Systems and methods for joint replacement

• US 8,998,910 B2
• Filed: 07/24/2009
• Issued: 04/07/2015
• Est. Priority Date: 07/24/2008
• Status: Active Grant

• Current Assignee: Orthalign, Inc.
• Original Assignee: Orthalign, Inc.
• Inventors: Borja, Santiago P., van der Walt, Nicholas
• Primary Examiner(s): SEVILLA, CHRISTIAN ANTHONY
• Application Number:
  US12/509,388
• Publication Number:
  US 20100063508A1
• Time in Patent Office: 2,083 Days
• Field of Search: 606/87, 606/88, 606/102, 606/130, 335/12
• US Class Current: 606/88
• 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. An orthopedic orientation system, for use in a joint procedure, comprising:

an orthopedic fixture, comprising;

a base member having at least one attachment opening configured to receive a pin for securing the base member to a tibia,

an adjustment block disposed adjacent to a side surface of the base member;

a movement device having a first end at least partially projecting into the side surface of the base member and extending therefrom toward the adjustment block;

the movement device enabling at least one degree of freedom of the adjustment block relative to the base member when the base member is in a fixed position and orientation relative to the tibia;

the adjustment block providing at least one additional and different degree of freedom of movement relative to the base member when the movement device is in a fixed position and orientation;

an elongated structure coupled to the adjustment block and extending away from the base member;

a first measuring device extending from a proximal portion of the base, the first measuring device configured to contact a location on a proximal surface of the tibia on a mechanical axis;

a second measuring device extending from a distal portion of the elongated structure, the second measuring device configured to be positioned adjacent to a distal surface to identify a orientation of a plane extending through the tibia which contains the mechanical axis;

a surgical orientation device coupled to the adjustment block and having an associated reference system, the surgical orientation device comprising;

a portable housing configured to connect to the tibia by way of the orthopedic fixture;

a sensor located within the housing, the sensor configured to monitor the orientation of the housing in the reference system, the sensor further configured to generate orientation data corresponding to the monitored orientation of the surgical orientation device;

an output device configured to inform a user of an orientation relative to a reference plane or axis.

2. The system of claim 1, wherein the sensor is a multi-axis accelerometer and further comprises a control module configured to convert a first plurality of sensor outputs into an angle output to be output via the output device when the surgical orientation device is in a first range of positions relative to gravity and further is configured to convert a second plurality of sensor outputs into an angle output to be displayed by the display module when the surgical orientation device is in a second range of positions relative to gravity.

3. The system of claim 1, wherein the sensor is adapted to provide position and/or orientation information relative to the reference system.

4. The system of claim 1, wherein the sensor comprises gyroscopic sensors to detect angular position changes and accelerometers to detect linear position changes.

5. The system of claim 1, wherein the sensor is configured to sense magnetic fields and the surgical orientation device is configured to determine a change in orientation based upon such magnetic fields.

6. The system of claim 5, wherein the sensor comprises a magnetometer.

7. The system of claim 1, wherein the reference plane includes the mechanical axis.

8. The system of claim 1, wherein the base has a plurality of spaced apart attachment openings such that the base can be coupled with the tibia in a non-rotatable state relative to the tibia, the fixture enabling the surgical orientation device to be adjustable in multiple degrees of freedom when the base is in said non-rotatable state to adjust a medial-lateral orientation and an anterior-posterior orientation of the surgical orientation device.

9. The system of claim 1, wherein the system is configured to determine the orientation of the mechanical axis of the joint by obtaining information concerning the position of at least a portion of an opposite end of the leg.

10. The system of claim 9, wherein the elongated structure is adapted to move to position the second measuring device in contact with a plurality of anatomical landmarks near a distal portion of the tibia and the surgical orientation device is adapted to generate orientation data based upon the its orientation when the second measuring device is in such contact.

11. The system of claim 10, wherein the surgical orientation device is configured to determine the reference plane or axis based upon the orientation of the surgical orientation device after the second measuring device has been placed in contact with at least two anatomical landmarks.

12. The system of claim 1, wherein the at least one degree of freedom enabled by the movement device is a first rotational movement about a first axis and the at least one additional and different degree of freedom is a second rotational movement about a second axis perpendicular to the first axis, providing movement of the surgical orientation device in two degrees of freedom relative to the base.

13. The system of claim 1, further comprising an additional sensor, wherein at least one of the surgical orientation device and additional sensor is configured to send information about its orientation to the other of the surgical orientation device or additional sensor.

14. The system of claim 13, wherein the additional sensor is disposed on a portion of the fixture that can be non-rotatably coupled with the tibia.

15. The system of claim 13, wherein the additional sensor is disposed in a reusable housing that can be detachably coupled to the portion of the fixture that can be non-rotatably coupled with the tibia.

19. The system of claim 1, wherein the second measuring device is configured to be positioned adjacent to a medial malleolus of the tibia or a lateral malleolus of the fibula to identify the orientation of the saggital plane extending through the tibia which contains the mechanical axis.

16. An orthopedic orientation system for use in a joint procedure, comprising:

an orthopedic fixture having a base having at least one mounting channel having an anterior end disposed on an anterior side of the base and a posterior end disposed on the posterior side of the base, the channel configured for supporting said fixture adjacent a knee bone adjacent the joint, and an adjustment block coupled with the base by at least one hinge comprising a shaft projecting from one of the base and the adjustment block into a recess of the other of the base or adjustment block,

the adjustment block adjustable in two substantially perpendicular degrees of freedom when the base is immobilized relative to the knee bone to adjust a medial-lateral angle and an anterior-posterior angle of said adjustment block;

an elongated structure coupled to the adjustment block and extending away from the base;

a landmark acquisition device coupled to the elongated structure, the landmark acquisition device configured to contact a distal portion of the knee bone, wherein a length between the base and the landmark acquisition device spans a length of the knee bone;

a surgical orientation device comprising;

a portable housing configured to connect to the knee bone by way of the orthopedic fixture;

the surgical orientation device configured to monitor orientation in a reference system;

an output device configured to inform a user of orientation information pertinent to a procedure on the joint.

17. The orthopedic orientation system of claim 16, wherein the system is configured to identify an anatomical landmark of the knee bone opposite the joint.

18. The orthopedic orientation system of claim 17, where the knee bone is a femur and the system is adapted to determine the location of the center of a head of the femur based upon movement of the femur.

20. An orthopedic orientation system for use in a joint procedure, comprising:

an orthopedic fixture having a base having at least one mounting structure having an anterior end disposed on an anterior side of the base and a posterior end disposed on the posterior side of the base, the base configured for supporting said fixture adjacent a knee bone adjacent the joint, and an adjustment block moveably coupled with the base,

the adjustment block configured to adjust a medial-lateral angle and an anterior-posterior angle of said adjustment block when the base is immobilized relative to the knee bone;

an elongated structure coupled to the adjustment block and extending away from the base;

a landmark acquisition device coupled to the elongated structure, the landmark acquisition device configured to contact a distal portion of the knee bone, wherein a length between the base and the landmark acquisition device spans a length of the knee bone;

a surgical orientation device comprising;

a portable housing configured to connect to the knee bone by way of the orthopedic fixture;

the surgical orientation device configured to monitor orientation in a reference system;

an output device configured to inform a user of orientation information pertinent to a procedure on the joint.