US20070233121A1 - Computer Assisted Knee Arthroplasty Instrumentation, Systems, and Processes - Google Patents

Computer Assisted Knee Arthroplasty Instrumentation, Systems, and Processes Download PDF

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US20070233121A1
US20070233121A1 US11697957 US69795707A US2007233121A1 US 20070233121 A1 US20070233121 A1 US 20070233121A1 US 11697957 US11697957 US 11697957 US 69795707 A US69795707 A US 69795707A US 2007233121 A1 US2007233121 A1 US 2007233121A1
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instrumentation
bone
relative
rod
present invention
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Christopher Carson
Crista Smothers
Christopher Lyons
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Carson Christopher P
Crista Smothers
Lyons Christopher M
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Abstract

Instrumentation, systems, and processes for tracking anatomy, instrumentation, trial implants, implants, and references, and rendering images and data related to them in connection with surgical operations, for example total knee arthroplasties (“TKA”). These instrumentation, systems, and processes are accomplished by using a computer to intraoperatively obtain images of body parts and to register, navigate, and track surgical instruments. Disclosed in this document are also alignment modules and other structures and processes which allow for coarse and fine alignment of instrumentation and other devices relative to bone for use in connection with the tracking systems of the present invention.

Description

    CROSS-REFERENCE TO RELATED APPLICATIONS
  • This application is a divisional of U.S. patent application Ser. No. 10/229,372 filed on Aug. 27, 2002, which is continuation-in-part of U.S. patent application Ser. No. 10/084,012 filed on Feb. 27, 2002, which claims the benefit of U.S. Provisional Application No. 60/355,899 filed on Feb. 11, 2002 and Provisional Application No. 60/271,818 filed on Feb. 27, 2001. The disclosure of each prior application is incorporated by reference in its entirety.
  • BACKGROUND OF THE INVENTION Field of the Invention
  • The field of the invention includes instrumentation, systems, and processes for tracking anatomy, implements, instrumentation, trial implants, implant components and virtual constructs or references, and rendering images and data related to them in connection with orthopedic, surgical and other operations, for example Total Knee Arthroplasty (“TKA”). Anatomical structures and such items may be attached to or otherwise associated with fiducial functionality, and constructs may be registered in position using fiducial functionality whose position and orientation can be sensed and tracked by systems and processes in three dimensions in order to perform TKA. Such structures, items and constructs can be rendered onscreen properly positioned and oriented relative to each other using associated image files, data files, image input, other sensory input, based on the tracking. Such instrumentation, systems, and processes, among other things, allow surgeons to navigate and perform TKA using images that reveal interior portions of the body combined with computer generated or transmitted images that show surgical implements, instruments, trials, implants, and/or other devices located and oriented properly relative to the body part. Such instrumentation, systems, and processes allow, among other things, more accurate and effective resection of bone, placement and assessment of trial implants and joint performance, and placement and assessment of performance of actual implants and joint performance.
  • BACKGROUND AND SUMMARY
  • A leading cause of wear and revision in prosthetics such as knee implants, hip implants and shoulder implants is less than optimum implant alignment. In a Total Knee Arthroplasty, for example, current instrument design for resection of bone limits the alignment of the femoral and tibial resections to average values for varus/valgus flexion/extension, and external/internal rotation. Additionally, surgeons often use visual landmarks or “rules of thumb” for alignment which can be misleading due to anatomical variability. Intramedullary referencing instruments also violate the femoral and tibial canal. This intrusion increases the risk of fat embolism and unnecessary blood loss in the patient. Surgeons also rely on instrumentation to predict the appropriate implant size for the femur and tibia instead of the ability to intraoperatively template the appropriate size of the implants for optimal performance. Another challenge for surgeons is soft tissue or ligament balancing after the bone resections have been made. Releasing some of the soft tissue points can change the balance of the knee; however, the multiple options can be confusing for many surgeons. In revision TKA, for example, many of the visual landmarks are no longer present, making alignment and restoration of the joint line difficult. The present invention is applicable not only for knee repair, reconstruction or replacement surgery, but also repair, reconstruction or replacement surgery in connection with any other joint of the body as well as any other surgical or other operation where it is useful to track position and orientation of body parts, non-body components and/or virtual references such as rotational axes, and to display and output data regarding positioning and orientation of them relative to each other for use in navigation and performance of the operation.
  • Several providers have developed and marketed various forms of imaging systems for use in surgery. Many are based on CT scans and/or MRI data or on digitized points on the anatomy. Other systems align preoperative CT scans, MRIs or other images with intraoperative patient positions. A preoperative planning system allows the surgeon to select reference points and to determine the final implant position. Intraoperatively, the system calibrates the patient position to that preoperative plan, such as using a “point cloud” technique, and can use a robot to make femoral and tibial preparations.
  • Instrumentation, systems, and processes according to one embodiment of the present invention use position and/or orientation tracking sensors such as infrared sensors acting stereoscopically or otherwise to track positions of body parts, surgery-related items such as implements, instrumentation, trial prosthetics, prosthetic components, and virtual constructs or references such as rotational axes which have been calculated and stored based on designation of bone landmarks. Processing capability such as any desired form of computer functionality, whether standalone, networked, or otherwise, takes into account the position and orientation information as to various items in the position sensing field (which may correspond generally or specifically to all or portions or more than all of the surgical field) based on sensed position and orientation of their associated fiducials or based on stored position and/or orientation information. The processing functionality correlates this position and orientation information for each object with stored information regarding the items, such as a computerized fluoroscopic imaged file of a femur or tibia, a wire frame data file for rendering a representation of an instrumentation component, trial prosthesis or actual prosthesis, or a computer generated file relating to a rotational axis or other virtual construct or reference. The processing functionality then displays position and orientation of these objects on a screen or monitor, or otherwise. Thus, instrumentation, systems, and processes according to one embodiment of the invention can display and otherwise output useful data relating to predicted or actual position and orientation of body parts, surgically related items, implants, and virtual constructs for use in navigation, assessment, and otherwise performing surgery or other operations.
  • As one example, images such as fluoroscopy images showing internal aspects of the femur and tibia can be displayed on the monitor in combination with actual or predicted shape, position and orientation of surgical implements, instrumentation components, trial implants, actual prosthetic components, and rotational axes in order to allow the surgeon to properly position and assess performance of various aspects of the joint being repaired, reconstructed or replaced. The surgeon may navigate tools, instrumentation, trial prostheses, actual prostheses and other items relative to bones and other body parts in order to perform TKA's more accurately, efficiently, and with better alignment and stability. Instrumentation, systems, and processes according to the present invention can also use the position tracking information and, if desired, data relating to shape and configuration of surgical related items and virtual constructs or references in order to produce numerical data which may be used with or without graphic imaging to perform tasks such as assessing performance of trial prosthetics statically and throughout a range of motion, appropriately modifying tissue such as ligaments to improve such performance and similarly assessing performance of actual prosthetic components which have been placed in the patient for alignment and stability. Instrumentation, systems, and processes according to the present invention can also generate data based on position tracking and, if desired, other information to provide cues on screen, aurally or as otherwise desired to assist in the surgery such as suggesting certain bone modification steps or measures which may be taken to release certain ligaments or portions of them based on performance of components as sensed by instrumentation, systems, and processes according to the present invention.
  • According to a preferred embodiment of instrumentation, systems, and processes according to the present invention, at least the following steps are involved:
  • 1. Obtain appropriate images such as fluoroscopy images of appropriate body parts such as femur and tibia, the imager being tracked in position via an associated fiducial whose position and orientation is tracked by position/orientation sensors such as stereoscopic infrared (active or passive) sensors according to the present invention.
  • 2. Register tools, instrumentation, trial components, prosthetic components, and other items to be used in surgery, each of which corresponds to a fiducial whose position and orientation can be tracked by the position/orientation sensors.
  • 3. Locating and registering body structure such as designating points on the femur and tibia using a probe associated with a fiducial in order to provide the processing functionality information relating to the body part such as rotational axes.
  • 4. Navigating and positioning instrumentation such as cutting instrumentation in order to modify bone, at least partially using images generated by the processing functionality corresponding to what is being tracked and/or has been tracked, and/or is predicted by the system, and thereby resecting bone effectively, efficiently and accurately.
  • 5. Navigating and positioning trial components such as femoral components and tibial components, some or all of which may be installed using impactors with a fiducial and, if desired, at the appropriate time discontinuing tracking the position and orientation of the trial component using the impactor fiducial and starting to track that position and orientation using the body part fiducial on which the component is installed.
  • 6. Assessing alignment and stability of the trial components and joint, both statically and dynamically as desired, using images of the body parts in combination with images of the trial components while conducting appropriate rotation, anterior-posterior drawer and flexion/extension tests and automatically storing and calculating results to present data or information which allows the surgeon to assess alignment and stability.
  • 7. Releasing tissue such as ligaments if necessary and adjusting trial components as desired for acceptable alignment and stability.
  • 8. Installing implant components whose positions may be tracked at first via fiducials associated with impactors for the components and then tracked via fiducials on the body parts in which the components are installed.
  • 9. Assessing alignment and stability of the implant components and joint by use of some or all tests mentioned above and/or other tests as desired, releasing tissue if desired, adjusting if desired, and otherwise verifying acceptable alignment, stability and performance of the prosthesis, both statically and dynamically.
  • This process, or processes including it or some of it may be used in any total or partial joint repair, reconstruction or replacement, including knees, hips, shoulders, elbows, ankles and any other desired joint in the body.
  • Such processes are disclosed in U.S. Ser. No. 60/271,818 filed Feb. 27, 2001, entitled Image Guided System for Arthroplasty, which is incorporated herein by reference as are all documents incorporated by reference therein.
  • Instrumentation, systems, and processes according to the present invention represent significant improvement over other previous instrumentation, systems, and processes. For instance, systems which use CT and MRI data generally require the placement of reference frames preoperatively which can lead to infection at the pin site. The resulting 3D images must then be registered, or calibrated, to the patient anatomy intraoperatively. Current registration methods are less accurate than the fluoroscopic system. These imaging modalities are also more expensive. Some “imageless” systems, or non-imaging systems, require digitizing a large number of points to define the complex anatomical geometries of the knee at each desired site. This can be very time intensive resulting in longer operating room time. Other imageless systems determine the mechanical axis of the knee by performing an intraoperative kinematic motion to determine the center of rotation at the hip, knee, and ankle. This requires placement of reference frames at the iliac crest of the pelvis and in or on the ankle. This calculation is also time consuming at the system must find multiple points in different planes in order to find the center of rotation. This is also problematic in patients with a pathologic condition. Ligaments and soft tissues in the arthritic patient are not normal and thus will give a center of rotation that is not desirable for normal knees. Robotic systems require expensive CT or MRI scans and also require pre-operative placement of reference frames, usually the day before surgery. These systems are also much slower, almost doubling operating room time and expense.
  • Some systems provide variable alignment modules, but none of these systems allow gross placement of cutting instruments followed by fine adjustment of cutting instruments through computer assisted navigation technology. Further, these systems can only be used with tibial instrumentation and cannot be used for femoral alignment and cutting.
  • None of these systems can effectively track femoral and/or tibial trials during a range of motion and calculate the relative positions of the articular surfaces, among other things. Also, none of them currently make suggestions on ligament balancing, display ligament balancing techniques, or surgical techniques. Additionally, none of these systems currently track the patella.
  • An aspect of the present invention is to use computer processing functionality in combination with imaging and position and/or orientation tracking sensors to present to the surgeon during surgical operations visual and data information useful to navigate, track and/or position implements, instrumentation, trial components, prosthetic components and other items and virtual constructs relative to the human body in order to improve performance of a repaired, replaced or reconstructed knee joint.
  • Another aspect of the present invention is to use computer processing functionality in combination with imaging and position and/or orientation tracking sensors to present to the surgeon during surgical operations visual and data information useful to assess performance of a knee and certain items positioned therein, including components such as trial components and prosthetic components, for stability, alignment and other factors, and to adjust tissue and body and non-body structure in order to improve such performance of a repaired, reconstructed or replaced knee joint.
  • Another aspect of the present invention is to use computer processing functionality in combination with imaging and position and/or orientation tracking sensors to present to the surgeon during surgical operations visual and data information useful to show predicted position and movement of implements, instrumentation, trial components, prosthetic components and other items and virtual constructs relative to the human body in order to select appropriate components, resect bone accurately, effectively and efficiently, and thereby improve performance of a repaired, replaced or reconstructed knee joint. Further areas of applicability of the present invention will become apparent from the detailed description provided hereinafter. It should be understood that the detailed description and specific examples, while indicating the preferred embodiment of the invention, are intended for purposes of illustration only and are not intended to limit the scope of the invention.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • The accompanying drawings, which are incorporated in and form a part of the specification, illustrate the embodiments of the present invention and together with the written description serve to explain the principles, characteristics, and features of the invention. In the drawings:
  • FIG. 1 is a schematic view of a particular embodiment of instrumentation, systems, and processes according to the present invention.
