METHOD AND SYSTEM FOR ALIGNING A PROSTHESIS DURING SURGERY

• US 20120157887A1
• Filed: 12/16/2011
• Published: 06/21/2012
• Est. Priority Date: 12/17/2010
• Status: Active Grant

• Current Assignee: Intellijoint Surgical Inc.
• Original Assignee: Intellijoint Surgical Inc.
• Inventors: Fanson, Richard Tyler, Hladio, Andre Novomir, Bakirtzian, Armen Garo
• Granted Patent: US 9,138,319 B2
• Time in Patent Office: Days
• US Class Current: 600/595
• CPC Class Codes: A61B 17/17 Guides or aligning means for drills , mills, pins or wires
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1746 for the acetabulum
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2048 using an accelerometer or inertia sensor
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2057 Details of tracking cameras
• CPC Class Codes: A61B 2034/2065 Tracking using image or pattern recognition
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• CPC Class Codes: A61B 2090/3945 Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/0077 Devices for viewing the surface of the body, e.g. camera, magnifying lens
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/1114 Tracking parts of the body
• CPC Class Codes: A61B 5/1127 using markers
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 6/032 : Transmission computed tomography [CT]
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 2/32 : for the hip
• CPC Class Codes: A61F 2/46 : Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
• CPC Class Codes: A61F 2/4609 : of acetabular cups

Abstract

Presented are methods and systems for determining, monitoring, and displaying the relative positioning of two rigid bodies during surgery. In particular, the present disclosure relates to methods and systems for positioning a prosthesis relative to a bone during a surgery as well as to systems and methods for verifying resulting relative positioning of adjacent bones.

Claims

1. A system for performing a hip replacement surgery, comprising:

a pelvis sensor unit configured to be coupled to a patient'"'"'s pelvis;

a registration sensor unit;

an insertion tool sensor unit configured to be coupled to an acetabular insertion tool;

a femur sensor unit configured to be coupled to the patient'"'"'s femur; and

a computer-readable storage medium having instructions executable by at least one processing device that, when executed, cause the processing device to

(a) calculate a positional relationship between the pelvis sensor unit and the patient'"'"'s pelvis based on a registration measurement between the pelvis sensor unit and the registration sensor unit, wherein the registration measurement is based on at least three reference points;

(b) measure an initial positional relationship between the pelvis sensor unit and the femur sensor unit,

(c) track an orientation of the acetabular insertion tool during an implantation procedure based on a positional relationship between the pelvis sensor unit and the insertion tool sensor unit,

(d) calculate angles of abduction and anteversion based on the orientation of the acetabular insertion tool,

(e) provide a real-time display conveying the angles of abduction and anteversion during the implantation procedure,

(f) measure a post-reduction positional relationship between the pelvis sensor unit and the femur sensor unit,

(g) calculate a change in leg position based on the initial positional relationship, the post-reduction positional relationship, and the positional relationship between the pelvis sensor unit and the patient'"'"'s pelvis, and

(h) provide a display of the change in leg position.

2. The system of claim 1, wherein the initial positional relationship includes an initial leg translational measurement.

3. The system of claim 1, wherein the initial positional relationship includes an initial leg orientation measurement.

4. The system of claim 1, wherein the computer-readable storage medium further includes instructions executable by at least one processing device that, when executed, cause the processing device to

track a femur orientation during a leg positioning procedure based on a positional relationship between the pelvis sensor unit and the femur sensor unit, and

provide a real-time display conveying the femur orientation during the leg positioning procedure.

5. The system of claim 1, wherein the computer-readable storage medium further includes instructions executable by at least one processing device that, when executed, cause the processing device to calculate a center-of-rotation of the patient'"'"'s femur.

6. The system of claim 5, wherein the center-of-rotation is calculated based on an acetabulum surface measurement between the pelvis sensor unit and the registration sensor unit.

7. The system of claim 5, wherein the center-of-rotation is calculated based on a femur articulation measurement between the pelvis sensor unit and the femur sensor unit.

8. The system of claim 1, wherein the change in leg position is calculated based on a comparison between the initial positional relationship and the post-reduction positional relationship.

9. The system of claim 8, wherein the change in leg position is calculated based on a femur articulation measurement between the pelvis sensor unit and the femur sensor unit.

10. The system of claim 1, wherein the change in leg position includes a leg length measurement, an offset measurement, and/or an anterior-posterior position measurement.

11. A system for performing a hip replacement surgery, comprising:

a pelvis sensor unit configured to be coupled to a patient'"'"'s pelvis;

a reference sensor unit; and

a computer-readable storage medium having instructions executable by at least one processing device that, when executed, cause the processing device to

(a) calculate a positional relationship between the pelvis sensor unit and the patient'"'"'s pelvis based on a registration measurement between the pelvis sensor unit and the reference sensor unit, wherein the registration measurement includes at least three reference points;

(b) track an orientation of an acetabular insertion tool during an implantation procedure based on a positional relationship between the pelvis sensor unit and the reference sensor unit, wherein the reference sensor unit is coupled to the acetabular insertion tool during the implantation procedure,

(c) calculate implant parameters based on the orientation of the acetabular insertion tool, and

(d) provide a real-time display of the implant parameters during the implantation procedure.

12. The system of claim 11, wherein the computer-readable storage medium further includes instructions executable by at least one processing device that, when executed, cause the processing device to

(e) calculate an initial leg position based on a initial positional relationship measurement between the pelvis sensor unit and the reference sensor unit, wherein the reference sensor unit is coupled to the patient'"'"'s femur,

(f) measure a post-reduction leg position based on a post-reduction positional relationship between the pelvis sensor unit and the reference sensor unit,

(g) calculate a change in leg position between the initial leg position and the post-reduction leg position, and

(h) provide a display of the change in leg position.

