SYSTEM AND METHOD FOR ASSESSING, MEASURING, AND CORRECTING AN ANTERIOR-POSTERIOR BONE CUT

• US 20140276860A1
• Filed: 09/13/2013
• Published: 09/18/2014
• Est. Priority Date: 03/18/2013
• Status: Active Grant

• Current Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Original Assignee: OrthoSensor, Inc (Stryker Corporation)
• Inventors: Stein, Marc, Roche, Martin
• Granted Patent: US 9,566,020 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 17/1764 for the knee
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/104 Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• 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 5/103 Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes A61B5/08 takes precedence; measuring aids for tailors A41H1/00; measuring instruments specially adapted for dentistry A61C19/04
• CPC Class Codes: A61B 5/1036 Measuring load distribution, e.g. podologic studies
• CPC Class Codes: A61B 5/1072 measuring distances on the body, e.g. measuring length, height or thickness A61B5/1076 takes precedence
• CPC Class Codes: A61B 5/1121 Determining geometric values, e.g. centre of rotation or angular range of movement
• CPC Class Codes: A61B 5/45 For evaluating or diagnosing the musculoskeletal system or teeth A61B5/1036, A61B5/1074, A61B7/006 take precedence
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 5/4571 Evaluating the hip
• CPC Class Codes: A61B 5/4585 Evaluating the knee
• CPC Class Codes: A61B 5/4851 Prosthesis assessment or monitoring
• CPC Class Codes: A61B 5/4887 Locating particular structures in or on the body
• CPC Class Codes: A61B 5/686 : Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61F 2/38 : for elbows or knees
• CPC Class Codes: A61F 2/3836 : Special connection between upper and lower leg, e.g. constrained
• CPC Class Codes: A61F 2/461 : of knees
• CPC Class Codes: A61F 2/4657 : Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2/4684 : Trial or dummy prostheses
• CPC Class Codes: A61F 2002/4658 : for measuring dimensions, e.g. length
• CPC Class Codes: A61F 2002/4668 : for measuring angles
• CPC Class Codes: G06F 3/0481 : based on specific properties of the displayed interaction object or a metaphor-based environment, e.g. interaction with desktop elements like windows or icons, or assisted by a cursor's changing behaviour or appearance

Abstract

A system and method is disclosed herein for measuring anterior-posterior slope of a bone to set a cutting jig coupled to the muscular-skeletal system. The system comprises a sensored module that can be placed within a prosthetic component to measure anterior-posterior slope. The system further includes a remote system for receiving, processing, and displaying quantitative measurements from the sensors. A first bone and a second bone are placed in extension. A sensored module is referenced to a bone landmark of the first bone. The sensored module includes a three-axis accelerometer that is configured to measure position, tilt, and rotation. A bone cutting jig is coupled to the first bone. The sensored insert is coupled to the bone cutting jig. The accelerometer in the sensored insert is used to measure the anterior-posterior slope. The bone cutting jig is then adjusted to a predetermined anterior-posterior slope as measured by the sensored insert.

Claims

1. A method of measuring anterior-posterior slope or tilt in support of a bone cut comprising the steps of:

placing a first bone and a second bone in approximately extension;

coupling a sensored insert to a bone landmark of the first bone;

referencing a three-axis accelerometer of a sensored insert to the bone landmark when the bone is in approximately extension and where the three-axis accelerometer measures position, tilt, and rotation;

coupling a first bone cutting jig to the first bone;

coupling the sensored insert to the first bone cutting jig; and

measuring the anterior-posterior slope of a bone cut of the first bone with the three-axis accelerometer.

2. The method of claim 1 further including the steps of:

zeroing the three-axis accelerometer of the sensored insert to a first reference plane; and

zeroing the three-axis accelerometer of the sensored insert to a second reference plane where the second reference plane is perpendicular to the first reference plane.

3. The method of claim 2 where the step of zeroing the three-axis accelerometer of the sensored insert to a first reference plane comprises the steps of:

placing the sensored insert on the first reference plane; and

measuring the first reference plane;

reversing a position of the sensored insert on the first reference plane 180 degrees;

measuring the first reference plane;

averaging measurements of the first reference plane where the three-axis accelerometer is referenced to gravity; and

zeroing the three-axis accelerometer to the averaged measurements of the first reference plane where the first reference plane corresponds to zero gravity.

4. The method of claim 1 further including the steps of:

placing a bone cutting jig shim on the sensored insert; and

inserting a tab of the bone cutting jig shim into the first bone cutting jig to couple and align the sensored insert to the first cutting jig.

5. The method of claim 1 further including the steps of:

monitoring the position of the first and second bones on a remote system;

monitoring the anterior-posterior slope of the bone cut of the first bone cutting jig on the remote system; and

adjusting the first bone cutting jig to cut an anterior-posterior slope or tilt to a first predetermined slope.

6. The method of claim 5 further including the steps of:

coupling a second bone cutting jig to the second bone;

coupling the sensored insert to the second bone cutting jig; and

measuring the anterior-posterior slope of a bone cut of the second bone with the three-axis accelerometer.