  • FIG. 2 is a view of a knee prepared for surgery, including a femur and a tibia, to which fiducials according to one embodiment of the present invention have been attached.
  • FIG. 3 is a view of a portion of a leg prepared for surgery according to the present invention with a C-arm for obtaining fluoroscopic images associated with a fiducial according to one embodiment of the present invention.
  • FIG. 4 is a fluoroscopic image of free space rendered on a monitor according to one embodiment of the present invention.
  • FIG. 5 is a fluoroscopic image of femoral head obtained and rendered according one embodiment of the present invention.
  • FIG. 6 is a fluoroscopic image of a knee obtained and rendered according to one embodiment of the present invention.
  • FIG. 7 is a fluoroscopic image of a tibia distal end obtained and rendered according to one embodiment of the present invention.
  • FIG. 8 is a fluoroscopic image of a lateral view of a knee obtained and rendered according to one embodiment of the present invention.
  • FIG. 9 is a fluoroscopic image of a lateral view of a knee obtained and rendered according to one embodiment of the present invention.
  • FIG. 10 is a fluoroscopic image of a lateral view of a tibia distal end obtained and rendered according to one embodiment of the present invention.
  • FIG. 11 shows a probe according to one embodiment of the present invention being used to register a surgically related component for tracking according to one embodiment of the present invention.
  • FIG. 12 shows a probe according to one embodiment of the present invention being used to register a cutting block for tracking according to one embodiment of the present invention.
  • FIG. 13 shows a probe according to one embodiment of the present invention being used to register a tibial cutting block for tracking according to one embodiment of the present invention.
  • FIG. 14 shows a probe according to one embodiment of the present invention being used to register an alignment guide for tracking according to one embodiment of the present invention.
  • FIG. 15 shows a probe according to one embodiment of the present invention being used to designate landmarks on bone structure for tracking according one embodiment of the present invention.
  • FIG. 16 is another view of a probe according to one embodiment of the present invention being used to designate landmarks on bone structure for tracking according one embodiment of the present invention.
  • FIG. 17 is another view of a probe according to one embodiment of the present invention being used to designate landmarks on bone structure for tracking according one embodiment of the present invention.
  • FIG. 18 is a screen face produced according to one embodiment of the present invention during designation of landmarks to determine a femoral mechanical axis.
  • FIG. 19 is a view produced according to one embodiment of the present invention during designation of landmarks to determine a tibial mechanical axis.
  • FIG. 20 is a screen face produced according to one embodiment of the present invention during designation of landmarks to determine an epicondylar axis.
  • FIG. 21 is a screen face produced according to one embodiment of the present invention during designation of landmarks to determine an anterior-posterior axis.
  • FIG. 22 is a screen face produced according to one embodiment of the present invention during designation of landmarks to determine a posterior condylar axis.
  • FIG. 23 is a screen face according to one embodiment of the present invention which presents graphic indicia which may be employed to help determine reference locations within bone structure.
  • FIG. 24 is a screen face according to one embodiment of the present invention showing mechanical and other axes which have been established according to one embodiment of the present invention.
  • FIG. 25 is another screen face according to one embodiment of the present invention showing mechanical and other axes which have been established according to one embodiment of the present invention.
  • FIG. 26 is another screen face according to one embodiment of the present invention showing mechanical and other axes which have been established according to one embodiment of the present invention.
  • FIG. 27 shows navigation and placement of an extramedullary rod according to one embodiment of the present invention.
  • FIG. 28 is a view of an extramedullary rod according to one embodiment of the present invention.
  • FIG. 29 is another view showing navigation and placement of an extramedullary rod according to one embodiment of the present invention.
  • FIG. 30 is a screen face produced according to one embodiment of the present invention which assists in navigation and/or placement of an extramedullary rod.
  • FIG. 31 is another view of a screen face produced according to one embodiment of the present invention which assists in navigation and/or placement of an extramedullary rod.
  • FIG. 32 is a view which shows navigation and placement of an alignment guide according to one embodiment of the present invention.
  • FIG. 33 is another view which shows navigation and placement of an alignment guide according to one embodiment of the present invention.
  • FIG. 34 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
  • FIG. 35 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
  • FIG. 36 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
  • FIG. 37 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
  • FIGS. 38A-C are views showing certain aspects of a gimbal alignment module according to one embodiment of the present invention.
  • FIGS. 39A-C are views showing other aspects of the module shown in FIGS. 38A-C.
  • FIGS. 40A-C show other aspects of the module shown in FIGS. 38A-C.
  • FIG. 41 shows additional aspects of the module shown in FIGS. 38A-C.
  • FIGS. 42A and B are an exploded perspective view showing certain aspects of a tibial gimbal alignment module according to one embodiment of the present invention.
  • FIG. 43 shows other aspects of the module shown in FIGS. 42A and 42B.
  • FIG. 44 shows additional aspects of the module shown in FIGS. 42A and 42B.
  • FIG. 45 additional aspects of the module shown in FIGS. 42A and 42B.
  • FIGS. 46A and 46B show another structure for alignment modules according to alternative embodiments of the present invention.
  • FIG. 47 shows another structure for alignment modules according to alternative embodiments of the present invention.
  • FIG. 48 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
  • FIG. 49 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
  • FIG. 50 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
  • FIG. 51 is a screen face which shows a fluoroscopic image of bone in combination with computer generated images of axes and components in accordance with one embodiment of the present invention.
  • FIG. 52 is a view showing placement of a cutting block according to one embodiment of the present invention.
  • FIG. 53 is a screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
  • FIG. 54 is another screen face according to one embodiment of the present invention which may be used to assist in navigation and/or placement of instrumentation.
  • FIG. 55 is a view showing placement of an alignment guide according to one embodiment of the present invention.
  • FIG. 56 is another view showing placement of a cutting block according to one embodiment of the present invention.
  • FIG. 57 is a view showing navigation and placement of the cutting block of FIG. 45.
  • FIG. 58 is another view showing navigation and placement of a cutting block according to one embodiment of the present invention.
  • FIG. 59 is a view showing navigation and placement of a tibial cutting block according to one embodiment of the present invention.
  • FIG. 60 is a screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
  • FIG. 61 is another screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
  • FIG. 62 is another screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
  • FIG. 63 is another screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
  • FIG. 64 is another screen face according to one embodiment of the present invention which may be used to assist in navigation and placement of instrumentation.
  • FIG. 65 is a view showing navigation and placement of a femoral component using an impactor to which a fiducial according to one embodiment of the present invention is attached.
  • FIG. 66 is a view showing navigation and placement of a tibial trial component according to one embodiment of the present invention.
  • FIG. 67 is a view showing articulation of trial components during trial reduction according to one embodiment of the present invention.
  • FIG. 68 is a screen face according to one embodiment of the present invention which may be used to assist in assessing joint function.
  • FIG. 69 is a screen face according to one embodiment of the present invention which may be used to assist in assessing joint function.
  • FIG. 70 is a screen face according to one embodiment of the present invention which may be used to assist in assessing joint function.
  • FIG. 71 is a screen face according to one embodiment of the present invention which contains images and textural suggestions for assisting in assessing performance and making adjustments to improve performance of a joint in accordance with one aspect of the invention.
  • FIG. 72 is a screen face according to one embodiment of the present invention which contains images and textural suggestions for assisting in assessing performance and making adjustments to improve performance of a joint in accordance with one aspect of the invention.
  • FIG. 73 is a screen face according to one embodiment of the present invention which contains images and textural suggestions for assisting in assessing performance and making adjustments to improve performance of a joint in accordance with one aspect of the invention.
  • FIG. 74 is a screen face according to one embodiment of the present invention which contains images and textural suggestions for assisting in assessing performance and making adjustments to improve performance of a joint in accordance with one aspect of the invention.
  • FIG. 75 is a computer generated graphic according to one embodiment of the present invention which allows visualization of trial or actual components installed in the bone structure according to one embodiment of the invention.
  • DETAILED DESCRIPTION OF THE EMBODIMENTS
  • The following description of the preferred embodiment(s) is merely exemplary in nature and is in no way intended to limit the invention, its application, or uses.
  • Instrumentation, systems, and processes according to a preferred embodiment of the present invention use computer capacity, including standalone and/or networked, to store data regarding spatial aspects of surgically related items and virtual constructs or references including body parts, implements, instrumentation, trial components, prosthetic components and rotational axes of body parts. Any or all of these may be physically or virtually connected to or incorporate any desired form of mark, structure, component, or other fiducial or reference device or technique which allows position and/or orientation of the item to which it is attached to be sensed and tracked, preferably in three dimensions of translation and three degrees of rotation as well as in time if desired. In the preferred embodiment, such “fidicuals” are reference frames each containing at least three, preferably four, sometimes more, reflective elements such as spheres reflective of lightwave or infrared energy, or active elements such as LEDs.
  • In a preferred embodiment, orientation of the elements on a particular fiducial varies from one fiducial to the next so that sensors according to the present invention may distinguish between various components to which the fiducials are attached in order to correlate for display and other purposes data files or images of the components. In a preferred embodiment of the present invention, some fiducials use reflective elements and some use active elements, both of which may be tracked by preferably two, sometimes more infrared sensors whose output may be processed in concert to geometrically calculate position and orientation of the item to which the fiducial is attached.
  • Position/orientation tracking sensors and fiducials need not be confined to the infrared spectrum. Any electromagnetic, electrostatic, light, sound, radiofrequency or other desired technique may be used. Alternatively, each item such as a surgical implement, instrumentation component, trial component, implant component or other device may contain its own “active” fiducial such as a microchip with appropriate field sensing or position/orientation sensing functionality and communications link such as spread spectrum RF link, in order to report position and orientation of the item. Such active fiducials, or hybrid active/passive fiducials such as transponders can be implanted in the body parts or in any of the surgically related devices mentioned above, or conveniently located at their surface or otherwise as desired. Fiducials may also take the form of conventional structures such as a screw driven into a bone, or any other three dimensional item attached to another item, position and orientation of such three dimensional item able to be tracked in order to track position and orientation of body parts and surgically related items. Hybrid fiducials may be partly passive, partly active such as inductive components or transponders which respond with a certain signal or data set when queried by sensors according to the present invention.
  • Instrumentation, systems, and processes according to a preferred embodiment of the present invention employ a computer to calculate and store reference axes of body components such as in a TKA, for example, the mechanical axis of the femur and tibia. From these axes such systems track the position of the instrumentation and osteotomy guides so that bone resections will locate the implant position optimally, usually aligned with the mechanical axis. Furthermore, during trial reduction of the knee, the systems provide feedback on the balancing of the ligaments in a range of motion and under varus/valgus, anterior/posterior and rotary stresses and can suggest or at least provide more accurate information than in the past about which ligaments the surgeon should release in order to obtain correct balancing, alignment and stability. Instrumentation, systems and processes according to the present invention allow the attachment of a variable alignment module so that a surgeon can grossly place a cutting block based on visual landmarks or navigation and then finely adjust the cutting block based on navigation and feedback from the system.
  • Instrumentation, systems, and processes according to the present invention can also suggest modifications to implant size, positioning, and other techniques to achieve optimal kinematics. Instrumentation, systems, and processes according to the present invention can also include databases of information regarding tasks such as ligament balancing, in order to provide suggestions to the surgeon based on performance of test results as automatically calculated by such instrumentation, systems, and processes.
  • FIG. 1 is a schematic view showing one embodiment of a system according to the present invention and one version of a setting according to the present invention in which surgery on a knee, in this case a Total Knee Arthroplasty, may be performed. Instrumentation, systems, and processes according to the present invention can track various body parts such as tibia 10 and femur 12 to which fiducials of the sort described above or any other sort may be implanted, attached, or otherwise associated physically, virtually, or otherwise. In the embodiment shown in FIG. 1, fiducials 14 are structural frames some of which contain reflective elements, some of which contain LED active elements, some of which can contain both, for tracking using stereoscopic infrared sensors suitable, at least operating in concert, for sensing, storing, processing and/or outputting data relating to (“tracking”) position and orientation of fiducials 14 and thus components such as 10 and 12 to which they are attached or otherwise associated. Position sensor 16, as mentioned above, may be any sort of sensor functionality for sensing position and orientation of fiducials 14 and therefore items with which they are associated, according to whatever desired electrical, magnetic, electromagnetic, sound, physical, radio frequency, or other active or passive technique. In the preferred embodiment, position sensor 16 is a pair of infrared sensors disposed on the order of a meter, sometimes more, sometimes less, apart and whose output can be processed in concert to provide position and orientation information regarding fiducials 14.
