EP2197353A1 - Dispositif et procédé de détermination de l'état d'ancrage d'une endoprothèse implantée - Google Patents

Dispositif et procédé de détermination de l'état d'ancrage d'une endoprothèse implantée

Info

Publication number
EP2197353A1
EP2197353A1 EP08838968A EP08838968A EP2197353A1 EP 2197353 A1 EP2197353 A1 EP 2197353A1 EP 08838968 A EP08838968 A EP 08838968A EP 08838968 A EP08838968 A EP 08838968A EP 2197353 A1 EP2197353 A1 EP 2197353A1
Authority
EP
European Patent Office
Prior art keywords
endoprosthesis
frequency
state
vibration
signal
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP08838968A
Other languages
German (de)
English (en)
Inventor
Dietmar Ruwisch
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of EP2197353A1 publication Critical patent/EP2197353A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4851—Prosthesis assessment or monitoring
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0875—Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4528—Joints

Definitions

  • the present invention relates to a device for determining the anchoring state of an implanted endoprosthesis, comprising: means for vibrational excitation of the endoprosthesis, and means for detecting the vibrational state of the endoprosthesis,
  • the means for vibrational excitation of the endoprosthesis in this case comprise a vibrator, which is placed on the tissue in the region of the thigh bone of a patient.
  • the vibrating device vibrates the entire thigh and thus also the thigh bone and the hip prosthesis implanted in it.
  • this device of the prior art comprises an acceleration sensor installed in the upper region of the hip prosthesis, which generates a corresponding signal as a function of acceleration or deceleration. In particular, by shock loads of the acceleration sensor, a striking signal is triggered.
  • this object is achieved in that the means for vibrational excitation of the endoprosthesis are designed to emit a modulated ultrasonic signal, comprising a Ultraschallalägersigna! and a tunable modulation signal.
  • the modulation signal is tunable in its frequency, at the interface between the endoprosthesis and the surrounding tissue, in particular surrounding bone.
  • Modulation signal and its energy transfer to the endoprosthesis vibrational excitation of the prosthesis without simultaneous direct excitation of the surrounding bone vibration can be achieved.
  • the use of Uitraschailsignaien is known from numerous medical examination methods, such as imaging techniques, and for the patient usually not associated with stress or pain.
  • the modulation signal superimposed on the ultrasound carrier signal is intended to ensure that at the interface between the endoprosthesis and the surrounding bone there is an energy transfer to the prosthesis, which stimulates the same to a forced oscillation. Basically, this would be a frequency modulation of the carrier signal using the
  • the modulated ultrasound signal is an amplitude-modulated ultrasound signal! which is technically very easy to generate.
  • the function of the ultrasound carrier signal is essentially to transport the modulation signal to the interface between the endoprosthesis and the surrounding bone. Therefore, the frequency of the
  • Uifraschallvicsignals preferably chosen such that the material of a body in which the endoprosthesis is implanted, is penetrated substantially undisturbed.
  • a "material” of the body in this case, for example, various layers of skin, layers of fat, bone, etc. are considered.
  • the frequency of the ultrasound carrier signal is within a frequency range of 2OkHz to 40 MHz, and preferably about 100 kHz.
  • the means for vibrational excitation are adapted to the frequency of the modulation signal in a frequency interval, the at least one e ⁇ vartete resonant frequency of the endoprosthesis fürzustimrnen.
  • the means for vibrational excitation then make it possible to find a natural frequency of the implanted endoprosthesis as the frequency of the forced oscillation, so that it is excited to resonant vibrations. Due to the maximum energy transfer in this case from the radiated overall ultrasound signal to the implanted prosthesis, the means for detecting the vibrational state of the prosthesis can then provide particularly clear signals which enable a determination as to whether the endoprosthesis has loosened, in particular with the aid of a comparison of a current one found resonant frequency of the endoprosthesis with a detected in a previous study resonance frequency,
  • the middle! for detecting the vibrational state of the endoprosthesis comprise a sensor attached to the endoprosthesis, which is designed to detect the vibrational state of the endoprosthesis, and a
