Computer-aided methods, systems, and apparatuses for shoulder arthroplasty

• US 8,109,942 B2
• Filed: 04/21/2005
• Issued: 02/07/2012
• Est. Priority Date: 04/21/2004
• Status: Expired due to Fees

• Current Assignee: Smith & Nephew BV (Smith & Nephew PLC)
• Original Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Inventors: Carson, Christopher Patrick
• Primary Examiner(s): Jackson, Gary
• Assistant Examiner(s): Mendoza, Michael G
• Application Number:
  US11/111,325
• Publication Number:
  US 20050245808A1
• Time in Patent Office: 2,483 Days
• Field of Search: 606/130, 606/87, 606/86.R, 606/79, 606/80, 606/96, 600/429, 600/439, 600/424, 600/426, 600/407, 600/443
• US Class Current: 606/130
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/1684 for the shoulder
• CPC Class Codes: A61B 17/1778 for the shoulder
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• 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 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• CPC Class Codes: A61B 2034/254 being adapted depending on the stage of the surgical procedure
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for

Abstract

A method for performing shoulder arthroplasty or hemiarthroplasty is provided. The method includes generating navigational reference information relating to position and orientation of a body part forming at least a portion of the shoulder joint. The reference information may be stored in a computer. Navigational references are attached to the body part and an object. Information is received regarding the position and orientation of the object with respect to the body part and the object is navigated according to this information. The body part may be modified using the object and the modification may be displayed on a monitor associated with the computer. The navigational references may be used to track a shoulder arthroplasty trial component. Information is received regarding the position and orientation of the trial component with respect to the body part. This information is used to navigate the trial component to the body part.

Claims

1. A method for performing shoulder arthroplasty or hemiarthroplasty surgical operations on portions of a shoulder joint, the method comprising:

generating navigational reference information relating to position and orientation of a body part forming at least a portion of the shoulder joint, wherein the body part is a humerus;

storing at least some of the navigational reference information in a computer;

attaching at least one first navigational reference capable of being tracked by the navigational sensor to the body part;

attaching at least one second navigational reference capable of being tracked by a navigational sensor to a surgical instrument;

receiving information from the navigational sensor regarding the position and orientation of the surgical instrument with respect to the body part, wherein the information received from the navigational sensor comprises the epicondylar axis of the humerus and the information received is used to determine the retroversion reference axis;

navigating the surgical instrument relative to the body part according to the position and orientation information;

tracking a trial component using the navigational sensor;

receiving information from the navigational sensor regarding the position and orientation of the trial component with respect to the body part;

generating and displaying on the monitor associated with the computer a visual image of the trial component properly positioned and oriented relative to the body part;

navigating the trial component relative to the body part and attaching the trial component to the body part according to the image;

performing soft tissue balancing tests while the navigation sensor continues to track the first and second navigational references;

using data generated by the computer to assess alignment and stability of the joint with the trial component attached; and

releasing soft tissue to adjust alignment and stability.

2. The method of claim 1, wherein the surgical instrument comprises at least one of the following:

a reamer, a resection guide, a cutting block and a probe.

3. The method of claim 1, wherein the information received from the navigational sensor comprises information regarding the anatomical axis of the humerus.

4. The method of claim 1, wherein the information received from the navigational sensor is used to determine an axis of the rotation for the shoulder joint.

5. The method of claim 1, further comprising:

modifying the body part using the surgical instrument; and

generating and displaying on a monitor associated with the computer information regarding the modification of the body part.

6. The method of claim 5, wherein the information displayed is used to determine the proper shoulder arthroplasty or hemiarthroplasty component size.

7. The method of claim 1, further comprising:

removing the trial component from the joint; and

navigating a prosthetic component using position and orientation information regarding the trial component.

8. The method of claim 7, wherein the prosthetic component comprises at least one of the following:

a humeral component and a glenoid component.

9. The method of claim 1, wherein the navigational reference information is generated by an imager.

10. The method of claim 9, wherein the imager comprises one of the following:

a C-arm fluoroscope, a CT scanner, MRI equipment, ultrasound equipment, laser scanning equipment and a probe.

