Background
Joint replacement surgery mainly includes knee replacement surgery and hip replacement surgery. In total knee arthroplasty, the distal femur and tibia that make up the knee joint need to be machined to a shape and size suitable for prosthetic implantation. The machining of the femur and tibia is mainly performed by cutting multiple planes with a saw. The shape of the bone after being machined substantially determines the accuracy of the implantation of the knee prosthesis, and thus the machining accuracy of each plane determines the accuracy of the implantation of the prosthesis. In total hip replacement surgery, the proximal ends of the acetabulum and femur that make up the hip joint are machined to a shape and size suitable for prosthetic implantation. Hip arthroplasty involves the grinding of the acetabular fossa and osteotomy and reaming of the proximal femoral head. The accuracy of hip replacement relates to the accuracy of prosthetic implantation on the acetabular side and the accuracy of prosthetic implantation on the femoral side. The accuracy of the implantation of the acetabular-side prosthesis depends on the machining accuracy of the acetabular fossa and the accuracy of the control of the implantation angle and depth of the acetabular prosthesis during implantation. The accuracy of implantation of the prosthesis on the femoral side depends on the accuracy of reaming on the femoral side.
When the acetabular fossa is machined, the acetabular fossa needs to be ground by a grinding tool. The grinding tool generally comprises a hemispherical file head, a connecting rod with a certain length, a holding sleeve sleeved outside the connecting rod and a pistol-shaped power tool. One end of the connecting rod is connected with the file head, and the other end is connected with the power output end of the pistol-shaped tool. In use, a surgeon holds the handle of the pistol-shaped power tool in one hand and the grip sleeve in the other hand, inserts the rasp head into the acetabulum and applies force in the axial direction of the extension rod to grind bone tissue on the acetabular surface. During the grinding process, the surgeon controls the angle of the extension rod with the pelvis and the depth of grinding through experience to control the machining accuracy.
After the acetabular fossa is machined, a cup holder is required to implant the prosthetic cup into the acetabulum. The cup holding device comprises a straight connecting rod or a connecting rod with an elbow and a hammer. One end of the connecting rod is connected with the prosthesis cup, the other end of the connecting rod is used for receiving the striking of a hammer, and the middle of the connecting rod is used for being held by a surgeon. In use, the surgeon grasps the middle of the extension rod to grasp the angle of the extension rod relative to the pelvis and hammers the other end with a hammer to press the prosthetic cup into the acetabular fossa. During implantation, the cup holder as a whole is displaced axially with each hammer as the prosthetic cup enters the acetabular cup.
In recent years, techniques for assisting surgery using a robotic system have become mature, such as knee joint surgery robots sold by MAKO surgery (MAKO surgic). Generally, a robotic system includes a robotic arm, a navigational positioning system, and a control system. The mechanical arm corresponds to the arm of the surgeon, and can hold the surgical tool and position the surgical tool with high accuracy. The navigational positioning system corresponds to the surgeon's eye and can measure the position of the surgical tool and patient tissue in real time. The control system corresponds to the surgeon's brain, storing the surgical plan internally. The control system calculates the route and/or the position to be reached of the mechanical arm according to the information acquired by the navigation positioning system in operation, and can actively control the mechanical arm to move, or the mechanical arm is manually pushed to move along the route, the surface or the body defined by the virtual boundary after the virtual boundary of the mechanical arm is set by a force feedback mode. In a robotic system of the equine surgical company, an electric pendulum saw is suspended from the end of the arm. The surgical positioning of the pendulum saw adjacent the knee joint by a robotic arm and the actuation and pushing of the motorized pendulum saw by the surgeon operates to cut bone, thereby preparing the installation site for the implant of the prosthesis. Robotically-assisted knee replacement surgery has a number of advantages over traditional knee replacement surgery. For example, experience dependence on the surgeon is reduced; reduces iatrogenic injury caused by the use of the traditional mechanical positioning structure.
However, the robotic system described above may not be suitable for the type of surgery, such as hip replacement surgery, because as previously described multiple procedures are required in the hip surgery (e.g., reaming the acetabulum, tapping the acetabular cup, reaming the femoral side), and correspondingly, different configurations of surgical tools are required. Systems designed to accommodate multiple tools require multiple end effectors and removal and installation of different types of effectors onto a robotic arm during a surgical procedure can increase surgical time. In addition, the process of striking the acetabular cup to the acetabular cup can generate high impact forces that can damage the delicate robotic arm.
There is therefore a need for an actuator suitable for use in a robotic system for hip surgery.
The equine surgical company also provided a surgical robot for hip replacement, whose constitution was disclosed in chinese patent No. CN 102612350B. In performing acetabular reaming using the surgical robot, it is necessary to mount a reaming tool to a gripping structure at the distal end of the mechanical arm and then connect a power unit to the reaming tool. The holding structure (sleeve) is also used for connecting the cup holder for the operation of installing the acetabular prosthesis, so that after the acetabular grinding operation is completed, the power device is required to be detached, then the grinding tool is detached, and finally the cup holder is installed on the holding structure. And during installation, the rod connected with the grinding tool needs to penetrate the sleeve, the upper end is connected with the power device, and the lower end is connected with the grinding tool (such as an acetabular file). During the mounting or dismounting process, one end of the rod needs to be inserted into or pulled out from one end of the sleeve, and the serial connection length of the rod and the sleeve is large, so that a large operation space is needed. The process is complex in operation, and a large operation space is needed in the installation process or the disassembly process.
