Source: http://www.google.com/patents/US20100063509?dq=5179747
Timestamp: 2015-11-25 00:59:34
Document Index: 327936058

Matched Legal Cases: ['Application No. 61', 'Application No. 61', 'Application No. 61', 'Application No. 61', 'Application No. 61', 'Application No. 61', 'Application No. 61', 'Application No. 61', 'Application No. 61', 'Application No. 61', 'Application No. 61']

Patent US20100063509 - Systems and methods for joint replacement - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign inAdvanced Patent SearchPatentsSystems and methods for joint replacement are provided. The systems and methods include a surgical orientation device and at least one orthopedic fixture. The surgical orientation device and orthopedic fixtures can be used to locate the orientation of an axis in the body, to adjust an orientation of...http://www.google.com/patents/US20100063509?utm_source=gb-gplus-sharePatent US20100063509 - Systems and methods for joint replacementAdvanced Patent SearchPublication numberUS20100063509 A1Publication typeApplicationApplication numberUS 12/509,414Publication dateMar 11, 2010Priority dateJul 24, 2008Also published asCA2731436A1, EP2344078A1, EP2344078A4, US8911447, US8998910, US20100063508, US20100064216, US20100069911, US20100137869, US20150100058, WO2010011978A1Publication number12509414, 509414, US 2010/0063509 A1, US 2010/063509 A1, US 20100063509 A1, US 20100063509A1, US 2010063509 A1, US 2010063509A1, US-A1-20100063509, US-A1-2010063509, US2010/0063509A1, US2010/063509A1, US20100063509 A1, US20100063509A1, US2010063509 A1, US2010063509A1InventorsSantiago P. Borja, Nicholas van der WaltOriginal AssigneeOrthAlign, Inc.Export CitationBiBTeX, EndNote, RefManPatent Citations (6), Referenced by (23), Classifications (7), Legal Events (3) External Links: USPTO, USPTO Assignment, EspacenetSystems and methods for joint replacement
US 20100063509 A1Abstract
Systems and methods for joint replacement are provided. The systems and methods include a surgical orientation device and at least one orthopedic fixture. The surgical orientation device and orthopedic fixtures can be used to locate the orientation of an axis in the body, to adjust an orientation of a cutting plane or planes along a bony surface, to distract a joint, or to otherwise assist in an orthopedic procedure or procedures.
1. A method for preparing a portion of a knee for receiving a knee implant, comprising:
coupling an orthopedic fixture with a proximal feature of the patient's leg; connecting a portable surgical orientation device to an adjustment device that is connected to the orthopedic fixture and moveable relative to the leg; moving the adjustment device to move the portable surgical orientation device in response to a prompt from the portable surgical orientation device to orient the orthopedic fixture relative to a mechanical axis of the leg. 2. The method of Claim 1, wherein the orthopedic fixture includes a base and further comprising coupling the base with a proximal feature of a tibia.
3. The method of Claim 2, further comprising coupling a distal portion of the base of the orthopedic fixture with a distal feature of the tibia.
4. The method of Claim 1, wherein the orthopedic fixture further comprises a cutting guide and moving the adjustment device orients the cutting guide relative to the mechanical axis of the leg.
5. The method of Claim 4, further comprising coupling the cutting guide with the orthopedic fixture after the orthopedic fixture has been coupled with the leg.
6. The method of Claim 5, further comprising orienting the cutting guide at approximately 90 degrees relative to a mechanical axis of the leg.
7. The method of Claim 4, further comprising securing the cutting guide to the tibia and resecting the proximal tibia along the cutting guide to define a tibial plateau.
8. The method of Claim 1, further comprising coupling a cutting guide to the adjustment device and moving the cutting guide with the adjustment device in response to the prompt from the surgical orientation device.
9. The method of Claim 1, wherein the method further comprises referencing a distal portion of the tibia to orient the orthopedic fixture.
10. The method of Claim 1, further comprising aligning the orthopedic fixture with one or more anatomical landmarks such that the portable surgical orientation device is aligned with a saggital plane of the tibia.
11. The method of Claim 10, further comprising recording information indicative of the saggital plane in the portable surgical orientation device.
