Method and apparatus for finding the position of a mechanical axis of a limb

• US 6,928,742 B2
• Filed: 05/17/2001
• Issued: 08/16/2005
• Est. Priority Date: 08/31/2000
• Status: Expired due to Term

• Current Assignee: Smith & Nephew Orthopaedics Ag (Smith & Nephew PLC)
• Original Assignee: Plus Orthopedics AG (Smith & Nephew PLC)
• Inventors: Hauri, Thomas, Hauri, Bernhard, Broers, Holger, Berner, Werner
• Primary Examiner(s): Bennett, G. Bradley
• Assistant Examiner(s): JOHNSON, AMY COHEN
• Application Number:
  US10/363,488
• Publication Number:
  US 20040054442A1
• Time in Patent Office: 1,552 Days
• Field of Search: 335/12, 335/15, 332/27, 332/28, 332/031.8, 33D/IG.21, 600/587, 600/476, 382/128, 382/131, 606/87, 606/88, 606/89, 606/82
• US Class Current: 33/512
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• 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 2034/2072 Reference field transducer attached to an instrument or patient
• 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 5/103 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 5/1079 using optical or photographic means
• CPC Class Codes: A61B 5/4504 Bones A61B5/4547 takes precedence
• CPC Class Codes: A61B 5/6878 Bone

Abstract

A method of finding the position of a mechanical axis running in the longitudinal direction through a limb that is rotatably supported by its first end in a center of rotation that is not fixed and is not accessible for the mechanical determination of coordinates, by means of an optical coordinate-measurement device with an indicator to detect measurement-point coordinates in one rotational position of the limb, such that, for each rotational position, a multi-point indicator rigidly attached near the second end of the limb signals several measurement-point coordinates, and, from the sets of measurement-point coordinates detected in a plurality of rotational positions, at least one group is selected that can be assigned to the same site of the center of rotation, and the measurement-point-coordinate sets assigned to this site of the center of rotation are used to calculate the mechanical axis.

Claims

1. A method of finding the position of a mechanical axis running in the longitudinal direction through a limb, the limb rotatably supported by a first end via a movable and inaccessible center of rotation for the mechanical determination of coordinates, comprising:

providing an optical coordinate-measurement device with at least one multi-point indicator to signal measurement-point coordinates in a rotational position of the limb;

rigidly attaching said multi point indicator near a second end of the limb;

detecting several measurement-point coordinates (P₁₁, P₂₁, P₃₁, P_n1) per rotational position of the limb;

recording said measurement-point coordinates;

selecting from measurement-point-coordinate sets (P₁₁-P_n1, P₁₂-P_n2, P_1m-P_nm) at least one group;

assigning said at least one group to a same site of the center of rotation; and

calculating the position of the first end of the limb and a mechanical axis running through the first and second ends using the measurement-point-coordinate sets (P₁₁-P_n1, P₁₂-P_n2, P_1m-P_nm) assigned to said site of the center of rotation without piercing a skin of the limb above said second end.

2. The method according to claim 1, further comprising:

calculating several spherical surfaces that represent paths through which the second end of the limb moves from the at least one group of measurement point coordinate sets (P₁₁-P_n1, P₁₂-P_n2, P_1m-P_nm) assigned to said same site of the center of rotation; and

calculating the coordinates of a point on which said spherical surfaces are centered to represent the center of rotation of the limb as a point on the mechanical axis, said calculation employing the equation

position P_{(n m)} relative to P_{(n+i m)}=position P_{(n m+j)} relative to P_(n+im+j).

3. The method of claim 1, wherein the selection of the at least one group of measurement-point-coordinate sets (P₁₁-P_n1, P₁₂-P_n2, P_1m-P_nm) from a number of sets that have been collected in a plurality of rotational positions of the limb is performed by proceeding through several steps of an iteration procedure, in each step of which one measurement-point-coordinate set is eliminated and an improvement thereby achieved is evaluated.

4. The method according to claim 3, wherein the evaluation is accomplished by means of an iterative calculation by a least-squares method.

5. The method of claim 1, further comprising:

calibrating the multi-point indicator before beginning the collection of the measurement-point coordinates;

comparing measurement-point coordinate relations resulting from said calibration with the relations of the recorded measurement-point coordinates for every rotational position of the limb; and

deleting a measurement-point-coordinate set lying outside a predetermined tolerance limit.

