides a preoperative planning method for hip-preserving surgery, which comprises: obtaining a three-dimensional bone model of the hip joint; generating at least two alternative osteotomy schemes based on the three-dimensional bone model of the hip joint; the alternative osteotomy scheme is one of a periacetabular osteotomy scheme, a femoral rotational osteotomy scheme, a periacetabular femoral rotational combined osteotomy scheme, a proximal femoral osteotomy scheme, and a periacetabular proximal femoral combined osteotomy scheme; selecting the best alternative osteotomy scheme as the preoperative planning scheme for hip-preserving surgery.

[0005] The second aspect of the present application provides a manufacturing system of the preoperative planning method for hip-preserving surgery, which comprises: a model acquisition module for acquiring a three-dimensional bone model of the hip joint; an osteotomy scheme generation module for generating at least two alternative osteotomy schemes based on the three-dimensional bone model of the hip joint; the alternative osteotomy scheme is one of a periacetabular osteotomy scheme, a femoral rotational osteotomy scheme, a periacetabular femoral rotational combined osteotomy scheme, a proximal femoral osteotomy scheme, and a periacetabular proximal femoral combined osteotomy scheme; a scheme determination module for selecting the best alternative osteotomy scheme as the preoperative planning scheme for hip-preserving surgery.

[0006] The third aspect of the present application provides an electronic device, comprising a memory and a processor; the memory is configured to store a program, and the processor is coupled to the memory and used to execute the program in the memory, so as to: obtain a three-dimensional bone model of the hip joint; generating at least two alternative osteotomy schemes based on a three-dimensional bone model of the hip joint; the alternative osteotomy schemes are one of a periacetabular osteotomy scheme, a femoral rotational osteotomy scheme, an acetabular-femoral rotational combined osteotomy scheme, a proximal femoral osteotomy scheme, and an acetabular-proximal femoral combined osteotomy scheme; selecting an optimal alternative osteotomy scheme as a preoperative planning scheme for hip-preserving surgery.

[0007] The fourth aspect of the present application provides a computer-readable storage medium having a computer program stored thereon, and the program is executed by a processor to implement the preoperative planning method for hip-preserving surgery as described above.

[0008] In the present application, by respectively generating preoperative planning schemes of different types of surgery, transverse comparison is performed, so that not only optimization of individual types of surgery can be achieved, but also optimization of different types of surgery can be achieved. BRIEF DESCRIPTION OF DRAWINGS

[0009] Figure 1 a flowchart of the preoperative planning method for hip-preserving surgery according to an embodiment of the present application; Figure 2 a schematic diagram of osteotomy surface planning of periacetabular osteotomy in the preoperative planning method for hip-preserving surgery according to an embodiment of the present application; Figure 3 a schematic diagram of evaluation indexes in the preoperative planning method for hip-preserving surgery according to an embodiment of the present application; Figure 4 an architectural diagram of the preoperative planning device for hip-preserving surgery according to an embodiment of the present application; Figure 5 an architectural diagram of an electronic device according to an embodiment of the present application. DETAILED DESCRIPTION

[0010] In order to make the above objectives, features and advantages of the present application more apparent, specific embodiments of the present application will be described in detail below with reference to the accompanying drawings. Although exemplary embodiments of the present application are shown in the drawings, it should be understood that the present application can be implemented in various forms and should not be limited by the embodiments described herein. On the contrary, these embodiments are provided so that the present application can be more thoroughly understood and the scope of the present application can be accurately conveyed to those skilled in the art.

[0011] It should be noted that, unless otherwise specified, the technical terms or scientific terms used in the present application should be understood as their usual meanings understood by those skilled in the art to which the present application belongs.

[0012] The embodiments of the present application provide the preoperative planning method for hip-preserving surgery as described above, and specific schemes of the method are provided by Figures 1-3As shown, this method can be performed by a preoperative planning device for hip-preserving surgery, which can be integrated into electronic devices such as computers, servers, computer clusters, and data centers. Combined with... Figure 1 As shown, the preoperative planning method for the hip-preserving surgery includes: S101, Obtain the three-dimensional skeletal model of the hip joint; S102, Based on the three-dimensional skeletal model of the hip joint, generate at least two alternative osteotomy schemes; the alternative osteotomy schemes are one of the following: periacetabular osteotomy scheme, femoral rotational osteotomy scheme, combined acetabular-femoral rotational osteotomy scheme, proximal femoral osteotomy scheme, and combined acetabular-femoral proximal osteotomy scheme. S103, select the best alternative osteotomy plan as the preoperative planning plan for hip-preserving surgery.

[0013] In this application, by generating preoperative planning schemes for different surgical types and comparing them horizontally, it is possible not only to optimize individual surgical types, but also to optimize different surgical types.

[0014] In this way, by generating multiple different types of osteotomy plans on the same patient's three-dimensional skeletal model, we can achieve horizontal comparison between different types of hip-preserving surgery, rather than just fine-tuning parameters within a single procedure.

[0015] In this way, the most suitable surgical type and its corresponding osteotomy plan can be selected automatically or semi-automatically for patients with different pathological types and different anatomical structural characteristics.