12. The method of Claim 10, wherein the anatomical landmarks include one or more of an insertion point of an anterior cruciate ligament and an insertion point of a patella tendon.
directing a visible light proximally from the portable surgical orientation device; and moving the adjustment device until the visible light intersects one or more of the insertion point of the anterior cruciate ligament and the insertion point of the patella tendon. 14. The method of Claim 10, further comprising compensating for a vertical height of the portable surgical orientation device from the mechanical axis of the leg.
15. The method of Claim 1, further comprising moving the adjustment device to align the portable surgical orientation device with a coronal plane of the patient and recording information indicative of the coronal plane in the portable surgical orientation device.
positioning a target adjacent to an anatomical landmark of the patient's ankle; directing a visible light distally from the portable surgical orientation device; and moving the adjustment device until the visible light is aligned with the target. 17. The method of Claim 16, further comprising compensating for an anterior-posterior spacing of the portable surgical orientation device from the anterior surface of the patient's tibia.
extending a probe coupled with the adjustment device and the portable surgical orientation device toward a distal portion of the tibia; moving the adjustment device to contact the probe with an anatomical landmark on a lateral side of the distal portion of the tibia; moving the adjustment device to contact the probe with an anatomical landmark on a medial side of the distal portion of the tibia; and recording information indicative of the saggital plane in the portable surgical orientation device at at least one of the anatomical landmarks on the lateral side of the distal portion of the tibia and the anatomical landmarks on the medial side of the distal portion of the tibia. 19. The method of Claim 15, further comprising:
extending a probe coupled with the adjustment device and the portable surgical orientation device toward a distal portion of the tibia; moving the adjustment device to contact the probe with an anatomical landmark on a lateral side of the distal portion of the tibia; moving the adjustment device to contact the probe with an anatomical landmark on a medial side of the distal portion of the tibia; and recording information indicative of the coronal plane in the portable surgical orientation device at at least one of the anatomical landmark on the lateral side of the distal portion of the tibia and the anatomical landmark on the medial side of the distal portion of the tibia. 20. The method of Claim 1, further comprising:
coupling the orthopedic fixture with the tibia by inserting a mounting pin through a bore in the orthopedic fixture and into a medial portion of the tibial tuberosity; pivoting the orthopedic fixture about a first axis extending through the mounting pin to a preferred varus-valgus orientation as indicated on the portable surgical orientation device; moving the adjustment device about a second axis that is substantially perpendicular to the first axis to position a cutting guide in a preferred anterior-posterior slope orientation as indicated on the portable surgical orientation device; and securing the cutting guide to the anterior surface of the tibia at the preferred varus-valgus and flexion-extension orientations by inserting a plurality of pins through the cutting guide. 21. The method of Claim 1, wherein the orthopedic fixture further comprises a base having a proximal mounting structure, a distal mounting structure, and an elongate member extending therebetween, the method further comprising:
coupling the distal mounting structure with an anterior tibial surface located proximal of the ankle joint. 22. The method of Claim 1, further comprising directing a visible light from the portable surgical orientation device onto an anterior surface of the tibia at a cutting surface of the cutting guide prior to resecting the proximal tibia.
