Robotic guide assembly for use in computer-aided surgery

• US 20110130761A1
• Filed: 04/07/2006
• Published: 06/02/2011
• Est. Priority Date: 04/07/2005
• Status: Active Grant

• Current Assignee: Omnilife Science, Inc. (OrthoUnited, Inc.)
• Original Assignee: Perception Raisonnement Action en Medecine
• Inventors: Rit, Jacques, Plaskos, Christopher, Lavallee, Stephane
• Granted Patent: US 9,421,019 B2
• Time in Patent Office: Days
• US Class Current: 606/87
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 2017/1602 Mills
• 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 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• 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 34/30 Surgical robots
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for

Abstract

A system for guiding resurfacing operations on at least a portion of a joint of at least one bone is provided and uses a guide with actuators (motors) controlled by a computer to position a cutting tool relative to a bone so that the bone surface can be cut in a flexible and accurate manner.

Claims

1. A system for guiding a cutting tool capable of cutting bone portions at a level of a head of a bone, comprising:

means for attaching the system to only one side of the bone through an incision in the bone;

an adjustment mechanism rotatably coupled to the attachment means for adjusting the position of the cutting tool;

a positioning mechanism coupled to the adjustment mechanism and having at least two degrees of rotational freedom for further adjusting the position of the cutting tool; and

a guide intended to support the cutting tool and pivotally coupled to the positioning mechanism along one axis of rotation of the positioning mechanism.

2. The system of claim 1, wherein the cutting tool is one of a saw-blade cutter and a milling device.

3. The system of claim 1, wherein the attachment means comprises an anchor element that is fixedly inserted into the bone and at least one fixation pin that passes through the bone and is coupled to the anchor element by being received through a through hole formed therein.

4. The system of claim 3, wherein the anchor is an elongated substantially hollow member, with the through hole formed in a side thereof, the fixation pin being an elongated member that is received in the through hole.

5. The system of claim 3, wherein the attachment means further comprises a guide that is detachably coupled to the anchor and includes at least one guide through hole that is axially aligned with the through hole in the anchor element so as to guide the fixation pin through the bone and into the through hole formed in the anchor element, wherein the guide includes a base that is disposed outside and along one side of the bone and an arm that is detachably coupled to the anchor element, the base including the at least one guide through hole.

6. The system of claim 1, wherein the adjustment mechanism includes a base that is fixedly attached to the attachment means and a second part that is pivotally attached to the base and has two rotational degrees of freedom and includes a mounting surface for fixedly mounting to positioning mechanism.

7. The system of claim 6, wherein the at least two rotational degrees of freedom comprises a first rotational degree of freedom that is generally aligned with a varas/valgus direction of an implant and a second rotational degree of freedom that is generally aligned with transverse rotation directions of the implant.

8. The system of claim 1, wherein the at least two rotational degrees of freedom of the positioning mechanism have rotational axes that are substantially parallel to one another and substantially parallel to axes of rotation of the orienting mechanism, wherein orienting mechanism is attached to the positioning mechanism along one of the rotational axes of the positioning mechanism, with the guide being attached to the positioning mechanism along the other rotational axis, and wherein the two rotational axes are arranged so that combined rotation along the two rotational axes changes the position of the guide in a sagittal plane in one rotational and two translational degrees of freedom.

9. The system of claim 8, wherein the positioning mechanism includes a gear unit and a motor unit that is detachably coupled to the gear unit, the motor unit containing a pair of actuators to cause rotation about the rotational axes of the positioning mechanism to cause movement of the positioning mechanism relative to the orienting apparatus and movement of the guide relative to the positioning mechanism.

10. The system of claim 1, wherein the positioning mechanism includes a brake mechanism that is operatively connected to a gear unit thereof such that the brake mechanism prevents rotation about one or more of the two rotational degrees of freedom.

11. The system of claim 10, wherein the brake mechanism is configured so that rotation about one or more of the two rotational axes associated with the two rotational degrees of freedom is prevented so long as the brake mechanism is actuated.

12. The system of claim 11, wherein the brake mechanism comprises a spring-loaded manual brake mechanism with an interface element, the brake mechanism being actuated by manipulation of the interface element, wherein a single interface element engages or disengages the brake mechanism simultaneously from the two rotational axes.

