This application claims priority to and the benefit of U.S. patent application Ser. No. 16/387,607, filed Apr. 18, 2019 and Japanese Patent Application No. 2018-084121, filed Apr. 25, 2018, the entire contents of which are incorporated herein by reference.
The present disclosure relates to an information processing apparatus, an information processing method, and a recording medium.
Artificial joint replacement surgery to replace a deformed joint with an artificial joint is widely performed. Apparatuses and the like used to support a preoperative plan for artificial joint replacement surgery are known.
Known apparatuses and the like to support a preoperative plan for artificial joint replacement surgery have room for improvement.
The present disclosure relates to an improved information processing apparatus, information processing method, and recording medium.
An information processing apparatus according to an embodiment includes a controller configured to determine a height at which to fix a cup of an artificial hip joint in a patient in accordance with a femoral head center on a contralateral side opposite from an affected hip joint of the patient, a teardrop lower edge of a hip joint of the patient, and a CE angle of the affected hip joint of the patient.
An information processing method according to an embodiment is executed by an information processing apparatus including a controller. The information processing method includes determining a height at which to fix a cup of an artificial hip joint in a patient in accordance with a femoral head center on a contralateral side opposite from an affected hip joint of the patient, a teardrop lower edge of a hip joint of the patient, and a CE angle of the affected hip joint of the patient.
A non-transitory computer-readable recording medium according to an aspect stores computer program instructions, that when executed by a computer, perform steps including determining a height at which to fix a cup of an artificial hip joint in a patient in accordance with a femoral head center on a contralateral side opposite from an affected hip joint of the patient, a teardrop lower edge of a hip joint of the patient, and a CE angle of the affected hip joint of the patient.
In the accompanying drawings:
Embodiments are described below in detail with reference to the drawings.
In the present embodiment, the information processing apparatus 10 determines the position and angle at which to fix the cup 25 on the patient's acetabulum and the size of the cup 25 as the preoperative plan. The position at which to fix the cup 25 includes the height at which to fix the cup 25 on the acetabulum and the depth at which to embed the cup 25 in the acetabulum.
Referring again to
The controller 11 is a processor that controls and manages the information processing apparatus 10 overall, starting with the functional blocks of the information processing apparatus 10. The controller 11 is a processor, such as a central processing unit (CPU), that executes a program with prescribed control procedures. Such a program may, for example, be stored in the memory 12 or on an external storage medium or the like connected to the information processing apparatus 10.
In the present embodiment, the controller 11 determines the position and angle at which to fix the cup 25 on the patient's acetabulum and the size of the cup 25 as the preoperative plan. The processing executed by the controller 11 for the preoperative plan is described in detail below.
The memory 12 includes a variety of memory devices and records various information depending on the intended use. For example, the memory 12 stores data necessary for operation of the controller 11. The memory 12 may include a device such as random access memory (RAM) that functions as a working memory. The memory 12 may, for example, store information related to artificial hip joints that a doctor can use in artificial hip joint replacement surgery. For example, the memory 12 may store the size, shape, and the like of artificial hip joints that a doctor can use. The memory 12 stores, for example, a predetermined algorithm that the controller 11 uses to create the preoperative plan.
The input interface 13 receives operation input from a user of the information processing apparatus 10 and may include operation buttons (operation keys), for example. The input interface 13 may, for example, include a keyboard and a mouse. The input interface 13 may be constituted by a touch panel, and operation input from the user may be received by a portion of a display device displaying operation keys that receive operation input from the user.
The display 14 is a display device constituted by a well-known display, such as a liquid crystal display (LCD), an organic electro-luminescence display (OELD), or an inorganic electro-luminescence display (IELD). The display 14 displays various information. For example, the display 14 displays the preoperative plan created by the information processing apparatus 10. The display 14 may, for example, display information related to the position and angle at which to fix the cup 25 and the size of the cup 25, which were determined as the preoperative plan.
The communication interface 15 can, for example, communicate with an external device using a network that is wireless, wired, or a combination of wireless and wired. The communication interface 15 can, for example, transmit and receive information over the network. The communication interface 15 communicates using a communication method of a wireless communication standard, for example. Examples of wireless communication standards include Worldwide Interoperability for Microwave Access (WiMAX), IEEE802.11, Bluetooth® (Bluetooth is a registered trademark in Japan, other countries, or both), Infrared Data Association (IrDA), Near Field Communication (NFC), communication standards conforming to ARIB STD-T109 (for example, Rev. 1.2), and communication standards conforming to ITS FORUM RC-010. The communication interface 15 may support one or more of the communication standards listed above as examples. To support a plurality of communication standards, the communication interface 15 may include a plurality of communication modules corresponding to respective wireless communication standards. For example, the information processing apparatus 10 can transmit information related to the created preoperative plan to another external device via the communication interface 15.