  • In the embodiment shown in FIG. 1, computing functionality 18 can include processing functionality, memory functionality, input/output functionality whether on a standalone or distributed basis, via any desired standard, architecture, interface and/or network topology. In this embodiment, computing functionality 18 is connected to a monitor on which graphics and data may be presented to the surgeon during surgery. The screen preferably has a tactile interface so that the surgeon may point and click on screen for tactile screen input in addition to or instead of, if desired, keyboard and mouse conventional interfaces. Additionally, a foot pedal 20 or other convenient interface may be coupled to functionality 18 as can any other wireless or wireline interface to allow the surgeon, nurse or other desired user to control or direct functionality 18 in order to, among other things, capture position/orientation information when certain components are oriented or aligned properly. Items 22 such as trial components and instrumentation components may be tracked in position and orientation relative to body parts 10 and 12 using fiducials 14.
  • Computing functionality 18 can process, store and output on monitor 24 and otherwise various forms of data which correspond in whole or part to body parts 10 and 12 and other components for item 22. For example, in the embodiment shown in FIG. 1, body parts 10 and 12 are shown in cross-section or at least various internal aspects of them such as bone canals and surface structure are shown using fluoroscopic images. These images are obtained using a C-arm attached to a fiducial 14. The body parts, for example, tibia 10 and femur 12, also have fiducials attached. When the fluoroscopy images are obtained using the C-arm with fiducial 14, a position/orientation sensor 16 “sees” and tracks the position of the fluoroscopy head as well as the positions and orientations of the tibia 10 and femur 12. The computer stores the fluoroscopic images with this position/orientation information, thus correlating position and orientation of the fluoroscopic image relative to the relevant body part or parts. Thus, when the tibia 10 and corresponding fiducial 14 move, the computer automatically and correspondingly senses the new position of tibia 10 in space and can correspondingly move implements, instruments, references, trials and/or implants on the monitor 24 relative to the image of tibia 10. Similarly, the image of the body part can be moved, both the body part and such items may be moved, or the on screen image otherwise presented to suit the preferences of the surgeon or others and carry out the imaging that is desired. Similarly, when an item 22 such as an extramedullary rod 36 (See, e.g., FIG. 28), intramedullary rod, or other type of rod, that is being tracked moves, its image moves on monitor 24 so that the monitor shows the item 22 in proper position and orientation on monitor 24 relative to the femur 12. The rod 36 can thus appear on the monitor 24 in proper or improper alignment with respect to the mechanical axis and other features of the femur 12, as if the surgeon were able to see into the body in order to navigate and position rod 36 properly
  • The computer functionality 18 can also store data relating to configuration, size and other properties of items 22 such as implements, instrumentation, trial components, implant components and other items used in surgery. When those are introduced into the field of position/orientation sensor 16, computer functionality 18 can generate and display overlain or in combination with the fluoroscopic images of the body parts 10 and 12, computer generated images of implements, instrumentation components, trial components, implant components and other items 22 for navigation, positioning, assessment and other uses.
  • Additionally, computer functionality 18 can track any point in the position/orientation sensor 16 field such as by using a designator or a probe 26. The probe also can contain or be attached to a fiducial 14. The surgeon, nurse, or other user touches the tip of probe 26 to a point such as a landmark on bone structure and actuates the foot pedal 20 or otherwise instructs the computer 18 to note the landmark position. The position/orientation sensor 16 “sees” the position and orientation of fiducial 14 “knows” where the tip of probe 26 is relative to that fiducial 14 and thus calculates and stores, and can display on monitor 24 whenever desired and in whatever form or fashion or color, the point or other position designated by probe 26 when the foot pedal 20 is hit or other command is given. Thus, probe 26 can be used to designate landmarks on bone structure in order to allow the computer 18 to store and track, relative to movement of the bone fiducial 14, virtual or logical information such as mechanical axis 28, medial laterial axis 30 and anterior/posterior axis 32 of femur 12, tibia 10 and other body parts in addition to any other virtual or actual construct or reference.
  • Instrumentation, systems, and processes according to an embodiment of the present invention such as the subject of FIGS. 2-75, can use the so-called FluoroNAV system and software provided by Medtronic Sofamor Danek Technologies. Such systems or aspects of them are disclosed in U.S. Pat. Nos. 5,383,454; 5,871,445; 6,146,390; 6,165,81; 6,235,038 and 6,236,875, and related (under 35 U.S.C. Section 119 and/or 120) patents, which are all incorporated herein by this reference. Any other desired systems can be used as mentioned above for imaging, storage of data, tracking of body parts and items and for other purposes. The FluoroNav system requires the use of reference frame type fiducials 14 which have four and in some cases five elements tracked by infrared sensors for position/orientation of the fiducials and thus of the body part, implement, instrumentation, trial component, implant component, or other device or structure being tracked. Such systems also use at least one probe 26 which the surgeon can use to select, designate, register, or otherwise make known to the system a point or points on the anatomy or other locations by placing the probe as appropriate and signaling or commanding the computer to note the location of, for instance, the tip of the probe. The FluoroNav system also tracks position and orientation of a C-arm used to obtain fluoroscopic images of body parts to which fiducials have been attached for capturing and storage of fluoroscopic images keyed to position/orientation information as tracked by the sensors 16. Thus, the monitor 24 can render fluoroscopic images of bones in combination with computer generated images of virtual constructs and references together with implements, instrumentation components, trial components, implant components and other items used in connection with surgery for navigation, resection of bone, assessment and other purposes.
  • FIGS. 2-75 are various views associated with Total Knee Arthroplasty surgery processes according to one particular embodiment and version of the present invention being carried out with the FluoroNav system referred to above. FIG. 2 shows a human knee in the surgical field, as well as the corresponding femur and tibia, to which fiducials 14 have been rigidly attached in accordance with this embodiment of the invention. Attachment of fiducials 14 preferably is accomplished using structure that withstands vibration of surgical saws and other phenomenon which occur during surgery without allowing any substantial movement of fiducial 14 relative to body part being tracked by the system. FIG. 3 shows fluoroscopy images being obtained of the body parts with fiducials 14 attached. The fiducial 14 on the fluoroscopy head in this embodiment is a cylindrically shaped cage which contains LEDs or “active” emitters for tracking by the sensors 16. Fiducials 14 attached to tibia 10 and femur 12 can also be seen. The fiducial 14 attached to the femur 12 uses LEDs instead of reflective spheres and is thus active, fed power by the wire seen extending into the bottom of the image.
  • FIGS. 4-10 are fluoroscopic images shown on monitor 24 obtained with position and/or orientation information received by, noted and stored within computer 18. FIG. 4 is an open field with no body part image, but which shows the optical indicia which may be used to normalize the image obtained using a spherical fluoroscopy wave front with the substantially flat surface of the monitor 24. FIG. 5 shows an image of the femur 12 head. This image is taken in order to allow the surgeon to designate the center of rotation of the femoral head for purposes of establishing the mechanical axis and other relevant constructs relating to of the femur according to which the prosthetic components will ultimately be positioned. Such center of rotation can be established by articulating the femur within the acetabulum or a prosthesis to capture a number of samples of position and orientation information and thus in turn to allow the computer to calculate the average center of rotation. The center of rotation can be established by using the probe and designating a number of points on the femoral head and thus allowing the computer to calculate the geometrical center or a center which corresponds to the geometry of points collected. Additionally, graphical representations such as controllably sized circles displayed on the monitor can be fitted by the surgeon to the shape of the femoral head on planar images using tactile input on screen to designate the centers according to that graphic, such as are represented by the computer as intersection of axes of the circles. Other techniques for determining, calculating or establishing points or constructs in space, whether or not corresponding to bone structure, can be used in accordance with the present invention.
  • FIG. 5 shows a fluoroscopic image of the femoral head while FIG. 6 shows an anterior/posterior view of the knee which can be used to designate landmarks and establish axes or constructs such as the mechanical axis or other rotational axes. FIG. 7 shows the distal end of the tibia and FIG. 8 shows a lateral view of the knee. FIG. 9 shows another lateral view of the knee while FIG. 10 shows a lateral view of the distal end of the tibia.
  • Registration of Surgically Related Items
  • FIGS. 11-14 show designation or registration of items 22 which will be used in surgery. Registration simply means, however it is accomplished, ensuring that the computer knows which body part, item or construct corresponds to which fiducial or fiducials, and how the position and orientation of the body part, item or construct is related to the position and orientation of its corresponding fiducial or a fiducial attached to an impactor or other other component which is in turn attached to an item. Such registration or designation can be done before or after registering bone or body parts as discussed with respect to FIGS. 4-10. FIG. 11 shows a technician designating with probe 26 an item 22 such as an instrument component to which fiducial 14 is attached. The sensor 16 “sees” the position and orientation of the fiducial 14 attached to the item 22 and also the position and orientation of the fiducial 14 attached to the probe 26 whose tip is touching a landmark on the item 22. The technician designates onscreen or otherwise the identification of the item and then activates the foot pedal or otherwise instructs the computer to correlate the data corresponding to such identification, such as data needed to represent a particular cutting block component for a particular knee implant product, with the particularly shaped fiducial 14 attached to the component 22. The computer has then stored identification, position and orientation information relating to the fiducial for component 22 correlated with the data such as configuration and shape data for the item 22 so that upon registration, when sensor 16 tracks the item 22 fiducial 14 in the infrared field, monitor 24 can show the cutting block component 22 moving and turning, and properly positioned and oriented relative to the body part which is also being tracked. FIGS. 12-14 show similar registration for other instrumentation components 22.
  • Registration of Anatomy and Constructs
  • Similarly, the mechanical axis and other axes or constructs of body parts 10 and 12 can also be “registered” for tracking by the system. Again, the system has employed a fluoroscope to obtain images of the femoral head, knee and ankle of the sort shown in FIGS. 4-10. The system correlates such images with the position and orientation of the C-arm and the patient anatomy in real time as discussed above with the use of fiducials 14 placed on the body parts before image acquisition and which remain in position during the surgical procedure. Using these images and/or the probe, the surgeon can select and register in the computer 18 the center of the femoral head and ankle in orthogonal views, usually anterior/posterior and lateral, on a touch screen. The surgeon uses the probe to select any desired anatomical landmarks or references at the operative site of the knee or on the skin or surgical draping over the skin, as on the ankle. These points are registered in three dimensional space by the system and are tracked relative to the fiducials on the patient anatomy which are preferably placed intraoperatively. FIG. 15 shows the surgeon using probe 26 to designate or register landmarks on the condylar portion of femur 12 using probe 26 in order to feed to the computer 18 the position of one point needed to determine, store, and display the epicondylar axis. (See FIG. 20 which shows the epicondylar axis and the anterior-posterior plane and for lateral plane.) Although registering points using actual bone structure such as in FIG. 15 is one preferred way to establish the axis, a cloud of points approach by which the probe 26 is used to designate multiple points on the surface of the bone structure can be employed, as can moving the body part and tracking movement to establish a center of rotation as discussed above. Once the center of rotation for the femoral head and the condylar component have been registered, the computer is able to calculate, store, and render, and otherwise use data for, the mechanical axis of the femur 12. FIG. 17 once again shows the probe 26 being used to designate points on the condylar component of the femur 12.
  • FIG. 18 shows the onscreen images being obtained when the surgeon registers certain points on the bone surface using the probe 26 in order to establish the femoral mechanical axis. The tibial mechanical axis is then established by designating points to determine the centers of the proximal and distal ends of the tibia so that the mechanical axis can be calculated, stored, and subsequently used by the computer 18. FIG. 20 shows designated points for determining the epicondylar axis, both in the anterior/posterior and lateral planes while FIG. 21 shows such determination of the anterior-posterior axis as rendered onscreen. The posterior condylar axis is also determined by designating points or as otherwise desired, as rendered on the computer generated geometric images overlain or displayed in combination with the fluoroscopic images, all of which are keyed to fiducials 14 being tracked by sensors 16.
  • FIG. 23 shows an adjustable circle graphic which can be generated and presented in combination with orthogonal fluoroscopic images of the femoral head, and tracked by the computer 18 when the surgeon moves it on screen in order to establish the centers of the femoral head in both the anterior-posterior and lateral planes.
  • FIG. 24 is an onscreen image showing the anterior-posterior axis, epicondylar axis and posterior condylar axis from points which have been designated as described above. These constructs are generated by the computer 18 and presented on monitor 24 in combination with the fluoroscopic images of the femur 12, correctly positioned and oriented relative thereto as tracked by the system. In the fluoroscopic/computer generated image combination shown at left bottom of FIG. 24, a “sawbones” knee as shown in certain drawings above which contains radio opaque materials is represented fluoroscopically and tracked using sensor 16 while the computer generates and displays the mechanical axis of the femur 12 which runs generally horizontally. The epicondylar axis runs generally vertically, and the anterior/posterior axis runs generally diagonally. The image at bottom right shows similar information in a lateral view. Here, the anterior-posterior axis runs generally horizontally while the epicondylar axis runs generally diagonally, and the mechanical axis generally vertically.
