Assessing the condition of a joint and devising treatment

• US 8,112,142 B2
• Filed: 06/27/2007
• Issued: 02/07/2012
• Est. Priority Date: 09/14/1998
• Status: Expired due to Term

• Current Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Original Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Inventors: Alexander, Eugene J., Andriacchi, Thomas P., Lang, Philipp, Steines, Daniel
• Primary Examiner(s): Casler, Brian
• Assistant Examiner(s): Cwern, Jonathan
• Application Number:
  US11/769,434
• Publication Number:
  US 20080015433A1
• Time in Patent Office: 1,686 Days
• Field of Search: 600/407, 600/427
• US Class Current: 600/407
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• 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 5/1038 Measuring plantar pressure during gait
• CPC Class Codes: A61B 5/112 Gait analysis
• CPC Class Codes: A61B 5/1121 Determining geometric values, e.g. centre of rotation or angular range of movement
• CPC Class Codes: A61B 5/1122 of movement trajectories
• CPC Class Codes: A61B 5/1127 using markers
• CPC Class Codes: A61B 5/4514 Cartilage
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 5/7257 using Fourier transforms
• CPC Class Codes: G09B 23/30 Anatomical models G09B23/281 - G09B23/288 take precedence

Abstract

Methods are disclosed for assessing the condition of a cartilage in a joint, particularly in a human knee. The methods include converting an image such as an MRI to a three dimensional map of the cartilage. The cartilage map can be correlated to a movement pattern of the joint to assess the affect of movement on cartilage wear. Changes in the thickness of cartilage over time can be determined so that therapies can be provided. Information on thickness of cartilage and curvature of cartilage or subchondral bone can be used to plan therapy. Information on movement pattern can be used to plan therapy.

Claims

1. A method of treating a human joint disease involving cartilage comprising:

obtaining an electronic volumetric image of a joint, wherein said image includes both normal and diseased cartilage tissue;

creating a three-dimensional model from said image representing at least a portion of a surface of the joint;

electronically evaluating said three-dimensional model to obtain information including volume of at least a portion of the normal cartilage tissue, the diseased cartilage tissue, or both; and

selecting a therapy for treating the joint disease based on said information.

2. The method of claim 1, wherein the electronic volumetric image is obtained at an initial time,

further including obtaining a second electronic volumetric image of the normal cartilage tissue, the diseased cartilage tissue, or both at a later time, and electronically evaluating said second electronic volumetric image to obtain information including volume of the at least a portion of the normal cartilage tissue, the diseased cartilage tissue, or both, and

determining the change in volume of the portion of the normal cartilage tissue, the diseased cartilage tissue, or both between the later and the initial times.

3. The method of claim 1, wherein said electronically evaluating further comprises:

assessing a condition of the cartilage in the joint of a human, which method comprises,

electronically transferring an electronically generated image of the cartilage of the joint from a transferring device to a receiving device located distant from the transferring device,

receiving the transferred image at the distant location,

converting the transferred image to a degeneration pattern of the cartilage, and

transmitting the degeneration pattern to a site for analysis.

4. The method of claim 1, wherein said therapy comprises utologous chondrocyte transplantation, osteochondral allografting, osteochondral autografting, tibial corticotomy, femoral or tibial osteotomy.

5. The method of claim 1, wherein said therapy uses cartilage or bone tissue grown ex vivo, stem cells, an artificial non-human material, an agent that stimulates repair of said diseased tissue, or an agent that protects said diseased tissue and that protects adjacent normal tissue.

6. The method of claim 1, wherein said information is used to determine a geometrical feature of a tissue transplant, a tissue graft, a tissue implant, a tissue replacement material, a tissue scaffold, or a tissue regenerating material or tissue repair system.

7. The method of claim 1, wherein said image is obtained using ultrasound, computed tomography, positron emission tomography, a single photon emission computed tomography scan, or MRI.

8. The method of claim 1, wherein the portion of a surface of the joint includes a region of interest that encompasses the diseased cartilage tissue but does not encompass the entire articular cartilage.

