Knee-preserving surgical robot and control method thereof

Abstract

The embodiment of the application is suitable for the technical field of computer-aided medical treatment and surgical robot, and provides a knee-preserving surgery robot and a control method thereof. The knee-preserving surgery robot comprises: a preoperative planning unit, which is used for determining an osteotomy plane based on a key point of surgery on a three-dimensional model of a patient's skeleton, and planning a correction angle in the case of establishing a target force line; an intraoperative execution unit, which is used for assisting in osteotomy operation according to the osteotomy plane under the assistance of a navigation system, so that the angle after the osteotomy is expanded meets the requirement of the correction angle; and a postoperative evaluation unit, which is used for simulating a postoperative bone image, calculating a force line angle based on the simulated postoperative bone image, and adjusting the correction angle formed by actual osteotomy according to the force line angle. The proximal end and the distal end of the patient's skeleton and the corresponding surgical tools are respectively provided with a tracer, and the navigation system provides position data for the operation performed by the intraoperative execution unit and the postoperative evaluation unit by tracking the position change of the tracer.

Description

Technical Field

[0001] This application belongs to the field of computer-aided medical technology and surgical robot technology, and in particular relates to a knee-preserving surgical robot and its control method. Background Technology

[0002] Knee-preserving surgery is a collective term for a series of surgical procedures aimed at preserving the patient's own knee joint, relieving pain, and slowing down joint degeneration through correcting alignment or local repair. For example, knee-preserving surgeries such as high tibial osteotomy (HTO) and distal femoral osteotomy (DFO) can correct lower limb alignment, resolve abnormal stress on the patient's knee joint, relieve pain, and improve knee joint function through osteotomy.

[0003] Traditional knee-preserving surgeries such as HTO and DFO rely on manual measurement of anatomical parameters from X-rays or CT images by the surgeon. This method is susceptible to projection errors and soft tissue obstruction, leading to significant errors in the planned osteotomy angles and positions. Furthermore, traditional knee-preserving surgeries typically use guide plates during osteotomy, making it difficult to correct surgical deviations in a timely manner, potentially resulting in under- or over-correction, which negatively impacts surgical precision. In addition, postoperative evaluation in traditional knee-preserving surgeries requires full-length X-rays after surgery, which is time-consuming and cannot provide timely feedback to the surgeon during the operation, further affecting the surgical outcome. Summary of the Invention

[0004] In view of this, embodiments of this application provide a knee-preserving surgical robot and its control method, which can accurately plan the preoperative operation of knee-preserving surgery and precisely complete the relevant surgical operations, thereby improving the accuracy and safety of the surgical operation and ensuring the surgical effect.

[0005] A first aspect of this application provides a knee-preserving surgical robot, comprising: The preoperative planning unit is used to determine the osteotomy plane based on the surgical key points on the three-dimensional model of the patient's bones, and to plan the correction angle after establishing the target force line; The intraoperative execution unit is used to perform osteotomy operation according to the osteotomy plane with the assistance of the navigation system, so that the angle after the osteotomy site is opened by the bone stretching device meets the requirements of the correction angle. The postoperative assessment unit is used to simulate postoperative bone images, calculate the force line angle based on the simulated postoperative bone images, and adjust the correction angle formed by the actual osteotomy according to the force line angle. The proximal and distal ends of the bone and the corresponding surgical tools are equipped with tracers. The navigation system provides position data for the relevant operations performed by the intraoperative execution unit and the postoperative evaluation unit by tracking the position changes of the tracers.

[0006] Optionally, the preoperative planning unit is specifically used for: The patient's medical images were acquired, and after segmenting the femur and tibia based on the medical images, a three-dimensional model of the patient's femur and tibia was obtained through three-dimensional reconstruction. Identify the key surgical points in the three-dimensional model and determine the osteotomy plane based on the key surgical points.

[0007] Optionally, the key surgical points include the osteotomy entry point and the knee joint hinge point, and determining the osteotomy plane based on the key surgical points includes: Connect the osteotomy incision point and the knee joint hinge point to obtain the first vector; Determine a second vector perpendicular to the current two-dimensional medical image, and calculate the cross product of the first and second vectors to obtain a third vector; The osteotomy plane is determined based on the osteotomy inlet point and the third vector, wherein the third vector is the normal vector of the osteotomy plane.

[0008] Optionally, the preoperative planning unit is further specifically used for: The key surgical points in the three-dimensional model are projected onto the two-dimensional medical image; The target force line is established based on the projection points on the two-dimensional medical image; wherein, the target force line for high tibial osteotomy is the line connecting the center point of the hip joint after projection and the target point for force line correction and its extension; the target force line for distal femoral osteotomy is the line connecting the center point of the ankle joint after projection and the target point for force line correction and its extension. The correction angle is determined based on the target force line.

[0009] Optionally, determining the correction angle based on the target force line includes: In the case of the current surgery being a high tibial osteotomy, the rotation is performed with the knee joint hinge point as the center of rotation and the first line connecting the center point of the ankle joint to the knee joint hinge point as the radius, until the first line intersects the target force line. The angle of rotation of the first line is the correction angle of the high tibial osteotomy. In the case of the current surgery being distal femoral osteotomy, the rotation is performed with the knee joint hinge point as the center of rotation and the second line connecting the center point of the hip joint to the knee joint hinge point as the radius, until the second line intersects the target force line. The angle of rotation of the second line is the correction angle of the distal femoral osteotomy.

