Adjustable guide in computer assisted orthopaedic surgery

• US 9,220,509 B2
• Filed: 06/29/2010
• Issued: 12/29/2015
• Est. Priority Date: 06/30/2009
• Status: Active Grant

• Current Assignee: Blue Ortho
• Original Assignee: Blue Ortho
• Inventors: Boyer, Anthony, Lavallee, Stphane
• Primary Examiner(s): SEVILLA, CHRISTIAN ANTHONY
• Application Number:
  US13/381,615
• Publication Number:
  US 20120143198A1
• Time in Patent Office: 2,009 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/151 for corrective osteotomy
• CPC Class Codes: A61B 17/152 for removing a wedge-shaped piece of bone
• CPC Class Codes: A61B 17/154 for preparing bone for knee prosthesis
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis

Abstract

The present invention relates to a surgical navigation device, for the purpose of adjusting cutting planes to a desired position with respect to a bone of a patient, the device comprising:

• • an adjustable guide (15) that contains several adjustable screws (1) that create contact points with the surface of the bone or cartilage such that the guide fits to the bone in a unique position calculated such that the holes and cutting blocks of the adjustable guide fit with the position planned on preoperative CT or MR images of the patient,
  • a dedicated screwdriver (7) to adjust automatically the screws (1) to their target length,
  • a navigation system used to check the correct position of the adjustable guide with respect to essential anatomical points and if necessary means to correct the positions of the adjustable screws.

Claims

1. A surgical device, for the purpose of adjusting one or more cutting blocks to a desired position with respect to a bone of a patient, the device comprising:

an adjustable guide with at least six adjustable screws whose length is calculated to create a contact point when the adjustable guide is in a desired position planned on preoperative CT or MR images,

wherein the adjustable guide comprises two pairs of holes capable of guiding pins which position and fix said cutting blocks,

a dedicated screwdriver to adjust the position of each screw to a target value,

a navigation system operable to check a correct position of the adjustable guide with respect to one or more anatomical points.

3. The device of claim 1, wherein the adjustable guide is connected to two cutting blocks or pairs of holes with three adjustable screws.

4. The device of claim 1, wherein the adjustable guide is connected to one cutting block or pair of holes with three adjustable screws and the cutting block or pair of holes is connected to a pair of holes with two adjustable screws.

5. The device of claim 1, wherein the dedicated screwdriver comprises a motor and a computer for controlling the motor to adjust the length of each screw automatically to a target position.

7. The device of claim 1, wherein the anatomical points are acquired from one or more intra-operative CT or MR images of the patient including the anatomical points, and the anatomical points are registered with a position of the adjustable block.

12. The device of claim 1, wherein the adjustable guide has more than twelve adjustable screws.

2. A surgical device, for the purpose of adjusting one or more cutting blocks to a desired position with respect to a bone of a patient, the device comprising:

an adjustable guide with at least six adjustable screws whose length is calculated to create a contact point when the adjustable guide is in a desired position planned on preoperative CT or MR images,

wherein the adjustable guide comprises one cutting block and one pair of holes capable of guiding one or more pins which position and fix a cutting block,

a dedicated screwdriver to adjust a position of each screw to a target value,

a navigation system operable to check a correct position of the adjustable guide with respect to one or more anatomical points.

8. The device of claim 2, wherein the adjustable guide is connected to two cutting blocks or pairs of holes with three adjustable screws.

9. The device of claim 2, wherein the adjustable guide is connected to one cutting block or pair of holes with three adjustable screws and the cutting block or pair of holes is connected to a pair of holes with two adjustable screws.

10. The device of claim 2, wherein the dedicated screwdriver comprises a motor and a computer for controlling the motor to adjust the length of each screw automatically to a target position.

11. The device of claim 2, wherein the anatomical points are acquired from one or more intra-operative CT or MR images of the patient including the anatomical points, and the anatomical points are registered with a position of the adjustable block.

13. The device of claim 2, wherein the adjustable guide has more than twelve adjustable screws.

6. A method of adjusting one or more cutting blocks to a desired position with respect to a bone of a patient, said method comprising:

(1) acquiring one or more CT or MR images and planning an implant position responsive to said images;

(2) extracting one or more bone and/or cartilage surfaces from said images;

(3) calculating one or more screw lengths contained in an adjustable guide for said cutting blocks, said adjustable guide having at least six adjustable screws, such that the adjustable guide is in a desired position when the screws are in contact with the bone and/or cartilage surface;

(4) adjusting the screws of the adjustable guide to a target position using a dedicated screwdriver prior to incising the patient;

(5) positioning the adjustable guide in contact with the bone and/or cartilage surface, attaching a navigation tracker to the adjustable guide, the tracker having a known relationship with respect to the adjustable guide, and operating a navigation system responsive to a position of the tracker to check that the adjustable guide is in a correct position with respect to one or more anatomical points or with respect to additional patient data collected intra-operatively; and

(6) iterating steps (3) and/or (4) until condition of step (5) is met.

14. The method of claim 6, wherein step (5) comprises determining at least one reference anatomical point in a coordinate system of the adjustable guide from kinematics of the patient'"'"'s bone.

15. The method of claim 6, wherein step (5) comprises digitizing at least one reference anatomical point with a navigation pointer.