Augmented reality guidance systems for superimposing virtual implant components onto the physical joint of a patient

• US 10,368,947 B2
• Filed: 03/05/2019
• Issued: 08/06/2019
• Est. Priority Date: 03/12/2016
• Status: Active Grant

• Current Assignee: Philipp K. Lang
• Original Assignee: Philipp K. Lang
• Inventors: Lang, Philipp K.
• Primary Examiner(s): Chang, Olivia C
• Application Number:
  US16/292,777
• Publication Number:
  US 20190192226A1
• Time in Patent Office: 154 Days
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/1666 for the acetabulum
• CPC Class Codes: A61B 17/17 Guides or aligning means for drills , mills, pins or wires
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1742 for the hip
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/1775 for the foot or ankle
• CPC Class Codes: A61B 17/1778 for the shoulder
• CPC Class Codes: A61B 2017/00216 with eye tracking or head position tracking control
• CPC Class Codes: A61B 2017/568 produced with shape and dimensions specific for an individual patient
• CPC Class Codes: A61B 2034/104 Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2048 using an accelerometer or inertia sensor
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2059 Mechanical position encoders
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/368 changing the image on a display according to the operator's position
• CPC Class Codes: A61B 2090/372 Details of monitor hardware
• CPC Class Codes: A61B 2090/373 : using light, e.g. by using optical scanners
• CPC Class Codes: A61B 2090/374 : NMR or MRI
• CPC Class Codes: A61B 2090/376 : using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/3762 : using computed tomography systems [CT]
• CPC Class Codes: A61B 2090/502 : Headgear, e.g. helmet, spectacles
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/74 : Manipulators with manual electric input means
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61F 2/32 : for the hip
• CPC Class Codes: A61F 2/3859 : Femoral components
• CPC Class Codes: A61F 2/389 : Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2002/4018 : Heads or epiphyseal parts of humerus
• CPC Class Codes: A61F 2002/4205 : Tibial components
• CPC Class Codes: A61F 2002/4207 : Talar components
• CPC Class Codes: Y02A 90/10 : Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

Devices and methods for performing a surgical step or surgical procedure with visual guidance using an optical head mounted display are disclosed.

Claims

1. A system for preparing a physical joint in a patient, the system comprising:

at least one processor, and

a see through optical head mounted display, and

a user interface,

wherein the user interface is configured to select a virtual implant component from a library of virtual implant components,

wherein the system is configured to display the virtual implant component by the see through optical head mounted display, wherein the virtual implant component is a three-dimensional digital representation corresponding to at least one portion of a physical implant component, a placement indicator of the physical implant component, or a combination thereof, wherein the system is configured to display at least a portion of the virtual implant component onto a surface of the physical joint visible directly through the see through optical head mounted display, so as to superimpose the at least a portion of the virtual implant component onto the surface of the physical joint,

wherein the system is configured to allow superimposition and alignment of the at least a portion of the virtual implant component with at least one anatomic structure of the physical joint, and wherein the see through optical head mounted display is registered in a coordinate system, wherein the at least one anatomic structure is registered in the coordinate system, and wherein the virtual implant component is registered in the coordinate system.

2. The system of claim 1, wherein the user interface comprises at least one of a graphical user interface, a voice recognition, a gesture recognition, a virtual interface displayed by the optical head mounted display, a virtual keyboard displayed by the optical head mounted display, a physical keyboard, a physical computer mouse, or a physical track pad.

3. The system of claim 1, wherein the system is configured to maintain the display of the at least a portion of the virtual implant component in relationship to the at least one anatomic structure.

4. The system of claim 3, wherein the physical joint is a knee and wherein the system is configured to maintain the display of the at least a portion of the virtual implant component in relationship to the at least one anatomic structure when the knee is moved through a range of motion or when the knee is moved into different positions of at least one of flexion, extension, rotation, abduction, adduction or combinations thereof.

5. The system of claim 1, wherein the system is for preparing the physical joint of the patient for a prosthesis and wherein the prosthesis is for a knee replacement, hip replacement, shoulder joint replacement, or ankle joint replacement.

6. The system of claim 1, wherein the system is configured to display two or more virtual components from the library of virtual implant components.

7. The system of claim 1, wherein the library of virtual implant components is composed of two or more virtual implant components of different sizes, different shapes, or combinations thereof, wherein each virtual implant component of the library is a three-dimensional digital representation corresponding to at least one portion of a corresponding physical implant component, a placement indicator of a corresponding physical implant component, or a combination thereof.