Disclosure of Invention
The present disclosure provides an arthroplasty actuator and surgical system that solves the problem of inconvenience in performing hip arthroplasty procedures in the prior art.
A first aspect of the present disclosure provides a joint forming actuator, including a power device and a tool assembly, the power device including a robot connection end and an internally provided power assembly, the robot connection end being configured to be connected to a robot arm end of a robot, the power assembly including a power source and an output shaft, the output shaft being connected to the power source; the tool assembly comprises a connecting part and a surgical tool, the surgical tool is rotatably arranged on the connecting part, the tool assembly is detachably arranged on the power device through the connecting part, and when the tool assembly is connected with the power device through the connecting part, the surgical tool is engaged with the output shaft to receive the rotary motion output by the output shaft.
In a first possible embodiment, the surgical tool is engaged by an insertion or socket action in the axial direction with respect to the output shaft.
In combination with the above possible implementation, in a second possible implementation, the surgical tool and the output shaft are configured as a spline connection.
In combination with the foregoing possible implementation manner, in a third possible implementation manner, a radial positioning structure is further provided between the surgical tool and the power device.
In combination with the above possible implementation manner, in a fourth possible implementation manner, the radial positioning structure is disposed between the surgical tool and the output shaft.
In combination with the foregoing possible implementation manner, in a fifth possible implementation manner, the radial positioning structure is a shaft hole matching between the output shaft and the surgical tool.
In combination with the above possible implementation manner, in a sixth possible implementation manner, the connecting portion and the power device are connected by a screwing structure so as to form axial and circumferential limits on the connecting portion.
In combination with the foregoing possible implementation manner, in a seventh possible implementation manner, the screwing structure includes a screwing groove and a positioning pin that are disposed on a circumferential surface, and the screwing groove is used for guiding the positioning pin and includes a limiting portion that limits the circumferential direction and the axial direction of the positioning pin.
In combination with the foregoing possible implementation manner, in an eighth possible implementation manner, the rotary groove is disposed in the power device, and the positioning pin is disposed in the connection portion.
In combination with the foregoing possible implementation manner, in a ninth possible implementation manner, the rotary groove includes a screwing section and a positioning section that are connected, and the positioning pin enters the positioning section along the screwing section to enable the connection portion and the power device to have a circumferential positioning relationship and an axial positioning relationship.
In combination with the foregoing possible implementation manner, in a tenth possible implementation manner, a positioning module is disposed between the connection portion and the power device, and the positioning module forms a predetermined acting force between the connection portion and the power device.
In combination with the foregoing possible implementation manner, in an eleventh possible implementation manner, the positioning module includes an elastic member, and the elastic member is pressed by the power device and the tool assembly to generate a predetermined force, and a direction of the predetermined force is an axial direction of the output shaft.
In combination with the foregoing possible implementation manner, in a twelfth possible implementation manner, an elastic member is disposed between the surgical tool and the connecting portion in the tool assembly, and the elastic member presses the surgical tool to axially compress the surgical tool and the output shaft.
In combination with the above possible implementation, in a thirteenth possible implementation, the surgical tool is an acetabular rasp bar assembly or a intramedullary reamer.
In combination with the foregoing possible implementation manner, in a fourteenth possible implementation manner, the device further includes a tracer component, where the tracer component is disposed on a surface of the power device.
In combination with the above possible implementation, in a fifteenth possible implementation, the power means form an extension of the end section when connected to the end section of the mechanical arm, the output shaft being transverse to the end section.
In combination with the above possible implementation, in a sixteenth possible implementation, the powered device further includes a prosthesis mounting actuator interface.
In combination with the above possible implementation manner, in a seventeenth possible implementation manner, the robot connection end and the prosthesis mounting actuator interface are distributed at two ends of the power device.
In combination with the foregoing possible implementation, in an eighteenth possible implementation, the power device further includes a handle configured to be substantially parallel to a shaft to which the surgical tool is attached.
In combination with the above possible implementation, in a nineteenth possible implementation, the handle and the surgical tool are distributed on both sides of the power device.
A second aspect of the present disclosure proposes a surgical system comprising an actuator, a robotic arm, a navigation system and a control system, the actuator being the arthroplasty actuator of the first aspect of the present disclosure; the mechanical arm is used for carrying an actuator; the navigation system is used for measuring the position of the actuator; the control system is used for driving the mechanical arm to move the actuator to the target position according to the operation plan.
