Osteotomy procedure

• US 7,318,827 B2
• Filed: 12/02/2002
• Issued: 01/15/2008
• Est. Priority Date: 12/02/2002
• Status: Expired due to Fees

• Current Assignee: Aesculap AG (B. Braun Holding GmbH & Co. KG)
• Original Assignee: Aesculap AG (B. Braun Holding GmbH & Co. KG)
• Inventors: Pinzuti, Jean-Baptiste, Leitner, Francois
• Primary Examiner(s): Ramana; Anuradha
• Application Number:
  US10/307,594
• Publication Number:
  US 20040106926A1
• Time in Patent Office: 1,870 Days
• Field of Search: 606/86, 606/87, 606/88, 606/89, 606/79, 606/96, 606/97, 606/102, 600/411, 600/416, 600/424, 600/425, 600/426, 600/427
• US Class Current: 606/87
• CPC Class Codes: A61B 17/142 with reciprocating saw blades, e.g. with cutting edges at the distal end of the saw blades
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/152 for removing a wedge-shaped piece of bone
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• 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 2034/2068 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 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

An osteotomy resection procedure for removing a wedge from a bone utilizing a localization device. The localization device being used to track reference points associated with the bone, track surgical instruments, perform calculations to determine a resection angle for the wedge, and assist a surgeon in performing the procedure.

Claims

1. A localization device for use in an osteotomy procedure to remove a wedge from a bone by making first and second cuts in the bone to reshape said bone, wherein, prior to removing said wedge, said bone extends between a first position corresponding to a first end of said bone and a second position corresponding to a second end of said bone and wherein, after removing said wedge, said second end of said bone is relocated to a third position such that a desired correction angle is produced between a first vector extending from the first position to the second position and a second vector extending from the first position to the third position, said device comprising:

sensors for sensing information corresponding to the locations of markers associated with one or more of the bones and one or more surgical instruments;

a computer coupled to said sensors for tracking the markers;

means for recording an angle and depth of the first cut;

means for determining a pivot point within the recorded first cut in the bone; and

means for calculating a resection angle for making the second cut relative to the recorded first cut that will produce the desired correction angle when the wedge is removed from the bone.

2. The localization device of claim 1, further comprising:

means for guiding the second cut relative to the first cut so as to produce the calculated resection angle.

3. The localization device of claim 2 wherein said means for recording an angle and depth of the first cut comprises:

markers trackable by said localization device for mounting to said bone in order to permit tracking of said reference points associated with said bone;

a first cut cutting jig having a guide, said cutting jig capable of receiving a marker for use by said localization device in orienting said guide with respect to said bone;

a saw having a cutting tip insertable into said guide for making said first cut, said saw capable of receiving a marker for use by the localization device in tracking said cutting tip with respect to the bone; and

a display device adapted to generate a display indicating the position of said cutting tip with respect to the bone during the cutting of the bone to provide visual assistance for performing said first cut.

4. The localization device of claim 3 wherein said means for guiding the second cut relative to the first cut comprises:

a second cut cutting jig having a guide, said second cut cutting jig capable of receiving a marker for use by the localization device in orienting said second cut cutting jig guide with respect to said bone;

a second saw having a cutting tip insertable into said second cut cutting jig guide for making said second cut, said second saw capable of receiving a marker for use by the localization device in orienting said cutting tip with respect to said bone; and

wherein said display is further adapted to generate a display indicating the position of the cutting tip of said second saw during said second cut with respect to the bone to provide visual assistance for performing said second cut.

5. The localization device of claim 2 wherein said means for recording an angle and depth of the first cut comprises:

means for obtaining reference points associated with the bone using said localization device;

means for tracking a first cut cutting jig having a guide relative to said bone, said cutting jig capable of receiving a marker for use by the localization device in orienting said guide with respect to the bone; and

means for tracking a saw having a cutting tip, said saw capable of receiving a marker for use by the localization device in tracking said cutting tip with respect to the bone; and

means for generating a display indicating the position of said cutting tip with respect to the bone during the cutting of the bone to provide visual assistance for performing said first cut.

6. The localization device of claim 5 wherein said means for guiding the second cut comprises:

means for tracking a second cut cutting jig having a guide, said second cut cutting jig capable of receiving a marker for use by the localization device in orienting said second cut cutting jig guide with respect to the bone, so that said second cut may be performed such that said second cut will intersect said first cut at said pivot point at the resection angle with respect to said first cut; and

means for tracking a second saw having a cutting tip insertable into said second cut cutting jig guide for making said second cut, said saw capable of receiving a marker for use by said localization device in orienting said cutting tip of said second saw with respect to the bone; and

means for displaying a representation indicating the position of the cutting tip of said second so with respect to the bone during the cutting of the bone to provide visual assistance for performing said second cut.

7. The localization device of claim 2, wherein said guiding means comprises at least:

a visual display coupled to said computer for guiding a surgeon during the osteotomy procedure.

8. The localization device of claim 1, wherein said means for calculating said resection angle comprises at least means for solving the equation:

9. The localization device of claim 1, wherein said means for calculating said resection angle comprises at least means for determining

A′

=K+KA cos(α

)+KA^ortho sin(α

)

where A′

is the third position, K is the first position, KA is a vector extending from the first position to the second position, KA^ortho is a vector of equal magnitude and orthogonal to KA, and α

is the desired correction angle.

10. The localization device of claim 9, wherein said means for calculating said resection angle further comprises at least means for solving the equation:

11. The localization device of claim 1 wherein the means for recording an angle and depth of the first cut comprises:

means for determining an axis of said bone using the localization device and the markers mounted to the bone; and

means for guiding a cutting jig for making the first cut having a marker mounted thereon relative to the bone using the localization device.

12. The localization device of claim 11 wherein the means for recording an angle and depth of the first cut further comprises:

means for generating a display showing the axis and the position of the cutting jig relative to the axis.

13. The localization device of claim 12 further comprising:

means for generating a display showing the wedge angle that would result if the second resection cut were commenced at the location pointed to by a tracked pointer and ended at the pivot point.

14. The localization device of claim 1 wherein said means for calculating a resection angle comprises:

means for determining the location of the third position with reference to the first position; and

means for calculating said resection angle based on said pivot point, said second point, said second position, and said third position.

15. The localization device of claim 1 wherein said means for determining a pivot point comprises:

a check blade insertable into said first cut, said check blade having a marker so that it may be tracked by said localization device;

means for observing said marker on said check blade via said localization device to determine the depth of said first cut;

means for recording said location corresponding to said depth of said first cut as said pivot point.

16. The localization device of claim 1 wherein said means for determining said pivot point comprises:

means for tracking a check blade that can be fully inserted into said first cut, said check blade having a marker so that it may be tracked by localization device;

means for observing said marker.