A device for identifying lines connecting specific points on an object

The device uses fixed and movable markers with a smartphone to determine the tibia's mechanical axis within the same field of view, addressing accuracy and surgeon burden issues in knee replacement surgery.

JP7768929B2Active Publication Date: 2025-11-12ZIMMER GMBH
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Patent Information

Application Number
JP2023084816
Authority / Receiving Office
JP · JP
Patent Type
Patents
Current Assignee / Owner
Filing Date
2023-05-23
Publication Date
2025-11-12
Estimated Expiration
2043-05-23

AI Technical Summary

Technical Problem

Existing devices fail to accurately determine the mechanical axis of the tibia during knee replacement surgery, and they impose a significant burden on surgeons by requiring them to view the mechanical axis and the bone cut in separate fields of view.

Method used

A device comprising fixed markers, a movable marker, and a smartphone with imaging and calculation capabilities is used to determine the mechanical axis of the tibia by capturing images of marker units and converting positional relationships into relative coordinates, allowing the mechanical axis to be displayed within the same field of view.

Benefits of technology

The device enables accurate determination of the mechanical axis with reduced surgeon burden by allowing simultaneous viewing of the axis and bone cut, enhancing surgical efficiency and accuracy.

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Abstract

To provide a device for identifying a straight line connecting specific points of an object easily at a low cost which can properly determine a mechanical axis of the tibia in comparison to a conventional technique, and reduces a burden on an operator by allowing the operator to confirm the mechanical axis and confirm a portion of the bone to be cut within a same field of view.SOLUTION: A device includes multiple fixed markers 12a, 12b positioned relative to each other, a movable marker 14, movable imaging means 16, display means 16 and arithmetic processing means 16. A three-dimensional coordinate system of each fixed marker is a reference for a three-dimensional coordinates of a specific point of an object. Each fixed marker is used to determine the specific point of the object together with the movable marker. The imaging means is used to image one of the fixed markers and the movable marker simultaneously. The arithmetic processing means is used to identify a straight line connecting the specific points of the object. The display means displays at least the straight line connecting the specific points of the object.SELECTED DRAWING: Figure 1
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Description

[Technical Field]

[0001] The present invention relates to a device for identifying a straight line connecting specific points on an object, and more particularly to a device for determining and displaying a more appropriate position for the mechanical axis of the tibia (tibial functional axis), which is necessary during knee replacement surgery. [Background technology]

[0002] In knee prosthesis surgery, when performing osteotomy on the tibia, it is necessary to determine in advance a so-called mechanical axis, which is displayed by connecting a first reference position located on the proximal side of the tibia (specifically, a point on the intercondylar eminence on the superior articular surface of the proximal portion of the tibia, including the lateral and medial condyles) and a second reference position located on the distal side of the tibia (specifically, a center point in the width direction of the distal end of the tibia, including the medial malleolus of the tibia and the lateral malleolus of the fibula). The mechanical axis serves as a reference line for determining the osteotomy plane of the tibia, for example, to perform high tibial osteotomy on the proximal portion of the tibia. Therefore, it is important to determine the mechanical axis of the tibia.

[0003] As a technology related to tibial osteotomy, for example, Patent Document 1 discloses an optical tracking system 42 that includes a detection device 44 and a trackable element (e.g., a navigation marker 46) that is placed on a tracked object and can be detected by the detection device 44 (Figure 6 of Patent Document 1), and it is stated that the detection device 44 includes a visible light-based detector that detects a pattern on the trackable element, or a stereoscopic camera pair that is sensitive to infrared light and can be placed in an operating room where the osteotomy surgery is performed. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] Japanese Patent Application Laid-Open No. 2016-505326 Summary of the Invention [Problem to be solved by the invention]

[0005] Although Patent Document 1 discloses that the optical tracking system 42 includes a detection device 44 and a navigation marker 46, which enables the detection device 44 to track the orientation of an object (e.g., a tibia) to detect the object's movement as it moves within the coordinate system of the detection device 44, it does not disclose at all that these components 44, 46 can combine to determine the mechanical axis of the tibia.

