US20050119561A1 - Enhanced graphics features for computer assisted surgery system - Google Patents
Enhanced graphics features for computer assisted surgery system Download PDFInfo
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- US20050119561A1 US20050119561A1 US11/031,241 US3124105A US2005119561A1 US 20050119561 A1 US20050119561 A1 US 20050119561A1 US 3124105 A US3124105 A US 3124105A US 2005119561 A1 US2005119561 A1 US 2005119561A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1721—Guides or aligning means for drills, mills, pins or wires for applying pins along or parallel to the axis of the femoral neck
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- A—HUMAN NECESSITIES
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- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1703—Guides or aligning means for drills, mills, pins or wires using imaging means, e.g. by X-rays
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- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1742—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip
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Definitions
- This invention relates to a computer assisted surgery system with enhanced graphics capabilities for use in inserting multiple screws into a hip fracture and orienting a total hip acetabular component.
- Fractures of the femoral neck, one kind of hip fracture, are a common injury of the elderly with over 150,000 such fractures occurring annually.
- the currently accepted treatment for mildly displaced femoral neck fractures is surgical fixation.
- three cannulated screws are inserted in the hip, from the lateral aspect of the femur, across the fracture site and into the femoral head.
- the initial step is the placement of three guide pins, over which the screws are inserted, in a characteristic triangular pattern. This is typically performed under fluoroscopic guidance, usually with the aid of a drill guide.
- surgeons prefer to use a drill guide with a single bore, but doing so may make it difficult to achieve the desired triangular spacing and optimum placement of the guide pins in the femoral neck.
- Other surgeons prefer a drill guide with multiple bores that are fixed in the proper triangular spacing, but this requires a larger incision and doesn't permit the surgeon much flexibility to modify the preset pattern. With either drill guide, it can be difficult to accurately predict the final guide pin placement. Further, the surgery requires a significant number of fluoroscopic images and x-ray exposure for the surgeon, patient and operating room staff.
- Fluoroscopic based image guided surgery systems can be of benefit in predicting the paths of the guide pins and in significantly reducing the amount of radiation exposure.
- Image guided systems such as those taught in U.S. Pat. Nos. 5,772,594 and 6,285,902, incorporated herein by reference, employ a computer and a localizing device to track a drill or drill guide and superimpose a trajectory line on fluoroscopic images.
- U.S. Pat. No. 6,285,902 describes a system in which, preferably, orthopaedic surgical tools outfitted with infrared LEDs are tracked by an optical localizing device. The poses of these tools are determined and graphic representations of the tools are superimposed on standard intraoperative x-ray images.
- a drill guide outfitted with infrared LEDs is tracked and the trajectory of its bore is displayed on the x-ray image of the involved bone. This allows a surgeon to accurately predict the trajectory of a guide pin that passes through the bore of the drill guide. The surgeon can see the path each guide pin will take and can improve the accuracy and speed of insertion of the guide pin with only a minimum number of x-ray images. These systems, however, do not provide help in selecting paths that will lead to the desired triangular pattern with proper spacing between screws. On the other hand, a tracked drill guide with multiple bores may be used, but this requires a large incision and does not leave the surgeon with flexibility in the spacing or orientation (e.g., parallel vs. diverging) of the screws.
- ASIS anterior superior iliac spines
- the pelvis may be tilted relative to the operating table, making it difficult to use the table or any vertical or horizontal plane as a reliable reference.
- U.S. Pat. No. 6,002,859 teaches a system for orienting the acetabular cup that is based on a CT scan to preoperatively construct a 3-D model of the pelvis and plan the placement of the acetabular component.
- a registration step is required to correlate the position of the patient's pelvis with the 3-D model.
- one objective of the present invention is to provide a computer assisted surgery system with enhanced graphic features for assisting a surgeon in positioning multiple guide pins in a bone as part of a hip fracture fixation surgery and in orienting an acetabular cup during a total hip replacement surgery.
- Another objective of the invention is to provide a technique and apparatus for displaying a graphic representation of a drill guide that includes a real trajectory corresponding to the bore of the drill guide and one or more virtual trajectories relative to the actual trajectory that indicate possible other drill guide trajectories.
- Another objective of the invention is to provide a technique and apparatus for displaying graphic representations of implants or instruments in positions retained from previous steps of the procedure.
- Still another objective of the invention is a method and apparatus for accurately orienting an acetabular component relative to the pelvis in a total hip replacement surgery.
- Still another objective of the invention is a method and apparatus for noninvasively determining the location of bony landmarks inside a patient's body.
- a computer assisted surgery system including a computer, a localizing device and a display monitor.
- the system also includes a drill guide for use in placing multiple guide pins for hip fracture surgery and a probe and positioning instrument for use in orienting an acetabular cup.
- the poses of all three instruments are measurable by a localizing device.
- the system is improved for use in the femoral neck fracture surgery and acetabular cup orientation procedure by two enhancements to the graphic capabilities of the original computer assisted surgery system.
- the first enhancement is inclusion in the instrument representation of features that are not physically present on the instrument, but that provide additional information and functionality to the surgeon. While these virtual features are visible only in the graphic representation, their poses are related to the poses of real features of the instrument and their poses in space can be calculated.
- a virtual feature may represent a physical feature that is typically present on a conventional instrument but removed in the instrument under consideration.
- a virtual feature may also represent a physical feature that would improve the function of an instrument but cannot be added, or are not desirable to add, because of physical constraints, instrument simplicity, or other reasons (e.g., a long probe tip for indicating points inside of tissues) but whose function instead can be sufficiently simulated with appropriate modeling in the instrument's graphic representation.
- virtual features may include modeling of physical features that are present on physical instruments at other times during the surgery or modeling of physical features that are located at other poses during other steps of the surgery and are related in position to the instrument being used in the current step (e.g., guide pin trajectories of past or future steps of the procedure).
- the representation of features virtually instead of physically allows the surgeon to benefit from the additional positioning information while still promoting simpler instruments and less invasive surgical technique.
- the second enhancement to the graphics features is the ability to retain a version of the instrument representation on the display in the position that it occupied at a given point in time. This allows the surgeon to view representations of previously placed hardware (e.g., guide pins) without requiring the acquisition of new x-ray images. Further, virtual features may also be retained in order to carry over information from one step of the procedure to another (e.g., template information or planning markings) or to indicate the location of previously identified positions (e.g., selected landmarks or fiducials).
- a drill guide is used with a graphic representation that comprises a real trajectory that corresponds to the bore of the drill guide and that shows the path a guide pin will take when inserted with the drill guide at its present position.
- the graphic representation further comprises one or more virtual trajectories that are defined relative to the real trajectory and represents other possible positions for guide pins.
- the virtual trajectories are the other two positions of the desired triangular pattern of parallel guide pins typically used in femoral neck fracture fixation.
- the virtual trajectories can be redefined by the surgeon to achieve any desired pattern and spacing of the guide pins.
- the surgeon uses the computer assisted surgery system to insert the first guide pin by aligning the pattern of real and virtual trajectories in an appropriate position over the x-ray images of the femoral head and neck. Subsequent guide pins are inserted by aligning the virtual trajectories with x-ray images of the femur and previously placed guide pins. Alternatively, representations of previously placed guide pins and virtual trajectories are retained and the subsequent guide pin placements are made by aligning the actual trajectory of the drill guide with the retained virtual trajectories.
- This invention has the advantages of assisting the surgeon in achieving a desired screw pattern, permitting a small incision with a single bore drill guide, and allowing the surgeon flexibility in placing the guide pins.
- a probe is used to identify the location of three landmarks on the pelvis.
- the graphic representation of the probe includes a virtual tip, at a fixed and known distance from the real tip of the probe.
- Two roughly orthogonal x-ray views of the pelvis are obtained and the probe is moved, always above the skin, in the vicinity of the bony landmark, until a graphic representation of the virtual probe tip overlays the image of the landmark in both x-rays, and the 3-D position of the landmark is calculated.
- This process is preferably performed for both anterior superior iliac spines and the anterior pubis and a pelvic coordinate frame is established.
- a positioning instrument with attached acetabular cup is tracked by the localizer and the system provides both a graphic representation of the orientation of the acetabular cup over the x-ray images and an alphanumeric readout of two calculated angular orientation values familiar to the surgeon.
- This invention has the advantages of non-invasively identifying accepted landmarks for establishing a pelvic reference frame, of automatically registering the images, and of not requiring a CT scan prior to surgery.
- FIG. 1 illustrates the femur with inserted cannulated screws as an example of prior art.
- FIG. 2 illustrates the femur, drill and drill guide as an example of prior art.
- FIG. 3 illustrates the femur, drill and drill guide and an example of a screen display of two images and superimposed instrument representation.
- FIG. 4 is an example of a screen display of two images and superimposed actual and virtual trajectories.
- FIG. 5 is an example of a screen display of two images, superimposed actual and virtual trajectories and inserted guide pin.
- FIG. 6 is an example of a screen display of two images, superimposed actual and virtual trajectories and inserted guide pins.
- FIG. 7 illustrates a probe and body landmark with surrounding soft tissue and an example of a screen display of two images with a superimposed representation of the probe.
- FIG. 8 illustrates a pelvis and probe and an example of a screen display with two images of the pelvis with a superimposed representation of the probe.
- FIG. 9 illustrates a pelvis with reference planes and a positioning instrument and an example of a screen display of two images of the pelvis superimposed with a representation of the positioning instrument and text messages.
- FIG. 10 is an example of a screen display with two images of a surgical instrument with superimposed retained representation.
- FIG. 11 is an example of a screen display of two images with a superimposed retained representation of the drill guide.
- FIG. 12 is an example of a screen display of two images with superimposed representation of the drill guide and a retained representation of the drill guide.
- FIG. 1A the screws ( 102 ) are inserted from the lateral aspect of the trochanteric area of the femur ( 101 ) through the femoral neck ( 103 ) and into the femoral head ( 104 ) in a roughly parallel manner.
- FIG. 1B the screws describe the vertices of a triangle with one screw placed inferiorly (toward the knee), one placed anteriorly (toward the front) and one placed posteriorly (toward the back).
- the first step of the procedure is the insertion of three guide pins ( 110 ) under fluoroscopic guidance. Numerous x-ray images involving frequent reorientation of the fluoroscope are required to monitor the progress of the guide pin insertion in both AP (front-to-back) and lateral (side) views.
- a drill guide ( 105 ) with three or more holes ( 106 ) is typically used to assist in keeping the guide pins ( 110 ) roughly parallel during the insertion.
- the computer assisted surgical system described in the previous application can assist the surgeon in this procedure by superimposing a graphic representation ( 130 ) of the drill guide ( 123 ) on the images ( 120 ) of the femur ( 101 ).
- the surgeon aligns the drill guide representation ( 130 ) such that the guide pin ( 110 ) will be inserted in a position that accommodates the remaining two guide pins in the desired triangular pattern.
- the surgeon inserts the first guide pin ( 110 ) and obtains new AP and lateral x-rays ( 120 ) to show the final position of the guide pin ( 110 ) relative to the bone ( 101 ).
- the remaining two pins are inserted in a similar fashion with the surgeon using the drill guide representation ( 130 ) to align the drill guide ( 123 ).
- the current invention augments the capability of the computer assisted surgery system by providing additional information to the surgeon in a novel manner.
- prior art systems display information directly related to physical features of the drill guide
- the preferred embodiment of the current invention includes information that is not directly derived from a physical feature of the instrument.
- FIG. 4 shows the improved graphic representation ( 130 , 131 ) of the same drill guide ( 123 ) which, in addition to a real trajectory ( 130 ) corresponding to the sleeve of the physical drill guide, also includes virtual trajectories ( 131 ) representing possible positions for the other two guide pins required in the surgery.
- these virtual trajectories ( 131 ) take the form of dashed lines, but may be displayed in any manner that allows for their differentiation from the real trajectory ( 130 ) without departing from the instant invention.
- three different representations are available for use in placement of the pin in the inferior, anterior, or posterior positions.
- the representation of the drill guide for placement of the inferior guide pin contains two virtual trajectories ( 131 ) located superior to the real drill guide trajectory ( 130 ).
- the virtual trajectories ( 131 ) are located posterior to the real trajectory ( 130 ) while for posterior guide pin placement the virtual trajectories ( 131 ) are located anterior to the real trajectory ( 130 ).
- a single representation may be used by physically rotating the drill guide about its trajectory axis.
- Other representations, with alternative spacing and orientation of the virtual trajectories ( 131 ) relative to the real drill guide trajectory ( 130 ), may be made available to the surgeon to accommodate a range of bone sizes, fracture patterns, or surgeon preferences.
- the guide's real trajectory ( 130 ) and the two virtual trajectories ( 131 ) are superimposed on the images ( 121 and 122 ) of the femur.
- the surgeon is able to see relative to the femur image ( 125 ) how the positioning of the first pin will affect the positioning of the final three-pin pattern.
- the first guide pin placed is the inferior one.
- any pin placement order with corresponding drill guide representations may be used.
- the representation ( 130 , 132 and 133 ) of the drill guide is changed to one for posterior pin placement.
- the drill guide's real trajectory ( 130 ) represents that of the posterior guide pin
- one virtual trajectory ( 132 ) represents the position of the previously placed inferior guide pin ( 135 )
- the other virtual trajectory ( 133 ) represents the proposed trajectory of the future anterior pin.
- the surgeon aligns the drill guide ( 110 ) with the femur ( 101 ) such that the inferior virtual trajectory ( 132 ) overlays the image of the previously placed guide pin ( 135 ), while the other virtual trajectory ( 133 ) and the real trajectory ( 130 ) are aligned into their proper positions relative to the femur image ( 125 ). Then, the surgeon again advances the guide pin ( 110 ) through the drill guide ( 123 ) and into the bone ( 101 ).
- the representation of the drill guide is changed to show the virtual trajectories ( 131 ) inferiorly and posteriorly while the drill guide's real trajectory ( 130 ) is displayed anteriorly.
- the surgeon aligns the virtual trajectories ( 131 ) to overlay the images of the previously placed pins ( 135 ) and advances the guide pin ( 110 ) through the drill guide ( 123 ) and into the bone ( 101 ).
