Intraoperative knee joint space adjustment apparatus and knee joint surgical device
By using intraoperative knee joint space adjustment devices and equipment, the position of the implant can be monitored and adjusted in real time, solving the problem of inaccurate implant placement in existing technologies, improving the accuracy and success rate of knee joint surgery, and ensuring postoperative functional recovery and stability of the knee joint.
Patent Information
- Application Number
- PCT/CN2025/099988
- Authority / Receiving Office
- WO · WO
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2024-07-11
- Filing Date
- 2025-06-09
- Publication Date
- 2026-01-15
AI Technical Summary
In current unicompartmental knee replacement surgery, the placement of the implant depends on the surgeon's experience, resulting in low surgical precision and affecting the surgical outcome and success rate.
A device and apparatus for adjusting the knee joint gap during surgery are provided, including a display unit, a monitoring unit and an adjustment unit. The device simulates the position of the implant in the preoperative planning image, monitors the knee joint gap value in real time, and adjusts the position of the implant according to the gap value so that it is close to 0 or less than a first preset value.
It improves the precision and success rate of surgery, reduces surgical risks and the workload of doctors, and ensures the functional recovery and long-term stability of the knee joint after surgery.
Smart Images

Figure CN2025099988_15012026_PF_FP_ABST
Abstract
Description
Intraoperative knee joint space adjustment device and knee joint surgical equipment
[0001] This application claims priority to Chinese Patent Application No. 202410925625.2, filed on July 11, 2024, entitled "Intraoperative Knee Joint Space Adjustment Device and Knee Joint Surgical Equipment", the entire contents of which are incorporated herein by reference. Technical Field
[0002] This application belongs to the field of computer-aided medical technology, and in particular relates to an intraoperative knee joint space adjustment device and a knee joint surgical device. Background Technology
[0003] Unicompartmental knee replacement surgery is an effective surgical procedure for treating unilateral knee joint diseases, including two specific forms: medial condyle replacement and lateral condyle replacement. Its principle is similar to total knee replacement: the damaged cartilage and bone are removed, and then the implant is placed in the appropriate position.
[0004] One of the keys to a successful unicompartmental knee replacement surgery is placing the implant in the correct position, which requires adjusting the knee joint space. Currently, traditional surgical methods typically rely on the surgeon's experience to adjust the knee joint space to determine the implant placement. This method has low precision and can easily lead to significant deviations between the surgical outcome and expectations, affecting the success of the surgery. Technical issues
[0005] In view of this, this application provides an intraoperative knee joint space adjustment device and a knee joint surgical device to accurately determine the optimal position of the implant during unicompartmental knee surgery, thereby improving surgical precision and success rate. Technical solutions
[0006] The first aspect of this application provides an intraoperative knee joint space adjustment device, comprising a display unit, a monitoring unit, and an adjustment unit; wherein:
[0007] The display unit is used to display an image of the knee joint surgical site, the image including the implant, which is simulated and displayed at the initial position of the implant as determined according to the preoperative planning scheme;
[0008] A monitoring unit is used to monitor the knee joint space value in the image under the influence of the implant in a simulated display during the movement of the knee joint.
[0009] An adjustment unit is used to adjust the simulated implant from the initial position to a target position based on the knee joint gap value, wherein the target position is a position where the knee joint gap value is equal to or greater than 0 and less than a first preset value.
[0010] The second aspect of this application provides a method for intraoperative knee joint space adjustment, comprising:
[0011] Images showing the surgical site of the knee joint, the images including the implant simulated at the initial position of the implant as determined according to the preoperative planning scheme;
[0012] During the knee joint movement, the knee joint space value under the influence of the implant, as shown in the simulated image, is monitored.
[0013] Based on the knee joint gap value, the simulated implant is adjusted from the initial position to the target position, where the knee joint gap value is equal to or greater than 0 and less than a first preset value.
[0014] A third aspect of this application provides a knee joint surgery device, including a memory, a processor, and a computer program stored in the memory and executable on the processor, wherein the processor executes the computer program to implement the intraoperative knee joint space adjustment method as described in the second aspect above.
[0015] The fourth aspect of this application provides a computer-readable storage medium storing a computer program that, when executed by a processor, implements the intraoperative knee joint space adjustment method as described in the second aspect above.
[0016] The fifth aspect of this application provides a computer program product that, when run on a computer, causes the computer to perform the intraoperative knee joint space adjustment method described in the second aspect above. Beneficial effects
[0017] Compared with the prior art, this application has the following beneficial effects:
[0018] This application simulates the implant in the image of the knee joint surgical site, allowing the surgeon to monitor the knee joint gap value in real time under the influence of implant installation while controlling the patient's knee joint movement. Based on this gap value, the implant's placement can be adjusted, thereby modifying the surgical plan. This ensures that after the implant is actually installed in the patient's knee joint according to the adjusted plan, the knee joint gap value is as close to zero as possible, improving surgical precision and success rate, reducing surgical risks and the surgeon's workload, and ensuring postoperative knee joint functional recovery and long-term stability. 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 is a schematic diagram of an intraoperative knee joint space adjustment device provided in an embodiment of this application;
[0021] Figure 2 is a schematic diagram of an intraoperative knee joint space adjustment method provided in an embodiment of this application;
[0022] Figure 3 is a schematic diagram of a knee joint surgery device provided in an embodiment of this application;
[0023] Figure 4 is a schematic diagram of the data processing process of each module of a knee joint surgery device provided in an embodiment of this application;
[0024] Figure 5 is a schematic diagram of another knee joint surgery device provided in an embodiment of this application. Embodiments of the present invention
[0025] 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.