  • FIG. 24, as is the case with a number of screen presentations generated and presented by the system of FIGS. 4-75, also shows at center a list of landmarks to be registered in order to generate relevant axes and constructs useful in navigation, positioning and assessment during surgery. Textual cues may also be presented which suggest to the surgeon next steps in the process of registering landmarks and establishing relevant axes. Such instructions may be generated as the computer 18 tracks, from one step to the next, registration of items 22 and bone locations as well as other measures being taken by the surgeon during the surgical operation.
  • FIG. 25 shows mechanical, lateral, anterior-posterior axes for the tibia according to points are registered by the surgeon.
  • FIG. 26 is another onscreen image showing the axes for the femur 12.
  • Modifying Bone
  • After the mechanical axis and other rotation axes and constructs relating to the femur and tibia are established, instrumentation can be properly oriented to resect or modify bone in order to fit trial components and implant components properly according to the embodiment of the invention shown in FIGS. 4-75. Instrumentation such as, for instance, cutting blocks 34, to which fiducials 14 are mounted, can be employed. The system can then track cutting block 34 as the surgeon manipulates it for optimum positioning. In other words, the surgeon can “navigate” the cutting block 34 for optimum positioning using the system, the monitor, visual landmarks, and other devices, such as variable alignment modules 54. In this manner, instrumentation may be positioned according to the system of this embodiment in order to align the ostetomies to the mechanical and rotational axes or reference axes on an extramedullary rod 36 or any other structure that allows the instrumentation to be positioned without invading the medullary canal. The touchscreen 24 can then also display the instrument, such as the cutting block 34 and/or the implant and/or the variable alignment module 54 relative to the instruments and the rod 36 during this process, in order, among other things, properly to select size of implant and perhaps implant type. As the instrument moves, the varus/valgus, flexion/extension and internal/external rotation of the relative component position can be calculated and shown with respect to the referenced axes; in the preferred embodiment, this can be done at a rate of six cycles per second or faster. The instrument position is then fixed in the computer and physically and the bone resections are made.
  • FIG. 27 shows orientation of an extramedullary rod 36 to which a fiducial 14 is attached via impactor 22. The surgeon views the screen 24 which has an image as shown in FIG. 32 of the rod 36 overlain on or in combination with the femur 12 fluoroscopic image as the two are actually positioned and oriented relative to one another in space. The surgeon then navigates the rod 36 into place preferably along the mechanical axis of the femur and drives it home with appropriate mallet or other device.
  • FIG. 28 shows an extramedullary rod 36, according to one embodiment of the invention, which includes a first end that is adapted to fasten to bone and a second end that is adapted for attachment or connection to a cutting block 34 or other instrumentation. In a preferred embodiment of this invention, the first end of the extramedullary rod 36 has a pointed, splined tip 38 that is capable being being driven or otherwise introduced into and fastened to bone with a mallet, wrench or other suitable tool or device. The tip can feature threads, curved spines, or any structure that is suitable for efficient and effective introduction into and purchase of or fastening bone sufficient to support cutting block 34 or other instrumentation while being used to alter bone. Devices according to aspects of the present invention thus avoid the need to bore a hole in the metaphysis of the femur and place a reamer or other rod 36 into the medullary canal which can cause fat embolism, hemorrhaging, infection and other untoward and undesired effects.
  • As shown in FIG. 28, the second end of the extramedullary rod 36 may be attached to a base member 40 (permanently or in releasable fashion) and that is capable of permanent or releasable attachment to a cylindrical connector 42. The cylindrical connector 42 is capable of permanent or releasable attachment to a cylindrical knob 44 that has an integrated, circumferential groove 46. The circumferential groove 46 is adapted to secure an impactor or any other desired structure to the second end of the extramedullary rod 36. The base member 40, connector 42, and knob 44 may form a unitary structure that is capable of permanent or releasable attachment to an extramedullary rod 36. Any desired connection structure can be employed.
  • FIG. 29 also shows the extramedullary rod 36 being located through computer assisted navigation. FIG. 30 shows fluoroscopic images, both anterior-posterior and lateral, with axes, and with a computer generated and tracked image of the rod 36 superposed or in combination with the fluoroscopic images of the femur and tibia. FIG. 31 shows the rod 36 superposed on the femoral fluoroscopic image similar to what is shown in FIG. 30.
  • FIG. 30 also shows other information relevant to the surgeon such as the name of the component being overlain on the femur image (new EM nail), suggestions or instructions at the lower left, and angle of the rod 36 in varus/valgus and extension relative to the axes. Any or all of this information can be used to navigate and position the rod 36 relative to the femur. At a point in time during or after placement of the rod 36, its tracking may be “handed off” from the impactor fiducial 14 to the femur fiducal 14 as discussed below.
  • Once the extramedullary rod 36, intramedullary rod, other type of rod or any other type of structural member has been placed, instrumentation can be positioned as tracked in position and orientation by sensor 16 and displayed on screen face 24. Thus, a cutting block 34 of the sort used to establish the condylar anterior cut, with its fiducial 14 attached, is introduced into the field and positioned on the rod 36. Because the cutting block 34 corresponds to a particular implant product and can be adjusted and designated on screen to correspond to a particular implant size of that product, the computer 18 can generate and display a graphic of the cutting block 34 and the femoral component overlain on the fluoroscopic image as shown in FIGS. 34-37. The surgeon can thus navigate and position the cutting block 34 on screen using not only images of the cutting block 34 on the bone, but also images of the corresponding femoral component which will be ultimately installed. The surgeon can thus adjust the positioning of the physical cutting block 34 component, and secure it to the rod 36 in order to resect the anterior of the condylar portion of the femur in order to optimally fit and position the ultimate femoral component being shown on the screen. FIG. 35 is another view of the cutting block 34 of FIG. 32 being positioned.
  • Cutting blocks 34 and other instrumentation may be positioned relative to femoral, tibial or other bone using instruments and devices such as variable alignment or orientation modules, versions of which according to particular aspects of the invention are shown in FIGS. 38-47. FIGS. 38-41 show a first version of a variable alignment module 54. It includes a post 58 which may be connected to an extramedullary rod 36 as shown in FIG. 28, an intramedullary rod or as otherwise desired. Post 58 connects to a cutting block or other instrument 34 via two gimbal members, first or outer gimbal 60 and a second or inner gimbal 62. First or outer gimbal 60, which may be mechanically connected to cutting block 34 as shown in FIGS. 40 A-C and 41, is connected in pivoting fashion to second gimbal 62 using, for example, openings 64 and pins 70. First gimbal 60 receives a worm gear 66 which cooperates with a first follower (located on the second gimbal 62) whose teeth follow action of the worm gear 66 in order to vary the angle of the first and second gimbals 60, 62 relative to each other. In the embodiment shown in FIGS. 38-41, worm gear 66 in this fashion adjusts varus/valgus angulation of cutting block or instrument 34 relative to bone.
  • FIGS. 39A-C shows more clearly the post 58 (which can receive and be secured to extramedullary rod 36 or other devices using, for example, a bore and pin 70) and second gimbal 62 connected in pivoting relationship in a fashion conceptually similar to the manner in which first and second gimbals 60 and 62 are connected. As shown in FIG. 39C, post 58 penetrates gimbal 62 in pivoting fashion using openings 64 and pins 70. Second gimbal 62 receives a worm gear 68 which cooperates with a second follower on post 58 to vary the angle of post 58 relative to second gimbal 62.
  • As shown in FIGS. 40A-C and 41, the angulation of cutting block 34 relative to rod 36 may be varied in varus and valgus using worm gear 66 and flexion/extension using worm gear 68.
  • FIGS. 42-45 show a variable alignment module which may used for instrumentation employed in connection with the tibia. The operation and structure are conceptually similar to the femoral module shown in FIGS. 38-41. Here, a first gimbal 76 may be rigidly or otherwise mounted to a member 74 which in turn receives instrumentation such as a cutting block 75. First gimbal 76 connects to second gimbal 78 using pin 82 extending through holes 80 in first gimbal 76 to capture second gimbal 78 so that it may pivot relative to first gimbal 76. A worm gear 84 connects to first gimbal 76 and drives a follower on second gimbal 78 to adjust angulation of second gimbal 78 relative to first gimbal 76. Worm gear 84 can thus adjust flexion/extension orientation of the cutting block 75 relative to the tibia.
  • A post 86 which receives extramedullary rod 36 or other rod or bone-connecting structure, and which may be formed of a cylindrical member in combination with other structure for retaining rod 36 in desired relationship, is received relative to second gimbal 78 in adjustable fashion. In the embodiment shown in FIGS. 42-45, an adjustment screw 88 cooperates with a slot in the second gimbal 78 in order to allow the post 86 to rotate within gimbal 78 and be secured at desired angulation. Adjustment screw 88 and slot 90 are but one variation of any adjustment mechanism, such as worm and follower, rack and pinion, vernier, or other angulation control devices or structures which could be used in this embodiment, the embodiment shown in FIGS. 38-41 other embodiments. Accordingly, this structure may be used to adjust varus/valgus alignment of cutting block 75.
  • With respect to the femoral structure shown in FIGS. 38-41 and the tibial structure shown in FIGS. 42-45, other structures which allow adjustment of angulation or orientation not only of the two axis, but any desired angulation of cutting block 75 relative to rod 36 (and thus bone) can be used. Gimbals can be reversed in structure and function, different calibration and adjustment mechanisms can be used including with indicia in order to introduce repeatability, and other structures may be employed as well. Fiducials 14 can be attached to any desired portion of these structures, directly or indirectly, for tracking in accordance with aspects of the invention.
  • FIGS. 46 and 47 show two structures among many which can be used to adjust positioning of cutting block 34 or other instrumentation relative to rod 36. In the version shown in FIG. 46, rod 36 which may be extramedullary, intramedullary, or otherwise, features a spherical or otherwise curved three-dimensional head with a generally concentric threaded bore. An adjustment bolt 90 features threads which cooperate with the threads in head 36. The bolt 90 penetrates cutting block 34 in desired fashion so that the cutting block 34, which features a recess 92 on its bottom surface that corresponds to the shape of the head of 36, however closely, can be angulated as desired in any dimension and then set via tightening of bolt 90 at any desired angulation in multiple planes.
  • FIG. 47 shows a variation in which the cutting block 34 may be connected to external fixation systems 92, such as those described U.S. Pat. No. 5,728,095, which is incorporated herein by this reference, in order to adjustably position the cutting block 34 relative to femoral or tibial bone. As described in that patent and others on the subject, calibrations may be employed on the struts connecting the cutting block 34 and the fixator element 92 in order for repeatability and controllability of angulation of cutting block 34 relative to fixation element or device 92.
  • FIGS. 48-52 show instrumentation that has been navigated and positioned on the proximal portion of the tibia 10 as shown in FIG. 52 and as tracked by sensor 16 and on screen by images of the cutting block and the implant component as shown in FIGS. 48-51.
  • FIGS. 53 and 54 show other onscreen images generated during this bone modification process for purposes of navigation and positioning cutting blocks 34 and other instrumentation for proper resection and other modification of femur and tibia in order to prepare for trial components and implant components according to instrumentation, systems, and processes of the embodiment of the present invention shown in FIGS. 4-75.
  • FIGS. 55-59 also show instrumentation being positioned relative to femur 12 as tracked by the system for resection of the condylar component in order to receive a particular size of implant component. Various cutting blocks 34 and their attached fiducials can be seen in these views.
  • FIG. 60 shows a femoral component overlaid on the femur as instrumentation is being tracked and positioned in order for resection of bone properly and accurately to be accomplished. FIG. 61 is another navigational screen face showing a femoral component overlay as instrumentation is being positioned for resection of bone.
  • FIG. 62 is tibial component overlay information on a navigation screen as the cutting block 34 for the tibial plateau is being positioned for bone resection.
  • FIGS. 63 and 64 show femoral component and tibial component overlays, respectively, according to certain position and orientation of cutting blocks/instrumentation as resecting is being done. The surgeon can thus visualize where the implant components will be and can assess fit, and other things if desired, before resections are made.
  • Navigation, Placement and Assessment of Trials and Implants
  • Once resection and modification of bone has been accomplished, implant trials can then be installed and tracked by the system in a manner similar to navigating and positioning the instrumentation, as displayed on the screen 24. Thus, a femoral component trial, a tibial plateau trial, and a bearing plate trial may be placed as navigated on screen using computer generated overlays corresponding to the trials.
