Devices and methods for surgery

• US 9,861,446 B2
• Filed: 03/10/2017
• Issued: 01/09/2018
• Est. Priority Date: 03/12/2016
• Status: Active Grant

• Current Assignee: Philipp K. Lang
• Original Assignee: Philipp K. Lang
• Inventors: Lang, Philipp K.
• Primary Examiner(s): Coley, Zade
• Assistant Examiner(s): Chang, Olivia C
• Application Number:
  US15/456,084
• Publication Number:
  US 20170258526A1
• Time in Patent Office: 305 Days
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/1666 for the acetabulum
• CPC Class Codes: A61B 17/17 Guides or aligning means for drills , mills, pins or wires
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1742 for the hip
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/1775 for the foot or ankle
• CPC Class Codes: A61B 17/1778 for the shoulder
• CPC Class Codes: A61B 2017/00216 with eye tracking or head position tracking control
• CPC Class Codes: A61B 2017/568 produced with shape and dimensions specific for an individual patient
• CPC Class Codes: A61B 2034/104 Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
• 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 2034/2059 Mechanical position encoders
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/368 changing the image on a display according to the operator's position
• CPC Class Codes: A61B 2090/372 Details of monitor hardware
• CPC Class Codes: A61B 2090/373 : using light, e.g. by using optical scanners
• 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 2090/3762 : using computed tomography systems [CT]
• CPC Class Codes: A61B 2090/502 : Headgear, e.g. helmet, spectacles
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/74 : Manipulators with manual electric input means
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61F 2/32 : for the hip
• CPC Class Codes: A61F 2/3859 : Femoral components
• CPC Class Codes: A61F 2/389 : Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2002/4018 : Heads or epiphyseal parts of humerus
• CPC Class Codes: A61F 2002/4205 : Tibial components
• CPC Class Codes: A61F 2002/4207 : Talar components
• CPC Class Codes: H05K 999/99 : dummy group
• CPC Class Codes: Y02A 90/10 : Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

Devices and methods for performing a surgical step or surgical procedure with visual guidance using an optical head mounted display are disclosed.

Claims

1. A method of preparing a physical joint for a prosthesis in a patient comprising:

obtaining one or more intra-operative measurements from the physical joint of the patient to determine one or more intra-operative coordinates of the physical joint;

generating, by a computer, a virtual surgical guide, wherein the virtual surgical guide is a three-dimensional digital representation corresponding to at least one portion of a physical surgical guide, a placement indicator of the physical surgical guide, or a combination thereof; and

displaying, at a predetermined position, predetermined orientation or combination thereof, using a see through optical head mounted display, the virtual surgical guide onto a surface of the physical joint visible directly through the see through optical head mounted display, so as to superimpose the virtual surgical guide onto the surface of the physical joint,

wherein the virtual surgical guide is configured to allow superimposition and alignment of the physical surgical guide with the virtual surgical guide,

wherein the predetermined position, predetermined orientation or combination thereof, of the virtual surgical guide is maintained on the surface of the physical joint by the computer when the physical guide is moved in the field of view of a user,

wherein the physical joint of the patient and the physical surgical guide are visible directly through the see through optical head mounted display,

wherein the physical surgical guide is configured to guide a bone cut of the physical joint,

wherein the one or more intra-operative coordinates of the physical joint of the patient are registered in a coordinate system,

wherein the see through optical head mounted display is registered in the coordinate system.

2. The method of claim 1, wherein the physical surgical guide is configured to guide a bone cut in a knee replacement, hip replacement, shoulder joint replacement or ankle joint replacement.

3. The method of claim 1, wherein the predetermined position, predetermined orientation or combination thereof, of the virtual surgical guide determines a tibial slope for implantation of one or more tibial implant components in a knee replacement.

4. The method of claim 1, wherein the predetermined position predetermined orientation or combination thereof, of the virtual surgical guide determines an angle of varus or valgus correction for a femoral and/or a tibial component in a knee replacement.

5. The method of claim 1, wherein the virtual surgical guide is a three-dimensional digital representation corresponding to at least one portion of a physical distal femoral guide or cut block and the predetermined position, predetermined orientation or combination thereof, of the virtual surgical guide determines a femoral component flexion.

6. The method of claim 1, wherein the virtual surgical guide is a three-dimensional digital representation corresponding to at least one portion of a physical anterior or posterior femoral surgical guide or cut block and the predetermined position, predetermined orientation or combination thereof, of the virtual surgical guide determines a femoral component rotation.

7. The method of claim 1, wherein the virtual surgical guide is a three-dimensional digital representation corresponding to at least one portion of a physical chamfer femoral guide or cut block.

8. The method of claim 1, wherein the virtual surgical guide is a three-dimensional digital representation corresponding to at least one portion of a physical multi-cut femoral guide or cut block and the predetermined position, predetermined orientation or combination thereof, of the virtual surgical guide determines one or more of an anterior cut, posterior cut, chamfer cuts and a femoral component rotation.

9. The method of claim 1, wherein the virtual surgical guide is used in a hip replacement and the predetermined position, predetermined orientation or combination thereof, of the virtual surgical guide determines a leg length after implantation.

10. The method of claim 1, wherein the virtual surgical guide is a virtual plane for aligning the physical saw blade to guide the bone cut of the joint.

11. The method of claim 1, wherein the one or more intraoperative measurements are obtained by detecting one or more optical markers attached to the surface of the joint of the patient.

12. The method of claim 11 further obtaining one or more intraoperative measurements by detecting one or more optical markers attached to the operating room table, fixed structures in the operating room or combinations thereof.

13. The method of claim 1, wherein the see through optical head mounted display comprises one or more cameras or image capture or video capture systems to detect one or more optical markers attached to the surface of the joint of the patient including their coordinates (x, y, z) and at least one or more of a position, orientation, alignment, direction of movement or speed of movement of the one or more optical markers.

14. The method of claim 1, wherein the virtual surgical guide is used to guide a bone cut of a talus or distal tibia in an ankle joint replacement and wherein the see through optical head mounted display is used to align the virtual surgical guide based on a predetermined talar or tibial implant component position and/or alignment, wherein the predetermined talar or tibial implant component position and/or alignment includes a coronal plane implant component alignment, a sagittal plane implant component alignment, an axial plane implant component alignment, an implant component rotation of an implant component or combinations thereof.

15. The method of claim 1, wherein the virtual surgical guide is used to guide a bone cut of a proximal humerus in a shoulder joint replacement and wherein the see through optical head mounted display is used to align the virtual surgical guide based on a predetermined humeral implant component position and/or alignment, wherein the humeral implant component position and/or alignment includes a coronal plane implant component alignment, a sagittal plane implant component alignment, an axial plane implant component alignment, a humeral implant component rotation, a humeral implant component version or combinations thereof.

16. The method of claim 1 wherein, the virtual surgical guide is registered to the surface of the joint and superimposition of the virtual surgical guide onto the surface of the physical joint is maintained in relationship with the surface of the physical joint.

17. The method of claim 1, wherein one or more see through optical head mounted displays are registered in the coordinate system.