Systems and methods for measuring parameters in joint replacement surgery

• US 9,456,765 B2
• Filed: 09/23/2015
• Issued: 10/04/2016
• Est. Priority Date: 09/16/2011
• Status: Active Grant

• Current Assignee: MAKO Surgical Corporation (Stryker Corporation)
• Original Assignee: MAKO Surgical Corporation (Stryker Corporation)
• Inventors: Odermatt, Daniel, Thompson, Matthew
• Primary Examiner(s): Sevilla, Christian
• Assistant Examiner(s): GIBSON, ERIC SHANE
• Application Number:
  US14/863,115
• Publication Number:
  US 20160008087A1
• Time in Patent Office: 377 Days
• Field of Search: 606 86 R- 89 R, 606/102, 600/424, 600/587, 600/595, 623 2211- 2338
• US Class Current: 1/1
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2505/05 Surgical care
• 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
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 34/76 Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/107 Measuring physical dimensions, e.g. size of the entire body or parts thereof
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 5/4571 Evaluating the hip
• CPC Class Codes: A61B 5/4851 Prosthesis assessment or monitoring
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

A computer-assisted surgery system includes a display, an input device configured to receive data input by a user, and a processor, coupled to the input device and the display. The processor is configured to establish a first position of a pre-operative center of rotation of a joint in a first coordinate space of a first bone and a second coordinate space of a second bone and establish a second position of the pre-operative center of rotation of the joint in the first coordinate space, wherein the second position is a projection into the first coordinate space of the position of the pre-operative center of rotation maintained in a constant position in the second coordinate space. The processor is further configured to determine a change in a parameter associated with the joint based on the first and second positions and output a result indicating the determined change to the display.

Claims

1. A computer-assisted surgery system comprising:

a display;

an input device configured to receive data input by a user;

a processor, operatively coupled to the input device and the display and configured to;

establish a first position of a pre-operative center of rotation of a joint in a first coordinate space of a first bone and a second coordinate space of a second bone;

establish a second position of the pre-operative center of rotation of the joint in the first coordinate space of the first bone, wherein the second position is a projection into the first coordinate space of the first bone of the position of the pre-operative center of rotation maintained in a constant position in the second coordinate space of the second bone; and

determine a change in a parameter associated with the joint based on the first and second positions; and

output a result indicative of the determined change in the parameter to the display.

2. The computer-assisted surgery system of claim 1, wherein the processor is configured to establish the second position of the pre-operative center of rotation of the joint by:

estimating, by the processor after modification of the joint, a position of a center of rotation of the modified joint; and

positioning, by the processor in a virtual coordinate space, a virtual representation of the second bone in a predetermined pose based, at least in part, on the center of rotation of the modified joint.

3. The computer-assisted surgery system of claim 1, wherein the joint is a hip joint, and wherein the first coordinate space is a pelvic space and the second coordinate space is a femoral space.

4. The computer-assisted surgery system of claim 3, wherein the processor is configured to establish the second position of the pre-operative center of rotation of the joint by:

estimating, by the processor after modification of the hip joint, a position of a center of rotation of the modified hip joint; and

positioning, by the processor in a virtual coordinate space, a virtual representation of a femur in a predetermined pose based, at least in part, on the center of rotation of the modified hip joint.

5. The computer-assisted surgery system of claim 4, wherein the processor is configured to position the virtual representation of the femur in the predetermined pose by:

establishing a first axis associated with the femur, the first axis comprising a virtual axis passing through the center of rotation of the modified hip joint and an estimated midpoint between epicondyles of the femur; and

establishing a second axis associated with the femur, the second axis comprising a virtual transverse axis passing through the epicondyles of the femur,

wherein the virtual representation of the femur is positioned in the virtual coordinate space so that the first axis is substantially parallel with a superior/inferior axis of the pelvis and the second axis is substantially parallel with a coronal plane of the pelvis.

6. The computer-assisted surgery system of claim 1, further comprising a data storage device containing computed tomography (CT) data associated with the joint of a patient, wherein the processor is further configured to:

retrieve the CT data associated with the joint;

receive information indicative of a geometric feature of the joint; and

estimate the center of rotation of the joint based on the analysis of the geometric feature.