  • During the trial installation process, and also during the implant component installation process, instrument positioning process or at any other desired point in surgical or other operations according to the present invention, the system can transition or segue from tracking a component according to a first fiducial to tracking the component according to a second fiducial. Thus, as shown as FIG. 36, the trial femoral component is mounted on an impactor to which is attached a fiducial 14. The trial component is installed and positioned using the impactor. The computer 18 “knows” the position and orientation of the trial relative to the fiducial on the impactor (such as by prior registration of the component attached to the impactor) so that it can generate and display the image of the femoral component trial on screen 24 overlaid on the fluoroscopic image of the condylar component. At any desired point in time, before, during or after the trial component is properly placed on the condylar component of the femur to align with mechanical axis and according to proper orientation relative to other axes, the system can be instructed by foot pedal or otherwise to begin tracking the position of the trial component using the fiducial attached to the femur rather than the one attached to the impactor. According to the preferred embodiment, the sensor 16 “sees” at this point in time both the fiducials on the impactor and the femur 12 so that it already “knows” the position and orientation of the trial component relative to the fiducial on the impactor and is thus able to calculate and store for later use the position and orientation of the trial component relative to the femur 12 fiducial. Once this “handoff” happens, the impactor can be removed and the trial component tracked with the femur fiducial 14 as part of or moving in concert with the femur 12. Similar handoff procedures may be used in any other instance as desired in accordance with the present invention.
  • FIG. 66 shows the tibial plateau trial being tracked and installed in a manner similar to femoral component trial as discussed above. Alternatively, the tibial trial can be placed on the proximal tibia and then registered using the probe 26. Probe 26 is used to designate preferably at least three features on the tibial trial of known coordinates, such as bone spike holes. As the probe is placed onto each feature, the system is prompted to save that coordinate position so that the system can match the tibial trial's feature's coordinates to the saved coordinates. The system then tracks the tibial trial relative to the tibial anatomical reference frame.
  • Once the trial components are installed, the surgeon can assess alignment and stability of the components and the joint. During such assessment, in trial reduction, the computer can display on monitor 24 the relative motion between the trial components to allow the surgeon to make soft tissue releases and changes in order to improve the kinematics of the knee. The system can also apply rules and/or intelligence to make suggestions based on the information such as what soft tissue releases to make if the surgeon desires. The system can also display how the soft tissue releases are to be made.
  • FIG. 67 shows the surgeon articulating the knee as he monitors the screen which is presenting images such as those shown in FIGS. 68-70 which not only show movement of the trial components relative to each other, but also orientation, flexion, and varus/valgus. During this assessment, the surgeon may conduct certain assessment processes such as external/internal rotation or rotary laxity testing, varus/valgus tests, and anterior-posterior drawer at 0 and 90 degrees and mid range. Thus, in the AP drawer test, the surgeon can position the tibia at the first location and press the foot pedal. He then positions the tibia at the second location and once again presses the foot pedal so that the computer has registered and stored two locations in order to calculate and display the drawer and whether it is acceptable for the patient and the product involved. If not, the computer can apply rules in order to generate and display suggestions for releasing ligaments or other tissue, or using other component sizes or types, such as shown, for example, in FIGS. 71-74. Once the proper tissue releases have been made, if necessary, and alignment and stability are acceptable as noted quantitatively on screen about all axes, the trial components may be removed and actual components navigated, installed, and assessed in performance in a manner similar to that in which the trial components were navigated, installed, and assessed.
  • FIG. 75 is another computer generated 3-dimensional image of the trial components as tracked by the system during trialing.
  • At the end of the case, all alignment information can be saved for the patient file. This is of great assistance to the surgeon due to the fact that the outcome of implant positioning can be seen before any resectioning has been done on the bone. The system is also capable of tracking the patella and resulting placement of cutting guides and the patellar trial position. The system then tracks alignment of the patella with the patellar femoral groove and will give feedback on issues, such as, patellar tilt.
  • The tracking and image information provided by instrumentation, systems, and processes according to the present invention facilitate telemedical techniques, because they provide useful images for distribution to distant geographic locations where expert surgical or medical specialists may collaborate during surgery. Thus, instrumentation, systems, and processes according to the present invention can be used in connection with computing functionality 18 which is networked or otherwise in communication with computing functionality in other locations, whether by PSTN, information exchange infrastructures such as packet switched networks including the Internet, or as otherwise desire. Such remote imaging may occur on computers, wireless devices, videoconferencing devices or in any other mode or on any other platform which is now or may in the future be capable of rending images or parts of them produced in accordance with the present invention. Parallel communication links such as switched or unswitched telephone call connections may also accompany or form part of such telemedical techniques. Distant databases such as online catalogs of implant suppliers or prosthetics buyers or distributors may form part of or be networked with functionality 18 to give the surgeon in real time access to additional options for implants which could be procured and used during the surgical operation.
  • As various modifications could be made to the exemplary embodiments, as described above with reference to the corresponding illustrations, without departing from the scope of the invention, it is intended that all matter contained in the foregoing description and shown in the accompanying drawings shall be interpreted as illustrative rather than limiting. Thus, the breadth and scope of the present invention should not be limited by any of the above-described exemplary embodiments, but should be defined only in accordance with the following claims appended hereto and their equivalents.

Claims (6)

  1. 1. A process for conducting knee surgery, comprising:
    a. exposing bones in the vicinity of knee joint;
    b. fastening a rod to bone in the vicinity of the knee joint in a manner intended at least coarsely to align the rod to a desired axis relative to the bone;
    c. attaching a rod retention component of an alignment module to the rod, the alignment module comprising:
    i. a rod retention component adapted to connect to the rod;
    ii. a surgical instrumentation retention component adapted to connect to surgical instrumentation;
    iii. an intermediate component adapted to connect to the rod retention component in a fashion that allows the rod retention component and intermediate component to rotate relative to each other about at least one axis, and adapted to connect to the surgical instrumentation retention component in a fashion that allows the surgical instrumentation retention component and the intermediate component to rotate relative to each other about at least one axis;
    iv. an adjustment mechanism connecting the intermediate component and the rod retention component, the adjustment mechanism adapted to control and fix orientation of the intermediate component relative to the rod retention component; and
    v. an adjustment mechanism connecting the intermediate component and the surgical instrumentation retention component, the adjustment mechanism adapted to control and fix orientation of the intermediate component and the surgical instrumentation retention component;
    d. attaching instrumentation to the alignment module;
    e. adjusting at least one of the adjustment mechanisms in order to finely align the instrumentation relative to the bone;
    f. resecting bone using the instrumentation;
    g. attaching a surgical implant to the resected bone;
    h. reassembling the knee; and
    i. closing the exposed knee.
  2. 2. The process according to claim 1, further comprising attaching a fiducial at least indirectly to the instrumentation and tracking the instrumentation position using the fiducial and a surgical navigation system.
  3. 3. The process according to claim 1, in which fastening the rod to the bone does not include penetrating the medullary canal with the rod.
  4. 4. The process according to claim 1, in which the instrumentation is adjusted by adjusting both adjustment mechanisms.
  5. 5. A process for conducting knee surgery, comprising:
    a. exposing bones in the vicinity of knee joint;
    b. fastening a structural member to bone in the vicinity of the knee joint in a manner intended at least coarsely to align the structural member to a desired axis relative to the bone;
    c. attaching a second member of an alignment module to the structural member, the alignment module comprising:
    i. a first member adapted to be connected to instrumentation;
    ii. a second member connected to the first member in a fashion that allows the second member and the first member to be varied in orientation relative to each other about at least two substantially orthogonal axes;
    iii. adjustment structure for controlling motion of the second member relative to the first member and for fixing the position of the second member relative to the first member;
    iv. attaching instrumentation to the first member; and
    v. attaching at least one fiducial to the instrumentation, at least indirectly;
    d. tracking orientation of the instrumentation relative to bone using the fiducial and a surgical navigation system;
    e. adjusting the adjustment structure in order to finely align the instrumentation relative to the bone;
    f. resecting bone using the instrumentation;
    g. attaching a surgical implant to the resected bone;
    h. reassembling the knee; and
    i. closing the exposed knee.
  6. 6. A process according to claim 5, in which tracking orientation of the instrumentation relative to the bone involves storing, processing and displaying radiograms of the bone taken before the process begins.
US11697957 2001-02-27 2007-04-09 Computer Assisted Knee Arthroplasty Instrumentation, Systems, and Processes Abandoned US20070233121A1 (en)

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US10229372 US7547307B2 (en) 2001-02-27 2002-08-27 Computer assisted knee arthroplasty instrumentation, systems, and processes
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Cited By (71)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080161815A1 (en) * 2006-02-27 2008-07-03 Biomet Manufacturing Corp. Patient Specific Knee Alignment Guide And Associated Method
US20100286710A1 (en) * 2009-05-05 2010-11-11 Blue Ortho Device and Method For Instrument Adjustment in Computer Assisted Surgery
US20110218546A1 (en) * 2008-10-22 2011-09-08 Blue Ortho Device for controlled adjustment of a surgical positioning unit
