The invention relates to a method for transferring statics of an orthopedic appliance, for instance, a prosthesis, an orthosis, or a prosthesis shaft, and to a device for performing the method.
In orthopedic technology a problem consists in transferring the geometry of an orthopedic test appliance or of an appliance to be replaced, for instance, a test shaft in the case of providing a lower leg shaft, to the definite shaft. In the following, the term “test appliance” means any orthopedic appliance whose geometry/statics is to be transferred to a definite appliance by means of the method according to the invention.
Presently, the actual provision with a shaft starts with an impression of the amputation stump. Then, a positive model is made of this impression and is modelled in line with particular medical, orthopedic, and biomechanical criteria. Subsequently, a thermoplastic test shaft is produced therefrom, so that the construction of the prosthesis and the fit may be optimized on the patient, and then a definite prosthesis shaft is produced, for instance, with a cast resin method. Particular care has to be taken that the position of an adapter for other prosthesis fit components is transferred from the test shaft to the definite prosthesis shaft as accurately as possible. Conventionally, a transfer device is used into which the grouted test shaft is clamped, wherein the adapter of the test shaft is fixed to the transfer device. After the removal of the test shaft the positive will remain on the transfer device. The definite prosthesis shaft is then manufactured over this positive model, wherein the adapter position is transferred in any plane with sufficient accuracy.
In addition to this largely manual modelling of the test shaft, methods are also known in which the amputation stump is measured by a 3D scanner. Such solutions are, for instance, illustrated in DE 10 2004 007 455 A1, DE 10 2007 014 747 A1, or EP 0 555 207 B1.
EP 1 044 648 B1 discloses a method in which the measuring of an amputation stump is performed by means of reference objects attached thereto, which are then taken from different viewing directions by means of a camera or the like, wherein the contour line of the stump is then determined from the reference distances.
U.S. Pat. No. 6,463,351 B1 describes a method in which a model of the amputation stump is first of all made and this model is then measured via a 3D scanner. Suitable modifications may then be performed on the scan so as to enable an individual adaptation to the patient.
DE 42 32 606 A1 finally illustrates a method in which the inner contour of an orthopedic appliance is scanned and detected by means of a scanner.
It has shown that these known methods do not enable a transfer of statics of an available orthopedic appliance, in the following referred to as test appliance, to an appliance, for instance, a definite shaft, with the required accuracy, or else with extremely high effort only.
Contrary to this it is an object of the invention to provide a method and a device for performing the method by means of which this transfer of statics can be performed with high accuracy and comparatively little effort.
With respect to the method this object is solved with the features of claim 1, and with respect to the device with the features of independent claim 11.
Advantageous further developments of the invention are the subject matter of the subclaims.
The method according to the invention enables the transfer of statics of an available orthopedic test appliance, for instance, a test shaft, to a definite appliance, for instance, a prosthesis shaft. In accordance with the invention, the appliance is first of all grouted with a casting compound pursuant to one variant. After the hardening, this casting compound represents a positive of the inner contour of the appliance. In accordance with the invention, grouting is performed such that a protrusion is formed preferably at the proximal end of the test appliance. This protrusion may also be applied in some other manner.
The protrusion may then be provided with markings, for instance, three markings. Alternatively, it is also possible to form the protrusion itself as a marking contour which enables a later relative positioning of models.
In the following step the test appliance is then scanned along with the protrusion. In this process, the adapter for applying fit components, for instance, a foot of a lower leg prosthesis, should also be scanned if possible.
In a further step the positive is separated from the test appliance and this positive is scanned along with the protrusion.
Alternatively, the inner contour of the test appliance may also be scanned directly, so that grouting is not necessary.
Subsequently, the models of the appliance scan and of the positive/inner contour scan obtained during scanning are stored.
In accordance with the invention, these models are then positioned relatively to each other in that the identical protrusions of the positive/inner contour scan and of the appliance scan are superimposed computationally by means of the markings and/or the marking contour.
After this superimposing, the protrusions that are not required for the actual appliance may be deleted/unmarked, and then the appliance model thus obtained may be stored with its outer and inner contours in a suitable data storage.
This appliance model is then imported to a construction program for generating CAD data of a construction model for the definite orthopedic appliance.
This method enables a transfer of statics with a very low effort, wherein in particular the relative positioning of the two models (test appliance model and positive/inner contour model) is very simple since only the protrusions in accordance with the invention have to be taken into account with this relative positioning.
The processing in the construction program is particularly simple if the appliance model and the positive/inner contour model are available as a point cloud after scanning, wherein these point clouds are then converted to the test appliance model (inner contour and outer contour) by surface reconstruction.