[0016] It should be noted that the hip-preserving schemes in this application are only compared horizontally among periacetabular osteotomy schemes, femoral rotational osteotomy schemes, proximal femoral osteotomy schemes, and their combined osteotomy schemes. No comparison is made with the planning schemes for other procedures such as core decompression surgery. This comparison of hip-preserving surgeries is, in fact, a comparison between different osteotomy and corrective surgical procedures.

[0017] In one embodiment, step S103, selecting the optimal alternative osteotomy plan as the preoperative planning scheme for hip-preserving surgery, includes: Generate postoperative prediction models for alternative osteotomy options; Evaluation indicators for alternative osteotomy options were calculated based on a postoperative prediction model. Based on the evaluation indicators, alternative osteotomy options were screened to obtain a preoperative planning scheme for hip-preserving surgery.

[0018] The postoperative prediction model may include at least one of the following: Postoperative bone morphology prediction model based on geometric reconstruction; A biomechanical prediction model for the hip joint based on finite element analysis; Postoperative functional recovery prediction model trained based on historical case data; Postoperative comprehensive prediction model based on multi-model fusion.

[0019] It should be noted that if the alternative osteotomy plan provides the adjusted acetabular and femoral head positions, these positions can be directly used to calculate the corresponding evaluation indicators. In this case, the postoperative prediction model is a simple calculation of mechanics and structure. For example, knowing the femoral head position and the resected femoral head, calculating the positional relationship between the distal end of the resected femoral head and the distal end of the original femoral head only requires... In one embodiment, the evaluation indicators include one or more of the following: femoral anteversion angle, femoral neck-shaft angle, femoral weight-bearing zone orientation, CE angle, anterior CE angle, 65° CE angle, acetabular top angle, offset difference, leg length difference, rotation center difference, femoral anterior displacement distance, femoral posterior displacement distance, head-acetabular coverage, osteotomy volume, and hip joint integrity rate.

[0020] Among them, the following parameters are considered: femoral anteversion angle: used to assess the impact of femoral rotation on joint stability; femoral neck-shaft angle: used to assess the weight-bearing transmission path; femoral weight-bearing zone orientation: used to assess whether the weight-bearing area shifts to the healthy bone area; CE angle, anterior CE angle, 65° CE angle, and acetabular apex angle: used to comprehensively assess the coverage and stability of the femoral head within the acetabulum; offset difference: used to assess the lever arm balance of both hip joints; leg length difference: used to assess the consistency of lower limb length after surgery; rotation center difference: used to assess whether the kinematic center of the hip joint has returned to its normal position; femoral anterior displacement distance and femoral posterior displacement distance: used to characterize the relative displacement of the femur after osteotomy; osteotomy volume: used to assess the degree of surgical trauma and bone preservation; femoral head-acetabular coverage: used to quantitatively characterize the degree to which the femoral head is covered by the acetabulum; and hip joint integrity rate: used to comprehensively assess the structural integrity and functional retention of the joint.

[0021] In the case of comprehensive comparison, different weights can be set for the selected evaluation indicators, and the index of all evaluation indicators can be calculated based on the weights, thereby using the index to achieve horizontal comparison.

[0022] In this way, under the same three-dimensional bone model and the same evaluation criteria, alternative osteotomy plans corresponding to different surgical types can be evaluated in a unified manner, so as to achieve objective comparison between different surgical types.

[0023] In one embodiment, the osteotomy location of the osteotomy surface in the periacetabular osteotomy scheme includes: The distance between the depression between the anterior superior iliac spine and the anterior inferior iliac spine and the corresponding osteotomy surface is 1 cm. The distance between the depression in front of the greater sciatic notch and the corresponding osteotomy surface is 1 cm. The distance between the edge of the preset nerve-sensitive area at the junction of the osteotomy surface and the outer surface of the hip joint is the preset distance.

[0024] The osteotomy location is the initial osteotomy location, which can be modified to achieve a better planning effect.

[0025] In one embodiment, the process of generating a periacetabular osteotomy plan includes: Key points for identifying the 3D skeletal model of the hip joint; Assess the direction of the acetabular opening, the location and extent of the covered defect, and determine the adjusted acetabular angle and acetabular position information; Multiple osteotomy surfaces are generated around the acetabulum; The postoperative assessment indicators of the acetabulum were simulated, and the osteotomy surface, adjusted acetabular angle information, and acetabular position information were corrected.

[0026] Based on the aforementioned key points, a spatial reference coordinate system for the acetabulum and femoral head is established.

[0027] The assessment includes evaluating the direction of the acetabular opening, the location and extent of the coverage defect, including: calculating the abduction angle, anteversion angle or a combination thereof of the acetabulum in the current state, and the relevant angular parameters of the femoral head coverage; determining the area of ​​insufficient coverage of the femoral head in the anterior, lateral or posterosuperior direction; and quantifying the extent of the coverage defect.

[0028] The postoperative evaluation indicators for simulating the acetabulum include: a model based on virtual osteotomy and acetabular repositioning; and calculation of at least one or more postoperative evaluation indicators, including but not limited to: CE angle, anterior CE angle, 65° CE angle, acetabular top angle, head-acetabular coverage, and rotation center difference.