[0006] In recent years, there has been a desire to determine the mechanical axis of the tibia more appropriately than in the past, and there is also a strong desire to reduce the burden on the surgeon when performing osteotomy of the proximal part of the tibia by allowing the surgeon to check the mechanical axis and the part of the bone to be cut within the same field of view.

[0007] The present invention has been made in consideration of the above circumstances, and aims to provide an inexpensive and simple device for identifying a straight line connecting specific points on an object, which can determine the mechanical axis of the tibia more appropriately than conventional devices, and which reduces the burden on the surgeon by allowing the surgeon to check the mechanical axis and the part of the bone to be cut within the same field of view. [Means for solving the problem]

[0008] In order to solve the above problem, the device of the present invention for identifying a straight line connecting specific points of an object includes a plurality of fixed markers positioned relative to each other, a movable marker, a movable imaging means, a display means, and a calculation processing means, wherein the three-dimensional coordinate system of each of the fixed markers is a reference for the three-dimensional coordinates of the specific points of the object, each of the fixed markers is used together with the movable marker to determine the specific points of the object, the imaging means is used to simultaneously photograph one of the fixed markers and the movable marker, the calculation processing means is used to identify the specific points of the object and the straight line connecting those points, and the display means is used to display at least the straight line connecting the specific points of the object. [Effects of the Invention]

[0009] In this invention, assuming the use of a mechanism as a navigation system, i.e., a simple and inexpensive mechanism including a movable imaging means, a display means, a plurality of fixed markers, a movable marker, and a processing means, when determining, for example, the mechanical axis of the tibia, taking into consideration the positional relationship between fixed markers simultaneously placed at a plurality of locations on the tibia and one movable marker sequentially placed at a position relatively close to each of the fixed markers, the imaging means photographs marker units consisting of each fixed marker and a movable marker for the number of locations where the movable markers are placed, and the display means displays the marker units for the number of locations where the movable markers are placed. Next, in this invention, the processing means determines the positions of the fixed markers and the movable markers in the three-dimensional coordinate system of the imaging means from the image data displayed in this way, and converts the position of a specific point corresponding to the movable marker into relative coordinates with respect to the fixed marker. Furthermore, in the present invention, since the positional relationship between the fixed markers is known, the position of a specific point determined using one fixed marker and a movable marker can be converted into relative coordinates with respect to the other fixed marker.As a result, the position information of the specific point converted into relative coordinates with respect to the fixed marker is stored in the calculation processing means, specific points on the tibia are determined, and these specific points are further displayed on the display means, thereby making it possible to determine the mechanical axis of the tibia.

[0010] In the device for identifying a line connecting specific points on an object of the present invention, the fixed markers and the movable markers are close to each other, and the imaging means is movable, so that the imaging means can properly capture images of each marker unit consisting of a fixed marker and a movable marker. As a result, the mechanical axis of, for example, the tibia can be determined more properly than before from multiple image data, taking into account the positional relationship between the fixed markers.

[0011] Furthermore, according to the device of the present invention for identifying a straight line connecting specific points on an object, the imaging means is particularly movable. Therefore, when this device is used to determine the mechanical axis of the tibia, for example, by making at least the imaging means and the display means the same device, the surgeon can confirm the mechanical axis and the part of the tibia to be cut within the same field of view, thereby reducing the burden on the surgeon. [Brief explanation of the drawings]

[0012] [Figure 1] FIG. 1 is a plan view showing an apparatus for identifying a line connecting specific points on an object, in particular an apparatus for determining the mechanical axis of a tibia, according to an embodiment of the present invention, where (a) shows a removable marker positioned near a first marker fixed to the tibia, and (b) shows a removable marker positioned near a second marker fixed to the tibia. [Figure 2] FIG. 2 is a perspective view of a system including the device shown in FIGS. 1(a) and 1(b) and a device for cutting the tibia. DETAILED DESCRIPTION OF THE INVENTION

