CA2439249C - Total knee arthroplasty systems - Google Patents
Total knee arthroplasty systems Download PDFInfo
- Publication number
- CA2439249C CA2439249C CA2439249A CA2439249A CA2439249C CA 2439249 C CA2439249 C CA 2439249C CA 2439249 A CA2439249 A CA 2439249A CA 2439249 A CA2439249 A CA 2439249A CA 2439249 C CA2439249 C CA 2439249C
- Authority
- CA
- Canada
- Prior art keywords
- knee joint
- component
- fiducials
- tracked
- computer
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
- 238000011883 total knee arthroplasty Methods 0.000 title claims abstract description 14
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 52
- 210000000629 knee joint Anatomy 0.000 claims abstract description 29
- 239000007943 implant Substances 0.000 claims description 47
- 210000000689 upper leg Anatomy 0.000 claims description 45
- 210000002303 tibia Anatomy 0.000 claims description 29
- 238000005520 cutting process Methods 0.000 claims description 27
- 238000001356 surgical procedure Methods 0.000 abstract description 22
- 210000003484 anatomy Anatomy 0.000 abstract description 9
- 238000000034 method Methods 0.000 description 43
- 230000008569 process Effects 0.000 description 32
- 239000000523 sample Substances 0.000 description 30
- 210000003127 knee Anatomy 0.000 description 25
- 238000002271 resection Methods 0.000 description 15
- 210000003041 ligament Anatomy 0.000 description 11
- 238000003384 imaging method Methods 0.000 description 10
- 230000033001 locomotion Effects 0.000 description 10
- 238000012545 processing Methods 0.000 description 10
- 230000000875 corresponding effect Effects 0.000 description 8
- 238000002594 fluoroscopy Methods 0.000 description 7
- 210000002683 foot Anatomy 0.000 description 7
- 238000012360 testing method Methods 0.000 description 7
- 241001227561 Valgus Species 0.000 description 6
- 241000469816 Varus Species 0.000 description 6
- 210000003423 ankle Anatomy 0.000 description 6
- 210000004872 soft tissue Anatomy 0.000 description 6
- 210000001519 tissue Anatomy 0.000 description 6
- 230000004048 modification Effects 0.000 description 5
- 238000012986 modification Methods 0.000 description 5
- 230000000007 visual effect Effects 0.000 description 5
- 238000002595 magnetic resonance imaging Methods 0.000 description 4
- 238000004891 communication Methods 0.000 description 3
- 238000002591 computed tomography Methods 0.000 description 3
- 210000001624 hip Anatomy 0.000 description 3
- 230000008407 joint function Effects 0.000 description 3
- 210000004417 patella Anatomy 0.000 description 3
- 230000009467 reduction Effects 0.000 description 3
- 230000008439 repair process Effects 0.000 description 3
- 208000003241 Fat Embolism Diseases 0.000 description 2
- 208000015181 infectious disease Diseases 0.000 description 2
- 238000011900 installation process Methods 0.000 description 2
- 238000009877 rendering Methods 0.000 description 2
- 238000003860 storage Methods 0.000 description 2
- 210000000588 acetabulum Anatomy 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- 230000002917 arthritic effect Effects 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 230000002596 correlated effect Effects 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 238000009826 distribution Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 210000001513 elbow Anatomy 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 210000003128 head Anatomy 0.000 description 1
- 230000006872 improvement Effects 0.000 description 1
- 230000001939 inductive effect Effects 0.000 description 1
- 238000002329 infrared spectrum Methods 0.000 description 1
- 210000002414 leg Anatomy 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 230000003287 optical effect Effects 0.000 description 1
- 230000000399 orthopedic effect Effects 0.000 description 1
- 230000001575 pathological effect Effects 0.000 description 1
- 210000004197 pelvis Anatomy 0.000 description 1
- 238000002360 preparation method Methods 0.000 description 1
- 230000001953 sensory effect Effects 0.000 description 1
- 210000002832 shoulder Anatomy 0.000 description 1
- 230000011664 signaling Effects 0.000 description 1
- 238000001228 spectrum Methods 0.000 description 1
- 210000003813 thumb Anatomy 0.000 description 1
- 230000007704 transition Effects 0.000 description 1
- 238000013519 translation Methods 0.000 description 1
- 238000012800 visualization Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/361—Image-producing devices, e.g. surgical cameras
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/102—Modelling of surgical devices, implants or prosthesis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/102—Modelling of surgical devices, implants or prosthesis
- A61B2034/104—Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/107—Visualisation of planned trajectories or target regions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2055—Optical tracking systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2068—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis using pointers, e.g. pointers having reference marks for determining coordinates of body points
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2072—Reference field transducer attached to an instrument or patient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/25—User interfaces for surgical systems
- A61B2034/252—User interfaces for surgical systems indicating steps of a surgical procedure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/25—User interfaces for surgical systems
- A61B2034/254—User interfaces for surgical systems being adapted depending on the stage of the surgical procedure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/25—User interfaces for surgical systems
- A61B2034/256—User interfaces for surgical systems having a database of accessory information, e.g. including context sensitive help or scientific articles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B2090/363—Use of fiducial points
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
- A61B2090/376—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
- A61B2090/376—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy
- A61B2090/3762—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy using computed tomography systems [CT]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3904—Markers, e.g. radio-opaque or breast lesions markers specially adapted for marking specified tissue
- A61B2090/3916—Bone tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3983—Reference marker arrangements for use with image guided surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/25—User interfaces for surgical systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
- A61F2/3859—Femoral components
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
- A61F2/389—Tibial components
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4657—Measuring instruments used for implanting artificial joints
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4684—Trial or dummy prostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
- A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
- A61F2002/30891—Plurality of protrusions
- A61F2002/30892—Plurality of protrusions parallel
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2002/4632—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using computer-controlled surgery, e.g. robotic surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2002/4632—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using computer-controlled surgery, e.g. robotic surgery
- A61F2002/4633—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using computer-controlled surgery, e.g. robotic surgery for selection of endoprosthetic joints or for pre-operative planning
Abstract
Systems for total knee arthroplasties ("TKA") are described herein. Anatomical structures may be registered in position, sensed, and tracked in three dimensions according to the system of the invention, allowing surgeons to perform surgeries more effectively. The systems comprise an imager for providing images of portions of the knee joint, a position sensor, a computer to store images of knee joint portions, and receive position information, a TKA surgical instrument attachable to bone in the knee joint, and a monitor to display positioning information.
Description
TOTAL KNEE ARTHROPLASTY SYSTEMS
FIELD OF INVENTION
Systems and processes for tracking anatomy, implements, instrumentation, trial implants, implant components and virtual constructs or references, and rendering images and data related to them in connection with orthopedic, surgical and other operations, for example Total Knee Arthroplasty ("TKA"). Anatomical structures and such items may be attached to or otherwise associated with fiducial functionality, and constructs may be registered in position using fiducial functionality whose position and orientation can be sensed and tracked by systems and according to processes of the present invention in three dimensions in order to perform TKA. Such structures, items and constructs can be rendered onscreen properly positioned and oriented relative to each other using associated image files, data files, image input, other sensory input, based on the tracking. Such systems and processes, among other things, allow surgeons to navigate and perform TKA using images that reveal interior portions of the body combined with computer generated or transmitted images that show surgical implements, instruments, trials, implants, and/or other devices located and oriented properly relative to the body part. Such systems and processes allow, among other things, more accurate and effective resection of bone, placement and assessment of trial implants and joint performance, and placement and assessment of performance of actual implants and joint performance.
BACKGROUND AND SUMMARY
A leading cause of wear and revision in prosthetics such as knee implants, hip implants and shoulder implants is less than optimum implant alignment. In a Total Knee Arthroplasty, br example, current instrument design for resection of bone limits the alignment of the femoral and tibial resections to average values for varus/valgus flexion/extension, and external/internal rotation. Additionally, surgeons often use visual landmarks o "rules of thumb" for alignment which can be misleading due to anatomical variability. Intramedullary referencing instruments also violate the femoral and tibial canal. This intrusion increases the risk of fat embolism and unnecessary blood loss in the patient. Surgeons also rely on instrumentation to predict the appropriate implant size for the femur and tibia instead of the ability to intraoperatively template the appropriate size of the implants for optimal performance. Another challenge for surgeors is soft tissue or ligament balancing after the bone resections have been made. Releasing some of the soft tissue points can change the balance of the knee; however, the multiple options can be confusing for many surgeons. In revision TKA, for example, many of the visual landmarks are no longer present, making alignment and restoration of the joint line difficult. The present invention is applicable not only for knee repair, reconstruction or replacement surgery, but also repair, reconstruction or replacement surgery in connection with any other joint of the body as well as any other surgical or other operation where it is useful to track position and orientation of body parts, non body components and/or virtual references such as rotational axes, and to display and output data regarding positioning and orientation of them relative to each other for use in navigation and performance of the operation.
Several providers have developed and marketed various forms of imaging systems for use in surgery. Many are based on CT scans and/or MRI
data or on digitized points on the anatomy. Other systems align preoperative CT scans, MRIs or other images with intraoperative patient positions. A
preoperative planning system allows the surgeon to select reference points and to determine the final implant position. lntraoperatively, the system calibrates the patient position to that preoperative plan, such as using a "point cloud" technique, and can use a robot to make femoral and tibial preparations.
FIELD OF INVENTION
Systems and processes for tracking anatomy, implements, instrumentation, trial implants, implant components and virtual constructs or references, and rendering images and data related to them in connection with orthopedic, surgical and other operations, for example Total Knee Arthroplasty ("TKA"). Anatomical structures and such items may be attached to or otherwise associated with fiducial functionality, and constructs may be registered in position using fiducial functionality whose position and orientation can be sensed and tracked by systems and according to processes of the present invention in three dimensions in order to perform TKA. Such structures, items and constructs can be rendered onscreen properly positioned and oriented relative to each other using associated image files, data files, image input, other sensory input, based on the tracking. Such systems and processes, among other things, allow surgeons to navigate and perform TKA using images that reveal interior portions of the body combined with computer generated or transmitted images that show surgical implements, instruments, trials, implants, and/or other devices located and oriented properly relative to the body part. Such systems and processes allow, among other things, more accurate and effective resection of bone, placement and assessment of trial implants and joint performance, and placement and assessment of performance of actual implants and joint performance.
BACKGROUND AND SUMMARY
A leading cause of wear and revision in prosthetics such as knee implants, hip implants and shoulder implants is less than optimum implant alignment. In a Total Knee Arthroplasty, br example, current instrument design for resection of bone limits the alignment of the femoral and tibial resections to average values for varus/valgus flexion/extension, and external/internal rotation. Additionally, surgeons often use visual landmarks o "rules of thumb" for alignment which can be misleading due to anatomical variability. Intramedullary referencing instruments also violate the femoral and tibial canal. This intrusion increases the risk of fat embolism and unnecessary blood loss in the patient. Surgeons also rely on instrumentation to predict the appropriate implant size for the femur and tibia instead of the ability to intraoperatively template the appropriate size of the implants for optimal performance. Another challenge for surgeors is soft tissue or ligament balancing after the bone resections have been made. Releasing some of the soft tissue points can change the balance of the knee; however, the multiple options can be confusing for many surgeons. In revision TKA, for example, many of the visual landmarks are no longer present, making alignment and restoration of the joint line difficult. The present invention is applicable not only for knee repair, reconstruction or replacement surgery, but also repair, reconstruction or replacement surgery in connection with any other joint of the body as well as any other surgical or other operation where it is useful to track position and orientation of body parts, non body components and/or virtual references such as rotational axes, and to display and output data regarding positioning and orientation of them relative to each other for use in navigation and performance of the operation.
Several providers have developed and marketed various forms of imaging systems for use in surgery. Many are based on CT scans and/or MRI
data or on digitized points on the anatomy. Other systems align preoperative CT scans, MRIs or other images with intraoperative patient positions. A
preoperative planning system allows the surgeon to select reference points and to determine the final implant position. lntraoperatively, the system calibrates the patient position to that preoperative plan, such as using a "point cloud" technique, and can use a robot to make femoral and tibial preparations.
2
3 PCT/US02/05955 Systems and processes according to one embodiment of the present invention use position and/or orientation tracking sensors such as infrared sensors acting stereoscopically or otherwise to track positions of body parts, surgery-related items such as implements, instrumentation, trial prosthetics, prosthetic components, and virtual constructs or references such as rotational axes which have been calculated and stored based on designation of bone landmarks. Processing capability such as any desired form of computer functionality, whether standalone, networked, or otherwise, takes into account the position and orientation information as to various items in the position sensing field (which may correspond generally or specifically to all or portions or more than all of the surgical field) based on sensed position and orientation of their associated fiducials or based on stored position and/or orientation information. The processing functionality correlates this position and orientation information for each object with stored information regarding the items, such as a computerized fluoroscopic imaged file of a femur or tibia, a wire frame data file for rendering a representation of an instrumentation component, trial prosthesis or actual prosthesis, or a computer generated file relating to a rotational axis or other virtual construct or reference. The processing functionality then displays position and orientation of these objects on a screen or monitor, or otherwise. Thus, systems and processes according to one embodiment of he invention can display and otherwise output useful data relating to predicted or actual position and orientation of body parts, surgically related items, implants, and virtual constructs for use in navigation, assessment, and otherwise performing surgery or other operations.
As one example, images such as fluoroscopy images showing internal aspects of the femur and tibia can be displayed on the monitor in combination with actual or predicted shape, position and orientation of surgical implements, instrumentation components, trial implants, actual prosthetic components, and rotational axes in order to allow the surgeon to properly position and assess performance of various aspects of the joint being repaired, reconstructed or replaced. The surgeon may navigate tools, instrumentation, trial prostheses, actual prostheses and other items relative to bones and other body parts in order to perform TKA's more accurately, efficiently, and with better alignment and stability. Systems and processes according to the present invention can also use the position tracking information and, if desired, data relating to shape and configuration of surgical related items and virtual constructs or references in order to produce numerical data which may be used with or without graphic imaging to perform tasks such as assessing performance of trial prosthetics statically and throughout a range of motion, appropriately modifying tissue such as ligaments to improve such performance and similarly assessing performance of actual prosthetic components which have been placed in the patient for alignment and stability. Systems and processes according to the present invention can also generate data based on position tracking and, if desired, other information to provide cues on screen, aurally or as otherwise desired to assist in the surgery such as suggesting certain bone modification steps or measures which may be taken to release certain ligaments or portions of them based on performance of components as sensed by systems and processes according to the present invention.
According to a preferred embodiment of systems and processes according to the present invention, at least the following steps are involved:
1. Obtain appropriate images such as fluoroscopy images of appropriate body parts such as femur and tibia, the imager being tracked in position via an associated fiducial whose position and orientation is tracked by position/orientation sensors such as stereoscopic infrared (active or passive) sensors according to the present invention.
2. Register tools, instrumentation, trial components, prosthetic components, and other items to be used in surgery, each of which corresponds to a fiducial whose position and orientation can be tracked by the position/orientation sensors.
3. Locating and registering body structure such as designating points on the femur and tibia using a probe associated with a fiducial in order
As one example, images such as fluoroscopy images showing internal aspects of the femur and tibia can be displayed on the monitor in combination with actual or predicted shape, position and orientation of surgical implements, instrumentation components, trial implants, actual prosthetic components, and rotational axes in order to allow the surgeon to properly position and assess performance of various aspects of the joint being repaired, reconstructed or replaced. The surgeon may navigate tools, instrumentation, trial prostheses, actual prostheses and other items relative to bones and other body parts in order to perform TKA's more accurately, efficiently, and with better alignment and stability. Systems and processes according to the present invention can also use the position tracking information and, if desired, data relating to shape and configuration of surgical related items and virtual constructs or references in order to produce numerical data which may be used with or without graphic imaging to perform tasks such as assessing performance of trial prosthetics statically and throughout a range of motion, appropriately modifying tissue such as ligaments to improve such performance and similarly assessing performance of actual prosthetic components which have been placed in the patient for alignment and stability. Systems and processes according to the present invention can also generate data based on position tracking and, if desired, other information to provide cues on screen, aurally or as otherwise desired to assist in the surgery such as suggesting certain bone modification steps or measures which may be taken to release certain ligaments or portions of them based on performance of components as sensed by systems and processes according to the present invention.
According to a preferred embodiment of systems and processes according to the present invention, at least the following steps are involved:
1. Obtain appropriate images such as fluoroscopy images of appropriate body parts such as femur and tibia, the imager being tracked in position via an associated fiducial whose position and orientation is tracked by position/orientation sensors such as stereoscopic infrared (active or passive) sensors according to the present invention.
2. Register tools, instrumentation, trial components, prosthetic components, and other items to be used in surgery, each of which corresponds to a fiducial whose position and orientation can be tracked by the position/orientation sensors.
3. Locating and registering body structure such as designating points on the femur and tibia using a probe associated with a fiducial in order
4 to provide the processing functionality information relating to the body part such as rotational axes.
4. Navigating and positioning instrumentation such as cutting instrumentation in order to modify bone, at least partially using images generated by the processing functionality corresponding to what is being tracked and/or has been tracked, and/or is predicted by the system, and thereby resecting bone effectively, efficiently and accurately.
4. Navigating and positioning instrumentation such as cutting instrumentation in order to modify bone, at least partially using images generated by the processing functionality corresponding to what is being tracked and/or has been tracked, and/or is predicted by the system, and thereby resecting bone effectively, efficiently and accurately.
5. Navigating and positioning trial components such as femoral components and tibial components, some or all of which may be installed using impactors with a fiducial and, if desired, at the appropriate time discontinuing tracking the position and orientation of the trial component using the impactor fiducial and starting to track that position and orientation using the body part fiducial on which the component is installed.
6. Assessing alignment and stability of the trial components and joint, both statically and dynamically as desired, using images of the body parts in combination with images of the trial components while conducting appropriate rotation, anterior-posterior drawer and flexion/extension tests and automatically storing and calculating results to present data or information which allows the surgeon to assess alignment and stability.
7. Releasing tissue such as ligaments if necessary and adjusting trial components as desired for acceptable alignment and stability.
8. Installing implant components whose positions may be tracked at first via fiducials associated with impactors for the components and then tracked via fiducials on the body parts in which the componentsare installed.
9. Assessing alignment and stability of the implant components and joint by use of some or all tests mentioned above and/or other tests as desired, releasing tissue if desired, adjusting if desired, and otherwise verifying acceptable alignment, stability and performance of the prosthesis, both statically and dynamically.
This process, or processes including it or some of it may be used in any total or partial joint repair, reconstruction or replacement, including knees, hips, shoulders, elbows, ankles and any other desired joint in the body.
Systems and processes according to the present invention represent significant improvement over other previous systems and processes. For instance, systems which use CT and MRI data generally require the placement of reference frames pre-operatively which can lead to infection at the pin site.
The resulting 3D images must then be registered, or calibrated, to the patient anatomy intraoperatively. Current registration methods are less accurate than the fluoroscopic system. These imaging modalities are also more expensive.
Some "imageless" systems, or non-imaging systems, require digitizing a large number of points to define the complex anatomical geometries of the knee at each desired site. This can be very time intensive resulting in longer operating room time. Other imageless systems determine the mechanical axis of the knee by performing an intraoperative kinematic motion to determine the center of rotation at the hip, knee, and ankle. This requires placement of reference frames at the iliac crest of the pelvis and in or on the ankle. This calculation is also time consuming at the system must find multiple points in different planes in order to find the center of rotation. This is also problematic in patients with a pathologic condition. Ligaments and soft tissues in the arthritic patient are not normal and thus will give a center of rotation that is not desirable for normal knees.
Robotic systems require expensive CT or MRI scans and also require pre-operative placement of reference frames, usually the day before surgery. These systems are also much slower, almost doubling operating room time and expense.
None of these systems can effectively track femoral and/or tibial trials during a range of motion and calculate the relative positions of the articular surfaces, among other things. Also, none of them currently make suggestions on ligament balancing, display ligament balancing techniques, or surgical techniques. Additionally, none of these systems currently track the patella.
An object of certain aspects of the present invention is to use computer processing functionality in combination with imaging and position and/or orientation tracking sensors to present to the surgeon during surgical operations visual and data information useful to navigate, track and/or position implements, instrumentation, trial components, prosthetic components and other items and virtual constructs relative to the human body in order to improve performance of a repaired, replaced or reconstructed knee joint.
Another object of certain aspects of the present invention is to use computer processing functionality in combination with imaging and position and/or orientation tracking sensors to present to the surgeon during surgical operations visual and data information useful to assess performance of a knee and certain items positioned therein, including components such as trial components and prosthetic components, for stability, alignment and other factors, and to adjust tissue and body and nonbody structure in order to improve such performance of a repaired, reconstructed or replaced knee joint.
Another object of certain aspects of the present invention is to use computer processing functionality in combination with imaging and position and/or orientation tracking sensors to present to the surgeon during surgical operations visual and data information useful to show predicted position and movement of implements, instrumentation, trial components, prosthetic components and other items and virtual constructs relative to the human body in order to select appropriate components, resect bone accurately, effectively and efficiently, and thereby improve performance of a repaired, replaced or reconstructed knee joint.
Other objects, features and advantages of the present invention are apparent with respect to the remainder of this document.
BRIEF DESCRIPTION OF THE DRAWINGS
Fig. I is a schematic view of a particular embodiment of systems and processes according to the present invention.
Fig. 2 is a view of a knee prepared for surgery, including a femur and a tibia, to which fiducials according to one embodiment of the present invention have been attached.
Fig. 3 is a view of a portion of a leg prepared for surgery according to the present invention with a C-arm for obtaining fluoroscopic images associated with a fiducial according to one embodiment of the present invention.
Fig. 4 is a fluoroscopic image of free space rendered on a monitor according to one embodiment of the present invention.
Fig. 5 is a fluoroscopic image of femoral head obtained and rendered according one embodiment of the present invention.
Fig. 6 is a fluoroscopic image of a knee obtained and rendered according to one embodiment of the present invention.
Fig. 7 is a fluoroscopic image of a tibia distal end obtained and rendered according to one embodiment of the present invention.
Fig. 8 is a fluoroscopic image of a lateral view of a knee obtained and rendered according to one embodiment of the present invention.
Fig. 9 is a fluoroscopic image of a lateral view of a knee obtained and rendered according to one embodiment of the present invention.
Fig. 10 is a fluoroscopic image of a lateral view of a tibia distal end obtained and rendered according to one embodiment of the present nvention.
Fig. 11 shows a probe according to one embodiment of the present invention being used to register a surgically related component for tracking according to one embodiment of the present invention.
Fig. 12 shows a probe according to one embodimeit of the present invention being used to register a cutting block for tracking according to one embodiment of the present invention.
Fig. 13 shows a probe according to one embodiment of the present invention being used to register a tibial cutting blockfor tracking according to one embodiment of the present invention.
Fig. 14 shows a probe according to one embodiment of the present invention being used to register an alignment guide for tracking according to one embodiment of the present invention.
Fig. 15 shows a probe according to one embodiment of the present invention being used to designate landmarks on bone structure for tracking according one embodiment of the present invention.
Fig. 16 is another view of a probe according to one embodiment of he present invention being used to designate landmarks on bone structure for tracking according one embodiment of the present invention.
Fig. 17 is another view of a probe according to one embodiment of the present invention being used to designate landmarks on bone structure for tracking according one embodiment of the present invention.
Fig. 18 is a screen face produced according to one embodiment of the present invention during designation of landmarks to determine a femoral mechanical axis.
Fig. 19 is a view produced according to one embodiment of the present invention during designation of landmarks to determine a tibial mechanical axis.
Fig. 20 is a screen face produced according to one embodiment of the present invention during designation of landmarks to determine an epicondylar axis.
Fig. 21 is a screen face produced according to one embodiment of the present invention during designation of landmarks to determine an anterior-posterior axis.
Fig. 22 is a screen face produced according to one embodiment of the present invention during designation of landmarks to determine a posterior condylar axis.
Fig. 23 is a screen face according to one embodiment of the present invention which presents graphic indicia which may be employed to help determine reference locations within bone structure.
Fig. 24 is a screen face according to one embodiment of the present invention showing mechanical and other axes which have been established according to one embodiment of the present invention.
Fig. 25 is another screen face according to one embodiment of the present invention showing mechanical and other axes which have been established according to one embodiment of the present invention.
Fig. 26 is another screen face according to one embodiment of the present invention showing mechanical and other axes which have been established according to one embodiment of the present invention.
Fig. 27 shows navigation and placement of an extramedullary rod according to one embodiment of the present invention.
Fig. 28 is another view showing navigation and placement of an extramedullary rod according to one embodiment of the present invention.
Fig. 29 is a screen face produced according to one embodiment of the present invention which assists in navigation and/or placement of an extramedullary rod.
Fig. 30 is another view of a screen face produced according to one embodiment of the present invention which assists in navigation and/or placement of an extramedullary rod.
Fig. 31 is a view which shows navigation and placement of an alignment guide according to one embodiment of the present invention.
Fig. 32 is another view which shows navigation and placement of an alignment guide according to one embodiment of the present invention.
Fig. 33 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 34 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 35 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 36 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 37 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 38 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 39 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 40 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 41 is a view showing placement of a cutting block according to one embodiment of the present invention.
Fig. 42 is a screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
Fig. 43 is another screen face according to one embodiment of the present invention which may be used to assist in navigation and/or placement of instrumentation.
Fig. 44 is a view showing placement of an alignment guide according to one embodiment of the present invention.
Fig. 45 is another view showing placement of a cutting block according to one embodiment of the present invention.
Fig. 46 is a view showing navigation and placement of the cutting block of Fig. 45.
Fig. 47 is another view showing navigation and placement of a cutting block according to one embodiment of the present invention.
Fig. 48 is a view showing navigation and placement of a tibial cutting block according to one embodiment of the present invention.
Fig. 49 is a screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
Fig. 50 is another screen face according to one embodiment of the present invention which may be used to assist in navigatbn and placement of instrumentation.
Fig. 51 is another screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
Fig. 52 is another screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
Fig. 53 is another screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
Fig. 54 is a view showing navigation and placement of a femoral component using an impactor to which a fiducial according to one embodiment of the present invention is attached.
Fig. 55 is a view showing navigation and placement of a tibial trial component according to one embodiment of the present invention.
Fig. 56 is a view showing articulation of trial components during trial reduction according to one embodiment of the present invention.
Fig. 57 is a screen face according to one embodiment of the present invention which may be used to assist in assessing joint function.
Fig. 58 is a screen face according to one embodiment of the present invention which may be used to assist in assessing joint function.
