COMPUTER-AIDED OSTEOPLASTY SURGERY SYSTEM

• US 20070249967A1
• Filed: 03/20/2007
• Published: 10/25/2007
• Est. Priority Date: 03/21/2006
• Status: Active Grant

• Current Assignee: Smith & Nephew Orthopaedics Ag (Smith & Nephew PLC), Universite Joseph Fourier
• Original Assignee: Perception Raisonnement Action en Medecine
• Inventors: Kelly, Bryan, Besson, Sylvain, Pearle, Andrew, Plaskos, Christopher, Granchi, Carinne, Lavallee, Stephane, Buly, Robert
• Granted Patent: US 7,949,386 B2
• Time in Patent Office: Days
• US Class Current: 600/595
• CPC Class Codes: A61B 17/1742 for the hip
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 5/1121 Determining geometric values, e.g. centre of rotation or angular range of movement
• CPC Class Codes: A61B 5/1127 using markers
• CPC Class Codes: A61B 5/4504 Bones A61B5/4547 takes precedence
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for

Abstract

A method for performing computer-assisted orthopaedic surgery includes the steps of: (1) producing and displaying three-dimensional geometrical models of first and second bones, the first and second bones forming a joint; (2) identifying a zone of impingement between the first bone and the second bone on at least one of the bones; and (3) generating and displaying a color map of at least one surface of at least one bone, the at least one surface being within the zone of impingement, the color map including different colors representing different depths of bone to be removed in order to achieve an increased range of motion between the first and second bones.

Claims

1. A method for performing computer-assisted orthopaedic surgery comprising the steps of:

using a device to acquire first coordinate points on a surface of a first bone;

using the device to acquire second coordinate points on a surface of a second bone that forms a joint with the first bone;

producing and displaying a three-dimensional geometrical surface model of the first bone based at least initially on the acquired first coordinate points;

producing and displaying a three-dimensional geometrical surface model of the second bone based at least initially on the acquired second coordinate points;

moving the first and second bones relative to one another and detecting maximum amplitudes of rotation between the first and second bones;

identifying a zone of impingement between the first and second bone on at least one of the bones;

displaying as a color map at least one surface of at least one bone model, the at least one surface being within the zone of impingement, the color map including different colors representing different depths of bone to be removed in order to achieve an increased range of motion between the two bones;

using a tracked tool to remove bone in the zone of impingement based on real time information provided on the color map; and

moving again the first and second bones relative to one another and detecting an increased amount of rotation between the first and second bones.

2. The method of claim 1, wherein the different colors are represented by a continuous or discrete spectrum of varying brightness of a single color.

3. The method of claim 1, wherein the step of acquiring points on each of the surfaces of the first and second bones comprises the step of:

projecting a current pointer position overtop of registered fluoroscopic images of the bones.

4. The method of claim 3, further including the step of:

extracting bone contours from the registered fluoroscopic images to assist in generating the three-dimensional geometrical surface models.

5. The method of claim 1, further including the step of:

superimposing the generated three dimensional geometrical surface models over registered fluoroscopic images of the bones to allow the surgeon to verify model accuracy.

6. The method of claim 1, further including the steps of:

continuously, in real time, updating the three-dimensional geometrical surface models of the bones as bone is removed; and

superimposing the updated three dimensional geometrical surface models over registered fluoroscopic images of the bones to allow the surgeon to compare the updated surface of the three dimensional geometrical model with the original surface model in the fluoroscopic image.

7. A method for performing computer-assisted orthopaedic surgery comprising the steps of:

producing and displaying three-dimensional geometrical models of first and second bones, the first and second bones forming a joint;

identifying a zone of impingement between the first bone and the second bone on at least one of the bones; and

generating and displaying a color map of at least one surface of at least one bone, the at least one surface being within the zone of impingement, the color map including different colors representing different depths of bone to be removed in order to achieve an increased range of motion between the first and second bones.

8. The method of claim 7, further including the steps of:

continuously, in real time, updating the three-dimensional geometrical surface models of the bones as bone is removed; and

continuously, in real time, updating the color map to show updated depths of the bone as it is removed.

