Orthpaedic Monitoring Systems, Methods, Implants and Instruments

• US 20080269596A1
• Filed: 03/10/2005
• Published: 10/30/2008
• Est. Priority Date: 03/10/2004
• Status: Abandoned Application

• Current Assignee: Alan Ashby, Assaf Govari, Avi Shalgi, Dudi Reznick, Ian Revie, Pesach Susel, Stefan Vilsmeier, Thorsten Burger
• Original Assignee: Alan Ashby, Assaf Govari, Avi Shalgi, Dudi Reznick, Ian Revie, Pesach Susel, Stefan Vilsmeier, Thorsten Burger
• Inventors: Govari, Assaf, Vilsmeier, Stefan, Shalgi, Avi, Susel, Pesach, Revie, Ian, Ashby, Alan, Burger, Thorsten, Reznick, Dudi
• Application Number:
  US10/598,626
• Publication Number:
  US 20080269596A1
• Time in Patent Office: Days
• US Class Current: 600/424
• CPC Class Codes: A61B 2017/00716 simulating physical properties
• CPC Class Codes: A61B 2017/0268 for the knee
• 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 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• 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 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/0818 Redundant systems, e.g. using two independent measuring systems and comparing the signals
• CPC Class Codes: A61B 2090/364 Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/367 creating a 3D dataset from 2D images using position information
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/3916 Bone tissue
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• CPC Class Codes: A61B 2090/3975 active
• CPC Class Codes: A61B 2090/3987 Applicators for implanting markers
• 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 34/20 : 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 6/12 : Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/4007 : characterised by using a plurality of source units
• CPC Class Codes: A61B 6/4266 : characterised by using a plurality of detector units A61B6/4014 takes precedence
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 2/34 : Acetabular cups
• CPC Class Codes: A61F 2/36 : Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/4603 : for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4607 : of hip femoral endoprostheses
• CPC Class Codes: A61F 2/4609 : of acetabular cups
• CPC Class Codes: A61F 2/461 : of knees
• CPC Class Codes: A61F 2002/3008 : radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2002/3067 : for data transfer
• CPC Class Codes: A61F 2002/3895 : unicompartimental
• CPC Class Codes: A61F 2002/4632 : using computer-controlled surgery, e.g. robotic surgery
• CPC Class Codes: A61F 2250/0002 : for data transfer
• CPC Class Codes: A61F 2250/0098 : radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: G06Q 10/087 : Inventory or stock management, e.g. order filling, procurement or balancing against orders

Abstract

Orthopaedic operating systems, operating rooms, computer aided surgical methods, trackable implants, instruments and surgical planning and IGS software applications are described. The integrated surgical system is for use in an orthopaedic operating room to enable a surgeon to carry out a computer aided surgical procedure on a subject. A subject support, wireless magnetic tracking system, registration system, at least a first display device, a control system and a surgeon interface operable by the surgeon to control operation of the plurality of parts of the integrated surgical system are provided. The method comprises determining the position of at least a first marker being wirelessly tracked by a wireless magnetic tracking system, registering the position of the body part of the subject with an image of the body part of the subject, displaying a registered image of the body part of the subject and at least an image representative of an implant, and receiving a command from a surgeon interface operable by the surgeon.

Claims

1. An integrated surgical system for use in an orthopaedic:

operating room to enable a surgeon to carry out a computer aided surgical procedure on a subject, the integrated surgical system comprising;

a subject support on which the subject can be positioned;

a first wireless magnetic tracking system, the tracking system generating a magnetic field defining a working volume of the tracking system, the subject support being located at least partially within the working volume, and the tracking system including a tracking control system configured to track the position of a marker detectable by the tracking system within the working volume and generate a signal indicative of the position of the marker within a reference frame of the tracking system;

a registration system configured to register the position of the body part of the subject with an image of the body part of the subject within the reference frame of the tracking system;

at least a first display device configured to display a registered image of the body part of the subject and at least an image representative of a trackable implant during the computer aided surgical procedure;

a control system configured to integrate the functionalities of a plurality of the parts of the surgical system; and

a surgeon interface operable by the surgeon to control operation of the plurality of parts of the integrated surgical system.

2. The system of claim 1, further comprising a second wireless tracking system, the second wireless tracking system being an infrared wireless tracking system and being in communication with the control system and configured to generate a signal indicative of the position of a tracked element in the reference frame of the second wireless tracking system.

3. The system claim 1, wherein the first display device is a touch sensitive display and comprises a part of the surgeon interface.

4. The system of claim 1, wherein the surgeon interface includes an orientation sensitive device operable by a surgeon to enter control commands.

5. The system of claim 1, wherein the surgeon interface includes heads up display wearable by the surgeon and configured to display at least a one of the images selected from the group comprising:

a captured image of the body part;

an image of a model of the body part;

a registered image of the body part;

a video image of the body part;

a representation of an implant;

a representation of an instrument;

an indication of the planned position of an implant, instrument or incision; and

any combination of the preceding.

6. The system of claim 1, further comprising a wall display unit, the wall display unit being configured to provide a plurality of image regions, each image region being capable of displaying a different image.

7. The system of claim 6, wherein the different images are selected from the group comprising:

a captured image of the body part;

an image of a model of the body part;

a registered image of the body part;

a video image of the body part;

a representation of an implant;

a representation of an instrument;

an indication of the planned position of an implant, instrument or incision; and

any combination of the preceding.

8. The system of claim 1, device, the surgical site display device including an image display portion and a support, and wherein the image display portion is positionable over the surgical site of the patient in use.

