Surgical orientation system and method

• US 7,559,931 B2
• Filed: 07/15/2005
• Issued: 07/14/2009
• Est. Priority Date: 06/09/2003
• Status: Active Grant

• Current Assignee: Orthalign, Inc.
• Original Assignee: Orthalign, Inc.
• Inventors: Stone, A. Curt
• Primary Examiner(s): Le; Long V
• Assistant Examiner(s): Brutus; Joel F
• Application Number:
  US11/182,528
• Publication Number:
  US 20050251026A1
• Time in Patent Office: 1,460 Days
• Field of Search: 606/91, 606/90, 606/102, 600/424, 600/426, 600/427, 600/428
• US Class Current: 606/91
• CPC Class Codes: A61B 17/175 for preparing the femur for hip prosthesis insertion
• CPC Class Codes: A61B 17/1778 for the shoulder
• CPC Class Codes: A61B 2017/00115 with audible or visual output
• CPC Class Codes: A61B 2034/2048 using an accelerometer or inertia sensor
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• 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 5/1071 measuring angles, e.g. using goniometers A61B5/1123 takes precedence
• CPC Class Codes: A61B 5/4504 Bones A61B5/4547 takes precedence
• CPC Class Codes: A61F 2/34 Acetabular cups
• CPC Class Codes: A61F 2/4609 of acetabular cups
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/30538 for adjusting angular orientation
• CPC Class Codes: A61F 2002/4632 using computer-controlled surgery, e.g. robotic surgery
• CPC Class Codes: A61F 2002/4668 for measuring angles
• CPC Class Codes: A61F 2002/4687 Mechanical guides for implantation instruments
• CPC Class Codes: A61F 2250/0006 for adjusting angular orientation

Abstract

A system and method for detecting and measuring changes in angular position with respect to a reference plane is useful in surgical procedures for orienting various instruments, prosthesis, and implants with respect to anatomical landmarks. One embodiment of the device uses dual orientation devices of a type capable of measuring angular position changes from a reference position. One such device provides information as to changes in position of an anatomical landmark relative to a reference position. The second device provides information as to changes in position of a surgical instrument and/or prosthesis relative to the reference position.

Claims

1. A method of positioning a medical prosthesis with respect to an anatomical feature of a patient, the method comprising:

identifying an implantation location in the patient for the medical prosthesis;

identifying an anatomical feature on the patient related to the implantation location, the anatomical feature establishing a plane for use in positioning the medical prosthesis;

providing a surgical instrument adapted to support the medical prosthesis and an alignment guide adapted to contact the anatomical feature, and identifying a first position of the surgical instrument relative to the anatomical feature, the alignment guide having at least a planar portion adapted to engage the plane of the anatomical feature;

coupling the alignment guide to the surgical instrument;

coupling a measuring device to the surgical instrument;

positioning the surgical instrument relative to the patient in a first position, the planar portion of the alignment guide in the first position being substantially parallel to the plane of the anatomical feature;

zeroing and measuring first positional changes with the measuring device;

removing the surgical instrument from the first position and removing the alignment guide from the surgical instrument;

coupling the medical prosthesis to the surgical instrument;

positioning the surgical instrument relative to the patient in a second position, the medical prosthesis in the second position being near the implantation location;

zeroing the measuring device, and measuring second positional changes with the measuring device; and

determining a relative position of the medical prosthesis to the anatomical feature and the implantation location, based on the first positional changes and the second positional changes.

2. The method of claim 1 wherein the measuring device includes a digital display to provide an indication of the first and second positional changes.

3. The method of claim 1 wherein the anatomical feature is an acetabulum and the medical prosthesis is an acetabular prosthetic socket.

4. The method of claim 1 further comprising identifying a reference position of the anatomical feature using the surgical instrument, and wherein the first positional changes are positional changes of the anatomical feature from the reference position.

5. The method of claim 1 wherein the measuring devices is a three-dimensional electronic orientation device and wherein the measuring device includes at least one rate sensor that provides a rate signal indicative of a change in angular position of the measuring device about an axis.

6. The method of claim 3 wherein the step of indentifying a first position of the surgical instrument relative to the anatomical feature includes coupling the alignment guide to the surgical instrument and contacting a distal end of the alignment guide to a rim of the acetabulum.

7. The method of claim 6 further comprising positioning the surgical instrument at a predetermined angular orientation relative to the acetabulum.

8. The method of claim 7 wherein the predetermined angular orientation is a predetermined anteversion angle.

9. A method of positioning a medical prosthesis with respect to an anatomical feature of a patient, the method comprising:

identifying an implantation location in the patient for the medical prosthesis;

identifying an anatomical feature on the patient related to the implantation location, the anatomical feature establishing a geometric landmark for use in positioning the medical prosthesis;

providing a first surgical instrument adapted to support an alignment guide, the alignment guide adapted to contact the anatomical feature, and identifying a first position of the surgical instrument relative to the anatomical feature, the alignment guide having at least a geometric portion adapted to engage the geometric landmark of the anatomical feature;

coupling a measuring device to the surgical instrument;

positioning the surgical instrument relative to the patient in the first position, the geometric portion of the alignment guide in the first position being substantially aligned with the geometric landmark of the anatomical feature;

zeroing the measuring device, and measuring first positional changes with the measuring device;

removing the surgical instrument from the first position;

coupling the measuring device to a second surgical instrument;

positioning the second surgical instrument relative to the patient in a second position, the measuring device in the second position being near the implantation location;

zeroing the measuring device, and measuring second positional changes with the measuring device; and

determining a relative position of the medical prosthesis to the anatomical feature and the implantation location, based on the first positional changes and the second positional changes.

10. The method of claim 9, wherein the first and second surgical instruments are the same instrument.

11. The method of claim 9, wherein first and second surgical instruments are different instruments.

12. The method of claim 9, wherein the first and second positions are substantially the same.

13. The method of claim 9, wherein the first and second positions are different.

14. A method of positioning a medical prosthesis in the acetabulum of a patient'"'"'s hip joint, the method comprising:

identifying an implantation location for implantation of the medical prosthesis in the acetabulum of the patient'"'"'s hip joint;

identifying the location of an acetabular rim, the acetabular rim establishing a plane for use in positioning the medical prosthesis;

providing a surgical instrument adapted to support the medical prosthesis and an alignment guide adapted to contact the acetabular rim, and identifying a first position of the surgical instrument relative to the acetabular rim, the alignment guide having at least a planar portion adapted to engage the plane of the acetabular rim;

coupling the alignment guide to the surgical instrument;

coupling a measuring device to the surgical instrument;

positioning the surgical instrument relative to the patient in a first position, the planar portion of the alignment guide in the first position being substantially parallel to the plane of the acetabular rim;

zeroing the measuring device, and measuring first positional changes with the measuring device;

removing the surgical instrument from the first position and removing the alignment guide from the surgical instrument;

coupling the measuring device to the surgical instrument;

positioning the surgical instrument relative to the patient in a second position, the medical prosthesis in the second position being near the implantation location;

zeroing the measuring device, and measuring second positional changes with the measuring device; and

determining a relative position of the medical prosthesis to the acetabular rim and the implantation location, based on the first positional changes and the second positional changes.

15. The method of claim 14, wherein the measuring device comprises a three-dimensional electronic orientation device and wherein the measuring device includes at least one rate sensor that provides a rate signal indicative of a change in angular position of the measuring device about an axis.

16. The method of claim 14, wherein the alignment guide is configured to contact three points along the acetabular rim, the three points defining the plane of the acetabular rim.