WO2004001569B1 - Computer assisted system and method for minimal invasive hip, uni knee and total knee replacement - Google Patents

Computer assisted system and method for minimal invasive hip, uni knee and total knee replacement

Info

Publication number
WO2004001569B1
WO2004001569B1 PCT/CA2003/000947 CA0300947W WO2004001569B1 WO 2004001569 B1 WO2004001569 B1 WO 2004001569B1 CA 0300947 W CA0300947 W CA 0300947W WO 2004001569 B1 WO2004001569 B1 WO 2004001569B1
Authority
WO
WIPO (PCT)
Prior art keywords
joint
placement
instrument
user
components
Prior art date
Application number
PCT/CA2003/000947
Other languages
French (fr)
Other versions
WO2004001569A2 (en
WO2004001569A3 (en
Inventor
Marwan Sati
Haniel Croitoru
Peter Tate
Liqun Fu
Original Assignee
Cedara Software Corp
Marwan Sati
Haniel Croitoru
Peter Tate
Liqun Fu
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Cedara Software Corp, Marwan Sati, Haniel Croitoru, Peter Tate, Liqun Fu filed Critical Cedara Software Corp
Priority to AU2003245758A priority Critical patent/AU2003245758A1/en
Priority to EP03737793A priority patent/EP1550024A2/en
Publication of WO2004001569A2 publication Critical patent/WO2004001569A2/en
Publication of WO2004001569A3 publication Critical patent/WO2004001569A3/en
Publication of WO2004001569B1 publication Critical patent/WO2004001569B1/en
Priority to US11/016,878 priority patent/US20050203384A1/en

Links

Classifications

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    • 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
    • A61F2002/4635—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using minimally invasive 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
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A61F2002/4658—Measuring instruments used for implanting artificial joints for measuring dimensions, e.g. length
    • 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
    • A61F2002/4668—Measuring instruments used for implanting artificial joints for measuring angles
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0085—Identification means; Administration of patients
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0085—Identification means; Administration of patients
    • A61F2250/0086—Identification means; Administration of patients with bar code

Abstract

As a general overview, the system (10) is used to assist the surgeon in performing an operation by acquiring and displaying an image of the patent. Subsequent movement of the patient and instruments is tracked and displayed on the image. Images of a selection of implants are stored by the system and may be called to be superimposed on the image. The surgical procedures may be planned using the images of the patient and instruments and implants and stored as a series of sequential tasks referred to defined datums, such as inclination or position. Gestures of the surgeon may be used in the planning stage to call the image of the instruments and in the procedure to increment the planned tasks.