8. The system of claim 7, wherein the user interface is configured to select the virtual implant component based on the size, the shape or combinations of thereof of the virtual implant component.

9. The system of claim 7, wherein the is user interface is configured to select the virtual implant component based on the size, the shape or combinations of thereof of the virtual implant component in relationship to the physical joint of the patient.

10. The system of claim 1, wherein the user interface is configured to adjust at least one of a color, brightness, intensity, contrast, or transparency of the display of the virtual implant component by the optical head mounted display and wherein at least one portion of the physical joint is visible through the superimposed virtual implant component.

11. The system of claim 6, wherein the system is configured to display two or more virtual implant components with a different color, a different degree of transparency or a combination thereof.

12. The system of claim 1, wherein the user interface is configured to allow movement of the virtual implant component in relationship to the physical joint of the patient.

13. The system of claim 1, wherein the user interface is configured to allow alignment of the display of the virtual implant component in relationship to the at least one anatomic structure of the physical joint of the patient visible directly through the see through optical head mounted display.

14. The system of claim 1, wherein the user interface is configured to allow modification of a position and/or orientation of the display of the virtual implant component in relationship to the at least one anatomic structure of the physical joint of the patient visible directly through the see through optical head mounted display.

15. The system of claim 1, wherein the virtual implant component is displayed, by the optical head mounted display, onto the surface of the physical joint at a predetermined position, predetermined orientation, predetermined rotation, predetermined resection level, predetermined alignment or combination thereof.

16. The system of claim 1, wherein the virtual implant component is aligned relative to at least one of a predetermined rotation axis, a predetermined flexion axis, a predetermined extension axis.

17. The system of claim 15, wherein the user interface is configured to allow modification of the predetermined position, predetermined orientation, predetermined rotation, predetermined resection level, predetermined alignment or combination thereof of the at least a portion of the virtual implant component to account for ligamentous laxity or tightness.

18. The system of claim 15, wherein the predetermined position, predetermined orientation, predetermined rotation, predetermined resection level, predetermined alignment or combination thereof of the virtual implant comprises at least one of a predetermined varus correction, a predetermined valgus correction, a predetermined femoral component flexion, a predetermined femoral component extension, a predetermined femoral component rotation, a predetermined femoral component position relative to an anterior cortex, a predetermined tibial component slope, a predetermined tibial component rotation, or a predetermined tibial component position relative to a tibial cortical rim in a knee replacement, or comprises at least one of a predetermined femoral neck resection for a femoral component, a predetermined leg length, a predetermined femoral component anteversion, a predetermined femoral component offset, a predetermined acetabular component anteversion, or a predetermined acetabular component inclination in a hip replacement.

19. The system of claim 1, wherein the system is configured to display the virtual implant component at a predetermined position, a predetermined orientation, a predetermined rotation, a predetermined alignment or a combination thereof relative to at least one of an anatomic axis, a biomechanical axis, or a deformity.

20. The system of claim 1, wherein the system is configured to display the virtual implant component, by the optical head mounted display, in relationship to the physical joint of the patient with at least one of a predetermined resection level, a predetermined varus angle, a predetermined valgus angle, a predetermined rotation, a predetermined flexion, a predetermined slope or a combination thereof.

21. The system of claim 20, wherein the user interface is configured to allow changing the position or orientation of the display of the virtual implant component relative to the predetermined resection level, predetermined varus angle, predetermined valgus angle, predetermined rotation, predetermined flexion, predetermined slope or combination thereof.

22. The system of claim 1, wherein the at least one anatomic structure comprises at least one anatomic landmark, anatomic plane, articular surface, cartilage surface, subchondral bone surface, cortical bone surface, cut bone surface, reamed bone surface, milled bone surface, impacted bone surface, tissue resection, tissue surface, or combinations thereof.

23. The system of claim 1, wherein the at least one anatomic structure comprises information about an anatomic axis, a biomechanical axis, a mechanical axis, a distance between two or more anatomic landmarks, a dimensions between two or more anatomic landmarks, a dimension between an anterior and a posterior anatomic structure, a dimension between a medial and a lateral anatomic structure, a dimension between a superior and an inferior anatomic structure, a curvature, a surface, an edge, a shape, a length, a width, a depth, or combinations thereof.

