In vivo joint space measurement device and method

• US 7,195,645 B2
• Filed: 07/09/2004
• Issued: 03/27/2007
• Est. Priority Date: 07/11/2003
• Status: Active Grant

• Current Assignee: Depuy Products Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Products Incorporated (Johnson & Johnson)
• Inventors: Dietz, Terry L., Sherman, Jason T., Disilvestro, Mark R.
• Primary Examiner(s): Philogene; Pedro
• Application Number:
  US10/888,243
• Publication Number:
  US 20050010301A1
• Time in Patent Office: 991 Days
• Field of Search: 623/18.11, 623/18.12, 623/16.11, 623/22.24, 623/22.13, 623/23.16, 623/23.49, 623/19.11, 600/12, 600/589, 600/587, 340/572.8, 235/487
• US Class Current: 623/18.11
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 5/076 Permanent implantations telemetry using implanted circuitry A61B5/0031; implanted stimulators for therapy A61N1/3605, A61N1/362, A61N1/372
• CPC Class Codes: A61B 5/1076 for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 90/06 Measuring instruments not otherwise provided for
• CPC Class Codes: A61F 2/32 for the hip
• CPC Class Codes: A61F 2/34 Acetabular cups
• CPC Class Codes: A61F 2/36 Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/367 Proximal or metaphyseal parts of shafts trochanteric devices connected to said proximal parts A61F2/30739
• CPC Class Codes: A61F 2/38 for elbows or knees
• CPC Class Codes: A61F 2/3859 Femoral components
• CPC Class Codes: A61F 2/389 Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2/40 for shoulders
• CPC Class Codes: A61F 2/4081 Glenoid components, e.g. cups
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2/488 Means for detecting or monitoring wear
• CPC Class Codes: A61F 2002/30079 magnetic
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30326 differing in height or in length
• CPC Class Codes: A61F 2002/30589 Sealing means
• CPC Class Codes: A61F 2002/30668 : Means for transferring electromagnetic energy to implants
• CPC Class Codes: A61F 2002/3067 : for data transfer
• CPC Class Codes: A61F 2002/30795 : Blind bores, e.g. of circular cross-section
• CPC Class Codes: A61F 2002/30807 : Plurality of blind bores
• CPC Class Codes: A61F 2002/30878 : with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
• CPC Class Codes: A61F 2002/30884 : Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
• CPC Class Codes: A61F 2002/30892 : parallel
• CPC Class Codes: A61F 2002/3611 : Heads or epiphyseal parts of femur
• CPC Class Codes: A61F 2002/4018 : Heads or epiphyseal parts of humerus
• CPC Class Codes: A61F 2002/4062 : Proximal or metaphyseal parts of shafts
• CPC Class Codes: A61F 2002/4661 : for measuring thickness
• CPC Class Codes: A61F 2002/4698 : magnetic
• CPC Class Codes: A61F 2210/009 : magnetic
• CPC Class Codes: A61F 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2250/0001 : Means for transferring electromagnetic energy to implants
• CPC Class Codes: A61F 2250/0002 : for data transfer
• CPC Class Codes: A61F 2250/0037 : differing in height or in length

Abstract

A joint endoprosthesis system has first and second prosthetic components. The second prosthetic component has a bearing surface. The interface of the bearing surface and the first prosthetic component defines the joint articulation. A signal source and sensor are affixed on opposite sides of the joint articulation. The signal source generates a first signal that is received by the sensor. The sensor generates a second signal that has a characteristic that varies depending on the distance between the sensor and the signal source. A transmitter transmits a signal. The signal has a characteristic that varies depending on the characteristic of the second signal. This system can be used to measure a dimension of the joint space and to determine whether a dimension of the joint space has changed over time. The system may alternatively use magnets and magnetic sensors.

Claims

1. A joint endoprosthesis system for use in a joint comprising two bones interfacing at a joint articulation in a patient'"'"'s body, the joint endoprosthesis system comprising:

a first prosthetic component;

a second prosthetic component;

a bearing component having a bearing surface to be placed against the first prosthetic component and a second surface to be placed against the second prosthetic component, the interface of the first prosthetic component and the bearing surface of the bearing component defining a joint articulation;

a signal source received within one of the prosthetic components on one side of the joint articulation and being capable of generating a first signal selected from the group consisting of a magnetic field and a magnetic flux density;

a sensor received within the other prosthetic component across the joint articulation from the signal source, the sensor being capable of producing a voltage, the magnitude of the voltage being dependent upon the magnitude of the first signal;

a modulator received within one of the prosthetic components and connected to receive the voltage generated by the sensor and being capable of converting the voltage received into a transmitter signal having a characteristic that varies depending on the magnitude of the voltage generated by the sensor; and

an internal transmitter received within one of the prosthetic components and connected to receive the transmitter signal from the modulator, the internal transmitter being capable of transmitting the transmitter signal from within the patient'"'"'s body to a location outside of the patient'"'"'s body.