Claims

AMENDED CLAIMS[Received by the International Bureau on 10 May 2004 (10.05.04 ): original claims 1-21 replaced by amended claims 1-47]THE EMBODIMENT OF THE INVENTION IN HICS AN EXCLUSIVE PROPERTY OR PRIVELEGE IS CLAIMED ARE DEFINED AS THE FOLLOWING:
1. A computer-implemented method for enhancing interaction between a user and a surgical computer assisted system, the method includes the steps of : recognising a placement of a tracked object with respect to a reference point; comparing the recognised obj ect placement with a plurality of predefined obj ect placements stored in a memory of the computer system, each of the predefined object placements associated with a desired action; matching the recognised object placement with the corresponding desired action by referencing the stored predefined object placements; and coordinating with the user the performance of the desired action.
2. The method of claim 1, wherein the tracked object is selected from the group comprising a surgical stroment and a hand of the user.
3. The method of claim 2, wherein the placement information of the instrument is selected from the group comprising: position)' orientation and movement as recognised by a tracking system.
4. The method of claim 2, wherein the placement of the user s hand includes orientation of the fingers of the hand as recognised by a tracking system.
5. The method of claim 4, wherein the predefined object placements are hand gestures.
6. The method of claim 5 further comprising the step of recognising the hand gestures of the hand that is tracked by the tracking system through the instrument located in the user's hand.
7. The method of claim 2 further comprising the step of providing identification of the instrument by a tracking system, said identification being recognizable by the tracking system.
8. The method of claim 7 further comprising the step of analyzing timing information related to an amount of time the instrument is held in a certain position with respect to the reference point, the amount of time associated the lack of movement is associated with the corresponding desired action,
9. The method of claim 5, wherein the associated desired action is associated with a hand gesinre of the predefined object placements.
10. The method of claim 5 wherein the hand gestures are associated with the desired actions in a workflow of the user.
11. The method of claim 2 further comprising the step of detecting from a set of desired steps of a workflow, based on the recognised object placement, that a given step of the workflow has been invoked.
12. The method of claim 11 further comprising the step of configuring a user interface to provide
25 information related to the given step for interpretation by the user.
13. The method of claim 11 wherein the user can access a selected step of the workflow in a given order,' and a user interface prompts the user to pass to a subsequent step if there is missing information.
14. The method of claim 2 further comprising the step of recognising the object selected from the group comprising an implant and the surgical instrument.
15. The method of claim 14, wherein the implant is encoded with identifying information.
16. The method of claim 15, wherein the implant has a bar code readable by a bar code reader coupled to the computer system.
17. The method according to claim 16, wherein the implant has a coded opto-reflecting bar-code information recognizable by a tracking system.
18. Themethod of claim 15 further comprising the step of registering said implant once having been detected by the computer system as a "used inventory" item.
19. The method of claim 2, wherein the desired action is related to a specific workflow task.
20 A surgical computer assisted system for enhancing interaction between a user and selected steps of a workflow, the system comprising; a tracking system for recognising a placement of a tracked object with respect to a reference point; a processor for comparing the recognised object placement with a plurality of predefined object placements stored in a memory, each of the predefined object placements associated with a desired action, and for matching the recognised object placement with the corresponding desired action by referencing the stored predefined object placements; and
a user interface for coordinating with the user the performance of the desired action.
21. A system for coordinating the placement of a plurality of interacting joint replacement components for reconstruction of a patient's joint, the system comprising:
a tracking system for recording a set of reference points coupled to the patient and for monitoring placement of an instrument relative to the joint, the reference points being located on either side of the joint for indicating a reference geometry of the joint;
a processor for coordinating the preferred placement of the components in the reconstructed joint and for coordinating the placement of the instrument, both of the placements being based on the predefined dimensions of the components and the reference geometry of the joint; and
a display for displaying a feedback indicator to a user of the system, the feedback indicator for guiding the placement of the instrument relative to the joint;
wheiein a virtual representation of the components and the instrument are configured for display on the display with representative images of the j oint
22. The system of claim 21, wherein the reference geometry provided by the reference points is selected from the group comprising a reference length and a reference angle.
23. The system of claim 22, wherein a feedback indicator is selected from the group comprising visual, auditory and other sensory indicators.
24. The system of claim 23, wherein the reference geometry is represented by the display as the feedback indicator.
25. The system of claim 22, wherein reference length is calculated as the distance between the pair of reference points.
26. The system of claim 25, wherein the preferred placement of the components is coordinated by a calculation relative to the reference length and the dimensions of the components such that the reconstructed joint length resembles the reference length,
27. The system of claim 26, wherein the reconstructed joint is selected from a group comprising a hip joint and a knee joint.
28. The system of claim 22, wherein the reference angle is calculated based on the reference points to represent the relative orientation between the patient's anatomy on either side of the joint
29. The system of claim 28, wherein said preferred placement of the components is calculated with reference to the reference angle, the reference length and the dimensions of the components such that the reconstructed joint orientation resembles the reference angle. •
30. The system of claim 28, wherein in a hip replacement surgery, the reference angle is a femoral aπteversϊon angle, measured between a plane defined by a trans-epicondylar axis and a long axis of a
