Assessing the Condition of a Joint and Devising Treatment

• US 20070276224A1
• Filed: 04/24/2007
• Published: 11/29/2007
• Est. Priority Date: 09/14/1998
• Status: Active Grant

• Current Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Original Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Inventors: Lang, Philipp, Steines, Daniel
• Granted Patent: US 7,881,768 B2
• Time in Patent Office: Days
• US Class Current: 600/410
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/1038 Measuring plantar pressure during gait
• CPC Class Codes: A61B 5/4514 Cartilage
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence

Abstract

Methods are disclosed for assessing the condition of a cartilage in a joint, particularly in a human knee. The methods include converting an image such as an MRI to a three dimensional map of the cartilage. The cartilage map can be correlated to a movement pattern of the joint to assess the affect of movement on cartilage wear. Changes in the thickness of cartilage over time can be determined so that therapies can be provided. Information o thickness of cartilage and curvature of cartilage or subchondral bone can be used to plan therapy. Information on movement pattern can be used to plan therapy.

Claims

1. A method of treating a human joint disease involving cartilage, the method comprising:

obtaining electronic image data of a joint;

deriving from said electronic image data a three-dimensional representation associated with a surface of said joint; and

devising an implant based on said three-dimensional representation.

2. The method of claim 1, wherein devising the implant includes determining the shape of the implant.

3. The method of claim 1, wherein said image data includes both normal and diseased cartilage tissue.

4. The method of claim 1, wherein the surface of said joint is an articular surface.

5. The method of claim 1, wherein said articular surface includes bone.

6. The method of claim 1, wherein said articular surface includes cartilage.

7. The method of claim 1, wherein said three-dimensional representation is derived, at least in part, from bone.

8. The method of claim 1, wherein said three-dimensional representation is derived, at least in part, from cartilage.

9. The method of claim 1, wherein more than 30% of said implant has a thickness that is similar to normal cartilage.

10. The method of claim 1, wherein more than 50% of said implant has a thickness that is similar to normal cartilage.

11. The method of claim 1, wherein at least more than 70% of said implant has a thickness that is similar to normal cartilage.

12. The method of claim 1, wherein the implant is for one of a tibio-femoral articulation, a hip, and an ankle.

13. The method of claim 12, wherein more than 30% of said implant has a thickness that is similar to normal cartilage.

14. The method of claim 12, wherein more than 50% of said implant has a thickness that is similar to normal cartilage.

15. The method of claim 12, wherein at least more than 70% of said implant has a thickness that is similar to normal cartilage.

16. The method of claim 1, wherein at least a portion of said implant has a thickness that is similar to normal cartilage.

17. The method of claim 1, wherein substantially each portion of said implant has a thickness that is similar to normal cartilage.

18. The method of claim 1, wherein at least a portion of the undersurface of said implant substantially matches subchondral bone.

19. A method of treating a human joint disease involving cartilage, the method comprising:

obtaining electronic image data of a joint;

deriving from the electronic image data a plurality of points associated with a surface of said joint; and

devising an implant based on said points.

20. The method of claim 19, wherein devising the implant includes determining the shape of the implant.

21. The method of claim 19, wherein said image data includes both normal and diseased cartilage tissue.

22. The method of claim 19, wherein the plurality of points form a 3-D representation associated with the surface.

23. The method of claim 19, wherein the surface of said joint is an articular surface.

24. The method of claim 23, wherein the points are located on one of the articular surface and subjacent to the articular surface.

25. The method of claim 23, wherein said articular surface includes bone.

26. The method of claim 23, wherein said articular surface includes cartilage.

27. The method of claim 19, wherein said points are derived, at least in part, from bone.

28. The method of claim 19, wherein said points are derived, at least in part, from cartilage.

29. The method of claim 19, wherein more than 30% of said implant has a thickness that is similar to normal cartilage.

30. The method of claim 19, wherein more than 50% of said implant has a thickness that is similar to normal cartilage.

31. The method of claim 19, wherein at least more than 70% of said implant has a thickness that is similar to normal cartilage.