[0010] Optionally, the intraoperative execution unit is specifically used for: With the assistance of the navigation system, the oscillating saw is controlled to perform osteotomy along the osteotomy plane; After the osteotomy is completed, a bone stretching device is inserted at the osteotomy site and the angle at the osteotomy site is stretched to be equal to the correction angle.

[0011] Optionally, the postoperative assessment unit is specifically used for: Acquire position change data of the tracers installed at the proximal and distal ends of the skeleton tracked by the navigation system; Based on the location change data and the three-dimensional model of the patient's bones, a two-dimensional simulation image is reconstructed; The force line angle is calculated based on the two-dimensional simulated image, and the force line angle is the angle between the femoral mechanical axis and the tibial mechanical axis.

[0012] Optionally, the postoperative assessment unit is further specifically used for: The angle of the osteotomy site after being opened can be adjusted by adjusting the bone-opening device; The force line angle is recalculated based on the adjusted angle so that the calculated force line angle reaches the ideal force line angle; wherein, the angle after the osteotomy site is opened corresponding to the ideal force line angle is the target correction angle.

[0013] Optionally, the intraoperative execution unit is further specifically used for: When the angle at the osteotomy site after being opened by the bone-opening device is the target correction angle, a corresponding bone block is implanted at the osteotomy site so that the correction angle at the osteotomy site is the target correction angle.

[0014] A second aspect of this application provides a control method for a knee-preserving surgical robot, comprising: The osteotomy plane is determined based on the surgical key points on the three-dimensional model of the patient's bones, and the correction angle is planned after establishing the target force line. With the assistance of the navigation system, osteotomy is performed according to the osteotomy plane, so that the angle of the osteotomy site after being opened by the bone stretching device meets the requirements of the correction angle. Simulate postoperative bone images, calculate the force line angle based on the simulated postoperative bone images, and adjust the correction angle formed by the actual osteotomy according to the force line angle; The proximal and distal ends of the bone and the corresponding surgical tools are equipped with tracers. The navigation system provides positional data for intraoperative operation and postoperative evaluation by tracking the positional changes of the tracers.

[0015] A third aspect of this application provides a computer device including a memory, a processor, and a computer program stored in the memory and executable on the processor, wherein when the processor executes the computer program, the computer device performs the method described in the second aspect above.

[0016] A fourth aspect of this application provides a computer-readable storage medium storing a computer program that, when executed by a computer, implements the method described in the second aspect above.

[0017] A fifth aspect of this application provides a computer program product, including a computer program that, when run, causes the method described in the second aspect to be executed.

[0018] Compared with the prior art, the embodiments of this application have the following beneficial effects: This application embodiment utilizes a knee-preserving surgical robot to perform preoperative planning, intraoperative osteotomy, and postoperative evaluation of knee-preserving surgery. Specifically, the preoperative planning unit of the knee-preserving surgical robot can automatically segment the femur and tibia to reconstruct corresponding three-dimensional models of the femur and tibia. Based on this, by automatically identifying key surgical points and determining the osteotomy plane, the target force line can be established and the planned correction angle can be determined through automatic projection, thereby improving surgical precision and solving the problem in existing technologies where doctors need to manually measure anatomical parameters in patient X-rays or CT images, which is easily affected by projection errors and soft tissue obstruction, resulting in large errors. Using the intraoperative execution unit of the knee-preserving surgical robot, precise osteotomy can be performed according to the planned surgical plan, ensuring the accuracy and safety of osteotomy and contributing to improved surgical precision. In addition, the postoperative evaluation unit of the knee-preserving surgical robot can evaluate whether the force line angle is appropriate in real time, and can also provide timely feedback when the correction angle needs to be adjusted, facilitating targeted angle adjustments by the doctor. This solves the problem in existing technologies where the surgical effect can only be judged by postoperative X-rays, further improving the precision and safety of knee-preserving surgery and increasing surgical efficiency. Attached Figure Description

[0019] To more clearly illustrate the technical solutions in the embodiments of this application, the drawings used in the description of the embodiments or the prior art will be briefly introduced below. Obviously, the drawings described below are only some embodiments of this application. For those skilled in the art, other drawings can be obtained based on these drawings without creative effort.

[0020] Figure 1 This is a schematic diagram of a knee-preserving surgical robot provided in an embodiment of this application; Figure 2 This is a schematic diagram of an osteotomy plane provided in an embodiment of this application; Figure 3 This is a schematic diagram of a simulated postoperative bone image provided in an embodiment of this application; Figure 4 This is a schematic diagram illustrating the operation process of a knee-preserving surgery provided in an embodiment of this application; Figure 5 This is a schematic diagram of a control method for a knee-preserving surgical robot provided in an embodiment of this application; Figure 6 This is a schematic diagram of a computer device provided in an embodiment of this application. Detailed Implementation

[0021] In the following description, specific details such as particular system architectures and techniques are set forth for illustrative purposes and not for limitation, in order to provide a thorough understanding of the embodiments of this application. However, those skilled in the art will understand that this application may also be implemented in other embodiments without these specific details. In other instances, detailed descriptions of well-known systems, apparatuses, circuits, and methods have been omitted so as not to obscure the description of this application with unnecessary detail.

[0022] The technical solution of this application will be described below through specific embodiments.