[0029] It should be noted that the evaluation metrics used in the specific osteotomy plan generation process are the same as those used in the aforementioned horizontal comparison. The difference lies in that the evaluation metrics used in the specific osteotomy plan generation process are used to refine the osteotomy plan; therefore, this evaluation metric is a self-comparison, that is, how to refine it to achieve the best evaluation metric (or the evaluation metric reaching a preset threshold). In contrast, the evaluation metrics used in the aforementioned horizontal comparison are the evaluation metrics of each osteotomy plan that have already reached their best performance, and then a horizontal comparison is performed again to determine which osteotomy plans are the optimal plans.

[0030] In one embodiment, the process of generating a femoral rotational osteotomy scheme includes: Identify key points of the hip joint and necrotic areas of the femur; Generate osteotomy information and femoral adjustment information; Calculate at least one of the following assessment indicators: the overlap area between the adjusted necrotic area and the weight-bearing area of ​​the acetabulum, the postoperative hip joint integrity rate, and the overlap area between the necrotic area and the medial / lateral column of the femur. The osteotomy information and femoral adjustment information were revised based on the evaluation indicators.

[0031] The necrotic region includes: the spatial extent of the necrotic region; the volume or projected area of ​​the necrotic region; and the positional relationship of the necrotic region relative to the center of the femoral head.

[0032] In this way, the necrotic area is mapped onto the three-dimensional model of the femur to serve as a reference area for subsequent rotational adjustments.

[0033] Among them, osteotomy information includes the position, direction and tilt angle of the osteotomy plane; femoral adjustment information includes the rotation axis of the femoral head or proximal femur, rotation direction and rotation angle.

[0034] Among them, the overlapping area between the adjusted necrotic area and the acetabular weight-bearing area is used to assess whether the necrotic area has been moved out of the main weight-bearing area; the postoperative hip joint integrity rate is used to comprehensively assess the structural and functional integrity of the joint; the overlapping area between the necrotic area and the medial and / or lateral columns of the femur is used to assess the relationship between the necrotic area and the key weight-bearing structures after rotation.

[0035] In this way, by calculating and iteratively correcting the postoperative evaluation indicators of the femoral rotation osteotomy plan, the generated femoral rotation osteotomy plan can be used as an alternative osteotomy plan in S103 to participate in the cross-sectional evaluation and optimal selection of multiple plans.

[0036] In one embodiment, the process of generating a acetabular femoral rotation combined with osteotomy scheme includes: Identify key points in the 3D skeletal model of the hip joint and the necrotic area of ​​the femur; Assess the direction of the acetabular opening, the location and extent of the covered defect, and determine the adjusted acetabular angle and acetabular position information; Generate and refine multiple osteotomy surfaces around the acetabulum; Based on the adjusted acetabular angle and acetabular position information, osteotomy and adjustment information of the femur are generated; Based on osteotomy and adjustment information, several evaluation indicators were calculated, including the direction of the acetabular opening, the location of the defect covered, the degree of the defect covered, the overlapping area of ​​the necrotic area and the weight-bearing area of ​​the acetabulum, the postoperative hip joint integrity rate, and the overlapping area of ​​the necrotic area and the medial / lateral column of the femur. Based on several evaluation indicators, the osteotomy information was corrected and adjusted to obtain a combined osteotomy scheme for acetabular femoral rotation.

[0037] It should be noted that assessing the direction of the acetabular opening, the location and extent of the defect, can be done by mapping the contralateral femoral head to the assessment, thus avoiding assessment errors and planning problems caused by the femoral head being in an abnormal position on this side.

[0038] The adjustment of the femoral side is not generated independently, but is designed in conjunction with the spatial relationship after the adjustment of the acetabulum.

[0039] In this application, based on osteotomy information and adjustment information, several evaluation indicators are calculated, including the direction of the acetabular opening, the location of the defect being covered, the degree of the defect being covered, the overlapping area of ​​the necrotic area and the weight-bearing area of ​​the acetabulum, the postoperative hip joint integrity rate, and the overlapping area of ​​the necrotic area and the medial / lateral column of the femur. Multiple evaluation indicators are calculated jointly to perform collaborative correction based on the evaluation indicators, thereby achieving closed-loop optimization of the acetabulum-femur.

[0040] In this way, by conducting joint postoperative evaluation and iterative revision of the acetabular femoral rotation combined osteotomy scheme, this scheme can be used as an alternative osteotomy scheme in S103, and can be evaluated and optimally selected in a cross-sectional manner with other surgical types.

[0041] In this application, the acetabular-femoral rotation combined with osteotomy scheme is to jointly adjust the spatial posture of the acetabulum and the rotational position of the femur under the same three-dimensional skeletal model of the hip joint, so as to achieve synergistic optimization of the femoral head coverage relationship and the weight-bearing transfer of the necrotic area.

[0042] In one implementation, the process of generating a proximal femoral osteotomy plan includes: Identify key points in the 3D skeletal model of the hip joint and abnormal areas of the femur; Generate osteotomy information and osteotomy type; the osteotomy type includes intertrochanteric osteotomy, varus osteotomy, valgus osteotomy, and derotation osteotomy. Calculate at least one of the following evaluation indicators after adjustment: femoral anteversion angle, femoral neck-shaft angle, femoral weight-bearing zone orientation, femoral anterior displacement distance, and femoral posterior displacement distance; The osteotomy information and osteotomy type were adjusted based on the evaluation indicators.