US8070752B2 (en) 2006-02-27 2011-12-06 Biomet Manufacturing Corp. Patient specific alignment guide and inter-operative adjustment
US8092465B2 (en) 2006-06-09 2012-01-10 Biomet Manufacturing Corp. Patient specific knee alignment guide and associated method
US8133234B2 (en) 2006-02-27 2012-03-13 Biomet Manufacturing Corp. Patient specific acetabular guide and method
US8170641B2 (en) 2009-02-20 2012-05-01 Biomet Manufacturing Corp. Method of imaging an extremity of a patient
US8241293B2 (en) 2006-02-27 2012-08-14 Biomet Manufacturing Corp. Patient specific high tibia osteotomy
US8265949B2 (en) 2007-09-27 2012-09-11 Depuy Products, Inc. Customized patient surgical plan
US8298237B2 (en) 2006-06-09 2012-10-30 Biomet Manufacturing Corp. Patient-specific alignment guide for multiple incisions
US8343159B2 (en) 2007-09-30 2013-01-01 Depuy Products, Inc. Orthopaedic bone saw and method of use thereof
US8357111B2 (en) 2007-09-30 2013-01-22 Depuy Products, Inc. Method and system for designing patient-specific orthopaedic surgical instruments
US8377066B2 (en) 2006-02-27 2013-02-19 Biomet Manufacturing Corp. Patient-specific elbow guides and associated methods
US8407067B2 (en) 2007-04-17 2013-03-26 Biomet Manufacturing Corp. Method and apparatus for manufacturing an implant
US8473305B2 (en) 2007-04-17 2013-06-25 Biomet Manufacturing Corp. Method and apparatus for manufacturing an implant
US8486150B2 (en) 2007-04-17 2013-07-16 Biomet Manufacturing Corp. Patient-modified implant
US8532807B2 (en) 2011-06-06 2013-09-10 Biomet Manufacturing, Llc Pre-operative planning and manufacturing method for orthopedic procedure
US8535387B2 (en) 2006-02-27 2013-09-17 Biomet Manufacturing, Llc Patient-specific tools and implants
US8568487B2 (en) 2006-02-27 2013-10-29 Biomet Manufacturing, Llc Patient-specific hip joint devices
US8591516B2 (en) 2006-02-27 2013-11-26 Biomet Manufacturing, Llc Patient-specific orthopedic instruments
US8597365B2 (en) 2011-08-04 2013-12-03 Biomet Manufacturing, Llc Patient-specific pelvic implants for acetabular reconstruction
US8603180B2 (en) 2006-02-27 2013-12-10 Biomet Manufacturing, Llc Patient-specific acetabular alignment guides
US8608749B2 (en) 2006-02-27 2013-12-17 Biomet Manufacturing, Llc Patient-specific acetabular guides and associated instruments
US8608748B2 (en) 2006-02-27 2013-12-17 Biomet Manufacturing, Llc Patient specific guides
US8632547B2 (en) 2010-02-26 2014-01-21 Biomet Sports Medicine, Llc Patient-specific osteotomy devices and methods
US8668700B2 (en) 2011-04-29 2014-03-11 Biomet Manufacturing, Llc Patient-specific convertible guides
US8715289B2 (en) 2011-04-15 2014-05-06 Biomet Manufacturing, Llc Patient-specific numerically controlled instrument
US8764760B2 (en) 2011-07-01 2014-07-01 Biomet Manufacturing, Llc Patient-specific bone-cutting guidance instruments and methods
US8858561B2 (en) 2006-06-09 2014-10-14 Blomet Manufacturing, LLC Patient-specific alignment guide
US8864769B2 (en) 2006-02-27 2014-10-21 Biomet Manufacturing, Llc Alignment guides with patient-specific anchoring elements
US8956364B2 (en) 2011-04-29 2015-02-17 Biomet Manufacturing, Llc Patient-specific partial knee guides and other instruments
US9060788B2 (en) 2012-12-11 2015-06-23 Biomet Manufacturing, Llc Patient-specific acetabular guide for anterior approach
US9066727B2 (en) 2010-03-04 2015-06-30 Materialise Nv Patient-specific computed tomography guides
US9066734B2 (en) 2011-08-31 2015-06-30 Biomet Manufacturing, Llc Patient-specific sacroiliac guides and associated methods
US9084618B2 (en) 2011-06-13 2015-07-21 Biomet Manufacturing, Llc Drill guides for confirming alignment of patient-specific alignment guides
US20150223941A1 (en) * 2012-08-27 2015-08-13 Conformis, Inc. Methods, Devices and Techniques for Improved Placement and Fixation of Shoulder Implant Components
US9113971B2 (en) 2006-02-27 2015-08-25 Biomet Manufacturing, Llc Femoral acetabular impingement guide
US9173661B2 (en) 2006-02-27 2015-11-03 Biomet Manufacturing, Llc Patient specific alignment guide with cutting surface and laser indicator
US9204977B2 (en) 2012-12-11 2015-12-08 Biomet Manufacturing, Llc Patient-specific acetabular guide for anterior approach
WO2016007492A1 (en) * 2014-07-07 2016-01-14 Smith & Nephew, Inc. Alignment precision
US9237950B2 (en) 2012-02-02 2016-01-19 Biomet Manufacturing, Llc Implant with patient-specific porous structure
US9241745B2 (en) 2011-03-07 2016-01-26 Biomet Manufacturing, Llc Patient-specific femoral version guide
US9271744B2 (en) 2010-09-29 2016-03-01 Biomet Manufacturing, Llc Patient-specific guide for partial acetabular socket replacement
US9289253B2 (en) 2006-02-27 2016-03-22 Biomet Manufacturing, Llc Patient-specific shoulder guide
US9295497B2 (en) 2011-08-31 2016-03-29 Biomet Manufacturing, Llc Patient-specific sacroiliac and pedicle guides
US9301812B2 (en) 2011-10-27 2016-04-05 Biomet Manufacturing, Llc Methods for patient-specific shoulder arthroplasty
US9339278B2 (en) 2006-02-27 2016-05-17 Biomet Manufacturing, Llc Patient-specific acetabular guides and associated instruments
US9345548B2 (en) 2006-02-27 2016-05-24 Biomet Manufacturing, Llc Patient-specific pre-operative planning
US9351743B2 (en) 2011-10-27 2016-05-31 Biomet Manufacturing, Llc Patient-specific glenoid guides
US9386993B2 (en) 2011-09-29 2016-07-12 Biomet Manufacturing, Llc Patient-specific femoroacetabular impingement instruments and methods
US9393028B2 (en) 2009-08-13 2016-07-19 Biomet Manufacturing, Llc Device for the resection of bones, method for producing such a device, endoprosthesis suited for this purpose and method for producing such an endoprosthesis
US9408616B2 (en) 2014-05-12 2016-08-09 Biomet Manufacturing, Llc Humeral cut guide
US9451973B2 (en) 2011-10-27 2016-09-27 Biomet Manufacturing, Llc Patient specific glenoid guide
US9498233B2 (en) 2013-03-13 2016-11-22 Biomet Manufacturing, Llc. Universal acetabular guide and associated hardware
US9517145B2 (en) 2013-03-15 2016-12-13 Biomet Manufacturing, Llc Guide alignment system and method
US9554910B2 (en) 2011-10-27 2017-01-31 Biomet Manufacturing, Llc Patient-specific glenoid guide and implants
US9561040B2 (en) 2014-06-03 2017-02-07 Biomet Manufacturing, Llc Patient-specific glenoid depth control
US9579107B2 (en) 2013-03-12 2017-02-28 Biomet Manufacturing, Llc Multi-point fit for patient specific guide
US9579106B2 (en) 2010-03-31 2017-02-28 New York Society For The Relief Of The Ruptured And Crippled, Maintaining The Hospital For Special Surgery Shoulder arthroplasty instrumentation
US9675400B2 (en) 2011-04-19 2017-06-13 Biomet Manufacturing, Llc Patient-specific fracture fixation instrumentation and method
US9795399B2 (en) 2006-06-09 2017-10-24 Biomet Manufacturing, Llc Patient-specific knee alignment guide and associated method
US9820868B2 (en) 2015-03-30 2017-11-21 Biomet Manufacturing, Llc Method and apparatus for a pin apparatus
US9826981B2 (en) 2013-03-13 2017-11-28 Biomet Manufacturing, Llc Tangential fit of patient-specific guides
US9826994B2 (en) 2014-09-29 2017-11-28 Biomet Manufacturing, Llc Adjustable glenoid pin insertion guide
US9833245B2 (en) 2014-09-29 2017-12-05 Biomet Sports Medicine, Llc Tibial tubercule osteotomy
US9839436B2 (en) 2014-06-03 2017-12-12 Biomet Manufacturing, Llc Patient-specific glenoid depth control
US9839438B2 (en) 2013-03-11 2017-12-12 Biomet Manufacturing, Llc Patient-specific glenoid guide with a reusable guide holder
US9907659B2 (en) 2007-04-17 2018-03-06 Biomet Manufacturing, Llc Method and apparatus for manufacturing an implant
US9918740B2 (en) 2006-02-27 2018-03-20 Biomet Manufacturing, Llc Backup surgical instrument system and method
US9968376B2 (en) 2010-11-29 2018-05-15 Biomet Manufacturing, Llc Patient-specific orthopedic instruments
US10034713B2 (en) 2012-07-03 2018-07-31 7D Surgical Inc. Attachments for tracking handheld implements

Families Citing this family (200)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7635390B1 (en) 2000-01-14 2009-12-22 Marctec, Llc Joint replacement component having a modular articulating surface
US6695848B2 (en) 1994-09-02 2004-02-24 Hudson Surgical Design, Inc. Methods for femoral and tibial resection
US8062377B2 (en) 2001-03-05 2011-11-22 Hudson Surgical Design, Inc. Methods and apparatus for knee arthroplasty
DE69941304D1 (en) 1998-09-14 2009-10-01 Univ R State determination of a joint and damage precautionary
US7708741B1 (en) 2001-08-28 2010-05-04 Marctec, Llc Method of preparing bones for knee replacement surgery
US6712856B1 (en) * 2000-03-17 2004-03-30 Kinamed, Inc. Custom replacement device for resurfacing a femur and method of making the same
US9603711B2 (en) 2001-05-25 2017-03-28 Conformis, Inc. Patient-adapted and improved articular implants, designs and related guide tools
US7468075B2 (en) 2001-05-25 2008-12-23 Conformis, Inc. Methods and compositions for articular repair
US8500740B2 (en) 2006-02-06 2013-08-06 Conformis, Inc. Patient-specific joint arthroplasty devices for ligament repair
US8771365B2 (en) 2009-02-25 2014-07-08 Conformis, Inc. Patient-adapted and improved orthopedic implants, designs, and related tools
US8882847B2 (en) 2001-05-25 2014-11-11 Conformis, Inc. Patient selectable knee joint arthroplasty devices
US8545569B2 (en) 2001-05-25 2013-10-01 Conformis, Inc. Patient selectable knee arthroplasty devices
US8480754B2 (en) 2001-05-25 2013-07-09 Conformis, Inc. Patient-adapted and improved articular implants, designs and related guide tools
US8623026B2 (en) 2006-02-06 2014-01-07 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools incorporating anatomical relief
US8439926B2 (en) 2001-05-25 2013-05-14 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools
US8735773B2 (en) 2007-02-14 2014-05-27 Conformis, Inc. Implant device and method for manufacture
CA2447694A1 (en) 2001-05-25 2002-12-05 Imaging Therapeutics, Inc. Methods and compositions for articular resurfacing
US8083745B2 (en) 2001-05-25 2011-12-27 Conformis, Inc. Surgical tools for arthroplasty
US8556983B2 (en) 2001-05-25 2013-10-15 Conformis, Inc. Patient-adapted and improved orthopedic implants, designs and related tools
US8234097B2 (en) 2001-05-25 2012-07-31 Conformis, Inc. Automated systems for manufacturing patient-specific orthopedic implants and instrumentation
US7534263B2 (en) 2001-05-25 2009-05-19 Conformis, Inc. Surgical tools facilitating increased accuracy, speed and simplicity in performing joint arthroplasty
US7715602B2 (en) * 2002-01-18 2010-05-11 Orthosoft Inc. Method and apparatus for reconstructing bone surfaces during surgery
US9155544B2 (en) * 2002-03-20 2015-10-13 P Tech, Llc Robotic systems and methods
JP2005523766A (en) * 2002-04-30 2005-08-11 オルトソフト インコーポレイテッド Decision on the femoral cut in knee surgery
US8801720B2 (en) 2002-05-15 2014-08-12 Otismed Corporation Total joint arthroplasty system
US20040068263A1 (en) * 2002-10-04 2004-04-08 Benoit Chouinard CAS bone reference with articulated support
JP2006501977A (en) 2002-10-07 2006-01-19 コンフォーミス・インコーポレイテッドConforMIS, Inc. Minimally invasive joint implant with a three-dimensional contour conforming to the glenoid surface
US7869861B2 (en) * 2002-10-25 2011-01-11 Howmedica Leibinger Inc. Flexible tracking article and method of using the same
JP2006505366A (en) 2002-11-07 2006-02-16 コンフォーミス・インコーポレイテッドConforMIS, Inc. The method of treatment were determined and devising meniscus size and shape
US7094241B2 (en) 2002-11-27 2006-08-22 Zimmer Technology, Inc. Method and apparatus for achieving correct limb alignment in unicondylar knee arthroplasty
US20040172044A1 (en) * 2002-12-20 2004-09-02 Grimm James E. Surgical instrument and method of positioning same
US7029477B2 (en) * 2002-12-20 2006-04-18 Zimmer Technology, Inc. Surgical instrument and positioning method
US20040122305A1 (en) * 2002-12-20 2004-06-24 Grimm James E. Surgical instrument and method of positioning same
US7326252B2 (en) 2002-12-20 2008-02-05 Smith & Nephew, Inc. High performance knee prostheses
US20070282347A9 (en) * 2002-12-20 2007-12-06 Grimm James E Navigated orthopaedic guide and method
US8114086B2 (en) * 2004-03-08 2012-02-14 Zimmer Technology, Inc. Navigated cut guide locator
US7993341B2 (en) 2004-03-08 2011-08-09 Zimmer Technology, Inc. Navigated orthopaedic guide and method
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