Fig. 59 is a screen face according to one embodiment of the present invention which may be used to assist in assessing joint function.
Fig. 60 is a screen face according to one embodiment of the present invention which contains images and textural suggestions for assisting in assessing performance and making adjustments to improve performance of a joint in accordance with one aspect of the invention.
Fig. 61 is a screen face according to one embodiment of the present invention which contains images and textural suggestions for assisting in assessing performance and making adjustments to improve performance of a joint in accordance with one aspect of the invention.
Fig. 62 is a screen face according to one embodiment of the present invention which contains images and textural suggestions for assisting in assessing performance and making adjustments to improve performance of a joint in accordance with one aspect of the invention.
Fig. 63 is a screen face according to one embodiment of the present invention which contains images and textural suggestions for assisting in assessing performance and making adjustments to improve performance of a joint in accordance with one aspect of the invention.
Fig. 64 is a computer generated graphic according to one embodiment of the present invention which alows visualization of trial or actual components installed in the bone structure according to one embodiment of the invention.
DETAILED DESCRIPTION
Systems and processes according to a preferred embodiment of the present invention use computer capacity, hcluding standalone and/or networked, to store data regarding spatial aspects of surgically related items and virtual constructs or references including body parts, implements, instrumentation, trial components, prosthetic components and rotational axes of body parts. Any or all of these may be physically or virtually connected to or incorporate any desired form of mark, structure, component, or other fiducial or reference device or technique which allows position and/or orientation of the item to which it is attached to be sensed and tracked, preferably in three dimensions of translation and three degrees of rotation as well as in time if desired. In the preferred embodiment, such "fidicuals" are reference frames each containing at least three, preferably four, sometimes more, reflective elements such as spheres reflective of Iightwave or infrared energy, or active elements such as LEDs.
In a preferred embodiment, orientation of the elements on a particular fiducial varies from one fiducial to the next so that sensors according to the present invention may distinguish between various components to which the fiducials are attached in order to correlate for display and other purposes data files or images of the components. In a preferred embodiment of the present invention, some fiducials use reflective elements and some use active elements, both of which may be tracked by preferably two, sometimes more infrared sensors whose output may be processed in concert to geometrically calculate position and orientation of the item to which the fiducial is attached.
Position/orientation tracking sensors and fiducials need not be confined to the infrared spectrum. Any electromagnetic, electrostatic, light, sound, radiofrequency or other desired technique may be used. Alternatively, each item such as a surgical implement, instrumentation component, trial component, implant component or other device may contain its own "active"
fiducial such as a microchip with appropriate field sensing or position/orientation sensing functionality and communications link such as spread spectrum RF link, in order to report position and orientation of the item.
Such active fiducials, or hybrid active/passive fiducials such as transponders can be implanted in the body parts or in any of the surgically related devices mentioned above, or conveniently located at their surface or otherwise as desired. Fiducials may also take the form of conventional structures such as a screw driven into a bone, or any other three dimensional item attached to another item, position and orientation of such three dimensional item able to be tracked in order to track position and orientation of body parts and surgically related items. Hybrid fiducials may be partly passive, partly active such as inductive components or transponders which respond with a certain signal or data set when queried by sensors according to the present invention.
Systems and processes according to a preferred embodiment of the present invention employ a computer to calculate and sbre reference axes of body components such as in a TKA, for example, the mechanical axis of the femur and tibia. From these axes such systems track the position of the instrumentation and osteotomy guides so that bone resections will locate the implant position optimally, usually aligned with the mechanical axis.
Furthermore, during trial reduction of the knee, the systems provide feedback on the balancing of the ligaments in a range of motion and under varus/valgus, anterior/posterior and rotary stresses and can suggest or at least provide more accurate information than in the past about which ligaments the surgeon should release in order to obtain correct balancing, alignment and stability. Systems and processes according to the present invention can also suggest modifications to implant size, positioning, and other techniques to achieve optimal kinematics. Systems and processes according to the present invention can also include databases of information regarding tasks such as ligament balancing, in order to provide suggestions to the surgeon based on performance of test results as automatically calculated by such systems and processes.
FIG. I is a schematic view showing one embodiment of a system according to the present invention and one version of a setting according to the present invention in which surgery on a knee, in this case a Total Knee Arthroplasty, may be performed. Systems and processes according to the present invention can track various body parts such as tibia 10 and femur 12 to which fiducials of the sort described above or any other sort may be implanted, attached, or otherwise associated physically, virtually, or otherwise.
In the embodiment shown in FIG. 1, fiducials 14 are structural frames some of which contain reflective elements, some of which contain LED active elements, some of which can contain both, for tracking using stereoscopic infrared sensors suitable, at least operating in concert, for sensing, storing, processing and/or outputting data relating to ("tracking") positon and orientation of fiducials 14 and thus components such as, 10 and 12 to which they are attached or otherwise associated. Position sensor 16, as mentioned above, may be any sort of sensor functionality for sensing position and orientation of fiducials 14 and therefore items with which they are associated, according to whatever desired electrical, magnetic, electromagnetic, sound, physical, radio frequency, or other active or passive technique. In the preferred embodiment, position sensor 16 is a pair of infrared sensors disposed on the order of a meter, sometimes more, sometimes less, apart and whose output can be processed in concert to provide position and orientation information regarding fiducials 14.
In the embodiment shown in FIG. 1, computing functionality 18 can include processing functionality, memory functionality, input/output functionality whether on a standalone or distributed basis, via any desired standard, architecture, interface and/or network topology. In this embodiment, computing functionality 18 is connected to a monitor on which graphics and data may be presented to the surgeon during surgery. The screen preferably has a tactile interface so that the surgeon may point and click on screen for tactile screen input in addition to or instead of, if desired, keyboard and mouse conventional interfaces. Additionally, a foot pedal 20 or other convenient interface may be coupled to functionality 18 as can any other wireless or wireline interface to allow the surgeon, nurse or other desired user to control or direct functionality 18 in order to, among other things, capture position/orientation information when certain components are oriented or aligned properly. Items 22 such as trial components, instrumentation components may be tracked in position and orientation relative to body parts
This process, or processes including it or some of it may be used in any total or partial joint repair, reconstruction or replacement, including knees, hips, shoulders, elbows, ankles and any other desired joint in the body.
Systems and processes according to the present invention represent significant improvement over other previous systems and processes. For instance, systems which use CT and MRI data generally require the placement of reference frames pre-operatively which can lead to infection at the pin site.
The resulting 3D images must then be registered, or calibrated, to the patient anatomy intraoperatively. Current registration methods are less accurate than the fluoroscopic system. These imaging modalities are also more expensive.
Some "imageless" systems, or non-imaging systems, require digitizing a large number of points to define the complex anatomical geometries of the knee at each desired site. This can be very time intensive resulting in longer operating room time. Other imageless systems determine the mechanical axis of the knee by performing an intraoperative kinematic motion to determine the center of rotation at the hip, knee, and ankle. This requires placement of reference frames at the iliac crest of the pelvis and in or on the ankle. This calculation is also time consuming at the system must find multiple points in different planes in order to find the center of rotation. This is also problematic in patients with a pathologic condition. Ligaments and soft tissues in the arthritic patient are not normal and thus will give a center of rotation that is not desirable for normal knees.
Robotic systems require expensive CT or MRI scans and also require pre-operative placement of reference frames, usually the day before surgery. These systems are also much slower, almost doubling operating room time and expense.
None of these systems can effectively track femoral and/or tibial trials during a range of motion and calculate the relative positions of the articular surfaces, among other things. Also, none of them currently make suggestions on ligament balancing, display ligament balancing techniques, or surgical techniques. Additionally, none of these systems currently track the patella.
An object of certain aspects of the present invention is to use computer processing functionality in combination with imaging and position and/or orientation tracking sensors to present to the surgeon during surgical operations visual and data information useful to navigate, track and/or position implements, instrumentation, trial components, prosthetic components and other items and virtual constructs relative to the human body in order to improve performance of a repaired, replaced or reconstructed knee joint.
Another object of certain aspects of the present invention is to use computer processing functionality in combination with imaging and position and/or orientation tracking sensors to present to the surgeon during surgical operations visual and data information useful to assess performance of a knee and certain items positioned therein, including components such as trial components and prosthetic components, for stability, alignment and other factors, and to adjust tissue and body and nonbody structure in order to improve such performance of a repaired, reconstructed or replaced knee joint.
Another object of certain aspects of the present invention is to use computer processing functionality in combination with imaging and position and/or orientation tracking sensors to present to the surgeon during surgical operations visual and data information useful to show predicted position and movement of implements, instrumentation, trial components, prosthetic components and other items and virtual constructs relative to the human body in order to select appropriate components, resect bone accurately, effectively and efficiently, and thereby improve performance of a repaired, replaced or reconstructed knee joint.
Other objects, features and advantages of the present invention are apparent with respect to the remainder of this document.
BRIEF DESCRIPTION OF THE DRAWINGS
Fig. I is a schematic view of a particular embodiment of systems and processes according to the present invention.
Fig. 2 is a view of a knee prepared for surgery, including a femur and a tibia, to which fiducials according to one embodiment of the present invention have been attached.
Fig. 3 is a view of a portion of a leg prepared for surgery according to the present invention with a C-arm for obtaining fluoroscopic images associated with a fiducial according to one embodiment of the present invention.
Fig. 4 is a fluoroscopic image of free space rendered on a monitor according to one embodiment of the present invention.
Fig. 5 is a fluoroscopic image of femoral head obtained and rendered according one embodiment of the present invention.
Fig. 6 is a fluoroscopic image of a knee obtained and rendered according to one embodiment of the present invention.
Fig. 7 is a fluoroscopic image of a tibia distal end obtained and rendered according to one embodiment of the present invention.
Fig. 8 is a fluoroscopic image of a lateral view of a knee obtained and rendered according to one embodiment of the present invention.
Fig. 9 is a fluoroscopic image of a lateral view of a knee obtained and rendered according to one embodiment of the present invention.
Fig. 10 is a fluoroscopic image of a lateral view of a tibia distal end obtained and rendered according to one embodiment of the present nvention.
Fig. 11 shows a probe according to one embodiment of the present invention being used to register a surgically related component for tracking according to one embodiment of the present invention.
Fig. 12 shows a probe according to one embodimeit of the present invention being used to register a cutting block for tracking according to one embodiment of the present invention.
Fig. 13 shows a probe according to one embodiment of the present invention being used to register a tibial cutting blockfor tracking according to one embodiment of the present invention.
Fig. 14 shows a probe according to one embodiment of the present invention being used to register an alignment guide for tracking according to one embodiment of the present invention.
Fig. 15 shows a probe according to one embodiment of the present invention being used to designate landmarks on bone structure for tracking according one embodiment of the present invention.
Fig. 16 is another view of a probe according to one embodiment of he present invention being used to designate landmarks on bone structure for tracking according one embodiment of the present invention.
Fig. 17 is another view of a probe according to one embodiment of the present invention being used to designate landmarks on bone structure for tracking according one embodiment of the present invention.
Fig. 18 is a screen face produced according to one embodiment of the present invention during designation of landmarks to determine a femoral mechanical axis.
Fig. 19 is a view produced according to one embodiment of the present invention during designation of landmarks to determine a tibial mechanical axis.
Fig. 20 is a screen face produced according to one embodiment of the present invention during designation of landmarks to determine an epicondylar axis.
Fig. 21 is a screen face produced according to one embodiment of the present invention during designation of landmarks to determine an anterior-posterior axis.
Fig. 22 is a screen face produced according to one embodiment of the present invention during designation of landmarks to determine a posterior condylar axis.
Fig. 23 is a screen face according to one embodiment of the present invention which presents graphic indicia which may be employed to help determine reference locations within bone structure.
Fig. 24 is a screen face according to one embodiment of the present invention showing mechanical and other axes which have been established according to one embodiment of the present invention.
Fig. 25 is another screen face according to one embodiment of the present invention showing mechanical and other axes which have been established according to one embodiment of the present invention.
Fig. 26 is another screen face according to one embodiment of the present invention showing mechanical and other axes which have been established according to one embodiment of the present invention.
Fig. 27 shows navigation and placement of an extramedullary rod according to one embodiment of the present invention.
Fig. 28 is another view showing navigation and placement of an extramedullary rod according to one embodiment of the present invention.
Fig. 29 is a screen face produced according to one embodiment of the present invention which assists in navigation and/or placement of an extramedullary rod.
Fig. 30 is another view of a screen face produced according to one embodiment of the present invention which assists in navigation and/or placement of an extramedullary rod.
Fig. 31 is a view which shows navigation and placement of an alignment guide according to one embodiment of the present invention.
Fig. 32 is another view which shows navigation and placement of an alignment guide according to one embodiment of the present invention.
Fig. 33 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 34 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 35 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 36 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 37 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 38 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 39 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 40 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
Fig. 41 is a view showing placement of a cutting block according to one embodiment of the present invention.
Fig. 42 is a screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
Fig. 43 is another screen face according to one embodiment of the present invention which may be used to assist in navigation and/or placement of instrumentation.
Fig. 44 is a view showing placement of an alignment guide according to one embodiment of the present invention.
Fig. 45 is another view showing placement of a cutting block according to one embodiment of the present invention.
Fig. 46 is a view showing navigation and placement of the cutting block of Fig. 45.
Fig. 47 is another view showing navigation and placement of a cutting block according to one embodiment of the present invention.
Fig. 48 is a view showing navigation and placement of a tibial cutting block according to one embodiment of the present invention.
Fig. 49 is a screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
Fig. 50 is another screen face according to one embodiment of the present invention which may be used to assist in navigatbn and placement of instrumentation.
Fig. 51 is another screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
Fig. 52 is another screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
Fig. 53 is another screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
Fig. 54 is a view showing navigation and placement of a femoral component using an impactor to which a fiducial according to one embodiment of the present invention is attached.
Fig. 55 is a view showing navigation and placement of a tibial trial component according to one embodiment of the present invention.
Fig. 56 is a view showing articulation of trial components during trial reduction according to one embodiment of the present invention.
Fig. 57 is a screen face according to one embodiment of the present invention which may be used to assist in assessing joint function.
Fig. 58 is a screen face according to one embodiment of the present invention which may be used to assist in assessing joint function.
Fig. 59 is a screen face according to one embodiment of the present invention which may be used to assist in assessing joint function.
Fig. 60 is a screen face according to one embodiment of the present invention which contains images and textural suggestions for assisting in assessing performance and making adjustments to improve performance of a joint in accordance with one aspect of the invention.
Fig. 61 is a screen face according to one embodiment of the present invention which contains images and textural suggestions for assisting in assessing performance and making adjustments to improve performance of a joint in accordance with one aspect of the invention.
Fig. 62 is a screen face according to one embodiment of the present invention which contains images and textural suggestions for assisting in assessing performance and making adjustments to improve performance of a joint in accordance with one aspect of the invention.
Fig. 63 is a screen face according to one embodiment of the present invention which contains images and textural suggestions for assisting in assessing performance and making adjustments to improve performance of a joint in accordance with one aspect of the invention.
Fig. 64 is a computer generated graphic according to one embodiment of the present invention which alows visualization of trial or actual components installed in the bone structure according to one embodiment of the invention.
DETAILED DESCRIPTION
Systems and processes according to a preferred embodiment of the present invention use computer capacity, hcluding standalone and/or networked, to store data regarding spatial aspects of surgically related items and virtual constructs or references including body parts, implements, instrumentation, trial components, prosthetic components and rotational axes of body parts. Any or all of these may be physically or virtually connected to or incorporate any desired form of mark, structure, component, or other fiducial or reference device or technique which allows position and/or orientation of the item to which it is attached to be sensed and tracked, preferably in three dimensions of translation and three degrees of rotation as well as in time if desired. In the preferred embodiment, such "fidicuals" are reference frames each containing at least three, preferably four, sometimes more, reflective elements such as spheres reflective of Iightwave or infrared energy, or active elements such as LEDs.
In a preferred embodiment, orientation of the elements on a particular fiducial varies from one fiducial to the next so that sensors according to the present invention may distinguish between various components to which the fiducials are attached in order to correlate for display and other purposes data files or images of the components. In a preferred embodiment of the present invention, some fiducials use reflective elements and some use active elements, both of which may be tracked by preferably two, sometimes more infrared sensors whose output may be processed in concert to geometrically calculate position and orientation of the item to which the fiducial is attached.
Position/orientation tracking sensors and fiducials need not be confined to the infrared spectrum. Any electromagnetic, electrostatic, light, sound, radiofrequency or other desired technique may be used. Alternatively, each item such as a surgical implement, instrumentation component, trial component, implant component or other device may contain its own "active"
fiducial such as a microchip with appropriate field sensing or position/orientation sensing functionality and communications link such as spread spectrum RF link, in order to report position and orientation of the item.
Such active fiducials, or hybrid active/passive fiducials such as transponders can be implanted in the body parts or in any of the surgically related devices mentioned above, or conveniently located at their surface or otherwise as desired. Fiducials may also take the form of conventional structures such as a screw driven into a bone, or any other three dimensional item attached to another item, position and orientation of such three dimensional item able to be tracked in order to track position and orientation of body parts and surgically related items. Hybrid fiducials may be partly passive, partly active such as inductive components or transponders which respond with a certain signal or data set when queried by sensors according to the present invention.
Systems and processes according to a preferred embodiment of the present invention employ a computer to calculate and sbre reference axes of body components such as in a TKA, for example, the mechanical axis of the femur and tibia. From these axes such systems track the position of the instrumentation and osteotomy guides so that bone resections will locate the implant position optimally, usually aligned with the mechanical axis.
Furthermore, during trial reduction of the knee, the systems provide feedback on the balancing of the ligaments in a range of motion and under varus/valgus, anterior/posterior and rotary stresses and can suggest or at least provide more accurate information than in the past about which ligaments the surgeon should release in order to obtain correct balancing, alignment and stability. Systems and processes according to the present invention can also suggest modifications to implant size, positioning, and other techniques to achieve optimal kinematics. Systems and processes according to the present invention can also include databases of information regarding tasks such as ligament balancing, in order to provide suggestions to the surgeon based on performance of test results as automatically calculated by such systems and processes.
FIG. I is a schematic view showing one embodiment of a system according to the present invention and one version of a setting according to the present invention in which surgery on a knee, in this case a Total Knee Arthroplasty, may be performed. Systems and processes according to the present invention can track various body parts such as tibia 10 and femur 12 to which fiducials of the sort described above or any other sort may be implanted, attached, or otherwise associated physically, virtually, or otherwise.
In the embodiment shown in FIG. 1, fiducials 14 are structural frames some of which contain reflective elements, some of which contain LED active elements, some of which can contain both, for tracking using stereoscopic infrared sensors suitable, at least operating in concert, for sensing, storing, processing and/or outputting data relating to ("tracking") positon and orientation of fiducials 14 and thus components such as, 10 and 12 to which they are attached or otherwise associated. Position sensor 16, as mentioned above, may be any sort of sensor functionality for sensing position and orientation of fiducials 14 and therefore items with which they are associated, according to whatever desired electrical, magnetic, electromagnetic, sound, physical, radio frequency, or other active or passive technique. In the preferred embodiment, position sensor 16 is a pair of infrared sensors disposed on the order of a meter, sometimes more, sometimes less, apart and whose output can be processed in concert to provide position and orientation information regarding fiducials 14.
In the embodiment shown in FIG. 1, computing functionality 18 can include processing functionality, memory functionality, input/output functionality whether on a standalone or distributed basis, via any desired standard, architecture, interface and/or network topology. In this embodiment, computing functionality 18 is connected to a monitor on which graphics and data may be presented to the surgeon during surgery. The screen preferably has a tactile interface so that the surgeon may point and click on screen for tactile screen input in addition to or instead of, if desired, keyboard and mouse conventional interfaces. Additionally, a foot pedal 20 or other convenient interface may be coupled to functionality 18 as can any other wireless or wireline interface to allow the surgeon, nurse or other desired user to control or direct functionality 18 in order to, among other things, capture position/orientation information when certain components are oriented or aligned properly. Items 22 such as trial components, instrumentation components may be tracked in position and orientation relative to body parts
10 and 12 using fiducials 14.
Computing functionality 18 can process, store and output on monitor 24 and otherwise various forms of data which correspond in whole or part to body parts 10 and 12 and other components for item 22. For example, in the embodiment shown in FIG. 1, body parts 10 and 12 are shown in cross-section or at least various internal aspects of them such as bone canals and surface structure are shown using fluoroscopic images. These images are obtained using a C-arm attached to a fiducial 14. The body parts, for example, tibia 10 and femur 12, also have fiducials attached. When the fluoroscopy images are obtained using the C-arm with fiducial 14, a position/orientation sensor 16 "sees"and tracks the position of the fluoroscopy head as well as the positions and orientations of the tibia 10 and femur 12.
The computer stores the fluoroscopic images with this position/orientation information, thus correlating position and orientation of the fluoroscopic image relative to the relevant body part or parts. Thus, when the tibia 10 and corresponding fiducial 14 move, the computer automatically and correspondingly senses the new position of tibia 10 in space and can correspondingly move implements, instruments, references, trials and/or implants on the monitor 24 relative to the image of tibia 10. Similarly, the image of the body part can be moved, both the body part and such items may be moved, or the on screen image otherwise presented to suitthe preferences of the surgeon or others and carry out the imaging that is desired. Similarly, when an item 22 such as an extramedullary rod, intramedullary rod, or other type of rod, that is being tracked moves, its image moves on monitor 24 so that the monitor shows the item 22 in proper position and orientation on monitor 24 relative to the femur 12. The rod 22 can thus appear on the monitor 24 in proper or improper alignment with respect to the mechanical axis and other features of the femur 12, as f the surgeon were able to see into the body in order to navigate and position rod 22 properly The computer functionality 18 can also store data relating to configuration, size and other properties of items 22 such as implements, instrumentation, trial components, implant components and other items used in surgery. When those are introduced into the field of position/orientation sensor 16, computer functionality 18 can generate and display overlain or in combination with the fluoroscopic images of the body parts 10 and 12, computer generated images of implements, instrumentation components, trial components, implant components and other items 22 for navigation, positioning, assessment and other uses.
Additionally, computer functionality 18 can track any point in the position/orientation sensor 16 field such as by using a designator or a probe 26. The probe also can contain or be attached to a fiducial 14. The surgeon, nurse, or other user touches the tip of probe 26 to a point such as a landmark on bone structure and actuates the foot pedal 20 or otherwise instructs the computer 18 to note the landmark position. The position/orientation sensor 16 "sees" the position and orientation of fiducial 14 "knows" where the tip of probe 26 is relative to that fiducial 14 and thus calculates and stores, and can display on monitor 24 whenever desired and in whatever form or fashion or color, the point or other position designated by probe 26 when the foot pedal 20 is hit or other command is given. Thus, probe 26 cai be used to designate landmarks on bone structure in order to allow the computer 18 to store and track, relative to movement of the bone fiducial 14, virtual or logical information such as mechanical axis 28, medial laterial axis 30 and anterior/posterior axis 32 of femur 12, tibia 10 and other body parts in addition to any other virtual or actual construct or reference.
Systems and processes according to an embodiment of the present invention such as the subject of Figs. 2 - 64, can use the so-called FluoroNAV
system and software provided by Medtronic Sofamor Danek Technologies. Such systems or aspects of them are disclosed in U.S. Patent Nos. 5,383,454;
5,871,445; 6,146,390; 6,165,81; 6,235,038 and 6,236,875. Any other desired systems can be used as mentioned above for imaging, storage of data, tracking of body parts and items and for other purposes. The FluoroNav system requires the use of reference frame type fiducials 14 which have four and in some cases five elements tracked by infrared sensors for position/orientation of the fiducials and thus of the body part, implement, instrumentation, trial component, implant component, or other device or structure being tracked. Such systems also use at least one probe 26 which the surgeon can use to select, designate, register, or otherwise make known to the system a point or points on the anatomy or other locations by placing the probe as appropriate and signaling or commanding the computer to note the location of, for instance, the tip of the probe. The FluoroNav system also tracks position and orientation of a C-arm used to obtain fluoroscopic images of body parts to which fiducials have been attached for capturing and storage of fluoroscopic images keyed to position/orientation information as tracked by the sensors 16. Thus, the monitor 24 can render fluoroscopic images of bones in combination with computer generated images of virtual constructs and references together with implements, instrumentation components, trial components, implant components and other items used in connection with surgery for navigation, resection of bone, assessment and other purposes.
FIGS. 2 - 64 are various views associated with Total Knee Arthroplasty surgery processes according to one particular embodiment and version of the present invention being carried out with the FluoroNav system referred to above. FIG. 2 shows a human knee in the surgical field, as well as the corresponding femur and tibia, to which fiducials 14 have been rigidly attached in accordance with this embodiment of the invention. Attachment of fiducials 14 preferably is accomplished using structure that withstands vibration of surgical saws and other pheiomenon which occur during surgery without allowing any substantial movement of fiducial 14 relative to body part being tracked by the system. FIG. 3 shows fluoroscopy images being obtained of the body parts with fiducials 14 attached. The fiducial 14 on the fluoroscopy head in this embodiment is a cylindrically shaped cage which contains LEDs or "active" emitters for tracking by the sensors 16. Fiducials attached to tibia 10 and femur 12 can also be seen. The fiducial 14 attached to the femur 12 uses LEDs instead of reflective spheres and is thus active, fed power by the wire seen extending into the bottom of the image.
FIGS. 4-10 are fluoroscopic images shown on monitor 24 obtained with position and/or orientation information received by, noted and stored within computer 18. FIG. 4 is an open field with no body part image, but which shows the optical indicia which may be used to normalize the image obtained using a spherical fluoroscopy wave front with the substantially flat surface of the monitor 24. FIG. 5 shows an image of the femur 12 head. This image is taken in order to allow the surgeon to designate the center of rotation of the femoral head for purposes of establishing the mechanical axis and other relevant constructs relating to of the femur according to which the prosthetic components will ultimately be positioned. Such center of rotation can be established by articulating the femur within the acetabulum or a prosthesis to capture a number of samples of position and orientation informdion and thus in turn to allow the computer to calculate the average center of rotation. The center of rotation can be established by using the probe and designating a number of points on the femoral head and thus allowing the computer to calculate the geometrical center or a center which corresponds to the geometry of points collected. Additionally, graphical representations such as controllably sized circles displayed on the monitor can be fitted by the surgeon to the shape of the femoral head on planar images using tactile input on screen to designate the centers according to that graphic, such as are represented by the computer as intersection of axes of the circles. Other techniques for determining, calculating or establishing points or constructs in space, whether or not corresponding to bone structure, can be used in accordance with the present invention.
