Methods for determining meniscal size and shape and for devising treatment

• US 8,965,088 B2
• Filed: 01/17/2014
• Issued: 02/24/2015
• Est. Priority Date: 11/07/2002
• Status: Expired due to Term

• Current Assignee: Conformis Incorporated
• Original Assignee: Conformis Incorporated
• Inventors: Tsougarakis, Konstantinos, Steines, Daniel, Vissa, Bhaskar Rao, Lang, Philipp, Linder, Barry J.
• Primary Examiner(s): Tabatabai, Abolfazl
• Application Number:
  US14/157,707
• Publication Number:
  US 20140153798A1
• Time in Patent Office: 403 Days
• Field of Search: 382128-134, 378/65, 378/68, 378/69, 600/407, 600/435, 600/437, 600/439, 424/422, 424/423, 424/424, 424/425, 424/426, 324/309, 128/915, 128/916
• US Class Current: 382/128
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 5/1075 for measuring dimensions by non-invasive methods, e.g. for determining thickness of tissue layer A61B8/0858 takes precedence
• CPC Class Codes: A61B 5/4514 Cartilage
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61F 2/30756 Cartilage endoprostheses A61F2/3603 takes precedence
• CPC Class Codes: A61F 2/30942 for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
• CPC Class Codes: A61F 2/32 for the hip
• CPC Class Codes: A61F 2/34 Acetabular cups
• CPC Class Codes: A61F 2/36 Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/38 for elbows or knees
• CPC Class Codes: A61F 2/3804 for elbows
• CPC Class Codes: A61F 2/40 for shoulders
• CPC Class Codes: A61F 2/4202 for ankles
• CPC Class Codes: A61F 2/4241 for hands, e.g. fingers
• CPC Class Codes: A61F 2/4261 for wrists
• CPC Class Codes: A61F 2/44 for the spine, e.g. vertebrae, spinal discs
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30894 inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/30943 using mathematical models
• CPC Class Codes: A61F 2002/30948 : using computerized tomography, i.e. CT scans
• CPC Class Codes: A61F 2002/30952 : using CAD-CAM techniques or NC-techniques
• CPC Class Codes: A61F 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: G06T 7/0012 : Biomedical image inspection
• CPC Class Codes: Y10S 623/911 : Bone

Abstract

The present invention relates to methods for determining meniscal size and shape for use in designing therapies for the treatment of various joint diseases. The invention uses an image of a joint that is processed for analysis. Analysis can include, for example, generating a thickness map, a cartilage curve, or a point cloud. This information is used to determine the extent of the cartilage defect or damage and to design an appropriate therapy, including, for example, an implant. Adjustments to the designed therapy are made to account for the materials used.

Claims

1. A method for designing a system for repairing a joint of a patient comprising:

acquiring at least one of an isotropic data volume or near isotropic data volume from electronic image data the joint of the patient;

deriving from the isotropic or near isotropic data volume measurements of at least one articular surface of the joint, wherein the measurements include at least one patient-specific dimension or shape parameter; and

designing a patient-specific portion of a component of the system using the at least one patient-specific dimension or shape parameter.

2. The method of claim 1, wherein the electronic image data includes isotropic or near-isotropic three-dimensional image data.

3. The method of claim 1, wherein the electronic image data includes image data obtained from scans in at least two planes that intersect.

4. The method of claim 1, wherein the articular surface of the joint includes a subchondral bone surface of the joint.

5. The method of claim 1, wherein the articular surface of the joint includes a cartilage surface of the joint.

6. The method of claim 5, wherein the cartilage surface includes a diseased or damaged cartilage surface of the joint.

7. The method of claim 1, wherein the joint is a knee joint and the system includes a tibial implant for repairing the knee joint.

8. The method of claim 7, wherein the patient-specific dimension or shape parameter includes a measurement of a tibial plateau of the knee joint.

9. The method of claim 7, wherein the patient-specific dimension or shape parameter includes a measurement of a tibial spine of the knee joint.

10. The method of claim 7, wherein the patient-specific dimension or shape parameter is selected from the group consisting of:

a tibial bone dimension, a tibial cartilage measurement including thickness and/or shape, a femoral condyle bone dimension, a femoral cartilage measurement including thickness and/or shape, a patellar bone dimension, a patellar cartilage dimension including thickness and/or shape, a measurement of a ligament of the knee joint, and any combination thereof.

11. The method of claim 10, wherein the tibial bone dimension is selected from the group consisting of a maximum anterior-posterior distance, a maximum medial-lateral distance, a maximum distance from the tibial spine to the edge, a width of a tibial spine, a height of a tibial spines, an area of tibial plateau occupied a tibial spine, a depth of a tibial plateau, a 2D shape of a tibial plateau, a 3D shape of a tibial plateau, and any combination thereof.

12. The method of claim 10, wherein the femoral bone dimension is selected from the group consisting of a maximum anterior-posterior distance, a maximum superior-inferior distance, a maximum medial-lateral distance, a maximum distance from a trochlea to the medial or lateral edge;

a width of an intercondylar notch, a depth of an intercondylar notch, a curvature at a select region along one or both femoral condyles, a 2D of a femoral condyle, a 3D shape of a femoral condyle, and any combination thereof.

13. The method of claim 10, wherein the measurement of the ligament of the knee joint includes a size, length, or shape of the ligament.

14. The method of claim 1, wherein the joint is a knee joint and the system includes a femoral implant for repairing the knee joint.

15. The method of claim 14, wherein the patient-specific dimension or shape parameter includes a medio-lateral width of a lateral femoral condyle of the knee joint.

16. The method of claim 14, wherein the patient-specific dimension or shape parameter includes a medio-lateral width of a medial femoral condyle of the knee joint.

17. The method of claim 1, wherein the joint is a hip joint, a shoulder joint or an ankle joint of the patient.

18. A method for selecting a system for repairing a joint of a patient comprising:

acquiring at least one of an isotropic data volume or near isotropic data volume from electronic image data the joint of the patient;

deriving from the isotropic or near isotropic data volume measurements of at least one articular surface of the joint, wherein the measurements include at least one patient-specific dimension or shape parameter; and

selecting a component from pre-made components having a corresponding portion that closely matches the at least one patient-specific dimension or shape parameter.

19. The method of claim 18, wherein the step of selecting includes selecting a computer-readable model of the selected component from pre-made components.