US20040254586A1 - Pelvic plane locator and patient positioner - Google Patents

Pelvic plane locator and patient positioner Download PDF

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Publication number
US20040254586A1
US20040254586A1 US10/815,369 US81536904A US2004254586A1 US 20040254586 A1 US20040254586 A1 US 20040254586A1 US 81536904 A US81536904 A US 81536904A US 2004254586 A1 US2004254586 A1 US 2004254586A1
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United States
Prior art keywords
patient
pelvic
frame
app
features
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.)
Abandoned
Application number
US10/815,369
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English (en)
Inventor
Vineet Sarin
Robert Bruce
William Pratt
Clyde Pratt
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Kinamed Inc
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Individual
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Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to US10/815,369 priority Critical patent/US20040254586A1/en
Publication of US20040254586A1 publication Critical patent/US20040254586A1/en
Assigned to KINAMED, INC. reassignment KINAMED, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: BRUCE, ROBERT A., PRATT, CLYDE RONALD, PRATT, WILLIAM RALPH, SARIN, VINEET KUMAR
Priority to US12/878,594 priority patent/US8657830B2/en
Abandoned legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • 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
    • A61B17/1739—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
    • A61B17/1746—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip for the acetabulum
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2055—Optical tracking systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2072—Reference field transducer attached to an instrument or patient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/067—Measuring instruments not otherwise provided for for measuring angles
    • 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
    • A61B5/4504—Bones
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6867—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive specially adapted to be attached or implanted in a specific body part
    • A61B5/6878—Bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
    • A61B90/14—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4632—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using computer-controlled surgery, e.g. robotic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G13/00—Operating tables; Auxiliary appliances therefor
    • A61G13/0036—Orthopaedic operating tables
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G15/00—Operating chairs; Dental chairs; Accessories specially adapted therefor, e.g. work stands
    • A61G15/10—Parts, details or accessories
    • A61G15/12—Rests specially adapted therefor, e.g. for the head or feet

