Virtual implant placement in the OR

• US 8,876,830 B2
• Filed: 08/11/2010
• Issued: 11/04/2014
• Est. Priority Date: 08/13/2009
• Status: Active Grant

• Current Assignee: Zimmer Incorporated (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Zimmer Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Hodorek, Robert A., Zuhars, Joel, Claypool, Jody L.
• Primary Examiner(s): WOODALL, NICHOLAS W
• Application Number:
  US12/854,610
• Publication Number:
  US 20110196377A1
• Time in Patent Office: 1,546 Days
• Field of Search: 606 87- 88
• US Class Current: 606/87
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis

Abstract

A virtual implant placement method and system comprising models of implants and/or bones linked to tracking assemblies mounted onto the bones. A joint model is constructed intraoperatively based on the positions of the tracking assemblies to determine the positions of cut planes.

Claims

1. A virtual implant placement system for determining a first cut plane to resect a first bone, the first bone and a second bone being part of a joint, the system comprising:

a first tracking assembly adapted to be supported by the first bone and operable to generate a first position data corresponding to a plurality of first positions of the first tracking assembly as the joint is articulated;

a second tracking assembly adapted to be supported by the second bone and operable to generate a second position data;

a first implant model of a first implant, the first implant model linked to the first tracking assembly, the first implant model having at least two versions;

a second model of one of a second implant and the second bone, the second model linked to the second tracking assembly; and

a processing device determining the first cut plane by;

digitally linking at least a first version of the first implant model to the first bone to construct a virtual joint defining a relationship between articulating surfaces of the first implant model and the second model;

modelling a movement of the virtual joint based on movements of the first bone relative to the second bone based on a tracking of the first and the second tracking assemblies;

repeating the digitally linking and the modelling with a second version of the first implant model; and

determining the first cut plane based on a selected version of the first implant model, the first position data, the second model, and the second position data through said movement of the virtual joint; and

a viewing device displaying data related to the first cut plane.

2. The virtual implant placement system of claim 1, wherein the second position data corresponds to a plurality of second positions of the second tracking assembly as the joint is articulated.

3. The virtual implant placement system of claim 1, wherein the system further comprises a goodness-of-fit function, wherein the processing device performs a plurality of permutations of the virtual joint, for each permutation articulates the virtual joint and computes a goodness-of-fit score, and determines the first cut plane based on the permutation that yields an optimal score.

4. The virtual implant placement system of claim 3, wherein the optimal score is the lowest score.

5. The virtual implant placement system of claim 3, wherein the goodness-of-fit score comprises a maximum goodness-of-fit error, and the optimal score is the minimal maximum goodness-of-fit error.

6. The virtual implant placement system of claim 3, wherein the goodness-of-fit function is weighed to favor permutations that reflect motion constraints of the joint.

7. The virtual implant placement system of claim 6, wherein the motion constraints of the joint are derived from the first position data and the second position data.

8. The virtual implant placement system of claim 6, wherein the motion constraints are provided to the processing device.

9. The virtual implant placement system of claim 6, wherein the motion constraints are selectable from a list presented with a viewing device.

10. The virtual implant placement system of claim 3, wherein the virtual joint is constrained according to motion constraints of the joint.

11. The virtual implant placement system of claim 10, wherein the motion constraints of the joint are derived from the first position data and the second position data.

12. The virtual implant placement system of claim 10, wherein the motion constraints are provided to the processing system.

13. The virtual implant placement system of claim 10, wherein the motion constraints are selectable from a list presented with a viewing device.

14. The virtual implant placement system of claim 1, further comprising a stabilized resection tool including an operator interface, a cutting tool, a plurality of linear actuators rotatably coupling the operator interface and the cutting tool, and a tracking assembly operable to generate a third position data corresponding to the position of the cutting tool, wherein the processing device actuates at least one of the plurality of linear actuators to align the cutting tool with the first cut plane.

15. The virtual implant placement system of claim 1, further comprising a guide surface adapted to guide a cutting tool, wherein the processing device outputs adjustment parameters to align the cutting tool with the first cut plane.

16. The virtual implant placement system of claim 15, further comprising a support base including a plurality of apertures configured to removably affix the support base to the first bone, an adjustment mechanism supported by the support base and including a plurality of linear actuators, the linear actuators supporting the first tracking assembly and the guide surface, the linear actuators actuated according to the adjustment parameters to align the guide surface and the first cut plane.

17. The virtual implant placement system of claim 16, wherein the adjustment parameters are displayed with a viewing device to enable manual actuation of the linear actuators.

