Surgical orientation system and method

• US 8,057,479 B2
• Filed: 07/13/2009
• Issued: 11/15/2011
• Est. Priority Date: 06/09/2003
• Status: Active Grant

• Current Assignee: Orthalign, Inc.
• Original Assignee: Orthalign, Inc.
• Inventors: Stone, A. Curt
• Primary Examiner(s): Chen; Tse
• Assistant Examiner(s): Brutus; Joel F
• Application Number:
  US12/502,182
• Publication Number:
  US 20100016705A1
• Time in Patent Office: 855 Days
• Field of Search: 606/91, 606/102, 606/88, 606/96, 600/437
• 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 with imaging means A61B90/37, A61B34/20
• 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:

providing a surgical instrument adapted to support the medical prosthesis or an alignment guide adapted to contact the anatomical feature, and identifying a first position of the surgical instrument relative to the anatomical feature;

coupling a first measuring device to the surgical instrument in the first position and zeroing the first measuring device, the first measuring device being adapted to measure first positional changes;

attaching the first measuring device to the patient near the anatomical feature;

coupling a second measuring device to the surgical instrument in the first position and zeroing the second measuring device, the second measuring device being adapted to measure second positional changes; and

determining a relative position of the second measuring device to the anatomical feature, based on the first positional changes and the second positional changes.

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

3. The method of claim 1 wherein the first measuring device is operatively coupled to the second measuring device by a communication channel.

4. The method of claim 3 wherein the communication channel is a wireless infrared or radio frequency telemetry link.

5. The method of claim 3 wherein the second measuring device receives the first positional changes from the first measuring device via the communication channel.

6. The method of claim 5 wherein the second measuring device includes a digital display to provide an indication of the position of the second measuring device relative to the anatomical feature.

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

8. The method of claim 7 wherein the step of identifying 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.

9. The method of claim 8 further comprising positioning the surgical instrument at a predetermined angular orientation relative to the acetabulum.

10. The method of claim 9 wherein the predetermined angular orientation is a predetermined anteversion angle.

11. 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.

12. The method of claim 1 wherein the first and second measuring devices are three-dimensional electronic orientation devices and wherein each of the first and second measuring devices 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.

13. A method of positioning a medical prosthesis in a joint of a patient, the medical prosthesis being positioned with respect to an anatomical feature of the patient, the method comprising:

providing a surgical instrument adapted to prepare the joint to receive the medical prosthesis, the surgical instrument having an alignment guide coupled to the surgical instrument and adapted to be moveable with respect to the anatomical feature;

coupling a first measuring device to the patient, the first measuring device adapted to measure positional changes of the patient;

coupling a second measuring device to the surgical instrument when the surgical instrument is in a first position, the second measuring device adapted to measure positional changes of the alignment guide with respect to the anatomical feature or the joint;

zeroing the first and second measuring devices with respect to one another in the first position, the first measuring device providing a reference to the second measuring device for compensating for positional changes of the patient;

attaching the surgical instrument to the patient near the anatomical feature;

manipulating the alignment guide with respect to the joint so that the alignment guide is in a second position; and

determining a relative position of the second measuring device with respect to the anatomical feature based on the second position of the alignment guide.

14. The method of claim 13, further comprising coupling the first measuring device with one of the surgical instrument and the second measuring device.

15. The method of claim 14, further comprising coupling the first measuring device with the second measuring device.

16. The method of claim 13, further comprising coupling the first measuring device with the patient at a location spaced apart from the second measuring device.

17. The method of claim 13, wherein the reference comprises a wireless, electronic signal.

18. The method of claim 13, wherein the second measuring device comprises a processor for performing data processing.

19. A system for positioning a medical prosthesis in a joint of a patient, the medical prosthesis being positioned with respect to an anatomical feature of the patient, the system comprising:

a surgical instrument removably engageable to the patient adjacent the joint and near the anatomical feature, the surgical instrument configured to prepare the joint to receive the medical prosthesis;

an alignment guide movable couple to the surgical instrument and configured to be moveable with respect to the anatomical feature, the surgical instrument configured to support either the alignment guide or the prosthesis;

a first measuring device configured to be coupled to the patient, the first measuring device configured to measure positional changes of the patient;

a second measuring device configured to be coupled to the surgical instrument, the second measuring device configured to measure positional changes of the alignment guide with respect to the anatomical feature or the joint;

first and second zeroing devices on the first and second measuring respectively, wherein the first and second measuring devices are configured to be zeroed with respect to one another in a first position, the first measuring device configured to provide a reference to the second measuring device for compensating for positional changes of the patient; and

a communications module coupled to the first and second measuring devices for electronic communications between the first and second measuring devices, the communications module configured to communicate a second position of the second measuring device relative to the first measuring device and the first position,

wherein the alignment guide is configured to be manipulated with respect to the joint so that the alignment guide and the second measuring device are in the second position;

wherein the first and second measuring devices are configured to determine a relative position of the second measuring device with respect to the anatomical feature based on the second position of the alignment guide.

20. The system of claim 19, wherein the first measuring device is configured to be coupled to the second measuring device via wireless, electronic coupling.

21. The system of claim 19, wherein the reference comprises a wireless, electronic signal.

22. The method of claim 19, wherein the communications module comprises a processor for performing data processing.

23. The system of claim 19, wherein the second measuring device comprises a three-dimensional electronic orientation device and wherein the second measuring device includes at least one rate sensor that provides a rate signal indicative of a change in angular position of the second measuring device about an axis.

24. The system of claim 19, wherein the second measuring device includes a digital display to provide an indication of angular position changes.

25. The system of claim 24, wherein the first measuring device comprises a sensor array and wherein the system is configured to transmit positional information to the second measuring device for automatic adjustment of the digital display in the event of patient movement.

26. The system of claim 19, wherein the second measuring device comprises a first rate sensor, a second rate sensor, and a third rate sensor, each disposed about an orthogonal axis.

27. The system of claim 24, wherein the first measuring device does not include a display.

28. The system of claim 19, wherein the second zeroing device comprises a zeroing button.

29. The system of claim 19, wherein the first zeroing device comprises circuitry to reset or zero a sensor output.