US7241298B2 (en) * 2003-01-31 2007-07-10 Howmedica Osteonics Corp. Universal alignment guide
US20040153066A1 (en) * 2003-02-03 2004-08-05 Coon Thomas M. Apparatus for knee surgery and method of use
US6988009B2 (en) * 2003-02-04 2006-01-17 Zimmer Technology, Inc. Implant registration device for surgical navigation system
EP1605810A2 (en) * 2003-02-04 2005-12-21 Z-Kat, Inc. Computer-assisted knee replacement apparatus and method
US20040243148A1 (en) 2003-04-08 2004-12-02 Wasielewski Ray C. Use of micro- and miniature position sensing devices for use in TKA and THA
US20050021037A1 (en) * 2003-05-29 2005-01-27 Mccombs Daniel L. Image-guided navigated precision reamers
US7559931B2 (en) 2003-06-09 2009-07-14 OrthAlign, Inc. Surgical orientation system and method
US8057482B2 (en) * 2003-06-09 2011-11-15 OrthAlign, Inc. Surgical orientation device and method
FR2856268B1 (en) * 2003-06-18 2005-10-21 Perception Raisonnement Action A bone cutting guide
US6932823B2 (en) * 2003-06-24 2005-08-23 Zimmer Technology, Inc. Detachable support arm for surgical navigation system reference array
US7427272B2 (en) 2003-07-15 2008-09-23 Orthosoft Inc. Method for locating the mechanical axis of a femur
DE10335388B4 (en) * 2003-07-25 2006-06-22 Aesculap Ag & Co. Kg Set of surgical Referenzierungsvorrichtungen
WO2005032382A1 (en) * 2003-09-13 2005-04-14 Aesculap Ag & Co. Kg Method and device for determining the angle between the femur and the tibia
US7862570B2 (en) 2003-10-03 2011-01-04 Smith & Nephew, Inc. Surgical positioners
US20050124988A1 (en) * 2003-10-06 2005-06-09 Lauralan Terrill-Grisoni Modular navigated portal
EP1684672A1 (en) 2003-10-17 2006-08-02 SMITH & NEPHEW, INC. High flexion articular insert
US7764985B2 (en) 2003-10-20 2010-07-27 Smith & Nephew, Inc. Surgical navigation system component fault interfaces and related processes
US7392076B2 (en) * 2003-11-04 2008-06-24 Stryker Leibinger Gmbh & Co. Kg System and method of registering image data to intra-operatively digitized landmarks
WO2005048851A1 (en) 2003-11-14 2005-06-02 Smith & Nephew, Inc. Adjustable surgical cutting systems
DE602004023422D1 (en) 2003-11-18 2009-11-12 Smith & Nephew Inc Surgical technique and instruments for minimalinzisions-hip arthoplastiechirurgie
US8657824B2 (en) 2003-11-18 2014-02-25 Smith & Nephew, Inc. Universal double offset surgical instrument
WO2005063139A1 (en) * 2003-12-30 2005-07-14 Depuy International Ltd An instrument system for use in a surgical procedure
US8114083B2 (en) 2004-01-14 2012-02-14 Hudson Surgical Design, Inc. Methods and apparatus for improved drilling and milling tools for resection
US7857814B2 (en) * 2004-01-14 2010-12-28 Hudson Surgical Design, Inc. Methods and apparatus for minimally invasive arthroplasty
US8021368B2 (en) 2004-01-14 2011-09-20 Hudson Surgical Design, Inc. Methods and apparatus for improved cutting tools for resection
US7815645B2 (en) * 2004-01-14 2010-10-19 Hudson Surgical Design, Inc. Methods and apparatus for pinplasty bone resection
WO2005072629A1 (en) * 2004-01-16 2005-08-11 Smith & Nephew, Inc. Computer-assisted ligament balancing in total knee arthroplasty
US20050171545A1 (en) * 2004-01-30 2005-08-04 Howmedica Osteonics Corp. Knee computer-aided navigation instruments
US20060030854A1 (en) 2004-02-02 2006-02-09 Haines Timothy G Methods and apparatus for wireplasty bone resection
US20050267353A1 (en) * 2004-02-04 2005-12-01 Joel Marquart Computer-assisted knee replacement apparatus and method
US20060052691A1 (en) * 2004-03-05 2006-03-09 Hall Maleata Y Adjustable navigated tracking element mount
US20050215888A1 (en) * 2004-03-05 2005-09-29 Grimm James E Universal support arm and tracking array
US7641660B2 (en) * 2004-03-08 2010-01-05 Biomet Manufacturing Corporation Method, apparatus, and system for image guided bone cutting
US20060030855A1 (en) 2004-03-08 2006-02-09 Haines Timothy G Methods and apparatus for improved profile based resection
GB0405386D0 (en) * 2004-03-10 2004-04-21 Depuy Int Ltd Device
EP1737375A1 (en) * 2004-04-21 2007-01-03 Smith and Nephew, Inc. Computer-aided methods, systems, and apparatuses for shoulder arthroplasty
DE502004006571D1 (en) * 2004-04-27 2008-04-30 Brainlab Ag Planning method and apparatus for knee implants
FR2871362B1 (en) * 2004-06-11 2007-05-25 Michel Allard Pin attaching a support to a bone
FR2871363B1 (en) * 2004-06-15 2006-09-01 Medtech Sa A robotic surgical tool for guiding
JP2008508013A (en) * 2004-07-27 2008-03-21 バイオメット ユーケー リミテッド Bone jig
US8167888B2 (en) * 2004-08-06 2012-05-01 Zimmer Technology, Inc. Tibial spacer blocks and femoral cutting guide
US7377924B2 (en) * 2004-09-09 2008-05-27 Howmedica Osteonics Corp. Navigated drill guided resection block
US20060200025A1 (en) * 2004-12-02 2006-09-07 Scott Elliott Systems, methods, and apparatus for automatic software flow using instrument detection during computer-aided surgery
DE102004058122A1 (en) * 2004-12-02 2006-07-13 Siemens Ag Medical image registration aid for landmarks by computerized and photon emission tomographies, comprises permeable radioactive substance is filled with the emission tomography as radiation permeable containers, a belt and patient body bowl
GB0426767D0 (en) * 2004-12-06 2005-01-12 Biomet Merck Ltd Surgical instrument
DE602004019551D1 (en) * 2004-12-08 2009-04-02 Perception Raisonnement Action A device for positioning a bone cutting guide
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
US20060161059A1 (en) * 2005-01-20 2006-07-20 Zimmer Technology, Inc. Variable geometry reference array
US20060200158A1 (en) * 2005-01-29 2006-09-07 Farling Toby N Apparatuses and methods for arthroplastic surgery
EP1690503B1 (en) 2005-02-15 2013-07-24 BrainLAB AG User guidance for adjusting the cutting guides for the bones
CA2769658C (en) * 2005-02-18 2016-01-12 Richard D. Komistek Smart joint implant sensors
WO2006091704A1 (en) 2005-02-22 2006-08-31 Smith & Nephew, Inc. In-line milling system
US20110213221A1 (en) * 2005-03-29 2011-09-01 Roche Martin W Method for Detecting Body Parameters
WO2006105098A3 (en) 2005-03-29 2007-11-22 Martin Roche Body parameter detecting sensor and method for detecting body parameters
WO2006106419A3 (en) * 2005-04-07 2006-12-07 Stephane Lavallee Robotic guide assembly for use in computer-aided surgery
FR2884408B1 (en) * 2005-04-13 2007-05-25 Tornier Sas Surgical device for implanting a total or partial knee prosthesis
FR2884407B1 (en) * 2005-04-13 2007-05-25 Tornier Sas Surgical device for implanting a total or partial knee prosthesis
US20060271056A1 (en) * 2005-05-10 2006-11-30 Smith & Nephew, Inc. System and method for modular navigated osteotome
WO2006133573A1 (en) * 2005-06-17 2006-12-21 Orthosoft Inc. Method and apparatus for computer-assisted femoral head resurfacing
US7983777B2 (en) * 2005-08-19 2011-07-19 Mark Melton System for biomedical implant creation and procurement
US7835784B2 (en) * 2005-09-21 2010-11-16 Medtronic Navigation, Inc. Method and apparatus for positioning a reference frame
CA2520942C (en) * 2005-09-23 2013-03-19 Queen's University At Kingston Tactile amplification instrument and method of use
US20070118139A1 (en) * 2005-10-14 2007-05-24 Cuellar Alberto D System and method for bone resection
EP1779799B1 (en) * 2005-10-27 2008-12-17 BrainLAB AG Device for fixing a reference element
US20070149977A1 (en) * 2005-11-28 2007-06-28 Zimmer Technology, Inc. Surgical component positioner
US8814810B2 (en) * 2005-12-01 2014-08-26 Orthosensor Inc. Orthopedic method and system for mapping an anatomical pivot point
US8864686B2 (en) * 2005-12-01 2014-10-21 Orthosensor Inc. Virtual mapping of an anatomical pivot point and alignment therewith
US7810504B2 (en) * 2005-12-28 2010-10-12 Depuy Products, Inc. System and method for wearable user interface in computer assisted surgery
US7744600B2 (en) * 2006-01-10 2010-06-29 Zimmer Technology, Inc. Bone resection guide and method
US7780671B2 (en) 2006-01-23 2010-08-24 Zimmer Technology, Inc. Bone resection apparatus and method for knee surgery
US7662183B2 (en) * 2006-01-24 2010-02-16 Timothy Haines Dynamic spinal implants incorporating cartilage bearing graft material
US8038683B2 (en) * 2006-01-25 2011-10-18 Orthosoft Inc. CAS system for condyle measurement
CN100493471C (en) 2006-01-26 2009-06-03 清华大学深圳研究生院 Puncture guiding system of computer aided PCNL
US20070186738A1 (en) * 2006-01-31 2007-08-16 Zimmer Technology, Inc. Tibial cut guide assembly having rotatable cut guide body
EP2649951A3 (en) 2006-02-06 2013-12-25 ConforMIS, Inc. Patient selectable joint arthroplasty devices and surgical tools
US9808262B2 (en) 2006-02-15 2017-11-07 Howmedica Osteonics Corporation Arthroplasty devices and related methods
EP2007291A2 (en) 2006-02-15 2008-12-31 Otismed Corp. Arthroplasty jigs and related methods
US8323290B2 (en) * 2006-03-03 2012-12-04 Biomet Manufacturing Corp. Tensor for use in surgical navigation
WO2007106172A1 (en) * 2006-03-14 2007-09-20 Mako Surgical Corporation Prosthetic device and system and method for implanting prosthetic device
US8231634B2 (en) 2006-03-17 2012-07-31 Zimmer, Inc. Methods of predetermining the contour of a resected bone surface and assessing the fit of a prosthesis on the bone
US8560047B2 (en) * 2006-06-16 2013-10-15 Board Of Regents Of The University Of Nebraska Method and apparatus for computer aided surgery
US20080015602A1 (en) * 2006-06-22 2008-01-17 Howmedica Osteonics Corp. Cutting block for bone resection
EP2043561B1 (en) 2006-06-30 2016-01-27 Smith & Nephew, Inc. Anatomical motion hinged prosthesis
GB0614468D0 (en) * 2006-07-21 2006-08-30 Depuy Int Ltd Guide Assembly
US20080058949A1 (en) * 2006-09-06 2008-03-06 Roger Ryan Dees Implants with Transition Surfaces and Related Processes
US8460302B2 (en) 2006-12-18 2013-06-11 Otismed Corporation Arthroplasty devices and related methods
US8814874B2 (en) 2007-02-13 2014-08-26 Medtronic Navigation, Inc. Navigated cut guide for total knee reconstruction
EP1958575B1 (en) * 2007-02-13 2014-08-13 Brainlab AG Device or system for positioning or preparing the positioning of a medical operating instrument, especially an incision block or a cutting block or a ligament balancing device
WO2008101110A3 (en) * 2007-02-14 2008-10-23 Christopher Carson Method and system for computer assisted surgery for bicompartmental knee replacement
WO2008101090A3 (en) 2007-02-14 2008-11-27 Conformis Inc Implant device and method for manufacture
EP1982676B1 (en) * 2007-04-03 2012-07-11 Finsbury (Development) Limited Apparatus and system
WO2008157412A3 (en) 2007-06-13 2009-04-09 Raymond A Bojarski Surgical cutting guide
US20090018544A1 (en) * 2007-07-13 2009-01-15 Zimmer, Inc. Method and apparatus for soft tissue balancing
US9179983B2 (en) 2007-08-14 2015-11-10 Zimmer, Inc. Method of determining a contour of an anatomical structure and selecting an orthopaedic implant to replicate the anatomical structure
JP5171193B2 (en) * 2007-09-28 2013-03-27 株式会社 レキシー Preoperative planning for a program of artificial knee joint replacement surgery
USD642263S1 (en) 2007-10-25 2011-07-26 Otismed Corporation Arthroplasty jig blank
US8460303B2 (en) 2007-10-25 2013-06-11 Otismed Corporation Arthroplasty systems and devices, and related methods
US8715291B2 (en) 2007-12-18 2014-05-06 Otismed Corporation Arthroplasty system and related methods
US8545509B2 (en) 2007-12-18 2013-10-01 Otismed Corporation Arthroplasty system and related methods
US8737700B2 (en) 2007-12-18 2014-05-27 Otismed Corporation Preoperatively planning an arthroplasty procedure and generating a corresponding patient specific arthroplasty resection guide
US8617171B2 (en) 2007-12-18 2013-12-31 Otismed Corporation Preoperatively planning an arthroplasty procedure and generating a corresponding patient specific arthroplasty resection guide
US8221430B2 (en) 2007-12-18 2012-07-17 Otismed Corporation System and method for manufacturing arthroplasty jigs
US9408618B2 (en) 2008-02-29 2016-08-09 Howmedica Osteonics Corporation Total hip replacement surgical guide tool
WO2009111626A3 (en) 2008-03-05 2010-01-14 Conformis, Inc. Implants for altering wear patterns of articular surfaces
US8480679B2 (en) 2008-04-29 2013-07-09 Otismed Corporation Generation of a computerized bone model representative of a pre-degenerated state and useable in the design and manufacture of arthroplasty devices