2. The joint endoprosthesis system of claim 1 wherein the first prosthetic component comprises a distal femoral prosthesis having condyles and the second prosthetic component comprises a tibial prosthesis.

3. The joint endoprosthesis system of claim 1 wherein the first prosthetic component comprises an acetabular shell, the bearing comprises an acetabular liner and the second prosthetic component comprises a proximal femoral component having a femoral head with a surface for bearing against the acetabular liner.

4. The joint endoprosthesis system of claim 1 wherein the first prosthetic component comprises a humeral component and the second prosthetic component comprises a glenoid component.

5. The joint endoprosthesis system of claim 1 wherein:

the sensor comprises a Hall effect transducer;

the signal source comprises a permanent magnet and the modulator converts the voltage received from the Hall effect transducer into a radio-frequency wave.

6. The joint endoprosthesis system of claim 1 including an antenna received within one of the prosthetic components and coupled to the internal transmitter for transmitting the transmitter signal to a position outside of the patient'"'"'s body.

7. The joint endoprosthesis system of claim 1 wherein the first signal includes a magnetic field.

8. The joint endoprosthesis system of claim 1 further comprising a power source to be implanted in the patient'"'"'s body.

9. The joint endoprosthesis system of claim 5 wherein the first prosthetic component comprises a distal femoral component and the second prosthetic component comprises a tibial prosthesis.

10. The joint endoprosthesis system of claim 5 wherein the first prosthetic component comprises a femoral head, the second prosthetic component comprises an acetabular shell, and the bearing comprises an acetabular liner.

11. The joint endoprosthesis system of claim 5 wherein the first prosthetic component comprises a humeral component and the second prosthetic component comprises a glenoid component.

12. The joint endoprosthesis system of claim 1 wherein the modulator and transmitter comprise a single electronic element.

13. The joint endoprosthesis system of claim 1 wherein the modulator and transmitter comprise discrete electronic elements.

14. The joint endoprosthesis of claim 8 wherein the power source comprises a ferrite coil.

15. The joint endoprosthesis of claim 8 wherein the power source comprises a battery.

16. A method of determining a dimension of a joint space in the body of a patient wherein the patient has a joint endoprosthesis that includes a first prosthetic component and a bearing occupying the joint space adjacent the first prosthetic component, the method comprising:

generating a voltage within the patient'"'"'s body that has a characteristic that relates to a dimension of the joint space;

modulating the voltage within the patient'"'"'s body to produce a transmitter signal;

transmitting the transmitter signal from within the patient'"'"'s body to a location outside of the patient'"'"'s body, wherein the transmitted signal has a characteristic that relates to the characteristic of the voltage;

determining a dimension of the joint space based on the value of the characteristic of the transmitter signal.

17. The method of claim 16 wherein the step of generating a voltage comprises generating a magnetic field across the joint space.

18. The method of claim 17 wherein the magnetic field is generated on one side of the joint space and wherein the step of generating a voltage includes sensing a property of the magnetic field on the opposite side of the joint space.

19. The method of claim 18 wherein the step of modulating the voltage to produce a transmitter signal comprises producing a radio-frequency wave.

20. The method of claim 16 wherein the joint comprises the knee, the first prosthetic component comprises a distal femoral component and the bearing comprises a tibial bearing occupying a joint space adjacent the distal femoral component.

21. The method of claim 16 wherein the joint comprises the hip, the first prosthetic component comprises a proximal femoral component and the bearing comprises an acetabular liner.

22. The method of claim 16 wherein the joint comprises the shoulder, the first prosthetic component comprises a humeral component and the bearing comprises a glenoid component.

23. A method of determining a change in a dimension of a joint space in the body of a patient wherein the patient has a joint endoprosthesis that includes a first prosthetic component and a bearing occupying the joint space adjacent the first prosthetic component, the method comprising:

generating a first signal from one side of the joint space at a first location within the patient'"'"'s body;

receiving the first signal on the opposite side of the joint space at a second location within the patient'"'"'s body;

producing a voltage within the patient'"'"'s body, where the magnitude of the voltage depends upon a characteristic of the first signal;

modulating the voltage within the patient'"'"'s body to produce a transmitter signal a characteristic of which depends upon the magnitude of the voltage produced;

transmitting the transmitter signal from within the patient'"'"'s body to an external location;

determining the extent of change in a dimension of the joint space based on said characteristic of the transmitter signal.

24. The method of claim 23 wherein the step of generating a first signal creates a magnetic field at the second location.

