System and method for virtual representation of bones or a bone joint

• US 6,801,801 B1
• Filed: 05/03/2000
• Issued: 10/05/2004
• Est. Priority Date: 11/05/1997
• Status: Expired due to Term

• Current Assignee: AO Technology AG (Johnson & Johnson)
• Original Assignee: Synthes USA LLC (Johnson & Johnson)
• Inventors: Sati, Marwan
• Primary Examiner(s): Lateef, Marvin M.
• Assistant Examiner(s): JUNG, WILLIAM C
• Application Number:
  US09/562,951
• Time in Patent Office: 1,616 Days
• Field of Search: 600/407, 600/429, 378/20, 378/205, 606/130, 606/97
• US Class Current: 600/429
• CPC Class Codes: A61B 17/1714 for applying tendons or ligaments implements for applying tendons or ligaments A61F2/0805
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• 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 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 5/1077 Measuring of profiles
• CPC Class Codes: A61B 5/4504 Bones A61B5/4547 takes precedence
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 5/4533 Ligaments
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61F 2/0805 Implements for inserting tendons or ligaments

Abstract

A system for planning a surgical operation by using virtual representation of bones and/or a bone joint is disclosed. The system includes at least two reference frames each of which having first and second ends. The first end of each reference frame is configured to be affixed to the bones. The system also includes a plurality of first electromagnetic or acoustic wave emitting devices attached to the second end of each of the reference frames. In addition, the system includes a moveable pointer having first and second ends, wherein the first end is a pointing tip configured to be positioned at a plurality of desired locations of the bones or the bone joint and a plurality of second electromagnetic or acoustic wave emitting devices attached to the second end of the moveable pointer. Furthermore, the system includes a three-dimensional localizer device. This device includes at least two sensors and a digitizing device configured to determine three-dimensional coordinates of the first ends of the reference frames and the pointing tip based on positions and orientations of the first and second electromagnetic or acoustic wave emitting devices attached to the reference frames and the moveable pointer. Preferably, at least three first and at least three second electromagnetic or acoustic wave emitting devices art used. The system also includes an image processing unit configured to generate a virtual three-dimensional surface image based on the three-dimensional coordinates of the first ends of the reference frames and the pointing tip. The virtual three-dimensional surface image includes the plurality of desired locations of the bones or the bone joint that were pointed to by the pointing tip.

Claims

1. A system for planning a surgical operation by using virtual representation of bones and/or a bone joint, the system comprising:

at least two reference frames each of which having first and second ends, wherein the first end of each reference frame is configured to be affixed to bones;

a plurality of first electromagnetic or acoustic wave emitting devices attached to the second end of each of the reference frames;

a moveable pointer having first and second ends, wherein the first end is a pointing tip configured to directly contact bone, bone tissue or a bone joint at a plurality of desired locations;

a plurality of second electromagnetic or acoustic wave emitting devices attached to the second end of the moveable pointer;

a switching device configured to activate the second electromagnetic or acoustic wave emitting devices; and

a three-dimensional localizer device comprising;

at least two sensors; and

a digitizing device configured to determine three-dimensional coordinates of the first ends of the reference frames and the pointing tip based on positions and orientations of the first and second at least three electromagnetic or acoustic wave emitting devices attached to the reference frames and the moveable pointer; and

an image processing unit configured to generate a virtual three-dimensional surface image based on the three-dimensional coordinates of the first ends of the reference frames and the pointing tip, wherein the virtual three-dimensional surface image includes the plurality of desired locations of the bones or the bone joint that were pointed by the pointing tip.

2. The system according to claim 1 further comprising:

a monitor configured to display the virtual three-dimensional surface generated by the image processing unit.

3. The system according to claim 1 wherein the image processing unit is further configured to generate virtual three-dimensional surface images from a plurality of viewing angles.

4. The system according to claim 1 wherein the image processing unit is further configured to generate stationary or moving virtual three-dimensional surface images.

5. The system according to claim 1 wherein the image processing unit is further configured to generate a virtual three-dimensional representation of a connection between ligament attachment points determined by using the pointing tip.

6. The system according to claim 1 further comprising an arthroscope coupled to the image processing unit, wherein the image processing unit is further configured to generate an image at the display representing the objects observed by the arthroscope.