13. The system of claim 12, wherein the initial leg position is calculated based, in part, on an initial leg length measurement.

14. The system of claim 12, wherein the initial leg position is calculated based, in part, on an initial leg orientation measurement.

15. The system of claim 12, wherein the initial leg position is calculated based, in part, on a positional relationship between the pelvis sensor unit and the reference sensor unit when the reference sensor unit is coupled to the patient'"'"'s femur.

16. The system of claim 12, wherein the computer-readable storage medium further includes instructions executable by at least one processing device that, when executed, cause the processing device to calculate a center-of-rotation of the patient'"'"'s femur.

17. The system of claim 16, wherein the center-of-rotation is calculated based on an acetabulum surface measurement between the pelvis sensor unit and the reference sensor unit, wherein the reference sensor unit is brought in contact with three or more points along the acetabulum surface.

18. The system of claim 16, wherein the center-of-rotation is calculated based on a femur articulation measurement between the pelvis sensor unit and the reference sensor unit, wherein the reference sensor unit is coupled to the patient'"'"'s femur during the femur articulation measurement.

19. The system of claim 16, wherein the change in leg position is calculated based on a femur articulation measurement between the pelvis sensor unit and the reference sensor unit, wherein the reference sensor unit is coupled to the patient'"'"'s femur during the femur articulation measurement.

20. The system of claim 12, wherein the change in leg position includes a leg length measurement, an offset measurement, and/or an anterior-posterior position measurement.

21. The system of claim 12, wherein the computer-readable storage medium further includes instructions executable by at least one processing device that, when executed, cause the processing device to

track a femur orientation during a leg positioning procedure based on a positional relationship between the pelvis sensor unit and the reference sensor unit when the reference sensor unit is coupled to the patient'"'"'s femur, and

provide a real-time display conveying the femur orientation during the leg positioning procedure.

22. A system for performing a hip replacement surgery, comprising:

a pelvis sensor unit configured to be coupled to a patient'"'"'s pelvis;

a reference sensor unit; and

a computer-readable storage medium having instructions executable by at least one processing device that, when executed, cause the processing device to

(a) calculate a positional relationship between the pelvis sensor unit and the patient'"'"'s pelvis based on a registration measurement between the pelvis sensor unit and a reference sensor unit, wherein the registration measurement includes at least three reference points,

(b) calculate an initial leg position based on a initial positional relationship measurement between the pelvis sensor unit and the reference sensor unit when the reference sensor unit is coupled to the patient'"'"'s femur,

(c) track a femur orientation during a leg positioning procedure based on a positional relationship between the pelvis sensor unit and the reference sensor unit,

(d) provide a real-time display conveying the femur orientation during the leg positioning procedure,

(e) measure a post-reduction leg position based on a positional relationship between the pelvis sensor unit and the reference sensor unit,

(f) calculate a change in leg position between the initial leg position and the post-reduction leg position, and

(g) provide a display of the change in leg position.

23. The system of claim 22, wherein the computer-readable storage medium further includes instructions executable by at least one processing device that, when executed, cause the processing device to calculate a center-of-rotation of the patient'"'"'s femur.

24. The system of claim 23, wherein the center-of-rotation is calculated based on an acetabulum surface measurement between the pelvis sensor unit and the reference sensor unit, wherein the reference sensor unit is brought in contact with three or more points along the acetabulum surface.

25. The system of claim 23, wherein the center-of-rotation is calculated based on a femur articulation measurement between the pelvis sensor unit and the reference sensor unit, wherein the reference sensor unit is coupled to the patient'"'"'s femur during the femur articulation measurement.

26. The system of claim 23, wherein the change in leg position is calculated based on a femur articulation measurement between the pelvis sensor unit and the reference sensor unit, wherein the reference sensor unit is coupled to the patient'"'"'s femur during the femur articulation measurement.

27. The system of claim 22, wherein the change in leg position includes a leg length measurement, an offset measurement, and/or an anterior-posterior position measurement.

28. A computer-readable storage medium, for performing hip replacement surgery, having instructions executable by at least one processing device that, when executed, cause the processing device to

(a) calculate a positional relationship between a pelvis sensor unit and a patient'"'"'s pelvis, when the pelvis sensor unit is coupled to a first point on a patient'"'"'s pelvis;

(b) calculate an initial leg position based on a positional relationship between the pelvis sensor unit and a sensor unit coupled to the patient'"'"'s femur;

(c) track an orientation of an acetabular insertion tool during an implantation procedure based on a positional relationship between the pelvis sensor unit and a sensor unit coupled to the acetabular insertion tool;

(d) calculate implant parameters based on the orientation of the acetabular insertion tool;

(e) provide a real-time display conveying the implant parameters during the implantation procedure;

(f) track the patient'"'"'s femur during a leg positioning procedure based on a positional relationship between the pelvis sensor unit and the sensor unit coupled to the patient'"'"'s femur;

(g) measure a post-reduction leg position based on the positional relationship between the pelvis sensor unit and the sensor unit coupled to the patient'"'"'s femur;

(h) calculate a change in leg position between the initial leg position and the post-reduction leg position; and

(i) provide a display of the change in leg position.

29. The computer-readable storage medium of claim 28, wherein the implant parameters include angles of abduction and anteversion.

30. The computer-readable storage medium of claim 28, further comprising instructions executable by at least one processing device that, when executed, cause the processing device to

(j) track an orientation of the patient'"'"'s femur during the leg positioning procedure based on a positional relationship between the pelvis sensor unit and the sensor unit coupled to the patient'"'"'s femur;

and

(k) provide a real-time display conveying the orientation of the patient'"'"'s femur during the leg positioning procedure.