Operatively tuning implants for increased performance

• US 8,078,440 B2
• Filed: 09/19/2008
• Issued: 12/13/2011
• Est. Priority Date: 09/19/2008
• Status: Active Grant

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Inventors: McKinnon, Brian W., Nadzadi, Mark Ellsworth, Otto, Jason Karl
• Primary Examiner(s): Craig, Dwin M
• Application Number:
  US12/234,444
• Publication Number:
  US 20100076563A1
• Time in Patent Office: 1,180 Days
• Field of Search: 703/6, 623/18.11
• US Class Current: 703/6
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 5/4533 Ligaments
• CPC Class Codes: A61B 5/4824 Touch or pain perception evaluation A61B5/4821 takes precedence
• CPC Class Codes: A61B 5/6878 Bone
• CPC Class Codes: A61F 2/38 for elbows or knees
• CPC Class Codes: A61F 2002/30943 using mathematical models
• CPC Class Codes: A61F 2002/30955 using finite-element analysis
• CPC Class Codes: A61F 2002/3096 trimmed or cut to a customised size
• CPC Class Codes: B33Y 50/00 Data acquisition or data processing for additive manufacturing
• CPC Class Codes: B33Y 80/00 Products made by additive manufacturing
• CPC Class Codes: G16B 5/00 ICT specially adapted for modelling or simulations in systems biology, e.g. gene-regulatory networks, protein interaction networks or metabolic networks
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

A method for preoperatively characterizing an individual patient'"'"'s biomechanic function in preparation of implanting a prosthesis is provided. The method includes subjecting a patient to various activities, recording relative positions of anatomy during the various activities, measuring force environments responsive to the patient'"'"'s anatomy and affected area during the various activities, characterizing the patient'"'"'s biomechanic function from the relative positions and corresponding force environments, inputting the measured force environments, relative positions of knee anatomy, and patient'"'"'s biomechanic function characterization into the one or more computer simulation models, inputting a computer model of the prosthesis into the one or more computer simulation models, and manipulating the placement of the prosthesis in the computer simulation using the patient'"'"'s biomechanic function characterization and the computer model of the prosthesis to approximate a preferred biomechanical fit of the prosthesis.

Claims

1. A method for preoperatively approximating a preferred biomechanic fit of a prosthesis relative to a patient'"'"'s articular joint, comprising the steps of:

a. receiving information concerning a pre-operative physical articulation of the articular joint during at least one pre-operative physical activity of the patient, such information including;

i. a plurality of relative positions of the patient'"'"'s articular joint during the pre-operative physical articulation;

ii. a derived force environment of the patient'"'"'s articular joint during the pre-operative physical articulation;

b. inputting the information concerning the derived force environment and the relative positions of the patient'"'"'s articular joint into one or more computer simulation models;

c. inputting a prosthesis computer model into the one or more computer simulation models;

d. using the one or more computer simulation models, inputted prosthesis computer model, and inputted information, approximating a preferred biomechanic fit of the prosthesis relative to the patient'"'"'s articular joint; and

e. outputting information concerning the preferred biomechanic fit of the prosthesis relative to the patient'"'"'s articular joint.

2. The method of claim 1, wherein using the one or more computer simulation models comprises using a computer simulation model that corresponds to the at least one physical activity.

3. The method of claim 1, wherein outputting information concerning the preferred biomechanic fit of the prosthesis comprises outputting information concerning the preferred biomechanic fit of a standard prosthesis.

4. The method of claim 1, wherein outputting information concerning the preferred biomechanic fit of the prosthesis comprises outputting information concerning the preferred biomechanic fit of a modular prosthesis.

5. The method of claim 4, wherein outputting information concerning the preferred biomechanic fit of the modular prosthesis comprises outputting information concerning the preferred biomechanic fit of a unicondylar component and a patellofemoral component.

6. The method of claim 1, wherein outputting information concerning the preferred biomechanic fit of the prosthesis comprises outputting information concerning a patient specific prosthesis shaped according to at least one anatomic feature of the patient'"'"'s articular joint.

7. The method of claim 1, wherein approximating the preferred biomechanic fit of the prosthesis relative to the patient'"'"'s articular joint comprises the steps of:

a. iteratively running each of said one or more computer simulation models while changing at least one input variable between iterations; and

b. determining from the computer simulation models a relative placement for one or more components of the prosthesis.

8. The method of claim 1, further comprising the steps of:

a. recommending a preferred placement of the prosthesis to a surgeon;

b. receiving input from the surgeon related to the recommended placement, the input requesting an alteration of the placement; and

c. altering the placement of the prosthesis according to the input.

9. The method of claim 8, wherein the recommending step comprises recommending a plurality of preferred placements, and the receiving step includes receiving surgeon input of the surgeon'"'"'s preference of the preferred placements.

10. The method of claim 8, further comprising providing means for implanting the prosthesis.

11. The method of claim 1, wherein inputting the prosthesis computer model comprises inputting a 3-dimensional model.

12. The method of claim 1, wherein receiving information concerning the pre-operative physical articulation of the articular joint during the at least one pre-operative physical activity of the patient comprises receiving information concerning the pre-operative physical articulation during at least one of walking, chair rising, chair sitting, stair climbing, stair descending, squatting, swinging a golf club, jogging, kneeling, turning, and biking.

13. The method of claim 1, wherein outputting information concerning the preferred biomechanic fit comprises outputting information concerning a patient-specific instrument.

14. The method of claim 13, wherein outputting information concerning the patient-specific instrument comprises outputting information concerning a patient-specific cutting guide.

15. A method for preoperatively approximating a preferred biomechanic fit of a prosthesis relative to a patient'"'"'s articular joint, comprising the steps of:

a. receiving information concerning a pre-operative physical articulation of the articular joint during at least one physical activity of the patient, such information including;

i. a plurality of relative positions of the patient'"'"'s articular joint during the pre-operative physical articulation;

ii. a characterization of a kinetic biomechanic function of the patient'"'"'s articular joint during the pre-operative physical articulation;

b. inputting the information into one or more computer simulation models;

c. inputting a prosthesis computer model into the one or more computer simulation models;

d. using the one or more computer simulation models, inputted prosthesis computer model, and inputted information, approximating a preferred biomechanic fit of the prosthesis relative to the patient'"'"'s articular joint; and

e. outputting information concerning the preferred biomechanic fit of the prosthesis relative to the patient'"'"'s articular joint.

16. The method of claim 15, wherein outputting information concerning the preferred biomechanic fit of the prosthesis comprises outputting information concerning a preferred alignment and position of the prosthesis relative to the patient'"'"'s articular joint.

17. The method of claim 16, wherein outputting information concerning the preferred alignment and position of the prosthesis comprises outputting information concerning a patient-specific cutting guide.

18. The method of claim 15, wherein outputting information concerning the preferred biomechanic fit of the prosthesis comprises outputting information concerning a prosthesis custom designed for the patient'"'"'s articular joint.

19. The method of claim 15, further comprising receiving imaging of the patient'"'"'s articular joint.