[0023] Reference Figure 1 This illustration shows a schematic diagram of a knee-preserving surgical robot according to an embodiment of this application. Specifically, it may include a preoperative planning unit 101, an intraoperative execution unit 102, and a postoperative evaluation unit 103. The preoperative planning unit 101 can intelligently plan an osteotomy scheme, including the osteotomy location and correction angle, before surgery. The intraoperative execution unit 102 can execute the preoperatively planned osteotomy scheme with high precision during surgery. The postoperative evaluation unit can evaluate the force line in real time after surgery and make targeted adjustments to the correction angle, etc. Specifically: The preoperative planning unit 101 is used to determine the osteotomy plane based on the surgical key points on the three-dimensional model of the patient's bones, and to plan the correction angle after establishing the target force line.

[0024] The intraoperative execution unit 102 is used to perform osteotomy with the assistance of the navigation system according to the determined osteotomy plane, so that the angle after the osteotomy site is opened by the bone stretching device meets the requirements of the planned correction angle.

[0025] The postoperative assessment unit 103 is used to simulate postoperative bone images, calculate the force line angle based on the simulated postoperative bone images, and adjust the correction angle formed by the actual osteotomy according to the force line angle.

[0026] It should be noted that, Figure 1The knee-preserving surgical robot shown can be a device with relevant functions. Utilizing the various functional modules or units within this device, it can assist the surgeon at various stages of the knee-preserving surgery, including preoperative, intraoperative, and postoperative procedures. For example, it can assist in preoperative surgical planning, intraoperative osteotomy, and postoperative evaluation. This application does not limit the device's form or other aspects in its embodiments.

[0027] In this embodiment, the preoperative planning unit 101 is mainly used for preoperative planning. That is, the preoperative planning unit 101 can determine a suitable osteotomy plane based on a three-dimensional model of the patient's skeleton, establish a suitable target force line, and then plan a correction angle suitable for the patient's actual needs. It should be understood that in this embodiment, the skeleton includes the femur and tibia.

[0028] In knee-preserving surgery, the force line that needs to be established usually refers to the mechanical axis of the lower limb, such as the femoral mechanical axis or the tibial mechanical axis. Normally, in a healthy person without genu varum or genu valgum, when standing, a line connecting the center of the femoral head to the center of the ankle joint will pass precisely through the center of the knee joint. This line is the mechanical axis of the lower limb and is the ideal normal force line. For patients requiring knee-preserving surgery, such as those with medial knee wear and tear, or painful O-shaped legs, their force line passes through the medial side of the knee joint, leading to excessive medial load. One of the goals of knee-preserving surgery is to artificially shift this force line to the healthier side of the knee joint (usually the lateral side), so that the weight is no longer concentrated on the worn medial side, thereby relieving pain and slowing the progression of arthritis.

[0029] The establishment of the force line can be determined based on the patient's specific condition. Specifically, the force line is usually set at a certain percentage (from medial to lateral) along the tibial plateau of the knee joint. This percentage can be determined based on research showing the optimal force line correction target point that balances decompression and joint stability. In some examples, the force line can be set at approximately 62.5% of the tibial plateau of the knee joint; this target point is also known as the Fujisawa point.

[0030] In this embodiment, the knee-preserving surgery can be performed with the assistance of a navigation system. Specifically, tracers can be installed on the proximal and distal ends of the patient's bone and on the corresponding surgical instruments. In this way, the navigation system can provide positional data for the relevant operations performed by the intraoperative execution unit 102 and the postoperative evaluation unit 103 by tracking the positional changes of each tracer.

[0031] With a pre-planned surgical procedure, intraoperative operations can be performed according to the plan. That is, the intraoperative execution unit 102, with the assistance of the navigation system, can be used to perform osteotomy according to the pre-planned osteotomy plane, so that the angle after the osteotomy site is opened meets the requirements of the planned correction angle.

[0032] Specifically, after the osteotomy is performed according to the planned osteotomy plane, the doctor can use a bone retractor. By inserting the bone retractor into the osteotomy site and adjusting the angle of retraction, the angle at which the osteotomy site is retracted is equal to the planned correction angle. The aforementioned bone retractor is a specialized tool used to open the osteotomy gap and will be removed from the patient's osteotomy site after the relevant bone grafts are implanted.

[0033] The postoperative assessment unit 103 can perform operations after the surgeon inserts the bone retractor into the osteotomy site and adjusts it so that the angle after the osteotomy site is retracted meets the planned correction angle requirements. After the surgeon adjusts the bone retractor to the appropriate position and angle, the postoperative assessment unit 103 can simulate postoperative bone images in real time. In this way, the knee-preserving surgical robot can calculate the force line angle based on the simulated postoperative bone images and adjust the correction angle formed by the actual osteotomy according to the currently calculated force line angle. That is, through the real-time assessment of the postoperative assessment unit 103, it can be confirmed whether the planned correction angle is appropriate. For cases where the correction angle needs to be adjusted, the postoperative assessment unit 103 can provide a specific value of the target correction angle for the surgeon to make targeted adjustments according to the target correction angle. The aforementioned target correction angle that needs to be adjusted can be increased or decreased compared to the correction angle determined in the preoperative plan. For example, the target correction angle can be greater than the planned correction angle, or the target correction angle can be less than the planned correction angle. This depends on the surgical procedure and the actual situation of the patient, and this embodiment does not limit this.