23. The method of Claim 1, wherein the orthopedic fixture is an extramedullary tibial guide, and further comprising:
coupling the portable surgical orientation device to a landmark acquisition jig having a first elongate member having a proximal end and a distal end and a transverse member coupled with each of the proximal and distal ends; positioning the landmark acquisition jig such that the transverse member coupled with the proximal end of the elongate member is in contact with the proximal tibia adjacent to the collateral ligament attachment and the transverse member coupled with the distal end of the elongate member is in contact with the distal tibia adjacent to a malleolus; recording information indicative of a coronal plane of the tibia in the portable surgical orientation device; decoupling the portable surgical orientation device from the landmark acquisition jig before coupling the portable surgical orientation device to the extramedullary tibial guide. 24-39. (canceled)
[0001] This application claims benefit under 35 U.S.C. �119(e) to U.S. Provisional Patent Application No. 61/102,754, filed Oct. 3, 2008, U.S. Provisional Patent Application No. 61/135,863, filed Jul. 24, 2008, U.S. Provisional Patent Application No. 61/102,767, filed Oct. 3, 2008, U.S. Provisional Patent Application No. 61/155,093, filed Feb. 24, 2009, U.S. Provisional Patent Application No. 61/104,644, filed Oct. 10, 2008, U.S. Provisional Patent Application No. 61/153,268, filed Feb. 17, 2009, U.S. Provisional Patent Application No. 61/153,257, filed Feb. 17, 2009, U.S. Provisional Patent Application No. 61/153,255, filed Feb. 17, 2009, U.S. Provisional Patent Application No. 61/173,158, filed Apr. 27, 2009, U.S. Provisional Patent Application No. 61/187,632, filed Jun. 16, 2009, and U.S. Provisional Patent Application No. 61/173,159, filed Apr. 27, 2009, each of which is incorporated in its entirety by reference herein.
[0003] The present application is directed to systems and methods for joint replacement, in particular to systems and methods for knee joint replacement which utilize a surgical orientation device or devices.
[0005] Joint replacement procedures, including knee joint replacement procedures, are commonly used to replace a patient's joint with a prosthetic joint component or components. Such procedures often use a system or systems of surgical tools and devices, including but not limited to cutting guides (e.g. cutting blocks) and surgical guides, to make surgical cuts along a portion or portions of the patient's bone.
[0007] Where such complex and costly system are not used, simple methods are used, such “eyeballing” the alignment of rods with anatomical features, such as leg bones. These simple methods are not sufficiently accurate to reliably align and place implant components and the bones to which such components are attached.
[0008] Accordingly, there is a lack of devices, systems and methods that can be used to accurately position components of prosthetic joints without overly complicating the procedures, crowding the medical personnel, and/or burdening the physician of health-care facility with the great cost of complex navigation systems.
[0009] In accordance with at least one embodiment, a surgical orientation device for use in a total knee arthroplasty procedure having an associated three-dimensional coordinate reference system can comprise a portable housing configured to connect to a knee bone by way of one or more orthopedic fixtures, a sensor located within the housing, the sensor configured to monitor the orientation of the housing in the three-dimensional coordinate reference system, the sensor further configured to generate orientation data corresponding to the monitored orientation of the surgical orientation device, and wherein the sensor comprises a multi-axis accelerometer. The surgical orientation device can further comprise a display module configured to display one or more angle measurements corresponding to an offset from a flexion-extension angle or a varus-valgus angle of a mechanical axis of the knee joint, and wherein the sensor can be oriented relative to the housing at an acute angle to maximize the sensitivity of the sensor when coupled to a tibia or a femur.
[0010] In accordance with another embodiment, an orthopedic orientation system for use in a joint procedure can comprise an orthopedic fixture adapted to be coupled with a knee bone and to be adjustable in multiple degrees of freedom, and a surgical orientation device having an associated three-dimensional coordinate reference system. The device can comprise a portable housing configured to connect to a knee bone by way of the orthopedic fixtures, and a sensor located within the housing, the sensor configured to monitor the orientation of the housing in the three-dimensional coordinate reference system, the sensor further configured to generate orientation data corresponding to the monitored orientation of the surgical orientation device. The surgical orientation device can further comprise an output device configured to inform a user of the orientation of the device relative to a reference plane corresponding to a mechanical axis of the joint, and wherein the sensor can be configured for optimum sensitivity in the range of motion of the orthopedic fixture.
[0011] In accordance with at least one embodiment, an orthopedic system for orienting a cutting plane during a joint replacement procedure can comprise a base member attachable to an anterior face of a tibia, at least one adjustment device connected to and moveable relative to the base member, and at least one probe for referencing a plurality of anatomical landmarks, the anatomical landmarks referencing a mechanical axis of the leg. The at least one adjustment device can be moveable in at least one degree of freedom so as to orient a cutting guide relative to a proximal feature of the tibia, such that the cutting guide is oriented at a selected angle relative to the mechanical axis.
