HAPTIC GUIDANCE SYSTEM AND METHOD

• US 20090000626A1
• Filed: 06/23/2008
• Published: 01/01/2009
• Est. Priority Date: 03/06/2002
• Status: Active Grant

• Current Assignee: MAKO Surgical Corporation (Stryker Corporation)
• Original Assignee: MAKO Surgical Corporation (Stryker Corporation)
• Inventors: Roche, Martin, Ebbitt, Peter, Kang, Hyosig, Mozes, Alon, Moses, Dennis, Salcedo, Juan, Abovitz, Rony, Illsley, Scott, Arata, Louis, Mears, Dana, Hand, Randall, Hajaj, Binyamin, Dugal, Amardeep Singh, Ferre, Maurice R., Glauser, Sandi, Tapia, William, Blackwell, Timothy, QUAID, Arthur, Aly, Sherif
• Granted Patent: US 10,231,790 B2
• Time in Patent Office: Days
• US Class Current: 128/898
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1677 for the patella
• CPC Class Codes: A61B 17/1695 Trepans or craniotomes, i.e. specially adapted for drilling thin bones such as the skull
• 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 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/1767 for the patella
• CPC Class Codes: A61B 2017/00115 with audible or visual output
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2017/00725 Calibration or performance testing
• 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 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 2034/2048 using an accelerometer or inertia sensor
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2059 Mechanical position encoders
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• CPC Class Codes: A61B 2034/207 : Divots for calibration
• 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 2034/305 : Details of wrist mechanisms at distal ends of robotic arms
• CPC Class Codes: A61B 2090/08021 : of the patient or his organs
• CPC Class Codes: A61B 2090/365 : augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/3937 : Visible markers
• CPC Class Codes: A61B 2090/3983 : Reference marker arrangements for use with image guided surgery
• 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 34/30 : Surgical robots
• CPC Class Codes: A61B 34/35 : for telesurgery
• CPC Class Codes: A61B 34/37 : Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61B 34/70 : Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 34/74 : Manipulators with manual electric input means
• CPC Class Codes: A61B 34/76 : Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61B 5/1127 : using markers
• CPC Class Codes: A61B 5/745 : using a holographic display
• CPC Class Codes: A61B 90/14 : Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
• 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 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61F 2/30942 : for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
• CPC Class Codes: A61F 2/38 : for elbows or knees
• CPC Class Codes: A61F 2002/4632 : using computer-controlled surgery, e.g. robotic surgery
• CPC Class Codes: A61F 2002/4633 : for selection of endoprosthetic joints or for pre-operative planning
• CPC Class Codes: A61N 1/0534 : Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/3605 : Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/372 : Arrangements in connection with the implantation of stimulators
• CPC Class Codes: G05B 2219/36432 : By putting some constraints on some DOF, move within limited volumes, areas, planes, limits motion in x, y or z planes, virtual reality constraints
• CPC Class Codes: G05B 2219/39196 : Use of passive joint, no actuator but brake, brake on or off
• CPC Class Codes: G05B 2219/40478 : Graphic display of work area of robot, forbidden, permitted zone
• CPC Class Codes: G05B 2219/45117 : Medical, radio surgery manipulator
• CPC Class Codes: G05B 2219/45171 : Surgery drill
• CPC Class Codes: G06F 3/016 : Input arrangements with force or tactile feedback as computer generated output to the user
• CPC Class Codes: G16H 20/40 : relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 : for local operation
• CPC Class Codes: G16Z 99/00 : Subject matter not provided for in other main groups of this subclass

Abstract

A method for joint replacement is provided. A representation of a first bone is created, and a representation of a second bone is created. Bone preparation for implanting a first implant on the first bone is planned. The first bone to receive the first implant is prepared by manipulating a surgical tool to sculpt the first bone. Bone preparation for implanting a second implant on the second bone after preparing the first bone is planned. The second bone to receive the second implant is prepared by manipulating the surgical tool to sculpt the second bone.

Claims

1. A method for joint replacement, comprising:

creating a representation of a first bone;

creating a representation of a second bone;

planning bone preparation for implanting a first implant on the first bone;

preparing the first bone to receive the first implant by manipulating a surgical tool to sculpt the first bone;

planning bone preparation for implanting a second implant on the second bone after preparing the first bone; and

preparing the second bone to receive the second implant by manipulating the surgical tool to sculpt the second bone.