7. The system according to claim 1 wherein the three-dimensional localizer device localizes the position and orientation of said pointers and said reference frames by means of electromagnetic induction.

8. The system according to claim 1 wherein at least three first and at least three second electromagnetic or acoustic wave emitting devices are present.

9. The system according to claim 1 wherein the first and second electromagnetic or acoustic wave emitting devices are optical light sources.

10. The system according to claim 1 wherein the first and second electromagnetic or acoustic wave emitting devices are light emitting diodes.

11. The system according to claim 1 wherein the first and second electromagnetic or acoustic wave emitting devices are infrared light emitting diodes.

12. The system according to claim 1 wherein the first and second electromagnetic or acoustic wave emitting devices are optical reflectors.

13. The system according to claim 1 wherein the first and second electromagnetic or acoustic wave emitting devices are acoustical transmitters.

14. The system according to claim 1 wherein the first and second electromagnetic or acoustic wave emitting devices are microphones.

15. The system according to claim 1 wherein the virtual three-dimensional surface image comprise a ligament, drill holes and previously digitized surfaces of a femur or a tibia of a knee joint.

16. The system according to claim 1 wherein the position and orientation of the pointing tip in relation to the reference frames are determined by means of mechanic link devices.

17. A method for planning a surgical operation by using virtual representation of bones or a bone joint, the method comprising:

receiving signals from a plurality of transmitters attached to a first end of each of at least two reference frames, wherein a second end of one of the at least two frames is affixed to one bone and a second end of another one of the at least two frames is affixed to a second bone;

positioning a pointing tip of a moveable pointer directly on a portion of a bone, bone tissue or a bone joint at a plurality of desired positions;

causing a plurality of electromagnetic or acoustic wave emitting devices attached on the moveable pointer to emit signals each time the pointing tip is positioned at the plurality of desired positions;

digitizing the received signals;

calculating locations of the second end of each of the at least two reference frames and the pointing tip based on the digitized signals; and

generating a virtual three-dimensional rendering of a joint formed by the bones or bone joint based on the calculated locations.

18. The method according to claim 17 further comprising displaying the images at any desired angle of observation and at any scale.

19. The method according to claim 17 further comprising generating the desirable angle of observation a medio-lateral view or an anterior-posterior view.

20. The method according to claim 17 wherein the bones are different and further comprising generating a three-dimensional representation of a connection between ligament attachment points determined by using the pointing tip.

21. The method according to claim 20 wherein one bone is a femur, the other bone is a tibia, and the femur and tibia are connected by a knee, and the method further comprises:

generating a three-dimensional simulation of the ligament during flexion-extension of the knee; and

generating optimal locations of the ligament attachment points and of drill holes, to thereby allow a surgeon to plan a knee reconstruction procedure.

22. The method according to claim 20 further comprising:

generating at least one image of relevant elements which includes a ligament and drill holes using the pointing tip at two points; and

computing a cylinder having an axis through these two points and digitized surfaces of the femur and tibia.

23. A system for preparing a three-dimensional image of at least a portion of at least one bone, the system comprising:

a pointer comprising;

a first end configured to directly engage bone, bone tissue or a bone joint;

a first plurality of electromagnetic wave emitter (EWE) spaced apart from the first end of the pointer, the first plurality of EWE and the first end of the pointer having a known spatial relationship;

a first fiducial including a second plurality of EWE; and

a localizer device, comprising;

at least two sensors configured to detect electromagnetic waves emitted by the first and second plurality of EWE;

a first processor at least configured to;

determined 3D coordinates of the first and second plurality of EWE based upon electromagnetic waves emitted by the first and second plurality of EWE and detected by the at least two sensors;

determined 3D coordinates of a location of a surface of a bone contacted with the first end of the pointer based upon (1) 3D coordinates of the first plurality of EWE determined when the first end of the pointer is in contact with the location of the surface of the bone (2) the known spatial relationship between the first end of the pointer and the first plurality of EWE and (3) 3D coordinates of the second plurality of EWE based upon electromagnetic waves emitted by the second plurality of EWE and detected by the at least two sesors; and

a second processor at least configured to generate, based upon 3D coordinates of each of a plurality of respective locations of a surface of a bone contact by the first end of the pointer, a 3D image of at least a portion of the at least one bone.