[0013] The following describes in detail an apparatus for determining the mechanical axis of a tibia as an apparatus for identifying a line connecting specific points of an object according to an embodiment of the present invention (hereinafter, sometimes referred to as the "present apparatus"). However, the present apparatus is not limited to an apparatus for determining the mechanical axis of the tibia, and includes any apparatus for identifying a line connecting specific points of an object. Note that the example shown below is an example in which the imaging means, display means, and arithmetic processing means are implemented by the same device (for example, a smartphone with a camera (hereinafter, sometimes simply referred to as a "smartphone") on which an application for performing predetermined arithmetic processing is installed).

[0014] FIG. 1 is a plan view of the present device, particularly a device for determining the mechanical axis of the tibia, where (a) shows a removable marker positioned near a first marker fixed to the tibia, and (b) shows a removable marker positioned near a second marker fixed to the tibia.

[0015] As shown in FIGS. 1( a ) and 1 ( b ), the present device 10 includes a first marker 12 a , a second marker 12 b , a third marker 14 , and a smartphone 16 .

[0016] The first marker 12a is fixed directly to a proximal portion of the tibia T or indirectly via a marker fixing member (not shown). The first marker 12a may be fixed to the tibia T in any manner as long as the portion to be read can be read by the smartphone 16 (when photographed together with the third marker 14, as described below). The first marker 12a may be, for example, a matrix-type two-dimensional code such as a QR code (registered trademark), but is not limited to this and various other markers may be used. The first marker 12a fixed to the tibia T is in a fixed positional relationship with the second marker 12b (fixed to the tibia) described below.

[0017] Similarly, the second marker 12b is fixed to a distal portion of the tibia T directly or indirectly via a marker fixing member (not shown). The second marker 12b may be fixed to the tibia T in any manner as long as the portion to be read can be read by the smartphone 16 (when photographed together with the third marker 14, as described below). The second marker 12b may be, for example, a matrix-type two-dimensional code such as a QR code (registered trademark), but is not limited to this and various other markers may be used. The second marker 12b fixed to the tibia T is in a fixed positional relationship with the first marker 12a (fixed to the tibia) described below.

[0018] The three-dimensional coordinate systems of the first marker 12a and the second marker 12b each serve as a reference for the three-dimensional coordinates of a specific point used when determining the mechanical axis MA. To determine the specific point used when determining the mechanical axis MA, three three-dimensional coordinate systems are required: the three-dimensional coordinate system of the camera of the smartphone 16a, the three-dimensional coordinate systems of the first marker 12a and the second marker 12b (which are fixed markers), and the three-dimensional coordinate system of the third marker 14 (which is a movable marker). The position of the determined specific point is ultimately stored in the smartphone 16 as a relative coordinate with respect to the three-dimensional coordinate systems of the first marker 12a and the second marker 12b (which are fixed markers).

[0019] An example of the three-dimensional coordinate system of the first marker 12a and the second marker 12b is a coordinate system determined by the X-axis, Y-axis, and Z-axis shown in Figures 1(a) and 1(b), and having a point near the center of either the first marker 12a or the second marker 12b as its origin. These three axes indicate directions displayed on the screen of the smartphone 16. Specifically, the X-axis indicates the direction connecting the two markers 12a and 12b, the Z-axis indicates the direction passing through each of the markers 12a and 12b, and the Y-axis indicates a direction perpendicular to both the X-axis and the Z-axis.

