Robotic arthroplasty system including navigation

• US 8,840,629 B2
• Filed: 10/29/2013
• Issued: 09/23/2014
• Est. Priority Date: 08/28/2001
• Status: Expired due to Fees

• Current Assignee: Bonutti Skeletal Innovations LLC (Acacia Research Corporation)
• Original Assignee: Bonutti Skeletal Innovations LLC (Acacia Research Corporation)
• Inventors: Bonutti, Peter M.
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US14/065,630
• Publication Number:
  US 20140058393A1
• Time in Patent Office: 329 Days
• Field of Search: 606/32, 606/34, 606/87, 606/130, 600/426, 600/427, 600/407, 600/424, 600/425, 600/102, 600/166, 623/20.14, 623/20.3, 623/20.35
• US Class Current: 606/130
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/158 Cutting patella
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1626 Control means; Display units
• CPC Class Codes: A61B 17/1666 for the acetabulum
• CPC Class Codes: A61B 17/1668 for the upper femur A61B17/164 takes precedence
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1717 for applying intramedullary nails or pins
• CPC Class Codes: A61B 17/1721 for applying pins along or parallel to the axis of the femoral neck
• CPC Class Codes: A61B 17/1735 for rasps or chisels
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/1746 for the acetabulum
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/809 with bone-penetrating elements, e.g. blades or prongs bone staples A61B17/0642; intramedullary nails with a plate at an end A61B17/7233
• CPC Class Codes: A61B 2017/00004 : (bio)absorbable, (bio)resorbable, resorptive for implantable prostheses A61F2210/0004
• CPC Class Codes: A61B 2017/00557 : inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0268 : for the knee
• CPC Class Codes: A61B 2017/0409 : Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0414 : having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2034/102 : Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/105 : Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/2051 : Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 : Optical tracking systems
• CPC Class Codes: A61B 2046/201 : for extremities, e.g. having collection pouch
• CPC Class Codes: A61B 2046/205 : Adhesive drapes
• CPC Class Codes: A61B 2046/236 : with means for collecting drain fluid, e.g. drain tubes
• CPC Class Codes: A61B 2090/064 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/3614 : using optical fibre
• CPC Class Codes: A61B 2090/366 : using projection of images directly onto the body
• CPC Class Codes: A61B 2090/374 : NMR or MRI
• CPC Class Codes: A61B 2090/376 : using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2217/005 : with suction drainage system
• CPC Class Codes: A61B 2217/007 : with irrigation system
• 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 34/30 : Surgical robots
• CPC Class Codes: A61B 42/00 : Surgical gloves; Finger-stalls specially adapted for surgery; Devices for handling or treatment thereof
• CPC Class Codes: A61B 46/00 : Surgical drapes
• CPC Class Codes: A61B 5/4533 : Ligaments
• CPC Class Codes: A61B 5/4851 : Prosthesis assessment or monitoring
• CPC Class Codes: A61B 90/11 : with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/13 : guided by light, e.g. laser pointers
• CPC Class Codes: A61B 90/30 : Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61F 2/30721 : Accessories
• CPC Class Codes: A61F 2/30724 : Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
• CPC Class Codes: A61F 2/30767 : Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/30771 : applied in original prostheses, e.g. holes or grooves
• CPC Class Codes: A61F 2/34 : Acetabular cups
• CPC Class Codes: A61F 2/38 : for elbows or knees
• CPC Class Codes: A61F 2/3859 : Femoral components
• CPC Class Codes: A61F 2/3868 : with sliding tibial bearing
• CPC Class Codes: A61F 2/3872 : Meniscus for implantation between the natural bone surfaces
• CPC Class Codes: A61F 2/3877 : Patellae or trochleae
• CPC Class Codes: A61F 2/389 : Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2/4609 : of acetabular cups
• CPC Class Codes: A61F 2/461 : of knees
• CPC Class Codes: A61F 2/4684 : Trial or dummy prostheses
• CPC Class Codes: A61F 2002/2817 : Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
• CPC Class Codes: A61F 2002/2835 : Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/30079 : magnetic
• CPC Class Codes: A61F 2002/30326 : differing in height or in length
• CPC Class Codes: A61F 2002/30331 : made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2002/30364 : Rotation about the common longitudinal axis
• CPC Class Codes: A61F 2002/30387 : Dovetail connection
• CPC Class Codes: A61F 2002/30398 : Sliding
• CPC Class Codes: A61F 2002/30433 : using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
• CPC Class Codes: A61F 2002/30507 : using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30761 : Support means for artificial cartilage, e.g. cartilage defect covering membranes
• CPC Class Codes: A61F 2002/30883 : dovetail-shaped
• CPC Class Codes: A61F 2002/30892 : parallel
• CPC Class Codes: A61F 2002/3092 : having an open-celled or open-pored structure
• CPC Class Codes: A61F 2002/30934 : Special articulating surfaces
• CPC Class Codes: A61F 2002/30975 : made of two halves
• CPC Class Codes: A61F 2002/3401 : with radial apertures, e.g. radial bores for receiving fixation screws
• CPC Class Codes: A61F 2002/3403 : Polar aperture
• CPC Class Codes: A61F 2002/3895 : unicompartimental
• CPC Class Codes: A61F 2002/4631 : the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2002/4677 : using a guide wire
• CPC Class Codes: A61F 2210/009 : magnetic
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0033 : made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2220/0041 : using additional screws, bolts, dowels or rivets, e.g. connecting screws
• CPC Class Codes: A61F 2250/0037 : differing in height or in length
• CPC Class Codes: A61F 2310/00011 : Metals or alloys
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: A61F 2310/00029 : Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
• CPC Class Codes: A61F 2310/00131 : Tantalum or Ta-based alloys
• CPC Class Codes: A61F 2310/00365 : Proteins; Polypeptides; Degradation products thereof
• CPC Class Codes: A61G 13/0045 : specially adapted for hand or wrist surgeries
• CPC Class Codes: A61G 13/0054 : specially adapted for back or spinal surgeries
• CPC Class Codes: A61G 13/0063 : specially adapted for knee surgeries
• CPC Class Codes: A61G 13/0072 : specially adapted for shoulder surgeries
• CPC Class Codes: A61G 13/0081 : specially adapted for hip surgeries
• CPC Class Codes: A61G 13/1245 : Knees, upper or lower legs
• CPC Class Codes: A61G 13/125 : Ankles or feet
• CPC Class Codes: A61M 1/77 : Suction-irrigation systems aspiration tips supplying fluids A61M1/85; specific for negative pressure wound therapy A61M1/92; combined with tracheal tubes A61M16/0463

