SYSTEMS AND METHODS FOR JOINT REPLACEMENT

• US 20100063509A1
• Filed: 07/24/2009
• Published: 03/11/2010
• Est. Priority Date: 07/24/2008
• Status: Abandoned Application

• Current Assignee: Orthalign, Inc.
• Original Assignee: Orthalign, Inc.
• Inventors: Walt, Nicholas van der, Borja, Santiago P.
• Application Number:
  US12/509,414
• Publication Number:
  US 20100063509A1
• Time in Patent Office: Days
• US Class Current: 606/88
• CPC Class Codes: A61B 17/154 for preparing bone for knee prosthesis
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/1707 using electromagnetic effects, e.g. with magnet and external sensors
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/7017 pneumatic or hydraulic means
• CPC Class Codes: A61B 2034/2048 using an accelerometer or inertia sensor
• CPC Class Codes: A61B 2090/067 for measuring angles
• 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

Abstract

Systems and methods for joint replacement are provided. The systems and methods include a surgical orientation device and at least one orthopedic fixture. The surgical orientation device and orthopedic fixtures can be used to locate the orientation of an axis in the body, to adjust an orientation of a cutting plane or planes along a bony surface, to distract a joint, or to otherwise assist in an orthopedic procedure or procedures.

Claims

1. A method for preparing a portion of a knee for receiving a knee implant, comprising:

coupling an orthopedic fixture with a proximal feature of the patient'"'"'s leg;

connecting a portable surgical orientation device to an adjustment device that is connected to the orthopedic fixture and moveable relative to the leg;

moving the adjustment device to move the portable surgical orientation device in response to a prompt from the portable surgical orientation device to orient the orthopedic fixture relative to a mechanical axis of the leg.

2. The method of Claim 1, wherein the orthopedic fixture includes a base and further comprising coupling the base with a proximal feature of a tibia.

3. The method of Claim 2, further comprising coupling a distal portion of the base of the orthopedic fixture with a distal feature of the tibia.

4. The method of Claim 1, wherein the orthopedic fixture further comprises a cutting guide and moving the adjustment device orients the cutting guide relative to the mechanical axis of the leg.

5. The method of Claim 4, further comprising coupling the cutting guide with the orthopedic fixture after the orthopedic fixture has been coupled with the leg.

6. The method of Claim 5, further comprising orienting the cutting guide at approximately 90 degrees relative to a mechanical axis of the leg.

7. The method of Claim 4, further comprising securing the cutting guide to the tibia and resecting the proximal tibia along the cutting guide to define a tibial plateau.

8. The method of Claim 1, further comprising coupling a cutting guide to the adjustment device and moving the cutting guide with the adjustment device in response to the prompt from the surgical orientation device.

9. The method of Claim 1, wherein the method further comprises referencing a distal portion of the tibia to orient the orthopedic fixture.

10. The method of Claim 1, further comprising aligning the orthopedic fixture with one or more anatomical landmarks such that the portable surgical orientation device is aligned with a saggital plane of the tibia.

11. The method of Claim 10, further comprising recording information indicative of the saggital plane in the portable surgical orientation device.

12. The method of Claim 10, wherein the anatomical landmarks include one or more of an insertion point of an anterior cruciate ligament and an insertion point of a patella tendon.

13. The method of Claim 10, further comprising:

directing a visible light proximally from the portable surgical orientation device; and

moving the adjustment device until the visible light intersects one or more of the insertion point of the anterior cruciate ligament and the insertion point of the patella tendon.

14. The method of Claim 10, further comprising compensating for a vertical height of the portable surgical orientation device from the mechanical axis of the leg.

15. The method of Claim 1, further comprising moving the adjustment device to align the portable surgical orientation device with a coronal plane of the patient and recording information indicative of the coronal plane in the portable surgical orientation device.

16. The method of Claim 15, further comprising:

positioning a target adjacent to an anatomical landmark of the patient'"'"'s ankle;

directing a visible light distally from the portable surgical orientation device; and

moving the adjustment device until the visible light is aligned with the target.

17. The method of Claim 16, further comprising compensating for an anterior-posterior spacing of the portable surgical orientation device from the anterior surface of the patient'"'"'s tibia.

18. The method of Claim 15, further comprising:

extending a probe coupled with the adjustment device and the portable surgical orientation device toward a distal portion of the tibia;

moving the adjustment device to contact the probe with an anatomical landmark on a lateral side of the distal portion of the tibia;

moving the adjustment device to contact the probe with an anatomical landmark on a medial side of the distal portion of the tibia; and

recording information indicative of the saggital plane in the portable surgical orientation device at at least one of the anatomical landmarks on the lateral side of the distal portion of the tibia and the anatomical landmarks on the medial side of the distal portion of the tibia.

19. The method of Claim 15, further comprising:

extending a probe coupled with the adjustment device and the portable surgical orientation device toward a distal portion of the tibia;

moving the adjustment device to contact the probe with an anatomical landmark on a lateral side of the distal portion of the tibia;

moving the adjustment device to contact the probe with an anatomical landmark on a medial side of the distal portion of the tibia; and

recording information indicative of the coronal plane in the portable surgical orientation device at at least one of the anatomical landmark on the lateral side of the distal portion of the tibia and the anatomical landmark on the medial side of the distal portion of the tibia.

20. The method of Claim 1, further comprising:

coupling the orthopedic fixture with the tibia by inserting a mounting pin through a bore in the orthopedic fixture and into a medial portion of the tibial tuberosity;

pivoting the orthopedic fixture about a first axis extending through the mounting pin to a preferred varus-valgus orientation as indicated on the portable surgical orientation device;

moving the adjustment device about a second axis that is substantially perpendicular to the first axis to position a cutting guide in a preferred anterior-posterior slope orientation as indicated on the portable surgical orientation device; and

securing the cutting guide to the anterior surface of the tibia at the preferred varus-valgus and flexion-extension orientations by inserting a plurality of pins through the cutting guide.

21. The method of Claim 1, wherein the orthopedic fixture further comprises a base having a proximal mounting structure, a distal mounting structure, and an elongate member extending therebetween, the method further comprising:

coupling the distal mounting structure with an anterior tibial surface located proximal of the ankle joint.

22. The method of Claim 1, further comprising directing a visible light from the portable surgical orientation device onto an anterior surface of the tibia at a cutting surface of the cutting guide prior to resecting the proximal tibia.

23. The method of Claim 1, wherein the orthopedic fixture is an extramedullary tibial guide, and further comprising:

coupling the portable surgical orientation device to a landmark acquisition jig having a first elongate member having a proximal end and a distal end and a transverse member coupled with each of the proximal and distal ends;

positioning the landmark acquisition jig such that the transverse member coupled with the proximal end of the elongate member is in contact with the proximal tibia adjacent to the collateral ligament attachment and the transverse member coupled with the distal end of the elongate member is in contact with the distal tibia adjacent to a malleolus;

recording information indicative of a coronal plane of the tibia in the portable surgical orientation device;

decoupling the portable surgical orientation device from the landmark acquisition jig before coupling the portable surgical orientation device to the extramedullary tibial guide.

24-39. -39. (canceled)