The computational effort during relative positioning may be reduced if, prior to the superimposing of the scans, the non-identical areas are masked, so that only the cutaway models of the test appliance and of the positive and/or the inner contour have to be calculated.
After the superimposing of the cutaway models by means of the marking applied and/or the contour of the protrusion, the point clouds of the actual test appliance and of the positive and/or the inner contour as masked in the afore-explained step are made to overlap with the respectively assigned protrusion, and the point clouds for the test appliance and the positive and/or the inner contour thus aligned are stored separately, but positioned relatively to each other. This means that after this step the models of the test appliance and of the positive/the inner contour are arranged in a common coordinate system.
In accordance with the invention it is preferred if the same coordinate system is assigned to the two models also in the construction program, so that an alignment of the models can be made in this coordinate system. This alignment enables an individual adaptation to the respective patient.
This assignment of the same coordinate system for the arrangement of both models in the space may, for instance, be performed with auxiliary lines assigned during scanning to the test appliance and/or the positive and/or the inner contour.
In one solution, the test appliance model and the positive model/inner contour model are aligned in the construction program in the desired common coordinate system by means of the scanned auxiliary lines.
In an alternative, largely automated solution, this alignment is performed prior to scanning already. This may, for instance, be performed in that the grouted test appliance is aligned in an adjustment device in the desired coordinate system already, wherein the auxiliary lines may serve as orientation during evaluation. Correspondingly, after the removing of the test appliance, the positive remaining in the adjustment device is aligned in this coordinate system and is also scanned. During the importing of the models (appliance and positive) to the construction program, the alignment is then performed automatically in the coordinate system. During the direct scanning of the inner contour this alignment is maintained.
The auxiliary lines may be verticals to a patient's footprint with or without load, dotted function lines of floor reaction forces and of the force behavior with load and without offload on the appliance, or else construction reference lines. In the case of the last described automatic positioning of the models in the predetermined coordinate system it is, on principle, also possible to establish construction planes along the force behavior with load on the appliance.
In one embodiment of the invention the adjustment device is designed with a rotary plate onto which the test appliance is placed. The end section of the test appliance which is remote from the rotary plate is retained in a hinged fastener which is also rotatably retained on the adjustment device. The axes of rotation of the rotary plate and of the fastener are coaxial to each other. A 3D scanner may be held on the adjustment device to be movable in one direction, preferably parallel to this axis of rotation.
The appliance may, for instance, be an orthesis or a prosthesis or a prosthesis shaft.
The device according to the invention for performing the afore-described method comprises a 3D scanner for scanning the outer contour of the test appliance and for scanning the appliance inner contour, wherein a protrusion common in both scans is available.
Furthermore, the device has a data storage for storing the test appliance scan and the positive scan or the inner contour scan. Moreover, there exists an evaluation unit that is designed such that the two models are adapted to be aligned relative to each other by means of their protrusions, and that surface reconstruction of the point cloud models to an appliance model and a positive/inner contour model is enabled from which a construction model is then generated. Correspondingly, the device comprises means for generating CAD data for producing a construction model from the models (test appliance or outer contour model and positive or inner contour model) aligned relative to each other and in a patient-oriented coordinate system.
Such a device enables the transfer of statics from a test appliance to a definite orthopedic appliance with little computational effort, wherein this transfer is performed largely automatically.
This device may additionally be designed with an adjustment device for the defined positioning of the test appliance prior to scanning in a predetermined, preferably patient-oriented coordinate system, wherein load conditions may be taken into account during this positioning.
The evaluation unit mentioned may additionally be adapted to mask the areas of the test appliance point cloud and the positive/inner contour point cloud which do not belong to the protrusion, so that the relative alignment is performed by means of the remaining cutaway models.
The auxiliary lines are particularly simple to apply if the device according to the invention is designed with a light source for imaging auxiliary lines on the test appliance and/or the positive or on the inner contour.
As explained, for determining the inner contour, a scanning process may also be performed for scanning the appliance inner contour instead of producing a positive. In this case, care has to be taken that a marking contour remains on the outer contour and the inner contour which is common to both scans and which simplifies the relative positioning of the scans with respect to each other.
As explained, the markings to be applied may be renounced if the proximal extension is designed with an auxiliary geometry enabling the relative positioning of the models of the appliance outer contour and of the positive as described in the following.
A problem of this proceeding is the digital alignment of the individual scans and/or of the positive and the test appliance with respect to each other. The solution of this problem is the allocation of the same coordinate system for both individual scans. There are two approaches enabling this. The first approach is the distance linking in the construction program itself. This approach is easy to carry out, but has relatively little accuracy. The second approach is a particular proceeding during model digitalization (scan). This proceeding is very accurate, but requires some more effort than the first approach.