- the remainder of the procedure, including the placement of the cannulated screws over the guide pins ( 110 ), is performed in the usual manner.
- the surgeon should use good clinical judgment as to whether to follow the virtual trajectories exactly, to use them merely as reference marks, or to simply ignore them.
- the major advantage of this invention is its ability to assist the surgeon in positioning multiple guide pins relative to one another without the necessity of a multi-bore mechanical jig.
- a single-bore drill guide to accurately place these pins, a smaller skin incision may be used, resulting in less trauma to the patient, faster healing, less risk of infection, and other advantages of minimally invasive surgery.
- a tracking device may be rigidly affixed to the bone and any changes in the pose of the bone during the procedure may be recorded and compensated for.
- This device may be comprised of three LEDs affixed to an assembly that is attached to the pelvis with one or more screws.
- any device that attaches rigidly to the femur and tracks its changes in pose may be used.
- the software adjusts the pose of the instrument representation being overlaid on the x-ray images in order to maintain accurate relative superpositioning.
- the drill guide may be replaced by a probe, a drill, a bone saw, an implant positioner, or any other surgical instrument.
- the drill guide trajectory may be replaced by a representation of a probe tip, a drill bit, a saw blade, an implant, or any other physical feature of a surgical instrument or implant attached to a surgical instrument.
- the virtual guide pin trajectories may be replaced by graphics that represent measurements, markings, or modeling of surgical instrument features not necessarily present on the instrument being used nor related to an existing physical feature of the instrument.
- the virtual features may include graphics relating to another implant or instrument not currently affixed to the first implant or instrument, but whose position is ultimately related to it.
- the other implant or instrument may be used simultaneously with the first implant or instrument or may be involved with another step in the procedure, either before or after the current step.
- the virtual feature may be derived from a physical feature that has been removed from an instrument or implant or it may represent an alternative configuration or state of the current instrument or implant.
- the virtual feature may comprise any representation that is not directly derived from the current physical properties of the instrument or implant that it represents without departing from the instant invention.
- the graphic representations are displayed overlaid on x-ray images.
- the representations can be displayed overlaid on other medical imaging data (CT, MRI, etc.) or relative to other instruments or implants in a graphic picture not requiring imaging data.
- an instrument with a virtual feature is used to noninvasively determine the locations of specific points, structures, or landmarks within the body.
- Current art which includes directly touching landmarks by a probe, is not applicable in this case because the landmarks are covered by soft or bony tissue and therefore inaccessible to the tip of a probe. Therefore, the current invention, as shown in FIG. 7 , includes a probe ( 150 ) which has a graphic representation that includes a real probe tip portion ( 155 ) and a virtual probe tip portion ( 156 ).
- the real probe tip portion of the representation ( 155 ) correlates directly with the position of the real probe tip ( 151 ).
- the virtual probe tip portion of the representation ( 156 ) correlates with a point in space ( 152 ) that is located in a fixed and known relationship to the physical probe tip ( 151 ).
- two x-ray images ( 160 and 161 ) are obtained.
- the two images ( 160 and 161 ) are 90 degrees apart from one another, but may be any suitable angle apart without departing from the instant invention.
- the surgeon positions the probe ( 150 ) in space, relative to the bony landmark ( 154 ) such that the tip of the virtual cursor ( 156 ) is coincident with the bony landmark's image ( 159 ) in both views ( 160 and 161 ) simultaneously.
- the surgeon then presses a footswitch, or activates some other signaling device, and the 3-D position of the point in space ( 152 ) corresponding to the virtual probe tip ( 152 ), and therefore the 3-D position of the bony landmark ( 154 ), is calculated and recorded in the computer's memory.
- the virtual probe representation can be replaced with a straight line, a curved line, a plane, a curved surface, or some other graphic that allows for the alignment of the virtual probe with one or more landmarks or points.
- the identification of landmarks or points with the virtual probe is applicable to other surgeries and other imaging modalities.
- the purpose of identifying landmarks with the virtual probe is to establish a coordinate frame on a patient's pelvis relative to which is oriented the acetabular component in total hip replacement surgery.
- the patient is placed on his or her side on the operating room table and draped in the usual fashion.
- the surgeon then makes the usual incision and prepares the femur and pelvic acetabulum in the standard fashion.
- two modified AP x-ray images ( 171 and 172 ) of the patient's pelvis ( 181 ) are acquired by the C-arm fluoroscope and shown on the display ( 170 ).
- the first image ( 171 ) is an “inlet view” of the pelvis ( 181 ) taken with the C-arm aimed obliquely, approximately 40 degrees, from cephalad and anterior to caudal and posterior.
- the second image ( 172 ) is an “outlet view” of the pelvis ( 181 ) taken with the C-arm aimed from caudal and anterior to cephalad and posterior.
- the surgeon then uses a probe ( 150 ) outfitted with localizing emitters ( 177 ) to identify three landmarks ( 182 , 183 and 184 ) by positioning the probe ( 150 ) in such a manner that the virtual probe tip ( 156 ) overlays the image ( 173 ) of the first bony landmark ( 183 ) in both views ( 171 , 172 ).
- the system reads the pose of the probe ( 150 ) and calculates and records the three-dimensional location of the landmark ( 183 ). In this manner, the surgeon records the positions of the left anterior superior iliac spine (ASIS) ( 182 ), the right ASIS ( 183 ) and the top of the pubic symphysis ( 184 ).
- ASIS left anterior superior iliac spine
- the right ASIS 183
- the top of the pubic symphysis 184 Alternatively, other bony landmarks may be selected without departing from the instant invention.
- the three landmarks ( 182 , 183 and 184 ) are used to define a pelvic coordinate system.
- the first axis ( 185 ) of the pelvic coordinate system is contained in a line between the left ASIS ( 182 ) and right ASIS ( 183 ), a second axis ( 186 ) is perpendicular to the first axis and extends through the top of the pubic symphysis ( 184 ), and the third axis ( 187 ) is orthogonal to the first two axes ( 185 and 186 ).
- the “frontal” plane ( 188 ) is defined by the first two axes ( 185 and 186 ) and is considered by many orthopaedic surgeons to represent the standard vertical plane of the pelvis ( 181 ) during ambulation.
- the axial plane ( 189 ) is defined by the first and last axes ( 185 and 187 ); and a third plane, the sagittal plane (not shown), is defined by the last two axes ( 186 and 187 ).
- other axes and planes may be defined without departing from the instant invention.
- the surgeon then attaches an acetabular component ( 190 ) to a positioning instrument ( 191 ) outfitted with localizing emitters ( 192 ) and then places the component ( 190 ) into the patient's prepared acetabulum ( 179 ).
- the system displays a representation ( 195 ) of the positioning instrument ( 191 ) with the attached acetabular component ( 190 ) superimposed on the two images ( 171 and 172 ) by using the stored conic projection model of the C-arm.
- the display is updated in real time to show, graphically, the pose of instrument and implant representation ( 195 ) relative to the images of the pelvis.
- angular values ( 196 and 197 ) are calculated and displayed to quantify for the surgeon the orientation of the implant ( 190 ) relative to the pelvic landmarks ( 182 , 183 and 184 ).
- the implant axis ( 193 ) is defined as the axis normal to the plane of the rim of the acetabular implant ( 190 ). Preferably this axis ( 193 ) is coincident with the long axis of the positioning instrument ( 191 ).
- the first value ( 196 ), the “abduction angle” is the angle between the implant axis ( 193 ) and the second axis ( 186 ) when both axes ( 193 and 186 ) are projected on the frontal plane ( 188 ).
- a second value ( 197 ), the “forward flexion angle” is the angle between the implant axis ( 193 ) and the inter-ASIS axis ( 185 ) when both axes are projected on the axial plane ( 189 ).
- these values ( 196 and 197 ) are calculated continuously and displayed in numerical form in real time. Alternatively, other angles or values of interest to the surgeon may be calculated. These values may be displayed in numerous ways including numeric messages or graphic representations of angles or distances.
- views of the pelvis from points of view other than those available from the C-arm fluoroscope may be simulated and the orientation of the implant positioning instrument displayed relative to this simulated image.
- These simulated images may include lateral or axial views of the pelvis and may include any of a number of forms including bitmap pictures, previously obtained x-rays, or projections of CT data.
- a graphic representation of the implant positioning instrument is appropriately scaled and projected onto a plane that corresponds to that of the image. The representation is centered on the acetabulum and as the orientation of the implant positioning instrument is changed, its representation is reoriented in real time relative to the simulated image.
- an impacting device is used to press-fit the implant ( 190 ) into the acetabulum ( 179 ).
- the rest of the procedure, including final sizing of the components and closure of the incision is performed in the usual fashion.
- a tracking device may be rigidly affixed to the bone that records any changes in pose of the bone during the procedure.
- This device may be comprised of three LEDs affixed to an assembly that is attached to the pelvis with one or more screws.
- any device that attaches rigidly to the pelvis and tracks its changes in pose may be used.
- the software adjusts the pose of the instrument being overlaid on the x-ray images in order to maintain accurate relative superpositiong.
- the surgeon attaches an array of tracking emitters to the shaft of the femur prior to dislocating the hip and removing the femoral head.
- the surgeon presses the footswitch while rotating the femur around the femoral head, causing poses of the tracking array to be recorded.
- the location of the center of the femoral head relative to the tracking array is calculated by methods known in the art. Once the femoral and acetabular components have been placed, the sampling process and calculations are repeated.
- the software compares the data recorded before and after the placement of the prosthetic components to provide information to the surgeon regarding the preservation of leg length, femoral offset, or other geometries of the replaced hip.
- Stored models of the implants used may be incorporated into these calculations to improve the accuracy and usefulness of this information.
- the instrument's graphic representation ( 201 ) is then overlaid on the x-ray images ( 202 ) for a period of time that allows the surgeon to verify the accurate functioning of the system by comparing the position of the graphic representation ( 201 ) to the instrument's radiographic silhouettes ( 203 ) in the x-ray images ( 202 ).
- the recording of the pose of the instrument occurs at a point in time specified by the surgeon, and an instrument representation is retained immobile on the screen for the purpose of providing the surgeon with information relating to the surgical procedure.
- the retained instrument representation may be the same as the tracked instrument representation displayed in real time including any real or virtual features, or it may be different from the real-time representation and comprise alternate real or virtual features (e.g., the retained representation for a guide pin may be the cannulated screw that fits over that pin).
- the invention is an enhancement to the femoral neck fracture fixation procedure previously described.
- the drill guide representation including the real drill guide trajectory ( 130 ) and the two virtual trajectories ( 131 ) is overlaid on the AP image ( 121 ) and lateral image ( 122 ) of the femur.
- a drill guide representation ( 209 ) including the real drill guide trajectory ( 210 ) and the virtual trajectories ( 211 ), is displayed immobile on the same x-ray images ( 121 and 122 ) in the position it occupied relative to the bone ( 125 ) when the footswitch was pressed.
- This retained graphic ( 209 ) represents the final position of the first inserted guide pin ( 210 ) and the planned trajectories ( 211 ) for the subsequent two guide pins.
- a guide pin representation ( 210 ) may be retained on the images ( 121 and 122 ) in the positions that correspond to the final inserted poses of the guide pins.
- the footswitch that the surgeon uses to indicate that the pose of the instrument is to be recorded may be replaced with any other signaling device without departing from the instant invention.
- Other possibilities include a pushbutton on the instrument, a keypad or keyboard button, a drill trigger, or a voice activated switch.
- the graphic representations are displayed overlaid on x-ray images.
- the representations can be displayed overlaid on other medical imaging data (CT, MRI, etc.) or relative to other instruments in a graphic picture not requiring imaging data.
- a probe tip or crosshairs representing the virtual cursor tip described previously can be retained on the screen as a reference marker.
- multiple points, with optional interconnecting lines, may be retained to produce a straight or curved path relative to image or model data.
- the graphic representation that is retained on the screen may comprise screws used to hold reduction of a complex fracture or affix an implanted device, an implant or individual components of a multi-component implant, reference marks used in subsequent steps of the procedure, or any other instrument, implant, template, measurement, or graphic information that would benefit the surgeon by being retained in a specified position.
- the graphic representation to be retained may include real or virtual features, and may be the same or different from the representation that was displayed prior to the recording of the instrument's position.
- This invention has utility in numerous other image-guided surgical procedures. Those skilled in the art will recognize the applicability of this invention to other procedures and areas of surgery.
Abstract
A computer assisted surgery system with is enhanced graphics features is described for assisting a surgeon in orthopaedic procedures. A system is described for use in inserting multiple guide pins in hip fracture surgery using a single bore drill guide that has a graphical representation comprising its real trajectory and one or more virtual trajectories, the virtual trajectories representing potential positions of other guide pins to be placed during the procedure. Additionally, representations of inserted guide pins and virtual trajectories may be retained on the display at their inserted positions for use in aligning subsequent guide pins. A system is also described for orientation of an acetabular cup in a total hip replacement surgery. During cup insertion, the surgeon is provided with information regarding the orientation of the cup with respect to a pelvic reference frame that is based on accepted pelvic landmarks. The positions of each landmark is calculated by the system when a probe with a virtual tip, separate from its physical tip, is overlaid on the landmark in roughly orthogonal images of the pelvis.
Description
- This application is a continuation of U.S. application Ser. No. 09/683,104, filed Nov. 19, 2001, entitled “Enhanced Graphic Features For Computer Assisted Surgery,” which is hereby expressly incorporated herein in its entirety including the specification, claims, drawings and abstract.
- This invention relates to a computer assisted surgery system with enhanced graphics capabilities for use in inserting multiple screws into a hip fracture and orienting a total hip acetabular component.