[0026] The technical solution of this application will be described below through specific embodiments.
[0027] Referring to Figure 1, a schematic diagram of an intraoperative knee joint space adjustment device provided in an embodiment of this application is shown, which may specifically include a display unit 101, a monitoring unit 102, and an adjustment unit 103; wherein:
[0028] Display unit 101 is used to display an image of the knee joint surgical site, which may include an implant simulated at the initial position of the implant as determined according to the preoperative planning scheme.
[0029] The monitoring unit 102 is used to monitor the knee joint space value in the aforementioned images under the influence of the implant as shown in the simulation during knee joint movement.
[0030] The adjustment unit 103 is used to adjust the simulated implant from its initial position to a target position based on the knee joint gap value monitored by the monitoring unit 102, so that the knee joint gap value is equal to 0 under the influence of the adjusted implant, or the knee joint gap value is greater than 0 and less than a first preset value, wherein the first preset value can be a value as close to 0 as possible. In this way, by adjusting the initial position of the implant to the target position, the knee joint gap value can be as close to 0 as possible after the implant is actually installed in the target position, ensuring the stability of the implant installation.
[0031] The following section provides a detailed description of the specific functions of the aforementioned intraoperative knee joint space adjustment device and its various units. It should be noted that the surgeries and unicompartmental knee replacement surgeries mentioned in the embodiments of this application refer to unicompartmental knee replacement surgery.
[0032] Similar to other knee surgeries, before performing a unicompartmental knee replacement, data needs to be collected from the surgical site of the patient's knee joint, and a three-dimensional model, or preoperative planning model, needs to be constructed through three-dimensional reconstruction. This preoperative planning model allows the surgeon to plan the operation and determine the specific surgical approach. Furthermore, before the actual surgery, the actual surgical site needs to be registered with the preoperative planning model. This registration process can be accomplished by installing a tracer at the surgical site, combined with probes, navigation devices, and other equipment. In unicompartmental knee replacement surgery, the surgical site can include the femur and tibia at the knee joint. Therefore, tracers can be installed on both the femur and tibia, and registration between the surgical site and the preoperative planning model can be achieved using these tracers. This application's embodiments do not elaborate on the above data acquisition, model reconstruction, and registration processes.
[0033] In this embodiment of the application, after registration is completed, the display unit 101 can display an image of the knee joint surgical site. The image can not only display the registered knee joint surgical site, but also simulate the implant display at the corresponding surgical site according to the preoperative planning scheme.
[0034] In one possible implementation of this application embodiment, the display unit 101 may be a device with display function, such as a monitor. The display unit 101 may be a component of the knee joint surgery device provided in this application embodiment.
[0035] Specifically, after registration is completed, the display unit 101 can display the registration results and the position and angle of the femur and tibia in the surgical site in real time. In addition, in order to evaluate whether the implant placement determined in the preoperative planning scheme is accurate, the display unit 101 can also simulate the implant in a three-dimensional model according to the preoperative planning scheme and display the implant simulation at the registered surgical site.
[0036] In this embodiment, the doctor can plan a surgical procedure during the preoperative planning process. This plan includes specific bone cutting amounts, implant type, and initial position information. The initial position is the location for implant placement determined in the preoperative planning. The display unit 101 simulates and displays the implant at the initial position, that is, it simulates and displays an implant of the same type or size at the location determined in the preoperative planning. This process does not actually place the implant at the initial position; rather, it simulates an image of the implant at the initial position for the doctor to view.
[0037] In this embodiment of the application, the monitoring unit 102 can be used to monitor the knee joint space value when an implant is installed during the patient's knee joint movement.
[0038] In one possible implementation of this application, since the patient or the surgical site is under anesthesia during the operation, the movement of the patient's knee joint can be performed with the assistance of a doctor. Specifically, the doctor can assist the patient in performing knee extension and flexion movements. For example, the doctor can lift the patient's thigh and / or lower leg, so that the patient's knee joint is in an extended or flexed state.
[0039] While the patient's knee joint is in an extended or flexed position, the monitoring unit 102 can monitor the gap value of the patient's knee joint when the implant is installed.
[0040] It should be noted that no implant was actually installed at the patient's surgical site during this process; the implant was only simulated in the 3D model planned before the operation. Therefore, the process of monitoring the knee joint space value described above is also a process of simulating and determining the space value.
[0041] In this embodiment, the implants used in unicompartmental knee arthroplasty may include a femoral prosthesis and a tibial prosthesis. The knee joint gap value may refer to the gap between the surface of the femoral prosthesis and the surface of the tibial prosthesis, that is, the distance between the two prosthesis surfaces.
