JOINT PLACEMENT METHODS AND APPARATUSES

• US 20090164024A1
• Filed: 12/19/2008
• Published: 06/25/2009
• Est. Priority Date: 06/19/2006
• Status: Active Grant

• Current Assignee: iGO Technologies Inc.
• Original Assignee: iGO Technologies Inc.
• Inventors: Rudan, John, Kunz, Manuela, Ellis, Randy E.
• Granted Patent: US 8,177,850 B2
• Time in Patent Office: Days
• US Class Current: 623/22.150
• 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 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 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61F 2/32 for the hip
• CPC Class Codes: A61F 2/34 Acetabular cups
• CPC Class Codes: A61F 2/36 Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/3611 Heads or epiphyseal parts of femur
• CPC Class Codes: A61F 2002/3625 Necks
• CPC Class Codes: A61F 2002/4632 using computer-controlled surgery, e.g. robotic surgery

Abstract

Systems and methods for determining placement of prosthetic components in joint including defining patient-specific frame of reference for joint, determining patient-specific postoperative range of motion of joint, evaluating patient-specific range of motion of joint, automatically planning placement of components balancing need for range of motion with prosthesis stability through bony coverage, and applying manual adjustments to the automatically planned placement of component by giving greater or lesser weight to need for range of motion or prosthesis stability through bony coverage. Apparatuses for defining center of prosthetic femoral head and axis of prosthetic femoral neck including primary cylinder, first alignment receptacle and second alignment receptacle, and a divot on exterior of primary cylinder, divot having normal parallel to longitudinal axis of second alignment receptacle and position of the divot being translated toward an opening of the first alignment receptacle on the primary cylinder. Methods for using apparatuses. Apparatus for mounting spatially tracked device to impactor for impacting prosthetic cup into reamed socket.

Claims

1. A method for determining placement of prosthetic components in a joint, the method comprising:

defining a patient-specific frame of reference for the joint;

determining patient-specific postoperative range of motion of the joint;

evaluating patient-specific range of motion of the joint;

automatically planning placement of the components balancing the need for range of motion with prosthesis stability through bony coverage; and

applying manual adjustments to the automatically planned placement of the component by giving greater or lesser weight to the need for range of motion or prosthesis stability through bony coverage.

2. The method of claim 1, further comprising defining a patient specific frame of reference by recording passive joint movements and evaluation of the directions of the movements.

3. The method of claim 2, further comprising a patient specific frame of reference from passive movements by recording movements that are only limited by soft tissue characteristics, bony to bony impingement, bony to prosthesis impingement, soft tissue to bony impingement, soft tissue to soft tissue impingement, and/or soft tissue to prosthesis impingement.

4. The method of claim 1, further comprising evaluating the patient-specific range of motion by detecting impingement.

5. The method of claim 1, further comprising evaluating the patient-specific range of motion by calculating and comparing range of motion boundaries based on patient specific lifestyle requirements and undesirable laxity or tightness in the soft tissue.

6. The method of claim 1, further comprising determining postoperative outcome of the joint repair by considering component stability and postoperative kinematic behaviour.

7. The method of claim 1, further comprising automatically planning placement of the components considering the component stability and postoperative kinematics.

8. The method of claim 7, wherein automatically planning placement of the components considers component stability and postoperative kinematics to simulate and evaluate the results of a multitude of component placements.

9. A method of determining desired placement of a cup within an anatomical joint having a socket and having a stem with a center of rotation, the cup having a given range of motion for the stem, the method comprising:

placing the cup in the socket such that movement of a center of rotation of the cup is limited, while rotation of the cup about the center of rotation is permitted,

reducing the stem and cup such that the center of rotation of the stem and the center of rotation of the cup are concentric,

determining a range of motion of the joint by moving the stem, and

aligning the range of motion of the cup and the determined range of motion of the joint.

10. The method of claim 9 further comprising palpating a rim of the socket in order to determine a plane of the rim, and, at the same time as aligning the range of motion of the cup and the determined range of motion of the joint, aligning the cup within the socket to provide desired bony coverage to the cup within the rim.

11. The method of claim 9 further comprising modifying the range of motion of the joint to improve the alignment of the range of motion of the cup and the range of motion of the socket.

12. The method of claim 11 further comprising repeating the steps of claim 9.

13. The method of claim 10 further comprising modifying the joint to change spatial placement of the cup within the socket to improve bony coverage to the cup within the rim.

14. The method of claim 13 further comprising repeating the steps of claim 10.

15. A system for assisting in the placement of prosthetic components in a joint, the system comprising:

a module for calculation of joint movements;

a module for calculation of a functional reference system;

a module for recording patient specific joint range of motion; and

a module for evaluation of patient specific range of motion for impingement.

16. The system of claim 15, further comprising:

a module for automatically planning a placement for the prosthetic cup.

17. The system of claim 16, further comprising:

a module for determining bony coverage boundaries.

18. The system of claim 17, wherein the bony coverage boundaries include a socket rim plane.

19. The system of claim 17, further comprising:

a module for registration of a prosthetic stem'"'"'s head center and neck axis.

20. The system of claim 19, further comprising:

a module for navigating an impactor to place a prosthetic cup in a planned orientation.

21. The system of claim 15, further comprising:

navigator technology,

at least one output device, and

at least one central processing unit, wherein the modules are associated with the at least one central processing unit to receive inputs from the navigator technology and generate outputs for the at least one output device.