[0020] The third marker 14 can be attached to any point on the tibia T, including a point on the tibia T close to the first marker 12a and a point on the tibia T close to the second marker 12b, and can be detached from any of these points. Here, "the third marker 14 being attached to the tibia T" means that the third marker 14 is in contact with any part of the tibia T, regardless of whether or not other mechanical elements or the like are present to maintain contact between the third marker 14 and the tibia T. That is, the third marker 14 may be attached by piercing the tibia T directly with a needle-shaped tip, or the third marker 14 may simply be brought into contact with the tibia T using other mechanical elements or the like.

[0021] 1(a), the third marker 14 is attached directly to a proximal portion of the tibia T (specifically, to a point P1 on the intercondylar eminence on the superior articular surface of the proximal portion of the tibia including the lateral condyle and the medial condyle), or indirectly via a marker fixing member (not shown). By attaching the third marker 14 in this manner, the first marker 12a and the third marker 14 form a first marker unit U1 at the proximal portion of the tibia T.

[0022] 1(b), the third marker 14 is attached directly to a point on the distal side of the tibia T (specifically, the point P2 on the medial malleolus of the tibia T that is farthest from the fibula F), or indirectly via a marker fixing member (not shown). By attaching the third marker 14 in this manner, the second marker 12b and the third marker 14 form a second marker unit U2 at the distal part of the tibia T.

[0023] 1(b), for example, the third marker 14 is attached directly to a point on the distal side of the tibia T (specifically, point P3 on the lateral malleolus of the fibula F that is farthest from the tibia T), or indirectly via a marker fixing member (not shown) (the third marker 14 is not shown at point P3). By attaching the third marker 14 in this manner, the second marker 12b and the third marker 14 form a third marker unit U3 (not shown) at the distal part of the tibia T.

[0024] The third marker 14 may be attached in any manner to the tibia T as long as the portion to be read can be read by the smartphone 16 (when photographed together with the first marker 12a or the second marker 12b, as described below). The third marker 14 may also be a matrix-type two-dimensional code such as a QR code (registered trademark), but is not limited to this and various other markers may be used.

[0025] The smartphone 16 separately photographs each of the above-mentioned first marker unit U1 (composed of a first marker 12a fixed to the proximal side of the tibia T and a third marker 14 attached nearby on the tibia T), the second marker unit U2 (composed of a second marker 12b fixed to the distal side of the tibia T and a third marker 14 attached nearby on the tibia T), and the third marker unit U3 (composed of a second marker 12b fixed to the distal side of the tibia T and a third marker 14 attached nearby on the fibula F), and displays the information about them.

[0026] The smartphone 16 determines a first point (point P1 shown in FIG. 1(a)) at the proximal end of the tibia T and a second point (point P4 in FIG. 1(b)) at the distal end of the tibia T based on each of the captured images of the first, second, and third marker units U1, U2, and U3. The smartphone 16 then determines the mechanical axis MA based on the above two points (P1, P4), taking into consideration that the positional relationship between the first marker 12a and the second marker 12b fixed to the tibia T is fixed. The various calculation processes performed to determine the mechanical axis MA can be performed, for example, by a specific application installed in the smartphone 16 and having a calculation processing function.

[0027] As mentioned above, the examples shown above are examples in which the imaging means, display means, and arithmetic processing means are integrated into the same device (for example, a smartphone), but other examples of this type include notebook PCs as well. However, the present invention is not limited to these examples. In other words, the present invention also includes examples A) and B) in which these three means are shared among multiple devices as follows. A) An example in which a camera is used as an imaging means, a personal computer (hereinafter referred to as "PC") as a computing means, and a display as a display means. B) Example of using a camera as an imaging means and a notebook PC that combines a computing means and a display means When these three means are provided by two or more devices, there are no other particular restrictions as long as the devices are capable of communicating with each other via wired or wireless communication.

[0028] (Mechanism for determining the mechanical axis of the tibia T using this device) The present device 10 (specifically, a device for determining the mechanical axis MA of the tibia) including the first marker 12a, the second marker 12b, the third marker 14, and the smartphone 16 as described above operates as follows.