[0042] Therefore, the process by which monitoring unit 102 monitors the joint gap value involves calculating in real time the distance between each point on the simulated femoral prosthesis surface and the simulated tibial prosthesis surface during knee extension and flexion movements. Monitoring unit 102 can use the minimum value among the distances corresponding to each point on the femoral prosthesis surface as the knee joint gap value.
[0043] In one possible implementation of this application, the knee joint extension and flexion angle can be from -20 degrees to 160 degrees. That is, the doctor can control the patient's knee joint movement within the range of -20 degrees to 160 degrees. Specifically, when the patient's knee joint is extended so that the thigh and lower leg are in a straight line, the knee joint extension and flexion angle can be close to 0 degrees; when the patient's knee joint is flexed so that the thigh and lower leg are perpendicular, the knee joint extension and flexion angle can be close to 90 degrees. The above angle range can be determined according to the patient's actual movable angle, and this application does not limit it.
[0044] As an example, when the patient's thigh and lower leg are straight, the angle of extension and flexion of the patient's knee joint can be approximated as 0 degrees; when the patient's thigh and lower leg form a structure similar to that formed when the patient is sitting, the angle of extension and flexion of the patient's knee joint can be approximated as 90 degrees.
[0045] When the doctor lifts the patient's thigh and / or lower leg, causing the knee joint to move within a certain angle range of extension and flexion, the monitoring unit 102 can calculate in real time the gap value at the patient's knee joint assuming that an implant is placed at the surgical site.
[0046] It should be noted that the knee joint space value calculated by the monitoring unit 102 may be different when the patient's knee joint is in different angles of extension and flexion. The purpose of using the intraoperative knee joint space adjustment device provided in this application embodiment is to adjust the installation position of the implant so that the knee joint space value can be as close to 0 as possible during the patient's knee joint extension and flexion.
[0047] In this embodiment, the implant placement can be adjusted by the adjustment unit 103. The adjustment unit 103 can adjust the simulated implant from its initial position to a target position based on the knee joint gap value monitored by the monitoring unit 102. The target position is either such that the knee joint gap value is equal to 0, or such that the knee joint gap value is greater than 0 and less than a first preset value, where the first preset value can be a value as close to 0 as possible.
[0048] In the embodiments of this application, since the implant includes a femoral prosthesis and a tibial prosthesis, the installation position of the implant can be adjusted by adjusting the position of the femoral prosthesis and / or the tibial prosthesis.
[0049] In one possible implementation of this application embodiment, if the monitored knee joint space value is greater than a first preset value or less than 0, the adjustment unit 103 may preferentially adjust the position of the simulated tibial prosthesis.
[0050] Specifically, if the monitored knee joint gap value is greater than the first preset value, it indicates that after osteotomy and implant placement according to the preoperative plan, there is a gap between the tibial and femoral prostheses, meaning that the knee joint may become loose after surgery. If the monitored knee joint gap value is less than 0, it indicates that after osteotomy and implant placement according to the preoperative plan, there is an overlapping area between the tibial and femoral prostheses. Therefore, during the actual implant placement process, the femoral or tibial prosthesis may not be properly installed, or it may indicate that after installation according to the plan, the prostheses at the patient's knee joint may be pressed against each other, resulting in a tight situation.
[0051] In this embodiment, when the knee joint gap value is greater than a first preset value or less than 0, the position of the simulated tibial prosthesis can be adjusted. Specifically, the position of the tibial prosthesis can be adjusted along a first preset direction, which can be the proximal-distal direction of the prosthesis.
[0052] In a specific implementation, the adjustment unit 103 can determine the position of the tibial prosthesis after it has moved along the first preset direction, and the display unit 101 can simulate and display the tibial prosthesis at the adjusted position.
[0053] After the above treatment, the doctor can repeat the above operation by lifting the patient's thigh and / or lower leg to allow the patient's knee joint to perform extension and flexion movements, and monitor the knee joint space value again during this process.
[0054] In this embodiment, if, after adjusting the position of the tibial prosthesis, the knee joint gap value remains large during the patient's knee joint movement, for example, greater than a second preset value, then the adjustment unit 103 can adjust the position of the simulated femoral prosthesis. The second preset value can be a numerical value representing a large knee joint gap value, therefore the second preset value can be greater than the aforementioned first preset value.
[0055] In one possible implementation of this application embodiment, the position of the femoral prosthesis can be adjusted along a first preset direction or along a second preset direction; alternatively, it can be adjusted simultaneously along both the first and second preset directions. The second preset direction can refer to the anterior-posterior direction of the prosthesis. The proximal or posterior-posterior direction of the prosthesis can be clearly determined during surgery based on the relative position between the prosthesis placement and the patient; this application embodiment does not limit this.
[0056] In a specific implementation, the adjustment unit 103 can determine the position of the femoral prosthesis after it has moved along the first preset direction and / or the second preset direction, and the display unit 101 can simulate and display the femoral prosthesis at the adjusted position.
[0057] After adjusting the position of the tibial and / or femoral prostheses, the real-time positions of the tibial and femoral prostheses currently displayed on the display unit 101 are the target positions for implant placement. Whether the target position is appropriate can be verified by the physician through manipulation of the patient's knee joint using the monitoring unit 102.