The joint forming actuator provided by the present disclosure includes a power device and a tool assembly; the power device comprises a robot connecting end and a built-in power component, the robot connecting end is used for being connected to the tail end of a mechanical arm of the robot, the tool component is detachably arranged on the power device, and when the tool component is connected with the power device, the surgical tool rotates and moves under the driving of the power device. The power component is arranged in the shell and outputs power through the output shaft, the output shaft is connected with one end of the tool component to drive the surgical tool, and the surgical tool is guided without using a long guide cylinder, so that the structure of the actuator is more compact. Thus, the interference influence of an external power source on the operation space and the safety influence are reduced; the operation of assembling an external power source in the operation is reduced, so that the operation flow is smoother.
Drawings
FIG. 1 is a schematic view of a surgical system according to an embodiment of the present disclosure;
FIG. 2 is a schematic illustration of an articulation molding actuator in accordance with an embodiment of the present disclosure;
FIG. 3 is a schematic diagram of a robotic connection and a second interfacing prosthetic installation actuator of an embodiment of the present disclosure;
FIG. 4 is a schematic diagram of a power plant configuration of an embodiment of the present disclosure;
FIG. 5 is a cross-sectional view of the internal structure of a power plant according to an embodiment of the present disclosure;
FIG. 6 is a schematic illustration of the configuration of the output shaft of the power plant of FIG. 3 in accordance with an embodiment of the present disclosure;
FIG. 7 is a schematic diagram of an output shaft configuration of an embodiment of the present disclosure;
FIG. 8 is a schematic view of a coupling structure according to an embodiment of the present disclosure;
FIG. 9 is a schematic view of a joint and output shaft configuration of an embodiment of the present disclosure;
FIG. 10 is a cross-sectional view of a joint and output shaft arrangement of an embodiment of the present disclosure;
FIG. 11 is a schematic view of a first tool assembly according to an embodiment of the present disclosure;
FIG. 12 is a cross-sectional view of a first tool assembly according to an embodiment of the present disclosure;
FIG. 13 is a schematic view of a connection structure according to an embodiment of the present disclosure;
FIG. 14 is a schematic illustration of a snap-in structure and spline connection of an embodiment of the present disclosure;
FIG. 15 is a schematic cross-sectional view of a power plant and a first tool assembly according to an embodiment of the present disclosure;
fig. 16 is a schematic view of a connection between a first tool assembly and a power unit according to an embodiment of the disclosure.
FIG. 17 is a schematic view of another connection structure between the output shaft and the adapter shaft according to an embodiment of the disclosure;
FIG. 18 is a schematic view of another connection structure between an output shaft and a transfer shaft according to an embodiment of the disclosure;
FIG. 19 is a schematic illustration of an arthroplasty actuator coupled to a second tool assembly according to an embodiment of the present disclosure;
Reference numerals: 100-shell, 150-tracer component, 151-tracer element, 200-motor, 300-speed reducer, 400-output shaft, 401-input section, 402-middle section, 403-output section, 4031-coupling spline, 404-locating hole, 500-coupling, 501-first part, 502-second part, 600-joint, 601-hole, 602-spin groove, 6020-limit part, 6021-precession section, 6022-locating section, 603-hole, 610-spin structure, 700-extension rod main shaft, 701-spline joint, 702-joint hole, 703-locating shaft, 710-spline connection, 720-radial locating structure; 800-connecting rod lock head, 801-locating pin, 900-locating module, 901-clamping bracket, 902-elastic piece, 903-sliding sleeve, 1000a, 1000 b-operation tool, 1001-reamer bar, 1002-reamer edge, 30-robot connecting end, 13-second interface, 40-handle, 50-insulating cover, 60-handle sleeve, 70-ring groove, 1004-acetabular file, 2000-power device, 2100-power component, 2200-power source, 3000-tool component, 4000-support component, 5000-adjusting component, 6000-joint forming actuator, 7000-prosthesis mounting actuator, 8000-connecting part, 9000-navigation system, 9100-mechanical arm, 9200-control system.
Detailed Description
Features and exemplary embodiments of various aspects of the present disclosure will be described in detail below, and in order to make the objects, technical solutions and advantages of the present disclosure more apparent, the present disclosure will be described in further detail below with reference to the accompanying drawings and the detailed embodiments. It should be understood that the specific embodiments described herein are intended to be illustrative of the present disclosure and not limiting. It will be apparent to one skilled in the art that the present disclosure may be practiced without some of these specific details. The following description of the embodiments is merely intended to provide a better understanding of the present disclosure by showing examples of the present disclosure.
It is noted that relational terms such as first and second, and the like are used solely to distinguish one entity or action from another entity or action without necessarily requiring or implying any actual such relationship or order between such entities or actions. Moreover, the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. Without further limitation, an element defined by the phrase "comprising … …" does not exclude the presence of other like elements in a process, method, article, or apparatus that comprises an element.
It should be noted that, without conflict, the embodiments of the present disclosure and features of the embodiments may be combined with each other. The embodiments will be described in detail below with reference to the accompanying drawings.