[0034] Below, regarding Figure 1 The specific functions of each unit of the knee-preserving surgical robot shown will be described in further detail.

[0035] As mentioned earlier, the preoperative planning unit 101 is mainly used for preoperative planning, including determining the osteotomy plane, establishing the target force line, and planning the correction angle. Among these, the determination of the osteotomy plane can be achieved based on the reconstructed three-dimensional model of the patient's skeleton.

[0036] Specifically, for patients who need knee-preserving surgery, the preoperative planning unit 101 can acquire the patient's medical images, such as Dicom medical images, and segment the femur and tibia based on the acquired medical images, and then obtain a three-dimensional model of the patient's femur and tibia through three-dimensional reconstruction.

[0037] Based on this, the preoperative planning unit 101 can identify the key surgical points in the three-dimensional model and determine the appropriate osteotomy plane according to the key surgical points.

[0038] In this embodiment, the preoperative planning unit 101 may be configured with a neural network model capable of identifying key surgical points. After reconstructing the three-dimensional models of the patient's femur and tibia, the preoperative planning unit 101 can call the neural network model to automatically identify the key surgical points on the three-dimensional model.

[0039] In some examples, the key surgical points to be identified may include the center point of the hip joint, the center point of the knee joint, the center point of the ankle joint, the hinge point of the knee joint, as well as surgical points and target points for force line correction. The surgical points can be the osteotomy entry points, i.e., the points where osteotomy is performed during surgery; the target points for force line correction can be determined based on the established appropriate force lines. For example, the target points for force line correction could be points like the Fujisawa point in the aforementioned examples.

[0040] In this embodiment, the osteotomy plane can be determined based on the osteotomy entry point and the knee joint hinge point among the above-mentioned key surgical points.

[0041] Specifically, after the preoperative planning unit 101 identifies the relevant surgical key points, it can connect the osteotomy entry point and the knee joint hinge point to obtain a first vector. Then, by determining a second vector perpendicular to the current two-dimensional medical image, the cross product of the first and second vectors, i.e., the third vector, can be calculated. Thus, the preoperative planning unit 101 can determine the osteotomy plane based on the osteotomy entry point and the third vector. The third vector can be the normal vector of the osteotomy plane. The aforementioned two-dimensional medical image can be a two-dimensional X-ray image.

[0042] like Figure 2 The image shown is a schematic diagram of an osteotomy plane provided in an embodiment of this application. Figure 2 The image shows examples of osteotomy planes under two different surgical techniques. Specifically, in... Figure 2 In (a), an example of the osteotomy plane under high tibial osteotomy (HTO) is shown. Figure 2 In (b), an example of the osteotomy plane under distal femoral osteotomy (DFO) is shown.

[0043] See Figure 2 As shown in (a) on the left, the schematic diagram illustrates an example of surgical point 21a and knee joint hinge point 21b in a high tibial osteotomy. Connecting these two points yields a first vector. Based on the cross product of this first vector and a second vector perpendicular to the X-ray image, a third vector is obtained. Using this third vector as the normal vector, the following can be obtained: Figure 2 The osteotomy plane 201 is shown in the schematic diagram on the right side of (a) in the figure.

[0044] See Figure 2 As shown in (b) of the diagram on the left, an example of the surgical point 22a and the knee joint hinge point 22b in distal femoral osteotomy is illustrated. Connecting the two yields a first vector. Based on the cross product of this first vector and a second vector perpendicular to the X-ray image, a third vector is obtained. Using the third vector as the normal vector, the following can be obtained: Figure 2 The osteotomy plane 202 is shown in the schematic diagram on the right side of (b) in the figure.

[0045] In this embodiment of the application, the preoperative planning unit 101 can also be used to establish the target force line and complete the planning of the correction angle.

[0046] Specifically, the preoperative planning unit 101 can project surgical key points from the reconstructed 3D model onto a 2D medical image, such as a 2D X-ray image. In some examples, this projection operation can be implemented based on a digitally reconstructed radiograph (DRR) algorithm. The DRR reconstruction algorithm is a simulation technique that can generate 2D X-ray images at arbitrary angles from 3D image data (such as CT data).

[0047] Then, the preoperative planning unit 101 can establish the target force line based on the projection points on the two-dimensional medical image.

[0048] It should be noted that the target force line differs for different types of surgery. For example, the target force line for high tibial osteotomy can be the line connecting the projected center point of the hip joint and the target force line correction point (such as the Fujisawa point) and its extension; the target force line for distal femoral osteotomy is the line connecting the projected center point of the ankle joint and the target force line correction point (such as the Fujisawa point) and its extension.

[0049] Based on the established target force line, the preoperative planning unit 101 can determine the correction angle.

[0050] Specifically, if the current preoperative planning is for a high tibial osteotomy, the preoperative planning unit 101 can rotate with the knee joint hinge point as the center of rotation and the line connecting the center point of the ankle joint to the knee joint hinge point (the first line) as the radius, until the first line intersects the target force line. In this way, the angle of rotation of the first line can be used as the correction angle for the high tibial osteotomy.

[0051] If the current preoperative planning is for distal femoral osteotomy, the preoperative planning unit 101 can rotate with the knee joint hinge point as the center of rotation and the line connecting the center point of the hip joint to the knee joint hinge point (the second line) as the radius, until the second line intersects the target force line. In this way, the angle of rotation of the second line can be used as the correction angle for distal femoral osteotomy.

