Process and device for the preoperative determination of the positioning data of endoprosthetic parts

• US 6,385,475 B1
• Filed: 09/02/1999
• Issued: 05/07/2002
• Est. Priority Date: 03/11/1997
• Status: Expired due to Term

• Current Assignee: Aesculap AG (Lonza Group AG)
• Original Assignee: Aesculap AG (Lonza Group AG)
• Inventors: Cinquin, Philippe, Leitner, Francois, Lavallee, Stephane, Minfelde, Richard, Picard, Frederic, Saragaglia, Dominique, Schulz, Hans-Joachim
• Primary Examiner(s): Lateef, Marvin M.
• Assistant Examiner(s): SHAW, SHAWNA JEANNINE
• Application Number:
  US09/389,315
• Time in Patent Office: 978 Days
• Field of Search: 600/407, 600/595, 600/473, 600/425, 600/426, 606/130, 606/79, 606/82, 606/87, 606/88, 606/99, 606/102, 348/77, 128/920
• US Class Current: 600/407
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• 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 2017/00115 with audible or visual output
• CPC Class Codes: A61B 2017/00725 Calibration or performance testing
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• 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 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/3929 Active markers
• CPC Class Codes: A61B 2090/3945 Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 2090/3979 infrared
• 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 5/107 Measuring physical dimensions, e.g. size of the entire body or parts thereof
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 5/6878 Bone
• CPC Class Codes: A61B 90/06 : Measuring instruments not otherwise provided for
• CPC Class Codes: A61B 90/10 : for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 2/38 : for elbows or knees
• CPC Class Codes: A61F 2/4657 : Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/4632 : using computer-controlled surgery, e.g. robotic surgery
• CPC Class Codes: A61F 2002/4633 : for selection of endoprosthetic joints or for pre-operative planning
• CPC Class Codes: G01S 15/872 : Combination of several systems for attitude determination using inertial means G01C9/00, control of attitude G05D1/49
• CPC Class Codes: G01S 17/87 : Combinations of systems using electromagnetic waves other than radio waves
• CPC Class Codes: G01S 5/163 : Determination of attitude using inertial means G01C9/00; control of attitude G05D1/49
• CPC Class Codes: G01S 5/186 : Determination of attitude using inertial means G01C9/00; control of attitude G05D1/49
• CPC Class Codes: Y10S 128/92 : Computer assisted medical diagnostics
• CPC Class Codes: Y10S 623/901 : Method of manufacturing prosthetic device

Abstract

In order to be able to ascertain the position of the bone in the body without complicated procedures in a process for the preoperative determination of the positioning data of endoprosthetic parts of a central joint relative to the bones forming the central joint, a respective outer articular point is determined by way of movement of the bones about a respective outer joint which is located at the end of the two bones facing away from the central joint. An articular point is determined for each of the two bones in the area of the central joint, and a direction characteristic for each of these bones is determined by way of a straight-line connection of the two articular points obtained in this manner for the two bones. The orientation of the endoprosthetic parts relative to this characteristic direction is then determined. Apparatus for carrying out the process is also provided.

Claims

1. A device for the preoperative determination of positioning data of endoprosthetic parts of a central joint relative to two bones forming the central joint with marking elements securable to the bones, comprising:

a measuring device for determining the position of the marking elements in a space;

a data processing system adapted to receive signals corresponding to positioning data of the marking elements from the measuring device;

at least one marking element being provided for each of the two bones forming the central joint as well as for each of the two bones adjoining these and connected to them via an outer joint;

said data processing system being responsive to the signals during movement of the bones about the two outer joints to determine the points of greatest invariance as outer articular points; and

the data processing system determining a characteristic direction for each of the bones from the positioning of the outer articular points and the position of an inner articular point of the two bones forming the central joint.

2. A device as defined in claim 1, wherein the data processing system additionally determines the point of greatest invariance as the articular point of the central joint from the signals during the movement of the bones about the central joint.

3. A device as defined in claim 1, wherein a scanning instrument is associated with the data processing system for supplying signals corresponding to its positioning to the data processing system.

4. A device as defined in claim 3, wherein the data processing system generates a set of data describing the course of the joint surface from a plurality of signals generated by application of the scanning instrument to a joint surface of the bone adjoining the central joint.

5. A device as defined in claim 1, wherein the data processing system determines sawing planes for the orientation of the endoprosthetic parts, said sawing planes serving as contact surfaces for the endoprosthetic parts and taking up a predetermined orientation relative to the characteristic direction.

6. A device as defined in claim 5, wherein the sawing planes are at right angles to the characteristic direction.

7. A device as defined in claim 5, wherein the sawing planes are arranged at a specific distance from the articular point at the central joint determined for the respective bone.