[0043] The proximal femoral osteotomy scheme improves the weight-bearing transmission path of the hip joint by repositioning the anatomical structure of the proximal femur and adjusting the force line.

[0044] The abnormal regions include at least one of the following: abnormal femoral alignment, abnormal neck-shaft angle, abnormal anteversion angle, and areas of structural degeneration or deformity.

[0045] The key points and abnormal areas were used to establish a spatial reference coordinate system for the proximal femur, providing a basis for subsequent osteotomy type selection and osteotomy parameter generation.

[0046] Based on the osteotomy information and osteotomy type, a virtual osteotomy and repositioning of the proximal femur is performed to generate a postoperative virtual femur model and calculate evaluation indicators.

[0047] Among them, the osteotomy information and osteotomy type can be corrected based on the evaluation indicators, which can be used to correct the position, direction or tilt of the osteotomy plane, adjust the osteotomy range or amount, switch or combine different osteotomy types, or adjust the rotation angle or translation of the femur after osteotomy.

[0048] In one embodiment, the process of generating a proximal femoral osteotomy plan includes: Identify key points in the 3D skeletal model of the hip joint and abnormal areas of the femur; Generate osteotomy and adjustment information for the acetabulum and osteotomy information for the femur; Based on osteotomy and adjustment information, several evaluation indicators are calculated, including the direction of the acetabular opening, the location of the covered defect, the degree of the covered defect, the femoral anteversion angle, the femoral neck-shaft angle, the orientation of the femoral weight-bearing zone, the anterior femoral displacement distance, and the posterior femoral displacement distance. Based on several evaluation indicators, the osteotomy information was corrected and adjusted to obtain a combined osteotomy plan for the proximal femur of the acetabulum.

[0049] Among them, the osteotomy information of the proximal femur is generated under the constraint of the acetabular adjustment target, so that the adjustments on both sides are matched in a spatial and mechanical sense.

[0050] Among them, the acetabular-proximal femoral osteotomy combined approach simultaneously adjusts the spatial posture of the acetabulum and the force line structure of the proximal femur to synergistically improve the femoral head coverage relationship and the weight-bearing transmission path of the lower limb.

[0051] Among them, based on several evaluation indicators, osteotomy information and adjustment information are corrected, and at least one of the following correction operations are performed: correcting the number, position or direction of the acetabular osteotomy surface, adjusting the rotation angle or translation distance of the acetabulum, correcting the position or direction of the proximal femoral osteotomy plane, switching or combining different proximal femoral osteotomy types, and adjusting the rotation or translation parameters of the proximal femoral bone.

[0052] In one embodiment, the preoperative planning method for the hip-preserving surgery further includes: Obtain preoperative planning schemes for hip-preserving surgery, and / or simulation results; Displaying and interacting with preoperative planning schemes for hip-preserving surgery using virtual reality or augmented reality.

[0053] In traditional planning schemes, the model is displayed on a two-dimensional computer screen, and doctors need to use a mouse to rotate and zoom the model to understand the three-dimensional relationships.

[0054] In this application, the display is performed using virtual reality or augmented reality, allowing doctors to obtain true three-dimensional spatial perception and providing contextualized information overlay.

[0055] In this way, the preoperative planning of hip-preserving surgery is freed from the computer, making it a dynamic three-dimensional entity that can be touched, accessed, and interacted with.

[0056] In one embodiment, the preoperative planning method for the hip-preserving surgery further includes: Annotate the key structures of the 3D skeleton model; Based on the labeled key structures and the preoperative planning scheme for hip-preserving surgery, a virtual safety boundary is generated around the osteotomy surface.

[0057] In particular, all anatomical structures that need to be protected or avoided from damage during osteotomy are clearly marked on the three-dimensional skeletal model.

[0058] The key structures may include: contralateral intercompartmental articular cartilage, patellofemoral articular surface, cruciate ligament attachment points, collateral ligament attachment points, etc.

[0059] The safety boundary is a virtual surface or three-dimensional buffer that is parallel to the osteotomy surface and offset outward by a certain distance.

[0060] In this way, based on the virtual safety boundary, real-time collision detection and early warning can be performed; in automated planning based on artificial intelligence or optimization algorithms, the virtual safety boundary can serve as a hard constraint; and it can serve as a safety barrier for intraoperative navigation / robots.

[0061] This adds a proactive safety layer to the preoperative planning of hip-preserving surgery.

[0062] In this application, virtual safety boundaries are planned during the preoperative planning stage. On the one hand, there is no time limit, which allows for more detailed annotation and planning. On the other hand, preoperative medical images can be used to realize processes such as mapping and iteration.

[0063] This application provides a preoperative planning device for hip-preserving surgery, used to execute the preoperative planning method for hip-preserving surgery described above. The preoperative planning device for hip-preserving surgery will be described in detail below.

[0064] like Figure 4 As shown, the preoperative planning device for hip-preserving surgery includes: Model acquisition module 101 is used to acquire a three-dimensional skeletal model of the hip joint; The osteotomy scheme generation module 102 is used to generate at least two alternative osteotomy schemes based on a three-dimensional skeletal model of the hip joint; the alternative osteotomy schemes are one of the following: periacetabular osteotomy scheme, femoral rotational osteotomy scheme, combined acetabular-femoral rotational osteotomy scheme, proximal femoral osteotomy scheme, and combined acetabular-femoral proximal osteotomy scheme. The scheme determination module 103 is used to select the best alternative osteotomy scheme as the preoperative planning scheme for hip-preserving surgery.