  • a transponder unit adapted to transmit vibration output signals outputted from the sensor to a signal processing unit, the sensor being, for example, a vibrating and / or displacement measuring sensor and / or a laser vibrometer using such fire or related sensors to detect the vibration
  • Vibration state of an implanted endoprosthesis is generally known from the state of the art. Reference may be made again to the article by R Puers et al mentioned above, as well as, for example, to DE 10342823A1, to which reference is made in its entirety
  • the erfindu ⁇ gsgetowne device thus always allows the determination of the anchoring state of the implanted endoprosthesis, if it is equipped with a known from the prior art Beschieumgungs or similar sensor
  • an embodiment is proposed, which allows the determination of the anchoring state regardless of the presence of such a sensor, either because the sensor is no longer functional, or because the
  • the center! for detecting the vibrational state of the endoprosthesis comprise an ultrasound receiver and an evaluation unit
  • the ultrasound receiver and the evaluation unit connected to it determine the anchoring condition of the prosthesis on the basis of the ultrasound signals emitted by it during each forced oscillation
  • the evaluation unit is expediently designed to analyze UitraschaüsignaSe reflected from the endoprosthesis and received by the Uitraschailempnature ⁇ r.
  • This embodiment thus makes it possible to excite the implanted endoprosthesis with the help of the modulated Uitraschailsignais after the frequency of the tunable modulation signal has been set to the natural frequency of the prosthesis. It has been found that a prosthesis excited in such a way for forced vibrations causes a frequency or phase modulation of the reflected ultrasound signal in comparison to the ultrasound irradiated.
  • the means for vibrational excitation of the endoprosthesis are designed to the Modulationssigna! turn off and send the ultrasound carrier signal without modulation signal. Unless the
  • Prosthesis has been stimulated by the Moduiatio ⁇ ssignal far from the resonance, sounds the forced oscillation extremely fast. After switching off the modulation signal, it is then hardly possible to detect any modulation effects in the reflected ultrasound signal. However, if the Resonanzfai! has occurred, ie the Moduiationssignal has excited a natural frequency of the implanted and loose endoprosthesis due to appropriate Frequenzwahi, this still continues to vibrate after switching off the modulation signal for a relatively long time, so that modulation effects can be observed in the reflected Uitraschallsignal, especially in the form of a frequency modulation.
  • the analysis comprises a frequency analysis.
  • the examination of processes in the body of a patient by means of a frequency analysis of reflected ultrasound signals in the field of biology methods is generally known, in particular in the form of a Doppler analysis as a particularly simple form of frequency analysis (cf., for example, EP 1789747A1).
  • Endoprosthesis and the ultrasonic receiver comprise a common Uitraschallsende-Zempfangsaku.
  • Such combined ultrasound transmitters / receivers are also known both in the field of ultrasound imaging techniques and, for example, in the field of lithotripsy.
  • the device according to the invention serves to detect the resonance frequency of the implanted endoprosthesis in the context of a patient examination and with a result determined in a previous examination
  • the device according to the invention should be designed such that the means for detecting the vibrational state of the endoprosthesis is a storage unit for
  • the comparison between a currently determined resonance frequency of the endoprosthesis with a previously determined resonance frequency can be made by appropriately trained medical or technical personnel.
  • the means for detecting the vibrational state of the endoprosthesis is a comparison unit for the automatic comparison of current with earlier measurement results include.
  • the invention further relates to a method for determining the anchoring state of an implanted endoprosthesis using a device according to the invention, wherein the means for vibrational excitation of the endoprosthesis emit the modulated UltraschallaHsignal in the direction of the endoprosthesis and the vibration state of the
  • Endoprosthesis through the middle! is detected for detecting the vibrational state of the endoprosthesis
  • FIG. 1 shows a schematic overall view of a first embodiment of the device according to the invention
  • FIGS. 2A 1 2B and 2C show typical time profiles of an ultrasound carrier signal, a moduiatton signal or the resulting amplitude-modulated ultrasound signal,
  • FIG. 3 shows an overall schematic view similar to FIG. 1 for a second embodiment of the device according to the invention
