Assessing the condition of a joint and devising treatment

• US 8,369,926 B2
• Filed: 01/31/2011
• Issued: 02/05/2013
• 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: Lang, Philipp, Steines, Daniel
• Primary Examiner(s): Cwern, Jonathan
• Application Number:
  US13/017,886
• Publication Number:
  US 20110125009A1
• Time in Patent Office: 736 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 5/1038 Measuring plantar pressure during gait
• CPC Class Codes: A61B 5/4514 Cartilage
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 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 diseased or damaged joint of a patient, the method comprising:

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

creating a three dimensional representation of at least a portion of a subchondral bone surface of the diseased or damaged joint from the image data;

transmitting the three dimensional representation to a site for analysis; and

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

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

2. The method of claim 1, wherein said image data 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, further comprising estimating a surface of a region of cartilage based at least in part on the representation of the subchondral bone surface.

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

7. 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 subchondral bone surface.

8. 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 subchondral bone surface.

9. 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 subchondral bone surface.

10. 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 subchondral bone surface.

11. 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 subchondral bone surface.

12. 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 subchondral bone surface.

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

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

15. The method of claim 1, wherein the portion of the subchondral bone surface of the joint encompasses substantially all of a femoral condyle of the joint of the patient.

16. The method of claim 1, wherein the portion of the subchondral bone surface of the joint encompasses substantially all of a femoral notch of the joint of the patient.

17. The method of claim 1, wherein the portion of the subchondral bone surface of the joint encompasses substantially all of a tibial plateau of the joint of the patient.

18. The method of claim 1, wherein the portion of the subchondral bone surface of the joint encompasses a portion of a femoral condyle of the joint of the patient.

19. The method of claim 1, wherein the portion of the subchondral bone surface of the joint encompasses a portion of a femoral notch of the joint of the patient.

20. The method of claim 1, wherein the portion of the subchondral bone surface of the joint encompasses a portion of a tibial plateau of the joint of the patient.

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

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

creating a three dimensional representation of at least a portion of a subchondral bone surface of the diseased or damaged joint from the image data;

transmitting the three dimensional representation to a site for analysis;

estimating at least one of a dimension, curvature, shape and surface of a region of cartilage based at least in part on the representation; and

generating a physical model for use in the treatment of the joint that includes a surface portion that is derived from the representation and based on the estimation.

22. The method of claim 21, wherein said image data includes both normal and diseased cartilage tissue.

23. The method of claim 21, wherein said articular surface includes bone.

24. The method of claim 21, wherein said articular surface includes cartilage.

25. The method of claim 21, wherein the step of estimating further comprising estimating the dimensions of a region of cartilage based at least in part on the representation of the subchondral bone surface.

26. The method of claim 21, 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.

27. The method of claim 21, 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.

28. The method of claim 21, 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.

29. The method of claim 21, 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.

30. The method of claim 21, 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.

31. The method of claim 21, 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.

32. The method of claim 21, wherein at least a portion of said physical model has a thickness that is similar to normal cartilage.

33. The method of claim 21, wherein the surface portion substantially matches the three dimensional surface representation of at least a portion of the subchondral bone surface of the joint.

34. The method of claim 21, wherein the portion of the subchondral bone surface of the joint encompasses substantially all of a femoral condyle of the joint of the patient.

35. The method of claim 21, wherein the portion of the subchondral bone surface of the joint encompasses substantially all of a femoral notch of the joint of the patient.

36. The method of claim 21, wherein the portion of the subchondral bone surface of the joint encompasses substantially all of a tibial plateau of the joint of the patient.

37. The method of claim 21, wherein the portion of the subchondral bone surface of the joint encompasses a portion of a femoral condyle of the joint of the patient.

38. The method of claim 21, wherein the portion of the subchondral bone surface of the joint encompasses a portion of a femoral notch of the joint of the patient.

39. The method of claim 21, wherein the portion of the subchondral bone surface of the joint encompasses a portion of a tibial plateau of the joint of the patient.

40. A method of creating a physical model used in the treatment of a diseased or damaged knee joint of a patient, the method comprising:

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

creating a three dimensional representation of at least a portion of an articular surface of the diseased or damaged knee joint from the image data;

transmitting the three dimensional representation to a site for analysis; and

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

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

41. A method of creating a physical model used in the treatment of a diseased or damaged knee joint of a patient, the method comprising:

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

creating a three dimensional representation of at least a portion of a tibial plateau of the diseased or damaged knee joint from the image data;

transmitting the three dimensional representation to a site for analysis; and

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

wherein the physical model is configured for use in the treatment of the portion of the knee joint that encompasses at least a portion of the tibial plateau of the knee joint.

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

electronically receiving and processing image data of at least a portion of the diseased or damaged knee joint of the patient;

creating a three dimensional representation of at least a portion of a femoral condyle of the diseased or damaged knee joint from the image data;

transmitting the three dimensional representation to a site for analysis; and

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

wherein the physical model is configured for use in the treatment of the portion of the knee joint that encompasses at least a portion of the femoral condyle of the diseased or damaged 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:

generating a three-dimensional representation from electronic image data of at least a portion of the diseased or damaged articular surface of the joint of the patient;

transmitting the three-dimensional representation to a site for analysis;

deriving from the three-dimensional representation at least one or more articular dimensions of a subchondral bone surface of said joint; and

generating a physical model including a surface portion based on the one or more articular dimensions of the subchondral bone surface of the joint;

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