9. The system of claim 8, wherein the surgical site display device includes an image capturing device having a field of view including the surgical site and generating a surgical site image, and wherein the surgical site image is displayed in the image display portion.

10. The system of claim 9, wherein the surgical site image is a real time video image of the surgical site.

11. The system of claim 9, wherein a further image is overlayed on the surgical site image and the further image and the surgical site image are displayed in the image display portion at the same time, and wherein the further image is selected from the group comprising:

a captured image of the body part;

an image of a model of the body part;

a registered image of the body part;

a video image of the body part;

a representation of an implant;

a representation of an instrument;

an indication of the planned position of an implant, instrument or incision; and

any combination of the preceding.

14. The system of claim 1, further comprising an image storage device storing a plurality of captured images of the body part of the subject, the images of the body part being selected from the group comprising:

X-ray images;

CT scan images; and

X-ray fluoro images.

15. The system of claim 1, further comprising a body part model storage device, storing a plurality of generic 3-d models of different body parts.

16. The system of claim 1, further comprising an implant image storage device storing 3d images of a plurality of implants useable in the computer aided surgical procedure.

17. The system of claim 1, further comprising an instrument image storage device storing 3d images of a plurality of instruments useable in the computer aided surgical procedure.

18. The system of claim 1, wherein the registration system is an X-ray or X-ray fluoroscopy registration system.

19. The system of claim 18, wherein the registration system is configured to capture at least a first image and a second image of the body part from different directions with the patient on the operating table.

20. The system of claim 19, wherein the registration system includes a first x-ray source and a second x-ray source, a first detector positioned to capture the first image of the body part resulting from the first x-ray source and a second detector positioned to capture the second image of the body part resulting from the second x-ray source.

21. The system of claim 20, wherein the first detector and the second detector are positioned above the subject support and the first x-ray source and the second x-ray source are positioned below the subject support.

22. The system of claim 19, wherein the control system includes computer program instruction executable:

to generate a 3d image of the body part from the first image and second image;

to determine the position of the body part in the reference frame of the tracking system; and

to register the 3d image of the body part with the position of the body part in the reference frame of the tracking system.

23. The system of claim 1, wherein the tracking system includes a magnetic field generating subsystem and wherein the position of the magnetic field generating subsystem or subject support is movable so as to change the position or orientation of the working volume relative to the subject support.

24. The system claim 23, wherein a part of the subject support is movable and/or a part of the magnetic field generating subsystem is movable.

25. The system claim 21, wherein the first x-ray source and the second x-ray source are provided in a floor on which the subject support is located.

26. The system of claim 1, a video mixing and control subsystem which controls the display of images on a plurality of different image display parts of the system.

27. The system of claim 1, wherein the control system includes computer program instructions providing an orthopaedic surgery workflow program.

28. The system of claim 27, wherein the control system includes computer program instructions providing an orthopaedic implantation planning program.

29. The system of claim 28, wherein the control system includes computer program instructions providing an orthopaedic image guided surgery program for implementing the orthopaedic procedure at least partially planned by the orthopaedic planning program.

30. The system claim 27, wherein the tracking system passes data indicating the identity of a marker being tracked by the tracking system to the control system, and wherein the control system determines whether the marker is associated with the position of a bone, an implant or an instrument.

31. The system of claim 1, further comprising at least one marker wirelessly trackable by the tracking system.

32. The system of claim 31, wherein the marker is attached to an implant.

33. The system of claim 31, wherein the marker is attached to an instrument.

34. The system of claim 31, wherein the marker has a housing including a bone anchor for retaining the marker within the bone of the subject and wherein the marker is hermetically sealed in the housing.

35. The system of claim 34, wherein the housing is configured to be percutaneously implantable within the bone of a subject.

36. The system of claim 1, further comprising a prosthetic joint, the prosthetic joint comprising a first orthopaedic implant bearing a first marker wirelessly trackable by the tracking system and a second orthopaedic implant bearing a second marker wirelessly trackable by the tracking system.

37. The system of claim 36, wherein the prosthetic joint is a prosthetic knee joint, the first orthopaedic implant is a femoral component and the second orthopaedic component is a tibial component, and the femoral component includes a locating pin which in use is located within the femur and the first marker is located at least partially within the locating pin, and the tibial component includes a keel which in use is located within the tibia and the second marker is located at least partially within the keel.

38. The system of claim 36, wherein the prosthetic joint is a prosthetic hip joint, the first orthopaedic implant is an acetabular component and the second orthopaedic component is a femoral component, and the acetabular component is a cup and the first marker is located within a wall of the cup at an apex of the cup, and the femoral component includes a body and the second marker is located at least partially within the body.

39. The system of claim 1, wherein the system includes at least three markers wirelessly trackable by the wireless magnetic tracking system, and wherein:

a first of the three markers is configured to be powered by RF induction and is implantable in the bone of the subject;

a second of the three markers is configured to be powered by RF induction and is attachable to an orthopaedic implant for implanting in the body of the subject; and

a third of the three markers has a battery and is attachable to an instrument for use in the surgical procedure of implanting the orthopaedic implant in the body of the subject.

12. The system and further comprising an image capturing device which captures real time video images, and wherein the real time video images are displayed in real time on at least one display device of the system.

13. The system of claim 12, further comprising a surgical light, the surgical light being suspended and being movable to different positions and orientations with respect to the operating table, and wherein the image capturing device is provided as a part of the surgical light.

40-95. -95. (canceled)