[0058] In one possible implementation of this application embodiment, the adjustment unit 103 can further determine the implant contact point during the monitoring of the knee joint space value, and adjust the target position of the implant based on the implant contact point. The implant contact point can be the point on the femoral prosthesis surface with the shortest distance to the tibial prosthesis surface, which is the femoral surface point corresponding to the minimum value among the multiple knee joint space values monitored by the monitoring unit 102.
[0059] In this embodiment, the adjustment unit 103 can determine the centerline of the implant and adjust the target position of the implant so that the distance between the contact point of the implant and the centerline is less than a third preset value. The aforementioned third preset value can be a value that is as small as possible.
[0060] Specifically, while monitoring unit 102 monitors the knee joint space value, adjustment unit 103 can simultaneously record the position of the implant contact point and compare it with the implant's centerline. If the implant contact point is too far inward or too far outward from the centerline, adjustment unit 103 can automatically adjust the implant's position to bring the implant contact point as close to the centerline as possible. This allows for the determination of a suitable implant placement position.
[0061] After adjusting the knee joint space value as described above to determine the target position for implant placement, the doctor can install the implant in the determined target position during surgery and perform other surgical operations according to the preoperative plan to ensure accurate implant placement and improve the success rate of the surgery.
[0062] In this embodiment, by simulating the implant in the image of the knee joint surgery site, the knee joint gap value affected by the implant installation can be monitored in real time during the doctor's control of the patient's knee joint movement. The installation position of the implant can be adjusted according to the knee joint gap value, thereby adjusting the surgical plan. After the implant is actually installed at the patient's knee joint according to the adjusted surgical plan, the gap value of the patient's knee joint can be as close to 0 as possible, improving the accuracy and success rate of the surgery, reducing surgical risks and the doctor's workload, and ensuring the functional recovery and long-term stability of the knee joint after surgery.
[0063] Referring to Figure 2, a schematic diagram of an intraoperative knee joint space adjustment method provided in an embodiment of this application is shown, which may specifically include the following steps:
[0064] S201. Displaying an image of the surgical site of the knee joint, the image including the implant simulated at the initial position of the implant as determined according to the preoperative planning scheme.
[0065] S202. During the knee joint movement, monitor the knee joint space value in the image under the influence of the implant as shown in the simulation.
[0066] S203. Based on the knee joint gap value, adjust the simulated implant from the initial position to the target position, where the target position is the position where the knee joint gap value is equal to or greater than 0 and less than a first preset value.
[0067] It should be noted that this method can be applied to knee joint surgical devices, meaning that the execution subject of this application embodiment can be a knee joint surgical device. The aforementioned knee joint surgical device can, by executing the various steps of the method provided in this application embodiment, simulate and display the implant in a preoperative planning model and monitor the knee joint gap value affected by implant installation before the formal osteotomy and implant placement in a unicompartmental knee replacement surgery. Based on the knee joint gap value, the target position for implant installation in the preoperative planning scheme can be adjusted, thereby determining the optimal implant placement position and adjusting the surgical planning scheme accordingly. In this way, when the surgeon performs the surgery according to the adjusted surgical planning scheme, the accuracy and success rate of the surgery can be improved, surgical risks and the workload of the surgeon can be reduced, and postoperative functional recovery and long-term stability of the knee joint can be ensured.
[0068] The detailed execution process of each step in the above embodiments can be found in the description of the intraoperative knee joint space adjustment device embodiments, and will not be repeated here. Furthermore, the sequence number of each step in the above embodiments does not imply the order of execution; the execution order of each process should be determined by its function and internal logic, and should not constitute any limitation on the implementation process of the embodiments of this application.
[0069] To facilitate understanding of the embodiments of this application, a complete example will be used to provide a detailed description of this application below.
[0070] Figure 3 shows a schematic diagram of a knee joint surgery device provided in an embodiment of this application. Specifically, it may include a data acquisition module 301, a three-dimensional modeling module 302, a preoperative planning module 303, an intraoperative navigation module 304, and a dynamic balance assessment module 305, wherein:
[0071] The data acquisition module 301 is used to collect the patient's knee joint imaging data, physiological parameters, and anatomical information.
[0072] The 3D modeling module 302 is used to generate a 3D model of the patient's knee joint based on the collected data;
[0073] The preoperative planning module 303 is used to perform surgical simulation based on a three-dimensional model to determine the optimal surgical plan and implant size;
[0074] The intraoperative navigation module 304 is used to guide the surgeon to perform precise bone cutting and implant placement during the operation by interacting with the surgical instruments in real time.
[0075] The dynamic balance assessment module 305 is used to monitor changes in the joint space in real time and make dynamic adjustments according to preset standards to ensure joint stability and functional recovery.
[0076] In this embodiment, the data acquisition module 301 is mainly used to collect patient CT images, relevant data of the surgical site, and data on indications, such as data on various anatomical landmarks on the left and right sides and the medial and lateral sides of the knee joint. These anatomical landmarks may include the distal femoral center, medial epicondyle, lateral epicondyle, medial posterior femoral condyle, lateral posterior femoral condyle, femoral head center, tibial plateau center, medial tibial plateau, lateral tibial plateau, posterior cruciate ligament (PCL) insertion point, tibial tuberosity, lateral malleolus, medial malleolus, etc.