[0029] The first marker 12a is fixed at a predetermined position on the proximal side of the tibia T, and the second marker 12b is fixed at a predetermined position on the proximal side of the tibia T. Therefore, the first marker 12a and the second marker 12b, while fixed to the tibia T, are in a fixed positional relationship with each other. That is, the first marker 12a is located at a position with a fixed direction and distance from the second marker 12b, and the second marker 12b is located at a position with a fixed direction and distance from the first marker 12a. This makes it possible to clarify the positional relationship between points whose positional relationship with the first marker 12a is clear and points whose positional relationship with the second marker 12b is clear.

[0030] Under these conditions, for example, first, the third marker 14 is attached to a point on the tibia T close to the first marker 12a (in FIG. 1(a), point P1 on the intercondylar eminence on the superior articular surface of the proximal part of the tibia including the lateral condyle and the medial condyle), and the smartphone 16 photographs the first marker unit U1 composed of the first marker 12a and the third marker 14. Next, based on information about the photographed first marker unit U1, the smartphone 16 determines the position of point P1 in space using the position of the first marker 12a previously fixed to the tibia T as a reference, and point P1 is stored and displayed on the smartphone 16. This determines the first point (i.e., point P1) at the proximal end of the tibia T.

[0031] Next, the third marker 14 is removed from the point P1 and attached to a point on the tibia T close to the second marker 12b (in Figure 1(b) , the point P2 on the medial malleolus of the tibia T that is farthest from the fibula F), and the smartphone 16 photographs the second marker unit U2 consisting of the second marker 12b and the third marker 14 attached to point P2.

[0032] Furthermore, the third marker 14 is removed from the point P2 and attached to a point on the fibula F close to the second marker 12b (in Figure 1(b) , the point P3 on the lateral malleolus of the fibula F that is farthest from the tibia T), and the smartphone 16 photographs the third marker unit U3 consisting of the second marker 12b and the third marker 14 attached to point P3.

[0033] Based on the information about the second marker unit U2 and the information about the third marker unit U3 photographed in this manner, the smartphone 16 determines the positions of points P2 and P3 in space based on the position of the second marker 12b previously fixed to the tibia T, and also determines the midpoint between points P2 and P3 (point P4 in FIG. 1(b)), which is stored and displayed on the smartphone 16. This determines the second point (i.e., point P4) at the distal end of the tibia T.

[0034] Finally, based on the positions of a first point (point P1) on the proximal side of the tibia T determined based on the first marker 12a and a second point (point P4) on the distal side of the tibia T determined based on the second marker 12b, the smartphone 16 determines the mechanical axis MA of the tibia T, taking into account that the positional relationship between these markers 12a and 12b is fixed, and the mechanical axis MA is stored and displayed on the smartphone 16.

[0035] (Actions, etc., of the device 10 of the present application) The above-described device 10 of the present application is a type of so-called navigation system, since it uses a mechanism (smartphone 16) having an imaging function, a calculation function, and a display function. In such a system, the imaging function is realized by the camera of the smartphone 16, the calculation function is realized by an application for performing calculations installed on the smartphone 16, and the display function is realized by the screen of the smartphone 16. Note that when the smartphone 16 is used, predetermined operations can be performed efficiently by a single surgeon in particular (effect 1).

[0036] Alternatively, in such a navigation system, the imaging means, the processing means, and the display means can be substantially separate entities, provided that they are capable of communicating with each other via wire or wirelessly, instead of the smartphone 16. As a result, by allowing these three means to be operated by different people, division of labor can be achieved and the surgeon's operation can be specialized to one or two of these three means, thereby reducing the operational burden on each surgeon (effect 2).

[0037] Next, conventionally, when determining the mechanical axis of the tibia, only one fixed marker is placed on the tibia, and removable markers are attached sequentially to predetermined positions at the proximal end and distal end of the tibia, with these two types of markers forming one marker unit, and images are taken of the marker unit for the number of positions at which the removable markers were placed, and the mechanical axis of the tibia is determined based on the multiple images obtained in this way.