[0052] After completing the above preoperative planning, the knee-preserving surgical robot can use the intraoperative execution unit 102 to achieve precise osteotomy during the operation.

[0053] Specifically, before performing intraoperative osteotomy, tracers can be installed on the patient's bones and related surgical tools according to the requirements of the navigation system. For example, tracers can be installed on the proximal femur, distal femur, proximal tibia, distal tibia, and surgical tools such as oscillating saws. In this way, the navigation system can track the positional changes of the tracers to provide positional data for the subsequent osteotomy operation performed by the intraoperative execution unit 102, ensuring the accuracy of the osteotomy operation.

[0054] In this embodiment, after the tracers are installed, surgical tools such as the oscillating saw can be calibrated based on each tracer, and the three-dimensional model of the patient's bones can be aligned with the patient during surgery through registration and other operations. In this way, the intraoperative execution unit 102 can control the oscillating saw to perform osteotomy operations along the osteotomy plane determined in the preoperative plan with the assistance of the navigation system.

[0055] After the osteotomy is completed, a bone retractor can be inserted at the osteotomy site to widen the angle of the osteotomy site to be equal to the pre-planned correction angle.

[0056] In this embodiment, the knee-preserving surgical robot can use the postoperative evaluation unit 103 to evaluate the aforementioned osteotomy effect and confirm whether the correction angle is appropriate.

[0057] Specifically, the postoperative assessment unit 103 can acquire positional change data of the tracers installed at the proximal and distal ends of the bone tracked by the navigation system, and then reconstruct a two-dimensional simulated image based on the positional change data and the three-dimensional model of the patient's bones. This two-dimensional simulated image can be a two-dimensional X-ray image simulated after DRR reconstruction of the patient's three-dimensional bone model. The force line angle can be calculated from the two-dimensional simulated image; this force line angle can be the angle between the femoral mechanical axis and the tibial mechanical axis.

[0058] like Figure 3 The image shown is a schematic diagram of a simulated postoperative bone image provided in an embodiment of this application. Figure 3 Simulated images of the tibia and femur are shown in the image, respectively. Figure 3 (a) shows an example of a postoperative tibial correction simulation. Figure 3(b) shows an example of a postoperative femoral correction simulation.

[0059] In this embodiment of the application, the force line angle can be calculated based on the surgical key points on the previously identified three-dimensional model. These key points are projected onto a two-dimensional simulation image to calculate the force line angle.

[0060] In one possible implementation of this application embodiment, the postoperative evaluation unit 103 can also determine whether the preoperative planned correction angle is appropriate and whether the correction angle needs to be adjusted based on the simulated postoperative bone image.

[0061] In this embodiment, the angle at the osteotomy site after expansion can be adjusted by adjusting the bone expansion device. This allows the postoperative evaluation unit 103 to recalculate the force line angle based on the adjusted angle, ensuring that the calculated force line angle reaches the ideal force line angle. The angle at the osteotomy site after expansion corresponding to the aforementioned ideal force line angle can be identified as the target correction angle.

[0062] Specifically, the surgeon can adjust the bone-spreading device to open the osteotomy site at different angles. Simultaneously, for each opened angle, the postoperative assessment unit 103 can simulate postoperative bone imaging in real time and calculate the force line angle at the corresponding angle. When the force line angle calculated by the postoperative assessment unit 103 meets the planning requirements, such as reaching the ideal force line angle, the surgeon can stop adjusting the bone-spreading device and use the opened angle at this point as the target correction angle. This target correction angle can be considered a correction angle that matches the patient's actual condition and helps the patient achieve the best postoperative results.

[0063] After completing the aforementioned postoperative assessment procedures, the angle at which the osteotomy site is opened by the bone-releasing device is the target correction angle. With the assistance of the intraoperative execution unit 102 of the knee-preserving surgical robot, a corresponding bone block can be implanted at the osteotomy site. Once implanted, this bone block ensures that the correction angle at the osteotomy site is the target correction angle. Then, the bone-releasing device can be removed. The entire surgical procedure is now complete.

[0064] In this embodiment, a knee-preserving surgical robot can be used to complete preoperative planning, intraoperative osteotomy, and postoperative evaluation of knee-preserving surgery. Specifically, the preoperative planning unit of the knee-preserving surgical robot can automatically segment the femur and tibia to reconstruct corresponding three-dimensional models of the femur and tibia. Based on this, by automatically identifying key surgical points and determining the osteotomy plane, the target force line and the planned correction angle can be established through automatic projection, thereby improving surgical accuracy and solving the problem in the prior art where doctors need to manually measure anatomical parameters in the patient's X-ray or CT images, which is easily affected by projection errors and soft tissue obstruction, resulting in large errors. Using the intraoperative execution unit of the knee-preserving surgical robot, precise osteotomy can be performed according to the planned surgical plan, ensuring the accuracy and safety of osteotomy and helping to improve surgical precision. In addition, the postoperative evaluation unit of the knee-preserving surgical robot can evaluate whether the force line angle is appropriate in real time, and can also provide timely feedback when the correction angle needs to be adjusted, which allows doctors to make targeted angle adjustments. This solves the problem in the prior art that the surgical effect can only be judged by postoperative X-rays, further improving the accuracy and safety of knee-preserving surgery and increasing surgical efficiency.