The second problem is the alignment of the entire superimposed geometry of outer and inner contour in the space. The solution of this problem is the allocation of a common coordinate system, as it is available on the patient himself/herself. Here, too, there are two approaches. The first approach requires the transfer of auxiliary lines or the like on the test appliance to the construction program. In the second approach, the test appliance is aligned by means of the auxiliary lines in the desired coordinate system already prior to scanning. Then, this desired coordinate system is automatically assigned to the scan and is made a basis in the construction program later on.
In one variant for the allocation of the same coordinate system for the two models, care has to be taken that the markings applied are maintained in the process of the subsequent surface reconstruction. Subsequently, the two models (here outer contour of the test appliance and positive or inner contour) are imported to the construction program and linked with one another by means of the markings. The distances during linking should be kept as small as possible. This constitutes an approach for the allocation of the same coordinate system for both models. This means that the allocation is only performed in the construction program itself.
In the other approach the allocation of the coordinate system is performed in the scan program already. This requires a particular proceeding during the digitalizing of the models which will not be described in detail here. During the importing of the model geometry the same coordinate system in the construction program is assigned to both models (inner/outer contour) and both models are automatically aligned with respect to each other. The result of this approach shows higher accuracy than the afore-described approach.
The second problem is then to process the entire alignment of both models. Here, a coordinate system has to be coordinated in the construction program which, in the optimum case, is equal to the coordinate system defined on the patient. Here, too, there are two approaches enabling a transfer to the construction program. For both approaches it is possible to draw and/or indicate—preferably three—auxiliary lines with load in vertical progression on the appliance. Due to the comparatively simple performance, a front, side and rear view have proven of value in this respect.
In the first approach for solving this problem, care is taken that the three auxiliary lines are visible in the construction program after the surface reconstruction. By means of these markings, three planes positioned vertically on top of each other are then determined. The result thereof is the same alignment of front, side and plan view as is defined and optimized on the patient himself/herself.
In the alternative approach, the test appliance is aligned during scanning already. The test appliance is aligned and/or positioned by means of the vertical markings. Then, the test appliance is separated from the positive and the latter is also scanned, wherein the alignment is maintained.
During the importing to the construction program, the program then performs the alignment of the models as desired and automatically.
If the proceedings are performed correctly, it is possible with the digital appliance construction to adopt and possibly correct, displace or tilt positions of fit components such as prosthesis feet or adapter components, as has proven valuable in the initially described handicraft manufacturing method.
In the afore-described case, in which the test appliance is positioned in the load- or patient-oriented coordinate system, the forming of a protrusion with markings or of a protrusion designed as auxiliary geometry on the positive may on principle also be renounced. This, however, preconditions that the scanner, during the scanning of the inner and outer contours, remains at its predetermined measurement position, so that the scans can then be assumed in the construction program in their position already. The inner contour may be scanned directly, or else a positive may be produced which is then scanned for detecting the inner contour after the removal of the test appliance.
The applicant reserves the right of directing an own independent claim on this proceeding.
Furthermore, the applicant reserves the right of making the adjustment device described the subject matter of an own set of claims.
Preferred embodiments of the invention will be explained in detail in the following by means of schematic drawings. There show:
By means of
In one variant of the invention, grouting of the test appliance (TA) is accordingly performed first of all, wherein care is taken during grouting that a protrusion or the like is formed which does not belong to the actual test appliance contour.
Then, auxiliary lines are assigned to this grouted test appliance. These auxiliary lines may, for instance, be indicated by means of projection or else be applied on the test appliance. As already explained, different auxiliary lines, for instance, verticals to the patient's footprint with load or without load, dotted function lines of floor reaction forces and of the force behavior with load on the appliance, or else construction reference lines or the like may be used so as to enable a positioning of the model in a patient- or load-oriented coordinate system in later method steps.
In a subsequent step, markings may be applied on the protrusion. This applying of markings may be renounced if the protrusion itself is designed as an auxiliary geometry/marking contour.
In a further step, the test appliance is then scanned along with the protrusion and/or the auxiliary geometry by means of a 3D scanner. Subsequently, the test appliance is removed, so that the positive representing the inner contour of the test appliance remains. This positive comprises the protrusion that was imaged during the scanning of the test appliance, so that a relative positioning of the models of the outer contour and of the inner contour may be performed in the following by means of this protrusion.
This relative position, however, positions the two models only relative to each other. By means of the initially explained auxiliary lines, the models are then aligned in the patient- or load-oriented coordinate system in a final step. As will be explained in detail in the following, it is possible to make this alignment by means of the auxiliary lines in the construction program for generating the construction model. The variant in which the alignment of the test appliance in the desired coordinate system is performed during scanning already, so that practically a largely automated alignment of the two models (outer contour/inner contour) is enabled in the construction program is somewhat more comfortable.