2. The method of claim 1, wherein planning bone preparation for implanting the first implant includes superimposing a representation of the first implant on the representation of the first bone.

3. The method of claim 1, wherein planning bone preparation for implanting the second implant includes superimposing a representation of the second implant on the representation of the second bone.

4. The method of claim 1, wherein planning bone preparation for implanting the first implant includes associating a representation of the first implant with the representation of the first bone.

5. The method of claim 1, wherein planning bone preparation for implanting the second implant includes associating a representation of the second implant with the representation of the second bone.

6. The method of claim 1, further comprising displaying at least one of a depth, an internal/external angle, a varus/valgus angle, a flexion angle, and a size of at least one of a representation of the first implant and a representation of the second implant on a display device.

7. The method of claim 1, wherein planning bone preparation for implanting the first implant includes associating a representation of the first implant with the representation of the first bone based at least in part on a detected location of cartilage in a region of the first bone.

8. The method of claim 1, further comprising adjusting at least one of the representation of the first bone in response to movement of the first bone and the representation of the second bone in response to movement of the second bone.

9. The method of claim 1, wherein planning bone preparation for implanting the first implant includes detecting a height of a cartilage surface above the first bone.

10. The method of claim 9, wherein planning bone preparation for implanting the first implant further includes aligning at least a portion of a representation of the first implant with a representation of the height of the cartilage surface.

11. The method of claim 1, further comprising fitting the first implant to the first bone.

12. The method of claim 11, wherein planning bone preparation for implanting the second implant includes associating a representation of the second implant with the representation of the second bone based at least in part on a detected location of the first implant on the first bone.

13. The method of claim 1, wherein preparing the first bone includes constraining the surgical tool against at least one of penetrating a virtual boundary associated with the representation of the first bone and exceeding a parameter defined with respect to the representation of the first bone.

14. The method of claim 1, wherein preparing the second bone includes constraining the surgical tool against at least one of penetrating a virtual boundary associated with the representation of the second bone and exceeding a parameter defined with respect to the representation of the second bone.

15. The method of claim 1, further comprising:

sculpting the first bone with a surgical tool; and

constraining the surgical tool so that a tip of the surgical tool is constrained against penetrating a virtual boundary.

16. The method of claim 15, further comprising adjusting the virtual boundary in response to movement of the first bone.

17. The method of claim 1, further comprising:

sculpting the second bone with a surgical tool; and

constraining the surgical tool so that a tip of the surgical tool is constrained against penetrating a virtual boundary.

18. The method of claim 17, further comprising adjusting the virtual boundary in response to movement of the second bone.

19. The method of claim 1, wherein preparing the first bone includes the steps of:

superimposing a representation of a portion of material to be removed from the first bone on the representation of the first bone; and

updating the representation of the portion of material to be removed from the first bone with a representation of a portion of material actually removed by the surgical tool.

20. The method of claim 19, wherein the portion of material to be removed corresponds to at least a portion of a virtual object associated with the representation of the first bone.

21. The method of claim 1, wherein preparing the second bone includes:

superimposing a representation of a portion of material to be removed from the second bone on the representation of the second bone; and

updating the representation of the portion of material to be removed from the second bone with a representation of a portion of material actually removed by the surgical tool.

22. The method of claim 21, wherein the portion of material to be removed corresponds to at least a portion of a virtual object associated with the representation of the second bone.

23. The method of claim 1, further comprising:

creating a representation of the surgical tool; and

updating the representation of the surgical tool and at least one of the representation of the first and the representation of the second bone as the surgical tool and at least one of the first bone and the second bone move.

24. The method of claim 1, further comprising:

placing at least one of the first bone and the second bone in a support device; and

actuating the support device to move at least one of the first bone and the second bone from a first position to a second position.

25. The method of claim 24, wherein actuating the support device includes:

determining an actual pose of at least one of the first bone and the second bone;

determining a desired pose of the at least one of the first bone and the second bone; and

actuating the support device to move the at least one of the first bone and the second bone from the actual pose to the desired pose.