Definitions

  • the apparatus of the invention includes a patient positioning frame, adapted to adjustably mount in opposition to an adjustable backrest, and suitable for use in connection with computer assisted surgery for finding the orientation of a patient's pelvic plane.
  • the frame comprises: at least one anterior superior iliac spine (ASIS) locating feature, adapted to engage in close relation to the patient's ASIS; and at least one pubic locating feature, adapted to engage in close relation to the patient's pubic symphysis, the ASIS and pubic locating features defining an anterior pelvic plane (APP).
  • ASIS anterior superior iliac spine
  • APP anterior pelvic plane
  • the pelvic locating frame further comprises a group of index features, the group constrained to maintain a predetermined rotational relationship to the anterior pelvic plane (APP) defined by the ASIS and pubic locating features.
  • the computer 32 is also programmed with a user-friendly interface (software) which facilitates navigation.
  • the physician or other personnel can view output (for example on a video monitor) and input instructions to the computer 32 via I/O devices 34 , which suitably could include a monitor, keyboard, printer, foot pedals, and other input/output devices such as conventional “mouse” or similar pointing devices.
  • FIG. 2 shows one embodiment of the invention.
  • the invention includes a back rest assembly 200 .
  • the assembly 200 includes an adjustable back rest 202 that adjusts by sliding to fit firmly against the back of a patient positioned in lateral decubitus position.
  • the back rest which could be conventional, is fixed to a horizontal adjustment rod 204 which in turn is slidably fixable to a vertical adjustment rod 206 .
  • the slidable adjustments of horizontal rod 204 are lockable by locking screw assembly 208 .
  • the entire assembly can be fixed to an operating table (not shown) by mounting vertical adjustment rod (preferably by slidably attaching to a rail, by means of a Clark socket, but other means could be used).
  • Elements 214 through 230 collectively define a support assembly 232 .
  • the entire support assembly is mounted on a horizontal adjustment rod 234 .
  • Locking screw 236 when tightened, locks the assembly to horizontal adjustment rod 234 .
  • locking screw 236 allows rotational adjustment around the axis of rod 234 .
  • the entire support assembly can be mounted to a vertical adjustment rod 238 by inserting horizontal rod 234 through a yoke 240 mounted on vertical adjustment rod.
  • a slidable adjustment of horizontal rod 234 is lockable by locking screw assembly 244 .
  • Vertical adjustment rod 238 is attachable to an operating table (not shown).
  • the support assembly can be detached from vertical adjustment rod 238 by loosening locking screw assembly 244 , then removing horizontal adjustment rod 234 from yoke 240 . This ability to remove the support assembly facilitates adjustment of the locator to a patient's pelvis, as described below.
  • a “touch-plate” 250 is shown with 3 touch points 252 a 252 b and 252 c used to define a local coordinate system.
  • the touch plate 250 is (preferably removably) fixed to the support assembly in a way that maintains the predetermined angular relationship between the touch plate and the pubis and ASIS locators ( 223 a , 223 b and 230 ).
  • a coordinate system defined by the index features is in a predetermined, known rotational relationship to the Anterior pelvic plane (APP) as defined by the ASIS locators ( 223 a and 223 b ) and the pubic symphysis locator 230 .
  • APP Anterior pelvic plane
  • the local coordinate system of the touch-plate defines the APP coordinate system by a predetermined known transformation.
  • a vector is defined in the local coordinate system of the touch-plate that defines the orientation of a plane containing the ASIS locators and the Pubic symphysis locator.
  • the touch-plate retains a known rotational relationship with the pelvic plane (as defined by the ASIS locators and the pubic locator).
  • the touch-points are not required to be touch-points exactly as shown in FIG. 4, but rather could be any markers/features with a predetermined known relationship to the point in question, like 3 LEDs etc.
  • the index features are emphasized by indentations in the posts 280 , such indentations adapted to engage a complementary probe tip on a trackable probe.
  • other index features could be used, such as protrusions, marks, posts, or other landmarks.
  • the positions of the three touch points define the orientation of a coordinate system fixed in relation to the touch plate of FIG. 4.
  • the local coordinate system of the touch-plate in turn defines the anterior pelvic plane (APP) because the ASIS finders and the pubis finder are located in a fixed known position relative to the local coordinate axes of the touch plate.
  • the ASIS finders may adjust along the X-axis and the pubis symphysis locator may adjust along the Y-axis, but the APP coordinate system is not rotated by this adjustment.
  • the local coordinate system of the touch-plate defines the APP coordinate system by a predetermined known transformation.
  • a locating system such as an optical locating system is used to acquire the positions of the three touch points on the touch plate.
  • an optical tracking system and a touch probe are used, as described in U.S. Pat. No. 6,711,431.
  • steps 602 , 604 , and 606 the positions of each touchpoints are input to the digital computer, suitably by touching each touchpoint with the manual probe while cueing the computer to acquire the position of the probe relative to the locating system (in an operating room coordinate system).
  • the positions of each touchpoint are calculated (in three dimensions) by means described in U.S. Pat. No. 6,711,431 and the references cited therein. These positions are then used to calculate the real-time orientation of the touchplate assembly (relative to the tracking system, which defines an Operating Room reference frame).
  • the computer Given the acquired orientation of the touchplate, the computer next calculates the orientation of the patient's APP (step 608 ). This is done by applying a transformation which compensates for the known (from step 600 ) relative relationship between the APP and the touchplate.
  • the capabilities of the patient positioner are further exploited by placing a trackable target on the pelvis and continuing to track in real time the patient's pelvis (opt. Step 610 ).
  • the dynamic tracking techniques which are used to further track the pelvis are described elsewhere, but in general rely on initial acquisition of the patient's APP.
  • the initial location of the patient's APP can easily be acquired by use of the present invention as described above.
  • a pelvic tracker can optionally be attached, for example by mounting a trackable target by bone screw to a patient's pelvis at an arbitrary angle.
  • the arbitrary angle between the trackable target and the APP is then calculated and used to calculate a transformation.
  • the patient can be released from the positioner (during surgery) and the APP can be tracked in real time by the pelvic tracker. In most cases, however, a surgeon may prefer to retain the patient secured in the position throughout surgery, to maintain stability.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Biophysics (AREA)
  • Physics & Mathematics (AREA)
  • Dentistry (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Robotics (AREA)
  • Accommodation For Nursing Or Treatment Tables (AREA)
  • Prostheses (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
US10/815,369 2003-04-02 2004-04-01 Pelvic plane locator and patient positioner Abandoned US20040254586A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US10/815,369 US20040254586A1 (en) 2003-04-02 2004-04-01 Pelvic plane locator and patient positioner
US12/878,594 US8657830B2 (en) 2003-04-02 2010-09-09 Pelvic plane locator and patient positioner

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US45969503P 2003-04-02 2003-04-02
US10/815,369 US20040254586A1 (en) 2003-04-02 2004-04-01 Pelvic plane locator and patient positioner

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US12/878,594 Division US8657830B2 (en) 2003-04-02 2010-09-09 Pelvic plane locator and patient positioner

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US20040254586A1 true US20040254586A1 (en) 2004-12-16

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US12/878,594 Expired - Lifetime US8657830B2 (en) 2003-04-02 2010-09-09 Pelvic plane locator and patient positioner

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EP (1) EP1610705B1 (ja)
JP (2) JP4777878B2 (ja)
WO (1) WO2004089192A2 (ja)