7. The method of claim 6 further including the steps of:

monitoring the anterior-posterior slope of the bone cut of the second bone cutting jig on the remote system; and

adjusting the second bone cutting jig to cut an anterior-posterior slope or tilt to a second predetermined slope.

8. The method of claim 7 further including a step of adjusting the bone cut of the second bone cutting jig to cut an anterior-posterior slope of the second bone parallel to the bone cut of the first cutting jig using data from the three-axis accelerometer.

9. A method of measuring anterior-posterior slope or tilt in support of a bone cut comprising the steps of:

placing a first bone and a second bone in approximately extension;

coupling a sensored insert to a bone landmark of the first bone;

referencing a three-axis accelerometer of a sensored insert to the bone landmark when the bone is in approximately extension and where the three-axis accelerometer measures position, tilt, and rotation;

coupling a first bone cutting jig to the first bone;

coupling a second bone cutting jig to the second bone;

transmitting data from the three-axis accelerometer of the sensored insert related to the anterior-posterior slope of a bone cut of either the first bone cutting jig or the second bone cutting jig;

displaying the position of the first and second on the remote system; and

displaying the anterior-posterior slope of the bone cut of either the first or second bone cutting jigs.

10. The method of claim 9 further including the steps of:

zeroing the three-axis accelerometer of the sensored insert to a first reference plane; and

zeroing the three-axis accelerometer of the sensored insert to a second reference plane where the second reference plane is perpendicular to the first reference plane.

11. The method of claim 10 where the step of zeroing the three-axis accelerometer of the sensored insert to a first reference plane comprises the steps of:

placing the placing the sensored insert on the first reference plane; and

measuring the first reference plane;

reversing a position of the sensored insert on the first reference plane 180 degrees;

measuring the first reference plane;

averaging measurements of the first reference plane where the three-axis accelerometer is referenced to gravity; and

zeroing the three-axis accelerometer to the averaged measurements of the first reference plane where the first reference plane corresponds to zero gravity.

12. The method of claim 9 further including the steps of:

placing a bone cutting jig shim on the sensored insert; and

inserting a tab of the bone cutting jig shim into the first or second bone cutting jigs to couple and align the sensored insert to the bone cut.

13. The method of claim 9 further including the steps of:

coupling the sensored insert to the first bone cutting jig;

measuring the anterior-posterior slope of a bone cut of the first bone cutting jig with the three-axis accelerometer; and

adjusting the anterior-posterior slope of the bone cut of the first bone cutting to a first predetermined slope.

14. The method of claim 13 further including the steps of:

coupling the sensored insert to the second bone cutting jig;

measuring the anterior-posterior slope of a bone cut of the second bone cutting jig with the three-axis accelerometer; and

adjusting the anterior-posterior slope of the bone cut of the second bone cutting to a first predetermined slope.

15. The method of claim 14 further including a step of adjusting the bone cut of the second bone cutting jig to cut an anterior-posterior slope of the second bone parallel to the bone cut of the first cutting jig using data from the three-axis accelerometer.

16. A method of measuring anterior-posterior slope or tilt in support of a bone cut comprising the steps of:

placing a femur and a tibia in approximately extension;

coupling a sensored insert to a tibial crest of the tibia;

referencing a three-axis accelerometer of a sensored insert to the tibial crest when the bone is in approximately extension and where the three-axis accelerometer measures position, tilt, and rotation;

coupling a first bone cutting jig to a tibia;

coupling the sensored insert to the first bone cutting jig; and

measuring the anterior-posterior slope of a tibial bone cut of the first bone with the three-axis accelerometer.

17. The method of claim 16 further including the steps of:

zeroing the three-axis accelerometer of the sensored insert to a first reference plane; and

zeroing the three-axis accelerometer of the sensored insert to a second reference plane where the second reference plane is perpendicular to the first reference plane.

18. The method of claim 17 where the step of zeroing the three-axis accelerometer of the sensored insert to a first reference plane comprises the steps of:

placing the placing the sensored insert on the first reference plane; and

measuring the first reference plane;

reversing a position of the sensored insert on the first reference plane 180 degrees;

measuring the first reference plane;

averaging measurements of the first reference plane where the three-axis accelerometer is referenced to gravity; and

zeroing the three-axis accelerometer to the averaged measurements of the first reference plane where the first reference plane corresponds to zero gravity.

19. The method of claim 16 further including the steps of:

placing a bone cutting jig shim on the sensored insert; and

inserting a tab of the bone cutting jig shim into the first bone cutting jig to couple and align the sensored insert to the first cutting jig.

20. The method of claim 16 further including the steps of:

monitoring the position of the first and second bones on a remote system;

monitoring the anterior-posterior slope of the tibial bone cut of the first bone cutting jig on the remote system; and

adjusting the first bone cutting jig to cut an anterior-posterior slope or tilt to a first predetermined slope.

coupling a second bone cutting jig to the femur;

coupling the sensored insert to the second bone cutting jig; and

measuring the anterior-posterior slope of a femoral bone cut of the second bone cutting jig with the three-axis accelerometer.

monitoring the anterior-posterior slope of the femoral bone cut of the second bone cutting jig on the remote system; and

adjusting the second bone cutting jig to cut an anterior-posterior slope or tilt to a second predetermined slope.