Abstract

A system for performing surgery on a joint. The system includes a robotic subsystem and a navigation subsystem. The navigation subsystem provides the robotic subsystem, during the surgery, with information relating to positions of the bones associated with the joint thereby enabling separate tracking of the bones when the bones move during the surgery. The robotic subsystem includes a base, a plurality of arms, and a cutting tool. The navigation subsystem may include a plurality of locating devices.

Claims

1. A system for performing surgery on a femur and tibia of a knee joint, said system comprising:

a robotic subsystem including a cutting tool;

a navigation subsystem in communication with said robotic subsystem, said navigation subsystem including a plurality of locating devices;

a control unit in communication with said robotic subsystem;

a display in communication with said control unit; and

wherein said navigation subsystem is configured to provide said robotic subsystem, during the surgery, with information relating to positions of the femur and tibia thereby enabling separate tracking of the femur and tibia when the femur and tibia move during the surgery and said navigation subsystem is configured to cooperate with said robotic subsystem to determine a position of said cutting tool relative to the femur and tibia to guide movement of said cutting tool relative to the femur and tibia to cut away material from the femur and tibia.

2. The system as set forth in claim 1 wherein said cutting tool is capable of movement in five degrees of freedom.

3. The system as set forth in claim 2 wherein said cutting tool is capable of movement in six degrees of freedom.

4. The system as set forth in claim 1 wherein said cutting tool is capable of at least one of user-controlled movement or robotically-controlled movement.

5. The system as set forth in claim 1 wherein said robotic subsystem includes a computer to guide movement of said cutting tool relative to the femur and tibia to cut away material from the femur and tibia without the use of physical resection guides.

6. The system as set forth in claim 1 wherein said control unit is configured to receive information relating to the position of said cutting tool relative to the femur and tibia such that movement of said cutting tool relative to the femur during the surgery is viewable on said display and movement of said cutting tool relative to the tibia during the surgery is viewable on said display.

7. The system as set forth in claim 6 wherein said control unit is configured to display images of the femur and tibia on said display.

8. The system as set forth in claim 7 wherein said control unit is configured to display the position of said cutting tool relative to said images of the femur or tibia on said display during cutting of the femur or tibia so that the position of said cutting tool relative to the femur or tibia is viewable during the surgery.

9. The system as set forth in claim 7 including an image source in communication with said control unit for providing the images of the femur and tibia.

10. The system as set forth in claim 9 wherein said image source includes one of a fluoroscope or a magnetic resonance imaging unit.

