System and method for identifying a landmark

• US 9,220,514 B2
• Filed: 08/27/2008
• Issued: 12/29/2015
• Est. Priority Date: 02/28/2008
• Status: Active Grant

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Inventors: Rains, James K., Ritchey, Nicholas S., Austin, Gene Edward, Grusin, Nathaniel Kelly, Janna, Sied W., Heotis, Charles C.
• Primary Examiner(s): FERNANDEZ, KATHERINE L
• Application Number:
  US12/919,255
• Publication Number:
  US 20110208037A1
• Time in Patent Office: 2,680 Days
• Field of Search: 600/407, 600/409, 600/424, 606/62
• US Class Current: 1/1
• CPC Class Codes: A61B 17/1707 using electromagnetic effects, e.g. with magnet and external sensors
• CPC Class Codes: A61B 17/1725 for applying transverse screws or pins through intramedullary nails or pins
• CPC Class Codes: A61B 17/7017 pneumatic or hydraulic means
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61B 2090/397 electromagnetic other than visible, e.g. microwave
• CPC Class Codes: A61B 5/064 using markers A61B5/062 takes precedence

Abstract

A system (1010, 1110) for identifying a landmark is disclosed. The system includes a field generator (1016, 1116) for generating a magnetic field, an orthopaedic implant (1030, 1130) located within the magnetic field, the implant having at least one landmark (1028, 1128), a removable probe (1029, 1129) with a first magnetic sensor (1026, 1126), a landmark identifier (1016, 1116) with a second magnetic sensor (1020, 1120) and a processor (1012, 1112) for comparing sensor data from the first and second sensor and using the set distance to calculate the position of the landmark identifier relative to the at least one landmark. The system allows for blind targeting of one or more landmarks.

Claims

1. A system for identifying a landmark, the system comprising:

a. a field generator for generating a magnetic field;

b. an orthopaedic implant having at least one landmark;

c. a removable probe comprising a first magnetic sensor and a stop, the stop being configured to engage a portion of the orthopaedic implant or an instrument coupled to the orthopaedic implant to position the first magnetic sensor at a predetermined distance from the at least one landmark;

d. a landmark identifier;

e. a second magnetic sensor spaced from the landmark identifier and from the removable probe; and

f. a processor for receiving sensor data from the first and second magnetic sensors and for calculating a position of the landmark identifier relative to the at least one landmark,

wherein the processor is configured to generate position and orientation information for the first magnetic sensor and the second magnetic sensor based on the sensor data that is produced by the first magnetic sensor and the second magnetic sensor while the first magnetic sensor is located at the predetermined distance from the at least one landmark, and wherein the processor is configured to use the position and orientation information, the predetermined distance, and additional sensor data from the second magnetic sensor to calculate the position of the landmark identifier relative to the at least one landmark after the removable probe is removed from the orthopaedic implant.

2. The system of claim 1, wherein the landmark is selected from the group consisting of a structure, a void, a boss, a channel, a detent, a flange, a groove, a member, a partition, a step, an aperture, a bore, a cavity, a dimple, a duct, a gap, a notch, an orifice, a passage, a slit, a hole, or a slot.

3. The system of claim 1, wherein the orthopaedic implant is an intramedullary nail.

4. The system of claim 1, wherein the orthopaedic implant has an outer surface, an inner surface forming a cannulation, and a wall therebetween, wherein the groove is defined in the wall.

5. The system of claim 1, further comprising an insertion handle for positioning the orthopedic implant in a bone, the insertion handle being removably attached to the orthopaedic implant, the insertion handle including the second sensor.

6. The system of claim 1, further comprising a monitor electrically connected to the processor.

7. The system of claim 1, wherein the removable probe further comprises a tape that extends along the length of the removable probe.

8. The system of claim 1, wherein the landmark identifier comprises a drill sleeve.

9. The system of claim 1, wherein the landmark identifier further comprises a serrated tip.

10. The system of claim 1, wherein the processor provides feedback information to a user.

11. The system of claim 1 wherein the landmark identifier includes the field generator.

12. The system of claim 1 wherein the landmark identifier and the field generator are disposed within a common handheld housing.

13. The system of claim 1 wherein the landmark identifier includes a third sensor.

14. The system of claim 1, further comprising a measurement mechanism configured to measure depth of drill bit placement.

15. The system of claim 14, wherein the measurement mechanism is housed within the landmark identifier.

16. The system of claim 14, wherein the measurement mechanism comprises a capacitive array configured to sense motion along an axis.

17. The system of claim 16, wherein the capacitive array comprises a stator, a slider, and a measuring circuit configured determine a distance of movement along the axis based on voltages induced by relative movement of the slider and the stator.

18. The system of claim 14, wherein the measurement mechanism comprises an optical encoder.

19. The system of claim 18, wherein the measurement mechanism comprises a reflective code strip and a lens that directs light to the code strip,

wherein the optical encoder is configured to detect light reflected from the code strip and produce an electronic output that indicates linear motion of the code strip.

20. The system of claim 18, wherein the measurement mechanism comprises markings on a drill bit, wherein the optical encoder is configured to detect the markings on the drill bit.

21. The system of claim 14, wherein the measurement mechanism comprises a linear variable differential transformer configured to measure linear displacement of a drill bit.

22. The method of claim 1, wherein, to generate the position and orientation information for the first magnetic sensor and the second magnetic sensor, the processor is configured to generate a transformation matrix based on the received sensor data from the first magnetic sensor and the second magnetic sensor.