[0065] Based on the foregoing introduction, such as Figure 4 The diagram shown illustrates the operational flow of a knee-preserving surgery according to an embodiment of this application. According to... Figure 4 As shown, the knee-preserving surgical robot provided in this application is used for knee-preserving surgery. The process mainly includes three parts: preoperative intelligent planning, precise intraoperative osteotomy, and real-time postoperative evaluation. Specifically: I. Preoperative intelligent planning, including such as Figure 4 Each step in S401-S405 is shown below: S401. Obtain patient CT data and establish three-dimensional models of the femur and tibia.

[0066] Specifically, the femur and tibia can be segmented using traditional algorithms based on the patient's medical images, such as DICOM images. Then, three-dimensional reconstruction is used to create three-dimensional models of the femur and tibia.

[0067] S402. Use a neural network model to identify key points in the surgery.

[0068] The key surgical points in this application embodiment may include the center point of the hip joint, the center point of the knee joint, the center point of the ankle joint, the hinge point of the knee joint, as well as surgical points and target points for force line correction. The surgical point may be the osteotomy entry point, and the target point for force line correction may be the Fujisawa point in the aforementioned example.

[0069] S403. Determine the osteotomy plane based on the key points of the surgery.

[0070] In this embodiment, a vector can be obtained by connecting the surgical point and the knee joint hinge point, i.e., the first vector in the aforementioned example. Based on a second vector perpendicular to the current two-dimensional image, the cross product of the first and second vectors is calculated to obtain a third vector. This third vector can be considered as the normal vector of the osteotomy plane. In this way, a suitable osteotomy plane can be determined in the three-dimensional model.

[0071] S404. Determine the target force line based on the projection of the key surgical points onto the X-ray image.

[0072] The target force line differs depending on the type of surgery. For example, the target force line for high tibial osteotomy can be the line connecting the projected center point of the hip joint and the Fujisawa point, plus its extension; while the target force line for distal femoral osteotomy is the line connecting the projected center point of the ankle joint and the Fujisawa point, plus its extension.

[0073] S405. Based on the target force line, the Miniaci method is used to determine the correction angle.

[0074] For high tibial osteotomy, the rotation can be performed with the knee joint hinge point as the center of rotation and the line connecting the center of the ankle joint to the knee joint hinge point (the first line) as the radius, until the first line intersects the target force line. The angle of rotation along the first line can then be used as the correction angle for the high tibial osteotomy.

[0075] For distal femoral osteotomy, the rotation can be performed with the knee joint hinge point as the center of rotation and the line connecting the center of the hip joint to the knee joint hinge point (the second line) as the radius, until the second line intersects the target force line. In this way, the angle of rotation along the second line can be used as the correction angle for the distal femoral osteotomy.

[0076] II. Precise intraoperative osteotomy, including, for example Figure 4 Each step in S406-S408 is shown below: S406. Tracker required for installing the navigation system.

[0077] In the embodiments of this application, a patient bone tracer and a tool tracer such as a oscillating saw can be installed, wherein the bone osteotomy block and the main trunk, for example, the tracer is a proximal femoral tracer (main trunk) and a distal femoral tracer (rotation area), a proximal tibia tracer (rotation area) and a distal tibia tracer (main trunk).

[0078] S407. Based on the data obtained from the tracking device's position change by the navigation system, perform bone registration and calibrate the surgical tools.

[0079] After installing the tracer, surgical tools such as oscillating saws can be calibrated based on the tracer. At the same time, based on bone landmark acquisition and surface registration, the three-dimensional bone model can be aligned with the patient during surgery.

[0080] S408. Perform osteotomy and correction according to the preoperative plan.

[0081] Specifically, the osteotomy can be precisely performed using an oscillating saw according to the pre-operatively planned osteotomy plane. Then, a bone retractor can be used to determine the correction angle. The aforementioned bone retractor can be operated by the surgeon according to the pre-determined correction angle.

[0082] III. Postoperative real-time assessment, including such as Figure 4 Each step in S409-S410 is shown below: S409. Based on the corrected bone, simulate postoperative X-ray images.

[0083] Specifically, X-ray images can be simulated based on the corrected skeleton and the positions of the tracers in the trunk and rotation area. During this process, DRR reconstruction of the 3D skeleton model can be performed based on the position of the tracers under the navigation system, thereby simulating postoperative X-ray images.

[0084] S410. Based on the simulated postoperative X-ray images, assess the force line angle and adjust the correction angle.

[0085] The force line angle is the angle between the femoral mechanical axis and the tibial mechanical axis. Based on the simulated postoperative X-ray images, the ideal force line angle can be achieved by increasing or decreasing the correction angle, thus completing the adjustment of the correction angle.

[0086] The knee-preserving surgical robot provided in this application embodiment can accurately perform preoperative planning, thereby determining the osteotomy plane and correction angle. After precise osteotomy during the operation, a device can be used to correct the bone, and the correction angle can be adjusted by real-time evaluation of the force line angle after surgery. The knee-preserving surgical robot provided in this application embodiment can effectively shorten the surgeon's learning curve, improve surgical precision, and increase the efficiency of knee-preserving surgery.

[0087] Based on the foregoing embodiments, refer to Figure 5 The diagram illustrates a control method for a knee-preserving surgical robot according to an embodiment of this application, which may include the following steps: S501. Determine the osteotomy plane based on the surgical key points on the three-dimensional model of the patient's bones.

[0088] S502. With the target force line established, plan the correction angle.

