Precise hip component positioning for hip replacement surgery

• US 9,308,002 B2
• Filed: 04/05/2012
• Issued: 04/12/2016
• Est. Priority Date: 11/07/2002
• Status: Active Grant

• Current Assignee: Crescent H. Trust
• Original Assignee: Crescent H. Trust
• Inventors: Penenberg, Brad L.
• Primary Examiner(s): Boles, Sameh
• Application Number:
  US13/440,963
• Publication Number:
  US 20130053858A1
• Time in Patent Office: 1,468 Days
• Field of Search: None
• US Class Current: 1/1
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/164 intramedullary
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• 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 2017/00075 Motion
• CPC Class Codes: A61B 2017/3405 using mechanical guide means
• CPC Class Codes: A61B 2017/922 Devices for impaction, impact element
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2048 using an accelerometer or inertia sensor
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/067 for measuring angles
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61F 2/34 Acetabular cups
• CPC Class Codes: A61F 2/4603 for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4609 of acetabular cups
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/30471 : connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2002/3055 : for adjusting length
• CPC Class Codes: A61F 2002/30553 : for adjusting a position by translation along an axis
• CPC Class Codes: A61F 2002/30601 : telescopic
• CPC Class Codes: A61F 2002/4668 : for measuring angles
• CPC Class Codes: A61F 2002/4681 : by applying mechanical shocks, e.g. by hammering
• CPC Class Codes: A61F 2002/4687 : Mechanical guides for implantation instruments

Abstract

A device for accurately positioning the acetabular cup in a minimally invasive total hip arthroplasty (THA), comprising the steps of (a) placing the cup in roughly the correct position in the acetabulum using a acetabular component placement tool, (b) taking a first abduction reading and a first anteversion reading using a gyroscopic positioning unit aligned with the acetabular component placement tool, (c) taking an image of at least a portion of the cup using a radiography unit, (d) using the image to determine the actual orientation of the cup and required position of the cup to properly orient the acetabular component, (e) incrementally altering the position of the cup by using a striking tool, (f) taking new abduction and anteversion readings using the gyroscopic unit to determine the relative movement of the cup caused by the tapping, and (g) repeating any of the steps as necessary.

Claims

1. An acetabular component placement tool, comprising:

a surgical tool having a proximal end, and a distal end opposite the proximal end, wherein the proximal end is configured to receive an acetabular component;

a gyroscope holder, wherein the gyroscope holder comprises a first end to connect with the surgical tool at the distal end, and a second end opposite the first end; and

a first gyroscopic unit attached to the gyroscope holder at the second end so that a position of a plane of the acetabular component can be measured, wherein the distal end of the surgical tool comprises a plurality of holes at different levels, and wherein the first end of the gyroscope holder comprises a cross-sectional portion keyed to fit into each of the plurality of holes of the surgical tool to adjustably attach adjacent to the distal end of the surgical tool.

2. The placement tool of claim 1 wherein the first gyroscopic unit is provided by a smartphone or other electronic device configured with a gyroscopic application.

3. The placement tool of claim 1, further comprising a container that is at least partially transparent in one location and is sterilized sufficiently for use in surgery to cover the first gyroscopic unit.

4. The placement tool of claim 1, further comprising a compass aligned with the surgical tool.

5. The placement tool of claim 1 wherein the first gyroscopic unit is integral to the surgical tool.

6. The placement tool of claim 1 wherein the first gyroscopic unit is configured to transmit readings to a local computer or local computer network.

7. The placement tool of claim 1 wherein the first gyroscopic unit is configured to transmit readings aurally so that a surgeon does not have to look at the readings on a screen during a surgical procedure.

8. The placement tool of claim 1, further comprising a second gyroscopic unit attached to a pelvis of the patient to provide readings indicative of any movement of the pelvis during a surgical procedure, the first and second gyroscopic units configured to communicate their respective readings to each other.

9. An acetabular component placement tool, comprising:

a surgical tool having a proximal end, and a distal end opposite the proximal end, wherein the proximal end is configured to receive an acetabular component;

a gyroscope holder, wherein the gyroscope holder comprises a first end to connect with the surgical tool at the distal end; and

a first gyroscopic unit operatively connected to the distal end of the surgical tool so that an orientation of the acetabular component can be measured, wherein the distal end of the surgical tool comprises a plurality of holes at different levels, and wherein the first end of the gyroscope holder comprises a cross-sectional portion keyed to fit into each of the plurality of holes of the surgical tool to adjustably attach adjacent to the distal end of the surgical tool.

10. The placement tool of claim 9 wherein the first gyroscopic unit is provided by a smartphone or other electronic device configured with a gyroscopic application.

11. The placement tool of claim 9 further comprising a container that is at least partially transparent in one location and is sterilized sufficiently for use in surgery to cover the first gyroscopic unit.

12. The placement tool of claim 9 wherein the first gyroscopic unit is configured to transmit readings to a local computer or local computer network.

13. The placement tool of claim 9 wherein the first gyroscopic unit is configured to transmit readings aurally so that a surgeon does not have to look at the readings on a screen during a surgical procedure.

14. The placement tool of claim 9, further comprising a second gyroscopic unit attached to a pelvis of a patient to provide readings indicative of any movement of the pelvis during a surgical procedure.

15. An acetabular component placement tool, comprising:

a surgical tool having a proximal end, and a distal end opposite the proximal end, wherein the proximal end is configured to receive an acetabular component;

a gyroscope holder, wherein the gyroscope holder comprises a first end to connect with the surgical tool at the distal end;

a first gyroscopic unit operatively connected to the distal end of the surgical tool so that an orientation of the acetabular component can be measured; and

a second gyroscopic unit operatively connected to the surgical tool to measure the orientation of the acetabular component, wherein the distal end of the surgical tool comprises a plurality of holes at different levels, and wherein the first end of the gyroscope holder comprises a cross-sectional portion keyed to fit into each of the plurality of holes of the surgical tool to adjustably attach adjacent to the distal end of the surgical tool.

16. The placement tool of claim 15 wherein the first and second gyroscopic units are configured to transmit readings to a local computer or local computer network.

17. The placement tool of claim 15 wherein at least one of the first or second gyroscopic unit is configured to transmit readings aurally so that a surgeon does not have to look at the readings on a screen during a surgical procedure.

18. The placement tool of claim 15, further comprising a third gyroscopic unit attached to a pelvis of a patient to provide readings indicative of any movement of the pelvis during a surgical procedure.

19. The placement tool of claim 15, further comprising a third gyroscopic unit operatively connected to the surgical tool, wherein the first gyroscopic unit measures the orientation of the acetabular component in a first plane, the second gyroscopic unit measures the orientation of the acetabular component in a second plane perpendicular to the first plane, and the third gyroscopic unit measures the orientation of the acetabular component in a third plane perpendicular to the first and second planes.