13. The system of claim 1, wherein the guide comprises a saw-blade guide that is rotatably mounted to the positioning mechanism along one of its two rotational degrees of freedom, the saw-blade guide including a slot for receiving the tool in the form of a saw-blade, wherein the guide includes a linear sliding joint in a plane of the cut so that a saw-blade tip can be slid up to the start of the cut.

14. The system of claim 1, wherein the guide comprises a milling guide that is rotatably mounted to the positioning mechanism along one of its two rotational degrees of freedom to guide the tool which is in the form of a milling tool.

15. The system of claim 14, wherein the milling guide is configured for making planar cuts and includes at least one rotational degree of freedom and at least one translational degree of freedom in a cutting plane.

16. The system of claim 15, wherein an axis of the translational degree of freedom is at least substantially parallel to an axis of rotation of the milling tool, wherein an axis of the milling tool intersects at right angles the rotational degree of freedom of the milling guide.

17. The system of claim 14, wherein the milling tool guide includes a slot formed therein for guiding a saw-blade so as to permit the milling tool to be used for some cuts and the saw-blade to be used for making other cuts.

18. The system of Claim 14, wherein the milling guide and milling tool have an indexing system incorporated therein and constructed such that the milling tool is discretely advanced into the cut after each cutting swing of the cutting tool.

19. The system of claim 18, wherein an interface between a milling tool attachment piece and a translational joint of the milling guide is indexed so as to allow the milling tool to be advanced in discrete intervals, the indexing being in the form of a series of circumferential grooves formed in the outer surface of the milling tool attachment piece.

20. The system of claim 14, wherein the milling guide and the milling tool are configured to permit machining of non-planar cut surfaces, wherein an axis of the milling tool is arranged so that it is parallel to two rotational axes associated with the two rotational degrees of freedom of the positioning mechanism and only the translational degree of freedom is used.

21. A system for guiding a cutting tool capable of cutting bone portions of a bone during a joint reconstruction operation, comprising:

a fixation device for attaching the system to only one side of the bone through an incision in the bone;

an adjustment mechanism rotatably coupled to the attachment means for adjusting the position of the cutting tool;

a positioning mechanism coupled to the adjustment mechanism and having at least two degrees of rotational freedom for further adjusting the position of the cutting tool; and

a guide intended to support the cutting tool and pivotally coupled to the positioning mechanism along one axis of rotation of the positioning mechanism;

wherein the system calculates an optimal position of an implant relative to the bone and positions the guide such that a final cut surface corresponds to a planed implant position cut surface.

22. A modular system for guiding a cutting tool capable of cutting bone portions at a level of a head of a bone, comprising:

means for attaching the system to only one side of the bone through an incision in the bone;

means for positioning the cutting tool, the positioning means having at least two rotational degrees of freedom; and

a cutting guide interface intended to support the cutting tool and be pivotally coupled to the positioning means along one axis of rotation of the positioning means, the positioning means being constructed so as to support a plurality of cutting guide interfaces including a saw-blade guide and a milling tool guide;

wherein the positioning means includes a gear unit and an actuator unit that is detachably connected thereto for controllably driving the gear unit along the two rotational degrees of freedom, the gear unit and actuator unit defining two rotation axes corresponding to the two rotational degrees of freedom, with the attachment means being coupled to the positioning means along one rotation axis and the cutting guide interface being coupled to the positioning means along the other rotation axis.

23. The system of claim 22, wherein the positioning means includes a positioning mechanism defined by the gear and actuator units and an orienting mechanism that is fixedly connected in part to the attachment means and is rotatably coupled to the gear unit along one rotation axis of the gear unit, the orienting mechanism having two rotational degrees of freedom.

24. The system of claim 23, wherein the two rotational axes of the positioning mechanism are arranged substantially parallel to one another and substantially orthogonal to axes of rotation defined by the two rotational degrees of freedom of the orienting mechanism.

25. The system of claim 22, wherein the cutting guide interface includes at least one rotational degree of freedom and at least one translational degree of freedom in a cutting plane.

26-32. -32. (canceled)