Systems and methods for joint replacement

• US 8,911,447 B2
• Filed: 11/25/2009
• Issued: 12/16/2014
• Est. Priority Date: 07/24/2008
• Status: Active Grant

• Current Assignee: Orthalign, Inc.
• Original Assignee: Orthalign, Inc.
• Inventors: van der Walt, Nicholas, Shapiro, Charles S., Borja, Santiago P.
• Primary Examiner(s): BOLES, SAMEH RAAFAT
• Application Number:
  US12/626,162
• Publication Number:
  US 20100137869A1
• Time in Patent Office: 1,847 Days
• Field of Search: 606/102
• US Class Current: 606/102
• 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 17/1707 using electromagnetic effects, e.g. with magnet and external sensors
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/7017 pneumatic or hydraulic means
• CPC Class Codes: A61B 2034/2048 using an accelerometer or inertia sensor
• CPC Class Codes: A61B 2090/067 for measuring angles
• 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

Abstract

Systems and methods for joint replacement are provided. The systems and methods include a surgical orientation device and at least one orthopedic fixture. The surgical orientation device and orthopedic fixtures can be used to locate the orientation of an axis in the body, to adjust an orientation of a cutting plane or planes along a bony surface, to distract a joint, or to otherwise assist in an orthopedic procedure or procedures.

Claims

1. A method of performing an orthopedic procedure, comprising:

coupling an orthopedic fixture and a portable surgical orientation device with a distal portion of a limb that comprises a portion of a ball-and-socket joint, the portable surgical orientation device including a housing enclosing an inertial sensor and a microprocessor;

activating the inertial sensor within the portable surgical orientation device, such that the inertial sensor output is indicative of orientation, velocity, and/or position;

collecting the inertial sensor output from the inertial sensor using the portable surgical orientation device;

determining with the portable surgical orientation device a center of rotation of a ball portion of the limb based on the inertial sensor output; and

determining with the portable surgical orientation device a location of the mechanical axis of the limb based on the inertial sensor output.

2. The method of claim 1, wherein the limb is a leg and further comprising:

moving a femur of the leg through a range of motion;

detecting the movement of the femur using the portable surgical orientation device;

determining the center of rotation of the femur based on the detected movement of the femur; and

determining the location of the mechanical axis of the femur based at least in part upon the location of the center of rotation of the femur and the location of the center of the knee.

3. The method of claim 1 further comprising:

coupling a cutting guide with the portable surgical orientation device;

securing the cutting guide to an anterior feature of the limb such that the cutting guide is substantially perpendicular to the mechanical axis; and

resecting a bone of the limb to define a plateau aligned with the mechanical axis of the limb.

4. The method of claim 1, further comprising:

moving the portable surgical orientation device and cutting guide in at least one degree of freedom; and

displaying an angle of the cutting guide based on the inertial sensor output.

5. The method of claim 1, further comprising:

aligning the orthopedic fixture with a distal anatomical landmark prior to coupling the orthopedic fixture with the limb;

aligning the portable surgical orientation device with a plurality of proximal anatomical landmarks adjacent a proximal region of the limb;

collecting positional information corresponding to the anatomical landmarks; and

determining the location of the mechanical axis of the limb based on the positional information of the anatomical landmarks.

6. The method of claim 5, wherein the proximal anatomical landmarks comprise the greater trochanter and the center of the head of the femur and the distal anatomical landmark comprises a point of entrance of the femoral canal.

7. The method of claim 1, further comprising:

collecting an inertial sensor output at an origin at time T0;

after collecting the inertial sensor output at the origin, collecting an inertial sensor output during motion of the inertial sensor toward a point spaced apart from the origin at time T1; and

collecting the inertial sensor output from the point spaced apart from the origin during movement of the inertial sensor back toward the origin at time T2.

8. The method of claim 7, further comprising:

performing an integration of the inertial sensor output from time T0 to time T1 to determine the position of the point spaced apart from the origin; and

performing an integration of the inertial sensor output from time T1 to time T2 to confirm the position of the point spaced apart from the origin.

9. The method of claim 1, further comprising indicating end points of ranges of motion by holding the inertial sensor steady for at least a minimum time period.

10. The method of claim 1, wherein determining the center of rotation comprises moving of a portion of the limb, and further comprising signaling to the portable surgical orientation device the start or end of such moving of the portion of the limb.

11. The method of claim 10, wherein signaling is provided by minimizing motion for a minimum period of time at a start or an end of a motion.

12. The method of claim 11, wherein the minimum period of time is at least one second.

13. The method of claim 1, wherein collecting further comprises:

[a] placing the limb at a first position;

[b] swinging the limb about an axis intersecting the ball portion of the limb to a second position spaced away from the first position;

[c] during or after swinging defined at [b], collecting inertial data;

[d] swinging the limb about an axis intersecting the ball portion of the limb to a third position away from the second and first positions; and

[e] during and/or after swinging defined at [d], collecting inertial data.

14. The method of claim 13, wherein swinging defined at [b] is about an anterior-posterior axis and swinging defined at [d] is about a medial-lateral axis.

15. The method of claim 14, further comprising

[f] swinging the limb about the anterior-posterior axis to a fourth position in the same plane as but away from the second position;

[g] during or after swinging defined at [f], collecting inertial data;

[h] swinging the limb about the medial-lateral axis to a fifth position in the same plane as but away from the third position; and

[i] during and/or after swinging defined at [h], collecting inertial data.

16. The method of claim 13, wherein the trajectory from the second position to the third position comprises a medial-lateral component and an anterior-posterior component.

17. The method of claim 16, wherein the second position is medial of the first position and the third position is anterior of the first position.

18. The method of claim 1, wherein the portable surgical orientation device is configured such that after the activating the inertial sensor and before determining the center of rotation, a bias value of the inertial sensor is determined.

19. The method of claim 18, wherein the bias value of the inertial sensor corresponds to acceleration of gravity or the location of the portable surgical orientation device in an Earth Centered Rotating (ECR) coordinate system.

20. A method of performing an orthopedic procedure, comprising:

coupling an orthopedic fixture and a portable surgical orientation device with a distal portion of a limb that comprises a portion of a ball-and-socket joint, the portable surgical orientation device including a housing enclosing an inertial sensor and a microprocessor;

activating the inertial sensor within the portable surgical orientation device, such that the inertial sensor output is indicative of orientation, velocity, and/or position;

collecting inertial data from the inertial sensor using the portable surgical orientation device; and

determining with the portable surgical orientation device a center of rotation of a ball portion of the limb based on the inertial sensor output.