- Fractures of the femoral neck, one kind of hip fracture, are a common injury of the elderly with over 150,000 such fractures occurring annually. The currently accepted treatment for mildly displaced femoral neck fractures is surgical fixation. In the procedure, three cannulated screws are inserted in the hip, from the lateral aspect of the femur, across the fracture site and into the femoral head. The initial step is the placement of three guide pins, over which the screws are inserted, in a characteristic triangular pattern. This is typically performed under fluoroscopic guidance, usually with the aid of a drill guide. Some surgeons prefer to use a drill guide with a single bore, but doing so may make it difficult to achieve the desired triangular spacing and optimum placement of the guide pins in the femoral neck. Other surgeons prefer a drill guide with multiple bores that are fixed in the proper triangular spacing, but this requires a larger incision and doesn't permit the surgeon much flexibility to modify the preset pattern. With either drill guide, it can be difficult to accurately predict the final guide pin placement. Further, the surgery requires a significant number of fluoroscopic images and x-ray exposure for the surgeon, patient and operating room staff.
- Fluoroscopic based image guided surgery systems can be of benefit in predicting the paths of the guide pins and in significantly reducing the amount of radiation exposure. Image guided systems such as those taught in U.S. Pat. Nos. 5,772,594 and 6,285,902, incorporated herein by reference, employ a computer and a localizing device to track a drill or drill guide and superimpose a trajectory line on fluoroscopic images. U.S. Pat. No. 6,285,902 describes a system in which, preferably, orthopaedic surgical tools outfitted with infrared LEDs are tracked by an optical localizing device. The poses of these tools are determined and graphic representations of the tools are superimposed on standard intraoperative x-ray images. This allows the surgeon to view, in real time, the position of the tool or tools with respect to an imaged body part or another tool or tools. In the preferred embodiment, a drill guide outfitted with infrared LEDs is tracked and the trajectory of its bore is displayed on the x-ray image of the involved bone. This allows a surgeon to accurately predict the trajectory of a guide pin that passes through the bore of the drill guide. The surgeon can see the path each guide pin will take and can improve the accuracy and speed of insertion of the guide pin with only a minimum number of x-ray images. These systems, however, do not provide help in selecting paths that will lead to the desired triangular pattern with proper spacing between screws. On the other hand, a tracked drill guide with multiple bores may be used, but this requires a large incision and does not leave the surgeon with flexibility in the spacing or orientation (e.g., parallel vs. diverging) of the screws.
- Another surgery that is very common in the elderly is total hip replacement. Over 200,000 total hip surgeries are performed each year. This procedure replaces the natural ball and socket joint of the hip, with a metal ball attached to the femur and a plastic lined cup in the socket (acetabulum) of the pelvis. A crucial step in the procedure is the proper alignment of the acetabular cup relative to the pelvic anatomy. Cups that are not properly oriented can lead to dislocation of the new hip and may require reoperation to reorient the cup. However, it can be quite difficult to orient the acetabular cup correctly. Even though the acetabulum is typically fully exposed, and the surgeon has the freedom to place the cup in any orientation, the pelvic landmarks that would give the surgeon the proper frame of reference are not exposed. One such set of landmarks in common usage for defining a pelvic reference frame (albeit for evaluation purposes in post-operative x-rays) are the left and right anterior superior iliac spines (ASIS) and the anterior portion of the pubic bone. During surgery, however, these are not exposed and are thus hidden under sterile draping material and the patient's soft tissue. This problem is even worse with obese patients. Further, the pelvis may be tilted relative to the operating table, making it difficult to use the table or any vertical or horizontal plane as a reliable reference. This leaves the surgeon to orient the acetabular component based on very limited information: the pelvic anatomy exposed in the immediate vicinity of acetabulum, the general body orientation, any visual or palpable evidence of the orientation of the pelvis, and any other clues the surgeon can extract based on experience.
- Numerous surgical instruments have been introduced with features designed to assist the surgeon in orienting the acetabular component. U.S. Pat. No. 4,475,549 describes one such instrument, in which handles are oriented such that the cup is properly oriented when the handles are aligned with the patient axis. Again, however, this requires that the surgeon correctly identify the alignment of the patient (i.e., of the patient's pelvis) under the drape and soft tissue.
- Image guided techniques have also been applied to the problem of acetabular cup orientation. U.S. Pat. No. 6,002,859 teaches a system for orienting the acetabular cup that is based on a CT scan to preoperatively construct a 3-D model of the pelvis and plan the placement of the acetabular component. During surgery, a registration step is required to correlate the position of the patient's pelvis with the 3-D model. This currently requires the sampling of several points on the patient with a probe and their correlation to the 3-D model. While this system can improve the accuracy, and even the surgical outcome of the total hip procedure, it requires a CT scan which is not currently required, and a potentially time consuming intraoperative registration step.
- Accordingly, one objective of the present invention is to provide a computer assisted surgery system with enhanced graphic features for assisting a surgeon in positioning multiple guide pins in a bone as part of a hip fracture fixation surgery and in orienting an acetabular cup during a total hip replacement surgery.
- Another objective of the invention is to provide a technique and apparatus for displaying a graphic representation of a drill guide that includes a real trajectory corresponding to the bore of the drill guide and one or more virtual trajectories relative to the actual trajectory that indicate possible other drill guide trajectories.
- Another objective of the invention is to provide a technique and apparatus for displaying graphic representations of implants or instruments in positions retained from previous steps of the procedure.
- Still another objective of the invention is a method and apparatus for accurately orienting an acetabular component relative to the pelvis in a total hip replacement surgery.
- Still another objective of the invention is a method and apparatus for noninvasively determining the location of bony landmarks inside a patient's body.
- These and other objects of the present invention are achieved by the use of a computer assisted surgery system, including a computer, a localizing device and a display monitor. The system also includes a drill guide for use in placing multiple guide pins for hip fracture surgery and a probe and positioning instrument for use in orienting an acetabular cup. The poses of all three instruments are measurable by a localizing device. The system is improved for use in the femoral neck fracture surgery and acetabular cup orientation procedure by two enhancements to the graphic capabilities of the original computer assisted surgery system.
- The first enhancement is inclusion in the instrument representation of features that are not physically present on the instrument, but that provide additional information and functionality to the surgeon. While these virtual features are visible only in the graphic representation, their poses are related to the poses of real features of the instrument and their poses in space can be calculated. A virtual feature may represent a physical feature that is typically present on a conventional instrument but removed in the instrument under consideration. A virtual feature may also represent a physical feature that would improve the function of an instrument but cannot be added, or are not desirable to add, because of physical constraints, instrument simplicity, or other reasons (e.g., a long probe tip for indicating points inside of tissues) but whose function instead can be sufficiently simulated with appropriate modeling in the instrument's graphic representation. Further, virtual features may include modeling of physical features that are present on physical instruments at other times during the surgery or modeling of physical features that are located at other poses during other steps of the surgery and are related in position to the instrument being used in the current step (e.g., guide pin trajectories of past or future steps of the procedure). The representation of features virtually instead of physically allows the surgeon to benefit from the additional positioning information while still promoting simpler instruments and less invasive surgical technique.
- The second enhancement to the graphics features is the ability to retain a version of the instrument representation on the display in the position that it occupied at a given point in time. This allows the surgeon to view representations of previously placed hardware (e.g., guide pins) without requiring the acquisition of new x-ray images. Further, virtual features may also be retained in order to carry over information from one step of the procedure to another (e.g., template information or planning markings) or to indicate the location of previously identified positions (e.g., selected landmarks or fiducials).
- During the placement of guide pins in the hip fracture surgery, a drill guide is used with a graphic representation that comprises a real trajectory that corresponds to the bore of the drill guide and that shows the path a guide pin will take when inserted with the drill guide at its present position. The graphic representation further comprises one or more virtual trajectories that are defined relative to the real trajectory and represents other possible positions for guide pins. Preferably, the virtual trajectories are the other two positions of the desired triangular pattern of parallel guide pins typically used in femoral neck fracture fixation. The virtual trajectories can be redefined by the surgeon to achieve any desired pattern and spacing of the guide pins. During surgery, the surgeon uses the computer assisted surgery system to insert the first guide pin by aligning the pattern of real and virtual trajectories in an appropriate position over the x-ray images of the femoral head and neck. Subsequent guide pins are inserted by aligning the virtual trajectories with x-ray images of the femur and previously placed guide pins. Alternatively, representations of previously placed guide pins and virtual trajectories are retained and the subsequent guide pin placements are made by aligning the actual trajectory of the drill guide with the retained virtual trajectories. This invention has the advantages of assisting the surgeon in achieving a desired screw pattern, permitting a small incision with a single bore drill guide, and allowing the surgeon flexibility in placing the guide pins.
- During the procedure to orient the acetabular cup, a probe is used to identify the location of three landmarks on the pelvis. The graphic representation of the probe includes a virtual tip, at a fixed and known distance from the real tip of the probe. Two roughly orthogonal x-ray views of the pelvis are obtained and the probe is moved, always above the skin, in the vicinity of the bony landmark, until a graphic representation of the virtual probe tip overlays the image of the landmark in both x-rays, and the 3-D position of the landmark is calculated. This process is preferably performed for both anterior superior iliac spines and the anterior pubis and a pelvic coordinate frame is established. A positioning instrument with attached acetabular cup is tracked by the localizer and the system provides both a graphic representation of the orientation of the acetabular cup over the x-ray images and an alphanumeric readout of two calculated angular orientation values familiar to the surgeon. This invention has the advantages of non-invasively identifying accepted landmarks for establishing a pelvic reference frame, of automatically registering the images, and of not requiring a CT scan prior to surgery.
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FIG. 1 illustrates the femur with inserted cannulated screws as an example of prior art. -
FIG. 2 illustrates the femur, drill and drill guide as an example of prior art. -
FIG. 3 illustrates the femur, drill and drill guide and an example of a screen display of two images and superimposed instrument representation. -
FIG. 4 is an example of a screen display of two images and superimposed actual and virtual trajectories. -
FIG. 5 is an example of a screen display of two images, superimposed actual and virtual trajectories and inserted guide pin. -
FIG. 6 is an example of a screen display of two images, superimposed actual and virtual trajectories and inserted guide pins. -
FIG. 7 illustrates a probe and body landmark with surrounding soft tissue and an example of a screen display of two images with a superimposed representation of the probe. -
FIG. 8 illustrates a pelvis and probe and an example of a screen display with two images of the pelvis with a superimposed representation of the probe. -
FIG. 9 illustrates a pelvis with reference planes and a positioning instrument and an example of a screen display of two images of the pelvis superimposed with a representation of the positioning instrument and text messages. -
FIG. 10 is an example of a screen display with two images of a surgical instrument with superimposed retained representation. -
FIG. 11 is an example of a screen display of two images with a superimposed retained representation of the drill guide. -
FIG. 12 is an example of a screen display of two images with superimposed representation of the drill guide and a retained representation of the drill guide. - Current surgical practice for the treatment of a femoral neck fracture is the insertion of three cannulated screws through a small incision on the lateral (side) aspect of the hip. As shown in
FIG. 1A , the screws (102) are inserted from the lateral aspect of the trochanteric area of the femur (101) through the femoral neck (103) and into the femoral head (104) in a roughly parallel manner. When observed from a lateral view,FIG. 1B , the screws describe the vertices of a triangle with one screw placed inferiorly (toward the knee), one placed anteriorly (toward the front) and one placed posteriorly (toward the back). - The first step of the procedure, shown in
FIG. 2 , is the insertion of three guide pins (110) under fluoroscopic guidance. Numerous x-ray images involving frequent reorientation of the fluoroscope are required to monitor the progress of the guide pin insertion in both AP (front-to-back) and lateral (side) views. A drill guide (105) with three or more holes (106) is typically used to assist in keeping the guide pins (110) roughly parallel during the insertion. - As shown in
FIG. 3 , the computer assisted surgical system described in the previous application can assist the surgeon in this procedure by superimposing a graphic representation (130) of the drill guide (123) on the images (120) of the femur (101). The surgeon aligns the drill guide representation (130) such that the guide pin (110) will be inserted in a position that accommodates the remaining two guide pins in the desired triangular pattern. Once the drill guide (123) is properly aligned, the surgeon inserts the first guide pin (110) and obtains new AP and lateral x-rays (120) to show the final position of the guide pin (110) relative to the bone (101). The remaining two pins are inserted in a similar fashion with the surgeon using the drill guide representation (130) to align the drill guide (123). - The current invention augments the capability of the computer assisted surgery system by providing additional information to the surgeon in a novel manner. Whereas prior art systems display information directly related to physical features of the drill guide, the preferred embodiment of the current invention includes information that is not directly derived from a physical feature of the instrument.
FIG. 4 shows the improved graphic representation (130, 131) of the same drill guide (123) which, in addition to a real trajectory (130) corresponding to the sleeve of the physical drill guide, also includes virtual trajectories (131) representing possible positions for the other two guide pins required in the surgery. Preferably, these virtual trajectories (131) take the form of dashed lines, but may be displayed in any manner that allows for their differentiation from the real trajectory (130) without departing from the instant invention. Preferably, three different representations are available for use in placement of the pin in the inferior, anterior, or posterior positions. The representation of the drill guide for placement of the inferior guide pin contains two virtual trajectories (131) located superior to the real drill guide trajectory (130). For placement of the anterior guide pin, the virtual trajectories (131) are located posterior to the real trajectory (130) while for posterior guide pin placement the virtual trajectories (131) are located anterior to the real trajectory (130). Alternatively, if the pin pattern is symmetric and the drill guide is sufficiently able to rotate, a single representation may be used by physically rotating the drill guide about its trajectory axis. Other representations, with alternative spacing and orientation of the virtual trajectories (131) relative to the real drill guide trajectory (130), may be made available to the surgeon to accommodate a range of bone sizes, fracture patterns, or surgeon preferences. - As the surgeon positions the drill guide against the femur, the guide's real trajectory (130) and the two virtual trajectories (131) are superimposed on the images (121 and 122) of the femur. With the virtual trajectories (131) included in the instrument representation, the surgeon is able to see relative to the femur image (125) how the positioning of the first pin will affect the positioning of the final three-pin pattern. In the preferred embodiment, the first guide pin placed is the inferior one. Alternatively, any pin placement order with corresponding drill guide representations may be used. With the guide's real trajectory (130) shown on the display in its proper position relative to the femur image (125), the surgeon then inserts the guide pin (110) through the drill guide (123), and advances it into the bone (101).