24. The system of claim 22, wherein the at least one anatomic landmark comprises one or more of a portion of or an entire acetabulum, a portion of or an entire edge of an acetabulum, multiple portions of an edge of an acetabulum, a portion of an iliac wall, a portion of a pubic bone, a portion of an ischial bone, an anterior superior iliac spine, an anterior inferior iliac spine, a symphysis pubis, a portion of or an entire greater trochanter, a portion of or an entire lesser trochanter, a center of the femoral head, a portion of or an entire femoral shaft, a portion of or an entire femoral neck, a portion of or an entire femoral head, a fovea capitis, a transverse acetabular ligament, a pulvinar, a ligamentum teres, a labrum, one or more femoral osteophytes, one or more acetabular osteophytes, a portion of or an entire medial femoral condyle, a portion of or an entire lateral femoral condyle, a portion of or an entire femoral notch, a portion of or an entire trochlea, a portion of an anterior cortex of the femur, a portion of an anterior cortex of the femur with adjacent portions of the trochlea, a portion of an anterior cortex of the femur with adjacent portions of the trochlea and osteophytes, one or more femoral osteophytes, one or more tibial osteophytes, an epicondylar eminence, a medial epicondylar eminence, a lateral epicondylar eminence, a portion of or an entire medial tibial plateau, a portion of or an entire lateral tibial plateau, a portion of or an entire medial tibial spine, a portion of or an entire lateral tibial spine, a portion of an anterior cortex of the tibia, a portion of an anterior cortex of the tibia and a portion of a tibial plateau, a portion of or an entire patella, a medial edge of a patella, a lateral edge of a patella, a superior pole of a patella, an inferior pole of a patella, a patellar osteophyte, a medial wall of the femoral notch, a lateral wall of the femoral notch, a roof of the femoral notch, an anterior cruciate ligament origin, an anterior cruciate ligament insertion, a medial wall of the medial condyle, a lateral wall of the lateral condyle, a medial femoral condyle shape, a medial femoral condyle radius, a medial femoral condyle convexity, a medial femoral condyle concavity, a lateral femoral condyle shape, a lateral femoral condyle radius, a lateral femoral condyle convexity, a lateral femoral condyle concavity, an intercondylar notch shape, an intercondylar notch surface feature, a medial tibial spine, a lateral tibial spine, an anteromedial tibial rim, an anterolateral tibial rim, a medial tibial rim, a lateral tibial rim, a lowest point of the medial plateau, a lowest point of the lateral plateau, a highest point of the medial plateau, a highest point of the lateral plateau, a medial tibial plateau shape, a lateral tibial plateau shape, a medial tibial plateau surface, a medial tibial plateau surface feature, a medial tibial plateau radius, a medial tibial plateau convexity, a medial tibial plateau concavity, a lateral tibial plateau shape, a lateral tibial plateau surface, a lateral tibial plateau surface feature, a lateral tibial plateau radius, a lateral tibial plateau convexity, a lateral tibial plateau concavity, a portion of or an entire glenoid, a portion of or an entire coracoid process, a portion of or an entire acromion, a portion of a clavicle, a portion of or an entire humeral head, a portion of or an entire humeral neck, a portion of a humeral shaft, one or more humeral osteophytes, one or more glenoid osteophytes, a portion of or an entire glenoid labrum, a portion of or an entire shoulder ligament, a portion of or an entire coracoacromial ligament, or a portion of or an entire glenohumeral ligament.

25. The system of claim 1, wherein the virtual implant component is a virtual trial femoral component, a virtual trial tibial component, a virtual trial tibial insert, a virtual trial patellar component.

26. The system of claim 6, wherein the joint is a knee and wherein the system is configured to maintain the display of the two or more virtual implant components in relationship to the at least one anatomic structure when the knee is moved through a range of motion or when the knee is moved into different positions of flexion, extension, rotation, abduction, adduction or combinations thereof.

27. The system of claim 1, wherein the at least one portion of the virtual implant component is tangent or intersecting with the at least one anatomic structure.

28. The system of claim 1, wherein the at least one processor is integrated into the optical head mounted display.

29. The system of claim 1, wherein the at least one processor is separate from the optical head mounted display.

30. The system of claim 6, wherein the two or more virtual implant components comprise a femoral component and a tibial component in a knee replacement, a femoral and an acetabular component in a hip replacement, a humeral and a glenoid component in a shoulder joint replacement, or a tibial and a talar component in an ankle joint replacement.