FIG. 5 shows a fluoroscopic image of the femoral head while FIG. 6 shows an anterior/posterior view of the knee which can be used to designate landmarks and establish axes or constructs such as the mechanical axis or other rotational axes. FIG. 7 shows the distal end of the tibia and FIG. 8 shows a lateral view of the knee. FIG. 9 shows another lateral view of the knee while FIG. 10 shows a lateral view of the distal end of the tibia.
Registration of Surgically Related Items FIGS. 11-14 show designation or registration of items 22 which will be used in surgery. Registration simply means, however it is accomplished, ensuring that the computer knows which body part, item or construct corresponds to which fiducial or fiducials, and how the position and orientation of the body part, item or construct is related to the position and orientation of its corresponding fiducial or a fiducial attached to an impactor or other other component which is in turn attached to an item. Such registration or designation can be done before or after registering bone or body parts as discussed with respect to FIGS. 4 - 10. FIG. 11 shows a technician designating with probe 26 an item 22 such as an instrument component to which fiducial 14 is attached. The sensor 16 "sees" the position and orientation of the fiducial 14 attached to the item 22 and also the position and orientation of the fiducial 14 attached to the probe 26 whose tip is touching a landmark on the item 22. The technician designates onscreen or otherwise the identification of the item and then activates the foot pedal or otherwise instructs the computer to correlate the data corresponding to such identification, such as data needed to represent a particular cutting block component for a particular knee implant product, with the particularly shaped fiducial 14 attached to the component 22. The computer has then stored identification, position and orientation information relating to the fiducial for component 22 correlated with the data such as configuration and shape data for the item 22 so that upon registration, when sensor 16 tracks the item 22 fiducial 14 in the infrared field, monitor 24 can show the cutting block component 22 moving and turning, and properly positioned and oriented relative to the body part which is also being tracked. FIGS. 12.14 show similar registration for other instrumentation components 22.
Registration of Anatomy and Constructs Similarly, the mechanical axis and other axes or constructs of body parts 10 and 12 can also be "registered" for tracking by the system. Again, the system has employed a fluoroscope to obtain images of the femoral head, knee and ankle of the sort shown in FIGS. 4-10. The system correlates such images with the position and orientation of the Garm and the patient anatomy in real time as discussed above with the use of fiducials 14 placed on the body parts before image acquisition and which remain in position during the surgical procedure. Using these images and/or the probe, the surgeon can select and register in the computer 18 the center of the femoral head and ankle in orthogonal views, usually anterior/posterior and lateral, on a touch screen. The surgeon uses the probe to select any desired anatomical landmarks or references at the operative site of the knee or on the skin or surgical draping over the skin, as on the ankle. These points are registered in three dimensional space by the system and are tracked relative to the fiducials on the patient anatomy which are preferably placed intraoperatively.
FIG. 15 shows the surgeon using probe 26 to designate or register landmarks on the condylar portion of femur 12 using probe 26 in order to feed to he computer 18 the position of one point needed to determine, store, and display the epicondylar axis. (See FIG. 20 which shows the epicondylar axis and the anterior-posterior plane and for lateral plane.) Although registering points using actual bone structure such as in FIG. 15 is one preferred way to establish the axis, a cloud of points approach by which the probe 26 is used to designate multiple points on the surface of the bone structure can be employed, as can moving the body part and tracking movement to establish a center of rotation as discussed above. Once the center of rotation for the femoral head and the condylar component have been registered, the computer is able to calculate, store, and render, and otherwise use data for, the mechanical axis of the femur 12. FIG. 17 once again shows the probe 26 being used to designate points on the condylar component of the femur 12.
FIG. 18 shows, the onscreen images being obtained when the surgeon registers certain points on the bone surface using the probe 26 in order to establish the femoral mechanical axis. The tibial mechanical axis is then established by designating points to determine the centers of the proximal and distal ends of the tibia so that the mechanical axis can be calculated, stored, and subsequently used by the computer 18. FIG. 20 shows designated points for determining the epicondylar axis, both in the anterior/posterior and lateral planes while FIG. 21 shows such determination of the anterior-posterior axis as rendered onscreen. The posterior condylar axis is also determined by designating points or as otherwise desired, as rendered on the computer generated geometric images overlain or displayed in combination with the fluoroscopic images, all of which are keyed to fiducials 14 being tracked by sensors 16.
FIG. 23 shows an adjustable circle graphic which can be generated and presented in combination with orthogonal fluoroscopic images of the femoral head, and tracked by the computer 18 when the surgeon moves it on screen in order to establish the centers of the femoral head in both the anterior-posterior and lateral planes.
FIG. 24 is an onscreen image showing the anterior-posterior axis, epicondylar axis and posterior condylar axis from points which have been designated as described above. These constructs are generated by the computer 18 and presented on monitor 24 in combination with the fluoroscopic images of the femur 12, correctly positioned and oriented relative thereto as tracked by the system. In the fluoroscopic/computer generated image combination shown at left bottom of FIG. 24, a "sawbones" knee as shown in certain drawings above which contains radio opaque materials is represented fluoroscopically and tracked using sensor 16 while the computer generates and displays the mechanical axis of the femur 12 which runs generally horizontally. The epicondylar axis runs generally vertically, and the anterior/posterior axis runs generally diagonally. The image at bottom right shows similar information in a lateral view. He-e, the anterior-posterior axis runs generally horizontally while the epicondylar axis runs generally diagonally, and the mechanical axis generally vertically.
FIG. 24, as is the case with a number of screen presentations generated and presented by the stem of FIGS. 4 - 64, also shows at center a list of landmarks to be registered in order to generate relevant axes and constructs useful in navigation, positioning and assessment during surgery.
Textural cues may also be presented which suggest to the surgeon next steps in the process of registering landmarks and establishing relevant axes. Such instructions may be generated as the computer 18 tracks, from one step to the next, registration of items 22 and bone locations as well as other measures being taken by the surgeon during the surgical operation.
FIG. 25 shows mechanical, lateral, anterior-posterior axes for the tibia according to points are registered by the surgeon.
FIG. 26 is another onscreen image showing the axes for the femur 12.
Modifying Bone After the mechanical axis and other rotation axes and constructs relating to the femur and tibia are established, instrumentation can be properly oriented to resect or modify bone in order to fit trial components and implant components properly according to the embodiment of the invention shown in FIGS. 4 - 64. Instrumentation such as, for instance, cutting blocks, to which fiducials 14 are mounted, can be employed. The system can then track instrumentation as the surgeon manipulates it for optimum positioning. In other words, the surgeon can "navigate" the instrumentation for optimum positioning using the system and the monitor. In this manner, instrumentation may be positioned according to the system of this embodiment in order to align the ostetomies to the mechanical and rotational axes or reference axes on an extramedullary rod that does not violate the canal, on an intramedullary rod, or on any other type of rod. The touchscreen 24 can then also display the instrument such as the cutting block and/or the implant relative to the instrument and the rod during this process, in order, among other things, properly to select size of implant and perhaps implant type. As the instrument moves, the varus/valgus, flexion/extension and internal/external rotation of the relative component position can be calculated and shown with respect to the referenced axes; in the preferred embodiment, this can be done at a rate of six cycles per second or faster. The instrument position is then fixed in the computer and physically and the bone resections are made.
FIG. 27 shows orientation of an extramedullary rod to which a fiducial 14 is attached via impactor 22. The surgeon views the screen 24 which has an image as shown in FIG. 29 of the rod overlain on or incombination with the femur 12 fluoroscopic image as the two are actually positioned and oriented relative to one another in space. The surgeon then navigates the rod into place preferably along the mechanical axis of the femur and drives it home with appropriate mallet or other device. The present invention thus avoids the need to bore a hole in the metaphysis of the femur and place a reamer or other rod into the medullary canal which can cause fat embolism, hemorrhaging, infection and other untoward andundesired effects.
FIG. 28 also shows the extramedullary rod being located. FIG. 29 shows fluoroscopic images, both anterior-posterior and lateral, with axes, and with a computer generated and tracked image of the rod superposed or in combination with the fluoroscopic images of the femur and tibia. FIG. 30 shows the rod superposed on the femoral fluoroscopic image similar to what is shown in FIG. 29.
FIG. 29 also shows other information relevant to the surgeon such as the name of the component being overlain on the femur image (new EM nail), suggestions or instructions at the lower left, and angle of the rod in varus/valgus and extension relative to the axes. Any or all of this information can be used to navigate and position the rod relative to thefemur. At a point in time during or after placement of the rod, its tracking may be "handed off"
from the impactor fiduciall4 to the femur fiducal 14 as discussed below.
Once the extramedullary rod, intramedullary rod, other type of rod has been placed, instrumentation can be positioned as tracked in position and orientation by sensor 16 and displayed on screen face 24. Thus, a cutting block of the sort used to establish the condylar anterior cut, with its fiducial 14 attached, is introduced into the field and positioned on the rod. Because the cutting block corresponds to a particular implant product and can be adjusted and designated on screen to correspond to a particular implant size of that product, the computer 18 can generate and display a graphic of the cutting block and the femoral component overlain on the fluoroscopic image as shown in FIGS. 33-36. The surgeon can thus navigate and position the cutting block on screen using not only images of the cutting block on the bone, but also images of the corresponding femoral component which will be ultimately installed. The surgeon can thus adjust the positioning of the physical cutting block component, and secure it to the rod in order to resect the anterior of the condylar portion of the femur in order to optimally fit and position the ultimate femoral component being shown on the screen. FIG. 32 is another view of the cutting block of FIG. 31 being positioned. Other cutting blocks and other resections may be positioned and made similarly on the condylar component.
In a similar fashion, instrumentation may be navigated and positioned on the proximal portion of the tibia 10 as shown in FIG. 41 and as tracked by sensor 16 and on screen by images of the cutting block and the implant component as shown in FIGS. 37-40. FIGS. 42 and 43 show other onscreen images generated during this bone modification process for purposes of navigation and positioning cutting blocks and other instrumentation for proper resection and other modification of femur and tbia in order to prepare for trial components and implant components according to systems and processes of the embodiment of the present invention shown in FIGS. 4- 64.
FIGS. 44-48 also show instrumentation being positioned relative to femur 12 as tracked by the system for resection of the condylar component in order to receive a particular size of implant component. Various cutting blocks and their attached fiducials can be seen in these views.
FIG. 49 shows a femoral component overlaid on the femur as instrumentation is being tracked and positioned in order for resection of bone properly and accurately to be accomplished. FIG. 50 is another navigational screen face showing a femoral component overlay as instrumentation is being positioned for resection of bone.
FIG. 51 is tibial component overlay information on a navigation screen as the cutting block for the tibial plateau is being positioned for bone resection.
FIGS. 52 and 53 show femoral component and tibial component overlays, respectively, according to certain position and orientation of cutting blocks/instrumentation as resectioning is being done. The surgeon can thus visualize where the implant components will be and can assess fit, and other things if desired, before resections are made.
Navigation, Placement and Assessment of Trials and Implants Once resection and modification of bone has been accomplished, implant trials can then be installed and tracked by the system in a manner similar to navigating and positioning the instrumentatio], as displayed on the screen 24. Thus, a femoral component trial, a tibial plateau trial, and a bearing plate trial may be placed as navigated on screen using computer generated overlays corresponding to the trials.
During the trial installation process, and also during the implant component installation process, instrument positioning process or at any other desired point in surgical or other operations according to the present invention, the system can transition or segue from tracking a component according to a first fiducial to tracking the component according to a second fiducial. Thus, as shown as FIG. 33, the trial femoral component is mounted on an impactor to which is attached a fiducial 14. The trial component is installed and positioned ushg the impactor. The computer 18 "knows" the position and orientation of the trial relative to the fiducial on the impactor (such as by prior registration of the component attached to the impactor) so that it can generate and display the image of the femoral component trial on screen 24 overlaid on the fluoroscopic image of the condylar component. At any desired point in time, before, during or after the trial component is properly placed on the condylar component of the femur to align with mechanical axis and according to proper orientation relative to other axes, the system can be instructed by foot pedal or otherwise to begin tracking the position of the trial component using the fiducial attached to the femur rather than the one attached to the impactor. According to the preferred embodiment, the sensor 16 "sees" at this point in time both the fiducials on the impactor and the femur 12 so that it already "knows" the position and orientation of the trial component relative to the fiducial on the impactor and is thus able to calculate and store for later use the position and orientation of the trial component relative to the femur 12 fiducial. Once this "handoff" happens, the impactor can be removed and the trial component tracked with the femur fiducial 14 as part of or moving in concert with the femur 12. Similar handoff procedures may be used in any other instance as desired in accordance with the present invention.
FIG. 55 shows the tibial plateau trial being tracked and installed in a manner similar to femoral component trial as discussed above. Alternatively, the tibial trial can be placed on the proximal tibia and then registered using the probe 26. Probe 26 is used to designate preferably at least three features on the tibial trial of known coordinates, such as bone spike holes. As the probe is placed onto each feature, the system is prompted to save that coordinate position so that the system can match the tibial trial's feature's coordinates to the saved coordinates. The system then tracks tie tibial trial relative to the tibial anatomical reference frame.
Once the trial components are installed, the surgeon can assess alignment and stability of the components and the joint. During such assessment, in trial reduction, the computer can diEplay on monitor 24 the relative motion between the trial components to allow the surgeon to make soft tissue releases and changes in order to improve the kinematics of the knee. The system can also apply rules and/or intelligence to make suggestions based on the information such as what soft tissue releases to make if the surgeon desires. The system can also display how the soft tissue releases are to be made.
FIG. 56 shows the surgeon articulating the knee as he monitors the screen which is presenting images such as those shown in FIGS. 57 - 59 which not only show movement of the trial components relative to each other, but also orientation, flexion, and varus/valgus. During this assessment, the surgeon may conduct certain assessment processes such as ecternal/internal rotation or rotary laxity testing, varus/valgus tests, and anterior-posterior drawer at 0 and 90 degrees and mid range. Thus, in the AP drawer test, the surgeon can position the tibia at the first location and press the foot pedal.
He then positions the tibia at the second location and once again presses the foot pedal so that the computer has registered and stored two locations in order to calculate and display the drawer and whether it is acceptable for the patient and the product involved. If not, the computer can apply rules in order to generate and display suggestions for releasing ligaments or other tissue, or using other component sizes or types, such as shown, for example, in FIGS.
60-63. Once the proper tissue releases have been made, if necessary, and alignment and stability are acceptable as noted quantitatively on screen about all axes, the trial components may be removed and actual components navigated, installed, and assessed in performance in a manner similar to that in which the trial components were navigated, installed, and assessed.
FIG. 64 is another computer generated 3-dimensional image of the trial components as tracked by the system during trialing.
At the end of the case, all alignment information can be saved for the patient file. This is of great assistance to the surgeon due to the fact that the outcome of implant positioning can be seen before any resectioning has been done on the bone. The system is also capable of tracking the patella and resulting placement of cutting guides and the patellar trial position. The system then tracks alignment of the patella with the patellar femoral groove and will give feedback on issues, such as, patellar tilt.
The tracking and image information provided by systems and processes according to the present invention facilitate telemedical techniques, because they provide useful images for distribution to distant geographic locations where expert surgical or medical specialists may collaborate during surgery. Thus, systems and processes according to the present invention can be used in connection with computing functionality 18 which is networked or otherwise in communication with computing functionality in other locations, whether by PSTN, information exchange infrastructures such as packet switched networks including the Internet, or as otherwise desire. Such remote imaging may occur on computers, wireless devices, videoconferencing devices or in any other mode or on any other platform which is now or may in the future be capable of rending images or parts of them produced in accordance with the present invention. Parallel communication links such as switched or unswitched telephone call connections may also accompany or form part of such telemedical techniques. Distant databases such as online catalogs of implant suppliers or prosthetics buyers or distributors may form part of or be networked with functionality 18 to give the surgeon in real time access to additional options for implants which could be procured and used during the surgical operation.
Computing functionality 18 can process, store and output on monitor 24 and otherwise various forms of data which correspond in whole or part to body parts 10 and 12 and other components for item 22. For example, in the embodiment shown in FIG. 1, body parts 10 and 12 are shown in cross-section or at least various internal aspects of them such as bone canals and surface structure are shown using fluoroscopic images. These images are obtained using a C-arm attached to a fiducial 14. The body parts, for example, tibia 10 and femur 12, also have fiducials attached. When the fluoroscopy images are obtained using the C-arm with fiducial 14, a position/orientation sensor 16 "sees"and tracks the position of the fluoroscopy head as well as the positions and orientations of the tibia 10 and femur 12.
The computer stores the fluoroscopic images with this position/orientation information, thus correlating position and orientation of the fluoroscopic image relative to the relevant body part or parts. Thus, when the tibia 10 and corresponding fiducial 14 move, the computer automatically and correspondingly senses the new position of tibia 10 in space and can correspondingly move implements, instruments, references, trials and/or implants on the monitor 24 relative to the image of tibia 10. Similarly, the image of the body part can be moved, both the body part and such items may be moved, or the on screen image otherwise presented to suitthe preferences of the surgeon or others and carry out the imaging that is desired. Similarly, when an item 22 such as an extramedullary rod, intramedullary rod, or other type of rod, that is being tracked moves, its image moves on monitor 24 so that the monitor shows the item 22 in proper position and orientation on monitor 24 relative to the femur 12. The rod 22 can thus appear on the monitor 24 in proper or improper alignment with respect to the mechanical axis and other features of the femur 12, as f the surgeon were able to see into the body in order to navigate and position rod 22 properly The computer functionality 18 can also store data relating to configuration, size and other properties of items 22 such as implements, instrumentation, trial components, implant components and other items used in surgery. When those are introduced into the field of position/orientation sensor 16, computer functionality 18 can generate and display overlain or in combination with the fluoroscopic images of the body parts 10 and 12, computer generated images of implements, instrumentation components, trial components, implant components and other items 22 for navigation, positioning, assessment and other uses.
Additionally, computer functionality 18 can track any point in the position/orientation sensor 16 field such as by using a designator or a probe 26. The probe also can contain or be attached to a fiducial 14. The surgeon, nurse, or other user touches the tip of probe 26 to a point such as a landmark on bone structure and actuates the foot pedal 20 or otherwise instructs the computer 18 to note the landmark position. The position/orientation sensor 16 "sees" the position and orientation of fiducial 14 "knows" where the tip of probe 26 is relative to that fiducial 14 and thus calculates and stores, and can display on monitor 24 whenever desired and in whatever form or fashion or color, the point or other position designated by probe 26 when the foot pedal 20 is hit or other command is given. Thus, probe 26 cai be used to designate landmarks on bone structure in order to allow the computer 18 to store and track, relative to movement of the bone fiducial 14, virtual or logical information such as mechanical axis 28, medial laterial axis 30 and anterior/posterior axis 32 of femur 12, tibia 10 and other body parts in addition to any other virtual or actual construct or reference.
Systems and processes according to an embodiment of the present invention such as the subject of Figs. 2 - 64, can use the so-called FluoroNAV
system and software provided by Medtronic Sofamor Danek Technologies. Such systems or aspects of them are disclosed in U.S. Patent Nos. 5,383,454;
5,871,445; 6,146,390; 6,165,81; 6,235,038 and 6,236,875. Any other desired systems can be used as mentioned above for imaging, storage of data, tracking of body parts and items and for other purposes. The FluoroNav system requires the use of reference frame type fiducials 14 which have four and in some cases five elements tracked by infrared sensors for position/orientation of the fiducials and thus of the body part, implement, instrumentation, trial component, implant component, or other device or structure being tracked. Such systems also use at least one probe 26 which the surgeon can use to select, designate, register, or otherwise make known to the system a point or points on the anatomy or other locations by placing the probe as appropriate and signaling or commanding the computer to note the location of, for instance, the tip of the probe. The FluoroNav system also tracks position and orientation of a C-arm used to obtain fluoroscopic images of body parts to which fiducials have been attached for capturing and storage of fluoroscopic images keyed to position/orientation information as tracked by the sensors 16. Thus, the monitor 24 can render fluoroscopic images of bones in combination with computer generated images of virtual constructs and references together with implements, instrumentation components, trial components, implant components and other items used in connection with surgery for navigation, resection of bone, assessment and other purposes.
FIGS. 2 - 64 are various views associated with Total Knee Arthroplasty surgery processes according to one particular embodiment and version of the present invention being carried out with the FluoroNav system referred to above. FIG. 2 shows a human knee in the surgical field, as well as the corresponding femur and tibia, to which fiducials 14 have been rigidly attached in accordance with this embodiment of the invention. Attachment of fiducials 14 preferably is accomplished using structure that withstands vibration of surgical saws and other pheiomenon which occur during surgery without allowing any substantial movement of fiducial 14 relative to body part being tracked by the system. FIG. 3 shows fluoroscopy images being obtained of the body parts with fiducials 14 attached. The fiducial 14 on the fluoroscopy head in this embodiment is a cylindrically shaped cage which contains LEDs or "active" emitters for tracking by the sensors 16. Fiducials attached to tibia 10 and femur 12 can also be seen. The fiducial 14 attached to the femur 12 uses LEDs instead of reflective spheres and is thus active, fed power by the wire seen extending into the bottom of the image.
FIGS. 4-10 are fluoroscopic images shown on monitor 24 obtained with position and/or orientation information received by, noted and stored within computer 18. FIG. 4 is an open field with no body part image, but which shows the optical indicia which may be used to normalize the image obtained using a spherical fluoroscopy wave front with the substantially flat surface of the monitor 24. FIG. 5 shows an image of the femur 12 head. This image is taken in order to allow the surgeon to designate the center of rotation of the femoral head for purposes of establishing the mechanical axis and other relevant constructs relating to of the femur according to which the prosthetic components will ultimately be positioned. Such center of rotation can be established by articulating the femur within the acetabulum or a prosthesis to capture a number of samples of position and orientation informdion and thus in turn to allow the computer to calculate the average center of rotation. The center of rotation can be established by using the probe and designating a number of points on the femoral head and thus allowing the computer to calculate the geometrical center or a center which corresponds to the geometry of points collected. Additionally, graphical representations such as controllably sized circles displayed on the monitor can be fitted by the surgeon to the shape of the femoral head on planar images using tactile input on screen to designate the centers according to that graphic, such as are represented by the computer as intersection of axes of the circles. Other techniques for determining, calculating or establishing points or constructs in space, whether or not corresponding to bone structure, can be used in accordance with the present invention.
FIG. 5 shows a fluoroscopic image of the femoral head while FIG. 6 shows an anterior/posterior view of the knee which can be used to designate landmarks and establish axes or constructs such as the mechanical axis or other rotational axes. FIG. 7 shows the distal end of the tibia and FIG. 8 shows a lateral view of the knee. FIG. 9 shows another lateral view of the knee while FIG. 10 shows a lateral view of the distal end of the tibia.
Registration of Surgically Related Items FIGS. 11-14 show designation or registration of items 22 which will be used in surgery. Registration simply means, however it is accomplished, ensuring that the computer knows which body part, item or construct corresponds to which fiducial or fiducials, and how the position and orientation of the body part, item or construct is related to the position and orientation of its corresponding fiducial or a fiducial attached to an impactor or other other component which is in turn attached to an item. Such registration or designation can be done before or after registering bone or body parts as discussed with respect to FIGS. 4 - 10. FIG. 11 shows a technician designating with probe 26 an item 22 such as an instrument component to which fiducial 14 is attached. The sensor 16 "sees" the position and orientation of the fiducial 14 attached to the item 22 and also the position and orientation of the fiducial 14 attached to the probe 26 whose tip is touching a landmark on the item 22. The technician designates onscreen or otherwise the identification of the item and then activates the foot pedal or otherwise instructs the computer to correlate the data corresponding to such identification, such as data needed to represent a particular cutting block component for a particular knee implant product, with the particularly shaped fiducial 14 attached to the component 22. The computer has then stored identification, position and orientation information relating to the fiducial for component 22 correlated with the data such as configuration and shape data for the item 22 so that upon registration, when sensor 16 tracks the item 22 fiducial 14 in the infrared field, monitor 24 can show the cutting block component 22 moving and turning, and properly positioned and oriented relative to the body part which is also being tracked. FIGS. 12.14 show similar registration for other instrumentation components 22.
Registration of Anatomy and Constructs Similarly, the mechanical axis and other axes or constructs of body parts 10 and 12 can also be "registered" for tracking by the system. Again, the system has employed a fluoroscope to obtain images of the femoral head, knee and ankle of the sort shown in FIGS. 4-10. The system correlates such images with the position and orientation of the Garm and the patient anatomy in real time as discussed above with the use of fiducials 14 placed on the body parts before image acquisition and which remain in position during the surgical procedure. Using these images and/or the probe, the surgeon can select and register in the computer 18 the center of the femoral head and ankle in orthogonal views, usually anterior/posterior and lateral, on a touch screen. The surgeon uses the probe to select any desired anatomical landmarks or references at the operative site of the knee or on the skin or surgical draping over the skin, as on the ankle. These points are registered in three dimensional space by the system and are tracked relative to the fiducials on the patient anatomy which are preferably placed intraoperatively.
FIG. 15 shows the surgeon using probe 26 to designate or register landmarks on the condylar portion of femur 12 using probe 26 in order to feed to he computer 18 the position of one point needed to determine, store, and display the epicondylar axis. (See FIG. 20 which shows the epicondylar axis and the anterior-posterior plane and for lateral plane.) Although registering points using actual bone structure such as in FIG. 15 is one preferred way to establish the axis, a cloud of points approach by which the probe 26 is used to designate multiple points on the surface of the bone structure can be employed, as can moving the body part and tracking movement to establish a center of rotation as discussed above. Once the center of rotation for the femoral head and the condylar component have been registered, the computer is able to calculate, store, and render, and otherwise use data for, the mechanical axis of the femur 12. FIG. 17 once again shows the probe 26 being used to designate points on the condylar component of the femur 12.
FIG. 18 shows, the onscreen images being obtained when the surgeon registers certain points on the bone surface using the probe 26 in order to establish the femoral mechanical axis. The tibial mechanical axis is then established by designating points to determine the centers of the proximal and distal ends of the tibia so that the mechanical axis can be calculated, stored, and subsequently used by the computer 18. FIG. 20 shows designated points for determining the epicondylar axis, both in the anterior/posterior and lateral planes while FIG. 21 shows such determination of the anterior-posterior axis as rendered onscreen. The posterior condylar axis is also determined by designating points or as otherwise desired, as rendered on the computer generated geometric images overlain or displayed in combination with the fluoroscopic images, all of which are keyed to fiducials 14 being tracked by sensors 16.