  • 4A and 4B show a residual course or a frequency spectrum of an ultrasonic signal received with the device from FIG. 3
  • FIG. 1 shows a schematic view of a first embodiment of the inventive device 10 / ur determination of
  • Endoprostheses is used, for example, artificial knee joints
  • the device 10 according to the invention is intended to enable the determination of the anchoring state of the prosthesis 12 in the femur 14 in order to accomplish this otherwise conventionally done
  • the first embodiment of the device 10 shown in FIG. 1 comprises an ultrasound transducer 20 controlled by a central control computer. At its left-hand end in FIG. 1, this comprises a coupling pad 22, as used in the medical sector
  • the ultrasound transmission unit 20 with its KoppeSkissen 22nd placed in contact with the thigh of the patient 16, and ultrasonically emitted towards the prosthesis 12, as symbolized in Fig. 1 by schematically drawn wavy lines.
  • Ultraschallssgna! is shown in Fig. 2C.
  • the frequency of the UitraschalimethylsignaJs is about 80 kHz
  • the frequency of the modulation signal about 1 O kHz.
  • the modulated ultrasound signal shown in FIG. 2C displaces the prosthesis 12 into a forced oscillation having the frequency of the modulation signal shown schematically in FIG. 2B.
  • Vibratory excitation is known, detected by means of a sensor 24, which is housed in the embodiment of FIG. 1 by way of example in the head of the prosthesis 12. About a built-in sensor 24
  • Transponder unit are corresponding vibration measurement signals, in particular information about the amplitude and frequency of the forced
  • Signal processing unit 28 transmitted, which in turn to the central control computer 18 is connected. It goes without saying that the signal processing unit 28 can also be designed as an integrated part of the computer 18.
  • the computer 18 controls the ultrasonic transmitting unit 20 so that the
  • Frequency of the modulation signal in a frequency interval of typically about 100 Hz to about 10 kHz is tuned.
  • the prosthesis 12 is excited at the set fviodulationsfrequenz for forced oscillation. Whenever the modulation frequency is one of several regularly
  • Eigenfrequi2en reaches the implanted prosthesis 12, for example, a natural frequency of a bending vibration or a torsional vibration, a Resonanzfail occurs, d. H. the prosthesis 12 oscillates with particularly pronounced oscillation amplitudes, whereby this oscillation continues noticeably even after the modulation has been switched off.
  • the control computer 18 is designed to automatically examine the vibration measurement signals supplied to it via the sensor 24 and the signal processing unit 28 for the occurrence of resonances, in particular to determine and store resonance frequencies. If it is found that the resonant frequencies occurring in an examination of the patient 18 are essentially identical to those resonant frequencies which were observed in a previous examination, there is thus no indication of a loosening of the prosthesis 12 whose oscillation behavior has evidently not changed. If, on the other hand, a shift of at least one resonance frequency compared to one of the earlier examinations is observed, this is a strong indication that at least one of the possible natural oscillations of the prosthesis 12 has changed, which indicates a loosening of the prosthesis 12. As indicated schematically in FIG. 1, the central control computer 18 comprises a screen 28 on which, for example, the radiated ultrasound waves can be displayed. Expediently, the control computer 18 is furthermore designed to determine the currently determined during the examination of the patient 18
  • Resonance frequencies display, as well as, for example, a corresponding notification if changes compared to stored earlier measurement results are detected.
  • the control computer 18 is expediently equipped with a memory unit (not shown in the figures) for storing the measurement results, in particular previously determined resonance frequencies of the prosthesis 12, as well as advantageously also with a comparison unit for automatic comparison of current measurement results with earlier measurement results.
  • FIG. 1 While the first embodiment of the inventive device 10 shown schematically in FIG. 1 can refer to technologies known from the prior art with regard to the means for detecting the vibration state of the prosthesis 12 in the form of the sensor 24 and the signal processing unit 28, reference will now be made to FIGS .
  • the central control computer 18 controls a combined ultrasonic transmitting receiver 30. It comprises a ultrasonic transmitting unit 20 similar to that of the first embodiment of FIG.