[0065] In one implementation, the scheme determination module 103 is further configured to: A postoperative prediction model for alternative osteotomy options is generated; an evaluation index for the alternative osteotomy options is calculated based on the postoperative prediction model; and the alternative osteotomy options are screened based on the evaluation index to obtain a preoperative planning scheme for hip-preserving surgery.

[0066] In one embodiment, the evaluation indicators include one or more of the following: femoral anteversion angle, femoral neck-shaft angle, femoral weight-bearing zone orientation, CE angle, anterior CE angle, 65° CE angle, acetabular top angle, offset difference, leg length difference, rotation center difference, femoral anterior displacement distance, femoral posterior displacement distance, head-acetabular coverage, osteotomy volume, and hip joint integrity rate.

[0067] In one embodiment, the osteotomy location of the osteotomy surface in the periacetabular osteotomy scheme includes: the distance between the depression between the anterior superior iliac spine and the anterior inferior iliac spine and the corresponding osteotomy surface is 1 cm; the distance between the depression in front of the greater sciatic notch and the corresponding osteotomy surface is 1 cm; and the distance between the osteotomy surface and the edge of the preset nerve-sensitive area at the junction of the osteotomy surface and the outer surface of the hip joint is a preset distance.

[0068] In one embodiment, the osteotomy scheme generation module 102 is further configured to: Identify key points in the 3D skeletal model of the hip joint; assess the direction of the acetabular opening, the location and extent of the defect coverage, and determine the adjusted acetabular angle and position information; generate multiple osteotomy surfaces around the acetabulum; simulate postoperative assessment indicators of the acetabulum, and correct the osteotomy surfaces, adjusted acetabular angle, and acetabular position information.

[0069] In one embodiment, the osteotomy scheme generation module 102 is further configured to: Identify key points of the hip joint and necrotic areas of the femur; generate osteotomy information and femoral adjustment information; calculate at least one evaluation index among the overlapping area of ​​the adjusted necrotic area and the weight-bearing area of ​​the acetabulum, the postoperative hip joint integrity rate, and the overlapping area of ​​the necrotic area and the medial / lateral column of the femur; and correct the osteotomy information and femoral adjustment information based on the evaluation index.

[0070] In one embodiment, the osteotomy scheme generation module 102 is further configured to: Key points of the 3D skeletal model of the hip joint and the necrotic area of ​​the femur are identified; the direction of the acetabular opening, the location and extent of the defect coverage, and the adjusted acetabular angle and position information are determined; multiple osteotomy surfaces for periacetabular osteotomy are generated and corrected; based on the adjusted acetabular angle and position information, femoral osteotomy and adjustment information are generated; based on the osteotomy and adjustment information, several evaluation indicators are calculated for the acetabular opening direction, the location and extent of the defect coverage, the overlapping area of ​​the necrotic area and the acetabular weight-bearing area, the postoperative hip joint integrity rate, and the overlapping area of ​​the necrotic area and the medial / lateral column of the femur; based on these evaluation indicators, the osteotomy and adjustment information are corrected to obtain a combined acetabular-femoral rotation osteotomy scheme.

[0071] In one embodiment, the osteotomy scheme generation module 102 is further configured to: Identify key points of the three-dimensional skeletal model of the hip joint and abnormal areas of the femur; generate osteotomy information and osteotomy type; the osteotomy type includes intertrochanteric osteotomy, varus osteotomy, valgus osteotomy, and derotation osteotomy; calculate at least one of the following evaluation indicators: femoral anteversion angle, femoral neck-shaft angle, femoral weight-bearing zone orientation, femoral anterior displacement distance, and femoral posterior displacement distance; and correct the osteotomy information and osteotomy type based on the evaluation indicators.

[0072] In one embodiment, the osteotomy scheme generation module 102 is further configured to: The process involves identifying key points in the 3D skeletal model of the hip joint and abnormal areas of the femur; generating osteotomy and adjustment information for the acetabulum and femur; calculating several evaluation indicators based on the osteotomy and adjustment information, including the acetabular opening direction, the location of the defect covered, the degree of defect coverage, the femoral anteversion angle, the femoral neck-shaft angle, the orientation of the femoral weight-bearing zone, the anterior femoral displacement distance, and the posterior femoral displacement distance; and revising the osteotomy and adjustment information based on these evaluation indicators to obtain a combined proximal femoral osteotomy scheme for the acetabulum.

[0073] The preoperative planning device for hip preservation surgery provided in the above embodiments of this application and the preoperative planning method for hip preservation surgery provided in the embodiments of this application are based on the same inventive concept and have the same beneficial effects as the methods adopted, run or implemented by the applications stored therein.

[0074] The above describes the internal functions and structure of the preoperative planning device for hip-preserving surgery, such as... Figure 5 As shown, in practice, the preoperative planning device for hip preservation surgery can be implemented as an electronic device, including: a memory 301 and a processor 303.

[0075] Memory 301 can be configured to store a program.