Next, an example of the processing executed by the information processing apparatus 10 for the preoperative plan is described with reference to
To make a preoperative plan using the information processing apparatus 10, the user of the information processing apparatus 10, such as a doctor, operates the information processing apparatus 10 to input an image of the hip joint of the patient who will receive artificial hip joint replacement surgery. For example, the user performs an operation to input a captured computed tomography (CT) image, x-ray image, or the like of the patient's hip joint to the information processing apparatus 10. The information processing apparatus 10 receives input of the image of the patient's hip joint by the user operation (step S11).
The information processing apparatus 10 displays a screen requesting input of information pertaining to the artificial hip joint replacement surgery on the display 14 (step S12). The information pertaining to the artificial hip joint replacement surgery may include information related to the current condition of the patient's hip joint, required conditions related to the arrangement of the artificial hip joint at the time of the procedure, and the like. The user inputs information pertaining to the artificial hip joint replacement surgery through the input interface 13 in response to the screen displayed on the display 14.
In the present embodiment, the user-inputted information pertaining to the artificial hip joint replacement surgery includes basic information and acetabular roof information as illustrated in
The basic information is information related to the current condition of the patient's hip joint. The basic information includes the affected direction, the condition of the contralateral side, the patient's sex, and the leg length discrepancy.
The affected direction is information indicating which of the patient's left and right hip joints is the affected hip joint to be replaced by the artificial hip joint replacement surgery. In the example in
The condition of the contralateral side is information indicating whether the patient's contralateral hip joint (i.e. the opposite side from the affected side) is normal or exhibits deformation. A doctor can, for example, judge whether the condition of the contralateral side is normal or exhibits deformation by examining an image of the hip joint. When the contralateral hip joint is normal, the user checks the box labeled “normal”, for example. When the contralateral hip joint exhibits deformation, the user checks the box labeled “deformed”, for example. In the example in
The leg length discrepancy is information indicating the difference in length between the patient's left and right legs. In the example in
In the present disclosure, the direction orthogonal to the line L1 connecting the lower edges of the left and right teardrops 30a and 30b in front view of the patient is referred to as the height direction. Hence, the upward direction in
Referring again to
The Crowe classification of the patient's hip joint is information indicating the classification of the degree of subluxation on the acetabular roof side of the patient's hip joint. The Crowe classification has four groups, from Group I to Group IV. Typically, deformation of the acetabular roof increases from Group I to Group IV. A doctor can, for example, determine the Crowe classification of the patient's hip joint by examining an image of the hip joint. In the example in
The required CE angle is a condition on the center-edge (CE) angle required after the artificial hip joint replacement surgery. In the example in
When, for example, the cup 25 is disposed at a higher position (height), the CE angle increases due to the point P2 being positioned further outward along the shape of the acetabulum. For example,
As the required CE angle in the acetabular roof information illustrated in
The outward opening angle is the angle to the outside (i.e. outward from the patient) of the opening side of the cup 25 embedded by the artificial hip joint replacement surgery. The outward opening angle is the angle formed by a line segment, i.e. the opening, of the cup 25 in a side view relative to the line L1 connecting the lower edges of the left and right teardrops 30a and 30b. Accordingly, θ2 corresponds to the outward angle in
The forward opening angle is the forward angle (i.e. to the front of the patient) of the opening side of the cup 25 embedded by the artificial hip joint replacement surgery, i.e. the front opening angle. The patient having the artificial hip joint replacement surgery can move the leg forward more easily when the opening of the cup faces forward. The user can select from among 5°, 10°, 15°, and 20° as the forward opening angle in the example in
The required CE angle, the outward opening angle, and the forward opening angle, among the acetabular roof information, may be selected without input from the user by using one of the numerical values as a default for each item.
When the user inputs information pertaining to the artificial hip joint replacement surgery, the information processing apparatus 10 receives user input of the information pertaining to the artificial hip joint replacement surgery (step S13). That is, the information processing apparatus 10 receives input of the information pertaining to the artificial hip joint replacement surgery illustrated as an example in
The information processing apparatus 10 executes processing for the preoperative plan on the basis of an image of the patient's hip joint received as input in step S11 and the information pertaining to the artificial hip joint replacement surgery received as input in step S13. The information processing apparatus 10 makes the preoperative plan by performing step S14 through step S17, for example.