8. A device as defined in claim 1, further comprising a drive device for moving the bones relative to the outer joints and, where applicable, for the movement relative to the central joint.

9. A device as defined in claim 1, wherein the marking elements and the measuring device comprise one of radiation emitters and reflecting surfaces, and a radiation receiver, respectively.

10. A device as defined in claim 1, further comprising a robot, said robot aligning at least one of a tool jig and a tool relative to the characteristic direction.

11. A device as defined in claim 1, wherein a marking element with an orientation determined by the measuring device is associated with at least one of a tool and a tool jig, so that signals corresponding to this orientation are transferred to the data processing system.

12. A device as defined in claim 11, wherein the data processing system determines the orientation of the tool or the tcol jig relative to the characteristic direction.

13. A device as defined in claim 11, wherein:

the data processing system generates difference signals for observing the deviation in the orientation of the sawing jig in relation to the characteristic direction,

said signals being minimal with a correct orientation, and

said data processing system indicating the difference signals optically or acoustically.

14. A device as defined in claim 13, wherein the difference signals are indicated by way of lines inclined relative to one another, said lines extending parallel to one another with a correct orientation.

15. A device as defined in claim 14, wherein the lines intersect.

16. A device as defined in claim 13, wherein the difference signals are indicated by means of the distance between two parallel lines, the distance between said lines disappearing with a correct orientation.

17. A device as defined in claim 13, wherein the difference signals are represented by tones with at least one of a varying loudness and frequency.

18. A device as defined in claim 13, wherein two separate difference signals are generated for angular deviations in planes extending at right angles to one another.

19. A process for the preoperative determination of positioning data of endoprosthetic parts of a central joint relative to a first set of two bones forming the central joint, comprising the steps of:

moving, relative to one another, a second set of two bones coming together at a first outer joint and having a first bone from the first set of bones, located at an end of the first bone facing away from the central joint, to determine a first articular point for said first bone;

determining a second articular point in the area of the central joint for said first bone;

determining a first characteristic direction for said first bone by way of a straight-line connection of the first and second articular points; and

determining an orientation of the endoprosthetic parts relative to the first characteristic direction.

20. A method in accordance with claim 19, comprising the further steps of:

moving, relative to one another, a third set of two bones coming together at a second outer joint and having a second bone from the first set of bones, located at an end of the second bone facing away from the central joint, to determine a third articular point for said second bone;

determining a fourth articular point in the area of the central joint for said second bone;

determining a second characteristic direction for said second bone by way of a straight-line connection of the third and fourth articular points; and

determining the orientation of the endoprosthetic parts relative to the first and second characteristic directions.

21. A method in accordance with claim 20, comprising the further steps of:

securely connecting the second set of two bones and the third set of two bones to marking elements for determining the first and third articular points; and

determining the respective positions of the marking elements by a measuring device generating signals corresponding to the respective positions and supplying the signals to a data processing system.

22. A method in accordance with claim 19, wherein said second articular point is determined by way of movement, relative to one another, of the first set of two bones forming the central joint.

23. A method in accordance with claim 19, wherein the articular points are established by way of palpatation of the joint surfaces.

24. A method in accordance with claim 19, wherein the articular points are determined with a set of data reproducing the contour of the joint surface at the central joint.

25. A method in accordance with claim 24, wherein the set of data of the contour of the joint surface is determined by scanning the joint surface and storing a plurality of positioning data of points on the joint surface.

26. A method in accordance with claim 19, wherein for the orientation of the endoprosthetic parts, sawing planes serving as contact surfaces for the endoprosthetic parts are determined, said planes taking up predetermined orientation relative to the characteristic direction.

27. A method in accordance with claim 26, wherein the sawing planes are at right angles to the characteristic direction.

28. A method in accordance with claim 26, wherein the sawing planes are arranged at a specific distance from the second articular point.

29. A method in accordance with claim 19, wherein movement of the bones for determining the articular points is carried out by means of a drive device.

30. A method in accordance with claim 19, comprising the further steps of:

securely connecting the second set of two bones to marking elements for determining the first articular point; and

determining the respective positions of the marking elements by a measuring device generating signals corresponding to the respective positions and supplying the signals to a data processing system.

31. A method in accordance with claim 30, wherein:

the marking elements comprise one of radiation emitters and reflecting surfaces; and

the measuring device comprises several radiation receivers.

32. A method in accordance with claim 30, wherein the point of greatest invariance during the movement of the two bones forming each joint is determined as the articular point for each joint.

33. A method in accordance with claim 19, wherein a sawing jig is aligned relative to the first characteristic direction of the bone for marking a sawing plane.