7. The computer-assisted surgery system of claim 6, wherein the processor is further configured to:

generate a virtual representation of at least a part of the first bone, based on the obtained CT data associated with the joint;

capture positions of a plurality of anatomical landmarks associated with the first and second bones; and

electronically track a position of the virtual representation of the first bone based on the captured position.

8. The computer-assisted surgery system of claim 7, wherein the processor is configured to establish the first position of the pre-operative center of rotation of the joint by:

defining the first position relative to the virtual representation of the second bone so that a change in the position of the virtual representation of the second bone relative to the first bone results in a corresponding change in position of the pre-operative center of rotation of the joint relative to the first bone, and

wherein establishing the second position of the pre-operative center of rotation of the joint comprises;

electronically tracking a position of the pre-operative center of rotation of the joint; and

determining, upon positioning of the second bone in the predetermined pose in the virtual coordinate space, the second position as the electronically-tracked position of the pre-operative center of rotation of the joint.

9. A computer-assisted surgery system for determining a change in a parameter associated with a joint caused by a modification of a portion of the joint, the method comprising:

a display;

an input device; and

a processor, operatively coupled to the input device and the display and configured to;

establish a first point of reference relative to a first bone of a joint, the first point of reference indicative of an estimated pre-operative center of rotation of the joint in pelvic space;

establish, after a modification of the joint, a second point of reference indicative of an estimated post-modification center of rotation of the joint;

position a virtual representation of the first bone in a predetermined pose based on the second point of reference and relative to a second bone;

approximate, based on the positioning of the virtual representation of the first bone in the predetermined pose, a third point of reference in pelvic space indicative of a position of the first point of reference maintained in a fixed relationship relative to the first bone;

estimate a change in a parameter associated with the joint based on a difference between the third point of reference and the first point of reference; and

output a result indicative of the estimated change in the parameter to the display.

10. The computer-assisted surgery system of claim 9, wherein the joint is a hip joint, the first bone is a femur of the hip joint, and the second bone is a pelvis of the hip joint.

11. The computer-assisted surgery system of claim 10, wherein the processor is configured to position the virtual representation of the first bone in a predetermined pose by:

establishing a first axis associated with the femur, the first axis comprising a virtual axis passing through the second point of reference and an estimated midpoint between epicondyles of the femur; and

establishing a second axis associated with the femur, the second axis comprising a virtual transverse axis passing through the epicondyles of the femur,

wherein the virtual representation of the femur is positioned in a virtual space so that the first axis is parallel with a superior/inferior axis of the pelvis and the second axis is parallel with the coronal plane of the pelvis.

12. The computer-assisted surgery system of claim 9, wherein the processor is configured to establish the first point of reference by:

obtaining computed tomography (CT) data associated with the hip joint;

analyzing a geometric feature of the hip joint based on the CT data; and

estimating the center of rotation of the hip joint based on the analysis of the geometric feature.

13. The computer-assisted surgery system of claim 12, wherein the processor is further configured to:

generate a virtual representation of at least a part of the first bone, based on the obtained CT data associated with the hip joint;

capture positions of a plurality of anatomical landmarks associated with the first and second bones; and

electronically track a position of the virtual representation of the first bone based on the captured position.

14. The computer-assisted surgery system of claim 13, wherein the processor is further configured to establish the second point of reference by:

capturing a plurality of positions of the virtual representation of the first bone, wherein each of the plurality of positions corresponds to a unique pose of the first bone relative to the second bone; and

estimating the post-modification center of rotation of the joint based on the plurality of positions of the virtual representation.

15. The computer-assisted surgery system of claim 13, wherein the processor is further configured to define the first point of reference relative to the virtual representation of the first bone, and wherein approximating the third point of reference includes:

electronically tracking a relative position of the first point of reference relative to the second bone; and

determining the third point of reference as the electronically-tracked relative position of the first point of reference when the virtual representation of the first bone is positioned in the predetermined pose.

16. The computer-assisted surgery system of claim 9, wherein the parameter comprises at least one of leg length and offset.