25. The method of claim 23 wherein the step of modulating the voltage includes generating a radio-frequency wave.

26. The method of claim 25 wherein the characteristic of the radio-frequency wave that relates to distance between the first location and the second location includes at least one of the following:

frequency, amplitude and phase.

27. The method of claim 23 wherein the joint comprises the knee, the first prosthetic component comprises a distal femoral component and the bearing comprises a tibial bearing occupying a joint space adjacent the distal femoral component.

28. The method of claim 23 wherein the joint comprises the hip, the first prosthetic component comprises a proximal femoral component and the bearing comprises an acetabular liner.

29. The method of claim 23 wherein the joint comprises the shoulder, the first prosthetic component comprises a humeral component and the bearing comprises a glenoid component.

30. A joint endoprosthesis system for use in a joint comprising two bones interfacing at a joint articulation in a patient'"'"'s body, the joint endoprosthesis system comprising:

a first prosthetic component;

a second prosthetic component;

a bearing having a bearing surface to be placed against the first prosthetic component and a second surface facing the second prosthetic component, the interface of the first prosthetic component and the bearing surface of the bearing defining a joint articulation;

a magnet affixed within one of the prosthetic components;

a sensor affixed within the other prosthetic component, the sensor being capable of sensing a property of the magnetic field of the magnet and producing a voltage the magnitude of which depends upon the sensed property of the magnetic field; and

a modulator received within one of the prosthetic components and connected to receive the voltage produced by the sensor, the modulator being capable of producing a signal having a characteristic that varies depending on the voltage received from the sensor and that is capable of being transmitted from within the patient'"'"'s body to a location outside of the patient'"'"'s body.

31. The joint endoprosthesis system of claim 30 wherein the sensor is selected from the group consisting of:

a Hall effect sensor;

a three-dimensional Hall effect sensor;

a variable reluctance sensor;

a magnetoelastic sensor;

a magnetoresistive sensor;

a magnetorestrictive sensor;

a saturation core sensor;

a superconducting quantum interference device;

a nuclear magnetic resonance sensor;

am induction core magnetometer;

a proton precession magnetometer; and

an optically pumped magnetometer.

32. The joint endoprosthesis of claim 30 further comprising a power source to be implanted in the patient'"'"'s body.

33. The joint endoprosthesis system of claim 30 wherein the magnet is carried by one of the prosthetic components and the sensor is carried by the other prosthetic component.

34. The joint endoprosthesis of claim 32 wherein the power source comprises a ferrite coil.

35. The joint endoprosthesis of claim 32 wherein the power source comprises a battery.

36. The joint endoprosthesis of claim 34 wherein the magnets comprise superparamagnets and the cuff includes a magnetic field source.

37. A joint endoprosthesis system for use in a joint comprising two bones interfacing at a joint articulation in a patient'"'"'s body, the joint endoprosthesis system comprising:

a first prosthetic component;

a second prosthetic component;

a bearing having a bearing surface to be placed against the first prosthetic component and an opposite surface to face the second prosthetic component, the interface of the first prosthetic component and the bearing surface of the bearing defining a joint articulation;

a magnet affixed to one of the prosthetic components; and

an external cuff separate from the first prosthetic component, second prosthetic component and bearing, the external cuff including a sensor to be maintained outside of the patient'"'"'s body, the sensor being capable of sensing a property of the magnetic field of the magnet.

38. The joint endoprosthesis system of claim 37 wherein the sensor is selected from the group consisting of:

a Hall effect sensor;

a three-dimensional Hall effect sensor;

a variable reluctance sensor;

a magnetoelastic sensor;

a magnetoresistive sensor;

a magnetorestrictive sensor;

a saturation core sensor;

a superconducting quantum interference device;

a nuclear magnetic resonance sensor;

an induction core magnetometer;

a proton precession magnetometer; and

an optically pumped magnetometer.

39. The joint endoprosthesis system of claim 37 wherein the external cuff is inflatable.

40. The joint endoprosthesis system of claim 37 wherein the cuff includes an additional sensor.

41. The joint endoprosthesis system of claim 37 wherein the cuff includes an additional plurality of sensors.

42. The joint endoprosthesis of claim 37 further comprising an additional magnet affixed to one of the prosthetic components.

43. The joint endoprosthesis of claim 41 wherein the sensors are selected from the group consisting of:

a Hall effect sensor;

a three-dimensional Hall effect sensor;

a variable reluctance sensor;

a magnetoelastic sensor;

a magnetoresistive sensor;

a magnetorestrictive sensor;

a saturation core sensor;

a superconducting quantum interference device;

a nuclear magnetic resonance sensor;

an induction core magnetometer;

a proton precession magnetometer; and

an optically pumped magnetometer.