[0089] S503. With the assistance of the navigation system, osteotomy is performed according to the osteotomy plane, so that the angle of the osteotomy site after being opened by the bone-opening device meets the requirements of the planned correction angle.

[0090] S504. Simulate postoperative bone images and calculate the force line angle based on the simulated postoperative bone images.

[0091] S505. Adjust the correction angle formed by the actual osteotomy according to the force line angle.

[0092] The patient's bones are equipped with tracers at the proximal and distal ends, as well as on the corresponding surgical instruments. The navigation system can track the positional changes of each tracer to provide location data for intraoperative procedures and postoperative assessments.

[0093] It should be noted that since the steps in the above method embodiments are similar to the functions of the knee-preserving surgical robot described in the foregoing embodiments, the steps in the above method embodiments can be implemented by the relevant functional units of the knee-preserving surgical robot. For relevant details, please refer to the description of the foregoing embodiments, which will not be repeated here.

[0094] Reference Figure 6 The diagram illustrates a computer device provided in an embodiment of this application. Figure 6 As shown, the computer device 600 in this embodiment includes: a processor 610, a memory 620, and a computer program 621 stored in the memory 620 and executable on the processor 610. When the processor 610 executes the computer program 621, it implements the steps in various embodiments of the control method for the knee-preserving surgical robot described above, for example... Figure 5 The steps S501 to S505 are shown. Alternatively, when the processor 610 executes the computer program 621, it implements the functions of each module / unit in the above system embodiments, for example... Figure 1 The functions of units 101 to 103 are shown.

[0095] For example, the computer program 621 can be divided into one or more modules / units, which are stored in the memory 620 and executed by the processor 610 to complete this application. The one or more modules / units can be a series of computer program instruction segments capable of performing specific functions, which can be used to describe the execution process of the computer program 621 in the computer device 600. For example, the computer program 621 can be divided into a preoperative planning unit, an intraoperative execution unit, and a postoperative evaluation unit, with the specific functions of each unit as follows: The preoperative planning unit is used to determine the osteotomy plane based on the surgical key points on the three-dimensional model of the patient's bones, and to plan the correction angle after establishing the target force line.

[0096] The intraoperative execution unit is used to perform osteotomy with the assistance of the navigation system according to the determined osteotomy plane, so that the angle after the osteotomy site is opened by the bone-spreading device meets the requirements of the planned correction angle.

[0097] The postoperative assessment unit is used to simulate postoperative bone images, calculate the force line angle based on the simulated postoperative bone images, and adjust the correction angle formed by the actual osteotomy according to the force line angle.

[0098] The computer device 600 may be a device capable of implementing the functions related to the knee-preserving surgical robot in the foregoing embodiments. The computer device 600 may be a desktop computer or the aforementioned knee-preserving surgical robot, etc. The computer device 600 may include, but is not limited to, a processor 610 and a memory 620. Those skilled in the art will understand that... Figure 6 This is merely one example of computer device 600 and does not constitute a limitation on computer device 600. It may include more or fewer components than shown, or combine certain components, or different components. For example, computer device 600 may also include input / output devices, network access devices, buses, etc.

[0099] The processor 610 can be a central processing unit (CPU), or other general-purpose processors, digital signal processors (DSPs), application-specific integrated circuits (ASICs), field-programmable gate arrays (FPGAs), or other programmable logic devices, discrete gate or transistor logic devices, discrete hardware components, etc. The general-purpose processor can be a microprocessor or any conventional processor.

[0100] The memory 620 can be an internal storage unit of the computer device 600, such as a hard disk or RAM of the computer device 600. The memory 620 can also be an external storage device of the computer device 600, such as a plug-in hard disk, Smart Media Card (SMC), Secure Digital (SD) card, Flash Card, etc., equipped on the computer device 600. Furthermore, the memory 620 can include both internal and external storage units of the computer device 600. The memory 620 is used to store the computer program 621 and other programs and data required by the computer device 600. The memory 620 can also be used to temporarily store data that has been output or will be output.

[0101] This application also discloses a computer device, including a memory, a processor, and a computer program stored in the memory and executable on the processor, wherein when the processor executes the computer program, it implements the methods described in the foregoing embodiments.

[0102] This application also discloses a computer-readable storage medium storing a computer program that, when executed by a computer, implements the methods described in the foregoing embodiments.

[0103] This application also discloses a computer program product, including a computer program that, when run on a computer, causes the computer to perform the methods described in the foregoing embodiments.

[0104] The embodiments described above are only used to illustrate the technical solutions of this application, and are not intended to limit it. Although this application has been described in detail with reference to the foregoing embodiments, those skilled in the art should understand that modifications can still be made to the technical solutions described in the foregoing embodiments, or equivalent substitutions can be made to some of the technical features; and these modifications or substitutions do not cause the essence of the corresponding technical solutions to deviate from the spirit and scope of the technical solutions of the embodiments of this application, and should all be included within the protection scope of this application.