Hip replacement surgery involves grinding of the acetabular fossa and reaming of the femoral medullary cavity. The surgeon may use a navigation system and a robotic arm system to assist in hip replacement surgery. A surgical system for hip replacement surgery is disclosed in chinese patent No. CN102612350B, which describes the basic construction of the navigation system and the robotic arm system and the specific roles and implementations of each in surgery, and is not repeated here.
As shown in fig. 1, the robotic system proposed by the present disclosure includes a robotic arm 9100, a navigation system 9000, an articulation actuator 6000, and a control system 9200. The mechanical arm 9100 corresponds to an arm of a surgeon, and can hold and position a surgical tool with high accuracy. The navigation system 9000 corresponds to the surgeon's eye and can measure the position of surgical tools and patient tissue in real time. Control system 9200 corresponds to the surgeon's brain, storing the surgical plan internally. The control system 9200 may actively control the movement of the mechanical arm 9100 according to the route and/or the position of the mechanical arm according to the information obtained by the navigation system 9000 during the operation, or set the virtual boundary of the mechanical arm 9100 through a force feedback mode, and then manually push the mechanical arm 9100 to move along the route, the plane or the body defined by the virtual boundary.
Taking the acetabular milling of an arthroplasty actuator as an example, the surgical tool 1000a is an acetabular milling rasp bar assembly.
The arthroplasty actuator 6000 may be used to prepare a molded acetabular fossa or intramedullary canal over a hip joint. The arthroplasty actuator 6000 may include a power device 2000 and a tool assembly 3000. The power plant 2000 includes a robot link 30 and an internal power assembly 2100. The arthroplasty actuator 6000 is coupled to the distal end of the robotic arm 9100 via a robotic coupling end 30, and the power assembly 2100 includes a power source 2200 and an output shaft 400, the output shaft 400 coupled to the power source 2200. The tool assembly 3000 includes a connecting portion 8000 and a surgical tool 1000a, the surgical tool 1000a being rotatably disposed at the connecting portion 8000. The tool assembly 3000 is detachably mounted to the power unit 2000 via the connection 8000. When tool assembly 3000 is coupled to power device 2000 via coupling 8000, surgical tool 1000a is engaged with output shaft 400 to receive rotational movement output by output shaft 400. The power assembly 2100 is disposed inside the power plant 2000 and outputs power through the output shaft 400. The output shaft 400 engages an end of the tool assembly 3000 to drive the acetabular rasp bar assembly without the use of a long guide barrel to guide the bar, resulting in a more compact actuator structure. Thus, the interference influence of an external power source on the operation space and the safety influence are reduced; the operation of assembling an external power source in the operation is reduced, so that the operation flow is smoother.
Specifically, as shown in fig. 2, 4-6, the arthroplasty actuator 6000 includes a power device 2000 and a tool assembly 3000. Power plant 2000 includes a housing 100 and a power assembly 2100. The housing 100 is a hollow interior member and has a substantially quadrangular prism shape. The housing 100 is provided at both ends thereof with a robot connecting end 30 and a second interface 13, respectively. The robot link 30 is used to connect the arthroplasty actuator 6000 to the robotic arm 9100. The second interface 13 serves as a prosthesis mounting actuator interface for detachably connecting the prosthesis mounting actuator 7000 for prosthesis mounting by the prosthesis mounting actuator 7000 after the acetabular socket has been formed. The shell 100 is also provided with a handle 40, the interior of the handle 40 is hollow, and the handle 40 is detachably connected with the shell 100. The power device 2000 is configured for coupling to the tool assembly 3000 as a quick-fit interface disposed on the opposite side of the housing 100 from the position of the handle 40. When the tool assembly 3000 is mounted to the quick-fit interface, the handle 40 is substantially aligned with the axis of the acetabular rasp bar assembly, which are disposed on either side of the power device 2000. Various surfaces of the housing 100 are used to connect the tracer assemblies 150 to indicate the position of the actuators.
As shown in fig. 5, power assembly 2100 includes motor 200, reducer 300, output shaft 400, and coupling 500. The motor 200 and the decelerator 300 constitute a power source 2200, and the power source 2200 is integrated inside the handle 40 and fixedly connected with the housing 100. The shaft of the speed reducer 300 is connected to the output shaft 400 through a coupling 500. The power source 2200 and the output shaft 400 are both coaxially disposed, with the axis perpendicular to the housing 100.
As shown in fig. 7, the output shaft 400 includes an input section 401, a middle section 402, and an output section 403, which are disposed in this order. The input section 401 is provided with a keyway 4011 for receiving rotational movement from the power source 2200. The middle section 402 is mounted in bearings in the power plant 2000. The output section 403 is provided with a coupling spline 4031, the coupling spline 4031 comprising a plurality of circumferentially spaced apart protrusions for outputting torque. The length of the coupling spline 4031 is less than the length of the output section 403, i.e., the end section of the output section 403 is an optical axis.
