Navigation System for Hip Replacement Surgery Having Reference Mechanism and Method Using the Same

• US 20090171370A1
• Filed: 04/12/2006
• Published: 07/02/2009
• Est. Priority Date: 04/12/2005
• Status: Abandoned Application

• Current Assignee: Korea Advanced Institute of Science and Technology
• Original Assignee: Korea Advanced Institute of Science and Technology
• Inventors: Tonetti, Jerome Alain, Kim, Young Yong, Yoon, Yong San
• Application Number:
  US11/918,342
• Publication Number:
  US 20090171370A1
• Time in Patent Office: Days
• US Class Current: 606/130
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61F 2/4609 of acetabular cups
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/30092 using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2002/30331 made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2002/30507 using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30538 for adjusting angular orientation
• CPC Class Codes: A61F 2002/30649 Ball-and-socket joints
• CPC Class Codes: A61F 2002/4668 for measuring angles
• CPC Class Codes: A61F 2002/4687 Mechanical guides for implantation instruments
• CPC Class Codes: A61F 2002/4696 optical
• CPC Class Codes: A61F 2210/0014 using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2220/0025 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0033 made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2250/0006 for adjusting angular orientation

Abstract

A navigation system for an acetabular cup, which guides an insertion orientation of the acetabular cup inserted into a pelvis during a total hip replacement surgery, includes: a pelvis position tracer which includes probes in contact with three particular points of the pelvis placed on an anterior pelvic plane and a first reference mechanism disposed to indicate a specific reference plane when the probes come in contact with the particular points; and a pelvis position indicator which is fixed to the pelvis, and includes a second reference mechanism that is adjustable to indicate a plane parallel to the specific reference plane indicated by the first reference mechanism, or to indicate a plane perpendicular thereto, or to indicate the both planes. Accordingly, an insertion orientation of an acetabular cup can be guided by using a reference mechanism having a simple structure, and the acetabular cup can be accurately guided regardless of changes in the patient'"'"'s pelvic position during surgery, because a plane used in the insertion of the acetabular cup can be indicated continuously.

Claims

1. A navigation system for an acetabular cup, which guides an insertion orientation of the acetabular cup inserted into a pelvis during a total hip replacement surgery, and uses reference mechanisms, the navigation system comprising:

a pelvis position tracer which includes probes in contact with three particular points of the pelvis placed on an anterior pelvic plane and a first reference mechanism disposed to indicate a specific reference plane when the probes come in contact with the particular points; and

a pelvis position indicator which is fixed to the pelvis, and includes a second reference mechanism that is adjustable to indicate a plane parallel to the specific reference plane indicated by the first reference mechanism, or to indicate a plane perpendicular thereto, or to indicate the both planes.

2. The navigation system according to claim 1, wherein the probes of the pelvis position tracer comprise a first probe in contact with a symphysis pubis, a second probe in contact with a left anterior superior iliac spine, and a third probe in contact with a right anterior superior iliac spine.

3. The navigation system according to claim 2, wherein the first probe has a curve portion at its end in contact with the symphysis pubis, thereby forming the L-shape.

4. The navigation system according to claim 1, wherein the specific reference plane indicated by the first reference mechanism is an anterior pelvic plane and/or a sagittal plane.

5. The navigation system according to claim 1, wherein the pelvis position indicator further comprises one or more pins fixed to the pelvis, a base supported by the pins, a ball joint extended from the base, and a fixed block which is connected to the ball joint and at which the second reference mechanism is disposed.

6. The navigation system according to claim 5, wherein the fixed block is made of a shape memory alloy, is separated from the ball joint after being transformed in a specific temperature range higher than a room temperature, and is fixed firmly to the ball joint in the room temperature.

7. The navigation system according to claim 5, wherein the fixed block comprises two blocks connected with each other by means of a screw.

8. The navigation system according to claim 1, wherein the first and second reference mechanisms are flat polygonal plane-shaped.

9. The navigation system according to claim 1, wherein the first and second reference mechanisms are one or more rod-shaped members.

10. The navigation system according to claim 1, wherein the pelvis position indicator further comprises a third reference mechanism indicating a plane tilted at a specific angle with respect to a plane indicated by the second reference mechanism.

11. The navigation system according to claim 10, wherein the plane indicated by the third reference mechanism of the pelvis position indicator is perpendicular to the plane indicated by the second reference mechanism.

12. The navigation system according to claim 1, wherein the first reference mechanism is a laser level tool which emits a laser beam indicating the specific reference plane, and the second reference mechanism is a flat polygonal plane-shaped member having a plurality of through-holes through which the laser beam emitted from the laser level tool passes.

13. The navigation system according to claim 1, wherein the first reference mechanism comprises a laser indicator emitting a laser beam indicating the specific reference plane and a rod-shaped reference mechanism indicating a direction perpendicular to the specific reference plane, and the second reference mechanism comprises a reference mechanism having a mirror surface to reflect a laser beam emitted from the laser indicator and a rod-shaped reference mechanism fixed parallel to the mirror surface of the reference mechanism having the mirror surface, and

when the second reference mechanism is aligned with respect to the first reference mechanism, the reference mechanism having the mirror surface is aligned such that the laser beam emitted from the laser level tool of the first reference mechanism is reflected along an incident path of the laser beam, and the rod-shaped reference mechanism of the second reference mechanism is parallel to the rod-shaped reference mechanism of the first reference mechanism.

14. The navigation system according to claim 1, further comprising:

a caliper which is attached to at least one of the probes'"'"' respective ends in contact with the human body, and measures the thickness of the subcutaneous layer; and

a compensating tool compensating for an angle of a plane based on the result obtained by measuring the thickness of the subcutaneous layer.

15. The navigation system according to claim 14, wherein the caliper measures the thickness of the subcutaneous layer using an ultrasonic wave method.

16. The navigation system according to claim 14, wherein the caliper is provided at a probe in contact with the symphysis pubis.

17. A method of guiding an insertion orientation of an acetabular cup inserted into a pelvis during a total hip replacement surgery by using a navigation system for the acetabular cup, where the navigation system uses the reference mechanisms of claim 1, the method comprising:

(a) fixing the pelvis position indicator to the pelvis;

(b) allowing the first reference mechanism to indicate a specific reference plane by arranging the pelvis position tracer so that the probes of the pelvis position tracer come in contact with the three particular points;

(c) fixing the second reference mechanism of the pelvis position indicator after adjusting the second reference mechanism to indicate a plane parallel to the specific reference plane indicated by the first reference mechanism of the pelvis position tracer and/or a plane perpendicular the plane parallel to the specific reference plane;

(d) removing the pelvis position tracer arranged on the pelvis;

(e) separating the pelvis position indicator from the pelvis;

(f) disposing the pelvis to a desirable position;

(g) fixing again the pelvis position indicator to the position where the pelvis position indicator is fixed in the (a); and

(h) navigating the acetabular cup with reference to the plane indicated by the second reference mechanism of the pelvis position indicator.

18. The method according to claim 17, wherein the specific reference plane is an anterior pelvic plane and/or a sagittal plane.

19. The method according to claim 17, wherein the (b) comprises:

(b-1) allowing the first reference mechanism to indicate a first reference plane by arranging the pelvis position tracer so that the probes of the pelvis position tracer come in contact with the three particular points;

(b-2) measuring the thickness of the subcutaneous layer at a body part in contact with at least one of the probes; and

(b-3) tracing the specific reference plane by compensating for the first reference plane measured in the (b-1) based on the thickness of the subcutaneous layer measured in the (b-2)