[0012] In accordance with at least one embodiment, an interactive user interface for aiding a user in performing an orthopedic procedure can be provided, wherein the user interface is displayed on a display associated with a surgical orientation device configured to monitor the orientation of the surgical orientation device in a three-dimensional coordinate reference system and wherein the user interface is configured to perform acts comprising showing the user steps to be performed in the identified orthopedic procedure and guiding the user in performance of the steps. Guiding the user can comprise displaying one or more instructive images related to a first step to be performed in the identified orthopedic procedure, prompting the user to press a user input after performing the first step of the identified orthopedic procedure, receiving a confirmation from the user that the first step of the identified procedure has been performed, and displaying one or more instructive images related to the second step to be performed in the identified orthopedic procedure.
[0013] In accordance with another embodiment, a monitoring system can be provided for monitoring an orientation of a surgical orientation device having an associated three-dimensional coordinate reference system during an orthopedic procedure, the orientation system comprising a display having a window and an on-screen graphic, displayed in the window and representing one or more orientation measurements corresponding to an orientation of the surgical orientation device about one or more axes of the three-dimensional coordinate reference system, the one or more orientation measurements generated by a processor.
[0014] In accordance with at least one embodiment, a method for preparing a proximal portion of a tibia for receiving a knee implant can comprise coupling an orthopedic fixture with a proximal feature of the patient's leg, connecting a portable surgical orientation device to an adjustment device that is connected to the orthopedic fixture and moveable relative to the leg, moving the adjustment device to move the portable surgical orientation device in response to a prompt from the portable surgical orientation device to orient the orthopedic fixture relative to a mechanical axis of the leg.
[0015] In accordance with another embodiment, a method for performing total knee arthroplasty on a knee joint of a patient can comprise preparing a proximal portion of a tibia for receiving a knee implant, including coupling an orthopedic fixture with a proximal portion of the patient's tibia, connecting a portable surgical orientation device to a moveable portion of the orthopedic fixture, moving the moveable portion of the orthopedic fixture to move the portable surgical orientation device in response to a prompt from the portable surgical orientation device to orient a cutting guide at an intended orientation relative to a mechanical axis of the leg, and resecting the proximal tibia along the cutting guide to define a tibial plateau. The method can further comprise preparing a distal portion of a femur for receiving a knee implant, including coupling an orthopedic fixture and the portable surgical orientation device with an anterior surface of a distal portion of the femur, moving at least one of the femur and the tibia in response to a prompt from the portable surgical orientation device to align the femur with the mechanical axis of the leg, securing a cutting guide with an anterior feature of the femur such that the guide is substantially perpendicular to the mechanical axis, and resecting the distal femur.
[0016] In accordance with another embodiment, a method of performing an orthopedic procedure can comprise coupling an orthopedic fixture and the portable surgical orientation device with a distal portion of a limb that comprises a portion of a ball-and-socket joint, the portable surgical orientation device including a housing enclosing a sensor and a microprocessor. The method can further comprise activating the sensor within the portable surgical orientation device, such that the sensor outputs a signal indicative of orientation, collecting positional information of the portable surgical orientation device; and determining the location of the mechanical axis of the limb based on the positional information collected.