As shown in fig. 8, the coupling 500 is a quincuncial coupling. The coupling 500 comprises a first part 501 and a second part 502, the first part 501 and the second part 502 are provided with locking screws for fixing shafts, and an insulating sleeve is arranged between the first part 501 and the second part 502. The shaft at the output of the reducer 300 is connected to the first portion 501 by a coupling key and a locking screw, and the output shaft 400 is also connected to the second portion 502 by a key connection and a locking screw. The coupling 500 and the shaft at the output end of the reducer 300 and the keyed connection of the output shaft 400 increase the reliability of the transmission on the basis of the locking screw on the one hand and the keyed connection on the other hand increases the maximum torque that can be transmitted.
Referring to fig. 5 and 6, inside the joint forming actuator 6000, an insulating cover 50 is provided at the outer periphery of the coupling 500. The insulating cover 50 can isolate the housing 100 from the speed reducer 300, so as to prevent the electric leakage of the motor 200 from being conducted to the housing 100 through the speed reducer 300. The insulation cover 50 has a function of isolating wires/leads, preventing the wires/leads inside the housing 100 from rubbing or winding with the rotating coupling 500.
Referring to fig. 5 to 7 and 9 to 10, the housing 100 is further provided with a joint 600, and the joint 600 is fixed to the housing 100.
The joint 600 is used to connect the tool assembly 3000 and mount the output shaft 400. The main body of the connector 600 is columnar, a hole 601 is formed in the main body, four rotary grooves 602 are formed in the periphery of the main body, the rotary grooves 602 are used for guiding the pin shaft piece and comprise limiting parts 6020 for limiting the circumferential direction and the axial direction of the pin shaft piece, and two wing plates are radially arranged at one end of the connector 600. The bore 601 is configured to receive a bearing and receive the middle section 402 of the output shaft 400. The spiral groove 602 includes a precession section 6021 and a positioning section 6022, the precession section 6021 extending helically in a first axial direction, the positioning section 6022 extending in a second axial direction at an end of the precession section 6021 extending, wherein the first axial direction and the second axial direction are opposite. The side wall of the positioning section 6022 forms a limiting part 6020 the side wall of the positioning section 6022 is used for limiting the content in the groove in the second axial direction and the circumferential direction. The wings are used to secure the connector 600 to the housing 100. When the output shaft 400 is mounted to the joint 600, the coupling splines 4031 extend out of the bore 601 and are located outside of the housing 100.
As shown in fig. 11-13, tool assembly 3000 includes a connecting portion 8000 and a surgical tool 1000a. The surgical tool 1000a is rotatably provided at one end thereof to the connection portion 8000. The surgical tool 1000a is an acetabular milling rasp bar assembly and the other end is connected to an acetabular rasp. The acetabular milling rasp bar assembly includes a connecting bar spindle 700, an acetabular rasp connecting member, and a handle sleeve 60. One end of the connecting rod main shaft 700 is rotatably connected with the connecting part 8000, and the other end is provided with a file connecting part. The handle sleeve 60 is sleeved outside the main shaft 700 of the extension rod. The end of the extension rod main shaft 700 connected to the connection portion 8000 is provided with a spline joint 701 and a joint hole 702. The spline joint 701 can be fitted with the coupling spline 4031 to achieve transmission of rotational motion. But the two are not a tight fit and can be separated in the axial direction. The diameter of the engagement hole 702 is the same as the diameter of the optical axis portion on the output section 403.
The connection 8000 includes a extension bar lock 800 and an extension bar connection module. The extension rod lock head 800 is hollow and cup-shaped, and a round hole is arranged at the bottom. Four positioning pins 801 distributed along the circumferential direction are arranged on the inner circumferential surface of the extension rod lock head 800 near the opening. The extension rod connection module is disposed inside the extension rod lock 800 for rotatably connecting the acetabular milling rasp bar assembly to the extension rod lock 800.
The extension rod connection module includes a catch 901, a positioning module 900, and a pair of sliding sleeves 903, all coaxially retained within the extension rod lock 800. The clip 901 is ring-shaped and is provided at the outermost side (the opening side of the link lock 800). The positioning module 900 includes an elastic member 902 for providing a predetermined force between the connection portion 8000 and the power device 2000, and in this embodiment, the elastic member 902 is a thrust spring. The two sliding sleeves 903 are annular and are axially positioned between the clamping support 901 and the bottom of the extension rod lock head 800. The outer circumference of the sliding sleeve 903 is matched with the inner circumference of the extension rod lock head 800, and the inner hole is equal in diameter with the extension rod main shaft 700. The thrust spring is disposed between two sliding sleeves 903.
The main shaft 700 of the extension rod is sleeved in the clamping support 901, the thrust spring and the sliding sleeve 903. The outer circumferential surface of the extension bar main shaft 700 is further provided with two ring grooves 70 having a predetermined interval, and the ring grooves 70 are used for installing a retainer ring. In the assembled relationship, the clamping support 901, the thrust spring, the sliding sleeve 903 and the extension rod lock head 800 are all located between the two baffle rings, so that the extension rod lock head 800 and the extension rod main shaft 700 form a whole. The thrust spring is compressible, so that the extension rod lock head 800 has a certain activity along the axial direction of the extension rod main shaft.