[0077] Figure 4 shows a schematic diagram of the data processing process of each module of a knee joint surgery device provided in this application embodiment. Figure 4 illustrates the data input and output flow of each module of the knee joint surgery device in Figure 3. The CT image data obtained from the patient scan, surgical site-related data, indications, etc., will be input into the data acquisition module 301.
[0078] Based on the data collected by the data acquisition module 301, the 3D modeling module 302 can generate a 3D model of the patient's knee joint, i.e., the patient's preoperative planning model. During this process, the 3D modeling module 302 can employ advanced image processing algorithms to quickly and accurately construct a 3D model of the knee joint, providing multi-angle views and interactive operations.
[0079] Specifically, the 3D modeling module 302 can differentiate between muscles and bones to a certain extent by adjusting an appropriate threshold, based on the significant difference between bone CT values and other tissues such as muscles. Then, it can mark or modify the pixels of the knee joint in the current image under different views, and finally mark the three-dimensional voxels of the femur and tibia on the 3D image respectively, and use the voxels to perform 3D reconstruction to obtain a 3D model of the patient's knee joint.
[0080] As shown in Figure 4, the 3D modeling module 302 can use the CT image data, surgical site related data, indications and other data from the data acquisition module 301 to segment key images, namely the femoral head side, femoral knee joint side, tibial knee joint side and tibial ankle joint side images, and obtain the patient's femoral model and tibial model through 3D reconstruction.
[0081] In addition, the 3D modeling module 302 can use the generated femoral and tibia models, along with the anatomical information obtained by the data acquisition module 301, to mark anatomically significant landmarks on the 3D model, thereby reconstructing the relevant coordinate systems of the corresponding mechanical axes.
[0082] The preoperative planning module 303 can simulate surgery based on a 3D model, combining the doctor's clinical experience and biomechanical principles to provide doctors with multiple surgical options and determine the optimal surgical plan and implant size. The preoperative planning module 303 can also simulate the surgical procedure and predict postoperative outcomes.
[0083] As shown in Figure 4, the 3D model output by the 3D modeling module 302, along with parameters of different brands or types of implants, will be used as input data for the preoperative planning module 303 to perform preoperative planning and obtain a preoperative planning scheme. The preoperative planning scheme in this application is a preliminary surgical plan. By applying the knee joint surgery device or its modules provided in this application, the surgical plan obtained from the preoperative planning can be optimized through intraoperative adjustments. Through repeated adjustments, the optimal surgical plan can be obtained, allowing the surgeon to perform the surgery according to the optimal plan. The above adjustment process is performed before the actual osteotomy and implant placement.
[0084] Specifically, the preoperative planning module 303 can plan the corresponding implant positions and models for the femoral and tibial sides. The default positions of the implants can be set according to the coordinate system of the mechanical axes of the three-dimensional model, while the implant models can be adjusted in position and angle based on the three-dimensional view and the three-dimensional view of the CT scan. The positions to be adjusted can include vertical, horizontal, and anterior-posterior positions, and the angles can include anteroposterior tilt, inversion / exversion, and internal / external rotation.
[0085] As shown in Figure 4, the output data of the preoperative planning module 303 includes the initial position of the implant, which includes the installation position and installation angle of the implant determined in the preoperative planning scheme.
[0086] The intraoperative navigation module 304 can interact with surgical instruments in real time through a 3D model, registering with the bone at the surgical site on the patient's knee joint. After registration, it can navigate the position of the 3D model in real time. The intraoperative navigation module 304 can be used in conjunction with specific surgical instruments, tracking the position and movement of the instruments through sensors or markers and displaying the data in real time on the 3D model to ensure surgical precision. These surgical instruments may include tracers, marker acquisition devices, calibrators, and visual positioning devices mounted on the femur and tibia.
[0087] As shown in Figure 4, the 3D model output by the 3D modeling module 302 will serve as input data for the intraoperative navigation module 304, used for real-time interaction with surgical instruments and registration between the surgical site bones and the 3D model. The output data of the intraoperative navigation module 304 includes registration information and the real-time positions of the femur and tibia at the knee joint. This registration information and the real-time positions of the femur and tibia can be used as part of the input data for the dynamic balance assessment module 305 to monitor and adjust changes in the joint space.
[0088] In this embodiment, as shown in Figure 4, the input data of the dynamic balance assessment module 305 includes the output data of the preoperative planning module 303 and the output data of the intraoperative navigation module 304. The dynamic balance assessment module 305 can analyze the changes in the joint space during the patient's knee joint movement in real time using a built-in algorithm, based on the initial implant placement output by the preoperative planning module 303, the registration information output by the intraoperative navigation module 304, and the real-time positions of the femur and tibia. It can automatically adjust the implant position or recommend fine-tuning by the physician to achieve optimal balance. As shown in Figure 4, the output data of the dynamic balance assessment module 305 may include information such as the joint space and key angles of the implant.