[0076] Additionally, memory 301 can also be configured to store various other data to support operation on the electronic device. Examples of this data include instructions for any application or method used to operate on the electronic device, contact data, phonebook data, messages, pictures, videos, etc.

[0077] Memory 301 can be implemented by any type of volatile or non-volatile storage device or a combination thereof, such as static random access memory (SRAM), electrically erasable programmable read-only memory (EEPROM), erasable programmable read-only memory (EPROM), programmable read-only memory (PROM), read-only memory (ROM), magnetic storage, flash memory, magnetic disk, or optical disk. Processor 303, coupled to memory 301, is used to execute programs in memory 301 for: Obtain a 3D skeletal model of the hip joint; Based on a three-dimensional skeletal model of the hip joint, at least two alternative osteotomy schemes are generated; the alternative osteotomy schemes are one of the following: periacetabular osteotomy, femoral rotational osteotomy, combined acetabular-femoral rotational osteotomy, proximal femoral osteotomy, and combined acetabular-femoral proximal osteotomy. The best alternative osteotomy plan should be selected as the preoperative planning scheme for hip-preserving surgery.

[0078] In one implementation, the processor 303 is further configured to: A postoperative prediction model for alternative osteotomy options is generated; an evaluation index for the alternative osteotomy options is calculated based on the postoperative prediction model; and the alternative osteotomy options are screened based on the evaluation index to obtain a preoperative planning scheme for hip-preserving surgery.

[0079] In one embodiment, the evaluation indicators include one or more of the following: femoral anteversion angle, femoral neck-shaft angle, femoral weight-bearing zone orientation, CE angle, anterior CE angle, 65° CE angle, acetabular top angle, offset difference, leg length difference, rotation center difference, femoral anterior displacement distance, femoral posterior displacement distance, head-acetabular coverage, osteotomy volume, and hip joint integrity rate.

[0080] In one embodiment, the osteotomy location of the osteotomy surface in the periacetabular osteotomy scheme includes: the distance between the depression between the anterior superior iliac spine and the anterior inferior iliac spine and the corresponding osteotomy surface is 1 cm; the distance between the depression in front of the greater sciatic notch and the corresponding osteotomy surface is 1 cm; and the distance between the osteotomy surface and the edge of the preset nerve-sensitive area at the junction of the osteotomy surface and the outer surface of the hip joint is a preset distance.

[0081] In one implementation, the processor 303 is further configured to: Identify key points in the 3D skeletal model of the hip joint; assess the direction of the acetabular opening, the location and extent of the defect coverage, and determine the adjusted acetabular angle and position information; generate multiple osteotomy surfaces around the acetabulum; simulate postoperative assessment indicators of the acetabulum, and correct the osteotomy surfaces, adjusted acetabular angle, and acetabular position information.

[0082] In one implementation, the processor 303 is further configured to: Identify key points of the hip joint and necrotic areas of the femur; generate osteotomy information and femoral adjustment information; calculate at least one evaluation index among the overlapping area of ​​the adjusted necrotic area and the weight-bearing area of ​​the acetabulum, the postoperative hip joint integrity rate, and the overlapping area of ​​the necrotic area and the medial / lateral column of the femur; and correct the osteotomy information and femoral adjustment information based on the evaluation index.

[0083] In one implementation, the processor 303 is further configured to: Key points of the 3D skeletal model of the hip joint and the necrotic area of ​​the femur are identified; the direction of the acetabular opening, the location and extent of the defect coverage, and the adjusted acetabular angle and position information are determined; multiple osteotomy surfaces for periacetabular osteotomy are generated and corrected; based on the adjusted acetabular angle and position information, femoral osteotomy and adjustment information are generated; based on the osteotomy and adjustment information, several evaluation indicators are calculated for the acetabular opening direction, the location and extent of the defect coverage, the overlapping area of ​​the necrotic area and the acetabular weight-bearing area, the postoperative hip joint integrity rate, and the overlapping area of ​​the necrotic area and the medial / lateral column of the femur; based on these evaluation indicators, the osteotomy and adjustment information are corrected to obtain a combined acetabular-femoral rotation osteotomy scheme.

[0084] In one implementation, the processor 303 is further configured to: Identify key points of the three-dimensional skeletal model of the hip joint and abnormal areas of the femur; generate osteotomy information and osteotomy type; the osteotomy type includes intertrochanteric osteotomy, varus osteotomy, valgus osteotomy, and derotation osteotomy; calculate at least one of the following evaluation indicators: femoral anteversion angle, femoral neck-shaft angle, femoral weight-bearing zone orientation, femoral anterior displacement distance, and femoral posterior displacement distance; and correct the osteotomy information and osteotomy type based on the evaluation indicators.

[0085] In one implementation, the processor 303 is further configured to: The process involves identifying key points in the 3D skeletal model of the hip joint and abnormal areas of the femur; generating osteotomy and adjustment information for the acetabulum and femur; calculating several evaluation indicators based on the osteotomy and adjustment information, including the acetabular opening direction, the location of the defect covered, the degree of defect coverage, the femoral anteversion angle, the femoral neck-shaft angle, the orientation of the femoral weight-bearing zone, the anterior femoral displacement distance, and the posterior femoral displacement distance; and revising the osteotomy and adjustment information based on these evaluation indicators to obtain a combined proximal femoral osteotomy scheme for the acetabulum.