As shown in fig. 14, the connection and the power device 2000 will be connected by a snap-fit structure 610 to form axial and circumferential limits for the connection, wherein the snap-fit structure 610 is comprised of a dowel 801 and a snap-fit groove 602, i.e. the tool assembly 3000 is connected to the housing 100 by a snap-fit of the dowel 801 and the snap-fit groove 602.
Fig. 15 and 16 are schematic views of the acetabular rasp bar assembly mounted to a power device 2000. In assembled relationship, the locating pin 801 is inserted into the locating section 6022 of the spin slot 602. The two axially extending side walls of the locating section 6022 form a circumferential limit to the locating pin 801 and the end walls form an axial limit to the locating pin 801. Therefore, the extension bar lock 800 does not drop in the axial direction or rotate in the circumferential direction without external force. The radial positioning is formed between the connection 8000 and both the extension rod main shaft 700 and the housing 100, which is equivalent to the radial positioning formed between the extension rod main shaft 700 and the output shaft 400 (which is positioned on the housing 100). Referring specifically to fig. 14 and 16, the optical axis portion of the output shaft 400 and the engagement hole 702 of the main shaft 700 of the extension rod form a radial positioning structure 710, and the radial positioning structure 710 is an equal-diameter shaft hole mating structure, i.e. direct radial positioning is formed between the output shaft 400 and the engagement hole 702. Limited by the length and mating accuracy of the mating segments that form the radial positioning between the connection 8000 and the extension rod main shaft 700, there may be some radial play of the extension rod main shaft 700. And radial positioning between the optical axis portion of the output shaft 400 and the engagement hole 702 of the link main shaft 700 can improve radial positioning accuracy.
The spline joint 701 of the extension rod main shaft 700 aligns with and engages the coupling spline 4031 of the output shaft 400 to receive rotational movement. The axial force of the thrust spring against the lever lock 800 causes the locating pin 801 to be axially compressed against the end wall of the locating section 6022. Because the thrust spring is compressed, the connection between the connection portion 8000 and the power device 2000 has internal stress, and the internal stress enables stable axial positioning between the tool assembly 3000 and the power, and the design difficulty or the installation difficulty for ensuring the axial positioning precision cannot be increased, so that the connection is more stable, and the looseness is not easy to occur due to vibration and the like. And, the extension rod main shaft 700 is urged by the thrust spring against the output shaft 400 in the axial direction to form axial positioning.
Compared with screw thread screwing connection, the matching of the positioning pin 801 and the screw groove 602 is more labor-saving, and the rapid disassembly and assembly during operation are facilitated; the direct physical restraint of the locating section 6022 to the locating pin 801 is also more reliable relative to friction locking. In some alternative embodiments, the positioning pin 801 may be disposed on the outer circumferential surface of the extension bar lock 800, and the spin groove 602 is disposed on the inner circumferential surface of the joint 600. In other alternative embodiments, the locating pin 801 may be disposed on the inner/outer circumferential surface of the joint 600, and the rotation groove 602 may be disposed on the outer/inner circumferential surface of the extension rod lock head 800, so that the locating pin 801 is also guaranteed to be screwed when being matched with the rotation groove 602, and further axial and circumferential positioning of the joint 600 and the extension rod lock head 800 is achieved.
The joint between the output shaft 400 and the extension rod main shaft 700 is a spline connection 710, and the spline connection 710 is realized only by axially aligning the extension rod main shaft 700 with the output shaft 400 in the joint process, so that the operation is convenient. In some alternative embodiments, torque-transmittable connection between the output shaft 400 and the main shaft 700 of the extension rod can be formed by mutual engagement of end surfaces.
In some alternative embodiments, as shown in fig. 17, other radial positioning structures may be substituted for the radial positioning between the optical axis portion of the output shaft 400 and the engagement hole 702 of the extension rod main shaft 700. For example, a positioning shaft 703 is provided at the end of the main shaft 700 of the extension rod, and a positioning hole 404 is provided on the output shaft 400, and the shaft holes of the two are matched to form radial positioning. Alternatively, as shown in fig. 18, a shaft hole fitting structure is provided between the joint 600 and the extension rod main shaft 700, for example, a hole 603 having a diameter larger than that of the spline portion of the output shaft 400 is provided at the end of the joint 600, and the ends of the corresponding extension rod main shafts 700 are provided to have the same diameter, so that a shaft hole fitting is formed therebetween.
In some alternative embodiments, springs may also be provided at other locations as elastic members 902 in positioning module 900 to create internal stresses between tool assembly 3000 and power plant 2000. For example, a compression spring is fixed to the power unit 2000. When the tool assembly 3000 is mounted to the power device 2000, the extension rod lock head 800 compresses the compression spring, and the reaction force of the compression spring compresses the positioning pin 801 of the extension rod lock head 800 in the rotary groove 602, so that the pre-pressure is kept between the extension rod lock head 800 and the power device 2000, and a relatively stable connection is formed. In the final use condition, the extension rod main shaft 700 is axially compressed with the output shaft by the reaction force of the patient tissue. The compression spring may be a common coil spring, a disc spring, a corrugated spring, etc., and of course, the elastic member 902 is not limited to a spring form, and may be a resilient piece.