FIG. 23 shows an adjustable circle graphic which can be generated and presented in combination with orthogonal fluoroscopic images of the femoral head, and tracked by the computer 18 when the surgeon moves it on screen in order to establish the centers of the femoral head in both the anterior-posterior and lateral planes.
FIG. 24 is an onscreen image showing the anterior-posterior axis, epicondylar axis and posterior condylar axis from points which have been designated as described above. These constructs are generated by the computer 18 and presented on monitor 24 in combination with the fluoroscopic images of the femur 12, correctly positioned and oriented relative thereto as tracked by the system. In the fluoroscopic/computer generated image combination shown at left bottom of FIG. 24, a "sawbones" knee as shown in certain drawings above which contains radio opaque materials is represented fluoroscopically and tracked using sensor 16 while the computer generates and displays the mechanical axis of the femur 12 which runs generally horizontally. The epicondylar axis runs generally vertically, and the anterior/posterior axis runs generally diagonally. The image at bottom right shows similar information in a lateral view. He-e, the anterior-posterior axis runs generally horizontally while the epicondylar axis runs generally diagonally, and the mechanical axis generally vertically.
FIG. 24, as is the case with a number of screen presentations generated and presented by the stem of FIGS. 4 - 64, also shows at center a list of landmarks to be registered in order to generate relevant axes and constructs useful in navigation, positioning and assessment during surgery.
Textural cues may also be presented which suggest to the surgeon next steps in the process of registering landmarks and establishing relevant axes. Such instructions may be generated as the computer 18 tracks, from one step to the next, registration of items 22 and bone locations as well as other measures being taken by the surgeon during the surgical operation.
FIG. 25 shows mechanical, lateral, anterior-posterior axes for the tibia according to points are registered by the surgeon.
FIG. 26 is another onscreen image showing the axes for the femur 12.
Modifying Bone After the mechanical axis and other rotation axes and constructs relating to the femur and tibia are established, instrumentation can be properly oriented to resect or modify bone in order to fit trial components and implant components properly according to the embodiment of the invention shown in FIGS. 4 - 64. Instrumentation such as, for instance, cutting blocks, to which fiducials 14 are mounted, can be employed. The system can then track instrumentation as the surgeon manipulates it for optimum positioning. In other words, the surgeon can "navigate" the instrumentation for optimum positioning using the system and the monitor. In this manner, instrumentation may be positioned according to the system of this embodiment in order to align the ostetomies to the mechanical and rotational axes or reference axes on an extramedullary rod that does not violate the canal, on an intramedullary rod, or on any other type of rod. The touchscreen 24 can then also display the instrument such as the cutting block and/or the implant relative to the instrument and the rod during this process, in order, among other things, properly to select size of implant and perhaps implant type. As the instrument moves, the varus/valgus, flexion/extension and internal/external rotation of the relative component position can be calculated and shown with respect to the referenced axes; in the preferred embodiment, this can be done at a rate of six cycles per second or faster. The instrument position is then fixed in the computer and physically and the bone resections are made.
FIG. 27 shows orientation of an extramedullary rod to which a fiducial 14 is attached via impactor 22. The surgeon views the screen 24 which has an image as shown in FIG. 29 of the rod overlain on or incombination with the femur 12 fluoroscopic image as the two are actually positioned and oriented relative to one another in space. The surgeon then navigates the rod into place preferably along the mechanical axis of the femur and drives it home with appropriate mallet or other device. The present invention thus avoids the need to bore a hole in the metaphysis of the femur and place a reamer or other rod into the medullary canal which can cause fat embolism, hemorrhaging, infection and other untoward andundesired effects.
FIG. 28 also shows the extramedullary rod being located. FIG. 29 shows fluoroscopic images, both anterior-posterior and lateral, with axes, and with a computer generated and tracked image of the rod superposed or in combination with the fluoroscopic images of the femur and tibia. FIG. 30 shows the rod superposed on the femoral fluoroscopic image similar to what is shown in FIG. 29.
FIG. 29 also shows other information relevant to the surgeon such as the name of the component being overlain on the femur image (new EM nail), suggestions or instructions at the lower left, and angle of the rod in varus/valgus and extension relative to the axes. Any or all of this information can be used to navigate and position the rod relative to thefemur. At a point in time during or after placement of the rod, its tracking may be "handed off"
from the impactor fiduciall4 to the femur fiducal 14 as discussed below.
Once the extramedullary rod, intramedullary rod, other type of rod has been placed, instrumentation can be positioned as tracked in position and orientation by sensor 16 and displayed on screen face 24. Thus, a cutting block of the sort used to establish the condylar anterior cut, with its fiducial 14 attached, is introduced into the field and positioned on the rod. Because the cutting block corresponds to a particular implant product and can be adjusted and designated on screen to correspond to a particular implant size of that product, the computer 18 can generate and display a graphic of the cutting block and the femoral component overlain on the fluoroscopic image as shown in FIGS. 33-36. The surgeon can thus navigate and position the cutting block on screen using not only images of the cutting block on the bone, but also images of the corresponding femoral component which will be ultimately installed. The surgeon can thus adjust the positioning of the physical cutting block component, and secure it to the rod in order to resect the anterior of the condylar portion of the femur in order to optimally fit and position the ultimate femoral component being shown on the screen. FIG. 32 is another view of the cutting block of FIG. 31 being positioned. Other cutting blocks and other resections may be positioned and made similarly on the condylar component.
In a similar fashion, instrumentation may be navigated and positioned on the proximal portion of the tibia 10 as shown in FIG. 41 and as tracked by sensor 16 and on screen by images of the cutting block and the implant component as shown in FIGS. 37-40. FIGS. 42 and 43 show other onscreen images generated during this bone modification process for purposes of navigation and positioning cutting blocks and other instrumentation for proper resection and other modification of femur and tbia in order to prepare for trial components and implant components according to systems and processes of the embodiment of the present invention shown in FIGS. 4- 64.
FIGS. 44-48 also show instrumentation being positioned relative to femur 12 as tracked by the system for resection of the condylar component in order to receive a particular size of implant component. Various cutting blocks and their attached fiducials can be seen in these views.
FIG. 49 shows a femoral component overlaid on the femur as instrumentation is being tracked and positioned in order for resection of bone properly and accurately to be accomplished. FIG. 50 is another navigational screen face showing a femoral component overlay as instrumentation is being positioned for resection of bone.
FIG. 51 is tibial component overlay information on a navigation screen as the cutting block for the tibial plateau is being positioned for bone resection.
FIGS. 52 and 53 show femoral component and tibial component overlays, respectively, according to certain position and orientation of cutting blocks/instrumentation as resectioning is being done. The surgeon can thus visualize where the implant components will be and can assess fit, and other things if desired, before resections are made.
Navigation, Placement and Assessment of Trials and Implants Once resection and modification of bone has been accomplished, implant trials can then be installed and tracked by the system in a manner similar to navigating and positioning the instrumentatio], as displayed on the screen 24. Thus, a femoral component trial, a tibial plateau trial, and a bearing plate trial may be placed as navigated on screen using computer generated overlays corresponding to the trials.
During the trial installation process, and also during the implant component installation process, instrument positioning process or at any other desired point in surgical or other operations according to the present invention, the system can transition or segue from tracking a component according to a first fiducial to tracking the component according to a second fiducial. Thus, as shown as FIG. 33, the trial femoral component is mounted on an impactor to which is attached a fiducial 14. The trial component is installed and positioned ushg the impactor. The computer 18 "knows" the position and orientation of the trial relative to the fiducial on the impactor (such as by prior registration of the component attached to the impactor) so that it can generate and display the image of the femoral component trial on screen 24 overlaid on the fluoroscopic image of the condylar component. At any desired point in time, before, during or after the trial component is properly placed on the condylar component of the femur to align with mechanical axis and according to proper orientation relative to other axes, the system can be instructed by foot pedal or otherwise to begin tracking the position of the trial component using the fiducial attached to the femur rather than the one attached to the impactor. According to the preferred embodiment, the sensor 16 "sees" at this point in time both the fiducials on the impactor and the femur 12 so that it already "knows" the position and orientation of the trial component relative to the fiducial on the impactor and is thus able to calculate and store for later use the position and orientation of the trial component relative to the femur 12 fiducial. Once this "handoff" happens, the impactor can be removed and the trial component tracked with the femur fiducial 14 as part of or moving in concert with the femur 12. Similar handoff procedures may be used in any other instance as desired in accordance with the present invention.
FIG. 55 shows the tibial plateau trial being tracked and installed in a manner similar to femoral component trial as discussed above. Alternatively, the tibial trial can be placed on the proximal tibia and then registered using the probe 26. Probe 26 is used to designate preferably at least three features on the tibial trial of known coordinates, such as bone spike holes. As the probe is placed onto each feature, the system is prompted to save that coordinate position so that the system can match the tibial trial's feature's coordinates to the saved coordinates. The system then tracks tie tibial trial relative to the tibial anatomical reference frame.
Once the trial components are installed, the surgeon can assess alignment and stability of the components and the joint. During such assessment, in trial reduction, the computer can diEplay on monitor 24 the relative motion between the trial components to allow the surgeon to make soft tissue releases and changes in order to improve the kinematics of the knee. The system can also apply rules and/or intelligence to make suggestions based on the information such as what soft tissue releases to make if the surgeon desires. The system can also display how the soft tissue releases are to be made.
FIG. 56 shows the surgeon articulating the knee as he monitors the screen which is presenting images such as those shown in FIGS. 57 - 59 which not only show movement of the trial components relative to each other, but also orientation, flexion, and varus/valgus. During this assessment, the surgeon may conduct certain assessment processes such as ecternal/internal rotation or rotary laxity testing, varus/valgus tests, and anterior-posterior drawer at 0 and 90 degrees and mid range. Thus, in the AP drawer test, the surgeon can position the tibia at the first location and press the foot pedal.
He then positions the tibia at the second location and once again presses the foot pedal so that the computer has registered and stored two locations in order to calculate and display the drawer and whether it is acceptable for the patient and the product involved. If not, the computer can apply rules in order to generate and display suggestions for releasing ligaments or other tissue, or using other component sizes or types, such as shown, for example, in FIGS.
60-63. Once the proper tissue releases have been made, if necessary, and alignment and stability are acceptable as noted quantitatively on screen about all axes, the trial components may be removed and actual components navigated, installed, and assessed in performance in a manner similar to that in which the trial components were navigated, installed, and assessed.
FIG. 64 is another computer generated 3-dimensional image of the trial components as tracked by the system during trialing.
At the end of the case, all alignment information can be saved for the patient file. This is of great assistance to the surgeon due to the fact that the outcome of implant positioning can be seen before any resectioning has been done on the bone. The system is also capable of tracking the patella and resulting placement of cutting guides and the patellar trial position. The system then tracks alignment of the patella with the patellar femoral groove and will give feedback on issues, such as, patellar tilt.
The tracking and image information provided by systems and processes according to the present invention facilitate telemedical techniques, because they provide useful images for distribution to distant geographic locations where expert surgical or medical specialists may collaborate during surgery. Thus, systems and processes according to the present invention can be used in connection with computing functionality 18 which is networked or otherwise in communication with computing functionality in other locations, whether by PSTN, information exchange infrastructures such as packet switched networks including the Internet, or as otherwise desire. Such remote imaging may occur on computers, wireless devices, videoconferencing devices or in any other mode or on any other platform which is now or may in the future be capable of rending images or parts of them produced in accordance with the present invention. Parallel communication links such as switched or unswitched telephone call connections may also accompany or form part of such telemedical techniques. Distant databases such as online catalogs of implant suppliers or prosthetics buyers or distributors may form part of or be networked with functionality 18 to give the surgeon in real time access to additional options for implants which could be procured and used during the surgical operation.
Claims (13)
1. A system for performing total knee arthroplasty surgical operations on portions of a knee joint comprising:
(a) an imager for obtaining an image of at least portions of the knee joint, wherein the imager and at least one bone forming part of the knee joint are each attached to a fiducial capable of being tracked by a position sensor;
(b) at least one position sensor adapted to track position of said fiducials;
(c) a computer adapted to store at least one image of at least portions of the knee joint and to receive information from said at least one sensor in order to track position and orientation of said fiducials and thus the knee joint;
(d) a total knee arthroplasty surgical instrument component adapted to be attached to bone forming part of the knee joint using a tool, said tool attached to a fiducial, whereby the position of the surgical instrument component is capable of being tracked by said sensor and the position and orientation of the surgical instrument component is capable of being tracked by said computer;
(e) a monitor adapted to receive information from the computer in order to display at least one image of the surgical instrument component, positioned and oriented relative to the knee joint for navigation and positioning of the surgical instrument component relative to the knee joint.
(a) an imager for obtaining an image of at least portions of the knee joint, wherein the imager and at least one bone forming part of the knee joint are each attached to a fiducial capable of being tracked by a position sensor;
(b) at least one position sensor adapted to track position of said fiducials;
(c) a computer adapted to store at least one image of at least portions of the knee joint and to receive information from said at least one sensor in order to track position and orientation of said fiducials and thus the knee joint;
(d) a total knee arthroplasty surgical instrument component adapted to be attached to bone forming part of the knee joint using a tool, said tool attached to a fiducial, whereby the position of the surgical instrument component is capable of being tracked by said sensor and the position and orientation of the surgical instrument component is capable of being tracked by said computer;
(e) a monitor adapted to receive information from the computer in order to display at least one image of the surgical instrument component, positioned and oriented relative to the knee joint for navigation and positioning of the surgical instrument component relative to the knee joint.
2. A system for performing total knee arthroplasty surgical operations on portions of a knee joint comprising:
(a) an imager for obtaining an image of at least portions of the knee joint, wherein the imager and the femur are each attached to a fiducial capable of being tracked by a position sensor;
(b) at least one position sensor adapted to track position of said fiducials;
(c) a computer adapted to store at least one image of at least portions of the knee joint and to receive information from said at least one sensor in order to track position and orientation of said fiducials and thus the knee joint;
(d) a total knee arthroplasty implant trial component adapted to be attached to bone forming part of the knee joint using a tool, said tool attached to a fiducial, whereby the position of the trial component is capable of being tracked by said sensor and the position and orientation of the trial component is capable of being tracked by said computer;
(e) a monitor adapted to receive information from the computer in order to display at least one image of the trial component, positioned and oriented relative to the knee joint for navigation and positioning of the trial component relative to the knee joint.
(a) an imager for obtaining an image of at least portions of the knee joint, wherein the imager and the femur are each attached to a fiducial capable of being tracked by a position sensor;
(b) at least one position sensor adapted to track position of said fiducials;
(c) a computer adapted to store at least one image of at least portions of the knee joint and to receive information from said at least one sensor in order to track position and orientation of said fiducials and thus the knee joint;
(d) a total knee arthroplasty implant trial component adapted to be attached to bone forming part of the knee joint using a tool, said tool attached to a fiducial, whereby the position of the trial component is capable of being tracked by said sensor and the position and orientation of the trial component is capable of being tracked by said computer;
(e) a monitor adapted to receive information from the computer in order to display at least one image of the trial component, positioned and oriented relative to the knee joint for navigation and positioning of the trial component relative to the knee joint.
3. A system for performing total knee arthroplasty surgical operations on portions of a knee joint comprising:
(a) an imager for obtaining an image of at least portions of the knee joint, wherein the imager and the femur are each attached to a fiducial capable of being tracked by a position sensor;
(b) at least one position sensor adapted to track position of said fiducials;
(c) a computer adapted to store at least one image of at least portions of the knee joint and to receive information from said at least one sensor in order to track position and orientation of said fiducials and thus the knee joint;
(d) a total knee arthroplasty implant component adapted to be attached to bone forming part of the knee joint using a tool, said tool attached to a fiducial, whereby the position of the implant component is capable of being tracked by said sensor and the position and orientation of the implant component is capable of being tracked by said computer;
(e) a monitor adapted to receive information from the computer in order to display at least one image of the implant component, positioned and oriented relative to the knee joint for navigation and positioning of the implant component relative to the knee joint.
(a) an imager for obtaining an image of at least portions of the knee joint, wherein the imager and the femur are each attached to a fiducial capable of being tracked by a position sensor;
(b) at least one position sensor adapted to track position of said fiducials;
(c) a computer adapted to store at least one image of at least portions of the knee joint and to receive information from said at least one sensor in order to track position and orientation of said fiducials and thus the knee joint;
(d) a total knee arthroplasty implant component adapted to be attached to bone forming part of the knee joint using a tool, said tool attached to a fiducial, whereby the position of the implant component is capable of being tracked by said sensor and the position and orientation of the implant component is capable of being tracked by said computer;
(e) a monitor adapted to receive information from the computer in order to display at least one image of the implant component, positioned and oriented relative to the knee joint for navigation and positioning of the implant component relative to the knee joint.
4. A system according to claim 1 in which the instrument component is a rod.
5. A system according to claim 1 in which the instrument component is a cutting block.
6. A system according to claim 4 in which the rod is an intramedullary rod.
7. A system according to claim 4 in which the rod is an extramedullary rod.
8. A system according to claim 1, 2 or 3 in which the component corresponds to a femur.
9. A system according to claim 1, 2 or 3 in which the component corresponds to a tibia.
10. A system according to claim 1, 2 or 3 in which the imager comprises one of a C-arm fluoroscope, a CT scanner, and an MRI machine.
11. A system according to claim 1, 2 or 3 in which the fiducials comprise one of active fiducials, passive fiducials and hybrid active/passive fiducials.
12. A system according to claim 1, 2 or 3 in which the position sensors comprise one of infrared sensors, electromagnetic sensors, electrostatic sensors, light sensors, sound sensors, and radiofrequency sensors.
13. Use of the system of any one of claims 1 to 12 for performing total knee arthroplasty surgical operations on portions of a knee joint.
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US27181801P | 2001-02-27 | 2001-02-27 | |
US60/271,818 | 2001-02-27 | ||
US35589902P | 2002-02-11 | 2002-02-11 | |
US60/355,899 | 2002-02-11 | ||
PCT/US2002/005955 WO2002067783A2 (en) | 2001-02-27 | 2002-02-27 | Total knee arthroplasty systems and processes |
Publications (2)
Publication Number | Publication Date |
---|---|
CA2439249A1 CA2439249A1 (en) | 2002-09-06 |
CA2439249C true CA2439249C (en) | 2011-04-12 |
Family
ID=26955127
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA2439249A Expired - Fee Related CA2439249C (en) | 2001-02-27 | 2002-02-27 | Total knee arthroplasty systems |
Country Status (9)
Country | Link |
---|---|
US (11) | US6827723B2 (en) |
EP (3) | EP1379188A2 (en) |
JP (2) | JP4219170B2 (en) |
KR (1) | KR20030082942A (en) |
AT (2) | ATE431111T1 (en) |
AU (2) | AU2002247227A1 (en) |
CA (1) | CA2439249C (en) |
DE (2) | DE60232315D1 (en) |
WO (3) | WO2002067800A2 (en) |