6. The method of claim 1, further comprising specifying a second point required for the calculation of the mechanical axis, in terms of bony reference points by employing the optical coordinate measurement device with an additional indicator, said second point situated at the second end of the limb.

7. The method of claim 1, wherein the steps involved in the determination of the mechanical axis are carried out with computer assistance, such that the instructions regarding the actions needed to put the limb in particular rotational positions and information about the intermediate results of the relevant steps are displayed in a menu-guided environment.

8. The method of claim 1, further comprising aligning a cutting jig with respect to the mechanical axis that has been identified for the mechanical processing of the second end of the limb.

9. The method according to claim 8, wherein the identified mechanical axis is indicated by an adapter or multi-point indicator that is fixedly attached to the limb, and the cutting jig is aligned with respect to said adapter or multi-point indicator with by a calibrated jig adapter.

10. The method of claim 9, further comprising carrying out a translational adjustment of the cutting jig with respect to the adapter by tactile sampling of the cutting jig with an accessory indicator employing the coordinate-measurement device.

19. The method of claim 5, wherein comparing the measurement-point-coordinate relations resulting from the calibration with the relations of the recorded measurement-point coordinates comprises a plausibility consideration.

11. An arrangement for finding the position of a mechanical axis of a limb that is rotatably supported by its first end via a movable center of rotation comprising:

a camera arrangement with at least two cameras spaced apart from one another by a fixed distance for the spatially determined reception of transmitter signals

at least two multi-point indicators, each of which comprises a measurement-point field with several measurement points, to detect several measurement-point coordinates (P₁₁-P<sub>n−

1</sub>), such that a first multi-point indicator is constructed as a movable feeler for the tactile sampling of bony reference points in order to measure their coordinates, and

an evaluation unit for evaluating the measurement-point coordinate sets provided by the multi-point indicator and detected by the camera arrangement, in order to identify the mechanical axis of the limb extending through the first end of the limb without piercing a skin on the limb above a second end of the limb, and such that a second multi-point indicator is rigidly attached in the vicinity of said second end of the limb, in such a way that it provides measurement-point-coordinate sets for several rotational positions of the limb, all of which lie on spherical surfaces positioned around the associated site of the center of the rotation, and

a process control means to control sequential recording and storage of the measurement-point-coordinate sets obtained in the individual rotational positions of the limb, and subsequent processing thereof, according to a prespecified processing thereof, according to a prespecified processing sequence, and wherein the evaluation device comprises means for performing an iteration procedure, to specify a site of the center of rotation, for calculating the position of a mechanical axis on the basis of the site of the center of rotation, and for calculating a second point at the second end of the limb, specified on the basis of bony reference points on the limb.

12. The arrangement according to claim 11, further comprising an adjustable clamping device to serve as an adapter for fixating the second multi-point indicator near the second end of the limb.

13. The arrangement according to claim 11, further comprising a calibrated jig adapter that, can be connected both to the clamping device and to a cutting jig for the mechanical processing of the second end of the limb, said connection being in such a way that these elements cannot be rotated but are capable of translational displacement, so that the cutting jig can be aligned with the mechanical axis by way of the jig adapter and can be displaced along the alignment axis.

14. The arrangement according to claim 13, wherein the first multi-point indicator, which is designed as a tactile sampler, also serves as an indicator for detecting the current position of the cutting jig.

15. The arrangement according to claim 11, further comprising display and input means associated with the process control means and the evaluation unit, in order to implement at least one of an optical and acoustical menu guidance for the determination of the center of rotation and the mechanical axis.

16. The arrangement according to claim 15, wherein the menu guidance also comprises display and input means for positioning of the cutting jig.

17. The arrangement according to claim 11, wherein at least the second multipoint indicator comprises a plurality of IR light-emitting diodes as active transmitters of measurement-point coordinates, which are disposed in an indicator base constructed in tripod form.

18. The arrangement according to claim 13, further comprising display and input means associated with the process control means and the evaluation unit in order to implement at least on of an optical and acoustical menu guidance for the determination of the center of rotation and the mechanical axis and electric motors connected to the jig adapter for the translational displacement of the cutting jig with respect to the mechanical axis, and wherein the motors are driven in particular by control signals input in the context of the menu guidance.

20. The arrangement of claim 11, wherein the means for performing an iteration procedure employs an error-minimization calculation according to a least-squares method.