24. The system of claim 23, further comprising:

wherein the a first fiducial is configured to be attached to a bone; and

at least when the first fiducial is attached to a bone;

the first processor is configured to determine a spatial relationship between (1) a location of a surface of a bone contacted with the first end of the pointer to determine 3D coordinates of the location and (2) the second plurality of EWE.

25. The system of claim 24, wherein the first processor is configured to, upon movement of a bone having the first fiducial attached thereto from a first location to a different, new location:

determine new 3D coordinates of the second plurality of EWE based upon electromagnetic waves emitted by the second plurality of EWE and detected by the at least two sensors; and

determine new 3D coordinates of a location of a surface of the bone based upon a spatial relationship between the location of the surface of the bone and the new 3D coordinates of the second plurality of EWE.

26. The system of claim 24, further comprising:

a second fiducial configured to be attached to a second bone, the second fiducial comprising a third plurality of EWE;

wherein, at least when the second fiducial is attached to a second bone;

the at least two sensors of the localizing device are further configured to detect electromagnetic waves emitted by the third plurality of EWE of the second fiducial;

the first processor is configured to determined 3D coordinates of the third plurality of EWE based upon elelctromagnetic waves emitted by the third plurality of EWE and detected by the at least two sensors; and

the first processor is configured to determine a spatial relationship between (1) a location of a surface of a second bone contacted with the first end of the pointer to determine 3D coordinates of the location and (2) the third plurality of EWE.

27. The system of claim 26, wherein the first processor is configured to, upon movement of a second bone having the second fiducial attached thereto from a first location to a different, new location:

determine new 3D coordinates of the third plurality of EWE based upon electromagnetic waves emitted by the third plurality of EWE and detected by the at least two sensors; and

determine new 3D coordinates of a location of a surface of the second bone based upon a spatial relationship between the location of the surface of the second bone and the new 3D coordinates of the third plurality of EWE.

28. The system according to claim 23, wherein the first and second processors are the same.

29. The system according to claim 23, further comprising:

a monitor configured to display the 3D image generated by the second processor.

30. The system according to claim 23, wherein the second processor is further configured to generate a 3D representation of a connection between ligament attachment points determined by using the first end of the pointer.

31. The system according to claim 23, further comprising an arthroscope coupled to the second processor, wherein the second processor is furter configured to generate an image comprising representations of objects observed via the arthroscope.

32. The system according to claim 23, wherein the 3D image comprises a ligament, drill holes and previously digitized surfaces of a femur ora tibia of a knee joint.

33. A method for generating a three-dimensional image of a surface of at least one bone, the method comprising:

(a) attaching a first fiducial directly to a first bone, the first fiducial comprising a first plurality of electromagnetic wave emitters (EWE);

(b) contacting a location of a surface of the first bone with a first end of a pointer;

(c) receiving electromagnetic waves from the first plurality of EWE;

(d) receiving electromagnetic waves from a second plurality of EWE, the second plurality of EWE and the first end of the pointer having a known spatial relationship;

(e) determining three-dimensional (3D) coordinates of the first location of the surface of the first bone based upon the electromagnetic waves received from the first plurality of EWE, the second plurality of EWE, and the known spatial relationship between the second plurality of EWE and the first end of the pointer;

(f) repeating the steps of contacting a location of a surface of the first bone with a first end of a pointer, receiving electromagnetic waves from the second plurality of EWE and determining three-dimensional (3D) coordinates of the location of the surface of the first bone for each of a plurality of different locations of the surface of the first bone to obtain a plurality of 3D coordinates, each of the different 3D coordinates corresponding to a respective one of the different locations of the surface of the first bone; and

(g) generating a 3D image of the surface of the first bone based at least upon the plurality of 3D coordinates determined during the step of (f).

34. The method according to claim 33, further comprising:

(n) determining a spatial relationship between (1) at least one of the locations of the surface of the first bone for which 3D coordinates were determined during the step of (f) and (2) the second plurality of EWE.