Families Citing this family (526)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6695848B2 (en) | 1994-09-02 | 2004-02-24 | Hudson Surgical Design, Inc. | Methods for femoral and tibial resection |
US8603095B2 (en) | 1994-09-02 | 2013-12-10 | Puget Bio Ventures LLC | Apparatuses for femoral and tibial resection |
US8556983B2 (en) | 2001-05-25 | 2013-10-15 | Conformis, Inc. | Patient-adapted and improved orthopedic implants, designs and related tools |
US8480754B2 (en) | 2001-05-25 | 2013-07-09 | Conformis, Inc. | Patient-adapted and improved articular implants, designs and related guide tools |
US8545569B2 (en) | 2001-05-25 | 2013-10-01 | Conformis, Inc. | Patient selectable knee arthroplasty devices |
US9603711B2 (en) | 2001-05-25 | 2017-03-28 | Conformis, Inc. | Patient-adapted and improved articular implants, designs and related guide tools |
DE29704393U1 (en) * | 1997-03-11 | 1997-07-17 | Aesculap Ag | Device for preoperative determination of the position data of endoprosthesis parts |
US6045551A (en) | 1998-02-06 | 2000-04-04 | Bonutti; Peter M. | Bone suture |
US6477400B1 (en) | 1998-08-20 | 2002-11-05 | Sofamor Danek Holdings, Inc. | Fluoroscopic image guided orthopaedic surgery system with intraoperative registration |
US6447516B1 (en) | 1999-08-09 | 2002-09-10 | Peter M. Bonutti | Method of securing tissue |
US6368343B1 (en) | 2000-03-13 | 2002-04-09 | Peter M. Bonutti | Method of using ultrasonic vibration to secure body tissue |
US8781557B2 (en) | 1999-08-11 | 2014-07-15 | Osteoplastics, Llc | Producing a three dimensional model of an implant |
AU6634800A (en) | 1999-08-11 | 2001-03-05 | Case Western Reserve University | Method and apparatus for producing an implant |
US9208558B2 (en) | 1999-08-11 | 2015-12-08 | Osteoplastics Llc | Methods and systems for producing an implant |
US7635390B1 (en) | 2000-01-14 | 2009-12-22 | Marctec, Llc | Joint replacement component having a modular articulating surface |
US6702821B2 (en) | 2000-01-14 | 2004-03-09 | The Bonutti 2003 Trust A | Instrumentation for minimally invasive joint replacement and methods for using same |
US6635073B2 (en) | 2000-05-03 | 2003-10-21 | Peter M. Bonutti | Method of securing body tissue |
WO2001064124A1 (en) * | 2000-03-01 | 2001-09-07 | Surgical Navigation Technologies, Inc. | Multiple cannula image guided tool for image guided procedures |
US20050113846A1 (en) * | 2001-02-27 | 2005-05-26 | Carson Christopher P. | Surgical navigation systems and processes for unicompartmental knee arthroplasty |
US7909831B2 (en) * | 2001-02-28 | 2011-03-22 | Howmedica Osteonics Corp. | Systems used in performing femoral and tibial resection in knee surgery |
US8062377B2 (en) | 2001-03-05 | 2011-11-22 | Hudson Surgical Design, Inc. | Methods and apparatus for knee arthroplasty |
EP1389980B1 (en) * | 2001-05-25 | 2011-04-06 | Conformis, Inc. | Methods and compositions for articular resurfacing |
US9308091B2 (en) | 2001-05-25 | 2016-04-12 | Conformis, Inc. | Devices and methods for treatment of facet and other joints |
US20020194023A1 (en) * | 2001-06-14 | 2002-12-19 | Turley Troy A. | Online fracture management system and associated method |
US7708741B1 (en) | 2001-08-28 | 2010-05-04 | Marctec, Llc | Method of preparing bones for knee replacement surgery |
US6719765B2 (en) | 2001-12-03 | 2004-04-13 | Bonutti 2003 Trust-A | Magnetic suturing system and method |
JP3905393B2 (en) * | 2002-02-07 | 2007-04-18 | オリンパス株式会社 | Surgical device |
JP2005516724A (en) * | 2002-02-11 | 2005-06-09 | スミス アンド ネフュー インコーポレーテッド | Image guided fracture reduction |
US9155544B2 (en) | 2002-03-20 | 2015-10-13 | P Tech, Llc | Robotic systems and methods |
DE50202992D1 (en) * | 2002-03-21 | 2005-06-09 | Brainlab Ag | Retraktornavigation |
US6980849B2 (en) * | 2002-04-17 | 2005-12-27 | Ricardo Sasso | Instrumentation and method for performing image-guided spinal surgery using an anterior surgical approach |
US6993374B2 (en) * | 2002-04-17 | 2006-01-31 | Ricardo Sasso | Instrumentation and method for mounting a surgical navigation reference device to a patient |
US8180429B2 (en) * | 2002-04-17 | 2012-05-15 | Warsaw Orthopedic, Inc. | Instrumentation and method for mounting a surgical navigation reference device to a patient |
US8801720B2 (en) | 2002-05-15 | 2014-08-12 | Otismed Corporation | Total joint arthroplasty system |
US7248914B2 (en) | 2002-06-28 | 2007-07-24 | Stereotaxis, Inc. | Method of navigating medical devices in the presence of radiopaque material |
US6824539B2 (en) * | 2002-08-02 | 2004-11-30 | Storz Endoskop Produktions Gmbh | Touchscreen controlling medical equipment from multiple manufacturers |
EP1549235A4 (en) * | 2002-09-17 | 2010-05-05 | Extraortho Inc | Unilateral fixator |
EP1545368B1 (en) * | 2002-10-04 | 2009-03-11 | Orthosoft Inc. | Computer-assisted hip replacement surgery |
US20040068263A1 (en) * | 2002-10-04 | 2004-04-08 | Benoit Chouinard | CAS bone reference with articulated support |
US7869861B2 (en) * | 2002-10-25 | 2011-01-11 | Howmedica Leibinger Inc. | Flexible tracking article and method of using the same |
DE50206165D1 (en) * | 2002-11-05 | 2006-05-11 | Aesculap Ag & Co Kg | DEVICE FOR DETERMINING THE POSITION OF A KNEE ENDOPROTHESIS |
EP1563315A2 (en) * | 2002-11-14 | 2005-08-17 | GE Medical Systems Global Technology Company LLC | Interchangeable localizing devices for use with tracking systems |
US8419732B2 (en) * | 2002-11-14 | 2013-04-16 | Sixfix, Inc. | Method for using a fixator device |
US7318827B2 (en) | 2002-12-02 | 2008-01-15 | Aesculap Ag & Co. Kg | Osteotomy procedure |
AU2003299851B2 (en) | 2002-12-20 | 2009-12-10 | Smith & Nephew, Inc. | High performance knee prostheses |
US7660623B2 (en) | 2003-01-30 | 2010-02-09 | Medtronic Navigation, Inc. | Six degree of freedom alignment display for medical procedures |
US7492930B2 (en) * | 2003-02-04 | 2009-02-17 | Aesculap Ag | Method and apparatus for capturing information associated with a surgical procedure performed using a localization device |
WO2004069073A2 (en) * | 2003-02-04 | 2004-08-19 | Orthosoft, Inc. | Cas modular bone reference and limb position measurement system |
WO2004070573A2 (en) * | 2003-02-04 | 2004-08-19 | Z-Kat, Inc. | Computer-assisted external fixation apparatus and method |
EP1627272B2 (en) * | 2003-02-04 | 2017-03-08 | Mako Surgical Corp. | Interactive computer-assisted surgery system and method |
US6988009B2 (en) * | 2003-02-04 | 2006-01-17 | Zimmer Technology, Inc. | Implant registration device for surgical navigation system |
EP1697874B8 (en) * | 2003-02-04 | 2012-03-14 | Mako Surgical Corp. | Computer-assisted knee replacement apparatus |
US20050021037A1 (en) * | 2003-05-29 | 2005-01-27 | Mccombs Daniel L. | Image-guided navigated precision reamers |
EP1628590B1 (en) | 2003-06-02 | 2009-04-22 | Stephen B. Murphy | Method for providing coordinate system for hip arthroplasty |
WO2004112610A2 (en) | 2003-06-09 | 2004-12-29 | Vitruvian Orthopaedics, Llc | Surgical orientation device and method |
US7559931B2 (en) | 2003-06-09 | 2009-07-14 | OrthAlign, Inc. | Surgical orientation system and method |
WO2005000129A1 (en) * | 2003-06-27 | 2005-01-06 | Aesculap Ag & Co. Kg | Method and device for orienting a machining tool |
US7158754B2 (en) * | 2003-07-01 | 2007-01-02 | Ge Medical Systems Global Technology Company, Llc | Electromagnetic tracking system and method using a single-coil transmitter |
US20050020909A1 (en) * | 2003-07-10 | 2005-01-27 | Moctezuma De La Barrera Jose Luis | Display device for surgery and method for using the same |
US7470288B2 (en) * | 2003-07-11 | 2008-12-30 | Depuy Products, Inc. | Telemetric tibial tray |
WO2005039440A2 (en) * | 2003-07-11 | 2005-05-06 | Depuy Products, Inc. | In vivo joint space measurement device and method |
US7218232B2 (en) * | 2003-07-11 | 2007-05-15 | Depuy Products, Inc. | Orthopaedic components with data storage element |
EP1648349B1 (en) * | 2003-07-11 | 2010-12-08 | DePuy Products, Inc. | In vivo joint implant cycle counter |
WO2005009303A1 (en) * | 2003-07-24 | 2005-02-03 | San-Tech Surgical Sarl | Orientation device for surgical implement |
US7905924B2 (en) * | 2003-09-03 | 2011-03-15 | Ralph Richard White | Extracapsular surgical procedure |
CA2439850A1 (en) | 2003-09-04 | 2005-03-04 | Orthosoft Inc. | Universal method for determining acetabular and femoral implant positions during navigation |
US20050065617A1 (en) * | 2003-09-05 | 2005-03-24 | Moctezuma De La Barrera Jose Luis | System and method of performing ball and socket joint arthroscopy |
GB0320787D0 (en) * | 2003-09-05 | 2003-10-08 | Depuy Int Ltd | Flexible image guided surgery marker |
EP1663019B1 (en) * | 2003-09-13 | 2008-02-13 | AESCULAP AG & Co. KG | Device for determining the angle between the femur and the tibia |
US7862570B2 (en) | 2003-10-03 | 2011-01-04 | Smith & Nephew, Inc. | Surgical positioners |
CA2538126A1 (en) * | 2003-10-06 | 2005-05-06 | Smith & Nephew, Inc. | Modular navigated portal |
WO2005037147A1 (en) | 2003-10-17 | 2005-04-28 | Smith & Nephew, Inc. | High flexion articular insert |
US7764985B2 (en) * | 2003-10-20 | 2010-07-27 | Smith & Nephew, Inc. | Surgical navigation system component fault interfaces and related processes |
US20050085822A1 (en) * | 2003-10-20 | 2005-04-21 | Thornberry Robert C. | Surgical navigation system component fault interfaces and related processes |
US7392076B2 (en) * | 2003-11-04 | 2008-06-24 | Stryker Leibinger Gmbh & Co. Kg | System and method of registering image data to intra-operatively digitized landmarks |
ES2362491T3 (en) | 2003-11-14 | 2011-07-06 | SMITH & NEPHEW, INC. | ADJUSTABLE SURGICAL CUTTING SYSTEMS. |
US7815644B2 (en) * | 2003-12-19 | 2010-10-19 | Masini Michael A | Instrumentation and methods for refining image-guided and navigation-based surgical procedures |
US8175683B2 (en) * | 2003-12-30 | 2012-05-08 | Depuy Products, Inc. | System and method of designing and manufacturing customized instrumentation for accurate implantation of prosthesis by utilizing computed tomography data |
US7857814B2 (en) | 2004-01-14 | 2010-12-28 | Hudson Surgical Design, Inc. | Methods and apparatus for minimally invasive arthroplasty |
US9814539B2 (en) | 2004-01-14 | 2017-11-14 | Puget Bioventures Llc | Methods and apparatus for conformable prosthetic implants |
US7815645B2 (en) | 2004-01-14 | 2010-10-19 | Hudson Surgical Design, Inc. | Methods and apparatus for pinplasty bone resection |
US8114083B2 (en) | 2004-01-14 | 2012-02-14 | Hudson Surgical Design, Inc. | Methods and apparatus for improved drilling and milling tools for resection |
US20060030854A1 (en) | 2004-02-02 | 2006-02-09 | Haines Timothy G | Methods and apparatus for wireplasty bone resection |
US8021368B2 (en) | 2004-01-14 | 2011-09-20 | Hudson Surgical Design, Inc. | Methods and apparatus for improved cutting tools for resection |
CA2553368A1 (en) * | 2004-01-16 | 2005-08-11 | Smith & Nephew, Inc. | Computer-assisted ligament balancing in total knee arthroplasty |
US20050159759A1 (en) | 2004-01-20 | 2005-07-21 | Mark Harbaugh | Systems and methods for performing minimally invasive incisions |
US20050197569A1 (en) * | 2004-01-22 | 2005-09-08 | Mccombs Daniel | Methods, systems, and apparatuses for providing patient-mounted surgical navigational sensors |
US20050171545A1 (en) * | 2004-01-30 | 2005-08-04 | Howmedica Osteonics Corp. | Knee computer-aided navigation instruments |
US8758355B2 (en) * | 2004-02-06 | 2014-06-24 | Synvasive Technology, Inc. | Dynamic knee balancer with pressure sensing |
EP1720479B1 (en) * | 2004-03-05 | 2014-04-23 | Depuy International Limited | Registration methods and apparatus |
EP1722705A2 (en) * | 2004-03-10 | 2006-11-22 | Depuy International Limited | Orthopaedic operating systems, methods, implants and instruments |
WO2005099636A1 (en) * | 2004-03-31 | 2005-10-27 | Niigata Tlo Corporation | Intramedullary rod for assisting artificial knee joint replacing operation and method for managing operation using that rod |
WO2005104978A1 (en) | 2004-04-21 | 2005-11-10 | Smith & Nephew, Inc. | Computer-aided methods, systems, and apparatuses for shoulder arthroplasty |
EP1591075B1 (en) * | 2004-04-27 | 2008-03-19 | BrainLAB AG | Method and device for planning knee implants |
US7567834B2 (en) * | 2004-05-03 | 2009-07-28 | Medtronic Navigation, Inc. | Method and apparatus for implantation between two vertebral bodies |
SE529553C2 (en) * | 2005-02-22 | 2007-09-11 | Micropos Medical Ab | Antenna system for monitoring a target area inside a living body |
DE102004026525A1 (en) * | 2004-05-25 | 2005-12-22 | Aesculap Ag & Co. Kg | Method and device for the non-invasive determination of prominent structures of the human or animal body |
US20060025679A1 (en) * | 2004-06-04 | 2006-02-02 | Viswanathan Raju R | User interface for remote control of medical devices |
FR2871363B1 (en) * | 2004-06-15 | 2006-09-01 | Medtech Sa | ROBOTIZED GUIDING DEVICE FOR SURGICAL TOOL |
EP1616540B1 (en) * | 2004-07-14 | 2007-11-14 | BrainLAB AG | Positioning system with cannulated implant |
US7776055B2 (en) * | 2004-07-19 | 2010-08-17 | General Electric Company | System and method for tracking progress of insertion of a rod in a bone |
US8007448B2 (en) * | 2004-10-08 | 2011-08-30 | Stryker Leibinger Gmbh & Co. Kg. | System and method for performing arthroplasty of a joint and tracking a plumb line plane |
US8535329B2 (en) * | 2004-10-29 | 2013-09-17 | Kinamed, Inc. | Tracking tools and method for computer-assisted shoulder replacement surgery |
US20060200025A1 (en) * | 2004-12-02 | 2006-09-07 | Scott Elliott | Systems, methods, and apparatus for automatic software flow using instrument detection during computer-aided surgery |
DE102004058122A1 (en) * | 2004-12-02 | 2006-07-13 | Siemens Ag | Medical image registration aid for landmarks by computerized and photon emission tomographies, comprises permeable radioactive substance is filled with the emission tomography as radiation permeable containers, a belt and patient body bowl |
JP2008521574A (en) * | 2004-12-02 | 2008-06-26 | スミス アンド ネフュー インコーポレーテッド | System providing a reference plane for attaching an acetabular cup |
CA2594874A1 (en) * | 2005-01-18 | 2006-07-27 | Smith & Nephew, Inc. | Computer-assisted ligament balancing in total knee arthroplasty |
US20060190012A1 (en) * | 2005-01-29 | 2006-08-24 | Aesculap Ag & Co. Kg | Method and apparatus for representing an instrument relative to a bone |
AU2006216653B2 (en) | 2005-02-22 | 2012-03-15 | Smith & Nephew, Inc. | In-line milling system |
US20060241397A1 (en) * | 2005-02-22 | 2006-10-26 | Assaf Govari | Reference pad for position sensing |
US20060241405A1 (en) * | 2005-03-09 | 2006-10-26 | Aesculap Ag & Co. Kg | Method and apparatus for performing an orthodepic stability test using a surgical navigation system |
US20060235290A1 (en) * | 2005-04-04 | 2006-10-19 | Aesculap Ag & Co. Kg | Method and apparatus for positioning a cutting tool for orthopedic surgery using a localization system |
US9421019B2 (en) | 2005-04-07 | 2016-08-23 | Omnilife Science, Inc. | Robotic guide assembly for use in computer-aided surgery |
US20060247864A1 (en) * | 2005-04-29 | 2006-11-02 | Jose Tamez-Pena | Method and system for assessment of biomarkers by measurement of response to surgical implant |
WO2006119387A2 (en) * | 2005-05-02 | 2006-11-09 | Smith & Nephew, Inc. | System and method for determining tibial rotation |
US20060271056A1 (en) * | 2005-05-10 | 2006-11-30 | Smith & Nephew, Inc. | System and method for modular navigated osteotome |
US7306601B2 (en) * | 2005-06-10 | 2007-12-11 | Quantum Medical Concepts, Inc. | External fixation system with provisional brace |
US20070162142A1 (en) * | 2005-06-15 | 2007-07-12 | Vitruvian Orthopaedics, Llc | Knee surgery method and apparatus |
US9301845B2 (en) * | 2005-06-15 | 2016-04-05 | P Tech, Llc | Implant for knee replacement |
US8295909B2 (en) * | 2005-06-16 | 2012-10-23 | Brainlab Ag | Medical tracking system with infrared data transfer |
DE502005003845D1 (en) * | 2005-06-16 | 2008-06-05 | Brainlab Ag | Medical technology tracking system with infrared data transmission |
US7840256B2 (en) | 2005-06-27 | 2010-11-23 | Biomet Manufacturing Corporation | Image guided tracking array and method |
US20070015999A1 (en) * | 2005-07-15 | 2007-01-18 | Heldreth Mark A | System and method for providing orthopaedic surgical information to a surgeon |
US7983777B2 (en) * | 2005-08-19 | 2011-07-19 | Mark Melton | System for biomedical implant creation and procurement |
WO2007030866A1 (en) * | 2005-09-12 | 2007-03-22 | Advanced Surgical Design & Manufacture Limited | Image guided surgery |
DE102005043828A1 (en) * | 2005-09-13 | 2007-03-22 | H.C. Starck Gmbh | Process for the preparation of electrolytic capacitors |
US7835784B2 (en) | 2005-09-21 | 2010-11-16 | Medtronic Navigation, Inc. | Method and apparatus for positioning a reference frame |
CA2520942C (en) * | 2005-09-23 | 2013-03-19 | Queen's University At Kingston | Tactile amplification instrument and method of use |
US20070078678A1 (en) * | 2005-09-30 | 2007-04-05 | Disilvestro Mark R | System and method for performing a computer assisted orthopaedic surgical procedure |
US20070118139A1 (en) * | 2005-10-14 | 2007-05-24 | Cuellar Alberto D | System and method for bone resection |
US20070118140A1 (en) * | 2005-10-18 | 2007-05-24 | Aesculap Ag & Co. Kg | Method and apparatus for navigating a cutting tool during orthopedic surgery using a localization system |
US8192449B2 (en) * | 2005-10-25 | 2012-06-05 | Brainlab Ag | Non-penetrating fixing device |
US20070093709A1 (en) * | 2005-10-26 | 2007-04-26 | Abernathie Dennis L | Surgical navigation markers |
US20070100346A1 (en) * | 2005-10-27 | 2007-05-03 | Wyss Joseph G | Support for locating instrument guides |
WO2007056506A2 (en) * | 2005-11-09 | 2007-05-18 | Fell Barry M | System and method for shaping an anatomical component |
US20070179626A1 (en) * | 2005-11-30 | 2007-08-02 | De La Barrera Jose L M | Functional joint arthroplasty method |
US8864686B2 (en) * | 2005-12-01 | 2014-10-21 | Orthosensor Inc. | Virtual mapping of an anatomical pivot point and alignment therewith |
US8814810B2 (en) * | 2005-12-01 | 2014-08-26 | Orthosensor Inc. | Orthopedic method and system for mapping an anatomical pivot point |
SG132557A1 (en) * | 2005-12-05 | 2007-06-28 | Yang Kuang Ying Dr | Computer assisted navigation for total knee arthroplasty |
US7810504B2 (en) * | 2005-12-28 | 2010-10-12 | Depuy Products, Inc. | System and method for wearable user interface in computer assisted surgery |
US7662183B2 (en) * | 2006-01-24 | 2010-02-16 | Timothy Haines | Dynamic spinal implants incorporating cartilage bearing graft material |
US7885705B2 (en) | 2006-02-10 | 2011-02-08 | Murphy Stephen B | System and method for facilitating hip surgery |
US9808262B2 (en) | 2006-02-15 | 2017-11-07 | Howmedica Osteonics Corporation | Arthroplasty devices and related methods |
CA2642615A1 (en) | 2006-02-15 | 2007-08-30 | Otismed Corp | Arthroplasty jigs and related methods |
US9289253B2 (en) | 2006-02-27 | 2016-03-22 | Biomet Manufacturing, Llc | Patient-specific shoulder guide |
US10278711B2 (en) | 2006-02-27 | 2019-05-07 | Biomet Manufacturing, Llc | Patient-specific femoral guide |
US20150335438A1 (en) | 2006-02-27 | 2015-11-26 | Biomet Manufacturing, Llc. | Patient-specific augments |
US8591516B2 (en) | 2006-02-27 | 2013-11-26 | Biomet Manufacturing, Llc | Patient-specific orthopedic instruments |
US8092465B2 (en) | 2006-06-09 | 2012-01-10 | Biomet Manufacturing Corp. | Patient specific knee alignment guide and associated method |
US8282646B2 (en) | 2006-02-27 | 2012-10-09 | Biomet Manufacturing Corp. | Patient specific knee alignment guide and associated method |
US8608748B2 (en) | 2006-02-27 | 2013-12-17 | Biomet Manufacturing, Llc | Patient specific guides |
US8070752B2 (en) | 2006-02-27 | 2011-12-06 | Biomet Manufacturing Corp. | Patient specific alignment guide and inter-operative adjustment |
US8608749B2 (en) | 2006-02-27 | 2013-12-17 | Biomet Manufacturing, Llc | Patient-specific acetabular guides and associated instruments |
US8298237B2 (en) | 2006-06-09 | 2012-10-30 | Biomet Manufacturing Corp. | Patient-specific alignment guide for multiple incisions |
US8603180B2 (en) | 2006-02-27 | 2013-12-10 | Biomet Manufacturing, Llc | Patient-specific acetabular alignment guides |
US8858561B2 (en) | 2006-06-09 | 2014-10-14 | Blomet Manufacturing, LLC | Patient-specific alignment guide |
US8377066B2 (en) | 2006-02-27 | 2013-02-19 | Biomet Manufacturing Corp. | Patient-specific elbow guides and associated methods |
US8568487B2 (en) | 2006-02-27 | 2013-10-29 | Biomet Manufacturing, Llc | Patient-specific hip joint devices |
US9907659B2 (en) | 2007-04-17 | 2018-03-06 | Biomet Manufacturing, Llc | Method and apparatus for manufacturing an implant |
US9113971B2 (en) | 2006-02-27 | 2015-08-25 | Biomet Manufacturing, Llc | Femoral acetabular impingement guide |
US8535387B2 (en) | 2006-02-27 | 2013-09-17 | Biomet Manufacturing, Llc | Patient-specific tools and implants |
US9918740B2 (en) | 2006-02-27 | 2018-03-20 | Biomet Manufacturing, Llc | Backup surgical instrument system and method |
US8473305B2 (en) | 2007-04-17 | 2013-06-25 | Biomet Manufacturing Corp. | Method and apparatus for manufacturing an implant |
US9339278B2 (en) | 2006-02-27 | 2016-05-17 | Biomet Manufacturing, Llc | Patient-specific acetabular guides and associated instruments |
US7967868B2 (en) | 2007-04-17 | 2011-06-28 | Biomet Manufacturing Corp. | Patient-modified implant and associated method |
US8241293B2 (en) | 2006-02-27 | 2012-08-14 | Biomet Manufacturing Corp. | Patient specific high tibia osteotomy |
US9173661B2 (en) | 2006-02-27 | 2015-11-03 | Biomet Manufacturing, Llc | Patient specific alignment guide with cutting surface and laser indicator |
US8337426B2 (en) | 2009-03-24 | 2012-12-25 | Biomet Manufacturing Corp. | Method and apparatus for aligning and securing an implant relative to a patient |
US8864769B2 (en) | 2006-02-27 | 2014-10-21 | Biomet Manufacturing, Llc | Alignment guides with patient-specific anchoring elements |
US8407067B2 (en) | 2007-04-17 | 2013-03-26 | Biomet Manufacturing Corp. | Method and apparatus for manufacturing an implant |
US8133234B2 (en) | 2006-02-27 | 2012-03-13 | Biomet Manufacturing Corp. | Patient specific acetabular guide and method |
US9345548B2 (en) | 2006-02-27 | 2016-05-24 | Biomet Manufacturing, Llc | Patient-specific pre-operative planning |
US8323290B2 (en) * | 2006-03-03 | 2012-12-04 | Biomet Manufacturing Corp. | Tensor for use in surgical navigation |
US8337508B2 (en) * | 2006-03-20 | 2012-12-25 | Perception Raisonnement Action En Medecine | Distractor system |
WO2007107006A1 (en) * | 2006-03-23 | 2007-09-27 | Orthosoft Inc. | Method and system for tracking tools in computer-assisted surgery |
US8635082B2 (en) | 2006-05-25 | 2014-01-21 | DePuy Synthes Products, LLC | Method and system for managing inventories of orthopaedic implants |
US9795399B2 (en) | 2006-06-09 | 2017-10-24 | Biomet Manufacturing, Llc | Patient-specific knee alignment guide and associated method |
US8560047B2 (en) | 2006-06-16 | 2013-10-15 | Board Of Regents Of The University Of Nebraska | Method and apparatus for computer aided surgery |
US20080015602A1 (en) * | 2006-06-22 | 2008-01-17 | Howmedica Osteonics Corp. | Cutting block for bone resection |
US7756244B2 (en) * | 2006-06-22 | 2010-07-13 | Varian Medical Systems, Inc. | Systems and methods for determining object position |
EP2043561B1 (en) | 2006-06-30 | 2016-01-27 | Smith & Nephew, Inc. | Anatomical motion hinged prosthesis |
US8372078B2 (en) * | 2006-06-30 | 2013-02-12 | Howmedica Osteonics Corp. | Method for performing a high tibial osteotomy |
US20110057930A1 (en) * | 2006-07-26 | 2011-03-10 | Inneroptic Technology Inc. | System and method of using high-speed, high-resolution depth extraction to provide three-dimensional imagery for endoscopy |
WO2008017051A2 (en) | 2006-08-02 | 2008-02-07 | Inneroptic Technology Inc. | System and method of providing real-time dynamic imagery of a medical procedure site using multiple modalities |
US8565853B2 (en) | 2006-08-11 | 2013-10-22 | DePuy Synthes Products, LLC | Simulated bone or tissue manipulation |
WO2008030842A2 (en) * | 2006-09-06 | 2008-03-13 | Smith & Nephew, Inc. | Implants with transition surfaces and related processes |
US8083735B2 (en) * | 2006-11-17 | 2011-12-27 | Genii, Inc. | Compact electrosurgery apparatuses |
US20080118116A1 (en) * | 2006-11-20 | 2008-05-22 | General Electric Company | Systems and methods for tracking a surgical instrument and for conveying tracking information via a network |
US8460302B2 (en) | 2006-12-18 | 2013-06-11 | Otismed Corporation | Arthroplasty devices and related methods |
US20080161824A1 (en) * | 2006-12-27 | 2008-07-03 | Howmedica Osteonics Corp. | System and method for performing femoral sizing through navigation |
EP1952779B1 (en) * | 2007-02-01 | 2012-04-04 | BrainLAB AG | Method and system for Identification of medical instruments |
EP1955668B1 (en) * | 2007-02-07 | 2012-04-04 | BrainLAB AG | Method and device for the determination of alignment information during sonographically navigable repositioning of bone fragments |