[0086] In this application, Figure 5 The diagram only shows some components and does not mean that the electronic device includes only these components. Figure 5 The components shown.

[0087] The electronic device provided in this embodiment is based on the same inventive concept as the preoperative planning method for hip preservation surgery provided in this application embodiment, and has the same beneficial effects as the methods adopted, run or implemented by the application stored therein.

[0088] Those skilled in the art will understand that embodiments of this application can be provided as methods, systems, or computer program products. Therefore, this application can take the form of a completely hardware embodiment, a completely software embodiment, or an embodiment combining software and hardware aspects. Furthermore, this application can take the form of a computer program product embodied on one or more computer-readable storage media (including, but not limited to, disk storage, CD-ROM, optical storage, etc.) containing computer-usable program code.

[0089] This application is described with reference to flowchart illustrations and / or block diagrams of methods, apparatus (systems), and computer program products according to embodiments of this application. It will be understood that each block of the flowchart illustrations and / or block diagrams, and combinations of blocks in the flowchart illustrations and / or block diagrams, can be implemented by computer program instructions. These computer program instructions can be provided to a processor of a general-purpose computer, special-purpose computer, embedded processor, or other programmable data processing apparatus to produce a machine, such that the instructions, which execute via the processor of the computer or other programmable data processing apparatus, generate instructions for implementing the flowchart... Figure 1 One or more processes and / or boxes Figure 1 The computer program instructions may also be stored in a computer-readable storage medium that can direct a computer or other programmable data processing device to operate in a particular manner, such that the instructions stored in the computer-readable storage medium produce an article of manufacture including instruction means, which are implemented in a process Figure 1 One or more processes and / or boxes Figure 1 The function specified in one or more boxes.

[0090] These computer program instructions may also be loaded onto a computer or other programmable data processing equipment to cause a series of operational steps to be performed on the computer or other programmable equipment to produce a computer-implemented process, thereby providing instructions that execute on the computer or other programmable equipment for implementing the process. Figure 1 One or more processes and / or boxes Figure 1 The steps of the function specified in one or more boxes.

[0091] In a typical configuration, a computing device includes one or more processors (CPUs), input / output interfaces, network interfaces, and memory. Memory may include non-persistent storage in computer-readable media, such as random access memory (RAM) and / or non-volatile memory, such as read-only memory (ROM) or flash RAM. Memory is an example of computer-readable media.

[0092] This application also provides a computer-readable storage medium corresponding to the preoperative planning method for hip-preserving surgery provided in the foregoing embodiments, wherein a computer program (i.e., a program product) is stored thereon. When the computer program is run by a processor, it executes the interactive image analysis assistance method for 3D aerial imaging provided in any of the foregoing embodiments.

[0093] Computer-readable media includes both permanent and non-permanent, removable and non-removable media that can store information using any method or technology. Information can be computer-readable instructions, data structures, modules of programs, or other data. Examples of computer storage media include, but are not limited to, phase-change memory (PRAM), static random access memory (SRAM), dynamic random access memory (DRAM), other types of random access memory (RAM), read-only memory (ROM), electrically erasable programmable read-only memory (EEPROM), flash memory or other memory technologies, optical disc read-only memory (CDROM), digital versatile optical disc (DVD) or other optical storage, magnetic tape, magnetic magnetic disk storage or other magnetic storage devices, or any other non-transferable medium that can be used to store information accessible by a computing device. As defined herein, computer-readable media does not include transient computer-readable media, such as modulated data signals and carrier waves.

[0094] The computer-readable storage medium provided in the above embodiments of this application and the interactive image analysis assistance method for 3D aerial imaging provided in the embodiments of this application are based on the same inventive concept and have the same beneficial effects as the methods adopted, run or implemented by the applications stored therein.

[0095] It should be noted that numerous specific details are set forth in the specification provided herein. However, it will be understood that embodiments of this application may be practiced without these specific details. In some instances, well-known structures and techniques have not been shown in detail so as not to obscure the understanding of this specification.

[0096] It should also be noted that the terms "comprising," "including," or any other variations thereof are intended to cover non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements includes not only those elements but also other elements not expressly listed, or elements inherent to such a process, method, article, or apparatus. Without further limitation, an element defined by the phrase "comprising one..." does not exclude the presence of other identical elements in the process, method, article, or apparatus that includes said element.

[0097] The above description is merely an embodiment of this application and is not intended to limit this application. Various modifications and variations can be made to this application by those skilled in the art. Any modifications, equivalent substitutions, improvements, etc., made within the spirit and principle of this application should be included within the scope of the claims of this application.

Claims

1. A preoperative planning method for hip-preserving surgery, characterized in that, include: Obtain a 3D skeletal model of the hip joint; Based on a three-dimensional skeletal model of the hip joint, at least two alternative osteotomy plans are generated. The alternative osteotomy scheme is one of the following: periacetabular osteotomy, femoral rotational osteotomy, combined acetabular and femoral rotational osteotomy, proximal femoral osteotomy, and combined acetabular and femoral osteotomy. The best alternative osteotomy plan should be selected as the preoperative planning scheme for hip-preserving surgery.