35. The method according to claim 34, further comprising:

after the step of (n);

repeating the steps of receiving electromagnetic waves from the first plurality of EWE;

determining 3D coordinates of the first plurality of EWE based upon the electromagnetic waves received therefrom to obtain new 3D coordinates of the first plurality of EWE; and

determining new 3D coordinates of the at least one location of the surface of the first bone for which at least one location the spatial relationship was determined in the step of (n), wherein the determination of the new 3D coordinates is based upon the new 3D coordinates of the first plurality of EWE and the spatial relationship between the at least one location and the first plurality of EWE.

36. The method according to claim 33, further comprising:

(h) contacting a location of a surface of a second bone with the first end of the pointer;

(i) receiving electromagnetic waves from the second plurality of electromagnetic wave emitters (EWE);

(j) determining three-dimensional (3D) coordinates of the first location of the surface of the second based upon the electromagnetic waves received from the second plurality of EWE and the known spatial relationship between the second plurality of EWE and the first end of the pointer;

(k) repeating the steps of contacting a location of a surface of the second bone with a first end of a pointer;

receiving electromagnetic waves from the second plurality of EWE and determining three-dimensional (3D) coordinates of the location of the surface of the second bone for each of a plurality of different locations of the surface of the second bone to obtain a plurality of 3D coordinates, each of the 3D coordinates corresponindg to a respective one of the different locations of the surface of the second bone; and

(l) generating a 3D image of the surface of the second bone based at least upon the plurality of 3D coordinates determined during the step of (k).

37. The method according to claim 36, wherein the images generated in the step of (g) and the step (l) are the same image and the image comprises the surfaces of both the first and second bones.

38. The method according to claim 37, wherein the image that comprises the surfaces of both the first and second bones comprises:

a representation of a ligament attachment point of the first bone;

a representation of a ligament attachment point of the second bone; and

a representation of a connection between the attachment points of the first and second bones.

39. The method according to claim 36, further comprising:

(n) determining a spatial relationship between (1) at least one of the locations of the surface of the first bone for which 3D coordinates were determined during the step of (f) and (2) the second plurality of EWE.

40. The method according to claim 39, further comprising:

(o) attaching a second fiducial to the second bone, the second fiducial comprising a third plurality of EWE;

(p) receiving electromagnetic waves from the third plurality of EWE;

(q) determining 3D coordinates of the third plurality of EWE based upon the electromagntic waves received therefrom; and

(r) determining a spatial relationship between (1) at least one of the locations of the surface of the second bone for which 3D coordinates were determined during the step of (k) and (2) the third plurality of EWE.

41. The method according to claim 40, further comprising:

after the step of (n);

repeating the steps of receiving electromagnetic waves from the first plurality of EWE and determining 3D coordinates of the first plurality of EWE based upon the electromagnetic waves received therefrom to obtain new 3D coordinates of the first plurality of EWE; and

determining new 3D coordinates of the at least one location of the surface of the first bone for which at least one location the spatial relationship was determined in the step of (n), wherein the determination of the new 3D coordinates is based upon the new 3D coordinates of the first plurality of EWE and the spatial relationship between the at least one location and the first plurality of EWE.

42. The method according to claim 41, further comprising:

after the step of (r);

repeating the steps of receiving electromagnetic waves from the first plurality of EWE;

determining 3D coordinates of the first plurality of EWE based upon the electromagnetic waves received therefrom to obtain new 3D coordinates of the third plurality of EWE; and

determining new 3D coordinates of the at least one location of the surface of the second bone for which at least one location the spatial relationship was determined in the step of (r), wherein the determination of the new 3D coordinates is based upon the new 3D coordinates of the third plurality of EWE and the spatial relationship between the at least one location and the third plurality of EWE.

43. The method according to claim 42, wherein the images generated in the step of (g) and the step (l) are the same image and the images comprises the surfaces of both the first and second bones.

44. The method according to claim 42, wherein one of the first and second bones is a femur, the other of the first and second bones is a tibia, and the femur and tibia are connected by a knee, and the method further comprises:

generating a three-dimensional simulation of the ligament during flexion-extension of the knee; and

generating optimal locations of the ligament attachment points and of drill holes, to thereby allow a surgeon to plan a knee reconstruction procedure.

45. The method according to claim 44, further comprising generating at least one image including a representation of a ligament having an axis including a point of the femur and a point of the tibia.