US20080249394A1 (en) * | 2007-04-03 | 2008-10-09 | The Board Of Trustees Of The Leland Stanford Junior University | Method for improved rotational alignment in joint arthroplasty |
US20080262390A1 (en) * | 2007-04-19 | 2008-10-23 | Searete Llc, A Limited Liability Corporation Of The State Of Delaware | Fiducials for placement of tissue closures |
US20080262524A1 (en) * | 2007-04-19 | 2008-10-23 | Searete Llc, A Limited Liability Corporation Of The State Of Delaware | Systems and methods for closing of fascia |
US8926618B2 (en) | 2007-04-19 | 2015-01-06 | Howmedica Osteonics Corp. | Cutting guide with internal distraction |
US8934961B2 (en) | 2007-05-18 | 2015-01-13 | Biomet Manufacturing, Llc | Trackable diagnostic scope apparatus and methods of use |
WO2008151446A1 (en) * | 2007-06-15 | 2008-12-18 | Orthosoft Inc. | Computer-assisted surgery system and method |
EP2008606B1 (en) * | 2007-06-29 | 2009-08-05 | BrainLAB AG | Determination of correspondence object pairs for medical navigation |
JP2009056299A (en) | 2007-08-07 | 2009-03-19 | Stryker Leibinger Gmbh & Co Kg | Method of and system for planning surgery |
US8265949B2 (en) | 2007-09-27 | 2012-09-11 | Depuy Products, Inc. | Customized patient surgical plan |
JP5171193B2 (en) * | 2007-09-28 | 2013-03-27 | 株式会社 レキシー | Program for preoperative planning of knee replacement surgery |
ES2802126T3 (en) | 2007-09-30 | 2021-01-15 | Depuy Products Inc | Patient Specific Custom Orthopedic Surgical Instrument |
US8357111B2 (en) | 2007-09-30 | 2013-01-22 | Depuy Products, Inc. | Method and system for designing patient-specific orthopaedic surgical instruments |
KR100941612B1 (en) * | 2007-10-16 | 2010-02-11 | 주식회사 사이버메드 | Navigation method in bone ablation surgery |
USD642263S1 (en) | 2007-10-25 | 2011-07-26 | Otismed Corporation | Arthroplasty jig blank |
US8460303B2 (en) | 2007-10-25 | 2013-06-11 | Otismed Corporation | Arthroplasty systems and devices, and related methods |
EP2164419A1 (en) * | 2007-11-08 | 2010-03-24 | Orthosoft, Inc. | Trackable reference device for computer-assisted surgery |
US9017335B2 (en) * | 2007-11-19 | 2015-04-28 | Blue Ortho | Hip implant registration in computer assisted surgery |
US10582934B2 (en) | 2007-11-27 | 2020-03-10 | Howmedica Osteonics Corporation | Generating MRI images usable for the creation of 3D bone models employed to make customized arthroplasty jigs |
US8737700B2 (en) | 2007-12-18 | 2014-05-27 | Otismed Corporation | Preoperatively planning an arthroplasty procedure and generating a corresponding patient specific arthroplasty resection guide |
US8777875B2 (en) | 2008-07-23 | 2014-07-15 | Otismed Corporation | System and method for manufacturing arthroplasty jigs having improved mating accuracy |
US8221430B2 (en) | 2007-12-18 | 2012-07-17 | Otismed Corporation | System and method for manufacturing arthroplasty jigs |
US8160345B2 (en) | 2008-04-30 | 2012-04-17 | Otismed Corporation | System and method for image segmentation in generating computer models of a joint to undergo arthroplasty |
US8311306B2 (en) | 2008-04-30 | 2012-11-13 | Otismed Corporation | System and method for image segmentation in generating computer models of a joint to undergo arthroplasty |
US8715291B2 (en) | 2007-12-18 | 2014-05-06 | Otismed Corporation | Arthroplasty system and related methods |
US8617171B2 (en) | 2007-12-18 | 2013-12-31 | Otismed Corporation | Preoperatively planning an arthroplasty procedure and generating a corresponding patient specific arthroplasty resection guide |
US8545509B2 (en) | 2007-12-18 | 2013-10-01 | Otismed Corporation | Arthroplasty system and related methods |
US8480679B2 (en) | 2008-04-29 | 2013-07-09 | Otismed Corporation | Generation of a computerized bone model representative of a pre-degenerated state and useable in the design and manufacture of arthroplasty devices |
CN102626338B (en) | 2008-01-14 | 2014-11-26 | 康文图斯整形外科公司 | Apparatus and methods for fracture repair |
EP2237729B1 (en) * | 2008-01-16 | 2016-04-13 | Orthosoft, Inc. | Pinless system for computer assisted orthopedic surgery |
US8571637B2 (en) | 2008-01-21 | 2013-10-29 | Biomet Manufacturing, Llc | Patella tracking method and apparatus for use in surgical navigation |
WO2009094646A2 (en) | 2008-01-24 | 2009-07-30 | The University Of North Carolina At Chapel Hill | Methods, systems, and computer readable media for image guided ablation |
US8734455B2 (en) | 2008-02-29 | 2014-05-27 | Otismed Corporation | Hip resurfacing surgical guide tool |
WO2009108789A1 (en) * | 2008-02-29 | 2009-09-03 | Vot, Llc | Tibial prosthesis |
US8682052B2 (en) | 2008-03-05 | 2014-03-25 | Conformis, Inc. | Implants for altering wear patterns of articular surfaces |
US8340379B2 (en) | 2008-03-07 | 2012-12-25 | Inneroptic Technology, Inc. | Systems and methods for displaying guidance data based on updated deformable imaging data |
WO2009131716A1 (en) * | 2008-04-25 | 2009-10-29 | Stone Ross G | Navigation tracker fixation device and method for use thereof |
DE102008023218A1 (en) * | 2008-05-10 | 2009-11-12 | Aesculap Ag | Method and device for examining a body with an ultrasound head |
US8197489B2 (en) | 2008-06-27 | 2012-06-12 | Depuy Products, Inc. | Knee ligament balancer |
US8617175B2 (en) | 2008-12-16 | 2013-12-31 | Otismed Corporation | Unicompartmental customized arthroplasty cutting jigs and methods of making the same |
EP2344078B1 (en) | 2008-07-24 | 2018-04-18 | OrthAlign, Inc. | Systems for joint replacement |
EP2158879A1 (en) | 2008-09-01 | 2010-03-03 | MMK Consulting GmbH | Trial Prosthesis for total knee arthroplasty |
JP5632375B2 (en) * | 2008-09-03 | 2014-11-26 | アーオー テクノロジー アクチエンゲゼルシャフト | Device for operating a bone or bone fragment, or surgical instrument, tool or implant and method for positioning such a device |
ES2750264T3 (en) | 2008-09-10 | 2020-03-25 | Orthalign Inc | Hip surgery systems |
US8078440B2 (en) | 2008-09-19 | 2011-12-13 | Smith & Nephew, Inc. | Operatively tuning implants for increased performance |
US8192441B2 (en) * | 2008-10-03 | 2012-06-05 | Howmedica Osteonics Corp. | High tibial osteotomy instrumentation |
US9033958B2 (en) * | 2008-11-11 | 2015-05-19 | Perception Raisonnement Action En Medecine | Surgical robotic system |
WO2010063117A1 (en) | 2008-12-02 | 2010-06-10 | Andre Novomir Hladio | Method and system for aligning a prosthesis during surgery using active sensors |
EP2360393B1 (en) * | 2008-12-19 | 2013-04-03 | Toshiba Mitsubishi-Electric Industrial Systems Corporation | Power transmission device |
US8685093B2 (en) | 2009-01-23 | 2014-04-01 | Warsaw Orthopedic, Inc. | Methods and systems for diagnosing, treating, or tracking spinal disorders |
US8126736B2 (en) | 2009-01-23 | 2012-02-28 | Warsaw Orthopedic, Inc. | Methods and systems for diagnosing, treating, or tracking spinal disorders |
US8690776B2 (en) | 2009-02-17 | 2014-04-08 | Inneroptic Technology, Inc. | Systems, methods, apparatuses, and computer-readable media for image guided surgery |
US8554307B2 (en) | 2010-04-12 | 2013-10-08 | Inneroptic Technology, Inc. | Image annotation in image-guided medical procedures |
US8641621B2 (en) | 2009-02-17 | 2014-02-04 | Inneroptic Technology, Inc. | Systems, methods, apparatuses, and computer-readable media for image management in image-guided medical procedures |
US11464578B2 (en) | 2009-02-17 | 2022-10-11 | Inneroptic Technology, Inc. | Systems, methods, apparatuses, and computer-readable media for image management in image-guided medical procedures |
US8170641B2 (en) | 2009-02-20 | 2012-05-01 | Biomet Manufacturing Corp. | Method of imaging an extremity of a patient |
EP2405865B1 (en) | 2009-02-24 | 2019-04-17 | ConforMIS, Inc. | Automated systems for manufacturing patient-specific orthopedic implants and instrumentation |
US8551023B2 (en) | 2009-03-31 | 2013-10-08 | Depuy (Ireland) | Device and method for determining force of a knee joint |
US8556830B2 (en) | 2009-03-31 | 2013-10-15 | Depuy | Device and method for displaying joint force data |
US8740817B2 (en) | 2009-03-31 | 2014-06-03 | Depuy (Ireland) | Device and method for determining forces of a patient's joint |
US8597210B2 (en) | 2009-03-31 | 2013-12-03 | Depuy (Ireland) | System and method for displaying joint force data |
US8721568B2 (en) * | 2009-03-31 | 2014-05-13 | Depuy (Ireland) | Method for performing an orthopaedic surgical procedure |
US9655628B2 (en) | 2009-05-06 | 2017-05-23 | Blue Ortho | Reduced invasivity fixation system for trackers in computer assisted surgery |
US9084688B2 (en) | 2009-05-19 | 2015-07-21 | DePuy Synthes Products, Inc. | Dynamic trial implants |
ES2545398T3 (en) * | 2009-06-30 | 2015-09-10 | Blue Ortho | Adjustable guide for computer-assisted orthopedic surgery |
US8118815B2 (en) | 2009-07-24 | 2012-02-21 | OrthAlign, Inc. | Systems and methods for joint replacement |
US10869771B2 (en) | 2009-07-24 | 2020-12-22 | OrthAlign, Inc. | Systems and methods for joint replacement |
WO2011014687A2 (en) * | 2009-07-31 | 2011-02-03 | Inneroptic Technology, Inc. | Dual-tube stereoscope |
US8876830B2 (en) | 2009-08-13 | 2014-11-04 | Zimmer, Inc. | Virtual implant placement in the OR |
DE102009028503B4 (en) | 2009-08-13 | 2013-11-14 | Biomet Manufacturing Corp. | Resection template for the resection of bones, method for producing such a resection template and operation set for performing knee joint surgery |
WO2011031914A1 (en) * | 2009-09-10 | 2011-03-17 | Laurent Angibaud | Alignment guides for use in computer assisted orthopedic surgery to prepare a bone element for an implant |
US20110082351A1 (en) * | 2009-10-07 | 2011-04-07 | Inneroptic Technology, Inc. | Representing measurement information during a medical procedure |
US9282947B2 (en) | 2009-12-01 | 2016-03-15 | Inneroptic Technology, Inc. | Imager focusing based on intraoperative data |
CA2782137A1 (en) | 2009-12-11 | 2011-06-16 | Conformis, Inc. | Patient-specific and patient-engineered orthopedic implants |
US9011448B2 (en) | 2009-12-31 | 2015-04-21 | Orthosensor Inc. | Orthopedic navigation system with sensorized devices |
EP2523614A4 (en) | 2010-01-15 | 2017-02-15 | Conventus Orthopaedics, Inc. | Rotary-rigid orthopaedic rod |
CN105534561B (en) | 2010-01-20 | 2018-04-03 | 康文图斯整形外科公司 | For bone close to the device and method with bone cavity preparation |
EP2525740A4 (en) | 2010-01-21 | 2016-01-20 | Orthalign Inc | Systems and methods for joint replacement |
US8632547B2 (en) | 2010-02-26 | 2014-01-21 | Biomet Sports Medicine, Llc | Patient-specific osteotomy devices and methods |
WO2011107147A1 (en) * | 2010-03-03 | 2011-09-09 | Brainlab Ag | Method for enabling medical navigation with minimised invasiveness |
US9066727B2 (en) | 2010-03-04 | 2015-06-30 | Materialise Nv | Patient-specific computed tomography guides |
CA2829193A1 (en) | 2010-03-08 | 2011-09-15 | Conventus Orthopaedics, Inc. | Apparatus and methods for securing a bone implant |
US9579106B2 (en) | 2010-03-31 | 2017-02-28 | New York Society For The Relief Of The Ruptured And Crippled, Maintaining The Hospital For Special Surgery | Shoulder arthroplasty instrumentation |
CN102933163A (en) | 2010-04-14 | 2013-02-13 | 史密夫和内修有限公司 | Systems and methods for patient- based computer assisted surgical procedures |
GB201006716D0 (en) * | 2010-04-22 | 2010-06-09 | Depuy Ireland | A composite trial prosthesis |
EP2603173B1 (en) | 2010-08-12 | 2016-03-23 | Smith & Nephew, Inc. | Structures for use in orthopaedic implant fixation |
CN103379924B (en) | 2010-08-20 | 2015-07-29 | 凯斯西储大学 | Manufacture is added in the continuous number optical processing of implant |
US11865785B2 (en) | 2010-08-20 | 2024-01-09 | H. David Dean | Continuous digital light processing additive manufacturing of implants |
US20120316486A1 (en) | 2010-08-20 | 2012-12-13 | Andrew Cheung | Surgical Component Navigation Systems And Methods |
US9271744B2 (en) | 2010-09-29 | 2016-03-01 | Biomet Manufacturing, Llc | Patient-specific guide for partial acetabular socket replacement |
US9968376B2 (en) | 2010-11-29 | 2018-05-15 | Biomet Manufacturing, Llc | Patient-specific orthopedic instruments |
EP2651344A4 (en) * | 2010-12-17 | 2015-08-19 | Intellijoint Surgical Inc | Method and system for aligning a prosthesis during surgery |
US9921712B2 (en) | 2010-12-29 | 2018-03-20 | Mako Surgical Corp. | System and method for providing substantially stable control of a surgical tool |
US9119655B2 (en) | 2012-08-03 | 2015-09-01 | Stryker Corporation | Surgical manipulator capable of controlling a surgical instrument in multiple modes |
EP2754419B1 (en) | 2011-02-15 | 2024-02-07 | ConforMIS, Inc. | Patient-adapted and improved orthopedic implants |
US9241745B2 (en) | 2011-03-07 | 2016-01-26 | Biomet Manufacturing, Llc | Patient-specific femoral version guide |
US8715289B2 (en) | 2011-04-15 | 2014-05-06 | Biomet Manufacturing, Llc | Patient-specific numerically controlled instrument |
US9675400B2 (en) | 2011-04-19 | 2017-06-13 | Biomet Manufacturing, Llc | Patient-specific fracture fixation instrumentation and method |
US8956364B2 (en) | 2011-04-29 | 2015-02-17 | Biomet Manufacturing, Llc | Patient-specific partial knee guides and other instruments |
US8668700B2 (en) | 2011-04-29 | 2014-03-11 | Biomet Manufacturing, Llc | Patient-specific convertible guides |
WO2012149548A2 (en) * | 2011-04-29 | 2012-11-01 | The Johns Hopkins University | System and method for tracking and navigation |
US8532807B2 (en) | 2011-06-06 | 2013-09-10 | Biomet Manufacturing, Llc | Pre-operative planning and manufacturing method for orthopedic procedure |
US8979847B2 (en) | 2011-06-06 | 2015-03-17 | Biomet Manufacturing, Llc | Method and apparatus for implanting a knee prosthesis |
US9084618B2 (en) | 2011-06-13 | 2015-07-21 | Biomet Manufacturing, Llc | Drill guides for confirming alignment of patient-specific alignment guides |
US9220510B2 (en) * | 2011-06-15 | 2015-12-29 | Perception Raisonnement Action En Medecine | System and method for bone preparation for an implant |
US9498231B2 (en) | 2011-06-27 | 2016-11-22 | Board Of Regents Of The University Of Nebraska | On-board tool tracking system and methods of computer assisted surgery |
US11911117B2 (en) | 2011-06-27 | 2024-02-27 | Board Of Regents Of The University Of Nebraska | On-board tool tracking system and methods of computer assisted surgery |
CN103764061B (en) | 2011-06-27 | 2017-03-08 | 内布拉斯加大学评议会 | Tracing system and Computer Aided Surgery method that instrument carries |
US8968412B2 (en) | 2011-06-30 | 2015-03-03 | Depuy (Ireland) | Trialing system for a knee prosthesis and method of use |
US20130001121A1 (en) | 2011-07-01 | 2013-01-03 | Biomet Manufacturing Corp. | Backup kit for a patient-specific arthroplasty kit assembly |
US8764760B2 (en) | 2011-07-01 | 2014-07-01 | Biomet Manufacturing, Llc | Patient-specific bone-cutting guidance instruments and methods |
US20130012807A1 (en) * | 2011-07-05 | 2013-01-10 | King Fahd University Of Petroleum And Minerals | System and method for tracking position of handheld medical instruments |
US8597365B2 (en) | 2011-08-04 | 2013-12-03 | Biomet Manufacturing, Llc | Patient-specific pelvic implants for acetabular reconstruction |
US10722318B2 (en) * | 2011-08-24 | 2020-07-28 | Mako Surgical Corp. | Surgical tools for selectively illuminating a surgical volume |
US9066734B2 (en) | 2011-08-31 | 2015-06-30 | Biomet Manufacturing, Llc | Patient-specific sacroiliac guides and associated methods |
US9295497B2 (en) | 2011-08-31 | 2016-03-29 | Biomet Manufacturing, Llc | Patient-specific sacroiliac and pedicle guides |
CA2847182C (en) | 2011-09-02 | 2020-02-11 | Stryker Corporation | Surgical instrument including a cutting accessory extending from a housing and actuators that establish the position of the cutting accessory relative to the housing |
GB201115411D0 (en) | 2011-09-07 | 2011-10-19 | Depuy Ireland | Surgical instrument |
US9386993B2 (en) | 2011-09-29 | 2016-07-12 | Biomet Manufacturing, Llc | Patient-specific femoroacetabular impingement instruments and methods |
WO2013053398A1 (en) * | 2011-10-13 | 2013-04-18 | Brainlab | Medical tracking system comprising two or more communicating sensor devices |
WO2013063043A1 (en) | 2011-10-24 | 2013-05-02 | Synvasive Technology, Inc. | Knee balancing devices, systems and methods |
KR20130046337A (en) | 2011-10-27 | 2013-05-07 | 삼성전자주식회사 | Multi-view device and contol method thereof, display apparatus and contol method thereof, and display system |
US9301812B2 (en) | 2011-10-27 | 2016-04-05 | Biomet Manufacturing, Llc | Methods for patient-specific shoulder arthroplasty |
US9451973B2 (en) | 2011-10-27 | 2016-09-27 | Biomet Manufacturing, Llc | Patient specific glenoid guide |
WO2013062848A1 (en) | 2011-10-27 | 2013-05-02 | Biomet Manufacturing Corporation | Patient-specific glenoid guides |
US9554910B2 (en) | 2011-10-27 | 2017-01-31 | Biomet Manufacturing, Llc | Patient-specific glenoid guide and implants |
CN104244859A (en) * | 2011-11-23 | 2014-12-24 | J·萨萨尼 | Universal microsurgical simulator |
RU2634296C2 (en) * | 2012-01-03 | 2017-10-24 | Конинклейке Филипс Н.В. | Device for position determination |
US8670816B2 (en) | 2012-01-30 | 2014-03-11 | Inneroptic Technology, Inc. | Multiple medical device guidance |
US9237950B2 (en) | 2012-02-02 | 2016-01-19 | Biomet Manufacturing, Llc | Implant with patient-specific porous structure |
US8584853B2 (en) | 2012-02-16 | 2013-11-19 | Biomedical Enterprises, Inc. | Method and apparatus for an orthopedic fixation system |
US9381011B2 (en) | 2012-03-29 | 2016-07-05 | Depuy (Ireland) | Orthopedic surgical instrument for knee surgery |
US10206792B2 (en) | 2012-03-31 | 2019-02-19 | Depuy Ireland Unlimited Company | Orthopaedic surgical system for determining joint forces of a patients knee joint |
US10098761B2 (en) | 2012-03-31 | 2018-10-16 | DePuy Synthes Products, Inc. | System and method for validating an orthopaedic surgical plan |
US10070973B2 (en) | 2012-03-31 | 2018-09-11 | Depuy Ireland Unlimited Company | Orthopaedic sensor module and system for determining joint forces of a patient's knee joint |
US9545459B2 (en) | 2012-03-31 | 2017-01-17 | Depuy Ireland Unlimited Company | Container for surgical instruments and system including same |
US9314188B2 (en) | 2012-04-12 | 2016-04-19 | Intellijoint Surgical Inc. | Computer-assisted joint replacement surgery and navigation systems |
US9237951B1 (en) * | 2012-04-17 | 2016-01-19 | Sam Hakki | Apparatus and method for identifying tibia bone rotation in knee implant surgery |
EP2849683A4 (en) | 2012-05-18 | 2015-11-25 | Orthalign Inc | Devices and methods for knee arthroplasty |
US11871901B2 (en) | 2012-05-20 | 2024-01-16 | Cilag Gmbh International | Method for situational awareness for surgical network or surgical network connected device capable of adjusting function based on a sensed situation or usage |
KR101362252B1 (en) * | 2012-06-28 | 2014-02-14 | 서울대학교산학협력단 | Patient-specific registration guide and method using the same |
US9226796B2 (en) | 2012-08-03 | 2016-01-05 | Stryker Corporation | Method for detecting a disturbance as an energy applicator of a surgical instrument traverses a cutting path |
KR102397265B1 (en) | 2012-08-03 | 2022-05-12 | 스트리커 코포레이션 | Systems and methods for robotic surgery |
US9820818B2 (en) | 2012-08-03 | 2017-11-21 | Stryker Corporation | System and method for controlling a surgical manipulator based on implant parameters |
US9993305B2 (en) | 2012-08-08 | 2018-06-12 | Ortoma Ab | Method and system for computer assisted surgery |
US9649160B2 (en) | 2012-08-14 | 2017-05-16 | OrthAlign, Inc. | Hip replacement navigation system and method |
US20150223941A1 (en) * | 2012-08-27 | 2015-08-13 | Conformis, Inc. | Methods, Devices and Techniques for Improved Placement and Fixation of Shoulder Implant Components |
US9955915B2 (en) | 2012-08-30 | 2018-05-01 | The Regents Of The University Of Michigan | Ball joint center locating method using data from attached inertial measurement unit |
US9402637B2 (en) | 2012-10-11 | 2016-08-02 | Howmedica Osteonics Corporation | Customized arthroplasty cutting guides and surgical methods using the same |
US9204977B2 (en) | 2012-12-11 | 2015-12-08 | Biomet Manufacturing, Llc | Patient-specific acetabular guide for anterior approach |
US9060788B2 (en) | 2012-12-11 | 2015-06-23 | Biomet Manufacturing, Llc | Patient-specific acetabular guide for anterior approach |
US9993273B2 (en) | 2013-01-16 | 2018-06-12 | Mako Surgical Corp. | Bone plate and tracking device using a bone plate for attaching to a patient's anatomy |
AU2014207502B2 (en) * | 2013-01-16 | 2018-10-18 | Stryker Corporation | Navigation systems and methods for indicating line-of-sight errors |
CN103083117A (en) * | 2013-01-18 | 2013-05-08 | 周一新 | Joint prosthesis navigation model testing system |
US9839438B2 (en) | 2013-03-11 | 2017-12-12 | Biomet Manufacturing, Llc | Patient-specific glenoid guide with a reusable guide holder |
US9579107B2 (en) | 2013-03-12 | 2017-02-28 | Biomet Manufacturing, Llc | Multi-point fit for patient specific guide |
US9826981B2 (en) | 2013-03-13 | 2017-11-28 | Biomet Manufacturing, Llc | Tangential fit of patient-specific guides |
US9498233B2 (en) | 2013-03-13 | 2016-11-22 | Biomet Manufacturing, Llc. | Universal acetabular guide and associated hardware |
KR102101435B1 (en) | 2013-03-13 | 2020-04-17 | 스트리커 코포레이션 | System for arranging objects in an operating room in preparation for surgical procedures |
CA2897873A1 (en) | 2013-03-13 | 2014-10-09 | Stryker Corporation | Systems and methods for establishing virtual constraint boundaries |
US10314559B2 (en) | 2013-03-14 | 2019-06-11 | Inneroptic Technology, Inc. | Medical device guidance |
AU2014232933A1 (en) * | 2013-03-15 | 2015-10-29 | Arthromeda, Inc. | Systems and methods for providing alignment in total knee arthroplasty |
US9517145B2 (en) | 2013-03-15 | 2016-12-13 | Biomet Manufacturing, Llc | Guide alignment system and method |
US10105149B2 (en) | 2013-03-15 | 2018-10-23 | Board Of Regents Of The University Of Nebraska | On-board tool tracking system and methods of computer assisted surgery |
US9247998B2 (en) | 2013-03-15 | 2016-02-02 | Intellijoint Surgical Inc. | System and method for intra-operative leg position measurement |
US20150112349A1 (en) | 2013-10-21 | 2015-04-23 | Biomet Manufacturing, Llc | Ligament Guide Registration |
AU2014362251B2 (en) | 2013-12-12 | 2019-10-10 | Conventus Orthopaedics, Inc. | Tissue displacement tools and methods |
EP2901957A1 (en) * | 2014-01-31 | 2015-08-05 | Universität Basel | Controlling a surgical intervention to a bone |
FR3018185B1 (en) * | 2014-03-07 | 2016-04-15 | Ostesys | POSITIONING INSTRUMENT OF OSTEOTOMY TOOL HOLDERS |
US10282488B2 (en) | 2014-04-25 | 2019-05-07 | Biomet Manufacturing, Llc | HTO guide with optional guided ACL/PCL tunnels |
US9861491B2 (en) | 2014-04-30 | 2018-01-09 | Depuy Ireland Unlimited Company | Tibial trial system for a knee prosthesis |
US10456131B2 (en) | 2014-05-07 | 2019-10-29 | Biomedical Enterprises, Inc. | Method and apparatus for loading and implanting a shape memory implant |
US10456130B2 (en) | 2014-05-07 | 2019-10-29 | Biomedical Enterprises, Inc. | Method and apparatus for loading and implanting a shape memory implant |
US9408616B2 (en) | 2014-05-12 | 2016-08-09 | Biomet Manufacturing, Llc | Humeral cut guide |
US9561040B2 (en) | 2014-06-03 | 2017-02-07 | Biomet Manufacturing, Llc | Patient-specific glenoid depth control |
US9839436B2 (en) | 2014-06-03 | 2017-12-12 | Biomet Manufacturing, Llc | Patient-specific glenoid depth control |
US10357378B2 (en) * | 2014-07-22 | 2019-07-23 | Zimmer, Inc. | Devices and methods for trochanteric osteotomy |
PT3197403T (en) | 2014-09-24 | 2022-05-02 | Depuy Ireland Ultd Co | Surgical planning and method |
US9833245B2 (en) | 2014-09-29 | 2017-12-05 | Biomet Sports Medicine, Llc | Tibial tubercule osteotomy |
US9826994B2 (en) | 2014-09-29 | 2017-11-28 | Biomet Manufacturing, Llc | Adjustable glenoid pin insertion guide |
US9901406B2 (en) | 2014-10-02 | 2018-02-27 | Inneroptic Technology, Inc. | Affected region display associated with a medical device |
US11504192B2 (en) | 2014-10-30 | 2022-11-22 | Cilag Gmbh International | Method of hub communication with surgical instrument systems |
US10188467B2 (en) | 2014-12-12 | 2019-01-29 | Inneroptic Technology, Inc. | Surgical guidance intersection display |
US9931168B2 (en) * | 2015-01-12 | 2018-04-03 | Biomet Manufacuturing. LLC | Plan implementation |
US10363149B2 (en) | 2015-02-20 | 2019-07-30 | OrthAlign, Inc. | Hip replacement navigation system and method |
US9820868B2 (en) | 2015-03-30 | 2017-11-21 | Biomet Manufacturing, Llc | Method and apparatus for a pin apparatus |
WO2016173626A1 (en) * | 2015-04-28 | 2016-11-03 | Brainlab Ag | Method and device for determining geometric parameters for total knee replacement surgery |
JP2018525045A (en) * | 2015-05-28 | 2018-09-06 | バイオメット マニュファクチャリング,リミティド ライアビリティ カンパニー | Flexible planned kit knee protocol |
US10226262B2 (en) | 2015-06-25 | 2019-03-12 | Biomet Manufacturing, Llc | Patient-specific humeral guide designs |