[0038] However, when there is only one fixed marker, in order to determine the mechanical axis with high accuracy, the fixed marker must be relatively large, and as a result, it is necessary to perform imaging by placing the imaging means at a certain distance from the fixed marker, which not only makes the device itself difficult to handle, but also creates the risk of not being able to determine the mechanical axis appropriately.Furthermore, since the fixed marker is relatively large, there is a risk that the fixed marker will get in the way of surgery, which in turn creates a large psychological burden for the surgeon.

[0039] In contrast, the device 10 of the present application uses two relatively small fixed markers on the tibia T (one fixed to the proximal side of the tibia T and the other fixed to the distal side of the tibia T) when determining the mechanical axis of the tibia T. The device 10 of the present application also obtains the positions of the first marker 12a and the second marker 12b (which are fixed markers) and the third marker 14 (which is a movable marker) in the three-dimensional coordinate system of the smartphone 16 (which is an imaging means), and converts the position of a specific point corresponding to the third marker 14 into relative coordinates with respect to each of the first marker 12a and the second marker 12b. Furthermore, in the device 10 of the present application, because the positional relationship between the first marker 12a and the second marker 12b is known, the positions of specific points determined using the first marker 12a and the third marker 14, or specific points determined using the second marker 12b and the third marker 14, can be converted into relative coordinates with respect to the second marker 12b or the first marker 12a, which were not used to determine these specific points. As a result, in the device 10 of the present application, the position information of the specific points converted into relative coordinates with respect to the first marker 12a and the second marker 12b is stored in the smartphone 16 (as a processing means), specific points on the tibia T are determined, and these specific points are further displayed on the smartphone 16, thereby making it possible to determine the mechanical axis MA of the tibia T.

[0040] This allows the imaging means to be installed relatively close to the fixed marker for imaging, which not only has the advantage of making the device itself easier to handle, but also allows the mechanical axis to be determined more appropriately than before.Furthermore, since the fixed marker is relatively small, there is no risk that the fixed marker will interfere with the surgery, which in turn has the advantage of reducing the psychological burden on the surgeon (effect 3).

[0041] Furthermore, according to the present device 10, which determines the mechanical axis of the tibia T using the above-mentioned method, the smartphone 16 is particularly movable, allowing the surgeon to check the mechanical axis of the tibia T and the part of the tibia to be cut within the same field of view, thereby reducing the burden on the surgeon (effect 4).

[0042] As described above, the present device 10 allows the surgeon to perform operations efficiently using a navigation system (effect 1) or reduces the burden on the surgeon (effect 2), and simultaneously solves problems that are particularly in line with recent needs, namely, determining the mechanical axis of the tibia more appropriately than before (effect 3), and reducing the burden on the surgeon by allowing the surgeon to check the mechanical axis and the part of the bone to be cut within the same field of view (effect 4), thereby making it possible to perform osteotomy of the tibia T more easily and appropriately.

[0043] (Other possible implementations) In the device 10 of the present invention described above, the distance between the first marker 12a and the second marker 12b shown in FIGS. 1(a) and 1(b) can be set to 5 cm or more and 35 cm or less.

[0044] By setting the distance to 5 cm or more, the first marker 12a and the second marker 12b fixed to the tibia T do not overlap on the screen of the smartphone 16, and both of these markers can be clearly displayed by the smartphone 16. In contrast, considering that the length of the tibia is generally approximately 40 cm or less, setting the distance to 35 cm or less allows the first marker 12a and the second marker 12b to be reliably placed on the tibia.