The variant of renouncing the grouting for producing the inner contour and of scanning the inner contour directly on the test appliance by means of a 3D laser is not illustrated in
It is pointed out that the term “protrusion” does not necessarily mean a proximal protrusion of the test appliance. This term comprises generally any geometric modification of the test appliance which can be scanned identically during the scanning of the inner and outer contours and thus facilitates the relative positioning of the models of the outer contour and of the inner contour.
In the following, a concrete proceeding for producing the models for a shaft and a positive according to the invention will be explained.
Pursuant to
In the following step, the shaft is separated from the positive and the latter is scanned and is also stored (
Subsequently, both models available as point clouds are retrieved and cut digitally at the proximal protrusion. The markings applied are maintained in any case (
In a following step the positive model is cut. For this purpose, the shaft is unmarked and masked. Cutting is then performed at the proximal protrusion with the markings being maintained (
Subsequently, the shaft model is processed in an appropriate manner. First of all, the positive model is unmarked and masked (
In a following process step both cuts (shaft, positive) may then be superimposed in the program by means of the markings, wherein accuracy as high as possible has to be striven for (
These process steps will then be repeated for the other model (shaft and shaft cut). This means that the shaft model and the pertaining shaft cut are opened and superimposed (by means of the markings). Also with this relative positioning the cutaway model has to form the basis. Once the models have been superimposed with an accuracy as high as possible, the cutaway model will be unmarked and masked. The shaft model will again be renamed, stored, and exported in the stl format (
The aligned models are still available as point clouds. In a subsequent step, surface reconstruction of the positive model available as a point cloud is performed. Surface reconstruction of the shaft model available as a point cloud is not necessary since this outer contour merely is of subordinate significance for the fit and may be adapted to the respective conditions by the orthopedic specialist. It is to be understood that it is also possible to perform surface reconstruction for the shaft model. Care has to be taken that no new axial alignment of the models is performed (
For the subsequent shaft modelling, both models that are positioned relative to one another are imported to the construction program, wherein care has to be taken during this import that—as explained before—the two models that are positioned relative to one another are arranged in the space, i.e. in a patient- or load-oriented coordinate system. This means that the models have to be positioned in the coordinate system such that the position during use is represented (see
In this respect, a plurality of possibilities is generally available. Two of these possibilities will be explained by means of
The basis of both approaches is that the initially explained auxiliary lines (verticals oriented at the force behavior, oriented at floor reaction forces . . . ) are marked or projected. In the illustrated embodiment, three verticals to the footprint of the patient are illustrated, wherein theses verticals are assigned frontally, sagittally and dorsally with load. These auxiliary lines are imaged during scanning, so that the models of the outer and inner contours can be aligned in the construction program in the patient-oriented coordinate system prior to or after surface reconstruction by means of these auxiliary lines, so that the load case on the patient is exactly reproduced. These three planes that are positioned vertically on each other are indicated in
In the alternative solution pursuant to
The described proceeding enables the transfer of statics from the patient to the construction program, wherein the fit component positioning may also be assumed in the digital construction. The digital appliance construction will then be performed on principle in analogy to the approved handicraft method in the CAD program, wherein position corrections may be performed in a simple manner. Such corrections are illustrated in
In accordance with the illustration in
As explained, the hinged bracket 34 comprises a plurality of degrees of freedom, so that it is possible to mount the object to be scanned without problems in the predetermined relative position with respect to the rotary plate 16.
A device for performing the afore-described method variants thus comprises at least a 3D scanner for scanning the outer contour of the test appliance and the test appliance inner contour, a data storage for storing the data resulting from the scanning processes, and an evaluation unit via which surface resonstruction of the point cloud models available after scanning can be performed. Furthermore, means must be available by which the construction model can be calculated from these models obtained by surface resonstruction, wherein it is arranged in a patient-oriented coordinate system so as to be able to perform the afore-explained adaptation measures.
A largely automated production of the models is possible if the test appliance is positioned in the patient-oriented coordinate system via an adjustment device during scanning already, so that this positioning may be assumed automatically in the construction program.
Disclosed are a method for transferring statics of an orthopedic test appliance to a definite appliance and a device for performing this method. In accordance with the invention, the inner contour and the outer contour are scanned and aligned relative to each other by means of a protrusion/auxiliary geometry. In a further step, the models resulting from the scanning processes are positioned in a patient-/load-oriented coordinate system.
Number | Date | Country | Kind |
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10 2013 102 346.0 | Mar 2013 | DE | national |
10 2013 103 927.8 | Apr 2013 | DE | national |
10 2013 104 843.9 | May 2013 | DE | national |
10 2014 102 997.6 | Mar 2014 | DE | national |