The use of the hip arthroplasty will be described in detail.
In use, the arthroplasty actuator 6000 is coupled to the robotic arm 9100 via the robotic coupling end 30, and the tool assembly 3000 is not mounted to the arthroplasty actuator 6000. First, the robot arm 9100 enters a preparation position according to a predetermined surgical plan. The surgeon attaches the acetabular rasp bar assembly carrying the acetabular rasp 1004 to the arthroplasty actuator 6000 via the adapter 600. Specifically, the doctor holds the extension rod lock head 800 to axially sleeve the engagement hole of the extension rod main shaft 700 on the output section 403 of the output shaft 400, and makes the coupling spline 4031 aligned with the spline joint 701 for engagement. After the circumferential engagement of the output shaft 400 and the extension rod main shaft 700 is completed, the extension rod main shaft 700 is abutted against the output shaft 400, and a doctor pulls and rotates the extension rod lock head 800 in a direction approaching to the actuator, so that the positioning pin 801 of the extension rod lock head 800 finally enters the positioning section 6022 along the screwing section 6021 in the rotary groove 602.
Thus, the coupling spline 4031 engages the spline joint 701 to achieve circumferential engagement of the output shaft 400 and the extension rod main shaft 700, and the mating of the output section 403 and the engagement hole 702 improves the coaxiality of the connection, and also increases the radial positioning length of the docking rod main shaft 700 along with the extension rod lock head 800, improving the coaxiality of the output shaft 400 and the extension rod main shaft 700 when transmitting rotation. When the locating pin 801 is positioned within the locating section 6022, the locating pin 801 is constrained from rotating circumferentially relative to the fitting 600 by the two axially extending side walls of the locating section 6022. The thrust spring causes the extension bar lock head 800 to have a tendency to move relative to the joint 600 toward the extension bar main shaft 700, which tends to prevent the locating pin 801 from axially exiting the locating section 6022 to the precession section 6021. The thrust spring axially abuts the extension rod main shaft 700 against the output shaft 400, i.e., the thrust spring urges the extension rod main shaft 700 into axial engagement with the output shaft 400. In the above operation, the radially positioned portion of the extension rod spindle 700 is the top end, and the axial travel of the acetabular milling rasp bar assembly is small, and the required operation space is correspondingly small.
To this end, the acetabular rasp bar assembly is fully coupled to the shell 100 and the arthroplasty actuator 6000 is moved to a predetermined target location under the control of the robotic arm 9100 and a physician under the direction of a predetermined surgical plan. The motor 200 is started, and the rotation of the motor 200 is transmitted to the output shaft 400 through the decelerator 300 and the coupling 500 in order. Since the output shaft 400 is connected with the extension rod main shaft 700 through the coupling spline 4031 and the spline joint 701, the extension rod main shaft 700 is driven by the output shaft 400 to rotate, and in the rotating process, the extension rod lock head 800 is fixedly connected with the joint 600, so that the extension rod lock head 800 cannot rotate. The rotating extension rod spindle 700 rotates the acetabular file 1004 for grinding and shaping of the acetabular fossa.
After grinding and forming of the acetabular fossa is completed according to a predetermined operation plan, the mechanical arm 9100 enters a pose in which the acetabular grinding file rod assembly can be detached, a doctor overcomes the limitation that the thrust spring elastic force lifts the extension rod lock head 800, the positioning pin 801 is separated from the positioning section 6022, the extension rod lock head 800 is rotated, the positioning pin 801 is separated from the rotary groove 602 after passing through the precession section 6021, and the extension rod lock head 800 is separated from the joint 600. Removal is accomplished by moving the acetabular milling rasp bar assembly away from the adapter 600 in the axial direction of the extension bar spindle 700.
In summary, the motor 200, the reducer 300, the coupling, and the output shaft 400 are integrated inside the housing 100, and the power cord of the motor 200 may be introduced through the interface between the housing 100 and the mechanical arm 9100. The joint forming actuator 6000 is compact in structure, an external power source is not required to be arranged, and interference influence of the external power source and a power wire thereof on a surgical space and potential safety hazards caused by exposure of the power wire are avoided. The operation steps of the operation are reduced without assembling an external power source in the operation. The tool assembly 3000 is comprised of a connection 8000 and acetabular rasp bar assembly as a preloaded modular component that facilitates the detachable connection of the surgical tool 1000a to the output shaft 400.