23. A method for identifying a landmark, the method comprising:

providing an orthopaedic implant assembly having an orthopaedic implant with a longitudinal groove and a removable lead having a first magnetic sensor attached thereto situated within the longitudinal groove, the orthopaedic implant having a proximal end portion, a distal end portion, and at least one landmark on the distal end portion;

implanting the orthopaedic implant assembly in a patient;

obtaining position and orientation information generated based on signals produced by the first magnetic sensor while the removable lead is situated within the longitudinal groove;

removing the removable lead and the first magnetic sensor from the orthopaedic implant;

after removing the removable lead and the first magnetic sensor from the orthopaedic implant;

installing a first transfixion element in the proximal end portion;

after installing the first transfixion element in the proximal end portion, locating the at least one landmark using (i) a landmark identifier having a second magnetic sensor or a magnetic field generator, (ii) the position and orientation information generated based on signals produced by the first magnetic sensor while the removable lead is situated within the longitudinal groove, and (iii) a third magnetic sensor that is spaced apart from the landmark identifier; and

installing a second transfixion element in the located at least one landmark in the distal end portion.

24. A method for identifying a landmark, the method comprising:

providing an orthopaedic implant assembly having an orthopaedic implant with a longitudinal groove and a removable lead having a first magnetic sensor attached thereto situated within the longitudinal groove, the orthopaedic implant having a proximal end portion, a distal end portion, and at least one landmark on the distal end portion, the removeable lead being removeable through an opening defined in the proximal end portion;

providing a second magnetic sensor spaced from the orthopaedic implant;

placing the orthopaedic implant in a patient;

installing a first transfixion element in the proximal end portion;

after installing the first transfixion element in the proximal end portion, (i) identifying the at least one landmark on the distal end portion using a landmark identifier and the second sensor and (ii) installing a second transfixion element in the identified at least one landmark on the distal end portion; and

removing the removable lead through the opening in the proximal end portion.

25. The method of claim 24, wherein removing the removable lead comprises removing the removable lead before (i) identifying the at least one landmark using a landmark identifier and before (ii) installing a second transfixion element in the at least one landmark in the distal end portion.

26. The method of claim 24, wherein the orthopaedic implant defines a hole in the proximal end portion that is oriented transverse to the longitudinal groove;

wherein installing the first transfixion element in the proximal end portion comprises;

installing the first transfixion element in the proximal end portion through the hole in the proximal end portion while the probe extends through the longitudinal groove proximally and distally of the hole.

27. The method of claim 24, further comprising, after placing the orthopaedic implant in the patient, inserting the removable lead into the orthopaedic implant through the opening in the proximal end portion of the orthopaedic implant.

28. A system for targeting a landmark, comprising:

a medical implant having a landmark, the medical implant defining a groove;

a removable probe comprising a first magnetic field sensor;

a second magnetic field sensor;

a landmark identifier; and

a field generator for generating a magnetic field, wherein the landmark identifier and the field generator share a common housing;

a control unit configured to (i) receive data from the first magnetic sensor and the second magnetic sensor, and (ii) generate calibration information based on data received while the first magnetic field sensor is located in the groove in a predetermined position relative to the landmark,

wherein the control unit is configured to use the calibration information and data from the second magnetic sensor to provide information that indicates the position of the landmark identifier relative to the landmark after the removeable probe is removed from the medical implant.

29. The system of claim 28, wherein the medical implant has an outer surface, an inner surface forming a cannulation, and a wall between the inner surface and the outer surface, wherein the groove is defined in the wall.

30. The system of claim 28, further comprising an insertion handle that comprises the second magnetic field sensor, the insertion handle defining a passage to admit the removable probe through the insertion handle;

wherein the removable probe comprises a stop, the stop being located on the removable probe to position the first magnetic sensor in the predetermined position when the stop is engaged with the insertion handle and the removable probe extends through the passage and into the groove.

31. The system of claim 28, wherein the calibration information comprises (i) offset values that locate the first magnetic sensor and the second magnetic sensor in a coordinate system or (ii) data that indicates placement of the first magnetic sensor and the second magnetic sensor relative to one another.

32. The method of claim 28, wherein, to generate the calibration information, the processor is configured to generate the calibration information based on sensor data produced by the first magnetic sensor and the second magnetic sensor while the first magnetic field sensor is located in the groove in a predetermined position relative to the landmark.

33. The method of claim 28, wherein, to generate the calibration information, the processor is configured to generate a transformation matrix based on the data received from the first magnetic sensor and the second magnetic sensor.

34. A method for identifying a landmark, the method comprising:

providing an orthopaedic implant assembly having an orthopaedic implant with a longitudinal groove and a removable lead having a first magnetic sensor attached thereto situated within the longitudinal groove, the orthopaedic implant having a proximal end portion, a distal end portion, and at least one landmark on the distal end portion, the removeable lead being removeable through an opening defined in the proximal end portion;

placing the orthopaedic implant in a patient;

installing a first transfixion element in the proximal end portion at a location proximal to the first magnetic sensor of the removable lead while the removable lead is situated within the longitudinal groove;

after installing the first transfixion element in the proximal end portion;

identifying the at least one landmark on the distal end portion using a landmark identifier; and

installing a second transfixion element in the identified at least one landmark on the distal end portion.

35. The method of claim 34, further comprising removing the removable lead from the orthopaedic implant after installing the second transfixion element in the at least one landmark on the distal end portion.

36. The method of claim 34, wherein providing the orthopaedic implant assembly comprises providing an orthopaedic implant that defines a longitudinal cannulation, the longitudinal groove being offset from the longitudinal cannulation.