[0089] Specifically, the dynamic balance assessment module 305 can utilize registration information and the pre-operatively planned surgical plan to calculate the real-time joint gap during the patient's knee joint movement. This gap can simulate the joint gap after prosthesis installation and can be obtained by calculating the distance between the prosthesis surfaces. The dynamic balance assessment module 305 can automatically adjust the pre-operatively planned surgical plan based on the principle of internal and external joint gap balance and by collecting gap information from key angles. It can also prompt the surgeon to adjust the surgical plan based on the gap information. After the pre-operatively planned surgical plan is adjusted, the originally recorded gap value will be automatically updated, and the gap value will be recalculated to ultimately determine the optimal implant placement position, forming the final surgical plan.
[0090] After the above procedures are completed, the doctor can perform the surgery according to the final surgical plan.
[0091] Therefore, the functions achieved by the intraoperative knee joint space adjustment device in the aforementioned embodiments can be specifically accomplished by the intraoperative navigation module 304 and dynamic balance assessment module 305 of the knee joint surgery device in Figure 3. Specifically, the function of the display unit 101 in the aforementioned device embodiments can be implemented by the intraoperative navigation module 304 in this embodiment, and the functions of the monitoring unit 102 and the adjustment unit 103 can be implemented by the dynamic balance assessment module 305 in this embodiment. That is, the knee joint surgery device provided in this application embodiment can be a medical device or surgical device that includes the intraoperative knee joint space adjustment device in the aforementioned embodiments.
[0092] Based on the foregoing embodiments, the process of adjusting the intraoperative knee joint space during unicompartmental knee arthroplasty using the knee joint surgical device or intraoperative knee joint space adjustment device provided in this application can include the following steps:
[0093] 1. Using devices such as femoral tracers, tibial tracers, probes, and navigators, marker points are obtained on the patient's knee joint bones, and the registration results are calculated.
[0094] This step is the registration process. By acquiring a sufficient number of points on the femur and tibia of the patient's knee joint, the bones at the surgical site of the patient's knee joint are matched with the 3D model obtained from the 3D modeling. Through registration, changes in the patient's bones can be displayed in real time on the display unit, which is used to monitor the knee joint space.
[0095] 2. Using the registration results and femoral and tibial tracers, the position and angle of the femur and tibia can be displayed in real time during the operation.
[0096] 3. Based on the preoperatively planned positions of the femoral and tibial prostheses relative to the femur and tibia, the implants can be simulated and displayed in the intraoperative view in real time.
[0097] 4. Based on the real-time display of the femoral and tibial prostheses during the operation, the knee joint space value is calculated using an algorithm.
[0098] 5. According to the doctor's operation, the patient's knee joint moves within the range of extension and flexion angles from -20 degrees to 160 degrees. The distance from the surface of the femoral prosthesis to the surface of the tibial prosthesis during this process is calculated as the knee joint space value.
[0099] This step involves calculating the distances from all points on the femoral prosthesis to the surface of the tibial prosthesis in real time, and taking the minimum distance value as the knee joint space value. The point on the femoral prosthesis corresponding to this minimum distance value can be used as the implant contact point. The knee joint space value calculated above can include negative values.
[0100] 6. After calculating the gap value during the extension and flexion angles from -20 degrees to 160 degrees, if the gap value is greater than 0, it indicates that after osteotomy and implant installation according to the planned scheme at the extension and flexion angles, there is a gap between the femoral prosthesis and the tibial prosthesis, meaning the knee joint will be loose. If the gap value is less than 0, it indicates that after osteotomy and implant installation according to the planned scheme at the extension and flexion angles, there is an overlapping area between the femoral prosthesis and the tibial prosthesis, which may prevent proper implant installation or cause the femoral prosthesis and tibial prosthesis to compress each other after implant installation.
[0101] 7. Automatically adjust the position of the femoral prosthesis or tibial prosthesis based on the gap value during the patient's knee extension and flexion.
[0102] In this step, if the knee joint space value is greater than a certain large value or less than 0, the proximal and distal positions of the tibial prosthesis are adjusted first. At this time, the overall knee joint space value will increase or decrease. If, after adjustment, the knee joint space value is still large during extension or flexion to a certain angle, the proximal and distal or anterior and posterior positions of the femoral prosthesis can be adjusted.
[0103] 8. During the acquisition of knee joint space values, the position of the implant contact point can be recorded simultaneously and compared with the implant centerline. If the implant contact point is too far inward or too far outward from the implant centerline, the position of the femoral prosthesis can be automatically adjusted to ensure that the implant contact point is as close as possible to the implant centerline.
[0104] This application embodiment obtains a preoperative planning scheme for unicompartmental knee replacement surgery. Using the knee joint surgery equipment or intraoperative knee joint gap adjustment device provided in this application embodiment, the preoperative planning scheme can be adjusted and optimized before the actual osteotomy and implant placement. During this process, the implant placement position can be displayed through the intraoperative view. The surgeon can see the specific location of the implant and assess in real time the changes in knee joint gap during movement after implant placement at this location. By continuously adjusting the implant placement position, the knee joint gap during movement can meet relevant standards, such as making the knee joint gap as close to zero as possible. This results in a final optimized surgical plan. The surgeon can then perform the surgery according to the final plan. Using the knee joint surgery equipment provided in this application embodiment allows for personalized surgical planning based on the patient's actual condition, improving surgical accuracy and success rate. During surgery, real-time intraoperative navigation reduces surgical risks and the surgeon's workload. Furthermore, the dynamic balance assessment using this equipment helps ensure postoperative knee joint functional recovery and long-term stability.