The information processing apparatus 10 first determines the height at which to fix the cup 25, for example, as the preoperative plan (step S14).
The information processing apparatus 10 judges whether the contralateral hip joint of the patient undergoing the procedure is normal (step S21). For example, the information processing apparatus 10 can judge whether the contralateral hip joint of the patient is normal in accordance with user input received in step S13 of
When the information processing apparatus 10 judges that the contralateral hip joint is normal (step S21: Yes), the information processing apparatus 10 tentatively sets the height of the femoral head center of the artificial hip joint to the same height as that of the femoral head center on the contralateral side. The femoral head center of the artificial hip joint is, for example, the center of the femoral head ball 22. This tentatively determined height of the femoral head center of the artificial hip joint is referred to as the “tentative height” in the present disclosure. When the contralateral hip joint is judged to be normal (step S21: Yes), the information processing apparatus 10 thus sets the tentative height of the femoral head center of the artificial hip joint to the same height as that of the femoral head center on the contralateral side (step S22).
Conversely, when the contralateral hip joint is judged not to be normal (step S21: No), the information processing apparatus 10 sets the tentative height of the femoral head center of the artificial hip joint using the teardrop lower edges of the patient's acetabula as a reference (step S23). For example, the information processing apparatus 10 assumes that a cup 25, with a radius r and an outward opening angle facing outward 45° relative to the line L1, is disposed so that the lower edge E1 of the cup 25 is in contact with the line L1 in a side view, as illustrated in the example in
After the tentative height of the femoral head center of the artificial hip joint is set in step S22 and step S23, the information processing apparatus 10 judges whether a condition on the coverage of the cup 25 is satisfied at the set tentative height (step S24). The coverage of the cup 25 refers to the proportion of the outer surface of the hemispherical cup 25 that is in contact with the acetabulum when the cup 25 is embedded in the acetabulum. Accordingly, the condition related to coverage of the cup 25 refers to a condition related to the proportion of the outer surface of the cup 25 in contact with the acetabulum. The condition related to coverage of the cup 25 is determined in advance, for example, and stored in the memory 12. The information processing apparatus 10 judges whether the condition, stored in the memory 12, related to the coverage of the cup 25 is satisfied at the set tentative height. For example, a proportion (numerical value) of the outer surface of the hemispherical cup 25 that should be in contact with the acetabulum is stored in the memory 12 as the condition related to coverage. In step S24, the information processing apparatus 10 calculates the coverage of the cup 25 at the set tentative height and judges whether this coverage satisfies the condition related to coverage stored in the memory 12.
As the proportion of the cup 25 in contact with the acetabulum is smaller, the fixed connection between the cup 25 and the acetabulum weakens, making the cup 25 susceptible to detachment. Conversely, as the proportion of the cup 25 in contact with the acetabulum is larger, the fixed connection between the cup 25 and the acetabulum strengthens, making the cup 25 less susceptible to detachment. The cup 25 can therefore be made less susceptible to detachment from the acetabulum to a predetermined degree by setting the coverage of the cup 25 to a predetermined value or higher. The condition related to coverage may be set appropriately in accordance with the degree of reduction in susceptibility of the cup 25 to detachment from the acetabulum.
When it is judged that the condition related to coverage is not satisfied (step S24: No), the information processing apparatus 10 moves the tentative height of the femoral head center to a higher position and sets the new tentative height to the height of the femoral head center of the artificial hip joint after movement (step S25). Processing then transitions to step S24. Due to the shape of a human acetabulum, the contact area between the cup 25 and the acetabulum generally increases as the position is higher than the line L1. The coverage of the cup 25 thus increases as the position is higher than the line L1. Consequently, the condition related to coverage becomes easier to satisfy when the tentative height is raised in step S24.
The movement width when raising the tentative height may be determined appropriately. For example, the movement height may be raised in units of several millimeters. In this case, each time step S25 is executed in the flowchart in
When it is judged that the condition related to coverage is satisfied (step S24: Yes), the information processing apparatus 10 judges whether a condition related to the CE angle is satisfied (step S26). The condition related to the CE angle is the condition of “required CE angle” received in step S13 of
When it is judged that the condition related to the CE angle is not satisfied (step S26: No), the information processing apparatus 10 moves the tentative height higher and sets the new tentative height to the femoral head center of the artificial hip joint after movement (step S25). Processing then transitions to step S24.