34. A method in accordance with claim 33, wherein the alignment is carried out by means of a robot.

35. A method in accordance with claim 33, wherein the alignment is carried out manually and the orientation of the sawing jig relative to the first characteristic direction is thereby continuously determined as a result of measurement of the orientation of said jig.

36. A method in accordance with claim 35, wherein:

difference signals are generated for observing deviation of the orientation of the sawing jig in relation to the first characteristic direction; and

said difference signals are minimal with a correct orientation and are indicated optically or acoustically.

37. A method in accordance with claim 36, wherein the difference signals are indicated by means of lines inclined relative to one another, said lines extending parallel to one another with a correct orientation.

38. A method in accordance with claim 37, wherein the lines intersect.

39. A method in accordance with claim 36, wherein the difference signals are indicated by means of the distance between two parallel lines, the distance between said lines disappearing with a correct orientation.

40. A method in accordance with claim 36, wherein the difference signals are represented by tones having at least one of varying loudness and varying frequency.

41. A method in accordance with claim 36, wherein two separate difference signals are generated for angular deviations in planes extending at right angles to one another.

42. A method in accordance with claim 19, wherein the positioning data determined on the basis of the first characteristic direction is used to control a machining robot.

43. A device for the preoperative determination of positioning data of endoprosthetic parts of a central joint relative to a first set of two bones forming the central joint, comprising:

at least one marking element securable to each bone from a second set of two bones forming a first outer joint, said second set of two bones having a first bone from the first set of two bones;

a measuring device for determining the position of the marking elements in space;

a data processing system adapted to receive signals corresponding to positioning data of the marking elements from the measuring device; and

said data processing system is responsive to the signals during movement of the second set of bones about the first outer joint to determine the point of greatest invariance at the first outer joint as a first articular point;

wherein;

a second articular point is determined in the area of the central joint for said first bone; and

a first characteristic direction is determined for the first bone from the position of the first articular point and the second articular point.

44. A device in accordance with claim 43, further comprising:

at least one marking element securable to each bone from a third set of two bones forming a second outer joint, said third set of two bones having a second bone from the first set of two bones; and

said data processing system is responsive to the signals during the movement of the third set of bones about the second outer joint to determine the point of greatest invariance at the second outer joint as a third articular point;

wherein;

a fourth articular point is determined in the area of the central joint for said second bone; and

a second characteristic direction is determined for the second bone from the position of the third articular point and the fourth articular point.

45. A device in accordance with claim 43, wherein a scanning instrument is associated with the data processing system for supplying signals corresponding to its positioning to the data processing system.

46. A device in accordance with claim 45, wherein the data processing system generates a set of data describing the course of the joint surface from a plurality of signals generated by application of the scanning instrument to a joint surface of at least one of the bones adjoining the central joint.

47. A device in accordance with claim 43, wherein the data processing system determines sawing planes for the orientation of the endoprosthetic parts, said sawing planes serving as contact surfaces for endoprosthetic parts and taking up a predetermined orientation relative to the characteristic direction.

48. A device in accordance with claim 47, wherein the sawing planes are at right angles to the characteristic direction.

49. A device in accordance with claim 47, wherein the sawing planes are arranged at a specific distance from the second articular point.

50. A device in accordance with claim 43, further comprising a drive device for moving bones relative to respective joints.

51. A device in accordance with claim 43, wherein:

the marking elements comprise one of radiation emitters and reflecting surfaces; and

the measuring device comprises several radiation receivers.

52. A device in accordance with claim 43, further comprising a robot, said robot aligning at least one of a tool jig and a tool relative to the characteristic direction.

53. A device in accordance with claim 43, wherein a marking element with an orientation determined by the measuring device is associated with at least one of a tool and a tool jig, so that signals corresponding to the orientation are transferred to the data processing system.

54. A device in accordance with claim 53, wherein the data processing system determines the orientation of the tool or the tool jig relative to the characteristic direction.

55. A device in accordance with claim 53, wherein:

the data processing system generates difference signals for observing deviation in the orientation of the sawing jig in relation to the characteristic direction;

the data processing system indicating the difference signals optically or acoustically; and

said signals are minimal with a correct orientation.

56. A device in accordance with claim 55, wherein the difference signals are indicated by way of lines inclined relative to one another, said lines extending parallel to one another with a correct orientation.

57. A device in accordance with claim 56, wherein said lines intersect.

58. A device in accordance with claim 55, wherein the difference signals are indicated by means of the distance between two parallel lines, the distance between said lines disappearing with a correct orientation.

59. A device in accordance with claim 55, wherein the difference signals are represented by tones having at least one of varying loudness and varying frequency.

60. A device in accordance with claim 55, wherein two separate difference signals are generated for angular deviations in planes extending at right angles to one another.