18. The virtual implant placement system of claim 16, wherein the adjustment mechanism further includes a plurality of motors operable according to the adjustment parameters to actuate the plurality of linear actuators.

19. The virtual implant placement system of claim 15, further comprising an adjustable cut block and a docking station, the adjustable cut block including a cut block base, the guide surface adjustably coupled to the cut block base, and a locking mechanism, the docking station including at least one driving mechanism for adjusting a position of the guide surface relative to the cut block base according to the adjustment parameters when the adjustable cut block is mounted onto the docking station, the locking mechanism locking the position of the cut block base relative to the guide surface.

20. The virtual implant placement system of claim 19, wherein the adjustment parameters are displayed with a viewing device to enable manual actuation of the driving mechanism.

21. The virtual implant placement system of claim 19, wherein the driving mechanism is automatically actuated according to the adjustment parameters.

22. The virtual implant placement system of claim 1, wherein the processing device also determines a second cut plane adapted to resect the second bone, wherein the first cut plane and the second cut plane are determined independently so as to enable resectioning the first bone and the second bone in any order.

23. The virtual implant placement system of claim 1, wherein the processing device presents the virtual joint in the viewing device including a first visual indication of the first implant model and a second visual indication of the second model, alters the position of the first visual indication relative to the second visual indication in response to movement of the first tracking assembly relative to the first bone, and determines the first cut plane when the virtual joint presented with the viewing device corresponds to the joint through an articulating motion of the joint.

24. The virtual implant placement system of claim 23, wherein the processing device receives an input indicating that the virtual joint corresponds to the joint.

25. The virtual implant placement system of claim 23, further comprising a sensing device to determine a joint landmark relative to the first bone and the second bone, wherein the virtual joint includes a landmark visual indication.

26. The virtual implant placement system of claim 25, wherein the sensing device comprises a trackable pointer.

27. The virtual implant placement system of claim 25, wherein the sensing device comprises a camera generating images of the joint, and the landmark is identifiable in the images generated by the camera.

28. The virtual implant placement system of claim 23, further comprising a stabilized resection tool including an operator interface, a cutting tool, a plurality of linear actuators rotatably coupling the operator interface and the cutting tool, and a tracking assembly operable to generate a third position data corresponding to the position of the cutting tool, wherein the processing device actuates at least one of the plurality of linear actuators to align the cutting tool with the first cut plane.

29. The virtual implant placement system of claim 23, further comprising a guide surface adapted to guide a cutting tool, wherein the processing device outputs adjustment parameters to align the cutting tool with the first cut plane.

30. The virtual implant placement system of claim 29, further comprising a support base including a plurality of apertures configured to removably affix the support base to the first bone, an adjustment mechanism supported by the support base and including a plurality of linear actuators, the linear actuators supporting the first tracking assembly and the guide surface, and the linear actuators actuated according to the adjustment parameters to align the guide surface and the first cut plane.

31. The virtual implant placement system of claim 30, wherein the adjustment parameters are displayed in the viewing device to enable manual actuation of the linear actuators.

32. The virtual implant placement system of claim 30, wherein the adjustment mechanism further includes a plurality of motors operable according to the adjustment parameters to actuate the plurality of linear actuators.

33. The virtual implant placement system of claim 29, further comprising an adjustable cut block, a docking station, and a locking mechanism, the adjustable cut block including a cut block base adjustably coupled to the guide surface, the docking station including at least one driving mechanism for adjusting a position of the guide surface relative to the cut block base according to the adjustment parameters when the adjustable cut block is mounted onto the docking station, the locking mechanism locking the position of the cut block base relative to the guide surface.

34. The virtual implant placement system of claim 33, wherein the driving mechanism is automatically actuated according to the adjustment parameters.

35. The virtual implant placement system of claim 23, wherein the processing device also determines a second cut plane adapted to resect the second bone, wherein the first cut plane and the second cut plane are determined independently so as to enable resectioning the first bone and the second bone in any order.

36. The virtual implant placement system of claim 23, further comprising a first support device including a first base having a first plurality of apertures configured to removably affix the first base to the first bone, and a first plurality of linear actuators rotatably coupling the first base and the first tracking assembly to move the first tracking assembly relative to the first bone.

37. The virtual implant placement system of claim 23, wherein the viewing device is positioned relative to the joint such that the joint and the virtual joint presented in the viewing device can be viewed simultaneously from a first direction.

38. The virtual implant placement system of claim 23, wherein the viewing device displays simultaneously the virtual joint and a visual representation of the joint.