US10568647B2 (en) | 2015-06-25 | 2020-02-25 | Biomet Manufacturing, Llc | Patient-specific humeral guide designs |
US9949700B2 (en) | 2015-07-22 | 2018-04-24 | Inneroptic Technology, Inc. | Medical device approaches |
US10098707B2 (en) * | 2015-08-17 | 2018-10-16 | Orthogrid Systems Inc. | Surgical positioning system, apparatus and method of use |
CN107920818B (en) | 2015-09-03 | 2021-02-09 | 生物医药企业公司 | Elastic orthopedic implant and method of making same |
US10537445B2 (en) | 2015-10-19 | 2020-01-21 | Depuy Ireland Unlimited Company | Surgical instruments for preparing a patient's tibia to receive an implant |
US10195056B2 (en) | 2015-10-19 | 2019-02-05 | Depuy Ireland Unlimited Company | Method for preparing a patient's tibia to receive an implant |
US10058393B2 (en) | 2015-10-21 | 2018-08-28 | P Tech, Llc | Systems and methods for navigation and visualization |
CN113925610A (en) | 2015-12-31 | 2022-01-14 | 史赛克公司 | System and method for performing a procedure on a patient at a target site defined by a virtual object |
KR20170087610A (en) | 2016-01-21 | 2017-07-31 | 삼성전자주식회사 | Apparatus for cutting a wafer |
US10070971B2 (en) * | 2016-01-22 | 2018-09-11 | Warsaw Orthopedic, Inc. | Surgical instrument and method |
US9675319B1 (en) | 2016-02-17 | 2017-06-13 | Inneroptic Technology, Inc. | Loupe display |
US10537395B2 (en) | 2016-05-26 | 2020-01-21 | MAKO Surgical Group | Navigation tracker with kinematic connector assembly |
WO2018006026A1 (en) | 2016-06-30 | 2018-01-04 | Orthogrid Systems S.A.R.L | Surgical instrument positioning system, apparatus and method of use as a non-invasive anatomical reference |
CN106264731B (en) * | 2016-10-11 | 2019-07-16 | 昆明医科大学第一附属医院 | A method of based on the virtual knee joint single condyle displacement technique model construction of point-to-point registration technique |
US10278778B2 (en) | 2016-10-27 | 2019-05-07 | Inneroptic Technology, Inc. | Medical device navigation using a virtual 3D space |
US10940023B2 (en) | 2016-12-15 | 2021-03-09 | Stryker European Holdings I, Llc | Bone plate trial |
WO2018112025A1 (en) | 2016-12-16 | 2018-06-21 | Mako Surgical Corp. | Techniques for modifying tool operation in a surgical robotic system based on comparing actual and commanded states of the tool relative to a surgical site |
US10631881B2 (en) | 2017-03-09 | 2020-04-28 | Flower Orthopedics Corporation | Plating depth gauge and countersink instrument |
US10722310B2 (en) | 2017-03-13 | 2020-07-28 | Zimmer Biomet CMF and Thoracic, LLC | Virtual surgery planning system and method |
JP7344122B2 (en) | 2017-03-14 | 2023-09-13 | オースアライン・インコーポレイテッド | Systems and methods for measuring and balancing soft tissue |
EP3595554A4 (en) | 2017-03-14 | 2021-01-06 | OrthAlign, Inc. | Hip replacement navigation systems and methods |
US10918426B2 (en) | 2017-07-04 | 2021-02-16 | Conventus Orthopaedics, Inc. | Apparatus and methods for treatment of a bone |
US11259879B2 (en) | 2017-08-01 | 2022-03-01 | Inneroptic Technology, Inc. | Selective transparency to assist medical device navigation |
US11510741B2 (en) | 2017-10-30 | 2022-11-29 | Cilag Gmbh International | Method for producing a surgical instrument comprising a smart electrical system |
US11564756B2 (en) | 2017-10-30 | 2023-01-31 | Cilag Gmbh International | Method of hub communication with surgical instrument systems |
US11311342B2 (en) | 2017-10-30 | 2022-04-26 | Cilag Gmbh International | Method for communicating with surgical instrument systems |
US11026712B2 (en) | 2017-10-30 | 2021-06-08 | Cilag Gmbh International | Surgical instruments comprising a shifting mechanism |
US11291510B2 (en) | 2017-10-30 | 2022-04-05 | Cilag Gmbh International | Method of hub communication with surgical instrument systems |
US11911045B2 (en) | 2017-10-30 | 2024-02-27 | Cllag GmbH International | Method for operating a powered articulating multi-clip applier |
US11123070B2 (en) | 2017-10-30 | 2021-09-21 | Cilag Gmbh International | Clip applier comprising a rotatable clip magazine |
US11317919B2 (en) | 2017-10-30 | 2022-05-03 | Cilag Gmbh International | Clip applier comprising a clip crimping system |
US11229436B2 (en) | 2017-10-30 | 2022-01-25 | Cilag Gmbh International | Surgical system comprising a surgical tool and a surgical hub |
US11801098B2 (en) | 2017-10-30 | 2023-10-31 | Cilag Gmbh International | Method of hub communication with surgical instrument systems |
US11173048B2 (en) | 2017-11-07 | 2021-11-16 | Howmedica Osteonics Corp. | Robotic system for shoulder arthroplasty using stemless implant components |
US11432945B2 (en) | 2017-11-07 | 2022-09-06 | Howmedica Osteonics Corp. | Robotic system for shoulder arthroplasty using stemless implant components |
US11241285B2 (en) | 2017-11-07 | 2022-02-08 | Mako Surgical Corp. | Robotic system for shoulder arthroplasty using stemless implant components |
US11410259B2 (en) | 2017-12-28 | 2022-08-09 | Cilag Gmbh International | Adaptive control program updates for surgical devices |
US11786245B2 (en) | 2017-12-28 | 2023-10-17 | Cilag Gmbh International | Surgical systems with prioritized data transmission capabilities |
US11419630B2 (en) | 2017-12-28 | 2022-08-23 | Cilag Gmbh International | Surgical system distributed processing |
US11234756B2 (en) | 2017-12-28 | 2022-02-01 | Cilag Gmbh International | Powered surgical tool with predefined adjustable control algorithm for controlling end effector parameter |
US11540855B2 (en) | 2017-12-28 | 2023-01-03 | Cilag Gmbh International | Controlling activation of an ultrasonic surgical instrument according to the presence of tissue |
US11818052B2 (en) | 2017-12-28 | 2023-11-14 | Cilag Gmbh International | Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs |
US11132462B2 (en) | 2017-12-28 | 2021-09-28 | Cilag Gmbh International | Data stripping method to interrogate patient records and create anonymized record |
US10758310B2 (en) | 2017-12-28 | 2020-09-01 | Ethicon Llc | Wireless pairing of a surgical device with another device within a sterile surgical field based on the usage and situational awareness of devices |
US11202570B2 (en) | 2017-12-28 | 2021-12-21 | Cilag Gmbh International | Communication hub and storage device for storing parameters and status of a surgical device to be shared with cloud based analytics systems |
US11419667B2 (en) | 2017-12-28 | 2022-08-23 | Cilag Gmbh International | Ultrasonic energy device which varies pressure applied by clamp arm to provide threshold control pressure at a cut progression location |
US11100631B2 (en) | 2017-12-28 | 2021-08-24 | Cilag Gmbh International | Use of laser light and red-green-blue coloration to determine properties of back scattered light |
US11109866B2 (en) | 2017-12-28 | 2021-09-07 | Cilag Gmbh International | Method for circular stapler control algorithm adjustment based on situational awareness |
US11266468B2 (en) | 2017-12-28 | 2022-03-08 | Cilag Gmbh International | Cooperative utilization of data derived from secondary sources by intelligent surgical hubs |
US11744604B2 (en) | 2017-12-28 | 2023-09-05 | Cilag Gmbh International | Surgical instrument with a hardware-only control circuit |
US11464559B2 (en) | 2017-12-28 | 2022-10-11 | Cilag Gmbh International | Estimating state of ultrasonic end effector and control system therefor |
US11771487B2 (en) | 2017-12-28 | 2023-10-03 | Cilag Gmbh International | Mechanisms for controlling different electromechanical systems of an electrosurgical instrument |
US11612444B2 (en) | 2017-12-28 | 2023-03-28 | Cilag Gmbh International | Adjustment of a surgical device function based on situational awareness |
US11786251B2 (en) | 2017-12-28 | 2023-10-17 | Cilag Gmbh International | Method for adaptive control schemes for surgical network control and interaction |
US11423007B2 (en) | 2017-12-28 | 2022-08-23 | Cilag Gmbh International | Adjustment of device control programs based on stratified contextual data in addition to the data |
US11304745B2 (en) | 2017-12-28 | 2022-04-19 | Cilag Gmbh International | Surgical evacuation sensing and display |
US11666331B2 (en) | 2017-12-28 | 2023-06-06 | Cilag Gmbh International | Systems for detecting proximity of surgical end effector to cancerous tissue |
US11273001B2 (en) | 2017-12-28 | 2022-03-15 | Cilag Gmbh International | Surgical hub and modular device response adjustment based on situational awareness |
US11166772B2 (en) | 2017-12-28 | 2021-11-09 | Cilag Gmbh International | Surgical hub coordination of control and communication of operating room devices |
US11304720B2 (en) | 2017-12-28 | 2022-04-19 | Cilag Gmbh International | Activation of energy devices |
US11278281B2 (en) | 2017-12-28 | 2022-03-22 | Cilag Gmbh International | Interactive surgical system |
US20190201042A1 (en) | 2017-12-28 | 2019-07-04 | Ethicon Llc | Determining the state of an ultrasonic electromechanical system according to frequency shift |
US11257589B2 (en) | 2017-12-28 | 2022-02-22 | Cilag Gmbh International | Real-time analysis of comprehensive cost of all instrumentation used in surgery utilizing data fluidity to track instruments through stocking and in-house processes |
US11832899B2 (en) | 2017-12-28 | 2023-12-05 | Cilag Gmbh International | Surgical systems with autonomously adjustable control programs |
US11576677B2 (en) | 2017-12-28 | 2023-02-14 | Cilag Gmbh International | Method of hub communication, processing, display, and cloud analytics |
US11291495B2 (en) | 2017-12-28 | 2022-04-05 | Cilag Gmbh International | Interruption of energy due to inadvertent capacitive coupling |
US11633237B2 (en) | 2017-12-28 | 2023-04-25 | Cilag Gmbh International | Usage and technique analysis of surgeon / staff performance against a baseline to optimize device utilization and performance for both current and future procedures |
US11311306B2 (en) | 2017-12-28 | 2022-04-26 | Cilag Gmbh International | Surgical systems for detecting end effector tissue distribution irregularities |
US11376002B2 (en) | 2017-12-28 | 2022-07-05 | Cilag Gmbh International | Surgical instrument cartridge sensor assemblies |
US11284936B2 (en) | 2017-12-28 | 2022-03-29 | Cilag Gmbh International | Surgical instrument having a flexible electrode |
US11096693B2 (en) | 2017-12-28 | 2021-08-24 | Cilag Gmbh International | Adjustment of staple height of at least one row of staples based on the sensed tissue thickness or force in closing |
US11179208B2 (en) | 2017-12-28 | 2021-11-23 | Cilag Gmbh International | Cloud-based medical analytics for security and authentication trends and reactive measures |
US11324557B2 (en) | 2017-12-28 | 2022-05-10 | Cilag Gmbh International | Surgical instrument with a sensing array |
US11364075B2 (en) | 2017-12-28 | 2022-06-21 | Cilag Gmbh International | Radio frequency energy device for delivering combined electrical signals |
US11317937B2 (en) | 2018-03-08 | 2022-05-03 | Cilag Gmbh International | Determining the state of an ultrasonic end effector |
US11596291B2 (en) | 2017-12-28 | 2023-03-07 | Cilag Gmbh International | Method of compressing tissue within a stapling device and simultaneously displaying of the location of the tissue within the jaws |
US11571234B2 (en) | 2017-12-28 | 2023-02-07 | Cilag Gmbh International | Temperature control of ultrasonic end effector and control system therefor |
US11559307B2 (en) | 2017-12-28 | 2023-01-24 | Cilag Gmbh International | Method of robotic hub communication, detection, and control |
US20190201142A1 (en) | 2017-12-28 | 2019-07-04 | Ethicon Llc | Automatic tool adjustments for robot-assisted surgical platforms |
US11424027B2 (en) | 2017-12-28 | 2022-08-23 | Cilag Gmbh International | Method for operating surgical instrument systems |
US11857152B2 (en) | 2017-12-28 | 2024-01-02 | Cilag Gmbh International | Surgical hub spatial awareness to determine devices in operating theater |
US11389164B2 (en) | 2017-12-28 | 2022-07-19 | Cilag Gmbh International | Method of using reinforced flexible circuits with multiple sensors to optimize performance of radio frequency devices |
US11160605B2 (en) | 2017-12-28 | 2021-11-02 | Cilag Gmbh International | Surgical evacuation sensing and motor control |
US11013563B2 (en) | 2017-12-28 | 2021-05-25 | Ethicon Llc | Drive arrangements for robot-assisted surgical platforms |
US11937769B2 (en) | 2017-12-28 | 2024-03-26 | Cilag Gmbh International | Method of hub communication, processing, storage and display |
US11432885B2 (en) | 2017-12-28 | 2022-09-06 | Cilag Gmbh International | Sensing arrangements for robot-assisted surgical platforms |
US11308075B2 (en) | 2017-12-28 | 2022-04-19 | Cilag Gmbh International | Surgical network, instrument, and cloud responses based on validation of received dataset and authentication of its source and integrity |
US11304699B2 (en) | 2017-12-28 | 2022-04-19 | Cilag Gmbh International | Method for adaptive control schemes for surgical network control and interaction |
US11896443B2 (en) | 2017-12-28 | 2024-02-13 | Cilag Gmbh International | Control of a surgical system through a surgical barrier |
US10595887B2 (en) | 2017-12-28 | 2020-03-24 | Ethicon Llc | Systems for adjusting end effector parameters based on perioperative information |
US11864728B2 (en) | 2017-12-28 | 2024-01-09 | Cilag Gmbh International | Characterization of tissue irregularities through the use of mono-chromatic light refractivity |
US11896322B2 (en) | 2017-12-28 | 2024-02-13 | Cilag Gmbh International | Sensing the patient position and contact utilizing the mono-polar return pad electrode to provide situational awareness to the hub |
US11529187B2 (en) | 2017-12-28 | 2022-12-20 | Cilag Gmbh International | Surgical evacuation sensor arrangements |
US11253315B2 (en) | 2017-12-28 | 2022-02-22 | Cilag Gmbh International | Increasing radio frequency to create pad-less monopolar loop |
US11659023B2 (en) | 2017-12-28 | 2023-05-23 | Cilag Gmbh International | Method of hub communication |
US11446052B2 (en) | 2017-12-28 | 2022-09-20 | Cilag Gmbh International | Variation of radio frequency and ultrasonic power level in cooperation with varying clamp arm pressure to achieve predefined heat flux or power applied to tissue |
US11678881B2 (en) | 2017-12-28 | 2023-06-20 | Cilag Gmbh International | Spatial awareness of surgical hubs in operating rooms |
US11589888B2 (en) | 2017-12-28 | 2023-02-28 | Cilag Gmbh International | Method for controlling smart energy devices |
US10892995B2 (en) | 2017-12-28 | 2021-01-12 | Ethicon Llc | Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs |
US11602393B2 (en) | 2017-12-28 | 2023-03-14 | Cilag Gmbh International | Surgical evacuation sensing and generator control |
US11903601B2 (en) | 2017-12-28 | 2024-02-20 | Cilag Gmbh International | Surgical instrument comprising a plurality of drive systems |
US11559308B2 (en) | 2017-12-28 | 2023-01-24 | Cilag Gmbh International | Method for smart energy device infrastructure |
US11304763B2 (en) | 2017-12-28 | 2022-04-19 | Cilag Gmbh International | Image capturing of the areas outside the abdomen to improve placement and control of a surgical device in use |
US11832840B2 (en) | 2017-12-28 | 2023-12-05 | Cilag Gmbh International | Surgical instrument having a flexible circuit |
US11464535B2 (en) | 2017-12-28 | 2022-10-11 | Cilag Gmbh International | Detection of end effector emersion in liquid |
US11672605B2 (en) | 2017-12-28 | 2023-06-13 | Cilag Gmbh International | Sterile field interactive control displays |
US11484365B2 (en) | 2018-01-23 | 2022-11-01 | Inneroptic Technology, Inc. | Medical image guidance |
US11464532B2 (en) | 2018-03-08 | 2022-10-11 | Cilag Gmbh International | Methods for estimating and controlling state of ultrasonic end effector |
US11678927B2 (en) | 2018-03-08 | 2023-06-20 | Cilag Gmbh International | Detection of large vessels during parenchymal dissection using a smart blade |
US11259830B2 (en) | 2018-03-08 | 2022-03-01 | Cilag Gmbh International | Methods for controlling temperature in ultrasonic device |
US11207067B2 (en) | 2018-03-28 | 2021-12-28 | Cilag Gmbh International | Surgical stapling device with separate rotary driven closure and firing systems and firing member that engages both jaws while firing |
US11259806B2 (en) | 2018-03-28 | 2022-03-01 | Cilag Gmbh International | Surgical stapling devices with features for blocking advancement of a camming assembly of an incompatible cartridge installed therein |
US11278280B2 (en) | 2018-03-28 | 2022-03-22 | Cilag Gmbh International | Surgical instrument comprising a jaw closure lockout |
US11090047B2 (en) | 2018-03-28 | 2021-08-17 | Cilag Gmbh International | Surgical instrument comprising an adaptive control system |
US11197668B2 (en) | 2018-03-28 | 2021-12-14 | Cilag Gmbh International | Surgical stapling assembly comprising a lockout and an exterior access orifice to permit artificial unlocking of the lockout |
US11471156B2 (en) | 2018-03-28 | 2022-10-18 | Cilag Gmbh International | Surgical stapling devices with improved rotary driven closure systems |
US11219453B2 (en) | 2018-03-28 | 2022-01-11 | Cilag Gmbh International | Surgical stapling devices with cartridge compatible closure and firing lockout arrangements |
RU2690103C1 (en) * | 2018-04-10 | 2019-05-30 | Максим Игоревич Спицын | Tracker fixation connector for neuronavigation |
US11191594B2 (en) | 2018-05-25 | 2021-12-07 | Mako Surgical Corp. | Versatile tracking arrays for a navigation system and methods of recovering registration using the same |
EP3810015A1 (en) | 2018-06-19 | 2021-04-28 | Tornier, Inc. | Mixed-reality surgical system with physical markers for registration of virtual models |
US11510737B2 (en) | 2018-06-21 | 2022-11-29 | Mako Surgical Corp. | Patella tracking |
US11051829B2 (en) | 2018-06-26 | 2021-07-06 | DePuy Synthes Products, Inc. | Customized patient-specific orthopaedic surgical instrument |
US20200015899A1 (en) | 2018-07-16 | 2020-01-16 | Ethicon Llc | Surgical visualization with proximity tracking features |
CN109146931B (en) * | 2018-11-12 | 2021-11-02 | 深圳安科高技术股份有限公司 | Three-dimensional image processing method, system, device and storage medium |
US11291445B2 (en) | 2019-02-19 | 2022-04-05 | Cilag Gmbh International | Surgical staple cartridges with integral authentication keys |
US11357503B2 (en) | 2019-02-19 | 2022-06-14 | Cilag Gmbh International | Staple cartridge retainers with frangible retention features and methods of using same |
US11751872B2 (en) | 2019-02-19 | 2023-09-12 | Cilag Gmbh International | Insertable deactivator element for surgical stapler lockouts |
US11317915B2 (en) | 2019-02-19 | 2022-05-03 | Cilag Gmbh International | Universal cartridge based key feature that unlocks multiple lockout arrangements in different surgical staplers |
US11369377B2 (en) | 2019-02-19 | 2022-06-28 | Cilag Gmbh International | Surgical stapling assembly with cartridge based retainer configured to unlock a firing lockout |
EP3952774A1 (en) | 2019-04-12 | 2022-02-16 | Mako Surgical Corporation | Robotic systems and methods for manipulating a cutting guide for a surgical instrument |
USD952144S1 (en) | 2019-06-25 | 2022-05-17 | Cilag Gmbh International | Surgical staple cartridge retainer with firing system authentication key |
USD964564S1 (en) | 2019-06-25 | 2022-09-20 | Cilag Gmbh International | Surgical staple cartridge retainer with a closure system authentication key |
USD950728S1 (en) | 2019-06-25 | 2022-05-03 | Cilag Gmbh International | Surgical staple cartridge |
CN110236640B (en) * | 2019-07-04 | 2020-07-03 | 北京大学人民医院(北京大学第二临床医学院) | Intelligent bone cutting navigation device for orthopedics department and use method thereof |
US20210145458A1 (en) * | 2019-11-19 | 2021-05-20 | Thomas Paszicsnyek | Three-dimensional orientation system and method for orthopedic surgery |
US11776144B2 (en) | 2019-12-30 | 2023-10-03 | Cilag Gmbh International | System and method for determining, adjusting, and managing resection margin about a subject tissue |
US11759283B2 (en) | 2019-12-30 | 2023-09-19 | Cilag Gmbh International | Surgical systems for generating three dimensional constructs of anatomical organs and coupling identified anatomical structures thereto |
US11832996B2 (en) | 2019-12-30 | 2023-12-05 | Cilag Gmbh International | Analyzing surgical trends by a surgical system |
US11896442B2 (en) | 2019-12-30 | 2024-02-13 | Cilag Gmbh International | Surgical systems for proposing and corroborating organ portion removals |
US11648060B2 (en) | 2019-12-30 | 2023-05-16 | Cilag Gmbh International | Surgical system for overlaying surgical instrument data onto a virtual three dimensional construct of an organ |
US11284963B2 (en) | 2019-12-30 | 2022-03-29 | Cilag Gmbh International | Method of using imaging devices in surgery |
US11219501B2 (en) | 2019-12-30 | 2022-01-11 | Cilag Gmbh International | Visualization systems using structured light |
US11744667B2 (en) | 2019-12-30 | 2023-09-05 | Cilag Gmbh International | Adaptive visualization by a surgical system |
US11523820B2 (en) | 2020-01-29 | 2022-12-13 | DePuy Synthes Products, Inc. | Shape memory implants and a method and apparatus for the loading and implanting thereof |
USD995790S1 (en) | 2020-03-30 | 2023-08-15 | Depuy Ireland Unlimited Company | Robotic surgical tool |
EP4140435A1 (en) * | 2021-08-23 | 2023-03-01 | Ostesys | Navigation system for guiding an osteotomy procedure |
Family Cites Families (193)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US100602A (en) * | 1870-03-08 | Improvement in wrenches | ||
US4323080A (en) * | 1980-06-23 | 1982-04-06 | Melhart Albert H | Ankle stress machine |
US4567885A (en) * | 1981-11-03 | 1986-02-04 | Androphy Gary W | Triplanar knee resection system |
US4646729A (en) * | 1982-02-18 | 1987-03-03 | Howmedica, Inc. | Prosthetic knee implantation |
DE3213434C1 (en) * | 1982-04-10 | 1983-10-27 | Günther Dr.med. 7400 Tübingen Aldinger | Process for the production of individually designed endoprostheses or implants |
US4436684A (en) * | 1982-06-03 | 1984-03-13 | Contour Med Partners, Ltd. | Method of forming implantable prostheses for reconstructive surgery |
US4567886A (en) * | 1983-01-06 | 1986-02-04 | Petersen Thomas D | Flexion spacer guide for fitting a knee prosthesis |
US4566448A (en) * | 1983-03-07 | 1986-01-28 | Rohr Jr William L | Ligament tensor and distal femoral resector guide |
US4565192A (en) * | 1984-04-12 | 1986-01-21 | Shapiro James A | Device for cutting a patella and method therefor |
US4574794A (en) * | 1984-06-01 | 1986-03-11 | Queen's University At Kingston | Orthopaedic bone cutting jig and alignment device |
US4583554A (en) * | 1984-06-12 | 1986-04-22 | Medpar Ii | Knee ligament testing device |
US4802468A (en) * | 1984-09-24 | 1989-02-07 | Powlan Roy Y | Device for cutting threads in the walls of the acetabular cavity in humans |
CH671873A5 (en) * | 1985-10-03 | 1989-10-13 | Synthes Ag | |
DE3538654A1 (en) * | 1985-10-28 | 1987-04-30 | Mecron Med Prod Gmbh | DRILLING SYSTEM CONTAINING A DRILL GUIDE FOR THE INSERTION OF AN ENDOPROTHESIS AND RELATED PROSTHESIS |
US4722056A (en) * | 1986-02-18 | 1988-01-26 | Trustees Of Dartmouth College | Reference display systems for superimposing a tomagraphic image onto the focal plane of an operating microscope |
US4822365A (en) * | 1986-05-30 | 1989-04-18 | Walker Peter S | Method of design of human joint prosthesis |
US4936862A (en) * | 1986-05-30 | 1990-06-26 | Walker Peter S | Method of designing and manufacturing a human joint prosthesis |
US4815899A (en) * | 1986-11-28 | 1989-03-28 | No-Ma Engineering Incorporated | Tool holder and gun drill or reamer |
US4718413A (en) * | 1986-12-24 | 1988-01-12 | Orthomet, Inc. | Bone cutting guide and methods for using same |
US4841975A (en) * | 1987-04-15 | 1989-06-27 | Cemax, Inc. | Preoperative planning of bone cuts and joint replacement using radiant energy scan imaging |
US4991579A (en) * | 1987-11-10 | 1991-02-12 | Allen George S | Method and apparatus for providing related images over time of a portion of the anatomy using fiducial implants |
IL84752A (en) * | 1987-12-08 | 1991-11-21 | Elscint Ltd | Anatomical models and methods for manufacturing such models |
US5251127A (en) * | 1988-02-01 | 1993-10-05 | Faro Medical Technologies Inc. | Computer-aided surgery apparatus |
US5484437A (en) * | 1988-06-13 | 1996-01-16 | Michelson; Gary K. | Apparatus and method of inserting spinal implants |
US4892093A (en) * | 1988-10-28 | 1990-01-09 | Osteonics Corp. | Femoral cutting guide |
US5002545A (en) * | 1989-01-30 | 1991-03-26 | Dow Corning Wright Corporation | Tibial surface shaping guide for knee implants |
US4952213A (en) | 1989-02-03 | 1990-08-28 | Boehringer Mannheim Corporation | Tibial cutting guide |
US5098426A (en) * | 1989-02-06 | 1992-03-24 | Phoenix Laser Systems, Inc. | Method and apparatus for precision laser surgery |
US5078719A (en) * | 1990-01-08 | 1992-01-07 | Schreiber Saul N | Osteotomy device and method therefor |
US5171244A (en) * | 1990-01-08 | 1992-12-15 | Caspari Richard B | Methods and apparatus for arthroscopic prosthetic knee replacement |
US5129908A (en) * | 1990-01-23 | 1992-07-14 | Petersen Thomas D | Method and instruments for resection of the patella |