27 femur and a vector of the femoral neck.
31. The system of claim 23, wherein the feedback indicator is configured to guide the user's placement of the instrument selected from the group comprising: relative to an axis related to the preferred placement of the components; and relative to the reference geometry.
32. The system of claim 31, wherein the feedback indicator is configured to inform the user if the placement of the instrument is within a specified tolerance of the axis direction or the reference geometry.
33. The system of claim 32, wherein the feedback indicator is auditory.
34. The system of claim 23 wherein the feedback indicator is configured to inform the user of potential impingement of the replacement components.
35. The system of claim 21, wherein a magnified version of the virtual representation of the instrument is displayed on the display to correspond with the planned size of the replacement component.
36. A method for coordinating the preferred placement of a plurality of interacting joint replacement components for reconstruction of a patient's joint, the method comprising the steps of:
recording a pair of reference points coupled to the patient, the reference points being located on either side of the joint for indicating a reference geometry of the joint;
determining the preferred placement of the components in the reconstructed joint and determining the placement of the instrument, both of the placements beingbased on predefined dimensions of the components and the reference geometry of the joint;
monitoring placement of an instrument relative to the joint; and
displaying a feedback indicator to a user of the system, the feedback indicator guiding the placement of the instrument relative to the joint;
wherein a virtual representation of the components and the instrument are configured for display to the user with representative images of the joint.
28
37. A computer program product for coordinating the preferred placement of a plurality of interacting joint replacement components for reconstruction of a patient's joint, the program comprising:
a computer readable medium;
a digital imaging module stored on the medium for recording a pair of reference points coupled to the patient and for monitoring placement of an instrument relative to the joint, the reference points being located on either side of the joint for indicating a reference geometry of the joint;
a processing module stored on the medium for coordinating the preferred placement of the components in the reconstructed joint and for determining the placement of the instrument, both of the placements being based on the predefined dimensions of the components and the reference geometry of the joint; and
a display module stored on the medium for displaying a feedback indicator to a user of the system, the feedback indicator for guiding the placement of the instrument relative to the joint
wherein a virtual representation of the components and the instrument are configured for display to the user with representative images of the joint.
38. A system for coordinating the preferred placement of a joint replacement component for reconstruction of a patient's joint, the system comprising:
a tracking system for recording at least three reference points of the joint and for monitoring placement of an instrument relative to the joint, the reference points for indicating a reference surface geometry of the joint, the instrument configured for removing bone material relative to the reference surface geometry;
a processor for coordinating the preferred placement of the components in the reconstructed joint and for deterπuning the placement of the instrument, both of the placements being based on the predefined dimensions of the components and the reference surface geometry of the joint; and
a display for displaying a feedback indicator to a user of the system, the feedback indicator for guiding the placement of the instrument relative to the reference surface geometry of the joint;
29 wherein a virtual representation of the component and the instrument are configured for display to the user with representative images of the joint.
39. The system of claim 38, wherein the feedback indicator is selected from the group comprising visual, auditory, tactile and other sensory indicators.
40. The system of claim 39, wherein the reference surface geometry provided by the reference points defines a surface contour.
41. The system of claim 40, wherein the surface contour is used to define a portion of the joint that is to be removed by the instalment to enable the preferred placement of the joint replacement component.
42. The system of claim 40, wherein the feedback indicator is configured to guide the user's placement of the instrument's depth relative to the surface contour.
43. The system of claim 39, wherein the feedback indicator is configured to inform the user if the depth placement of the instrument is within a specified tolerance of a pre-defined depth relative to the reference surface geometry.
44. The system of claim 43, wherein the feedback indicator is visual.
45. The system of claim 44, wherein the visual feedback indicator is a colour coded depth guide,
46. The system of claim 40, wherein the surface contour is a plane associated with an interface surface of the joint.
47. A method for determining the orientation and position of an axis defined by at least one attribute of an anatomical region relative to a reference frame, the method comprising the steps of:
(i) tracking the position and orientation of the anatomical region relative to the frame;
(ii) tracking the position and orientation of an imaging device relative to the frame;
(iii) aligning the imaging device with the axis based on the attribute;
(iv) determining the position and orientation of the aligned imaging device relative to the position and orientation of the region; and,
30 (v) deterrnining the position and orientation of the axis relative to the reference frame.
31
PCT/CA2003/000947 2002-06-21 2003-06-23 Computer assisted system and method for minimal invasive hip, uni knee and total knee replacement WO2004001569A2 (en)

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AU2003245758A AU2003245758A1 (en) 2002-06-21 2003-06-23 Computer assisted system and method for minimal invasive hip, uni knee and total knee replacement
EP03737793A EP1550024A2 (en) 2002-06-21 2003-06-23 Computer assisted system and method for minimal invasive hip, uni knee and total knee replacement
US11/016,878 US20050203384A1 (en) 2002-06-21 2004-12-21 Computer assisted system and method for minimal invasive hip, uni knee and total knee replacement

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US39018802P 2002-06-21 2002-06-21
US60/390,188 2002-06-21

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