[0017] FIG. 1 shows a representation of a human leg, identifying the femoral head, knee joint, femur, tibia, and ankle;
[0018] FIG. 2A is a perspective view of a tibial preparation system according to one embodiment that can be used in connection with preparation of an aspect of a knee joint during a knee joint replacement procedure;
[0019] FIG. 2B is a perspective view of another tibial preparation system according to one embodiment that can be used in connection with preparation of an aspect of a knee joint during a knee joint replacement procedure;
[0020] FIG. 3A is a perspective view of a first arrangement of another tibial preparation system according to one embodiment that can be used in connection with preparation of an aspect of a knee joint during a knee joint replacement procedure;
[0021] FIG. 3B is a perspective view of a second arrangement of the tibial preparation system of FIG. 3A;
[0022] FIG. 4A is a perspective view of a first arrangement of another tibial preparation system according to one embodiment that can be used in connection with preparation of an aspect of a knee joint during a knee joint replacement procedure;
[0023] FIG. 4B is a perspective view of a second arrangement of the tibial preparation system of FIG. 4A;
[0024] FIG. 5 is a perspective view of femoral preparation system according to one embodiment that can be used in connection with preparation of an aspect of a knee joint during a knee joint replacement procedure;
[0025] FIG. 6 is a perspective view of a femoral preparation and knee distraction system according to one embodiment that can be used in connection with preparation of an aspect of a knee joint during a knee joint replacement procedure;
[0026] FIG. 7 is a perspective view of a surgical orientation device according to one embodiment that can be used for orienting a resection plane or planes;
[0027] FIG. 8 is a back view of the surgical orientation device of FIG. 7;
[0028] FIG. 9 is a perspective view of the surgical orientation device of FIG. 7;
[0029] FIG. 10A is a top view of the surgical orientation device of FIG. 7;
[0030] FIG. 10B is a bottom view of the surgical orientation device of FIG. 7;
[0031] FIG. 11 is a block diagram of an electrical system of the surgical orientation device of FIG. 7;
[0032] FIGS. 12A-12C illustrate operation of accelerometers according to embodiments that can be used as sensors in the electrical system of FIG. 11;
[0033] FIG. 12D is a perspective view of interior components of the surgical orientation device of FIG. 7;
[0034] FIG. 12E is a flow chart of an embodiment of an orientation measurement process performed by the surgical orientation device of FIG. 7;
[0035] FIG. 12F is a side view of a left leg of a patient illustrating an orientation reference frame;
[0036] FIG. 13 is a perspective view of a surgical orientation device according to another embodiment;
[0037] FIG. 14 is a perspective view of a coupling device according to one embodiment that can be used to connect the surgical orientation device of FIG. 7 to other components;
[0038] FIG. 15 is a perspective view an outer housing of the coupling device of FIG. 14;
[0039] FIG. 16 is a perspective view of interior components of the coupling device of FIG. 14;
[0040] FIG. 17 is a plan view of the coupling device of FIG. 14;
[0041] FIG. 17A is an exploded view a coupling device according to another embodiment;
[0042] FIG. 18 is a perspective view of an orthopedic fixture according to one embodiment which can be used as a universal jig;
[0043] FIG. 19 is an exploded view of the orthopedic fixture of FIG. 18;
[0044] FIG. 20 is a perspective view of a set of target probes according to one embodiment which can be used in conjunction with the orthopedic fixture of FIG. 18;
[0045] FIG. 21A is a perspective view of the tibial preparation system of FIG. 2A attached to the tibia;
[0046] FIG. 21B is a perspective view of a tibial preparation system, as modified from the tibial preparation system of FIG. 2A, emitting laser light onto a target probe;
[0047] FIG. 22A is a perspective view of the tibial preparation system of FIG. 2B;
[0048] FIG. 22B is a side view of the tibial preparation system of FIG. 2B;
[0049] FIG. 22C is a perspective view of the tibial preparation system of FIG. 2B, without a surgical orientation device attached;
[0050] FIG. 23A is a perspective view of a tibial preparation system, as modified from the tibial preparation system of FIG. 2B, showing measuring devices;
[0051] FIG. 23B is a perspective view of the tibial preparation system of FIG. 23A being used to reference an anatomical landmark;
[0052] FIG. 24 is a perspective view of a landmark acquisition assembly according to one embodiment that can be used in the tibial preparation system of FIG. 3A;
[0053] FIGS. 25A-B are perspective views of a primary and secondary rod of the landmark acquisition assembly of FIG. 24;
[0054] FIG. 26 is a front view of a connecting element of the landmark acquisition assembly of FIG. 24;
[0055] FIG. 27 is a perspective view of the second arrangement of the tibial preparation system of FIG. 3B, showing an extramedullary alignment guide according to one embodiment that can be used along the anterior side of the tibia;
[0056] FIGS. 28 and 29 are perspective views of the first arrangement of the tibial preparation system of FIG. 3A during a knee joint replacement procedure;
[0057] FIGS. 30-36B are perspective views of the second arrangement of the tibial preparation system of FIG. 3B during a knee joint replacement procedure;