11. The system as set forth in claim 1 including a source of non-physical cutting guides for providing non-physical cutting guides that indicate volumes of material to be removed from at least one of the femur or tibia, the non-physical cutting guides facilitating use of said cutting tool of said robotic subsystem to cut away material from the at least one of the femur or tibia.

12. The system as set forth in claim 11 including a computer connected to said source of non-physical cutting guides, said computer including a user interface for inputting a desired size of implant whereby said computer adjusts a non-physical cutting guide to correspond to the desired size of implant.

13. The system as set forth in claim 11 wherein said source of non-physical cutting guides includes optical cutting guides.

14. The system as set forth in claim 1 wherein said navigation subsystem includes a plurality of photo cells for receiving signals from said plurality of locating devices to determine positions of the femur and tibia.

15. The system as set forth in claim 1 wherein said plurality of locating devices includes a first plurality of locating devices for attaching to the femur and a second plurality of locating devices for attaching to the tibia.

16. The system as set forth in claim 15 wherein said locating devices are emitters.

17. The system as set forth in claim 15 wherein said locating devices are reflectors.

18. The system as set forth in claim 1 wherein said robotic subsystem includes a computer and said locating devices cooperate with said computer to provide said robotic subsystem with information relating to the position of said cutting tool relative to the femur and tibia.

19. The system as set forth in claim 1 including a movable foot holder operative to move a lower portion of a leg during the surgery so that the tibia is movable relative to the femur during the surgery.

20. The system as set forth in claim 1 wherein said cutting tool is a milling tool.

21. The system as set forth in claim 1 including a knee implant for replacing the cut away material of the femur and tibia.

22. The system as set forth in claim 21 wherein said knee implant includes a first member including a first articulating surface, said first member affixable to only one of a medial and lateral condyle of the femur, wherein the other of the medial and lateral condyles is not provided with an affixable articulating surface.

23. The system as set forth in claim 22 wherein said knee implant includes a second member including a second articulating surface, said second member affixable to the tibia opposite said first member.

24. The system as set forth in claim 23 wherein said knee implant includes a third member including a third articulating surface, said third member affixable to a trochlear section of the femur.

25. The system as set forth in claim 24 wherein said first and third articulating surfaces are each made of a metallic material.

26. The system as set forth in claim 22 wherein said first member is affixable to the medial condyle of the femur.

27. The system as set forth in claim 22 wherein said first member is affixable to the lateral condyle of the femur.

28. The system as set forth in claim 21 wherein said knee implant includes an inlaid implant for fitting into a recess formed in one of the femur or tibia by said cutting tool of said robotic subsystem under the guidance of said navigation subsystem and without any physical resection guides.

29. A system for performing surgery on a femur and tibia of a knee joint, said system comprising:

a robotic subsystem including a cutting tool and controls to move the cutting tool;

a navigation subsystem in communication with said robotic subsystem, said navigation subsystem including a plurality of locating devices;

a display; and

a control unit in communication with said display and said robotic subsystem to display a position of said cutting tool relative to the femur or tibia on said display during cutting of the femur or tibia,

wherein said navigation subsystem is configured to provide said robotic subsystem with information relating to positions of the femur and tibia thereby enabling separate tracking of the femur and tibia when the femur and tibia move during the surgery and said navigation subsystem is configured to cooperate with said robotic subsystem to determine the position of said cutting tool relative to the femur and tibia so that said controls of said robotic subsystem are capable of guiding movement of said cutting tool relative to the femur and tibia to cut away material from the femur and tibia without the use of physical resection guides.

30. A system for performing surgery on a femur and tibia of a knee joint, said system comprising:

a robotic subsystem including a cutting tool and controls to move the cutting tool;

a navigation subsystem in communication with said robotic subsystem and including a first plurality of reflective locating devices for attaching to the femur and a second plurality of reflective locating devices for attaching to the tibia, wherein said navigation subsystem is configured to provide said robotic subsystem with information relating to positions of the femur and tibia thereby enabling separate tracking of the femur and tibia when the femur and tibia move during the surgery and said navigation subsystem is configured to cooperate with said robotic subsystem to determine the position of said cutting tool relative to the femur and tibia to guide movement of said cutting tool relative to the femur and tibia to cut away material from the femur and tibia using non-physical cutting guides;

a display;

a control unit in communication with said display and said robotic subsystem to display a position of said cutting tool relative to the femur or tibia on said display during cutting of the femur or tibia; and

a user interface to input data corresponding to desired sizes of implants for the femur and tibia so that predetermined non-physical cutting guides associated with the desired sizes of implants are used to guide movement of said cutting tool relative to the femur and tibia.