Apparatus and methods for balancing a joint

• US 10,376,332 B2
• Filed: 02/29/2016
• Issued: 08/13/2019
• Est. Priority Date: 09/12/2011
• Status: Active Grant

• Current Assignee: Scripps Health
• Original Assignee: Scripps Health
• Inventors: Colwell, Jr., Clifford W., D'Lima, Darryl David
• Primary Examiner(s): Beccia, Christopher J
• Application Number:
  US15/056,855
• Publication Number:
  US 20160175117A1
• Time in Patent Office: 1,261 Days
• CPC Class Codes: A61B 17/1664 for the hip
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1682 for the foot or ankle
• CPC Class Codes: A61B 17/1684 for the shoulder
• CPC Class Codes: A61B 17/1686 for the hand or wrist
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• CPC Class Codes: A61B 2034/254 being adapted depending on the stage of the surgical procedure
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 2090/067 for measuring angles
• CPC Class Codes: A61B 2562/04 Arrangements of multiple sensors of the same type
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/103 Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes A61B5/08 takes precedence; measuring aids for tailors A41H1/00; measuring instruments specially adapted for dentistry A61C19/04
• CPC Class Codes: A61B 5/1036 Measuring load distribution, e.g. podologic studies
• CPC Class Codes: A61B 5/1076 for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 5/4585 Evaluating the knee
• CPC Class Codes: A61B 90/06 Measuring instruments not otherwise provided for
• CPC Class Codes: A61F 2/38 : for elbows or knees
• CPC Class Codes: A61F 2/461 : of knees
• CPC Class Codes: A61F 2/4657 : Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/4666 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61F 2002/4668 : for measuring angles
• CPC Class Codes: A61F 2002/4688 : having operating or control means

Abstract

A joint replacement balancing system which provides real-time feedback to a surgeon during a joint replacement surgery to assist the surgeon to balance a joint replacement. The joint replacement balancing system includes a non-transitory processor-readable medium storing code representing instructions to cause a processor to receive a signal from a joint balancing apparatus, determine if the joint replacement is out of balance, determine a corrective course of action to bring the joint into balance and generate and display to the surgeon during the joint replacement surgery a recommended corrective course of action to complete the joint replacement surgery.

Claims

1. In a joint replacement balancing system which provides real-time feedback to a surgeon during a joint replacement surgery to assist the surgeon to balance a joint replacement, a non-transitory processor-readable medium storing code representing instructions to cause a processor to:

receive a signal from a joint balancing apparatus, the signal communicating a first data set including a joint balancing parameter, the joint balancing apparatus disposed between a first bony structure and a second bony structure and including a first portion configured to be disposed between the first bony structure and a second portion configured to be disposed between the first portion and the second bony structure, and a transducer disposed between the first portion and the second portion;

determine, based on the first data set, if the joint replacement is out of balance;

determine, based on the first data set, a corrective course of action to bring the joint into balance; and

generate and display to the surgeon during the joint replacement surgery a recommended corrective course of action to complete the joint replacement surgery.

2. The non-transitory processor-readable medium of claim 1, wherein the joint balancing parameter comprises at least one of a force, a position, a displacement or a rotation associated with the joint balancing apparatus.

3. The non-transitory processor-readable medium of claim 1, wherein the display of the recommended action comprises displaying a recommendation selected from the group consisting of removing bone, tensioning ligament or removing ligament.

4. The non-transitory processor-readable medium of claim 1, wherein the code representing instructions to cause a processor to receive the signal includes code to receive the signal as the joint balancing apparatus is moved through a predefined range of motion during the surgery.

5. The non-transitory processor-readable medium of claim 1, wherein the code representing instructions to cause a processor to receive the signal includes code to receive a plurality of signals as the first bony structure is moved through a predefined range of motion with respect second bony structure during the surgery.

6. The non-transitory processor-readable medium of claim 1, further including code representing instructions to cause a processor to receive a signal including a second data set, the second data set associated with at least one of a force, a position, a displacement or a rotation associated with the apparatus after the performance of at least a part of a surgical procedure.

7. The non-transitory processor-readable medium of claim 1, wherein the transducer is a plurality of transducers.

8. The non-transitory processor-readable medium of claim 7, further including code representing instructions to cause a processor to:

receive a plurality of signals each including a force associated with one of the transducers from the plurality of transducers;

compare the force associated with each transducer from the plurality of transducers to the force associated with at least one other transducer from the plurality of transducers.

9. In a system which communicates with a temporary measuring device for use in joint replacement surgery to facilitate balancing a prosthetic joint, a non-transitory processor-readable medium storing code representing instructions to cause a processor to:

receive communications from the temporary measuring device, the communications including data representing distance and force as measured by at least a first transducer disposed at a first position between a first portion of the temporary measuring device and a second portion of the temporary measuring device disposed between the first portion and a second bony structure, the second bony structure disposed opposite the first bony structure, the communications further including data representing distance and force as measured by at least a second transducer disposed at a second position between the first portion of the temporary measuring device and the second portion of the temporary measuring device;

determine, based on the data representing distance and force as measured by the at least first transducer and second transducer, if the joint replacement surgery requires a corrective course of action;

determine a corrective course of action for the joint replacement surgery; and

provide, during the joint replacement surgery, the corrective course of action to a care provider.

10. The non-transitory processor-readable medium of claim 9, wherein the corrective course of action comprises a recommendation selected from the group consisting of removing bone, tensioning ligament or removing ligament.

11. The non-transitory processor-readable medium of claim 9, wherein providing comprises displaying a chart illustrating the corrective course of action.

12. The non-transitory processor-readable medium of claim 9, wherein providing comprises displaying an animation illustrating the corrective course of action.

13. The non-transitory processor-readable medium of claim 9, wherein providing comprises displaying a graphical figure illustrating the corrective course of action.

14. The non-transitory processor-readable medium of claim 9, wherein providing comprises an auditory message providing the corrective course of action.

15. The non-transitory processor-readable medium of claim 9, wherein providing comprises tactile feedback providing the corrective course of action.

16. The non-transitory processor-readable medium of claim 9, further including code representing instructions to cause a processor repeat the receiving, determining and providing steps.

17. The non-transitory processor-readable medium of claim 9, wherein the determination of the corrective course of action for the joint replacement surgery is based on a computer simulation of a procedure associated with real time events during the surgical procedure.