膝关节导航操作演示orthopilot kneesuite tka5.step by中文版

1、蛇牌导航OrthoPilot TKA 5.1系统操作2Instruments - interchangeability需要选用NP138工具配合IQ膝关节工具进行导航下膝关节置换操作NP138NP138清单3only for TKA 4.4for ankle kinematicsinstead scaled drillcoming from MIOS红框内为可选工具，需要额外订购4IQ工具，更可视的术野StandardMIOSIQSet-up in the workshop and in the OR6Trolley/ camera and RB position, transmitter o

2、rientation简单原则:探头和术野需要在整个手术过程中不被遮挡But:many ways lead to Rome!Dependant on:size of the OR (big, small)circumstances (Anaesthesia, laminar air flow)instruments usedPeople like to be guided, thats why this is our proposal . . . 7Trolley/ camera and RB position, transmitter orientation458Trolley/ camera

3、 and RB position, transmitter orientationCheck the extreme postionsWhich are the extreme positions?femur orientation block with external rotationpalpations on the ankleHow can I check & ensure good visibility?Integrated laser-pointer in the handle of the cameracamera-adjustment tool in the toolbox-m

4、enu9Algorithm for checking transmitter orientation & camera positionGive enough freedom to move for the cameraUse the integrated laser-pointer to point to the patients knee flexed in 90Use the camera adjustment tool to check for the two most extreme“ valuesTransmitter orientation current确保4个反射球都面向探头

5、，避免小球间的遮挡10Transmitter orientation - CAP11How to perform a perfect workshop?13How to implement a workshop?Where to order workshop equipment?Which workshop sets are available and how do they look like?If you perform a full workshop:NP611 + full Columbus or e.motion standard setNP611 + full Columbus o

6、r e.motion MIOS setNS720 + any IQ-setIf you perform a pure navigation demo:NP611 or NS720 +NP138NP138XD26514Which values to make a good presentation?The model legs are in principal alrightTake the points with care & avoid slipping away during acquisitionPalpate cut reference points in the centre of

7、the medial and lateral tibia plateauBe aware of good contact between tibia check plate and tibial cut DO NOT CHEAT!Ensure 4 point contactGap measurement in extension10-12 mm in 0 axisGap measurement in flexion 12-14 mm with bigger lateral gap (2-3mm)Be aware that the remaining extension and flexion

8、gaps may differ due to a deviation from planned to actual bone cut (magnetic piece)TKA 5.1 step by step16填写术者姓名、科室、患者姓名、出生年月、性别17TKA 5.1 只支持被动反射，红色新版反射球只能搭配5.1系统使用TKA 5.1 是唯一可以搭配IQ工具使用的软件选择患侧、假体类型、工具类型18术前可选：检测反射球是否在探头感应区，选择扳手按钮，localizer选项19进行股骨注册，通用顺序：先内侧再外侧 1. 内后髁注册20 2. 外后髁注册21 3. 爬坡点注册注册原理解释：完成

9、这3点注册后，即可得知股骨假体的前后径，从而计算股骨假体尺寸22102323 1. 胫骨平台内侧最低点注册242424 2. 胫骨平台外侧最低点注册2525 3. 胫骨脊注册How accurate - effects of wrong palpation胫骨脊注册位置：下图红点所示位置262/31/31/21/2MLPA272727 1. 内踝注册28282828 2. 外踝注册292929踝关节中心注册30点选下一步进入髋关节旋转中心注册31顺时针旋转髋关节，点亮全部绿色区域旋转过程中，避免导航和手术床的移动32点选下一步进入膝关节中心注册33屈曲位内外旋踝关节，点亮绿色区域膝关节屈伸，点

10、亮绿色区域34已完成所有注册步骤，获得术前病人的力线和屈伸度数35显示股骨假体尺寸和胫骨平台可选的尺寸如图右下角所示，选取截骨板，链接转换组建，进行胫骨截骨。36如图右下角所示，选取测试模块，检测胫骨截骨情况。3738如图右下角所示，选取股骨测量器，连接转换组建，进行股骨假体位置确定确保四点接触确定远端和后侧的截骨厚度确定股骨假体的旋转How accurate? - How do we ensure correct palpations? 3940进行爬坡点的第二次确认41伸直位软组织平衡42屈曲位软组织平衡43可调节股骨髁、垫片尺寸? 可调节伸直位、屈曲位的股骨假体旋转可调整关节线来调整远端的截骨操作方法：用探针指向屏幕中要调