[0105] The knee joint surgery device provided in this application can help doctors determine the location, extent, and severity of lesions by performing three-dimensional reconstruction and analysis of the knee joint, thereby formulating the best treatment plan and realizing the diagnosis and treatment of knee joint diseases. For example, for some complex fractures or soft tissue injuries, doctors can use this device to assist in diagnosis and treatment. Secondly, this device can predict the postoperative effect and complication risk based on the individual differences and characteristics of the patient's condition, thereby helping doctors select the best surgical plan and artificial joint prosthesis, realizing preoperative planning for knee replacement surgery. For example, for some young patients or patients who need to perform high-load sports, doctors can use this device to select a suitable artificial joint prosthesis and plan the corresponding surgical plan accordingly. Thirdly, this device can help doctors achieve precise surgical operation and positioning by monitoring the position and posture of surgical instruments in real time, thereby reducing surgical risks and complications, realizing intraoperative navigation during knee joint surgery. For example, during knee replacement surgery, doctors can use this device to assist in positioning the position and angle of the artificial joint prosthesis, improving the accuracy of prosthesis installation.
[0106] Referring to FIG5, a schematic diagram of a knee joint surgery device provided in an embodiment of this application is shown. As shown in FIG5, the knee joint surgery device 500 in this embodiment includes: a processor 510, a memory 520, and a computer program 521 stored in the memory 520 and executable on the processor 510. When the processor 510 executes the computer program 521, it implements the steps in various embodiments of the intraoperative knee joint gap adjustment method described above, such as steps S201 to S203 shown in FIG2. Alternatively, when the processor 510 executes the computer program 521, it implements the functions of each module / unit in the various device embodiments described above, such as the functions of units 101 to 103 shown in FIG1, or the functions of modules 301 to 305 shown in FIG3.
[0107] For example, the computer program 521 can be divided into one or more modules / units, which are stored in the memory 520 and executed by the processor 510 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 521 in the knee joint surgery device 500. For example, the computer program 521 can be divided into a data acquisition module, a 3D modeling module, a preoperative planning module, an intraoperative navigation module, and a dynamic balance assessment module, with the specific functions of each module as follows:
[0108] The data acquisition module is used to collect patients' knee joint imaging data, physiological parameters, and anatomical information;
[0109] The 3D modeling module is used to generate a 3D model of the patient's knee joint based on the collected data.
[0110] The preoperative planning module is used to simulate surgery based on a 3D model to determine the optimal surgical plan and implant size;
[0111] The intraoperative navigation module is used to guide surgeons in precise bone cutting and implant placement during surgery through real-time interaction with surgical instruments.
[0112] The dynamic balance assessment module is used to monitor changes in the joint space in real time and make dynamic adjustments according to preset standards to ensure joint stability and functional recovery.
[0113] The knee joint surgery device 500 can be the surgical device in the foregoing embodiments. The knee joint surgery device 500 may include, but is not limited to, a processor 510 and a memory 520. Those skilled in the art will understand that FIG5 is merely an example of the knee joint surgery device 500 and does not constitute a limitation on the knee joint surgery device 500. It may include more or fewer components than illustrated, or combine certain components, or different components. For example, the knee joint surgery device 500 may also include input / output devices, network access devices, buses, etc.
[0114] The processor 510 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.
[0115] The memory 520 can be an internal storage unit of the knee joint surgery device 500, such as a hard drive or RAM of the knee joint surgery device 500. The memory 520 can also be an external storage device of the knee joint surgery device 500, such as a plug-in hard drive, Smart Media Card (SMC), Secure Digital (SD) card, Flash Card, etc., equipped on the knee joint surgery device 500. Furthermore, the memory 520 can include both internal and external storage units of the knee joint surgery device 500. The memory 520 is used to store the computer program 521 and other programs and data required by the knee joint surgery device 500. The memory 520 can also be used to temporarily store data that has been output or will be output.
[0116] This application also discloses a knee joint surgery device, including a memory, a processor, and a computer program stored in the memory and executable on the processor. When the processor executes the computer program, it implements the methods described in the foregoing embodiments:
[0117] Images showing the surgical site of the knee joint, the images including the implant simulated at the initial position of the implant as determined according to the preoperative planning scheme;
[0118] During the knee joint movement, the knee joint space value under the influence of the implant, as shown in the simulated image, is monitored.
[0119] Based on the knee joint gap value, the simulated implant is adjusted from the initial position to the target position, where the knee joint gap value is equal to or greater than 0 and less than a first preset value.
[0120] This application also discloses a computer-readable storage medium storing a computer program that, when executed by a processor, implements the methods described in the foregoing embodiments:
[0121] Images showing the surgical site of the knee joint, the images including the implant simulated at the initial position of the implant as determined according to the preoperative planning scheme;
[0122] During the knee joint movement, the knee joint space value under the influence of the implant, as shown in the simulated image, is monitored.