11. The method of claim 1, wherein the navigational reference information is one of the following:

a resection plane, an anatomical axis, a mechanical axis, anterior/posterior reference plane, medial/lateral reference plane and rotational axis.

12. The method of claim 1, wherein the surgical instrument is a humeral reamer and the body part is a humerus and further comprising:

attaching a cutting block to the humeral reamer;

placing a surgical instrument through the cutting block into the humeral head; and

at least partially osteotomizing the humeral head.

13. A method for performing shoulder arthroplasty or hemiarthroplasty surgical operations on portions of a shoulder joint, the method comprising:

(a) attaching at least one first navigational reference capable of being tracked by a navigational sensor to a humerus forming at least a portion of the shoulder joint;

(b) generating navigational reference information relating to position and orientation of the humerus;

(c) storing at least some of the navigational reference information in a computer;

(d) tracking the position and orientation of the humerus as it moves;

(e) attaching at least one second navigational reference capable of being tracked by the navigational sensor to a humeral reamer;

(f) receiving information from the navigational sensor regarding the position and orientation of the humeral reamer with respect to the humerus;

(g) navigating the humeral reamer relative to the humerus according to the position and orientation information;

(h) attaching a cutting block to the humeral reamer;

(i) attaching at least one third navigational reference capable of being tracked by the navigational sensor to the cutting block;

(j) positioning the cutting block in at least one rotational degree of freedom through a range motion with infinite positions in the range; and

at least one translational degree of freedom through a range of motion with infinite positions in the range; and

(k) receiving continuous information from the navigational sensor regarding the position and orientation of the cutting block with respect to the humerus or the humeral reamer, wherein the information comprises rotational information in at least one degree of freedom and translational information in at least one degree of freedom.

14. A method for performing shoulder arthroplasty or hemiarthroplasty surgical operations on portions of a shoulder joint, the method comprising:

obtaining data corresponding to a body part forming a portion of the shoulder joint using a first fiducial that is attached to the body part, wherein the first fiducial is capable of being tracked by at least one position and orientation sensor;

tracking the position and orientation of a surgical instrument relative to the body part using a computer that receives signals from the position and orientation sensor, wherein the surgical instrument is attached to a second fiducial capable of being tracked by the position and orientation sensor;

navigating the surgical instrument relative to the body part using the computer, which generates and displays on a monitor a visual representation of the position and orientation of the surgical instrument relative to the body part;

modifying the body part using the surgical instrument;

moving the body part to assess the shoulder joint as the computer tracks the position and orientation of the body part;

wherein moving the body part to assess the shoulder joint comprises performing soft tissue balancing tests.

15. The method of claim 14, further comprising moving the body part as the computer tracks the position and orientation of an implant.

16. The method of claim 15, wherein moving the body part to assess the shoulder joint comprises assessing the alignment and stability of the shoulder joint with the implant attached to the shoulder joint.

17. The method of claim 16, further comprising releasing soft tissue to adjust alignment and stability of the shoulder joint.

18. The method of claim 14, wherein the surgical instrument comprises at least one of the following:

a reamer, a resection guide, a cutting block and a probe.

19. The method of claim 14, wherein the body part is the humerus.

20. The method of claim 14, wherein the body part is the glenoid.

21. The method of claim 14, wherein the data corresponding to the body part comprises position and orientation information of the body part.

22. The method of claim 21, further comprising determining an axis of the rotation for the shoulder joint using the data corresponding to the body part.

23. The method of claim 14, wherein the data corresponding to the body part comprises information regarding the anatomical axis of the humerus.

24. The method of claim 14, wherein the data corresponding to the body part comprises information regarding at least one of a resection plane, an anterior reference plane, a posterior reference plane, a medial reference plane, or a lateral reference plane.

25. The method of claim 14, further comprising generating information regarding the modification of the body part using the computer.

26. The method of claim 25, wherein the information is used to determine a size for an implant to be attached to the shoulder joint.