9. The method of claim 7, further including the steps of:

moving the first and second bones relative to one another and detecting maximum amplitudes of rotation between the first and second bones prior to and to permit identification of the zone of impingement; and

moving the first and second bones subsequent to one another after removal of bone in the zone of impingement and detecting an increased amount of rotation between the first and second bones.

10. The method of claim 7, wherein the first bone is a femur bone and the second bone is the pelvis bone and the joint is defined by the femur and the acetabulum surface of the pelvis bone, the range of motion being a rotation of the femur into the acetabulum, with the zone of impingement being defined by the femur and the acetabulum, the color map indicating different increased degrees of rotation with different colors that represent different depths between a current bone surface and an objective bone surface which results in a desired increased degree of rotation between the first and second bones being realized.

11. A method for performing computer-assisted orthopaedic surgery comprising the steps of:

using a device to acquire first coordinate points on a surface of a first bone;

using the device to acquire second coordinate points on a surface of a second bone that forms a joint with the first bone;

producing and displaying a three-dimensional geometrical surface model of the first bone based on the acquired first coordinate points;

producing and displaying a three-dimensional geometrical surface model of the second bone based on the acquired second coordinate points;

moving the first and second bones relative to one another and detecting when the geometrical models of the first and second bones come into contact with one another in a defined zone of impingement;

displaying as a color map at least one surface of at least one bone model, the at least one surface being within the zone of impingement, the color map including different colors representing different degrees of increased range of motion between the two bones, as well as different depths of bone to be removed in order to achieve the different increased range of motions between the two bones;

selecting one increased range of motion that is desired between the two bones; and

using a tracked tool to remove bone in the zone of impingement based on real time information provided on the color map until the selected increase in range of motion is achieved.

12. The method of claim 11, wherein the different colors represent different degrees of rotation between the first and second bones.

13. The method of claim 11, wherein each point of each model in a particular zone is represented with a color that is dependent on a depth or distance between a current surface of the bone and an objective surface of the bone surface that results in the selected increase in range of motion.

14. The method of claim 13, wherein the colors are part of a discrete color spectrum.

15. The method of claim 13, wherein the colors are part of a continuous color spectrum.

16. The method of claim 11, wherein darker colors of the color map represent greater depths of bone that need to be removed in order to achieve the selected increased range of motion.

17. The method of claim 11, wherein the first bone is a femur bone and the second bone is the pelvis bone and the joint is defined by the femur and the acetabulum surface of the pelvis bone.

18. The method of claim 17, wherein the range of motion is a rotation of the femur into the acetabulum, with the zone of impingement being defined by the femur and the acetabulum, the color map indicating different increased degrees of rotation with different colors that represent different depths between the current bone surface on which the acquired points were taken and the objective bone surface which would result in the selected increased degree of rotation between the two bones being realized.

19. The method of claim 18, further including the step of:

changing the colors of color map in real time as a device is used to remove the bone such that the colors progressively vanish as more bone is removed until the entire color map in the zone of impingement has a first target color which indicates that the objective bone surface has been reached.

20. The method of claim 11, wherein the zone of impingement includes a plurality of colors representing different depths of bone that are needed to be removed in order to achieve the selected additional range of motion.

21. The method of claim 11, wherein the color map is created and displayed for the first bone without information on a shape of the second bone.

22. The method of claim 11, wherein the color map is a dynamic color map and the method further including the step of:

creating and displaying in real time, an updated color map showing a current depth of bone as it is removed in order to achieve the different increased range of motions between the two bones and to guide an operator of the tool as to how much additional bone is to be removed.

23. The method of claim 11, further including the step of:

displaying at least the first geometrical bone model with a clock reference superimposed thereon and including twelve latitudinal lines projected on the three dimensional bone model, the latitudinal lines being divided radially from a center point with equal spacing to represent twelve hours of a clock, each latitudinal line being uniquely identified to assist a surgeon in identifying and conveying a particular position on the bone surface.

24. The method of claim 23, further including the step of:

highlighting the closest latitudinal line relative to a tool that is positioned on the bone surface to assist the surgeon in determining when the surgeon has changed locations on the bone surface.