- Once the first guide pin is inserted, new x-ray images are obtained. As shown in
FIG. 5 these images show the actual position of the first guide pin (135). In preparation for the placement of the second guide pin, the representation (130, 132 and 133) of the drill guide is changed to one for posterior pin placement. In the preferred embodiment, the drill guide's real trajectory (130) represents that of the posterior guide pin, while one virtual trajectory (132) represents the position of the previously placed inferior guide pin (135) and the other virtual trajectory (133) represents the proposed trajectory of the future anterior pin. Preferably, the surgeon aligns the drill guide (110) with the femur (101) such that the inferior virtual trajectory (132) overlays the image of the previously placed guide pin (135), while the other virtual trajectory (133) and the real trajectory (130) are aligned into their proper positions relative to the femur image (125). Then, the surgeon again advances the guide pin (110) through the drill guide (123) and into the bone (101). - Once the first two guide pins have been placed, new x-ray images are acquired as shown in
FIG. 6 . In the preferred embodiment, the representation of the drill guide is changed to show the virtual trajectories (131) inferiorly and posteriorly while the drill guide's real trajectory (130) is displayed anteriorly. Preferably, the surgeon aligns the virtual trajectories (131) to overlay the images of the previously placed pins (135) and advances the guide pin (110) through the drill guide (123) and into the bone (101). The remainder of the procedure, including the placement of the cannulated screws over the guide pins (110), is performed in the usual manner. - In any of the guide pin placement steps described, the surgeon should use good clinical judgment as to whether to follow the virtual trajectories exactly, to use them merely as reference marks, or to simply ignore them.
- The major advantage of this invention is its ability to assist the surgeon in positioning multiple guide pins relative to one another without the necessity of a multi-bore mechanical jig. By using a single-bore drill guide to accurately place these pins, a smaller skin incision may be used, resulting in less trauma to the patient, faster healing, less risk of infection, and other advantages of minimally invasive surgery.
- In the foregoing description, the assumption is made that the body part is held immobile throughout the procedure. Alternatively, a tracking device may be rigidly affixed to the bone and any changes in the pose of the bone during the procedure may be recorded and compensated for. This device may be comprised of three LEDs affixed to an assembly that is attached to the pelvis with one or more screws. However, any device that attaches rigidly to the femur and tracks its changes in pose may be used. As the tracking device changes pose, indicating a change in pose of the femur, the software adjusts the pose of the instrument representation being overlaid on the x-ray images in order to maintain accurate relative superpositioning.
- While the above description of the invention relates to insertion of cannulated screws in the fixation of a femoral neck fracture, those skilled in the art will recognize its applicability to numerous other surgical procedures. In alternative embodiments, the drill guide may be replaced by a probe, a drill, a bone saw, an implant positioner, or any other surgical instrument. The drill guide trajectory may be replaced by a representation of a probe tip, a drill bit, a saw blade, an implant, or any other physical feature of a surgical instrument or implant attached to a surgical instrument. The virtual guide pin trajectories may be replaced by graphics that represent measurements, markings, or modeling of surgical instrument features not necessarily present on the instrument being used nor related to an existing physical feature of the instrument.
- The virtual features may include graphics relating to another implant or instrument not currently affixed to the first implant or instrument, but whose position is ultimately related to it. The other implant or instrument may be used simultaneously with the first implant or instrument or may be involved with another step in the procedure, either before or after the current step. Additionally, the virtual feature may be derived from a physical feature that has been removed from an instrument or implant or it may represent an alternative configuration or state of the current instrument or implant. The virtual feature may comprise any representation that is not directly derived from the current physical properties of the instrument or implant that it represents without departing from the instant invention.
- In the preferred embodiment, the graphic representations are displayed overlaid on x-ray images. Alternatively, the representations can be displayed overlaid on other medical imaging data (CT, MRI, etc.) or relative to other instruments or implants in a graphic picture not requiring imaging data.
- In another example, an instrument with a virtual feature is used to noninvasively determine the locations of specific points, structures, or landmarks within the body. Often in orthopaedic procedures it is desirable to identify the position of bony landmarks that are hidden by soft tissue, in order to establish a body reference frame. Current art, which includes directly touching landmarks by a probe, is not applicable in this case because the landmarks are covered by soft or bony tissue and therefore inaccessible to the tip of a probe. Therefore, the current invention, as shown in
FIG. 7 , includes a probe (150) which has a graphic representation that includes a real probe tip portion (155) and a virtual probe tip portion (156). The real probe tip portion of the representation (155) correlates directly with the position of the real probe tip (151). The virtual probe tip portion of the representation (156) correlates with a point in space (152) that is located in a fixed and known relationship to the physical probe tip (151). - In order to identify the location of a bony landmark (154) surrounded by soft tissue (153) two x-ray images (160 and 161) are obtained. Preferably the two images (160 and 161) are 90 degrees apart from one another, but may be any suitable angle apart without departing from the instant invention. The surgeon then positions the probe (150) in space, relative to the bony landmark (154) such that the tip of the virtual cursor (156) is coincident with the bony landmark's image (159) in both views (160 and 161) simultaneously. The surgeon then presses a footswitch, or activates some other signaling device, and the 3-D position of the point in space (152) corresponding to the virtual probe tip (152), and therefore the 3-D position of the bony landmark (154), is calculated and recorded in the computer's memory.
- Alternatively, the virtual probe representation can be replaced with a straight line, a curved line, a plane, a curved surface, or some other graphic that allows for the alignment of the virtual probe with one or more landmarks or points. Further, those skilled in the art will recognize that the identification of landmarks or points with the virtual probe is applicable to other surgeries and other imaging modalities.
- In a preferred embodiment, the purpose of identifying landmarks with the virtual probe is to establish a coordinate frame on a patient's pelvis relative to which is oriented the acetabular component in total hip replacement surgery. The patient is placed on his or her side on the operating room table and draped in the usual fashion. The surgeon then makes the usual incision and prepares the femur and pelvic acetabulum in the standard fashion. In the preferred embodiment, shown in
FIG. 8 , two modified AP x-ray images (171 and 172) of the patient's pelvis (181) are acquired by the C-arm fluoroscope and shown on the display (170). The first image (171) is an “inlet view” of the pelvis (181) taken with the C-arm aimed obliquely, approximately 40 degrees, from cephalad and anterior to caudal and posterior. The second image (172) is an “outlet view” of the pelvis (181) taken with the C-arm aimed from caudal and anterior to cephalad and posterior. The surgeon then uses a probe (150) outfitted with localizing emitters (177) to identify three landmarks (182, 183 and 184) by positioning the probe (150) in such a manner that the virtual probe tip (156) overlays the image (173) of the first bony landmark (183) in both views (171, 172). By pressing the footswitch, the system reads the pose of the probe (150) and calculates and records the three-dimensional location of the landmark (183). In this manner, the surgeon records the positions of the left anterior superior iliac spine (ASIS) (182), the right ASIS (183) and the top of the pubic symphysis (184). Alternatively, other bony landmarks may be selected without departing from the instant invention. - As shown in
FIG. 9 , the three landmarks (182, 183 and 184) are used to define a pelvic coordinate system. The first axis (185) of the pelvic coordinate system is contained in a line between the left ASIS (182) and right ASIS (183), a second axis (186) is perpendicular to the first axis and extends through the top of the pubic symphysis (184), and the third axis (187) is orthogonal to the first two axes (185 and 186). The “frontal” plane (188) is defined by the first two axes (185 and 186) and is considered by many orthopaedic surgeons to represent the standard vertical plane of the pelvis (181) during ambulation. Likewise, the axial plane (189) is defined by the first and last axes (185 and 187); and a third plane, the sagittal plane (not shown), is defined by the last two axes (186 and 187). Alternatively, other axes and planes may be defined without departing from the instant invention. - The surgeon then attaches an acetabular component (190) to a positioning instrument (191) outfitted with localizing emitters (192) and then places the component (190) into the patient's prepared acetabulum (179). The system displays a representation (195) of the positioning instrument (191) with the attached acetabular component (190) superimposed on the two images (171 and 172) by using the stored conic projection model of the C-arm. As the surgeon moves the positioning instrument (191), the display is updated in real time to show, graphically, the pose of instrument and implant representation (195) relative to the images of the pelvis.
- At the same time, preferably, angular values (196 and 197) are calculated and displayed to quantify for the surgeon the orientation of the implant (190) relative to the pelvic landmarks (182, 183 and 184). The implant axis (193) is defined as the axis normal to the plane of the rim of the acetabular implant (190). Preferably this axis (193) is coincident with the long axis of the positioning instrument (191). The first value (196), the “abduction angle” is the angle between the implant axis (193) and the second axis (186) when both axes (193 and 186) are projected on the frontal plane (188). A second value (197), the “forward flexion angle” is the angle between the implant axis (193) and the inter-ASIS axis (185) when both axes are projected on the axial plane (189). Preferably, these values (196 and 197) are calculated continuously and displayed in numerical form in real time. Alternatively, other angles or values of interest to the surgeon may be calculated. These values may be displayed in numerous ways including numeric messages or graphic representations of angles or distances.
- Optionally, views of the pelvis from points of view other than those available from the C-arm fluoroscope may be simulated and the orientation of the implant positioning instrument displayed relative to this simulated image. These simulated images may include lateral or axial views of the pelvis and may include any of a number of forms including bitmap pictures, previously obtained x-rays, or projections of CT data. A graphic representation of the implant positioning instrument is appropriately scaled and projected onto a plane that corresponds to that of the image. The representation is centered on the acetabulum and as the orientation of the implant positioning instrument is changed, its representation is reoriented in real time relative to the simulated image.
- Once the surgeon has placed the acetabular component (190) into the proper orientation, an impacting device is used to press-fit the implant (190) into the acetabulum (179). The rest of the procedure, including final sizing of the components and closure of the incision is performed in the usual fashion.
- In the foregoing description, the assumption is made that the body part is held immobile throughout the procedure. Alternatively, a tracking device may be rigidly affixed to the bone that records any changes in pose of the bone during the procedure. This device may be comprised of three LEDs affixed to an assembly that is attached to the pelvis with one or more screws. However, any device that attaches rigidly to the pelvis and tracks its changes in pose may be used. As the tracking device changes pose, indicating a change in pose of the pelvis, the software adjusts the pose of the instrument being overlaid on the x-ray images in order to maintain accurate relative superpositiong.
- In alternative embodiments, other information regarding the fit and sizing of the implant is developed. In one alternative embodiment, the surgeon attaches an array of tracking emitters to the shaft of the femur prior to dislocating the hip and removing the femoral head. The surgeon presses the footswitch while rotating the femur around the femoral head, causing poses of the tracking array to be recorded. The location of the center of the femoral head relative to the tracking array is calculated by methods known in the art. Once the femoral and acetabular components have been placed, the sampling process and calculations are repeated. The software then compares the data recorded before and after the placement of the prosthetic components to provide information to the surgeon regarding the preservation of leg length, femoral offset, or other geometries of the replaced hip. Stored models of the implants used may be incorporated into these calculations to improve the accuracy and usefulness of this information.
- Numerous other image-guided surgical procedures can make use of the virtual probe as a means of identifying the locations of internal landmarks. This invention has utility in any case where the location of a point is to be determined, but it is impossible or undesirable to touch the point directly with a probe tip. Those skilled in the art will recognize the applicability of this invention to other procedures.
- Existing image guided surgery systems display real-time graphic representations of surgical instruments overlaid on images of the body part. As the instrument moves, so does its graphic representation on the screen and when the instrument is removed from the field its representation disappears from the screen. Likewise, a representation of an implant is only valid as long as the implant is attached to a tracked positioning device. A capability of the computer assisted surgical system described in U.S. Pat. No. 6,285,902 is the recording of a surgical instrument's pose at the same time an image of the instrument is acquired. As shown in
FIG. 10 , the instrument's graphic representation (201) is then overlaid on the x-ray images (202) for a period of time that allows the surgeon to verify the accurate functioning of the system by comparing the position of the graphic representation (201) to the instrument's radiographic silhouettes (203) in the x-ray images (202). - An extension of this capability is herein described that improves the surgeon's ability to perform surgery and reduces intraoperative procedure time and radiation exposure. With this invention, the recording of the pose of the instrument occurs at a point in time specified by the surgeon, and an instrument representation is retained immobile on the screen for the purpose of providing the surgeon with information relating to the surgical procedure. The retained instrument representation may be the same as the tracked instrument representation displayed in real time including any real or virtual features, or it may be different from the real-time representation and comprise alternate real or virtual features (e.g., the retained representation for a guide pin may be the cannulated screw that fits over that pin).
- In the preferred embodiment, the invention is an enhancement to the femoral neck fracture fixation procedure previously described. Returning to
FIG. 4 , the drill guide representation including the real drill guide trajectory (130) and the two virtual trajectories (131) is overlaid on the AP image (121) and lateral image (122) of the femur. Once the drill guide (105) is in the proper position, as evidenced by proper alignment of the drill guide trajectory (130) and the two virtual trajectories (131) in the head and neck of the femur image (125), the surgeon inserts the first guide pin (110). Preferably, with the pin (110) inserted and the drill guide (105) still in position, the surgeon presses a footswitch to cause the pose of the drill guide (105) to be recorded. Thereafter, as shown inFIG. 11 , a drill guide representation (209), including the real drill guide trajectory (210) and the virtual trajectories (211), is displayed immobile on the same x-ray images (121 and 122) in the position it occupied relative to the bone (125) when the footswitch was pressed. This retained graphic (209) represents the final position of the first inserted guide pin (210) and the planned trajectories (211) for the subsequent two guide pins. As shown inFIG. 12 , the procedure continues with the surgeon using a drill guide representation with a single trajectory representation (130) to insert the final two guide pins relative to the paths indicated by the retained virtual trajectories (211). Additionally, by pressing the footswitch after each remaining guide pin is inserted, a guide pin representation (210) may be retained on the images (121 and 122) in the positions that correspond to the final inserted poses of the guide pins. - The footswitch that the surgeon uses to indicate that the pose of the instrument is to be recorded may be replaced with any other signaling device without departing from the instant invention. Other possibilities include a pushbutton on the instrument, a keypad or keyboard button, a drill trigger, or a voice activated switch.