In an alternative embodiment, as shown in fig. 19, the surgical tool 1000b is a intramedullary reamer and the tool assembly 3000 includes a coupling 8000 and a intramedullary reamer. The reamer comprises a reamer rod 1001 and a reamer connected with the reamer rod 1001 and used for reaming marrow, wherein a spline joint 701 is arranged at the end part of the reamer rod 1001 and used for being connected with a coupling spline 4031; the reamer is provided with a reamer blade 1002 for reaming the femoral medullary cavity in a rotational motion. The connecting portion 8000 has the same structure as the connecting portion 8000 for connecting the acetabular milling file rod assembly, and the connecting rod connecting module connects the reamer rod 1001 with the connecting rod lock 800. And, the tool assembly 3000 connected with the intramedullary reamer is connected with the joint 600 and the output shaft 400 in the same way as the above, after the extension rod lock 800 is connected with the joint 600, the intramedullary reamer is connected to the output shaft 400 through the spline joint 701 and the coupling spline 4031, and the output shaft 400 drives the intramedullary reamer to rotate under the drive of the motor 200 and performs the reaming task of the proximal femur.
In an alternative embodiment, the first actuator 6000 is provided with three sets of tracer assemblies 150. Three sets of tracer assemblies 150 are provided on three sides of the housing 100, each set containing four co-planar tracer elements 151. As shown in fig. 2 to 4, three planes are provided on the housing 100, and three sets of trace elements 151 are provided on the three planes, respectively. The tracer element 151 may be a passive reflective ball or a reflective sheet, or may be an active electromagnetic generator or sensor.
It will be appreciated that in hip arthroplasty, the tracer devices 150 send positional information of the arthroplasty actuator 6000 to the locator, which is typically a device for receiving positional information in the navigation system 9000 fixedly disposed in the operative space, such that the arthroplasty actuator 6000 can be identified to the locator in a variety of poses by the arrangement of the three sets of tracer elements 151. The locator may be an optical navigator for identifying reflected light or a receiver for identifying electromagnetic signals, corresponding to the trace element 151.
With continued reference to fig. 1, a second aspect of the present disclosure proposes a surgical system for performing a hip arthroplasty procedure. Comprises an actuator, a mechanical arm 9100, a navigation system 9000 and a control system 9200, wherein the actuator is the joint forming actuator 6000 of the first aspect of the disclosure; the robotic arm 9100 is used to mount the arthroplasty actuator 6000 and control the orientation of the actuator. The robotic arm 9100 can either fully actively control the orientation of the actuators or cooperatively limit a portion of the degrees of freedom or range of motion of the actuators. Specifically, the robotic arm 9100 can be controlled via programming of the control system 9200 such that the robotic arm 9100 moves entirely autonomously in accordance with a surgical plan, or by providing tactile or force feedback to limit manual movement of the surgical tool 1000a or 1000b by a surgeon beyond a predetermined virtual boundary, or to provide virtual guidance to guide the surgeon along a certain degree of freedom. The virtual boundaries and virtual guides may be derived from a surgical plan or may be intraoperatively set by an input device. The actuator is detachably connected with the mechanical arm 9100; the navigation system 9000 is used to measure the position of the arthroplasty actuator 6000 and the patient. The navigation system 9000 generally includes a locator and a tracer. The tracer is mounted on the actuator, surgical tool and patient body. Tracers are typically arrays of a plurality of tracer elements, each of which may emit optical or electromagnetic signals in an active or passive manner. A locator (e.g. a binocular camera) measures the orientation of the tracer as described above by 3D measurement techniques. The control system 9200 is used to drive the robotic arm 9100 to move the arthroplasty actuator to a target location according to a surgical plan. The manipulator movement path, movement boundary, etc. may be included in the surgical plan.
Specifically, in the surgical system, after the arthroplasty actuator to which the tool assembly 3000 is not mounted is coupled to the mechanical arm 9100 via the robot coupling end 30, the mechanical arm 9100 is brought into a ready position according to a predetermined surgical plan under the control of the control system 9200, and in the ready position, the doctor mounts the tool assembly 3000 to the power device 2000. The actuator then moves according to the predetermined surgical plan. The built-in power source, i.e., the motor 200 and the decelerator 300, the surgical tool 1000a or 1000b is rotated by the motor 200 and the decelerator 300, and the control system controls the mechanical arm 9100 to limit the movement space of the surgical tool 1000a or 1000 b. The surgeon advances 6000 surgical tools 1000a or 1000b through the handle 40 on the housing 100 to advance the arthroplasty actuator within the allowed space of motion. In clinical surgery, grinding of the acetabular fossa is first performed and then reaming of the proximal femur is performed in the usual surgical sequence. The convenient replacement of surgical tools can be accomplished by replacing the preloaded tool assemblies 3000 during both procedures, wherein the surgical tool 1000a mounted in the first set of tool assemblies 3000 is an acetabular rasp bar assembly and the surgical tool 1000b mounted in the second set of tool assemblies 3000 is a intramedullary reamer. The installation principle and process of the tool assembly 3000 are embodied in the above embodiments, and are not described herein.
While the disclosure has been described in detail with respect to the general description and the specific embodiments thereof, it will be apparent to those skilled in the art that certain modifications and improvements may be made thereto based on the present application. Accordingly, such modifications or improvements may be made without departing from the spirit of the disclosure and are intended to be within the scope of the disclosure as claimed.