9. A method of treating a human joint disease involving cartilage comprising:

obtaining an electronic image of a joint, wherein said image includes both normal and diseased cartilage tissue;

creating a three-dimensional model from said image representing at least a portion of a surface of the joint;

electronically evaluating said three-dimensional model to obtain volumetric information including a surface area of at least a portion of the normal cartilage tissue, the diseased cartilage tissue, or both; and

selecting a therapy for treating the joint disease based on said information.

10. The method of claim 9, wherein the electronic image is obtained at an initial time,

further including obtaining a second electronic image of the joint at a later time,

electronically evaluating said second electronic image of the joint to obtain volumetric information including a surface area of the at least a portion of the normal cartilage tissue, the diseased cartilage tissue, or both, and

determining the change in thickness of the at least a portion of the normal cartilage tissue, the diseased cartilage tissue, or both between the later and the initial times.

11. The method of claim 9, wherein said electronically evaluating further comprises:

assessing a condition of the cartilage in the joint of a human, which method comprises,

electronically transferring an electronically generated image of the cartilage of the joint from a transferring device to a receiving device located distant fron the transferring device,

receiving the transferred image at the distant location,

converting the transferred image to a degeneration pattern of the cartilage, and transmitting the degeneration pattern to a site for analysis.

12. The method of claim 9, wherein said electronic image provides information on the thickness, shape, or curvature of said normal and said disease tissue or the location and size of said diseased tissue.

13. The method of claim 9, wherein said therapy comprises autologous chondrocyte transplantation, osteochondral allografting, osteochondral autografting, tibial corticotomy, femoral or tibial osteotomy.

14. The method of claim 9, wherein said therapy uses cartilage or bone tissue grown ex vivo, stem cells, an artificial non-human material, an agent that stimulates repair of said diseased tissue, or an agent that protects said diseased tissue and that protects adjacent normal tissue.

15. The method of claim 9, wherein said information is used to determine a geometrical feature of a tissue transplant, a tissue graft, a tissue implant, a tissue replacement material, a tissue scaffold, or a tissue regenerating material or tissue repair system.

16. The method of claim 9, wherein said image is obtained using ultrasound, computed tomography, positron emission tomography, a single photon emission computed tomography scan, or MRI.

17. The method of claim 9, wherein the portion of a surface of the joint includes a region of interest that encompasses the diseased cartilage tissue but does not encompass the entire articular cartilage.

18. A method of treating a human joint disease involving cartilage comprising:

obtaining an electronic image of a joint, wherein said image includes both normal and diseased cartilage tissue;

creating a three-dimensional model from said image representing at least a portion of a surface of the joint;

electronically evaluating said three-dimensional model to obtain information including cartilage thickness using three-dimensional information about at least a portion of the normal cartilage tissue, the diseased cartilage tissue, or both; and

selecting a therapy for treating the joint disease based on said information including the cartilage thickness.

19. The method of claim 18, wherein said electronic image is obtained at an initial time,

obtaining a second electronic image of the joint at a later time,

electronically evaluating the second electronic image to obtain information including cartilage thickness at the later time, and

determining the change in cartilage thickness between the later and the initial times.

20. The method of claim 18, wherein said electronically evaluating further comprises:

assessing a condition of the cartilage in the joint of a human, which method comprises,

electronically transferring an electronically generated image of the cartilage of the joint from a transferring device to a receiving device located distant from the transferring device,

receiving the transferred image at the distant location,

converting the transferred image to a degeneration pattern of the cartilage, and

transmitting the degeneration pattern to a site for analysis.

21. The method of claim 18, wherein said electronic image provides information on the thickness, shape, or curvature of said normal and said disease tissue or the location and size of said diseased tissue.

22. The method of claim 18, wherein said therapy comprises autologous chondrocyte transplantation, osteochondral allografting, osteochondral autografting, tibial corticotomy, femoral or tibial osteotomy.

23. The method of claim 18, wherein said therapy uses cartilage or bone tissue grown ex vivo, stem cells, an artificial non-human material, an agent that stimulates repair of said diseased tissue, or an agent that protects said diseased tissue and that protects adjacent normal tissue.

24. The method of claim 18, wherein said information is used to determine the thickness or other geometrical feature of a tissue transplant, a tissue graft, a tissue implant, a tissue replacement material, a tissue scaffold, or a tissue regenerating material or tissue repair system.

25. The method of claim 18, wherein said image is obtained using ultrasound, computed tomography, positron emission tomography, a single photon emission computed tomography scan, or MRI.