- In the preferred embodiment, the graphic representations are displayed overlaid on x-ray images. Alternatively, the representations can be displayed overlaid on other medical imaging data (CT, MRI, etc.) or relative to other instruments in a graphic picture not requiring imaging data.
- While the described application is for insertion of percutaneous hip screws, other surgical procedures may be addressed without departing from the instant invention. In an alternative embodiment, a probe tip or crosshairs representing the virtual cursor tip described previously can be retained on the screen as a reference marker. Likewise, multiple points, with optional interconnecting lines, may be retained to produce a straight or curved path relative to image or model data. In other alternative embodiments, the graphic representation that is retained on the screen may comprise screws used to hold reduction of a complex fracture or affix an implanted device, an implant or individual components of a multi-component implant, reference marks used in subsequent steps of the procedure, or any other instrument, implant, template, measurement, or graphic information that would benefit the surgeon by being retained in a specified position. Further, the graphic representation to be retained may include real or virtual features, and may be the same or different from the representation that was displayed prior to the recording of the instrument's position.
- This invention has utility in numerous other image-guided surgical procedures. Those skilled in the art will recognize the applicability of this invention to other procedures and areas of surgery.
Claims (10)
1. A computer assisted surgery system with enhanced graphic capabilities for insertion of guide pins into a body part, the system comprising:
an x-ray imaging device for generating at least one 2-D image of a body part;
a surgical instrument with a physical feature defining a real trajectory;
a localizing device for measuring the pose of the surgical instrument; and
a computer comprising:
means for displaying the at least one 2-D image of the body part;
means for generating a graphic representation of the real trajectory;
means for determining the location of one or more virtual trajectories relative to the real trajectory, wherein the one or more virtual trajectories represent possible positions of components used during a surgical operation; and
means for superimposing graphic representations of the real and virtual trajectories over the at least one 2-D image of the body part; wherein the virtual trajectories may be used for assisting the surgeon in aligning the surgical instrument relative to the body part or guide pins and said virtual trajectories need not represent a real feature of the surgical instrument.
2. The computer assisted surgery system of claim 1 wherein the surgical instrument is a drill guide, the real trajectory represents the bore of the drill guide and the virtual trajectories represent future possible drill guide trajectories.
3. The computer assisted surgery system of claim 2 further comprising:
means for recording the pose of the drill guide at a signal from the surgeon; and
means for retaining graphic representations of the real and virtual trajectories superimposed on the 2-D image of the body part corresponding to the recorded pose;
wherein the retained virtual trajectories serve as guide lines for subsequent pin insertions.
4. In a computer assisted surgery system with enhanced graphic capabilities for insertion of guide pins into a body part, the system comprising an x-ray imaging device for generating at least one 2-D image of a body part, a surgical instrument with a physical feature defining a real trajectory, a localizing device for measuring the pose of the surgical instrument, and a computer comprising instructions for:
displaying the at least one 2-D image of the body part;
generating a graphic representation of the real trajectory;
determining the location of one or more virtual trajectories relative to the real trajectory, wherein the one or more virtual trajectories represent possible positions of components used during a surgical operation; and
superimposing graphic representations of the real and virtual trajectories over the at least one 2-D image of the body part; wherein the virtual trajectories may be used for assisting the surgeon in aligning the surgical instrument relative to the body part or guide pins and said virtual trajectories need not represent a real feature of the surgical instrument.
5. The computer assisted surgery system of claim 4 wherein the surgical instrument is a drill guide, the real trajectory represents the bore of the drill guide and the virtual trajectories represent future possible drill guide trajectories.
6. The computer assisted surgery system of claim 4 , wherein said computer further comprises instructions for recording the pose of the drill guide at a signal from the surgeon; and retaining graphic representations of the real and virtual trajectories superimposed on the 2-D image of the body part corresponding to the recorded pose, wherein the retained virtual trajectories serve as guide lines for subsequent pin insertions.
7. A computer assisted surgery system with enhanced graphic capabilities for insertion of guide pins into a body part, the system comprising:
an x-ray imaging device that generates an image of a body part;
a surgical instrument with a physical feature defining a real trajectory;
a localizing device for measuring the pose of the surgical instrument; and
a computer that (a) displays the image of the body part; (b) generates a graphic representation of the real trajectory; (c) determines the location of one or more virtual trajectories relative to the real trajectory, wherein the one or more virtual trajectories represent possible positions of components used during a surgical operation; and (d) superimposes graphic representations of the real and virtual trajectories over the image of the body part; wherein the virtual trajectories may be used for assisting the surgeon in aligning the surgical instrument relative to the body part or guide pins.
8. The computer assisted surgery system of claim 7 , wherein said virtual trajectories need not represent a real feature of the surgical instrument.
9. The computer assisted surgery system of claim 7 , wherein the surgical instrument is a drill guide, the real trajectory represents the bore of the drill guide and the virtual trajectories represent future possible drill guide trajectories.
10. The computer assisted surgery system of claim 7 , wherein said computer also records the pose of the drill guide at a signal from the surgeon; and retains graphic representations of the real and virtual trajectories superimposed on the image of the body part corresponding to the recorded pose, wherein the retained virtual trajectories serve as guide lines for subsequent pin insertions.
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Cited By (30)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20020140709A1 (en) * | 2001-03-27 | 2002-10-03 | Frank Sauer | Augmented reality guided instrument positioning with modulated guiding graphics |
US20030037449A1 (en) * | 2001-08-23 | 2003-02-27 | Ali Bani-Hashemi | Augmented and virtual reality guided instrument positioning using along-the-line-of-sight alignment |
US20070038059A1 (en) * | 2005-07-07 | 2007-02-15 | Garrett Sheffer | Implant and instrument morphing |
US20080221570A1 (en) * | 2002-08-09 | 2008-09-11 | Vineet Kumar Sarin | Non-imaging tracking tools and method for hip replacement surgery |
US20080281330A1 (en) * | 2005-03-17 | 2008-11-13 | Ferrante Joseph M | Medical Securing Member Placement System |
US20080319491A1 (en) * | 2007-06-19 | 2008-12-25 | Ryan Schoenefeld | Patient-matched surgical component and methods of use |
WO2009006736A1 (en) * | 2007-07-10 | 2009-01-15 | Cooke T Derek V | Radiographic imaging method and apparatus |
US20090099570A1 (en) * | 2007-10-10 | 2009-04-16 | Francois Paradis | Hip replacement in computer-assisted surgery |
US7840256B2 (en) | 2005-06-27 | 2010-11-23 | Biomet Manufacturing Corporation | Image guided tracking array and method |
US20110040303A1 (en) * | 2009-08-11 | 2011-02-17 | The Cleveland Clinic Foundation | Method and apparatus for insertion of an elongate pin into a surface |
US8165659B2 (en) | 2006-03-22 | 2012-04-24 | Garrett Sheffer | Modeling method and apparatus for use in surgical navigation |
US8571637B2 (en) | 2008-01-21 | 2013-10-29 | Biomet Manufacturing, Llc | Patella tracking method and apparatus for use in surgical navigation |
US8696680B2 (en) | 2009-08-11 | 2014-04-15 | The Cleveland Clinic Foundation | Method and apparatus for insertion of an elongate pin into a surface |
US8934961B2 (en) | 2007-05-18 | 2015-01-13 | Biomet Manufacturing, Llc | Trackable diagnostic scope apparatus and methods of use |
US9050112B2 (en) | 2011-08-23 | 2015-06-09 | Flexmedex, LLC | Tissue removal device and method |
US9125611B2 (en) | 2010-12-13 | 2015-09-08 | Orthoscan, Inc. | Mobile fluoroscopic imaging system |
US9149286B1 (en) * | 2010-11-12 | 2015-10-06 | Flexmedex, LLC | Guidance tool and method for use |
US9265468B2 (en) | 2011-05-11 | 2016-02-23 | Broncus Medical, Inc. | Fluoroscopy-based surgical device tracking method |
US9398675B2 (en) | 2009-03-20 | 2016-07-19 | Orthoscan, Inc. | Mobile imaging apparatus |
US9510771B1 (en) | 2011-10-28 | 2016-12-06 | Nuvasive, Inc. | Systems and methods for performing spine surgery |
US20170000562A1 (en) * | 2015-07-01 | 2017-01-05 | Mako Surgical Corp. | Implant placement planning |
US9770339B2 (en) | 2005-07-14 | 2017-09-26 | Stout Medical Group, L.P. | Expandable support device and method of use |
US9848922B2 (en) | 2013-10-09 | 2017-12-26 | Nuvasive, Inc. | Systems and methods for performing spine surgery |
US9875544B2 (en) | 2013-08-09 | 2018-01-23 | Broncus Medical Inc. | Registration of fluoroscopic images of the chest and corresponding 3D image data based on the ribs and spine |
US10070968B2 (en) | 2010-08-24 | 2018-09-11 | Flexmedex, LLC | Support device and method for use |
US10285819B2 (en) | 2008-11-12 | 2019-05-14 | Stout Medical Group, L.P. | Fixation device and method |
US10568602B2 (en) | 2017-09-06 | 2020-02-25 | General Electric Company | Virtual positioning image for use in imaging |
US10758289B2 (en) | 2006-05-01 | 2020-09-01 | Stout Medical Group, L.P. | Expandable support device and method of use |
US10940014B2 (en) | 2008-11-12 | 2021-03-09 | Stout Medical Group, L.P. | Fixation device and method |
US11051954B2 (en) | 2004-09-21 | 2021-07-06 | Stout Medical Group, L.P. | Expandable support device and method of use |
Families Citing this family (204)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9833167B2 (en) * | 1999-05-18 | 2017-12-05 | Mediguide Ltd. | Method and system for superimposing virtual anatomical landmarks on an image |
US7778688B2 (en) | 1999-05-18 | 2010-08-17 | MediGuide, Ltd. | System and method for delivering a stent to a selected position within a lumen |
US9572519B2 (en) | 1999-05-18 | 2017-02-21 | Mediguide Ltd. | Method and apparatus for invasive device tracking using organ timing signal generated from MPS sensors |
US6702821B2 (en) | 2000-01-14 | 2004-03-09 | The Bonutti 2003 Trust A | Instrumentation for minimally invasive joint replacement and methods for using same |
US7635390B1 (en) | 2000-01-14 | 2009-12-22 | Marctec, Llc | Joint replacement component having a modular articulating surface |
CA2334495A1 (en) * | 2001-02-06 | 2002-08-06 | Surgical Navigation Specialists, Inc. | Computer-aided positioning method and system |
WO2002062250A1 (en) * | 2001-02-07 | 2002-08-15 | Synthes Ag Chur | Device and method for intraoperative navigation |
NO20011275L (en) * | 2001-03-13 | 2002-09-16 | Bjoern Franc Iversen | System for providing information about the result after insertion of the prosthesis into the hip joint |
NO20011769D0 (en) * | 2001-04-06 | 2001-04-06 | Bjoern Franc Iversen | Device and system for mutual positioning of prosthetic parts |
US7526112B2 (en) | 2001-04-30 | 2009-04-28 | Chase Medical, L.P. | System and method for facilitating cardiac intervention |
US7327862B2 (en) * | 2001-04-30 | 2008-02-05 | Chase Medical, L.P. | System and method for facilitating cardiac intervention |
US6723102B2 (en) * | 2001-06-14 | 2004-04-20 | Alexandria Research Technologies, Llc | Apparatus and method for minimally invasive total joint replacement |
US7708741B1 (en) | 2001-08-28 | 2010-05-04 | Marctec, Llc | Method of preparing bones for knee replacement surgery |