[0045] Next, the distance between the first marker 12a (or the second marker 12b) and the third marker 14 shown in FIGS. 1(a) and 1(b) can be 5 cm or more and 20 cm or less. When determining the mechanical axis in a conventional manner (using only one marker fixed to the tibia), if a conventional marker (e.g., a 5 cm × 5 cm square) is used, it is appropriate from the viewpoint of operability of the smartphone 16 to set the distance between these two types of markers 12a, 14 and the smartphone 16 to approximately 30 to 40 cm. Under such a premise, if the two types of markers 12a, 14 are changed to relatively large ones in order to determine the mechanical axis with higher accuracy, the smartphone 16 needs to be moved relatively far away from these two types of markers, which may result in a decrease in operability of the smartphone 16. Based on this rule of thumb, assuming that markers of the same size as those used up until now will be used, and taking into consideration the operability of the smartphone 16, it is essential that the distance between the first marker 12a (or second marker 12b) and the third marker 14 be between 5 cm and 20 cm.

[0046] 1(a) and the like, the first marker 12a and the second marker 12b are square, but the shape of these markers 12a and 12b is not limited to a square and can be any shape (for example, a circle, a hexagon, an octagon, a star, etc.). Here, each of the shapes listed above is a shape that, when the markers 12a and 12b are rotated on their surfaces around the center of gravity of the markers 12a and 12b, matches the original shape multiple times during a 360° rotation, and such a shape allows for suitable imaging, particularly regardless of the angular relationship between the smartphone 16 and the markers 12a and 12b.

[0047] The reason why the above-described shape is preferable is as follows: Both the first marker 12a and the second marker 12b are fixed to the tibia T, and once fixed, their orientation cannot be changed. In order to properly photograph each of the markers 12a and 12b, which cannot be changed in orientation, using the smartphone 16, it is necessary to appropriately adjust the position of the smartphone 16. However, if the longitudinal length and lateral length of these markers 12a and 12b are significantly different from each other, it may be difficult to adjust the position of the smartphone 16.

[0048] Furthermore, the subjects of one photograph are the first (or second) marker 12a (12b) and the third marker 14 that make up each marker unit U1, U2, U3. If the longitudinal and lateral lengths of these markers 12a and 12b differ significantly, the smartphone 16 may not be able to simultaneously and properly photograph the two types of markers 12a (12b) and 14 that make up each marker unit.

[0049] In contrast, if at least one of the first marker 12a and the second marker 12b has a shape such as a square or a circle as listed above, the longitudinal length and the transverse length of these markers 12a and 12b are equal, which not only makes it easier to adjust the position of the smartphone 16, but also allows the smartphone 16 to simultaneously and appropriately photograph the two types of markers 12a (12b), 14 that make up each marker unit U1, U2, and U3.

[0050] <System including the device of the present application and a device for cutting the tibia> 2 is a perspective view showing a system including the present device 10 and a device 20 for cutting the tibia T. The device 20 for cutting the tibia T includes a cutting guide 22 with a single slit defined therein, a blade 24 for cutting the tibia along the slit in the cutting guide 22, a blade holder 26 for holding the blade 24, and a handle piece 28 connected to the blade holder 26. The handle piece 28 includes a main body 28a and a button 28b attached to the main body 28a, and when the button 28b is pressed, the blade 24 vibrates in its short direction (i.e., left and right).

[0051] Once the mechanical axis MA of the tibia T has been determined using the present device 10 as described above, the cutting guide 22 is fixed to the tibia T so that the osteotomy angle planned by the surgeon is achieved when the tibia T is tilted in valgus, varus, and posterior tilt. Here, the osteotomy angle planned by the surgeon for the cutting guide 22 is determined by the obtained mechanical axis MA.

[0052] The position information of the mechanical axis MA is stored in the smartphone 16 (as a calculation processing means) as the positions of the first marker 12a and the second marker 12b (which are fixed markers) on a three-dimensional coordinate system. The installation angle when fixing the cutting guide 22 to the tibia T is an angle determined by converting the position information of the mechanical axis in the three-dimensional coordinate system of the first marker 12a and the second marker 12b into position information of the mechanical axis in the three-dimensional coordinate system of the camera of the smartphone 16 (as an imaging means), and then using the converted mechanical axis MA.

