System and method for facilitating hip surgery

• US 7,885,705 B2
• Filed: 02/10/2006
• Issued: 02/08/2011
• Est. Priority Date: 02/10/2006
• Status: Active Grant

• Current Assignee: M.D. Stephen B. Murphy
• Original Assignee: M.D. Stephen B. Murphy
• Inventors: Murphy, Stephen B.
• Primary Examiner(s): Le; Long V
• Assistant Examiner(s): Brutus; Joel F
• Application Number:
  US11/351,455
• Publication Number:
  US 20070209220A1
• Time in Patent Office: 1,824 Days
• Field of Search: 600/407, 600/410, 600/432, 600/423, 600/424
• US Class Current: 600/426
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• 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 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/067 for measuring angles
• 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 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 5/6878 Bone
• CPC Class Codes: A61B 90/06 Measuring instruments not otherwise provided for
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 2/36 Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/4607 of hip femoral endoprostheses
• 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 2002/4632 using computer-controlled surgery, e.g. robotic surgery
• CPC Class Codes: A61F 2002/4658 for measuring dimensions, e.g. length
• CPC Class Codes: A61F 2002/4668 for measuring angles

Abstract

A system and method for use during hip surgery includes a position frame that is removably secured to the patient'"'"'s femur. The system further includes a tracking unit and navigation engine that establish a pelvic coordinate system and, with the patient'"'"'s leg placed in a predetermined orientation, capture the location of the femoral position frame within the pelvic coordinate system. The system further includes an image generator configured to display one or more images for directing the surgeon to return the patient'"'"'s leg to the predetermined orientation following a trial reduction based upon the previously captured position. A leg change determination engine compares the current, post-reconstruction position of the femoral position tracking frame with the previously captured, pre-reconstruction position to derive leg length, offset, and anterior-posterior change values. The change values are then provided to the surgeon for evaluating the suitability of the trial reduction.

Claims

1. A system for performing hip surgery on a patient having a leg, a pelvis and a femur, the system comprising:

a tracking unit configured to detect a femoral position tracking frame removably secured to the patient'"'"'s femur;

a navigation engine coupled to the tracking unit, the navigation unit configured to establish a pelvic coordinate system at the patient'"'"'s pelvis and to derive a first, pre-reconstruction location of the femoral position tracking frame relative to the pelvic coordinate system and a pre-reconstruction orientation of the femoral position tracking frame relative to the pelvic coordinate system while the leg is in a predetermined orientation;

an image generator coupled to the tracking unit and the navigation engine; and

a display screen coupled to the image generator, wherein

the navigation engine is configured to utilize the previously derived pre-reconstruction orientation of the femoral position tracking frame to compute a plurality of orientation change values following a trial reduction as the patient'"'"'s leg is moved, and to provide the computed orientation change values to the image generator,

the image generator is configured to display on the display screen one or more images including the computed orientation change values to assist in returning the patient'"'"'s leg to the predetermined orientation following a trial reduction,

the navigation engine is further configured, with the patient'"'"'s leg returned to the predetermined orientation, to derive a second, post-reconstruction location of the femoral position tracking frame, and to compute one or more of a leg length change value, an offset change value and an anterior-posterior (AP) change value, based on the first, pre-reconstruction location,

the image generator displays the one or more computed leg length change value, the offset change value, and the AP change value, and

the system is free from establishing a coordinate system on the patient'"'"'s femur.

2. The system of claim 1 wherein the plurality of computed orientation change values displayed by the image generator include an indication of flexion, an indication of internal rotation and an indication of abduction of a current orientation of the patient'"'"'s leg relative to the predetermined orientation.

3. The system of claim 2 wherein the indication of flexion, the indication of internal rotation and the indication of abduction are displayed in at least near real-time.

4. The system of claim 1 wherein the image generator displays each of the computed leg length change value, the offset change value, and the AP change value.

