SYSTEMS AND METHODS FOR JOINT REPLACEMENT

• US 20100137869A1
• Filed: 11/25/2009
• Published: 06/03/2010
• Est. Priority Date: 07/24/2008
• Status: Active Grant

• Current Assignee: Orthalign, Inc.
• Original Assignee: Orthalign, Inc.
• Inventors: Shapiro, Charles S., Van Der Walt, Nicholas, Borja, Santiago P.
• Granted Patent: US 8,911,447 B2
• 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 performing total knee arthroplasty on a knee joint of a patient, comprising:

preparing a proximal portion of a tibia for receiving a knee implant, including;

coupling a orthopedic fixture with a proximal portion of the patient'"'"'s tibia;

connecting a portable surgical orientation device to a moveable portion of the orthopedic fixture;

moving the moveable portion of the orthopedic fixture to move the portable surgical orientation device in response to a prompt from the portable surgical orientation device to orient a cutting guide at an intended orientation relative to a mechanical axis of the leg; and

resecting the proximal tibia along the cutting guide to define a tibial plateau; and

preparing a distal portion of a femur for receiving a knee implant, including;

coupling an orthopedic fixture and the portable surgical orientation device with an anterior surface of the a distal portion of the femur;

moving at least one of the femur and the tibia in response to a prompt from the portable surgical orientation device to align the femur with the mechanical axis of the leg;

securing a cutting guide with an anterior feature of the femur such that the guide is substantially perpendicular to the mechanical axis; and

resecting the distal femur.

2. The method of claim 1, further comprising

inserting a mounting pin through a proximal portion of a base of the orthopedic fixture and into an anterior proximal surface of the tibia;

coupling a distal portion of the base with a distal anterior surface of the patient'"'"'s leg.

3. The method of claim 1, further comprising confirming the location of the mechanical axis of the femur by moving the femur through a range of motion to locate the center of rotation of the femur.

4. The method of claim 1, wherein the orthopedic fixture comprises a base having a plurality of apertures and further comprising inserting pins through said apertures to couple the base to the anterior surface of the femur.

5. The method of claim 1, wherein the orthopedic fixture is coupled with the cutting guide and further comprising translating a portion of the orthopedic fixture distally or proximally to adjust to distal-proximal location of the cutting guide.

6. The method of claim 1, wherein the orthopedic fixture is coupled with the cutting guide and further comprising rotating a portion of the orthopedic fixture in flexion or extension to adjust to a flexion-extension angle of the cutting guide relative to the mechanical axis.

7. The method of claim 1, wherein the orthopedic fixture is coupled with the cutting guide and further comprising rotating a portion of the orthopedic fixture varusly or valgusly to adjust to a varus-valgus angle of the cutting guide relative to the mechanical axis.

8. The method of claim 1, further comprising directing a visible light from the portable surgical orientation device toward an anatomical landmark adjacent a proximal end of the femur to confirm alignment of the femur with the mechanical axis.

9. The method of claim 1, further comprising

inserting a distraction instrument into the knee joint while the knee joint is in extension and positioning a reference feature of the distraction instrument in contact with the tibial plateau;

connecting the portable surgical orientation device with the distraction instrument;

moving a femur contacting component of the distraction instrument relative to the reference feature of the distraction instrument in response to a prompt from the portable surgical orientation device to align the tibia and femur with the mechanical axis of the leg.

10. The method of claim 9, wherein the distraction instrument further comprises an anterior block having a plurality of apertures formed therein, the method further comprising:

advancing a plurality of pins through the apertures while the portable surgical orientation device indicates that the femur is aligned with the mechanical axis; and

securing a cutting guide with the pins to secure the cutting guide to an anterior feature of the femur such that the cutting guide is substantially perpendicular to a saggital plane including the mechanical axis.

11. A method of performing an orthopedic procedure:

coupling an orthopedic fixture and the portable surgical orientation device with a distal portion of a limb that comprises a portion of a ball-and-socket joint, the portable surgical orientation device including a housing enclosing a sensor and a microprocessor;

activating the sensor within the portable surgical orientation device, such that the sensor outputs a signal indicative of orientation;

collecting positional information of the portable surgical orientation device;

determining the location of the mechanical axis of the limb based on the positional information collected.

12. The method of claim 11, wherein the limb is a leg and further comprising:

moving a femur of the leg through a range of motion;

detecting the movement of the femur using the surgical orientation device;

determining the center of rotation of the femur based on the detected movement of the femur;

determining the location of the mechanical axis of the femur based at least in part upon the location of the center of rotation of the femur and the location of the center of the knee.

13. The method of claim 11 further comprising:

coupling a cutting guide with the portable surgical orientation device;

securing the cutting guide to an anterior feature of the limb such that the cutting guide is substantially perpendicular to the mechanical axis; and

resecting a bone of the femur to define a plateau aligned with the mechanical axis of the limb.

14. The method of claim 11, further comprising:

moving the surgical orientation device and cutting guide in at least one degree of freedom; and

displaying an angle of the cutting guide based on output of the senor with reference to the location of the mechanical axis.

15. The method of claim 11, further comprising:

aligning the orthopedic fixture with a distal anatomical landmark prior to coupling the orthopedic fixture with the limb;

aligning the surgical orientation with a plurality of proximal anatomical landmarks adjacent a proximal region of the limb;

collecting positional information corresponding to the anatomical landmarks;

determining the location of the mechanical axis of the limb based on the positional information of the anatomical landmarks.

16. The method of claim 15, wherein the proximal anatomical landmarks comprise the greater trochanter and the center of the head of the femur and the distal anatomical landmark comprises a point of entrance of the femoral canal.