Assessing the condition of a joint and devising treatment

• US 8,306,601 B2
• Filed: 08/13/2011
• Issued: 11/06/2012
• Est. Priority Date: 09/14/1998
• Status: Expired due to Fees

• 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: Lang, Philipp, Steines, Daniel
• Primary Examiner(s): Cwern, Jonathan
• Application Number:
  US13/209,373
• Publication Number:
  US 20120072183A1
• Time in Patent Office: 451 Days
• Field of Search: 600/407, 600/427, 623/18.11
• 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 effect 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. Planning therapy may include generating one or more physical models.

Claims

1. A method of creating a physical model used in the treatment of an articular surface of a joint of a patient, the method comprising:

processing image data of at least a portion of the joint of the patient;

creating a three dimensional surface representation of at least a portion of a cartilage surface of the joint from the image data; and

generating a physical model that includes a surface portion that is derived from the three dimensional surface representation of at least a portion of the cartilage surface of the joint;

wherein the physical model is configured for use in the treatment of the joint.

2. The method of claim 1, wherein said cartilage surface includes both normal and diseased cartilage tissue.

3. The method of claim 1, wherein said articular surface includes bone.

4. The method of claim 1, wherein said articular surface includes cartilage.

5. The method of claim 1, wherein said articular surface includes cartilage and bone.

6. The method of claim 1, further comprising estimating a surface of a region of cartilage based at least in part on the representation of the cartilage surface of the joint.

7. The method of claim 1, further comprising estimating a dimension of a region of cartilage based at least in part on the representation of the cartilage surface of the joint.

8. The method of claim 1, further comprising estimating a thickness of a region of cartilage based at least in part on the representation of the cartilage surface of the joint.

9. The method of claim 1, further comprising estimating a curvature of a region of cartilage based at least in part on the representation of the cartilage surface of the joint.

10. The method of claim 1, further comprising estimating a thickness of a region of cartilage based at least in part on a representation of a subchondral bone surface of the joint.

11. The method of claim 1, further comprising estimating a volume of a region of cartilage based at least in part on the representation of the cartilage surface of the joint.

12. The method of claim 1, further comprising estimating a depth of a region of cartilage based at least in part on the representation of the cartilage surface of the joint.

13. The method of claim 1, further comprising estimating an area of a region of cartilage based at least in part on the representation of the cartilage surface of the joint.

14. The method of claim 1, further comprising estimating a width of a region of cartilage based at least in part on the representation of the cartilage surface of the joint.

15. The method of claim 1, wherein at least a portion of said physical model has a thickness that is similar to normal cartilage.

16. The method of claim 1, wherein the surface portion substantially matches the three dimensional surface representation of at least a portion of the cartilage surface of the joint.

17. The method of claim 1, wherein the at least a portion of the joint encompasses substantially all of a femoral condyle of the joint of the patient.

18. The method of claim 1, wherein the at least a portion of the joint encompasses substantially all of a femoral notch of the joint of the patient.

19. The method of claim 1, wherein the at least a portion of the joint encompasses substantially all of a tibial plateau of the joint of the patient.

20. The method of claim 1, wherein the at least a portion of the joint encompasses a portion of a femoral condyle of the joint of the patient.

21. The method of claim 1, wherein the at least a portion of the joint encompasses a portion of a femoral notch of the joint of the patient.

22. The method of claim 1, wherein the at least a portion of the joint encompasses a portion of a tibial plateau of the joint of the patient.

23. A method of creating a physical model used in the treatment of an articular surface of a joint of a patient, the method comprising:

processing image data of at least a portion of the joint of the patient;

estimating a surface of a region of cartilage based at least in part on a three dimensional representation of a subchondral bone surface, wherein the three dimensional representation is created from the image data; and

generating a physical model for use in the treatment of the joint that includes a surface portion that is derived from the estimated cartilage surface.

24. The method of claim 23, wherein said image data includes both normal and diseased cartilage tissue.

25. The method of claim 23, wherein said articular surface includes bone.

26. The method of claim 23, wherein said articular surface includes cartilage.

27. The method of claim 23, wherein the step of estimating further comprising estimating a dimension of a region of cartilage based at least in part on the representation of the subchondral bone surface.

28. The method of claim 23, wherein the step of estimating further comprising estimating a thickness of a region of cartilage based at least in part on the representation of the subchondral bone surface.

29. The method of claim 23, wherein the step of estimating further comprising estimating a curvature of a region of cartilage based at least in part on the representation of the subchondral bone surface.

30. The method of claim 23, wherein the step of estimating further comprising estimating a volume of a region of cartilage based at least in part on the representation of the subchondral bone surface.

31. The method of claim 23, wherein the step of estimating further comprising estimating a depth of a region of cartilage based at least in part on the representation of the subchondral bone surface.

32. The method of claim 23, wherein the step of estimating further comprising estimating an area of a region of cartilage based at least in part on the representation of the subchondral bone surface.

33. The method of claim 23, wherein the step of estimating further comprising estimating a width of a region of cartilage based at least in part on the representation of the subchondral bone surface.

34. The method of claim 23, wherein at least a portion of said physical model has a thickness that is similar to normal cartilage.

35. The method of claim 23, wherein the surface portion of the physical model substantially matches the three dimensional representation of at least a portion of the subchondral bone surface of the joint.

36. The method of claim 23, wherein the surface portion is derived from a three dimensional representation of the articular surface that encompasses substantially all of a femoral condyle of the joint of the patient.

37. The method of claim 23, wherein the at least a portion of the joint encompasses substantially all of a femoral notch of the joint of the patient.

38. The method of claim 23, wherein the at least a portion of the joint encompasses substantially all of a tibial plateau of the joint of the patient.

39. The method of claim 23, wherein the at least a portion of the joint encompasses a portion of a femoral condyle of the joint of the patient.

40. The method of claim 23, wherein the at least a portion of the joint encompasses a portion of a femoral notch of the joint of the patient.

41. The method of claim 23, wherein the at least a portion of the joint encompasses a portion of a tibial plateau of the joint of the patient.

42. A method of creating a physical model used in the treatment of a knee joint of a patient, the method comprising:

processing image data of at least a portion of the knee joint of the patient;

creating a three dimensional surface representation of at least a portion of a cartilage surface of the knee joint from the image data; and

generating a physical model that includes a surface portion that is derived from the three dimensional surface representation;

wherein the physical model is configured for use in the treatment of the knee joint.

43. A method of devising a physical model for treating a damaged or diseased articular surface of a patient'"'"'s joint, the method comprising:

processing image data of at least a portion of the patient'"'"'s joint;

generating a three dimensional representation from the image data of at least a portion of an articular surface of the patient'"'"'s joint;

deriving from the three dimensional representation one or more measurements selected from an articular dimension, curvature, shape and thickness of a cartilage surface of said joint; and

generating a physical model including a surface portion based on at least one of the measurements;

wherein the physical model is a device used in the treatment of the damaged or diseased articular surface of the joint of the patient.