When it is judged that the condition related to the CE angle is satisfied (step S26: Yes), the information processing apparatus 10 sets the height of the femoral head center of the artificial hip joint to the tentative height at the time the condition related to the CE angle was judged to be satisfied (step S27).
The information processing apparatus 10 sets the height at which to fix the cup 25 in accordance with the height of the femoral head center of the artificial hip joint set in step S27 (step S28). In other words, the information processing apparatus 10 sets the height at which to fix the cup 25 to the height at which the cup 25 corresponding to the femoral head ball 22 is disposed when the center of the femoral head ball 22 is at the position, determined in step S27, of the femoral head center of the artificial hip joint.
The processing to determine the height of the cup 25 in step S14 of
As described with reference to
The information processing apparatus 10 has been described as setting the height of the femoral head center of the artificial hip joint to the tentative height when a condition related to the CE angle and a condition related to coverage are satisfied. The height determination by the information processing apparatus 10 is not, however, restricted to the case of a condition related to the CE angle and a condition related to coverage being satisfied. For example, the information processing apparatus 10 may set the height of the femoral head center of the artificial hip joint to the tentative height when either a condition related to the CE angle or a condition related to coverage is satisfied.
The condition related to coverage has been described as being determined in advance and stored in the memory 12. However, the condition related to coverage is not necessarily stored in advance in the memory 12. For example, in step S12 of
Returning to
The information processing apparatus 10 can, for example, determine the size of the cup 25 using the contralateral femoral head diameter of the patient as a reference when the contralateral side is normal. The information processing apparatus 10 can, for example, determine the size of the cup 25 by selecting a cup 25 that has an outer diameter larger than the contralateral femoral head diameter by a certain amount (such as 5 mm).
The information processing apparatus 10 can, for example, determine the size of the cup 25 in accordance with a CT image of the fixing position of the cup 25 at the acetabular roof of the patient when the contralateral side is not normal. The information processing apparatus 10 can, for example, determine the size of the cup 25 by selecting a cup 25 that has an outer diameter allowing fixation to the wall around the acetabular roof in accordance with a CT image inputted by the user.
The information processing apparatus 10 determines the height at which to fix the cup 25 and the depth at which to embed the cup 25 in the acetabulum (step S16). The information processing apparatus 10 can, for example, determine the depth at which to embed the cup 25 using the patient's acetabular fossa surface or outer surface of the teardrop as a reference. The information processing apparatus 10 can, for example, determine to embed the cup 25 so that the outer surface of the cup 25 is in contact with the acetabular fossa surface or the outer surface of the teardrop. In other words, the depth at which to embed the cup 25 is a depth such that the outer surface of the cup 25 is in contact with the acetabular fossa surface or the outer surface of the teardrop.
The information processing apparatus 10 determines the angles at which to fix the cup 25 (step S17). The angles at which to fix the cup 25 include the outward opening angle and the forward opening angle. The information processing apparatus 10 determines to set the angles at which to fix the cup 25 to the outward opening angle and the forward opening angle for which input was received in step S13.
The information processing apparatus 10 can create a preoperative plan using the flowchart of
Various embodiments have been described for a complete and clear disclosure. The appended claims, however, are not limited to the above embodiments and are to be construed as encompassing all of the possible modifications and alternate configurations that a person of ordinary skill in the art could make within the scope of the fundamental features illustrated in this disclosure. The subject matter of the various embodiments may also be freely combined.
For example, a portion of the elements constituting the information processing apparatus 10 according to the above embodiment may be divided up among a plurality of apparatuses to form a system that, overall, achieves the same functions as the information processing apparatus 10.
The information pertaining to the artificial hip joint replacement surgery displayed by the information processing apparatus 10 in step S12 of
The information processing apparatus 10 may execute different processing in accordance with the Crowe classification of the patient's hip joint, for which input was received in step S13 of
Although this disclosure is based on embodiments and drawings, it is to be noted that various changes and modifications will be apparent to those skilled in the art based on this disclosure. Therefore, such changes and modifications are to be understood as included within the scope of this disclosure. For example, the functions and the like included in the various units, members, and steps may be reordered in any logically consistent way. Furthermore, units and members may be combined into one or divided.
Number | Date | Country | Kind |
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2018-084121 | Apr 2018 | JP | national |
Number | Date | Country | |
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Parent | 16387607 | Apr 2019 | US |
Child | 18477034 | US |