32. The method of claim 19, wherein the implant is for one of a tibio-femoral articulation, a hip, and an ankle.

33. The method of claim 32, wherein more than 30% of said implant has a thickness that is similar to normal cartilage.

34. The method of claim 32, wherein more than 50% of said implant has a thickness that is similar to normal cartilage.

35. The method of claim 32, wherein at least more than 70% of said implant has a thickness that is similar to normal cartilage.

36. The method of claim 19, wherein at least a portion of said implant has a thickness that is similar to normal cartilage.

37. The method of claim 19, wherein at least a portion of the undersurface of said implant substantially matches subchondral bone.

38. A method of treating a human joint disease involving cartilage, the method comprising:

generating a three-dimensional representation associated with a surface of said joint; and

devising an implant based on said three-dimensional representation.

39. The method of claim 38, wherein devising the implant includes determining the shape of the implant.

40. The method of claim 38, wherein the surface of said joint is an articular surface.

41. The method of claim 40, wherein said articular surface includes bone.

42. The method of claim 40, wherein said articular surface includes cartilage.

43. The method of claim 38, wherein the three-dimensional surface is derived, at least in part, from bone.

44. The method of claim 38, wherein the three-dimensional surface is derived, at least in part, from cartilage.

45. The method of claim 38, wherein more than 30% of said implant has a thickness that is similar to normal cartilage.

46. The method of claim 38, wherein more than 50% of said implant has a thickness that is similar to normal cartilage.

47. The method of claim 38, wherein at least more than 70% of said implant has a thickness that is similar to normal cartilage.

48. The method of claim 38, wherein the implant is for one of a tibio-femoral articulation, a hip, and an ankle.

49. The method of claim 48, wherein more than 30% of said implant has a thickness that is similar to normal cartilage.

50. The method of claim 48, wherein more than 50% of said implant has a thickness that is similar to normal cartilage.

51. The method of claim 48, wherein at least more than 70% of said implant has a thickness that is similar to normal cartilage.

52. The method of claim 38, wherein at least a portion of said implant has a thickness that is similar to normal cartilage.

53. The method of claim 38, wherein at least a portion of the undersurface of said implant substantially matches subchondral bone.

54. A method of treating a human joint, the joint including both normal and diseased cartilage, the method comprising:

generating a plurality of points associated with a surface of said joint; and

designing an implant based on said points.

55. The method of claim 54, wherein the plurality of points form a 3-D representation associated with the surface of said joint

56. The method of claim 54, wherein designing the implant includes determining the shape of said implant.

57. The method of claim 54, wherein the surface of said joint is an articular surface.

58. The method of claim 57, wherein the points are located on one of the articular surface and subjacent to said articular surface.

59. The method of claim 57, wherein said articular surface includes cartilage.

60. The method of claim 57, wherein said articular surface includes bone.

61. The method of claim 54, wherein the points are derived, at least in part, from bone.

62. The method of claim 54, wherein the points are derived, at least in part, from cartilage.

63. The method of claim 54, wherein more than 30% of said implant has a thickness that is similar to normal cartilage.

64. The method of claim 54, wherein more than 50% of said implant has a thickness that is similar to normal cartilage.

65. The method of claim 54, wherein at least more than 70% of said implant has a thickness that is similar to normal cartilage.

66. The method of claim 54, wherein the implant is for one of a tibio-femoral articulation, a hip, and an ankle.

67. The method of claim 66, wherein more than 30% of said implant has a thickness that is similar to normal cartilage.

68. The method of claim 66, wherein more than 50% of said implant has a thickness that is similar to normal cartilage.

69. The method of claim 66, wherein at least more than 70% of said implant has a thickness that is similar to normal cartilage.

70. A method of treating a human joint, the joint including both normal and diseased cartilage, the method comprising:

generating a plurality of points associated with a surface of said joint; and

devising an implant based on said points, wherein the plurality of points form a 3-D representation associated with the surface of said joint

71. The method of claim 70, wherein devising the implant includes determining the shape of said implant.

72. The method of claim 70, wherein the surface of said joint is an articular surface.

73. The method of claim 70, wherein the points are located on one of the articular surface and subjacent to said articular surface.