  • an ultrasonic receiving unit 32 and again a coupling pad 22 which is assigned to both units 20, 32, transmission side, ie with respect to the transmission of Ultraschallwelien using the transmitting unit 20 and the coupling pad 22 in the direction of the implanted prosthesis 12 'can be made to the first embodiment of FIG
  • the excised ultrasound carrier signal, the tunable modulation signal will enwitze ⁇ ! and the modulated ultrasound signal J resulting therefrom, in turn, the waveforms shown with reference to FIGS. 2A, 2B and 2C.
  • the second embodiment of the device 1 ⁇ ! differs from the first embodiment on the receiving side, ie with regard to the middle! for detecting the vibration state of the prosthesis 12 '.
  • the Ultraschallaü receiving unit 32 and the coupling pad 22 serve as
  • the control computer 18 again controls the UitraschaSIsendetician 20 such that they have an amplitude modulated total UltraschallSsigna! corresponding to that in Fig. 2C in the direction of the prosthesis 12 ! sending out.
  • the modulation frequency is tuned by the control computer 18.
  • the U-ray ball signals reflected by the vibrating prosthesis 12' are now measured with the aid of the ultrasound receiving unit 32, preferably as follows after switching off the fviodulation frequency as follows:
  • the prosthesis 12 'in the femur 14 is excited to forced oscillations, which results in that the ultrasound signal reflected by the prosthesis 12'! Similar to the known (ultrasound) Doppler effect has a frequency shift In particular found in the of the vibrating interface of the prosthesis 12 'reflected Uitraschailsignal frequency components that the typical line spectrum of a frequency or Correspond to phase modulation. In particular, secondary lines occur at the positive and negative integer multiples of the modulation frequency. These secondary lines are in resonance!
  • Control computer 18 expediently designed to turn off the transmission-side amplitude modulation at regular time intervals, so that temporarily "only” the Ultraschallvicsigna! is irradiated further. In this way, the secondary lines can be 1. Use order for evaluation.
  • the reflected ultrasound signal observed immediately after the modulation is turned off in the case of resonance is shown in FIG. 4A.
  • FIG. 4A The reflected ultrasound signal observed immediately after the modulation is turned off in the case of resonance is shown in FIG. 4A.
  • the occurrence of vibration components with higher and lower frequency than the underlying carrier frequency according to the aforementioned addition or subtraction of the oscillation frequency of the excited prosthesis 12 '.
  • 4A shows a corresponding wave pattern of the reflected ultrasound signal after switching off the transmission-side modulation in the event that a resonance case has been achieved with the aid of the modulation.
  • the control computer 18 is designed, in a manner known per se, to perform a frequency analysis of the received, schematically represented in FIG. 4A Make ultrasound.
  • the result of such a frequency analysis is shown in FIG. 4B.
  • One recognizes here first a central line corresponding to the Uitrascbal carrier frequency, in the present example approx. 80 kHz.
  • the Resonanzfail can now be identified by the appearance of other secondary lines, which are framed in Fig. 4B by circles, far from the resonance, ie if the irradiated Moduiationsfrequenz not an Eigenfreq ⁇ enz the possibly relaxed prosthesis 12 ' corresponds, they can
  • each resonant frequency of the prosthesis 12 ' can also be reliably determined and compared with corresponding measurement results of earlier examinations in order to prevent any loosening of the prosthesis
  • the device according to the invention is not limited to the embodiments presented purely by way of example.
  • the prosthesis 12, 12 ' is not necessarily a hip prosthesis, but may be any other type of endoprosthesis. It is understood that in this case other frequency intervals for the be used, in particular the frequency of the tunable modulation signal is to be adapted to the compared to a hip prosthesis changed vibration conditions.
  • the embodiments presented with reference to FIGS. 1 and 3 can, of course, also be combined with one another, ie a prosthesis 12 equipped with a sensor 24 can in principle be examined for loosening, for example, according to the second embodiment of FIG Sensor 24-based examination to check.
  • the above-mentioned memory unit for storing earlier measurement results, in particular previously determined resonance frequencies of the prosthesis 12, 12 ', may initially be provided as an integral part of the control computer 18. However, in the case of using a prosthesis 12 with built-in sensor 24, the storage unit may also be provided as part of the sensor 24. In this case, the patient 16 virtually carries along the results of earlier examinations.
  • the memory unit may also be designed as an external storage medium, for example in the form of a