US5098383A (en) * | 1990-02-08 | 1992-03-24 | Artifax Ltd. | Device for orienting appliances, prostheses, and instrumentation in medical procedures and methods of making same |
US5200316A (en) * | 1990-02-15 | 1993-04-06 | Miles Inc. | Immunoassay methods using noncross reactive cea gene family members antibodies |
US5002578A (en) * | 1990-05-04 | 1991-03-26 | Venus Corporation | Modular hip stem prosthesis apparatus and method |
US5274565A (en) * | 1990-10-03 | 1993-12-28 | Board Of Regents, The University Of Texas System | Process for making custom joint replacements |
WO1992006645A1 (en) | 1990-10-19 | 1992-04-30 | St. Louis University | Surgical probe locating system for head use |
US6347240B1 (en) * | 1990-10-19 | 2002-02-12 | St. Louis University | System and method for use in displaying images of a body part |
GB9026592D0 (en) * | 1990-12-06 | 1991-01-23 | Meswania Jayantilal M | Surgical instrument |
US6675040B1 (en) * | 1991-01-28 | 2004-01-06 | Sherwood Services Ag | Optical object tracking system |
US5662111A (en) * | 1991-01-28 | 1997-09-02 | Cosman; Eric R. | Process of stereotactic optical navigation |
US5092869A (en) * | 1991-03-01 | 1992-03-03 | Biomet, Inc. | Oscillating surgical saw guide pins and instrumentation system |
GB9114603D0 (en) * | 1991-07-05 | 1991-08-21 | Johnson David P | Improvements relating to patella prostheses |
ATE167995T1 (en) * | 1992-02-20 | 1998-07-15 | Synvasive Technology Inc | SURGICAL CUTTING BLOCK |
US5289826A (en) * | 1992-03-05 | 1994-03-01 | N. K. Biotechnical Engineering Co. | Tension sensor |
US5603318A (en) * | 1992-04-21 | 1997-02-18 | University Of Utah Research Foundation | Apparatus and method for photogrammetric surgical localization |
US5389101A (en) * | 1992-04-21 | 1995-02-14 | University Of Utah | Apparatus and method for photogrammetric surgical localization |
DE4213599A1 (en) * | 1992-04-24 | 1993-10-28 | Klaus Draenert | Prosthetic component and process for its manufacture |
US5190547A (en) | 1992-05-15 | 1993-03-02 | Midas Rex Pneumatic Tools, Inc. | Replicator for resecting bone to match a pattern |
US5379133A (en) * | 1992-06-19 | 1995-01-03 | Atl Corporation | Synthetic aperture based real time holographic imaging |
DE4225112C1 (en) | 1992-07-30 | 1993-12-09 | Bodenseewerk Geraetetech | Instrument position relative to processing object measuring apparatus - has measuring device for measuring position of instrument including inertia sensor unit |
US5370692A (en) * | 1992-08-14 | 1994-12-06 | Guild Associates, Inc. | Rapid, customized bone prosthesis |
US5517990A (en) * | 1992-11-30 | 1996-05-21 | The Cleveland Clinic Foundation | Stereotaxy wand and tool guide |
US5961555A (en) * | 1998-03-17 | 1999-10-05 | Huebner; Randall J. | Modular shoulder prosthesis |
DE4304571A1 (en) * | 1993-02-16 | 1994-08-18 | Mdc Med Diagnostic Computing | Procedures for planning and controlling a surgical procedure |
EP0699050B1 (en) | 1993-04-26 | 2004-03-03 | St. Louis University | Indicating the position of a probe |
US5961456A (en) * | 1993-05-12 | 1999-10-05 | Gildenberg; Philip L. | System and method for displaying concurrent video and reconstructed surgical views |
CA2126627C (en) * | 1993-07-06 | 2005-01-25 | Kim C. Bertin | Femoral milling instrumentation for use in total knee arthroplasty with optional cutting guide attachment |
AU684546B2 (en) * | 1993-09-10 | 1997-12-18 | University Of Queensland, The | Stereolithographic anatomical modelling process |
US5720752A (en) * | 1993-11-08 | 1998-02-24 | Smith & Nephew, Inc. | Distal femoral cutting guide apparatus with anterior or posterior referencing for use in knee joint replacement surgery |
US5417694A (en) * | 1993-11-08 | 1995-05-23 | Smith & Nephew Richards Inc. | Distal femoral cutting guide apparatus with anterior or posterior referencing for use in knee joint replacement surgery |
US5491510A (en) * | 1993-12-03 | 1996-02-13 | Texas Instruments Incorporated | System and method for simultaneously viewing a scene and an obscured object |
US5486178A (en) * | 1994-02-16 | 1996-01-23 | Hodge; W. Andrew | Femoral preparation instrumentation system and method |
BE1008128A3 (en) * | 1994-03-10 | 1996-01-23 | Materialise Nv | Method for supporting an object manufactured by stereo lithography or any rapid prototype manufacturing and method for manufacturing the taking used steunkonstruktie. |
GB9405299D0 (en) * | 1994-03-17 | 1994-04-27 | Roke Manor Research | Improvements in or relating to video-based systems for computer assisted surgery and localisation |
BE1008372A3 (en) * | 1994-04-19 | 1996-04-02 | Materialise Nv | METHOD FOR MANUFACTURING A perfected MEDICAL MODEL BASED ON DIGITAL IMAGE INFORMATION OF A BODY. |
US5598269A (en) * | 1994-05-12 | 1997-01-28 | Children's Hospital Medical Center | Laser guided alignment apparatus for medical procedures |
US5597379A (en) * | 1994-09-02 | 1997-01-28 | Hudson Surgical Design, Inc. | Method and apparatus for femoral resection alignment |
US6695848B2 (en) * | 1994-09-02 | 2004-02-24 | Hudson Surgical Design, Inc. | Methods for femoral and tibial resection |
US5755803A (en) * | 1994-09-02 | 1998-05-26 | Hudson Surgical Design | Prosthetic implant |
DE4432891C2 (en) | 1994-09-15 | 2003-11-06 | Brainlab Ag | Device and mask part set for non-invasive stereotactic immobilization in a reproducible position |
DE4434519A1 (en) | 1994-09-27 | 1996-03-28 | Brainlab Med Computersyst Gmbh | Fixing pin for fixing reference system in bone structure, esp. for head ring for neurosurgery |
DE4434539C2 (en) * | 1994-09-27 | 1998-06-04 | Luis Dr Med Schuster | Process for the production of an endoprosthesis as a joint replacement for knee joints |
DE69532829T2 (en) | 1994-10-07 | 2005-01-27 | St. Louis University | DEVICE FOR USE WITH A SURGICAL NAVIGATION SYSTEM |
ES2135635T3 (en) * | 1994-10-14 | 1999-11-01 | Synthes Ag | FIXING AND / OR LONGITUDINAL ALIGNMENT APPARATUS FOR OSTEOSYNTHESIS. |
US5613969A (en) * | 1995-02-07 | 1997-03-25 | Jenkins, Jr.; Joseph R. | Tibial osteotomy system |
DE19506197A1 (en) * | 1995-02-23 | 1996-09-05 | Aesculap Ag | Method and device for determining the location of a body part |
US6077270A (en) * | 1995-05-31 | 2000-06-20 | Katz; Lawrence | Method and apparatus for locating bone cuts at the distal condylar femur region to receive a femoral prothesis and to coordinate tibial and patellar resection and replacement with femoral resection and replacement |
US5733292A (en) * | 1995-09-15 | 1998-03-31 | Midwest Orthopaedic Research Foundation | Arthroplasty trial prosthesis alignment devices and associated methods |
IT1278856B1 (en) * | 1995-09-19 | 1997-11-28 | Orthofix Srl | ACCESSORY FOR EXTERNAL FIXER |
US5709689A (en) * | 1995-09-25 | 1998-01-20 | Wright Medical Technology, Inc. | Distal femur multiple resection guide |
US6351659B1 (en) * | 1995-09-28 | 2002-02-26 | Brainlab Med. Computersysteme Gmbh | Neuro-navigation system |
US5769861A (en) * | 1995-09-28 | 1998-06-23 | Brainlab Med. Computersysteme Gmbh | Method and devices for localizing an instrument |
US5772594A (en) * | 1995-10-17 | 1998-06-30 | Barrick; Earl F. | Fluoroscopic image guided orthopaedic surgery system with intraoperative registration |
US5716361A (en) * | 1995-11-02 | 1998-02-10 | Masini; Michael A. | Bone cutting guides for use in the implantation of prosthetic joint components |
US5704941A (en) * | 1995-11-03 | 1998-01-06 | Osteonics Corp. | Tibial preparation apparatus and method |
US5682886A (en) | 1995-12-26 | 1997-11-04 | Musculographics Inc | Computer-assisted surgical system |
US5676668A (en) * | 1996-02-20 | 1997-10-14 | Johnson & Johnson Professional, Inc. | Femoral locating device assembly |
US5722978A (en) * | 1996-03-13 | 1998-03-03 | Jenkins, Jr.; Joseph Robert | Osteotomy system |
US5799055A (en) | 1996-05-15 | 1998-08-25 | Northwestern University | Apparatus and method for planning a stereotactic surgical procedure using coordinated fluoroscopy |
US5779710A (en) * | 1996-06-21 | 1998-07-14 | Matsen, Iii; Frederick A. | Joint replacement method and apparatus |
US6167296A (en) * | 1996-06-28 | 2000-12-26 | The Board Of Trustees Of The Leland Stanford Junior University | Method for volumetric image navigation |
US5824085A (en) * | 1996-09-30 | 1998-10-20 | Integrated Surgical Systems, Inc. | System and method for cavity generation for surgical planning and initial placement of a bone prosthesis |
US5762125A (en) * | 1996-09-30 | 1998-06-09 | Johnson & Johnson Professional, Inc. | Custom bioimplantable article |
US5987189A (en) * | 1996-12-20 | 1999-11-16 | Wyko Corporation | Method of combining multiple sets of overlapping surface-profile interferometric data to produce a continuous composite map |
CA2225375A1 (en) * | 1996-12-23 | 1998-06-23 | Mark Manasas | Alignment guide for insertion of fluted or keyed orthopedic components |
US8480754B2 (en) * | 2001-05-25 | 2013-07-09 | Conformis, Inc. | Patient-adapted and improved articular implants, designs and related guide tools |
US8083745B2 (en) * | 2001-05-25 | 2011-12-27 | Conformis, Inc. | Surgical tools for arthroplasty |
US8545569B2 (en) * | 2001-05-25 | 2013-10-01 | Conformis, Inc. | Patient selectable knee arthroplasty devices |
US7618451B2 (en) * | 2001-05-25 | 2009-11-17 | Conformis, Inc. | Patient selectable joint arthroplasty devices and surgical tools facilitating increased accuracy, speed and simplicity in performing total and partial joint arthroplasty |
US7534263B2 (en) * | 2001-05-25 | 2009-05-19 | Conformis, Inc. | Surgical tools facilitating increased accuracy, speed and simplicity in performing joint arthroplasty |
US7468075B2 (en) * | 2001-05-25 | 2008-12-23 | Conformis, Inc. | Methods and compositions for articular repair |
US6083163A (en) * | 1997-01-21 | 2000-07-04 | Computer Aided Surgery, Inc. | Surgical navigation system and method using audio feedback |
US6205411B1 (en) * | 1997-02-21 | 2001-03-20 | Carnegie Mellon University | Computer-assisted surgery planner and intra-operative guidance system |
US5880976A (en) | 1997-02-21 | 1999-03-09 | Carnegie Mellon University | Apparatus and method for facilitating the implantation of artificial components in joints |
DE29704393U1 (en) * | 1997-03-11 | 1997-07-17 | Aesculap Ag | Device for preoperative determination of the position data of endoprosthesis parts |
US6041249A (en) * | 1997-03-13 | 2000-03-21 | Siemens Aktiengesellschaft | Device for making a guide path for an instrument on a patient |
US6026315A (en) * | 1997-03-27 | 2000-02-15 | Siemens Aktiengesellschaft | Method and apparatus for calibrating a navigation system in relation to image data of a magnetic resonance apparatus |
US6821123B2 (en) * | 1997-04-10 | 2004-11-23 | Nobel Biocare Ab | Arrangement and system for production of dental products and transmission of information |
US6016606A (en) * | 1997-04-25 | 2000-01-25 | Navitrak International Corporation | Navigation device having a viewer for superimposing bearing, GPS position and indexed map information |
US5865809A (en) * | 1997-04-29 | 1999-02-02 | Stephen P. Moenning | Apparatus and method for securing a cannula of a trocar assembly to a body of a patient |
DE19718686A1 (en) * | 1997-05-02 | 1998-11-05 | Laser Applikationan Gmbh | Target device for the straight insertion of an instrument into a human body |
US6021342A (en) * | 1997-06-30 | 2000-02-01 | Neorad A/S | Apparatus for assisting percutaneous computed tomography-guided surgical activity |
SG71035A1 (en) | 1997-08-01 | 2000-03-21 | Bitwave Pte Ltd | Acoustic echo canceller |
US6226548B1 (en) | 1997-09-24 | 2001-05-01 | Surgical Navigation Technologies, Inc. | Percutaneous registration apparatus and method for use in computer-assisted surgical navigation |
US6021343A (en) * | 1997-11-20 | 2000-02-01 | Surgical Navigation Technologies | Image guided awl/tap/screwdriver |
US6011987A (en) * | 1997-12-08 | 2000-01-04 | The Cleveland Clinic Foundation | Fiducial positioning cup |
US6022377A (en) * | 1998-01-20 | 2000-02-08 | Sulzer Orthopedics Inc. | Instrument for evaluating balance of knee joint |
US6503249B1 (en) * | 1998-01-27 | 2003-01-07 | William R. Krause | Targeting device for an implant |
US6258095B1 (en) * | 1998-03-28 | 2001-07-10 | Stryker Technologies Corporation | Methods and tools for femoral intermedullary revision surgery |
AU3924599A (en) | 1998-05-28 | 1999-12-13 | Orthosoft, Inc. | Interactive computer-assisted surgical system and method thereof |
ATE389364T1 (en) * | 1998-06-22 | 2008-04-15 | Ao Technology Ag | FIDUCIAL MATCHING USING FIDUCIAL SCREW |
US7239908B1 (en) * | 1998-09-14 | 2007-07-03 | The Board Of Trustees Of The Leland Stanford Junior University | Assessing the condition of a joint and devising treatment |
US6010506A (en) * | 1998-09-14 | 2000-01-04 | Smith & Nephew, Inc. | Intramedullary nail hybrid bow |
DE69922317D1 (en) * | 1998-09-29 | 2005-01-05 | Koninkl Philips Electronics Nv | Image processing method for ultrasonic medical images of the bone structure, and a computer-aided surgery device |
US6030391A (en) * | 1998-10-26 | 2000-02-29 | Micropure Medical, Inc. | Alignment gauge for metatarsophalangeal fusion surgery |
JP3974717B2 (en) * | 1998-10-27 | 2007-09-12 | 富士通株式会社 | Setting contents variable type telephone |
US6033410A (en) * | 1999-01-04 | 2000-03-07 | Bristol-Myers Squibb Company | Orthopaedic instrumentation |
US6285902B1 (en) * | 1999-02-10 | 2001-09-04 | Surgical Insights, Inc. | Computer assisted targeting device for use in orthopaedic surgery |
US6332891B1 (en) * | 1999-02-16 | 2001-12-25 | Stryker Corporation | System and method for performing image guided surgery |
US6692447B1 (en) * | 1999-02-16 | 2004-02-17 | Frederic Picard | Optimizing alignment of an appendicular |
US6558421B1 (en) * | 2000-09-19 | 2003-05-06 | Barry M. Fell | Surgically implantable knee prosthesis |
US6296645B1 (en) * | 1999-04-09 | 2001-10-02 | Depuy Orthopaedics, Inc. | Intramedullary nail with non-metal spacers |
DE19917867B4 (en) * | 1999-04-20 | 2005-04-21 | Brainlab Ag | Method and device for image support in the treatment of treatment objectives with integration of X-ray detection and navigation system |
US6190395B1 (en) * | 1999-04-22 | 2001-02-20 | Surgical Navigation Technologies, Inc. | Image guided universal instrument adapter and method for use with computer-assisted image guided surgery |
US6200316B1 (en) | 1999-05-07 | 2001-03-13 | Paul A. Zwirkoski | Intramedullary nail distal targeting device |
DE19922279A1 (en) * | 1999-05-11 | 2000-11-16 | Friedrich Schiller Uni Jena Bu | Procedure for generating patient-specific implants |
US6139544A (en) * | 1999-05-26 | 2000-10-31 | Endocare, Inc. | Computer guided cryosurgery |
US6195168B1 (en) * | 1999-07-22 | 2001-02-27 | Zygo Corporation | Infrared scanning interferometry apparatus and method |
US6235038B1 (en) | 1999-10-28 | 2001-05-22 | Medtronic Surgical Navigation Technologies | System for translation of electromagnetic and optical localization systems |
AU1122401A (en) * | 1999-11-01 | 2001-05-14 | Arthrovision, Inc. | Evaluating disease progression using magnetic resonance imaging |
US6344853B1 (en) | 2000-01-06 | 2002-02-05 | Alcone Marketing Group | Method and apparatus for selecting, modifying and superimposing one image on another |
US6702821B2 (en) * | 2000-01-14 | 2004-03-09 | The Bonutti 2003 Trust A | Instrumentation for minimally invasive joint replacement and methods for using same |
US6264647B1 (en) * | 2000-03-02 | 2001-07-24 | Precifar S.A. | Instrument holder for surgical instrument |
US6626945B2 (en) * | 2000-03-14 | 2003-09-30 | Chondrosite, Llc | Cartilage repair plug |
EP1142536B1 (en) * | 2000-04-05 | 2002-07-31 | BrainLAB AG | Patient referencing in a medical navigation system using projected light points |
EP1312025A2 (en) * | 2000-04-05 | 2003-05-21 | Therics, Inc. | System and method for rapidly customizing a design and remotely manufacturing biomedical devices using a computer system |
US6679917B2 (en) * | 2000-05-01 | 2004-01-20 | Arthrosurface, Incorporated | System and method for joint resurface repair |
EP2314257B9 (en) * | 2000-05-01 | 2013-02-27 | ArthroSurface, Inc. | System for joint resurface repair |
DE50008366D1 (en) | 2000-05-31 | 2004-11-25 | Stratec Medical Ag Oberdorf | DEVICE FOR POSITIONING A SURGICAL INSTRUMENT |
US6478287B2 (en) * | 2000-06-02 | 2002-11-12 | U.S. Fence, Llc | Plastic fence panel |
DE10031887B4 (en) | 2000-06-30 | 2008-02-07 | Stryker Leibinger Gmbh & Co. Kg | System for implantation of knee joint prostheses |
DE10033723C1 (en) * | 2000-07-12 | 2002-02-21 | Siemens Ag | Surgical instrument position and orientation visualization device for surgical operation has data representing instrument position and orientation projected onto surface of patient's body |
WO2002010440A1 (en) * | 2000-08-01 | 2002-02-07 | Pola Chemical Industries Inc. | Method of evaluating antifungal agent |
EP1190675B1 (en) * | 2000-09-26 | 2004-04-28 | BrainLAB AG | System for navigation-assisted orientation of elements on a body |
US6510334B1 (en) * | 2000-11-14 | 2003-01-21 | Luis Schuster | Method of producing an endoprosthesis as a joint substitute for a knee joint |
US6786930B2 (en) * | 2000-12-04 | 2004-09-07 | Spineco, Inc. | Molded surgical implant and method |
US6558391B2 (en) * | 2000-12-23 | 2003-05-06 | Stryker Technologies Corporation | Methods and tools for femoral resection in primary knee surgery |
US6685711B2 (en) * | 2001-02-28 | 2004-02-03 | Howmedica Osteonics Corp. | Apparatus used in performing femoral and tibial resection in knee surgery |
EP1389980B1 (en) * | 2001-05-25 | 2011-04-06 | Conformis, Inc. | Methods and compositions for articular resurfacing |
US20030006107A1 (en) * | 2001-06-25 | 2003-01-09 | Ming-Ta Tsai | Disk for use with a brake system |
FR2826254B1 (en) * | 2001-06-25 | 2004-06-18 | Aesculap Sa | DEVICE FOR POSITIONING A CUTTING PLAN OF A BONE CUTTING GUIDE |
DE60129774T2 (en) * | 2001-08-11 | 2007-12-06 | Agilent Technologies, Inc. (n.d.Ges.d. Staates Delaware), Santa Clara | Measuring device with imaging unit |
US6858032B2 (en) * | 2001-08-23 | 2005-02-22 | Midwest Orthopaedic Research Foundation | Rotating track cutting guide system |
AU2002361621A1 (en) * | 2001-11-14 | 2003-05-26 | Michael R. White | Apparatus and methods for making intraoperative orthopedic measurements |
US6712823B2 (en) * | 2001-12-14 | 2004-03-30 | Wright Medical Technology Inc. | Humeral head resection guide |
US20030153978A1 (en) * | 2002-02-08 | 2003-08-14 | Whiteside Biomechanics, Inc. | Apparatus and method of ligament balancing and component fit check in total knee arthroplasty |
US6711431B2 (en) * | 2002-02-13 | 2004-03-23 | Kinamed, Inc. | Non-imaging, computer assisted navigation system for hip replacement surgery |
FR2836372B1 (en) * | 2002-02-28 | 2004-06-04 | Obl | METHOD AND DEVICE FOR PLACING DENTAL IMPLANTS |
EP1487385A2 (en) * | 2002-03-19 | 2004-12-22 | The Board of Trustees for the University of Illinois | System and method for prosthetic fitting and balancing in joints |
AU2003224997A1 (en) * | 2002-04-16 | 2003-11-03 | Michael Conditt | Computer-based training methods for surgical procedures |
US6993374B2 (en) * | 2002-04-17 | 2006-01-31 | Ricardo Sasso | Instrumentation and method for mounting a surgical navigation reference device to a patient |
US8257360B2 (en) * | 2002-04-30 | 2012-09-04 | Orthosoft Inc. | Determining femoral cuts in knee surgery |
US8801720B2 (en) * | 2002-05-15 | 2014-08-12 | Otismed Corporation | Total joint arthroplasty system |
US20040030237A1 (en) * | 2002-07-29 | 2004-02-12 | Lee David M. | Fiducial marker devices and methods |
US7166114B2 (en) * | 2002-09-18 | 2007-01-23 | Stryker Leibinger Gmbh & Co Kg | Method and system for calibrating a surgical tool and adapter thereof |
GB2393625C (en) * | 2002-09-26 | 2004-08-18 | Meridian Tech Ltd | Orthopaedic surgery planning |
EP1545368B1 (en) * | 2002-10-04 | 2009-03-11 | Orthosoft Inc. | Computer-assisted hip replacement surgery |
EP1555962B1 (en) * | 2002-10-07 | 2011-02-09 | Conformis, Inc. | Minimally invasive joint implant with 3-dimensional geometry matching the articular surfaces |
AU2003290757A1 (en) * | 2002-11-07 | 2004-06-03 | Conformis, Inc. | Methods for determing meniscal size and shape and for devising treatment |
EP1567985B1 (en) * | 2002-12-04 | 2019-04-24 | ConforMIS, Inc. | Fusion of multiple imaging planes for isotropic imaging in mri and quantitative image analysis using isotropic or near-isotropic imaging |
US20050021037A1 (en) * | 2003-05-29 | 2005-01-27 | Mccombs Daniel L. | Image-guided navigated precision reamers |
US6944518B2 (en) * | 2003-09-18 | 2005-09-13 | Depuy Products, Inc. | Customized prosthesis and method of designing and manufacturing a customized prosthesis by utilizing computed tomography data |
US8752271B2 (en) * | 2004-07-30 | 2014-06-17 | Acushnet Company | Golf club groove configuration |
EP1703867B1 (en) * | 2004-01-12 | 2012-03-07 | Depuy Products, Inc. | Systems for compartmental replacement in a knee |
US7383164B2 (en) * | 2004-03-05 | 2008-06-03 | Depuy Products, Inc. | System and method for designing a physiometric implant system |
EP1981409B1 (en) * | 2006-02-06 | 2017-01-11 | ConforMIS, Inc. | Patient selectable joint arthroplasty devices and surgical tools |
JP2009529954A (en) * | 2006-03-14 | 2009-08-27 | マコ サージカル コーポレーション | Prosthetic device and system and method for implanting a prosthetic device |
US8337508B2 (en) * | 2006-03-20 | 2012-12-25 | Perception Raisonnement Action En Medecine | Distractor system |
US20070233267A1 (en) * | 2006-03-29 | 2007-10-04 | Farid Amirouche | Application of neural networks to prosthesis fitting and balancing in joints |
US8831302B2 (en) * | 2007-08-17 | 2014-09-09 | Mohamed Rashwan Mahfouz | Implant design analysis suite |
US20090264895A1 (en) * | 2008-04-22 | 2009-10-22 | Warsaw Orthopedic, Inc. | Systems and methods for implanting a bone fastener and delivering a bone filling material |
US8808394B2 (en) * | 2008-06-10 | 2014-08-19 | Alps South, LLC | Prosthetic liner with perspiration elimination mechanism |
US8078440B2 (en) * | 2008-09-19 | 2011-12-13 | Smith & Nephew, Inc. | Operatively tuning implants for increased performance |
-
2002
- 2002-02-27 WO PCT/US2002/005783 patent/WO2002067800A2/en not_active Application Discontinuation
- 2002-02-27 AU AU2002247227A patent/AU2002247227A1/en not_active Abandoned
- 2002-02-27 JP JP2002567158A patent/JP4219170B2/en not_active Expired - Fee Related
- 2002-02-27 US US10/084,278 patent/US6827723B2/en not_active Expired - Lifetime
- 2002-02-27 WO PCT/US2002/005956 patent/WO2002067784A2/en active Application Filing
- 2002-02-27 EP EP02721167A patent/EP1379188A2/en not_active Withdrawn
- 2002-02-27 DE DE60232315T patent/DE60232315D1/en not_active Expired - Lifetime
- 2002-02-27 AU AU2002254047A patent/AU2002254047B2/en not_active Ceased
- 2002-02-27 AT AT02723254T patent/ATE431111T1/en not_active IP Right Cessation
- 2002-02-27 CA CA2439249A patent/CA2439249C/en not_active Expired - Fee Related
- 2002-02-27 DE DE60232316T patent/DE60232316D1/en not_active Expired - Lifetime
- 2002-02-27 EP EP02715006A patent/EP1372516B1/en not_active Expired - Lifetime
- 2002-02-27 WO PCT/US2002/005955 patent/WO2002067783A2/en active Application Filing
- 2002-02-27 AT AT02715006T patent/ATE431110T1/en not_active IP Right Cessation
- 2002-02-27 US US10/084,291 patent/US20020198451A1/en not_active Abandoned
- 2002-02-27 JP JP2002567159A patent/JP4113779B2/en not_active Expired - Fee Related
- 2002-02-27 KR KR10-2003-7011283A patent/KR20030082942A/en not_active Application Discontinuation
- 2002-02-27 EP EP02723254A patent/EP1372517B1/en not_active Expired - Lifetime
- 2002-02-27 US US10/084,012 patent/US6923817B2/en not_active Expired - Lifetime
-
2005
- 2005-04-04 US US11/098,209 patent/US20050234468A1/en not_active Abandoned
-
2010
- 2010-10-05 US US12/898,318 patent/US20110071531A1/en not_active Abandoned
- 2010-10-05 US US12/898,193 patent/US20110071528A1/en not_active Abandoned
- 2010-10-05 US US12/898,215 patent/US20110071529A1/en not_active Abandoned
- 2010-10-05 US US12/898,298 patent/US20110071530A1/en not_active Abandoned
- 2010-10-05 US US12/898,365 patent/US20110071532A1/en not_active Abandoned
-
2012
- 2012-05-14 US US13/470,765 patent/US20120226481A1/en not_active Abandoned
- 2012-05-14 US US13/470,688 patent/US20120226198A1/en not_active Abandoned
Also Published As
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CA2439249C (en) | Total knee arthroplasty systems | |
CA2496054C (en) | Computer assisted knee arthroplasty instrumentation, system, and process | |
US20070123912A1 (en) | Surgical navigation systems and processes for unicompartmental knee arthroplasty | |
AU2002254047A1 (en) | Total knee arthroplasty systems and processes | |
WO2005104978A1 (en) | Computer-aided methods, systems, and apparatuses for shoulder arthroplasty |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
EEER | Examination request | ||
MKLA | Lapsed |
Effective date: 20150227 |