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US20060264731A1 (en) * 2003-06-02 2006-11-23 Murphy Stephen B Virtual trial reduction system for hip arthroplasty and coordinate systems therefor
EP1857069A1 (de) * 2006-05-16 2007-11-21 BrainLAB AG Medizintechnische Beckenpositionierungs- und Trackingvorrichtung
US20080214932A1 (en) * 2005-06-15 2008-09-04 Aesculap Ag & Co. Kg Method and surgical navigation system for creating a recess to receive an acetabulum
US20080221570A1 (en) * 2002-08-09 2008-09-11 Vineet Kumar Sarin Non-imaging tracking tools and method for hip replacement surgery
US20090105714A1 (en) * 2007-10-17 2009-04-23 Aesculap Ag Method and apparatus for determining the angular position of an acetabulum in a pelvic bone
US20090101158A1 (en) * 2007-10-17 2009-04-23 Aesculap Ag Method and apparatus for determining the frontal plane of the pelvic bone
JP2009525079A (ja) * 2006-01-31 2009-07-09 ライ，ロバート 位置決めブラケット
US7764985B2 (en) 2003-10-20 2010-07-27 Smith & Nephew, Inc. Surgical navigation system component fault interfaces and related processes
US7862570B2 (en) 2003-10-03 2011-01-04 Smith & Nephew, Inc. Surgical positioners
US20120022406A1 (en) * 2008-12-02 2012-01-26 Andre Novomir Hladio Method and system for aligning a prosthesis during surgery using active sensors
US8109942B2 (en) 2004-04-21 2012-02-07 Smith & Nephew, Inc. Computer-aided methods, systems, and apparatuses for shoulder arthroplasty
US8177788B2 (en) 2005-02-22 2012-05-15 Smith & Nephew, Inc. In-line milling system
US20120123299A1 (en) * 2009-07-31 2012-05-17 Timo Neubauer Malleolar registration clamp and malleolar registration method
US20120203140A1 (en) * 2011-02-08 2012-08-09 Henrik Malchau Patient Positioning Systems and Methods
EP2626031A3 (en) * 2007-11-01 2014-09-24 Stephen B. Murphy Method of calibrating an instrument to be used in establishing a reference plane for hip arthoplasty
US9101431B2 (en) 2007-11-01 2015-08-11 Stephen B. Murphy Guide for acetabular component positioning
US9138319B2 (en) 2010-12-17 2015-09-22 Intellijoint Surgical Inc. Method and system for aligning a prosthesis during surgery
US9247998B2 (en) 2013-03-15 2016-02-02 Intellijoint Surgical Inc. System and method for intra-operative leg position measurement
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US10251760B1 (en) 2007-11-01 2019-04-09 Stephen B. Murphy Acetabular template component and method of using same during hip arthrosplasty
US10335236B1 (en) 2007-11-01 2019-07-02 Stephen B. Murphy Surgical system using a registration device
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US10016287B2 (en) * 2013-06-03 2018-07-10 Stephen B. Murphy Method and apparatus for performing anterior hip surgery
JP5956047B1 (ja) * 2015-10-29 2016-07-20 アイテック株式会社 体位固定装置及び角度指示器
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Cited By (50)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080221570A1 (en) * 2002-08-09 2008-09-11 Vineet Kumar Sarin Non-imaging tracking tools and method for hip replacement surgery
US8271066B2 (en) * 2002-08-09 2012-09-18 Kinamed, Inc. Non-imaging tracking tools and method for hip replacement surgery
US20060264731A1 (en) * 2003-06-02 2006-11-23 Murphy Stephen B Virtual trial reduction system for hip arthroplasty and coordinate systems therefor
US8078254B2 (en) * 2003-06-02 2011-12-13 Murphy Stephen B Virtual trial reduction system for hip arthroplasty and coordinate systems therefor
US8491597B2 (en) 2003-10-03 2013-07-23 Smith & Nephew, Inc. (partial interest) Surgical positioners
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
US20050149041A1 (en) * 2003-11-14 2005-07-07 Mcginley Brian J. Adjustable surgical cutting systems
US7794467B2 (en) 2003-11-14 2010-09-14 Smith & Nephew, Inc. Adjustable surgical cutting systems
US8109942B2 (en) 2004-04-21 2012-02-07 Smith & Nephew, Inc. Computer-aided methods, systems, and apparatuses for shoulder arthroplasty
US8177788B2 (en) 2005-02-22 2012-05-15 Smith & Nephew, Inc. In-line milling system
US20080214932A1 (en) * 2005-06-15 2008-09-04 Aesculap Ag & Co. Kg Method and surgical navigation system for creating a recess to receive an acetabulum
US7996061B2 (en) 2005-06-15 2011-08-09 Aesculap Ag Method and surgical navigation system for creating a recess to receive an acetabulum
JP2009525079A (ja) * 2006-01-31 2009-07-09 ライ，ロバート 位置決めブラケット
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JP5261469B2 (ja) 2013-08-14
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US8657830B2 (en) 2014-02-25
US20110009778A1 (en) 2011-01-13
WO2004089192A3 (en) 2005-06-09
EP1610705A4 (en) 2010-05-05
WO2004089192A2 (en) 2004-10-21
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EP1610705A2 (en) 2006-01-04
EP1610705B1 (en) 2018-03-21

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