AU2002361572A1 (en) * | 2001-10-19 | 2003-04-28 | University Of North Carolina At Chape Hill | Methods and systems for dynamic virtual convergence and head mountable display |
US6711431B2 (en) * | 2002-02-13 | 2004-03-23 | Kinamed, Inc. | Non-imaging, computer assisted navigation system for hip replacement surgery |
US9375203B2 (en) | 2002-03-25 | 2016-06-28 | Kieran Murphy Llc | Biopsy needle |
US7927368B2 (en) * | 2002-03-25 | 2011-04-19 | Kieran Murphy Llc | Device viewable under an imaging beam |
US20030181810A1 (en) * | 2002-03-25 | 2003-09-25 | Murphy Kieran P. | Kit for image guided surgical procedures |
CA2479848A1 (en) * | 2002-04-05 | 2003-10-23 | Smith & Nephew, Inc. | Orthopaedic fixation method and device |
US8180429B2 (en) * | 2002-04-17 | 2012-05-15 | Warsaw Orthopedic, Inc. | Instrumentation and method for mounting a surgical navigation reference device to a patient |
ATE409006T1 (en) * | 2002-05-21 | 2008-10-15 | Plus Orthopedics Ag | ARRANGEMENT FOR DETERMINING FUNCTIONAL GEOMETRIC SIZE OF A JOINT OF A VERTEBRATE |
JP4439393B2 (en) | 2002-06-17 | 2010-03-24 | メイザー サージカル テクノロジーズ リミテッド | Robots for use with orthopedic inserts |
AU2003257339A1 (en) * | 2002-08-26 | 2004-03-11 | Orthosoft Inc. | Computer aided surgery system and method for placing multiple implants |
US7166114B2 (en) | 2002-09-18 | 2007-01-23 | Stryker Leibinger Gmbh & Co Kg | Method and system for calibrating a surgical tool and adapter thereof |
DE60326608D1 (en) * | 2002-10-04 | 2009-04-23 | Orthosoft Inc | COMPUTER-ASSISTED HIP SET OF SURGERY |
US7660623B2 (en) | 2003-01-30 | 2010-02-09 | Medtronic Navigation, Inc. | Six degree of freedom alignment display for medical procedures |
US7542791B2 (en) | 2003-01-30 | 2009-06-02 | Medtronic Navigation, Inc. | Method and apparatus for preplanning a surgical procedure |
WO2004068406A2 (en) | 2003-01-30 | 2004-08-12 | Chase Medical, L.P. | A method and system for image processing and contour assessment |
US20050043609A1 (en) * | 2003-01-30 | 2005-02-24 | Gregory Murphy | System and method for facilitating cardiac intervention |
EP1615577A2 (en) * | 2003-02-04 | 2006-01-18 | Orthosoft, Inc. | Cas modular bone reference assembly and limb position measurement system |
EP1667573A4 (en) * | 2003-02-04 | 2008-02-20 | Z Kat Inc | Method and apparatus for computer assistance with total hip replacement procedure |
US20050049672A1 (en) * | 2003-03-24 | 2005-03-03 | Murphy Kieran P. | Stent delivery system and method using a balloon for a self-expandable stent |
JP4777878B2 (en) * | 2003-04-02 | 2011-09-21 | キナメッド・インコーポレーテッド | Pelvic plane positioner and patient positioner |
FR2854318B1 (en) * | 2003-05-02 | 2010-10-22 | Perception Raisonnement Action | DETERMINING THE POSITION OF AN ANATOMIC ELEMENT |
AU2004251653A1 (en) | 2003-06-02 | 2005-01-06 | Stephen B. Murphy | Virtual trial reduction system for hip arthroplasty and coordinate systems therefor |
US7559931B2 (en) | 2003-06-09 | 2009-07-14 | OrthAlign, Inc. | Surgical orientation system and method |
WO2004112610A2 (en) * | 2003-06-09 | 2004-12-29 | Vitruvian Orthopaedics, Llc | Surgical orientation device and method |
WO2005006986A1 (en) * | 2003-07-22 | 2005-01-27 | Koninklijke Philips Electronics N.V. | Radiation mask for two dimensional ct detector |
US20050038338A1 (en) * | 2003-08-11 | 2005-02-17 | Bono James Vincent | Pre-operative planning of implantations |
US7862570B2 (en) | 2003-10-03 | 2011-01-04 | Smith & Nephew, Inc. | Surgical positioners |
US7764985B2 (en) | 2003-10-20 | 2010-07-27 | Smith & Nephew, Inc. | Surgical navigation system component fault interfaces and related processes |
US7794467B2 (en) | 2003-11-14 | 2010-09-14 | Smith & Nephew, Inc. | Adjustable surgical cutting systems |
US20070014452A1 (en) * | 2003-12-01 | 2007-01-18 | Mitta Suresh | Method and system for image processing and assessment of a state of a heart |
DE10357184A1 (en) * | 2003-12-08 | 2005-07-07 | Siemens Ag | Combination of different images relating to bodily region under investigation, produces display images from assembled three-dimensional fluorescence data image set |
US7873400B2 (en) * | 2003-12-10 | 2011-01-18 | Stryker Leibinger Gmbh & Co. Kg. | Adapter for surgical navigation trackers |
US7771436B2 (en) | 2003-12-10 | 2010-08-10 | Stryker Leibinger Gmbh & Co. Kg. | Surgical navigation tracker, system and method |
US7815644B2 (en) * | 2003-12-19 | 2010-10-19 | Masini Michael A | Instrumentation and methods for refining image-guided and navigation-based surgical procedures |
US7333643B2 (en) * | 2004-01-30 | 2008-02-19 | Chase Medical, L.P. | System and method for facilitating cardiac intervention |
US20050281465A1 (en) * | 2004-02-04 | 2005-12-22 | Joel Marquart | Method and apparatus for computer assistance with total hip replacement procedure |
FR2865928B1 (en) * | 2004-02-10 | 2006-03-17 | Tornier Sa | SURGICAL DEVICE FOR IMPLANTATION OF A TOTAL HIP PROSTHESIS |
WO2005084541A1 (en) * | 2004-03-05 | 2005-09-15 | Depuy International Ltd | Pelvis registration method and apparatus |
ITMI20040695A1 (en) * | 2004-04-08 | 2004-07-08 | Teleios S R L | AUTOMATIC POINTING EQUIPMENT FOR THE CORRECT POSITIONING OF THE DISTAL LOCKING SCREWS OF AN ENDOMIDOLLAR NAIL |
EP1737375B1 (en) | 2004-04-21 | 2021-08-11 | Smith & Nephew, Inc | Computer-aided navigation systems for shoulder arthroplasty |
US20060004284A1 (en) * | 2004-06-30 | 2006-01-05 | Frank Grunschlager | Method and system for generating three-dimensional model of part of a body from fluoroscopy image data and specific landmarks |
KR100617490B1 (en) | 2004-09-03 | 2006-09-04 | 한국과학기술원 | Acetabular cup orientator attachable on pelvic in THR |
US8361128B2 (en) * | 2004-09-30 | 2013-01-29 | Depuy Products, Inc. | Method and apparatus for performing a computer-assisted orthopaedic procedure |
FR2876896B1 (en) * | 2004-10-21 | 2007-10-26 | Gen Electric | METHOD FOR USING A TOMOGRAPHY DEVICE FOR OBTAINING RADIOSCOPIC IMAGES AND DEVICE FOR CARRYING OUT SAID METHOD |
US20060127852A1 (en) * | 2004-12-14 | 2006-06-15 | Huafeng Wen | Image based orthodontic treatment viewing system |
DE102005003318A1 (en) * | 2005-01-17 | 2006-07-27 | Aesculap Ag & Co. Kg | Displaying method for the position of a medical instrument in which planes and an intersection line are defined and determined for the femur and inserted instrument |
CA2594994C (en) * | 2005-01-26 | 2013-07-02 | Orthosoft Inc. | Computer-assisted hip joint resurfacing method and system |
US8055487B2 (en) * | 2005-02-22 | 2011-11-08 | Smith & Nephew, Inc. | Interactive orthopaedic biomechanics system |
US20060241397A1 (en) * | 2005-02-22 | 2006-10-26 | Assaf Govari | Reference pad for position sensing |
CA2601976A1 (en) | 2005-02-22 | 2006-08-31 | Smith & Nephew, Inc. | In-line milling system |
GB0507243D0 (en) * | 2005-04-09 | 2005-05-18 | Depuy Int Ltd | Acetabular cup positioning |
KR100706030B1 (en) * | 2005-04-12 | 2007-04-11 | 한국과학기술원 | Navigation system for hip replacement surgery having reference device and method using the same |
US20070016011A1 (en) * | 2005-05-18 | 2007-01-18 | Robert Schmidt | Instrument position recording in medical navigation |
DE102005028831A1 (en) * | 2005-06-15 | 2006-12-28 | Aesculap Ag & Co. Kg | Method and surgical navigation system for producing a receiving cavity for an acetabular cup |
US7458989B2 (en) * | 2005-06-30 | 2008-12-02 | University Of Florida Rearch Foundation, Inc. | Intraoperative joint force measuring device, system and method |
US7643862B2 (en) | 2005-09-15 | 2010-01-05 | Biomet Manufacturing Corporation | Virtual mouse for use in surgical navigation |
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 |
US9402639B2 (en) * | 2005-12-14 | 2016-08-02 | General Electric Company | Method and apparatus for alignment of a mobile fluoroscopic imaging system |
US20150335438A1 (en) | 2006-02-27 | 2015-11-26 | Biomet Manufacturing, Llc. | Patient-specific augments |
US8337426B2 (en) | 2009-03-24 | 2012-12-25 | Biomet Manufacturing Corp. | Method and apparatus for aligning and securing an implant relative to a patient |
US8603180B2 (en) | 2006-02-27 | 2013-12-10 | Biomet Manufacturing, Llc | Patient-specific acetabular alignment guides |
US9289253B2 (en) | 2006-02-27 | 2016-03-22 | Biomet Manufacturing, Llc | Patient-specific shoulder guide |
US8591516B2 (en) | 2006-02-27 | 2013-11-26 | Biomet Manufacturing, Llc | Patient-specific orthopedic instruments |
US8167823B2 (en) * | 2009-03-24 | 2012-05-01 | Biomet Manufacturing Corp. | Method and apparatus for aligning and securing an implant relative to a patient |
US8407067B2 (en) | 2007-04-17 | 2013-03-26 | Biomet Manufacturing Corp. | Method and apparatus for manufacturing an implant |
US9345548B2 (en) | 2006-02-27 | 2016-05-24 | Biomet Manufacturing, Llc | Patient-specific pre-operative planning |
US9173661B2 (en) | 2006-02-27 | 2015-11-03 | Biomet Manufacturing, Llc | Patient specific alignment guide with cutting surface and laser indicator |
US9918740B2 (en) | 2006-02-27 | 2018-03-20 | Biomet Manufacturing, Llc | Backup surgical instrument system and method |
US9339278B2 (en) | 2006-02-27 | 2016-05-17 | Biomet Manufacturing, Llc | Patient-specific acetabular guides and associated instruments |
US9907659B2 (en) | 2007-04-17 | 2018-03-06 | Biomet Manufacturing, Llc | Method and apparatus for manufacturing an implant |
US10765356B2 (en) * | 2006-03-23 | 2020-09-08 | Orthosoft Ulc | Method and system for tracking tools in computer-assisted surgery |
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 |
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 |
US7728868B2 (en) | 2006-08-02 | 2010-06-01 | Inneroptic Technology, Inc. | System and method of providing real-time dynamic imagery of a medical procedure site using multiple modalities |
ATE489906T1 (en) * | 2006-08-15 | 2010-12-15 | Ao Technology Ag | DEVICE FOR COMPUTER-ASSISTED DISTAL LOCKING OF INTEGRAL NAILS AND METHOD FOR LOCALIZING THE DISTAL LOCKING HOLES OF INTEGRAL NAILS |
US20080200917A1 (en) * | 2007-02-15 | 2008-08-21 | Lin Shih-Wei | Targeting device for femur intertrochanteric fracture |
US8784425B2 (en) | 2007-02-28 | 2014-07-22 | Smith & Nephew, Inc. | Systems and methods for identifying landmarks on orthopedic implants |
WO2008105874A1 (en) * | 2007-02-28 | 2008-09-04 | Smith & Nephew, Inc. | Instrumented orthopaedic implant for identifying a landmark |
US8792688B2 (en) | 2007-03-01 | 2014-07-29 | Titan Medical Inc. | Methods, systems and devices for three dimensional input and control methods and systems based thereon |
US11576736B2 (en) | 2007-03-01 | 2023-02-14 | Titan Medical Inc. | Hand controller for robotic surgery system |
WO2008153964A1 (en) * | 2007-06-07 | 2008-12-18 | Sam Hakki | Apparatus and method of determining acetabular center axis |
IL184151A0 (en) * | 2007-06-21 | 2007-10-31 | Diagnostica Imaging Software Ltd | X-ray measurement method |
DE102007049671A1 (en) * | 2007-10-17 | 2009-04-30 | Aesculap Ag | Method and device for determining the frontal plane of the pelvic bone |
DE102007049668B3 (en) * | 2007-10-17 | 2009-04-16 | Aesculap Ag | Method and device for determining the angular position of an acetabular cup in a pelvic bone |
EP2191783B1 (en) * | 2008-01-09 | 2016-08-03 | Stryker European Holdings I, LLC | System for stereotactic computer assisted surgery based on three-dimensional visualization |
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 |
GB0803625D0 (en) * | 2008-02-28 | 2008-04-02 | Depuy Int Ltd | Acetabular alignment guide |
US9220514B2 (en) * | 2008-02-28 | 2015-12-29 | Smith & Nephew, Inc. | System and method for identifying a landmark |
US8340379B2 (en) | 2008-03-07 | 2012-12-25 | Inneroptic Technology, Inc. | Systems and methods for displaying guidance data based on updated deformable imaging data |
US20090312629A1 (en) * | 2008-06-13 | 2009-12-17 | Inneroptic Technology Inc. | Correction of relative tracking errors based on a fiducial |
WO2009153789A1 (en) * | 2008-06-18 | 2009-12-23 | Surgix Ltd. | A method and system for stitching multiple images into a panoramic image |
EP3381382A1 (en) | 2008-07-24 | 2018-10-03 | OrthAlign, Inc. | Systems for joint replacement |
WO2010013236A1 (en) | 2008-07-29 | 2010-02-04 | Superfish Ltd | Increasing interest point coverage in an image |
EP2358310B1 (en) | 2008-09-10 | 2019-07-31 | OrthAlign, Inc. | Hip surgery systems |
US8315720B2 (en) * | 2008-09-26 | 2012-11-20 | Intuitive Surgical Operations, Inc. | Method for graphically providing continuous change of state directions to a user of a medical 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 |
US8554307B2 (en) | 2010-04-12 | 2013-10-08 | Inneroptic Technology, Inc. | Image annotation in image-guided medical procedures |