5. A system for performing hip surgery on a patient having a leg, a pelvis and a femur, the system comprising:

a femoral position tracking frame configured for attachment to the patient'"'"'s femur;

a pelvic position tracking frame configured for attachment to the patient'"'"'s pelvis;

means for calculating a pre-reconstruction orientation and position of the femoral position tracking frame relative to the pelvic position tracking frame, while the patient'"'"'s leg is in a predetermined orientation;

means for establishing a coordinate system at the patient'"'"'s pelvis;

means for computing, using the pre-reconstruction orientation of the femoral position tracking frame, a plurality of orientation change values as the patient'"'"'s leg is moved following a trial reduction;

means for presenting the plurality of orientation change values to a surgeon in returning the patient'"'"'s leg to the predetermined orientation following the trial reduction; and

means for computing a translational change between the pre-reconstruction position and a post-reconstruction position of the femoral position tracking frame, and for deriving at least one of a leg length change value, an offset change value and an anterior-posterior (AP) change value, based on the computed translational change,

wherein the system is free from establishing a femoral coordinate system.

6. The system of claim 5 further comprising a surgical tool, the surgical tool comprising:

an elongated body element adapted and configured to be received within a channel formed in the patient'"'"'s femur;

a support arm extending away from the elongated body element opposite from the patient'"'"'s femur;

a position tracking unit removably mounted to the support arm; and

a fastener adapted and configured to removably secure the position tracking unit relative to the patient'"'"'s femur, while the position tracking unit is mounted to the support arm,

wherein the elongated body element of the surgical tool is receiving within the channel and the tracking unit is mounted to the support arm and secured to the femur without removing the femur'"'"'s native head.

7. A method for performing hip surgery on a patient having a leg, a pelvis and a femur, the method comprising:

attaching a pelvic position tracking frame to the patient'"'"'s pelvis;

inserting a broach into the patient'"'"'s femur;

attaching a femoral position tracking frame to the broach whereby the femoral position tracking frame contacts the femur;

deriving a pre-reconstruction position of the femoral position tracking frame relative to the pelvic position tracking frame and a pre-reconstruction orientation of the femoral position tracking frame relative to the pelvic position tracking frame while the leg is in a predetermined orientation;

removing the femoral position tracking frame from the broach;

installing a prosthetic stem into the femur;

re-attaching the femoral position tracking frame to the broach whereby the femoral position tracking frame contacts the femur;

computing a plurality of orientation change values following the installation of the prosthetic stem as the patient'"'"'s leg is moved;

generating a display that includes the plurality of orientation change values to assist a surgeon in returning the patient'"'"'s leg to the predetermined orientation following the installation of the prosthetic stem;

computing at least one of a leg length change value, an offset change value and an anterior-posterior (AP) change value for the patient'"'"'s leg following the installation of the prosthetic stem, based on the derived pre-reconstruction position of the femoral position tracking frame; and

providing the computed at least one leg length change value, offset change value, and AP change value to the surgeon for evaluation.

8. The method of claim 7 wherein

the computing comprises detecting a translation change between the pre-reconstruction position of the femoral position tracking frame and a post-reconstruction position of the femoral position tracking frame, and

the at least one leg length change value, offset change value and AP change value is based on the detected translation change.

9. The method of claim 7 wherein the plurality of orientation change values are displayed in at least near real-time.

10. A method for performing hip surgery on a patient having a leg, a pelvis and a femur, the method comprising:

attaching a pelvic position tracking frame to the patient'"'"'s pelvis;

attaching a femoral position tracking frame to the patient'"'"'s femur;

deriving a pre-reconstruction position of the femoral position tracking frame relative to the pelvic position tracking frame and a pre-reconstruction orientation of the femoral position tracking frame relative to the pelvic position tracking frame while the leg is in a predetermined orientation;

installing a prosthetic stem into the femur;

computing a plurality of orientation change values, using the derived pre-reconstruction orientation of the femoral position tracking frame, as the patient'"'"'s leg is moved following the installation of the prosthetic stem;

generating a display that includes the computed plurality of orientation change values to assist a surgeon in returning the patient'"'"'s leg to the predetermined orientation following the installation of the prosthetic stem;

computing at least one of a leg length change value, an offset change value and an anterior-posterior (AP) change value for the patient'"'"'s leg following the installation of the prosthetic stem, based on the derived pre-reconstruction position of the femoral position tracking frame; and

providing the computed at least one leg length change value, offset change value, and AP change value to the surgeon for evaluation.

11. The method of claim 10 wherein the display includes an indication of flexion, an indication of internal rotation and an indication of abduction as the surgeon moves the patient'"'"'s leg.

12. The method of claim 10 wherein the display presents the plurality of orientation change values in at least near real-time.