Claims

1. A knee-preserving surgical robot, characterized by include: The preoperative planning unit is used to determine the osteotomy plane based on the surgical key points on the three-dimensional model of the patient's bones, and to plan the correction angle after establishing the target force line; The intraoperative execution unit is used to perform osteotomy operation according to the osteotomy plane with the assistance of the navigation system, so that the angle after the osteotomy site is opened by the bone stretching device meets the requirements of the correction angle. The postoperative assessment unit is used to simulate postoperative bone images, calculate the force line angle based on the simulated postoperative bone images, and adjust the correction angle formed by the actual osteotomy according to the force line angle. The proximal and distal ends of the bone and the corresponding surgical tools are respectively equipped with tracers. The navigation system provides position data for the relevant operations performed by the intraoperative execution unit and the postoperative evaluation unit by tracking the position changes of the tracers. Specifically, the postoperative assessment unit is used to: acquire positional change data of tracers installed at the proximal and distal ends of the bone, as tracked by the navigation system; reconstruct a two-dimensional simulated image based on the positional change data and a three-dimensional model of the patient's bone; calculate the force line angle based on the two-dimensional simulated image, where the force line angle is the angle between the femoral mechanical axis and the tibial mechanical axis; and... The postoperative assessment unit is also specifically used for: adjusting the angle of the osteotomy site after it is opened by adjusting the bone opening device; recalculating the force line angle based on the adjusted angle so that the calculated force line angle reaches the ideal force line angle, and the angle of the osteotomy site after it is opened corresponding to the ideal force line angle is the target correction angle.

2. The knee-preserving surgical robot of claim 1, wherein, The preoperative planning unit is specifically used for: The patient's medical images were acquired, and after segmenting the femur and tibia based on the medical images, a three-dimensional model of the patient's femur and tibia was obtained through three-dimensional reconstruction. Identify the key surgical points in the three-dimensional model and determine the osteotomy plane based on the key surgical points.

3. The knee-preserving surgical robot of claim 2, wherein, The key surgical points include the osteotomy entry point and the knee joint hinge point. Determining the osteotomy plane based on these key surgical points includes: Connect the osteotomy incision point and the knee joint hinge point to obtain the first vector; Determine a second vector perpendicular to the current two-dimensional medical image, and calculate the cross product of the first and second vectors to obtain a third vector; The osteotomy plane is determined based on the osteotomy inlet point and the third vector, wherein the third vector is the normal vector of the osteotomy plane.

4. The knee-preserving surgical robot according to any one of claims 1 to 3, characterized in that, The preoperative planning unit is also specifically used for: The surgical key points in the three-dimensional model of the patient's bones are projected onto the two-dimensional medical image; The target force line is established based on the projection points on the two-dimensional medical image; wherein, the target force line for high tibial osteotomy is the line connecting the center point of the hip joint after projection and the target point for force line correction and its extension; the target force line for distal femoral osteotomy is the line connecting the center point of the ankle joint after projection and the target point for force line correction and its extension. The correction angle is determined based on the target force line.

5. The knee-preserving surgical robot according to claim 4, characterized in that, The determination of the correction angle based on the target force line includes: In the case of the current surgery being a high tibial osteotomy, the rotation is performed with the knee joint hinge point as the center of rotation and the first line connecting the center point of the ankle joint to the knee joint hinge point as the radius, until the first line intersects the target force line. The angle of rotation of the first line is the correction angle of the high tibial osteotomy. In the case of the current surgery being distal femoral osteotomy, the rotation is performed with the knee joint hinge point as the center of rotation and the second line connecting the center point of the hip joint to the knee joint hinge point as the radius, until the second line intersects the target force line. The angle of rotation of the second line is the correction angle of the distal femoral osteotomy.

6. The knee-preserving surgical robot according to claim 1, characterized in that, The intraoperative execution unit is specifically used for: With the assistance of the navigation system, the oscillating saw is controlled to perform osteotomy along the osteotomy plane; After the osteotomy is completed, a bone stretching device is inserted at the osteotomy site and the angle at the osteotomy site is stretched to be equal to the correction angle.

7. The knee-preserving surgical robot according to claim 1, characterized in that, The intraoperative execution unit is also specifically used for: When the angle at the osteotomy site after being opened by the bone-opening device is the target correction angle, a corresponding bone block is implanted at the osteotomy site so that the correction angle at the osteotomy site is the target correction angle.

8. A computer device comprising a memory, a processor, and a computer program stored in the memory and executable on the processor, characterized in that, When the processor executes the computer program, the computer device performs the following method: The osteotomy plane is determined based on the surgical key points on the three-dimensional model of the patient's bones, and the correction angle is planned after establishing the target force line. With the assistance of the navigation system, osteotomy is performed according to the osteotomy plane, so that the angle of the osteotomy site after being opened by the bone stretching device meets the requirements of the correction angle. Simulate postoperative bone images, calculate the force line angle based on the simulated postoperative bone images, and adjust the correction angle formed by the actual osteotomy according to the force line angle; The proximal and distal ends of the bone and the corresponding surgical instruments are respectively equipped with tracers. The navigation system provides positional data for intraoperative operation and postoperative evaluation by tracking the positional changes of the tracers. The computer device also implements the following method: The system acquires position change data of tracers installed at the proximal and distal ends of the bone, as tracked by the navigation system; reconstructs a two-dimensional simulation image based on the position change data and a three-dimensional model of the patient's bone; calculates the force line angle based on the two-dimensional simulation image, where the force line angle is the angle between the femoral mechanical axis and the tibial mechanical axis; and... By adjusting the bone-spreading device, the angle of the osteotomy site after spreading is adjusted; based on the adjusted angle, the force line angle is recalculated so that the calculated force line angle reaches the ideal force line angle, and the angle of the osteotomy site after spreading corresponding to the ideal force line angle is the target correction angle.

Images