US8690776B2 (en) | 2009-02-17 | 2014-04-08 | Inneroptic Technology, Inc. | Systems, methods, apparatuses, and computer-readable media for image guided surgery |
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 |
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 |
US8366719B2 (en) | 2009-03-18 | 2013-02-05 | Integrated Spinal Concepts, Inc. | Image-guided minimal-step placement of screw into bone |
US8945147B2 (en) | 2009-04-27 | 2015-02-03 | Smith & Nephew, Inc. | System and method for identifying a landmark |
US9031637B2 (en) | 2009-04-27 | 2015-05-12 | Smith & Nephew, Inc. | Targeting an orthopaedic implant landmark |
JP5360686B2 (en) * | 2009-05-27 | 2013-12-04 | 株式会社リコー | Fixing apparatus and image forming apparatus |
US10869771B2 (en) | 2009-07-24 | 2020-12-22 | OrthAlign, Inc. | Systems and methods for joint replacement |
US8118815B2 (en) | 2009-07-24 | 2012-02-21 | OrthAlign, Inc. | Systems and methods for joint replacement |
WO2011014687A2 (en) * | 2009-07-31 | 2011-02-03 | Inneroptic Technology, Inc. | Dual-tube stereoscope |
US9370317B2 (en) | 2009-09-08 | 2016-06-21 | Brainlab Ag | Determining a plane of anatomical body part |
US20110082351A1 (en) * | 2009-10-07 | 2011-04-07 | Inneroptic Technology, Inc. | Representing measurement information during a medical procedure |
WO2011060536A1 (en) * | 2009-11-17 | 2011-05-26 | Queen's University At Kingston | Patient-specific guide for acetabular cup placement |
US8608802B2 (en) | 2009-11-20 | 2013-12-17 | Zimmer Knee Creations, Inc. | Implantable devices for subchondral treatment of joint pain |
KR20120132469A (en) | 2009-11-20 | 2012-12-05 | 니 크리에이션스, 엘엘씨 | Coordinate mapping system for joint treatment |
US8951261B2 (en) | 2009-11-20 | 2015-02-10 | Zimmer Knee Creations, Inc. | Subchondral treatment of joint pain |
KR20120104580A (en) | 2009-11-20 | 2012-09-21 | 니 크리에이션스, 엘엘씨 | Navigation and positioning instruments for joint repair |
WO2011063267A1 (en) * | 2009-11-20 | 2011-05-26 | Knee Creations, Llc | Instruments for a variable angle approach to a joint |
US8801800B2 (en) | 2009-11-20 | 2014-08-12 | Zimmer Knee Creations, Inc. | Bone-derived implantable devices and tool for subchondral treatment of joint pain |
US8821504B2 (en) | 2009-11-20 | 2014-09-02 | Zimmer Knee Creations, Inc. | Method for treating joint pain and associated instruments |
AU2010321812B2 (en) | 2009-11-20 | 2015-05-14 | Knee Creations, Llc | Instruments for targeting a joint defect |
FR2955250B1 (en) * | 2010-01-15 | 2012-02-03 | Tornier Sa | SURGICAL ASSISTANCE ASSEMBLY FOR THE IMPLANTATION OF A GLENOIDAL COMPONENT OF SHOULDER PROSTHESIS |
US9282947B2 (en) | 2009-12-01 | 2016-03-15 | Inneroptic Technology, Inc. | Imager focusing based on intraoperative data |
CA2825042C (en) | 2010-01-21 | 2021-01-05 | OrthAlign, Inc. | Systems and methods for joint replacement |
US10588647B2 (en) * | 2010-03-01 | 2020-03-17 | Stryker European Holdings I, Llc | Computer assisted surgery system |
US20120022357A1 (en) | 2010-04-26 | 2012-01-26 | David Chang | Medical emitter/detector imaging/alignment system and method |
DE102010020284A1 (en) * | 2010-05-12 | 2011-11-17 | Siemens Aktiengesellschaft | Determination of 3D positions and orientations of surgical objects from 2D X-ray images |
BR112012030791A2 (en) | 2010-06-03 | 2016-11-01 | Smith & Nephew Inc | orthopedic implants |
EP2593023B1 (en) | 2010-07-16 | 2018-09-19 | Stryker European Holdings I, LLC | Surgical targeting system and method |
US9968376B2 (en) | 2010-11-29 | 2018-05-15 | Biomet Manufacturing, Llc | Patient-specific orthopedic instruments |
AU2011342900A1 (en) | 2010-12-17 | 2013-07-18 | Intellijoint Surgical Inc. | Method and system for aligning a prosthesis during surgery |
US8890511B2 (en) | 2011-01-25 | 2014-11-18 | Smith & Nephew, Inc. | Targeting operation sites |
US20120209419A1 (en) | 2011-02-14 | 2012-08-16 | Mako Surgical Corporation | System and Method for Surgical Planning |
EP2677946B1 (en) | 2011-02-22 | 2016-08-17 | Zimmer Knee Creations, Inc. | Guide systems for joint repair |
CN103635153A (en) | 2011-05-06 | 2014-03-12 | 史密夫和内修有限公司 | Targeting landmark of orthopaedic devices |
EP2720631B1 (en) | 2011-06-16 | 2022-01-26 | Smith&Nephew, Inc. | Surgical alignment using references |
US9949665B2 (en) * | 2011-06-17 | 2018-04-24 | Brainlab Ag | Method, system and device for positioning 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 |
US10219811B2 (en) | 2011-06-27 | 2019-03-05 | Board Of Regents Of The University Of Nebraska | On-board tool tracking system and methods of computer assisted surgery |
EP3656317A1 (en) | 2011-09-02 | 2020-05-27 | Stryker Corporation | Surgical system including an instrument and method for using the instrument |
AU2012315809B2 (en) | 2011-09-29 | 2017-06-08 | Arthromeda, Inc. | System and method for precise prosthesis positioning in hip arthroplasty |
US9687308B2 (en) * | 2011-12-15 | 2017-06-27 | AO Technolgoy AG | Method and a device for computer assisted surgery |
DE102012200921B4 (en) * | 2012-01-23 | 2014-08-21 | Siemens Aktiengesellschaft | A method for determining a deviation of a medical instrument from a target position |
US8670816B2 (en) | 2012-01-30 | 2014-03-11 | Inneroptic Technology, Inc. | Multiple medical device guidance |
US9877847B2 (en) | 2012-02-29 | 2018-01-30 | Smith & Nephew, Inc. | Determining anatomical orientations |
US9314188B2 (en) | 2012-04-12 | 2016-04-19 | Intellijoint Surgical Inc. | Computer-assisted joint replacement surgery and navigation systems |
EP2849683A4 (en) | 2012-05-18 | 2015-11-25 | Orthalign Inc | Devices and methods for knee arthroplasty |
US10034713B2 (en) | 2012-07-03 | 2018-07-31 | 7D Surgical Inc. | Attachments for tracking handheld implements |
US9649160B2 (en) | 2012-08-14 | 2017-05-16 | OrthAlign, Inc. | Hip replacement navigation system and method |
ES2641310T3 (en) | 2012-09-27 | 2017-11-08 | Stryker European Holdings I, Llc | Determination of the rotation position |
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 |
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 |
US9585768B2 (en) | 2013-03-15 | 2017-03-07 | DePuy Synthes Products, Inc. | Acetabular cup prosthesis alignment system and method |
US9247998B2 (en) | 2013-03-15 | 2016-02-02 | Intellijoint Surgical Inc. | System and method for intra-operative leg position measurement |
US9248002B2 (en) | 2013-09-26 | 2016-02-02 | Howmedica Osteonics Corp. | Method for aligning an acetabular cup |
US10245160B2 (en) | 2013-12-29 | 2019-04-02 | Kambiz Behzadi | Prosthesis installation systems and methods |
US10172722B2 (en) | 2013-12-29 | 2019-01-08 | Kambiz Behzadi | Prosthesis installation systems and methods |
EP3089685B1 (en) | 2013-12-29 | 2020-07-15 | Behzadi, Kambiz | Prosthesis positioning systems |
US10610379B2 (en) | 2013-12-29 | 2020-04-07 | Kambiz Behzadi | Prosthesis installation systems and methods |
US10478318B2 (en) | 2013-12-29 | 2019-11-19 | Kambiz Behzadi | Prosthesis installation systems and methods |
US10245162B2 (en) | 2013-12-29 | 2019-04-02 | Kambiz Behzadi | Prosthesis installation systems and methods |
US9168154B2 (en) | 2013-12-29 | 2015-10-27 | Kambiz Behzadi | Prosthesis installation systems and methods |
US10456271B2 (en) | 2013-12-29 | 2019-10-29 | Kambiz Behzadi | Prosthesis revision systems and methods |
US20150216541A1 (en) * | 2014-02-03 | 2015-08-06 | Arthrex, Inc. | Pointing device and drilling tool |
US10828120B2 (en) * | 2014-06-19 | 2020-11-10 | Kb Medical, Sa | Systems and methods for performing minimally invasive surgery |
US9901406B2 (en) | 2014-10-02 | 2018-02-27 | Inneroptic Technology, Inc. | Affected region display associated with a medical device |
US10188467B2 (en) | 2014-12-12 | 2019-01-29 | Inneroptic Technology, Inc. | Surgical guidance intersection display |
CN112998807A (en) * | 2015-02-13 | 2021-06-22 | 瑟西纳斯医疗技术有限责任公司 | System and method for placing a medical device in a bone |
US10363149B2 (en) | 2015-02-20 | 2019-07-30 | OrthAlign, Inc. | Hip replacement navigation system and method |
US10716626B2 (en) * | 2015-06-24 | 2020-07-21 | Edda Technology, Inc. | Method and system for interactive 3D scope placement and measurements for kidney stone removal procedure |
US9949700B2 (en) | 2015-07-22 | 2018-04-24 | Inneroptic Technology, Inc. | Medical device approaches |
WO2017015738A1 (en) * | 2015-07-27 | 2017-02-02 | Synaptive Medical (Barbados) Inc. | Navigational feedback for intraoperative waypoint |
US10321961B2 (en) | 2015-11-05 | 2019-06-18 | Howmedica Osteonics Corp. | Patient specific implantation method for range of motion hip impingement |
US9675319B1 (en) | 2016-02-17 | 2017-06-13 | Inneroptic Technology, Inc. | Loupe display |
AU2017295728B2 (en) | 2016-07-15 | 2021-03-25 | Mako Surgical Corp. | Systems for a robotic-assisted revision procedure |
EP3533407A4 (en) * | 2016-10-25 | 2020-05-13 | LEXI Co., Ltd. | Surgery assistance system |
US10278778B2 (en) | 2016-10-27 | 2019-05-07 | Inneroptic Technology, Inc. | Medical device navigation using a virtual 3D space |
WO2018107042A2 (en) | 2016-12-08 | 2018-06-14 | The Cleveland Clinic Foundation | Model-based surgical planning and implant placement |
US10722310B2 (en) | 2017-03-13 | 2020-07-28 | Zimmer Biomet CMF and Thoracic, LLC | Virtual surgery planning system and method |
WO2018169980A1 (en) | 2017-03-14 | 2018-09-20 | OrthAlign, Inc. | Soft tissue measurement & balancing systems and methods |
CA3056382A1 (en) | 2017-03-14 | 2018-09-20 | OrthAlign, Inc. | Hip replacement navigation systems and methods |
US10881530B2 (en) * | 2017-04-28 | 2021-01-05 | Warsaw Orthopedic, Inc. | Surgical instrument and method |
US11259879B2 (en) | 2017-08-01 | 2022-03-01 | Inneroptic Technology, Inc. | Selective transparency to assist medical device navigation |
WO2019036524A1 (en) * | 2017-08-14 | 2019-02-21 | Scapa Flow, Llc | System and method using augmented reality with shape alignment for medical device placement in bone |
US11484365B2 (en) | 2018-01-23 | 2022-11-01 | Inneroptic Technology, Inc. | Medical image guidance |
US11523872B1 (en) * | 2018-12-03 | 2022-12-13 | Memic Innovative Surgery Ltd. | Systems and methods for guiding manipulation of endoscopic tools for endoscopic surgery |
CN111888059B (en) * | 2020-07-06 | 2021-07-27 | 北京长木谷医疗科技有限公司 | Full hip joint image processing method and device based on deep learning and X-ray |
US11890058B2 (en) | 2021-01-21 | 2024-02-06 | Arthrex, Inc. | Orthopaedic planning systems and methods of repair |
WO2022169906A1 (en) * | 2021-02-02 | 2022-08-11 | Circinus Medical Technology Llc | Systems and methods for simulating three- dimensional orientations of surgical hardware devices about an insertion point of an anatomy |
CN113681895B (en) * | 2021-08-20 | 2023-03-10 | 宜宾显微智能科技有限公司 | Guide pin positioning guide plate customization and simulation verification system and method |
US11759216B2 (en) | 2021-09-22 | 2023-09-19 | Arthrex, Inc. | Orthopaedic fusion planning systems and methods of repair |
Citations (25)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4305394A (en) * | 1980-12-22 | 1981-12-15 | Bertuch Jr Charles J | Acetabular cup positioning instrument |
US4475549A (en) * | 1982-01-18 | 1984-10-09 | Indong Oh | Acetabular cup positioner and method |
US4632111A (en) * | 1985-03-21 | 1986-12-30 | Minnesota Mining And Manufacturing Company | Acetabular cup positioning apparatus |
US4716894A (en) * | 1986-08-27 | 1988-01-05 | Zimmer, Inc. | Acetabular cup inserting instrument |
US4994064A (en) * | 1989-12-21 | 1991-02-19 | Aboczky Robert I | Instrument for orienting, inserting and impacting an acetabular cup prosthesis |
US5007936A (en) * | 1988-02-18 | 1991-04-16 | Cemax, Inc. | Surgical method for hip joint replacement |
US5251127A (en) * | 1988-02-01 | 1993-10-05 | Faro Medical Technologies Inc. | Computer-aided surgery apparatus |
US5562448A (en) * | 1990-04-10 | 1996-10-08 | Mushabac; David R. | Method for facilitating dental diagnosis and treatment |
US5638819A (en) * | 1995-08-29 | 1997-06-17 | Manwaring; Kim H. | Method and apparatus for guiding an instrument to a target |
US5682886A (en) * | 1995-12-26 | 1997-11-04 | Musculographics Inc | Computer-assisted surgical system |
US5772594A (en) * | 1995-10-17 | 1998-06-30 | Barrick; Earl F. | Fluoroscopic image guided orthopaedic surgery system with intraoperative registration |
US5799055A (en) * | 1996-05-15 | 1998-08-25 | Northwestern University | Apparatus and method for planning a stereotactic surgical procedure using coordinated fluoroscopy |
US5880976A (en) * | 1997-02-21 | 1999-03-09 | Carnegie Mellon University | Apparatus and method for facilitating the implantation of artificial components in joints |
US6006126A (en) * | 1991-01-28 | 1999-12-21 | Cosman; Eric R. | System and method for stereotactic registration of image scan data |
