Dynamic knee balancer with pressure sensing

• US 7,578,821 B2
• Filed: 10/25/2004
• Issued: 08/25/2009
• Est. Priority Date: 02/06/2004
• Status: Active Grant

• Current Assignee: Synvasive Technology Incorporated (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Synvasive Technology Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Howard, Michael, Cordes, Kevin, Katsuya, Toshinobu, Fisher, Michael G., Hedley, Anthony K.
• Primary Examiner(s): Robert; Eduardo C
• Assistant Examiner(s): HOFFMAN, MARY C
• Application Number:
  US10/973,936
• Publication Number:
  US 20050177170A1
• Time in Patent Office: 1,765 Days
• Field of Search: 606/102, 606 86- 88, 606/90, 623/20.14, 623/20.21, 600/587, 600/595
• US Class Current: 606/88
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 2017/0268 for the knee
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61F 2/38 for elbows or knees
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2/4684 Trial or dummy prostheses
• CPC Class Codes: A61F 2002/30092 using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2002/30428 made by inserting a protrusion into a slot
• CPC Class Codes: A61F 2002/30507 using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30538 for adjusting angular orientation
• CPC Class Codes: A61F 2002/30553 for adjusting a position by translation along an axis
• CPC Class Codes: A61F 2002/30566 Helical springs
• CPC Class Codes: A61F 2210/0014 using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2220/0025 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2250/0006 for adjusting angular orientation
• CPC Class Codes: A61F 2250/0008 for adjusting a position by translation along an axis or two perpendicular axes

Abstract

A device for performing a surgical procedure on a knee includes an adjustable femoral portion, a tibial portion and at least one sensor coupled with the femoral and/or tibial portions to sense pressure exerted by the femoral and tibial portions against one another. The femoral portion is adapted for removably coupling with a distal end of a femur to adjust tension in soft tissue adjacent the knee and has at least one positioning feature adapted to move relative to the distal end of the femur as the femoral portion is adjusted, thus helping position a femoral prosthetic on the distal end of the femur. The sensor(s) may be adapted to sense pressure at medial and lateral sides of the knee, and relative pressures may be displayed as data on a visual display. Adjustments to the femoral member may be made to balance pressure at flexion and extension of the knee.

Claims

1. A method for sensing pressure in a knee during a surgical procedure on the knee, the method comprising:

engaging femoral and tibial portions of a knee adjustment device with the knee;

sensing pressure exerted by the femoral and tibial portions against one another using at least one sensor coupled with at least one of the femoral or tibial portion;

displaying data describing the sensed force; and

adjusting at least one of the rotational orientation or anterior/posterior orientation of the femoral portion of the knee adjustment device to separately adjust dynamic tension in the lateral and medial collateral ligaments adjacent the knee,

wherein adjusting affects the force exerted by the femoral and tibial portions against one another,

wherein a stationary femoral member of the femoral portion of the knee adjustment device engages a distal femur of the knee and a mobile femoral member of the knee adjustment device is moveably coupled to the stationary femoral member, and

wherein adjusting at least one of the rotational orientation or anterior/posterior orientation of the femoral portion of the knee adjustment device comprises moving the mobile femoral member relative to the stationary femoral member.

2. A method as in claim 1, further comprising moving the knee through a range of motion from a flexed position to an extended position while the knee adjustment device remains engaged with the knee.

3. A method as in claim 2, wherein the adjusting step is performed before the moving step.

4. A method as in claim 2, wherein the adjusting step is performed after the moving step.

5. A method as in claim 2, wherein the adjusting step is performed before and after the moving step.

6. A method as in claim 2, wherein the adjusting step is performed one or more times to balance force data displayed while the knee is flexed with force data displayed while the knee is extended.

7. A method as in claim 2, further comprising providing positional data for helping position at least part of a prosthetic knee, wherein the adjusted femoral portion provides the positional data.

8. A method as in claim 1, further comprising processing the sensed force into the data describing the force.

9. A method as in claim 8, wherein processing comprises converting analog data to digital data.

10. A method as in claim 1, wherein sensing the force comprises:

transmitting a voltage to the at least one sensor;

measuring the voltage after it has passed through the sensor(s);

determining a percentage of the voltage passed through the sensor(s) relative to the voltage transmitted to the sensors; and

deriving the pressure from the percentage.

11. A method as in claim 1, wherein sensing the force comprises sensing with at least one sensor selected from the group consisting of piezoelectric sensors, force sensing resistors, strain gauges, load cells, other pressure sensors and other force sensors.

12. A method as in claim 1, wherein displaying the data comprises:

displaying at least a first number representing the pressure in a medial portion of the adjustment device; and

displaying at least a second number representing pressure in a lateral portion of the adjustment device, wherein a user separately adjusts the medial and collateral tensions based on the displayed medial and collateral force.

13. A method as in claim 12, wherein the first and second numbers represent relative amounts of force as compared to one another or to force(s) measured with different positioning of the knee.

14. A method as in claim 12, wherein the first and second numbers represent absolute amounts of force.

15. A method as in claim 1, further comprising:

receiving an input from a user of a desired amount of force to be exerted by the femoral and tibial members against one another; and

automatically adjusting the femoral portion of the adjustment device to achieve the desired amount of force.

16. A method as in claim 15, wherein receiving the input comprises receiving a first amount of desired force for a medial side of the knee and a second amount of desired force for a lateral side of the knee.

17. A method as in claim 1, further comprising automatically adjusting the adjustment device to balance the force exerted by the femoral and tibial members against one another while the knee is flexed with force exerted while the knee is extended.

18. A method as in claim 1, further comprising cutting the distal end of the femur to produce a cut surface, wherein the knee adjustment device is engaged against said cut surface.

19. A method as in claim 1, further comprising moving the knee through a range of motion from an extended position to a flexed position while the knee adjustment device remains engaged with the knee.

20. A method as in claim 2 or 19, wherein the patella of the knee remains in its anatomical position while the knee is moved through the range of motion.

21. A method as in claim 1, wherein moving the mobile femoral member relative to the stationary femoral member comprises separately moving laterally opposite sides of the mobile femoral member relative to the stationary femoral member.

22. A method as in claim 21, wherein the laterally opposite sides of the mobile femoral member comprises a medial side contacting the medial posterior condyle of the distal femur and a lateral side contacting the lateral posterior condyle of the distal femur.

23. A method as in claim 2, wherein a first surface of the femoral portion contacts the tibial portion when the knee is in the extended position, and wherein a posterior condylar surface of the femoral portion contacts the tibial portion when the knee is in the flexed position, the posterior condylar surface being disposed at a right angle relative to the first surface.