[0123] Based on the knee joint gap value, the simulated implant is adjusted from the initial position to the target position, where the knee joint gap value is equal to or greater than 0 and less than a first preset value.
[0124] This application also discloses a computer program product that, when run on a computer, causes the computer to perform the methods described in the foregoing embodiments:
[0125] Images showing the surgical site of the knee joint, the images including the implant simulated at the initial position of the implant as determined according to the preoperative planning scheme;
[0126] During the knee joint movement, the knee joint space value under the influence of the implant, as shown in the simulated image, is monitored.
[0127] Based on the knee joint gap value, the simulated implant is adjusted from the initial position to the target position, where the knee joint gap value is equal to or greater than 0 and less than a first preset value.
[0128] 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. An intraoperative knee joint space adjustment device, characterized in that, It includes a display unit, a monitoring unit, and an adjustment unit; wherein: The display unit is used to display an image of the knee joint surgical site, the image including the implant, which is simulated and displayed at the initial position of the implant as determined according to the preoperative planning scheme; A monitoring unit is used to monitor the knee joint space value in the image under the influence of the implant in a simulated display during the movement of the knee joint. An adjustment unit is used to adjust the simulated implant from the initial position to a target position based on the knee joint gap value, wherein the target position is a position where the knee joint gap value is equal to or greater than 0 and less than a first preset value.
2. The apparatus according to claim 1, characterized in that, The surgical sites include the femur and tibia, and tracers are installed on both the femur and tibia. These tracers are used to register the surgical sites with the preoperative planning model. The display unit is specifically used for: Based on the registration results, the position and angle of the femur and tibia at the surgical site are displayed in real time; and... According to the preoperative planning scheme, the implant is simulated and the implant is simulated and displayed at the registered surgical site.
3. The apparatus according to claim 1 or 2, characterized in that, The implant includes a femoral prosthesis and a tibial prosthesis, the knee joint gap value is the gap value between the surface of the femoral prosthesis and the surface of the tibial prosthesis, and the monitoring unit is specifically used for: During the knee joint extension and flexion movements, the distance between each point on the simulated femoral prosthesis surface and the simulated tibial prosthesis surface is calculated in real time, and the minimum value of the distance is taken as the knee joint space value.
4. The apparatus according to claim 3, characterized in that, The angle of knee extension and flexion is from -20 degrees to 160 degrees; wherein, when the knee joint is extended so that the thigh and lower leg are in a straight line, the angle of knee extension and flexion is close to 0 degrees; when the knee joint is flexed so that the thigh and lower leg are perpendicular, the angle of knee extension and flexion is close to 90 degrees.
5. The apparatus according to any one of claims 1-2 or 4, characterized in that, The adjustment unit is specifically used for: If the monitored knee joint space value is greater than the first preset value or less than 0, the position of the simulated tibial prosthesis is adjusted. If, after adjusting the position of the tibial prosthesis, the knee joint gap value is greater than the second preset value during the knee joint movement, then the position of the simulated femoral prosthesis is adjusted so that the second preset value is greater than the first preset value.
6. The apparatus according to claim 5, characterized in that, The adjustment of the position of the simulated tibial prosthesis includes: Determine the position of the tibial prosthesis after it has moved along a first preset direction, and simulate and display the tibial prosthesis at the adjusted position; The adjustment of the position of the femoral prosthesis displayed in the simulation includes: The position of the femoral prosthesis after moving along the first preset direction and / or the second preset direction is determined, and the femoral prosthesis is simulated and displayed at the adjusted position; wherein, the first preset direction is the proximal direction, and the second preset direction is the anterior-posterior direction.
7. The apparatus according to any one of claims 1-2, 4, or 6, characterized in that, The adjustment unit is also used for: During the monitoring of the knee joint space value, the implant contact point is determined; The target position of the implant is adjusted according to the implant contact point.
8. The apparatus according to claim 7, characterized in that, The step of adjusting the target position of the implant based on the implant contact point includes: Determine the centerline of the implant, and adjust the target position of the implant so that the distance between the contact point of the implant and the centerline is less than a third preset value.
9. A knee joint surgery 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, it implements the following method: Images showing the surgical site of the knee joint, the images including the implant simulated at the initial position of the implant as determined according to the preoperative planning scheme; During the knee joint movement, the knee joint space value under the influence of the implant, as shown in the simulated image, is monitored. Based on the knee joint gap value, the simulated implant is adjusted from the initial position to the target position, where the knee joint gap value is equal to or greater than 0 and less than a first preset value.
10. A computer-readable storage medium storing a computer program, characterized in that, When the computer program is executed by the processor, it implements the following method: Images showing the surgical site of the knee joint, the images including the implant simulated at the initial position of the implant as determined according to the preoperative planning scheme; During the knee joint movement, the knee joint space value under the influence of the implant, as shown in the simulated image, is monitored. Based on the knee joint gap value, the simulated implant is adjusted from the initial position to the target position, where the knee joint gap value is equal to or greater than 0 and less than a first preset value.
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