74. The method of claim 70, wherein said articular surface includes cartilage.

75. The method of claim 70, wherein said articular surface includes bone.

76. The method of claim 75, wherein the points are derived, at least in part, from bone.

77. The method of claim 75, wherein the points are derived, at least in part, from cartilage.

78. The method of claim 77, wherein more than 30% of said implant has a thickness that is similar to normal cartilage.

79. The method of claim 77, wherein more than 50% of said implant has a thickness that is similar to normal cartilage.

80. The method of claim 77, wherein at least more than 70% of said implant has a thickness that is similar to normal cartilage.

81. The method of claim 75, wherein the implant is for one of a tibio-femoral articulation, a hip, and an ankle.

82. The method of claim 81, wherein more than 30% of said implant has a thickness that is similar to normal cartilage.

83. The method of claim 81, wherein more than 50% of said implant has a thickness that is similar to normal cartilage.

84. The method of claim 81, wherein at least more than 70% of said implant has a thickness that is similar to normal cartilage.

85. A method of treating a human joint disease involving cartilage comprising:

obtaining electronic image data of a joint, wherein said image data includes both normal and diseased cartilage tissue;

deriving from said electronic image data a three-dimensional representation associated with a surface of said joint; and

making a physical model of the three-dimensional representation.

86. The method of claim 85, wherein the surface of said joint is an articular surface.

87. The method of claim 86, wherein said articular surface includes bone.

88. The method of claim 86, wherein said articular surface includes cartilage.

89. The method of claim 85, further including determining a shape of an implant based on said physical model.

90. The method of claim 85, wherein said three-dimensional representation is derived, at least in part, from bone.

91. The method of claim 85, wherein said three-dimensional representation is derived, at least in part, from cartilage.

92. The method of claim 85, wherein more than 30% of said physical model has a thickness that is similar to normal cartilage.

93. The method of claim 85, wherein more than 50% of said physical model has a thickness that is similar to normal cartilage.

94. The method of claim 85, wherein at least more than 70% of said physical model has a thickness that is similar to normal cartilage.

95. The method of claim 85, wherein the implant is for one of a tibio-femoral articulation, hip, and ankle.

96. The method of claim 95, wherein more than 30% of said physical model has a thickness that is similar to normal cartilage.

97. The method of claim 95, wherein more than 50% of said physical model has a thickness that is similar to normal cartilage.

98. The method of claim 95, wherein at least more than 70% of said physical model has a thickness that is similar to normal cartilage.

99. A method of treating a human joint disease involving cartilage, the method comprising:

obtaining electronic image data of a joint, wherein said image data includes both normal and diseased cartilage tissue;

deriving from the electronic image data a plurality of points that form a 3-D representation associated with a surface of said joint; and

making a physical model based on the points.

100. The method according to claim 99, further including determining a shape of an implant based on said points.

101. The method of claim 99, wherein at least a portion of said implant has a thickness that is similar to normal cartilage.

102. The method of claim 99, wherein at least a portion of the undersurface of said implant substantially matches subchondral bone.

103. The method of claim 99, wherein the points are derived, at least in part, from bone.

104. The method of claim 99, wherein said points are derived, at least in part, from cartilage.

105. The method of claim 99, wherein the surface of said joint is an articular surface.

106. The method of claim 105, wherein said articular surface includes bone.

107. The method of claim 105, wherein said articular surface includes cartilage.

108. The method of claim 99, wherein more than 30% of said physical model has a thickness that is similar to normal cartilage.

109. The method of claim 99, wherein more than 50% of said physical model has a thickness that is similar to normal cartilage.

110. The method of claim 99, wherein at least more than 70% of said physical model has a thickness that is similar to normal cartilage.

111. The method of claim 99, wherein the implant is for one of a tibio-femoral articulation, a hip, and an ankle.

112. The method of claim 111, wherein more than 30% of said physical model has a thickness that is similar to normal cartilage.

113. The method of claim 111, wherein more than 50% of said physical model has a thickness that is similar to normal cartilage.

114. The method of claim 111, wherein at least more than 70% of said physical model has a thickness that is similar to normal cartilage.