2. The preoperative planning method for hip-preserving surgery according to claim 1, characterized in that, The selection of the optimal alternative osteotomy plan as the preoperative planning scheme for hip-preserving surgery includes: Generate postoperative prediction models for alternative osteotomy options; Evaluation indicators for alternative osteotomy options were calculated based on a postoperative prediction model. Based on the evaluation indicators, alternative osteotomy options were screened to obtain a preoperative planning scheme for hip-preserving surgery.

3. The preoperative planning method for hip-preserving surgery according to claim 2, characterized in that, The evaluation indicators include one or more of the following: femoral anteversion angle, femoral neck-shaft angle, femoral weight-bearing zone orientation, CE angle, anterior CE angle, 65° CE angle, acetabular top angle, offset difference, leg length difference, rotation center difference, femoral anterior displacement distance, femoral posterior displacement distance, head-acetabular coverage, osteotomy volume, and hip joint integrity rate.

4. The preoperative planning method for hip-preserving surgery according to any one of claims 1-3, characterized in that, The osteotomy locations of the osteotomy surfaces in the periacetabular osteotomy scheme include: The distance between the depression between the anterior superior iliac spine and the anterior inferior iliac spine and the corresponding osteotomy surface is 1 cm. The distance between the depression in front of the greater sciatic notch and the corresponding osteotomy surface is 1 cm. The distance between the edge of the preset nerve-sensitive area at the junction of the osteotomy surface and the outer surface of the hip joint is the preset distance.

5. The preoperative planning method for hip-preserving surgery according to any one of claims 1-3, characterized in that, The process of generating a femoral rotational osteotomy plan includes: Identify key points of the hip joint and necrotic areas of the femur; Generate osteotomy information and femoral adjustment information; Calculate at least one of the following assessment indicators: the overlap area between the adjusted necrotic area and the weight-bearing area of ​​the acetabulum, the postoperative hip joint integrity rate, and the overlap area between the necrotic area and the medial / lateral column of the femur. The osteotomy information and femoral adjustment information were revised based on the evaluation indicators.

6. The preoperative planning method for hip-preserving surgery according to any one of claims 1-3, characterized in that, The process of generating a combined acetabular-femoral rotation osteotomy plan includes: Identify key points in the 3D skeletal model of the hip joint and the necrotic area of ​​the femur; Assess the direction of the acetabular opening, the location and extent of the covered defect, and determine the adjusted acetabular angle and acetabular position information; Generate and refine multiple osteotomy surfaces around the acetabulum; Based on the adjusted acetabular angle and acetabular position information, osteotomy and adjustment information of the femur are generated; Based on osteotomy and adjustment information, several evaluation indicators were calculated, including the direction of the acetabular opening, the location of the defect covered, the degree of the defect covered, the overlapping area of ​​the necrotic area and the weight-bearing area of ​​the acetabulum, the postoperative hip joint integrity rate, and the overlapping area of ​​the necrotic area and the medial / lateral column of the femur. Based on several evaluation indicators, the osteotomy information was corrected and adjusted to obtain a combined osteotomy scheme for acetabular femoral rotation.

7. The preoperative planning method for hip-preserving surgery according to any one of claims 1-3, characterized in that, The process of generating a proximal femoral osteotomy plan includes: Identify key points in the 3D skeletal model of the hip joint and abnormal areas of the femur; Generate osteotomy information and osteotomy type; the osteotomy type includes intertrochanteric osteotomy, varus osteotomy, valgus osteotomy, and derotation osteotomy. Calculate at least one of the following evaluation indicators after adjustment: femoral anteversion angle, femoral neck-shaft angle, femoral weight-bearing zone orientation, femoral anterior displacement distance, and femoral posterior displacement distance; The osteotomy information and osteotomy type were adjusted based on the evaluation indicators.

8. A preoperative planning device for hip-preserving surgery, characterized in that, include: The model acquisition module is used to acquire a three-dimensional skeletal model of the hip joint; The osteotomy scheme generation module is used to generate at least two alternative osteotomy schemes based on a three-dimensional skeletal model of the hip joint; the alternative osteotomy scheme is one of the following: periacetabular osteotomy scheme, femoral rotational osteotomy scheme, combined acetabular-femoral rotational osteotomy scheme, proximal femoral osteotomy scheme, and combined acetabular-femoral proximal osteotomy scheme. The scheme determination module is used to select the best alternative osteotomy scheme as the preoperative planning scheme for hip-preserving surgery.

9. An electronic device, characterized in that, include: Memory and processor; The memory is used to store programs; The processor, coupled to the memory, is used to execute the program for: Obtain a 3D skeletal model of the hip joint; Based on a three-dimensional skeletal model of the hip joint, at least two alternative osteotomy schemes are generated; the alternative osteotomy schemes are one of the following: periacetabular osteotomy, femoral rotational osteotomy, combined acetabular-femoral rotational osteotomy, proximal femoral osteotomy, and combined acetabular-femoral proximal osteotomy. The best alternative osteotomy plan should be selected as the preoperative planning scheme for hip-preserving surgery.

10. A computer-readable storage medium having a computer program stored thereon, characterized in that, The program is executed by a processor to implement the preoperative planning method for hip-preserving surgery as described in any one of claims 1-7.

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