26. The method of claim 25, wherein said information is used to generate a three-dimensional map of cartilage thickness or a physical model of said normal or said diseased tissue or both.

27. The method of claim 26, wherein said physical model is used to shape a tissue transplant, a tissue graft, a tissue implant, a tissue replacement material, a tissue scaffold or a tissue regenerating material or tissue repair system.

28. The method of claim 18, wherein the portion of a surface of the joint includes a region of interest that encompasses the diseased cartilage tissue but does not encompass the entire articular cartilage.

29. A method of treating a human joint disease involving cartilage comprising:

obtaining an electronic image of a joint, wherein said image includes both normal and diseased cartilage tissue;

creating a three-dimensional model from said image representing at least a portion of a surface of the ioint;

electronically evaluating said three-dimensional model to obtain information including three-dimensional curvature of at least a portion of the normal cartilage tissue, the diseased cartilage tissue, or both; and

selecting a therapy for treating the joint disease based on said information.

30. The method of claim 29, wherein said electronic image is obtained at an initial time, further including

obtaining a second electronic image of the joint at a later time,

electronically evaluating the second electronic image to obtain information including the three-dimensional curvature of the at least a portion of the normal cartilage tissue, the diseased cartilage tissue, or both, and

determining the change in the three-dimensional curvature between the later and the initial times.

31. The method of claim 29, wherein said electronically evaluating further comprises:

assessing a condition of the cartilage in the joint of a human, which method comprises,

electronically transferring an electronically generated image of the cartilage of the joint from a transferring device to a receiving device located distant from the transferring device,

receiving the transferred image at the distant location,

converting the transferred image to a degeneration pattern of the cartilage, and

transmitting the degeneration pattern to a site for analysis.

32. The method of claim 29, wherein said electronic image provides information on the thickness, shape, or curvature of said normal and said disease tissue or the location and size of said diseased tissue.

33. The method of claim 29, wherein said therapy comprises autologous chondrocyte transplantation, osteochondral allografting, osteochondral autografting, tibial corticotomy, femoral or tibial osteotomy.

34. The method of claim 29, wherein said therapy uses cartilage or bone tissue grown ex vivo, stem cells, an artificial non-human material, an agent that stimulates repair of said diseased tissue, or an agent that protects said diseased tissue and that protects adjacent normal tissue.

35. The method of claim 29, wherein said image is obtained using ultrasound, computed tomography, positron emission tomography, a single photon emission computed tomography scan, or MRI.

36. The method of claim 29, wherein said information is used to generate a physical model of said normal or said diseased tissue or both.

37. The method of claim 36, wherein said physical model is used to shape a tissue transplant, a tissue graft, a tissue implant, a tissue replacement material, a tissue scaffold or a tissue regenerating material or tissue repair system.

38. The method of claim 29, wherein the portion of a surface of the joint includes a region of interest that encompasses the diseased cartilage tissue but does not encompass the entire articular cartilage.

39. A method of treating a mammalian joint disease involving cartilage comprising:

obtaining an electronic volumetric image of a joint, wherein said image includes both normal and diseased cartilage tissue;

creating a three-dimensional model from said image representing at least a portion of a surface of the joint;

electronically evaluating said three-dimensional model to obtain information including a volume of cartilage loss in a region of a cartilage defect of the cartilage in the joint of a mammal, which includes;

determining a thickness, D_N, of the normal cartilage near the cartilage defect,

obtaining a thickness of the cartilage defect, D_D, of the region,

subtracting D_D from D_N to give a thickness of the cartilage loss, D_L, and

multiplying the D_L value times an area of the cartilage defect, A_D, to give the volume of cartilage loss, and

selecting a therapy for treating the joint disease based on said information.

40. The method of claim 39, further including electronically monitoring the effectiveness of said therapy.

41. The method of claim 40, wherein the electronic image is obtained at an initial time, further including:

obtaining a second electronic image of the joint at a later time,

electronically evaluating said second electronic image and determining the volume of cartilage loss in the region of the cartilage defect at the later time.

42. The method of claim 39, wherein the portion of a surface of the joint includes a region of interest that encompasses the diseased cartilage tissue but does not encompass the entire articular cartilage.