[0053] Next, the surgeon grasps the handle piece 28, inserts the blade 24 into the slit, and while pressing the button 28b of the handle piece 28, presses the blade 24 against the tibia T to cut a predetermined portion of the tibia T. Once cutting of the tibia T is complete, the surgeon stops pressing the button 28b of the handle piece 28 and pulls the blade 24 out of the slit.

[0054] According to the cutting of the tibia T described above, a more appropriate mechanical axis MA can be used than in the past, so the cutting guide 22 can be fixed to the tibia T with higher accuracy, and thus a higher level of cutting accuracy of the tibia T can be achieved. [Explanation of symbols]

[0055] 10. Apparatus of the present invention 12a First Marker 12b Second Marker 14 Third Marker 16. Smartphones 20 Tibia T cutting device 22 Cutting Guide 24 blades 26 Blade holder 28 Handle piece 28a Main body 28b button F fibula MA Mechanical Axis P1: A predetermined point on the superior articular surface of the proximal tibia, including the lateral and medial condyles P2 The point on the medial malleolus of the tibia T that is farthest from the fibula F P3 The point on the lateral malleolus of the fibula F that is farthest from the tibia T P4: Midpoint between points P2 and P3 (second point) T tibia X: The direction connecting the two markers 12a and 12b Y: A direction perpendicular to both X and Z Z: Direction passing through each marker 12a and 12b

Claims

1. An apparatus for identifying a straight line connecting specific points of an object, the apparatus comprising: a plurality of fixed markers positioned relative to each other; a movable marker; a movable imaging means; a display means; and a calculation processing means, a three-dimensional coordinate system of each of the fixed markers is a reference for three-dimensional coordinates of a specific point of the object, and each of the fixed markers is used together with the movable marker to determine the specific point of the object; the imaging means is used to simultaneously image one of the fixed markers and the movable marker; the arithmetic processing means is used to identify a straight line connecting specific points of the object, the display means is a device used to display at least a straight line connecting specific points of the object, An apparatus for determining a mechanical axis of a tibia, the apparatus comprising: a first marker on a proximal side and a second marker on a distal side located between a proximal end and a distal end of the tibia and displaced in at least a longitudinal direction of the tibia; a third marker detachable from the tibia; a movable imaging means; a display means; and a processing means, the first marker is used in conjunction with the third marker to determine a first point on the proximal end of the tibia; the second marker is used in conjunction with the third marker to determine a second point on the distal end of the tibia; the imaging means simultaneously images the first marker and the third marker, and simultaneously images the second marker and the third marker; the calculation means determines a mechanical axis connecting the first point and the second point; The display means displays at least the mechanical axis of the tibia.

2. The apparatus of claim 1 , wherein the first point is determined and stored based on a positional relationship between the position of the first marker and the third marker.

3. The apparatus of claim 1 , wherein the second point is determined and stored based on a positional relationship between the position of the second marker and the position of the third marker.

4. The device of claim 1 , wherein the distance between the first marker and the second marker is greater than or equal to 5 cm and less than or equal to 35 cm.

5. The device of claim 1 , wherein at least one of the distance between the first marker and the third marker and the distance between the second marker and the third marker is 5 cm or more and 20 cm or less.

6. A system comprising an apparatus described in any one of claims 1 to 5 and an apparatus for cutting the tibia.

Citation Information

Patent Citations

  • Methods and systems for planning and performing osteotomy

    JP2016505326A

  • Surgery support terminal and program

    JP2018047240A

  • Determining the Positional Information of Characteristic Points of a Leg for Osteotomy

    US20160106515A1

  • Method and device for determining geometric parameters for total knee replacement surgery

    US20180132937A1