US6064904A (en) * | 1997-11-28 | 2000-05-16 | Picker International, Inc. | Frameless stereotactic CT scanner with virtual needle display for planning image guided interventional procedures |
US6063124A (en) * | 1999-03-01 | 2000-05-16 | Amstutz; Harlan C. | Acetabular cup prosthesis insertion and removal assembly and technique |
US6214014B1 (en) * | 1998-05-19 | 2001-04-10 | Mcgann William A. | Acetabular total hip component alignment system for accurate intraoperative positioning in inclination |
US20010016684A1 (en) * | 1996-06-28 | 2001-08-23 | The Board Of Trustees Of The Leland Stanford Junior University | Method and apparaus for volumetric image navigation |
US6302890B1 (en) * | 2000-03-16 | 2001-10-16 | Leone Innovations Corporation | Pelvic alignment assembly |
US6370418B1 (en) * | 1997-03-18 | 2002-04-09 | Franciscus Pieter Bernoski | Device and method for measuring the position of a bone implant |
US6405072B1 (en) * | 1991-01-28 | 2002-06-11 | Sherwood Services Ag | Apparatus and method for determining a location of an anatomical target with reference to a medical apparatus |
US6470207B1 (en) * | 1999-03-23 | 2002-10-22 | Surgical Navigation Technologies, Inc. | Navigational guidance via computer-assisted fluoroscopic imaging |
US6711432B1 (en) * | 2000-10-23 | 2004-03-23 | Carnegie Mellon University | Computer-aided orthopedic surgery |
US6725080B2 (en) * | 2000-03-01 | 2004-04-20 | Surgical Navigation Technologies, Inc. | Multiple cannula image guided tool for image guided procedures |
US7130676B2 (en) * | 1998-08-20 | 2006-10-31 | Sofamor Danek Holdings, Inc. | Fluoroscopic image guided orthopaedic surgery system with intraoperative registration |
Family Cites Families (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5141512A (en) * | 1989-08-28 | 1992-08-25 | Farmer Malcolm H | Alignment of hip joint sockets in hip joint replacement |
DE29704393U1 (en) * | 1997-03-11 | 1997-07-17 | Aesculap Ag | Device for preoperative determination of the position data of endoprosthesis parts |
US6285902B1 (en) * | 1999-02-10 | 2001-09-04 | Surgical Insights, Inc. | Computer assisted targeting device for use in orthopaedic surgery |
US6671538B1 (en) * | 1999-11-26 | 2003-12-30 | Koninklijke Philips Electronics, N.V. | Interface system for use with imaging devices to facilitate visualization of image-guided interventional procedure planning |
US20010034530A1 (en) * | 2000-01-27 | 2001-10-25 | Malackowski Donald W. | Surgery system |
US6395005B1 (en) * | 2000-04-14 | 2002-05-28 | Howmedica Osteonics Corp. | Acetabular alignment apparatus and method |
US6993374B2 (en) * | 2002-04-17 | 2006-01-31 | Ricardo Sasso | Instrumentation and method for mounting a surgical navigation reference device to a patient |
US6743235B2 (en) * | 2002-10-15 | 2004-06-01 | Goli V. Subba Rao | Modular instrument for positioning acetabular prosthetic socket |
-
2001
- 2001-11-19 US US09/683,104 patent/US6917827B2/en not_active Expired - Fee Related
-
2005
- 2005-01-07 US US11/031,241 patent/US20050119561A1/en not_active Abandoned
- 2005-01-07 US US11/030,811 patent/US20050148855A1/en not_active Abandoned
Patent Citations (27)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4305394A (en) * | 1980-12-22 | 1981-12-15 | Bertuch Jr Charles J | Acetabular cup positioning instrument |
US4475549A (en) * | 1982-01-18 | 1984-10-09 | Indong Oh | Acetabular cup positioner and method |
US4632111A (en) * | 1985-03-21 | 1986-12-30 | Minnesota Mining And Manufacturing Company | Acetabular cup positioning apparatus |
US4716894A (en) * | 1986-08-27 | 1988-01-05 | Zimmer, Inc. | Acetabular cup inserting instrument |
US5251127A (en) * | 1988-02-01 | 1993-10-05 | Faro Medical Technologies Inc. | Computer-aided surgery apparatus |
US5748767A (en) * | 1988-02-01 | 1998-05-05 | Faro Technology, Inc. | Computer-aided surgery apparatus |
US5007936A (en) * | 1988-02-18 | 1991-04-16 | Cemax, Inc. | Surgical method for hip joint replacement |
US4994064A (en) * | 1989-12-21 | 1991-02-19 | Aboczky Robert I | Instrument for orienting, inserting and impacting an acetabular cup prosthesis |
US5562448A (en) * | 1990-04-10 | 1996-10-08 | Mushabac; David R. | Method for facilitating dental diagnosis and treatment |
US6006126A (en) * | 1991-01-28 | 1999-12-21 | Cosman; Eric R. | System and method for stereotactic registration of image scan data |
US6405072B1 (en) * | 1991-01-28 | 2002-06-11 | Sherwood Services Ag | Apparatus and method for determining a location of an anatomical target with reference to a medical apparatus |
US5638819A (en) * | 1995-08-29 | 1997-06-17 | Manwaring; Kim H. | Method and apparatus for guiding an instrument to a target |
US5772594A (en) * | 1995-10-17 | 1998-06-30 | Barrick; Earl F. | Fluoroscopic image guided orthopaedic surgery system with intraoperative registration |
US5682886A (en) * | 1995-12-26 | 1997-11-04 | Musculographics Inc | Computer-assisted surgical system |
US5799055A (en) * | 1996-05-15 | 1998-08-25 | Northwestern University | Apparatus and method for planning a stereotactic surgical procedure using coordinated fluoroscopy |
US6069932A (en) * | 1996-05-15 | 2000-05-30 | Northwestern University | Apparatus and method for planning a stereotactic surgical procedure using coordinated fluoroscopy |
US20010016684A1 (en) * | 1996-06-28 | 2001-08-23 | The Board Of Trustees Of The Leland Stanford Junior University | Method and apparaus for volumetric image navigation |
US5880976A (en) * | 1997-02-21 | 1999-03-09 | Carnegie Mellon University | Apparatus and method for facilitating the implantation of artificial components in joints |
US6370418B1 (en) * | 1997-03-18 | 2002-04-09 | Franciscus Pieter Bernoski | Device and method for measuring the position of a bone implant |
US6064904A (en) * | 1997-11-28 | 2000-05-16 | Picker International, Inc. | Frameless stereotactic CT scanner with virtual needle display for planning image guided interventional procedures |
US6214014B1 (en) * | 1998-05-19 | 2001-04-10 | Mcgann William A. | Acetabular total hip component alignment system for accurate intraoperative positioning in inclination |
US7130676B2 (en) * | 1998-08-20 | 2006-10-31 | Sofamor Danek Holdings, Inc. | Fluoroscopic image guided orthopaedic surgery system with intraoperative registration |
US6063124A (en) * | 1999-03-01 | 2000-05-16 | Amstutz; Harlan C. | Acetabular cup prosthesis insertion and removal assembly and technique |
US6470207B1 (en) * | 1999-03-23 | 2002-10-22 | Surgical Navigation Technologies, Inc. | Navigational guidance via computer-assisted fluoroscopic imaging |
US6725080B2 (en) * | 2000-03-01 | 2004-04-20 | Surgical Navigation Technologies, Inc. | Multiple cannula image guided tool for image guided procedures |
US6302890B1 (en) * | 2000-03-16 | 2001-10-16 | Leone Innovations Corporation | Pelvic alignment assembly |
US6711432B1 (en) * | 2000-10-23 | 2004-03-23 | Carnegie Mellon University | Computer-aided orthopedic surgery |
Cited By (51)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7176936B2 (en) * | 2001-03-27 | 2007-02-13 | Siemens Corporate Research, Inc. | Augmented reality guided instrument positioning with modulated guiding graphics |
US20020140709A1 (en) * | 2001-03-27 | 2002-10-03 | Frank Sauer | Augmented reality guided instrument positioning with modulated guiding graphics |
US7379077B2 (en) * | 2001-08-23 | 2008-05-27 | Siemens Corporate Research, Inc. | Augmented and virtual reality guided instrument positioning using along-the-line-of-sight alignment |
US20030037449A1 (en) * | 2001-08-23 | 2003-02-27 | Ali Bani-Hashemi | Augmented and virtual reality guided instrument positioning using along-the-line-of-sight alignment |
US8271066B2 (en) * | 2002-08-09 | 2012-09-18 | Kinamed, Inc. | Non-imaging tracking tools and method for hip replacement surgery |
US20080221570A1 (en) * | 2002-08-09 | 2008-09-11 | Vineet Kumar Sarin | Non-imaging tracking tools and method for hip replacement surgery |
US11051954B2 (en) | 2004-09-21 | 2021-07-06 | Stout Medical Group, L.P. | Expandable support device and method of use |
US20080281330A1 (en) * | 2005-03-17 | 2008-11-13 | Ferrante Joseph M | Medical Securing Member Placement System |
US7840256B2 (en) | 2005-06-27 | 2010-11-23 | Biomet Manufacturing Corporation | Image guided tracking array and method |
US20070038059A1 (en) * | 2005-07-07 | 2007-02-15 | Garrett Sheffer | Implant and instrument morphing |
US9770339B2 (en) | 2005-07-14 | 2017-09-26 | Stout Medical Group, L.P. | Expandable support device and method of use |
US8165659B2 (en) | 2006-03-22 | 2012-04-24 | Garrett Sheffer | Modeling method and apparatus for use in surgical navigation |
US10758289B2 (en) | 2006-05-01 | 2020-09-01 | Stout Medical Group, L.P. | Expandable support device and method of use |
US10813677B2 (en) | 2006-05-01 | 2020-10-27 | Stout Medical Group, L.P. | Expandable support device and method of use |
US11141208B2 (en) | 2006-05-01 | 2021-10-12 | Stout Medical Group, L.P. | Expandable support device and method of use |
US8934961B2 (en) | 2007-05-18 | 2015-01-13 | Biomet Manufacturing, Llc | Trackable diagnostic scope apparatus and methods of use |
US20080319491A1 (en) * | 2007-06-19 | 2008-12-25 | Ryan Schoenefeld | Patient-matched surgical component and methods of use |
US10786307B2 (en) | 2007-06-19 | 2020-09-29 | Biomet Manufacturing, Llc | Patient-matched surgical component and methods of use |
US9775625B2 (en) | 2007-06-19 | 2017-10-03 | Biomet Manufacturing, Llc. | Patient-matched surgical component and methods of use |
US10136950B2 (en) | 2007-06-19 | 2018-11-27 | Biomet Manufacturing, Llc | Patient-matched surgical component and methods of use |
WO2009006736A1 (en) * | 2007-07-10 | 2009-01-15 | Cooke T Derek V | Radiographic imaging method and apparatus |
US9554863B2 (en) | 2007-10-10 | 2017-01-31 | Orthosoft Inc. | Hip replacement in computer-assisted surgery |
US8790351B2 (en) | 2007-10-10 | 2014-07-29 | Orthosoft Inc. | Hip replacement in computer-assisted surgery |
US20090099570A1 (en) * | 2007-10-10 | 2009-04-16 | Francois Paradis | Hip replacement in computer-assisted surgery |
US8571637B2 (en) | 2008-01-21 | 2013-10-29 | Biomet Manufacturing, Llc | Patella tracking method and apparatus for use in surgical navigation |
US10292828B2 (en) | 2008-11-12 | 2019-05-21 | Stout Medical Group, L.P. | Fixation device and method |
US10285819B2 (en) | 2008-11-12 | 2019-05-14 | Stout Medical Group, L.P. | Fixation device and method |
US10285820B2 (en) | 2008-11-12 | 2019-05-14 | Stout Medical Group, L.P. | Fixation device and method |
US10940014B2 (en) | 2008-11-12 | 2021-03-09 | Stout Medical Group, L.P. | Fixation device and method |
US9398675B2 (en) | 2009-03-20 | 2016-07-19 | Orthoscan, Inc. | Mobile imaging apparatus |
WO2011019797A2 (en) * | 2009-08-11 | 2011-02-17 | The Cleveland Clinic Foundation | Method and apparatus for insertion of an elongate pin into a surface |
WO2011019797A3 (en) * | 2009-08-11 | 2011-07-21 | The Cleveland Clinic Foundation | Method and apparatus for insertion of an elongate pin into a surface |
US8696680B2 (en) | 2009-08-11 | 2014-04-15 | The Cleveland Clinic Foundation | Method and apparatus for insertion of an elongate pin into a surface |
US20110040303A1 (en) * | 2009-08-11 | 2011-02-17 | The Cleveland Clinic Foundation | Method and apparatus for insertion of an elongate pin into a surface |
US10070968B2 (en) | 2010-08-24 | 2018-09-11 | Flexmedex, LLC | Support device and method for use |
US9149286B1 (en) * | 2010-11-12 | 2015-10-06 | Flexmedex, LLC | Guidance tool and method for use |
US9833206B2 (en) | 2010-12-13 | 2017-12-05 | Orthoscan, Inc. | Mobile fluoroscopic imaging system |
US10178978B2 (en) | 2010-12-13 | 2019-01-15 | Orthoscan, Inc. | Mobile fluoroscopic imaging system |
US9125611B2 (en) | 2010-12-13 | 2015-09-08 | Orthoscan, Inc. | Mobile fluoroscopic imaging system |
US9265468B2 (en) | 2011-05-11 | 2016-02-23 | Broncus Medical, Inc. | Fluoroscopy-based surgical device tracking method |
US9050112B2 (en) | 2011-08-23 | 2015-06-09 | Flexmedex, LLC | Tissue removal device and method |
USRE49094E1 (en) | 2011-10-28 | 2022-06-07 | Nuvasive, Inc. | Systems and methods for performing spine surgery |
US9510771B1 (en) | 2011-10-28 | 2016-12-06 | Nuvasive, Inc. | Systems and methods for performing spine surgery |
US9875544B2 (en) | 2013-08-09 | 2018-01-23 | Broncus Medical Inc. | Registration of fluoroscopic images of the chest and corresponding 3D image data based on the ribs and spine |
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US6917827B2 (en) | 2005-07-12 |
US20050148855A1 (en) | 2005-07-07 |
US20020077540A1 (en) | 2002-06-20 |
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