Abstract

Dispositif (10, 10') servant à déterminer l'état d'ancrage d'une endoprothèse implantée (12, 12') et comprenant : - des moyens pour appliquer des oscillations à l'endoprothèse (12, 12'), et - des moyens pour détecter l'état d'oscillation de l'endoprothèse (12, 12'), les moyens d'application d'oscillations à l'endoprothèse (12, 12') étant agencés de façon à émettre un signal ultrasonore modulé comprenant un signal de fréquence porteuse ultrasonore et un signal de modulation à fréquence variable.
EP08838968A 2007-10-10 2008-10-08 Dispositif et procédé de détermination de l'état d'ancrage d'une endoprothèse implantée Withdrawn EP2197353A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102007048595A DE102007048595B3 (de) 2007-10-10 2007-10-10 Vorrichtung zur Bestimmung des Verankerungszustandes einer implantierten Endoprothese
PCT/EP2008/063473 WO2009050089A1 (fr) 2007-10-10 2008-10-08 Dispositif et procédé de détermination de l'état d'ancrage d'une endoprothèse implantée

Publications (1)

Publication Number Publication Date
EP2197353A1 true EP2197353A1 (fr) 2010-06-23

Family

ID=40276002

Family Applications (1)

Application Number Title Priority Date Filing Date
EP08838968A Withdrawn EP2197353A1 (fr) 2007-10-10 2008-10-08 Dispositif et procédé de détermination de l'état d'ancrage d'une endoprothèse implantée

Country Status (4)

Country Link
US (1) US20100222675A1 (fr)
EP (1) EP2197353A1 (fr)
DE (1) DE102007048595B3 (fr)
WO (1) WO2009050089A1 (fr)

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2371291A1 (fr) * 2010-03-31 2011-10-05 Dr. med. Roman Winkler Procédé de mesure et dispositif de production une image
FR3017043B1 (fr) * 2014-02-03 2017-10-13 Spineguard Systeme medical et procede pour localiser un point d'entree et identifier une trajectoire d'un instrument chirurgical dans une structure anatomique
CN111297330B (zh) * 2020-02-25 2021-01-08 中南大学湘雅二医院 一种测量鼻尖活动度及支架稳定性的装置及方法
DE102021117569A1 (de) 2021-07-07 2023-01-12 Karl Storz Se & Co. Kg Ultraschallgenerator zum Zuführen einer elektrischen Leistung zum Zertrümmern von Körpersteinen, Lithotripsievorrichtung, Lithotripsiesystem und Verfahren zum Identifizieren einer Sonotrode

Citations (1)

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US5921928A (en) * 1996-12-05 1999-07-13 Mayo Foundation For Medical Education And Research Acoustic force generation by amplitude modulating a sonic beam

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US6170488B1 (en) * 1999-03-24 2001-01-09 The B. F. Goodrich Company Acoustic-based remotely interrogated diagnostic implant device and system
US20010050087A1 (en) * 1999-03-24 2001-12-13 Pmd Holdings Corp. Ultrasonic detection of restenosis in stents
AU1924601A (en) * 1999-11-23 2001-06-04 Noveon Ip Holdings Corp. Implant loosening and fracture healing evaluation apparatus and method
US6899680B2 (en) * 2000-10-19 2005-05-31 Odetect As Ultrasound measurement techniques for bone analysis
DE10342823A1 (de) * 2003-09-17 2005-04-21 Peter Brehm Gmbh Vorrichtung zur Überprüfung des Sitzes einer implantierten Prothese
CN100536788C (zh) * 2004-10-20 2009-09-09 株式会社东芝 超声波多普勒诊断装置
EP2114247B1 (fr) * 2007-02-23 2013-10-30 Smith & Nephew, Inc. Traitement de donnees d'accelerometre detectees pour une determination de guerison osseuse

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Publication number Priority date Publication date Assignee Title
US5921928A (en) * 1996-12-05 1999-07-13 Mayo Foundation For Medical Education And Research Acoustic force generation by amplitude modulating a sonic beam

Non-Patent Citations (1)

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Title
See also references of WO2009050089A1 *

Also Published As

Publication number Publication date
US20100222675A1 (en) 2010-09-02
DE102007048595B3 (de) 2009-02-26
WO2009050089A1 (fr) 2009-04-23

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