US8160345B2 (en) 2008-04-30 2012-04-17 Otismed Corporation System and method for image segmentation in generating computer models of a joint to undergo arthroplasty
US8311306B2 (en) 2008-04-30 2012-11-13 Otismed Corporation System and method for image segmentation in generating computer models of a joint to undergo arthroplasty
EP2303193A4 (en) 2008-05-12 2012-03-21 Conformis Inc Devices and methods for treatment of facet and other joints
US8029566B2 (en) 2008-06-02 2011-10-04 Zimmer, Inc. Implant sensors
US8197489B2 (en) 2008-06-27 2012-06-12 Depuy Products, Inc. Knee ligament balancer
US8777875B2 (en) 2008-07-23 2014-07-15 Otismed Corporation System and method for manufacturing arthroplasty jigs having improved mating accuracy
US8118815B2 (en) * 2009-07-24 2012-02-21 OrthAlign, Inc. Systems and methods for joint replacement
US20100069911A1 (en) 2008-07-24 2010-03-18 OrthAlign, Inc. Systems and methods for joint replacement
EP2245986B1 (en) * 2008-08-22 2013-10-16 BrainLAB AG Arrangement of x-ray markers in the form of a pyramid
EP2358310A4 (en) 2008-09-10 2014-05-07 Orthalign Inc Hip surgery systems and methods
US8078440B2 (en) * 2008-09-19 2011-12-13 Smith & Nephew, Inc. Operatively tuning implants for increased performance
US20100100011A1 (en) * 2008-10-22 2010-04-22 Martin Roche System and Method for Orthopedic Alignment and Measurement
US9033958B2 (en) * 2008-11-11 2015-05-19 Perception Raisonnement Action En Medecine Surgical 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
US8617175B2 (en) 2008-12-16 2013-12-31 Otismed Corporation Unicompartmental customized arthroplasty cutting jigs and methods of making the same
JP5404342B2 (en) * 2009-01-06 2014-01-29 キヤノン株式会社 Optical scanning apparatus and image forming apparatus using the same
US8551023B2 (en) * 2009-03-31 2013-10-08 Depuy (Ireland) Device and method for determining force of a knee joint
US8721568B2 (en) 2009-03-31 2014-05-13 Depuy (Ireland) Method for performing an orthopaedic surgical procedure
US8597210B2 (en) 2009-03-31 2013-12-03 Depuy (Ireland) System and method for displaying joint force data
US8556830B2 (en) 2009-03-31 2013-10-15 Depuy Device and method for displaying joint force data
US8740817B2 (en) 2009-03-31 2014-06-03 Depuy (Ireland) Device and method for determining forces of a patient's joint
ES2588231T3 (en) * 2009-09-10 2016-10-31 Exactech Inc. Alignment guides for use in computer assisted orthopedic surgery to prepare an element for an implant bone
WO2012082164A1 (en) * 2010-01-21 2012-06-21 Orthallgn, Inc. Systems and methods for joint replacement
WO2011130567A3 (en) 2010-04-14 2012-04-19 Smith & Nephew, Inc. Systems and methods for patient- based computer assisted surgical procedures
EP2582328B1 (en) 2010-06-18 2017-09-13 Howmedica Osteonics Corp. Patient-specific total hip arthroplasty
CN103402462B (en) 2010-08-12 2016-09-07 史密夫和内修有限公司 The structure for fixing the orthopedic implant
US8551108B2 (en) 2010-08-31 2013-10-08 Orthosoft Inc. Tool and method for digital acquisition of a tibial mechanical axis
US9252966B2 (en) * 2010-12-08 2016-02-02 At&T Intellectual Property I, L.P. Method and system for configuring instrumentation devices
KR20130129246A (en) 2010-12-17 2013-11-27 아브니르 메디컬 아이엔씨. Method and system for aligning a prosthesis during surgery
US9921712B2 (en) 2010-12-29 2018-03-20 Mako Surgical Corp. System and method for providing substantially stable control of a surgical tool
EP2754419A3 (en) * 2011-02-15 2014-10-08 Conformis, Inc. Patient-adapted and improved orthopedic implants, designs and related tools
EP2677955B1 (en) * 2011-02-25 2018-05-16 Orthosoft, Inc. Bone and tool tracking with mems in computer-assisted surgery
US20120289830A1 (en) * 2011-05-10 2012-11-15 General Electric Company Method and ultrasound imaging system for image-guided procedures
US9220510B2 (en) 2011-06-15 2015-12-29 Perception Raisonnement Action En Medecine System and method for bone preparation for an implant
WO2012171555A1 (en) * 2011-06-15 2012-12-20 Brainlab Ag Method and device for determining the mechanical axis of a bone
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
WO2013116812A1 (en) 2012-02-03 2013-08-08 Orthohub, Inc. External fixator deformity correction systems and methods
US9381011B2 (en) 2012-03-29 2016-07-05 Depuy (Ireland) Orthopedic surgical instrument for knee surgery
US9545459B2 (en) 2012-03-31 2017-01-17 Depuy Ireland Unlimited Company Container for surgical instruments and system including same
US9314188B2 (en) 2012-04-12 2016-04-19 Intellijoint Surgical Inc. Computer-assisted joint replacement surgery and navigation systems
WO2013173700A1 (en) * 2012-05-18 2013-11-21 OrthAlign, Inc. Devices and methods for knee arthroplasty
JP6069621B2 (en) * 2012-06-05 2017-02-01 コリン リミテッドCorin Limited Patient implant alignment system
US9675471B2 (en) 2012-06-11 2017-06-13 Conformis, Inc. Devices, techniques and methods for assessing joint spacing, balancing soft tissues and obtaining desired kinematics for joint implant components
JP6010794B2 (en) * 2012-07-18 2016-10-19 バイオメット・ジャパン株式会社 Surgical jig
CN104736092B (en) * 2012-08-03 2017-07-21 史赛克公司 A system and method for robotic surgical
US9226796B2 (en) 2012-08-03 2016-01-05 Stryker Corporation Method for detecting a disturbance as an energy applicator of a surgical instrument traverses a cutting path
US9649160B2 (en) 2012-08-14 2017-05-16 OrthAlign, Inc. Hip replacement navigation system and method
US9402637B2 (en) 2012-10-11 2016-08-02 Howmedica Osteonics Corporation Customized arthroplasty cutting guides and surgical methods using the same
US9993273B2 (en) 2013-01-16 2018-06-12 Mako Surgical Corp. Bone plate and tracking device using a bone plate for attaching to a patient's anatomy
CN105073054B (en) 2013-01-16 2018-07-10 史赛克公司 It indicates the line of sight error navigation system and method
US9161799B2 (en) 2013-01-28 2015-10-20 Warsaw Orthopedic, Inc. Surgical implant system and method
US9204937B2 (en) * 2013-02-19 2015-12-08 Stryker Trauma Gmbh Software for use with deformity correction
US9247998B2 (en) 2013-03-15 2016-02-02 Intellijoint Surgical Inc. System and method for intra-operative leg position measurement
US20150282736A1 (en) * 2014-04-04 2015-10-08 Izi Medical Products, Llc Medical device for surgical navigation system
US10058393B2 (en) 2015-10-21 2018-08-28 P Tech, Llc Systems and methods for navigation and visualization
US10010346B2 (en) 2016-04-20 2018-07-03 Stryker European Holdings I, Llc Ring hole planning for external fixation frames

Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5408409A (en) * 1990-05-11 1995-04-18 International Business Machines Corporation Image-directed robotic system for precise robotic surgery including redundant consistency checking
US5748767A (en) * 1988-02-01 1998-05-05 Faro Technology, Inc. Computer-aided surgery apparatus
US5880976A (en) * 1997-02-21 1999-03-09 Carnegie Mellon University Apparatus and method for facilitating the implantation of artificial components in joints
US6554837B1 (en) * 1998-06-29 2003-04-29 Plus Endoprothetik Ag Device and method for inserting a prosthetic knee
US6685711B2 (en) * 2001-02-28 2004-02-03 Howmedica Osteonics Corp. Apparatus used in performing femoral and tibial resection in knee surgery
US6692447B1 (en) * 1999-02-16 2004-02-17 Frederic Picard Optimizing alignment of an appendicular
US6694168B2 (en) * 1998-06-22 2004-02-17 Synthes (U.S.A.) Fiducial matching using fiducial implants
US6702821B2 (en) * 2000-01-14 2004-03-09 The Bonutti 2003 Trust A Instrumentation for minimally invasive joint replacement and methods for using same
US6725082B2 (en) * 1999-03-17 2004-04-20 Synthes U.S.A. System and method for ligament graft placement
US7001346B2 (en) * 2001-11-14 2006-02-21 Michael R. White Apparatus and methods for making intraoperative orthopedic measurements

Family Cites Families (170)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US100602A (en) * 1870-03-08 Improvement in wrenches
US1076971A (en) 1912-12-16 1913-10-28 Charles Geiger Tool-holder.
US1201467A (en) 1915-04-26 1916-10-17 Emil J Hoglund Bone-cutting instrument.
US2092869A (en) 1936-03-24 1937-09-14 Pierre L Caffier Thermoresponsive device for registering temperatures of fluids
GB1100378A (en) 1965-07-08 1968-01-24 Zimmer Orthopaedic Ltd Acetabulum reamer
US3457922A (en) 1966-12-13 1969-07-29 Charles D Ray Stereotaxic surgical instrument and method
US3702611A (en) 1971-06-23 1972-11-14 Meyer Fishbein Surgical expansive reamer for hip socket
US4323080A (en) 1980-06-23 1982-04-06 Melhart Albert H Ankle stress machine
US4456010A (en) * 1980-10-27 1984-06-26 Codman & Shurtleff, Inc. Cranial drill
US4305394A (en) 1980-12-22 1981-12-15 Bertuch Jr Charles J Acetabular cup positioning instrument
US4567885A (en) 1981-11-03 1986-02-04 Androphy Gary W Triplanar knee resection system
DE3146803C2 (en) 1981-11-26 1984-08-02 Manfred 6054 Rodgau De Ernst
US4524766A (en) 1982-01-07 1985-06-25 Petersen Thomas D Surgical knee alignment method and system
US4421112A (en) 1982-05-20 1983-12-20 Minnesota Mining And Manufacturing Company Tibial osteotomy guide assembly and method
US4457307A (en) 1982-08-20 1984-07-03 Stillwell William T Bone cutting device for total knee replacement
US4567886A (en) 1983-01-06 1986-02-04 Petersen Thomas D Flexion spacer guide for fitting a knee prosthesis
US4566448A (en) 1983-03-07 1986-01-28 Rohr Jr William L Ligament tensor and distal femoral resector guide
US4534364A (en) 1983-09-19 1985-08-13 Lamoreux Larry W Sagittal knee test apparatus
US5037423A (en) 1983-10-26 1991-08-06 Pfizer Hospital Products Group, Inc. Method and instrumentation for the replacement of a knee prosthesis
US4565192A (en) * 1984-04-12 1986-01-21 Shapiro James A Device for cutting a patella and method therefor
US4574794A (en) 1984-06-01 1986-03-11 Queen's University At Kingston Orthopaedic bone cutting jig and alignment device
US4583554A (en) * 1984-06-12 1986-04-22 Medpar Ii Knee ligament testing device
US4802468A (en) 1984-09-24 1989-02-07 Powlan Roy Y Device for cutting threads in the walls of the acetabular cavity in humans
GB2167963B (en) 1984-11-30 1988-11-30 Straumann Inst Ag Device for treating a bone
EP0259312B1 (en) 1985-05-07 1990-08-16 Hans Georg Dr. Ender Device for osteotomy
GB8516167D0 (en) * 1985-06-26 1985-07-31 Finsbury Instr Ltd Surgical tool
US4712951A (en) 1985-08-26 1987-12-15 Brown Byron L Tool for cutting annular groove
CA1271998A (en) 1985-10-03 1990-07-24 Robert Frigg Sighting instrument
DE3538654A1 (en) * 1985-10-28 1987-04-30 Mecron Med Prod Gmbh , For use drilling system comprising a drill guide of an endoprosthesis and associated prosthesis
US4671275A (en) * 1985-11-14 1987-06-09 Deyerle William M Femoral shaft surgical rasp for use in hip prosthesis surgery
US4722056A (en) 1986-02-18 1988-01-26 Trustees Of Dartmouth College Reference display systems for superimposing a tomagraphic image onto the focal plane of an operating microscope
WO1987005789A1 (en) 1986-03-27 1987-10-08 Gregory James Roger Measurement of laxity of anterior cruciate ligament
US4703751A (en) 1986-03-27 1987-11-03 Pohl Kenneth P Method and apparatus for resecting a distal femoral surface
DE3770566D1 (en) 1986-10-02 1991-07-11 Sulzer Ag Instrument for cutting a curve in a femur bone.
US4759350A (en) 1986-10-17 1988-07-26 Dunn Harold K Instruments for shaping distal femoral and proximal tibial surfaces
US4815899A (en) * 1986-11-28 1989-03-28 No-Ma Engineering Incorporated Tool holder and gun drill or reamer
US4718413A (en) 1986-12-24 1988-01-12 Orthomet, Inc. Bone cutting guide and methods for using same
US5116338A (en) 1988-02-03 1992-05-26 Pfizer Hospital Products Group, Inc. Apparatus for knee prosthesis
US4991579A (en) * 1987-11-10 1991-02-12 Allen George S Method and apparatus for providing related images over time of a portion of the anatomy using fiducial implants
US4938762A (en) 1987-12-16 1990-07-03 Protek Ag Reference system for implantation of condylar total knee prostheses
EP0326768A3 (en) * 1988-02-01 1991-01-23 Faro Medical Technologies Inc. Computer-aided surgery apparatus
US5484437A (en) * 1988-06-13 1996-01-16 Michelson; Gary K. Apparatus and method of inserting spinal implants
US5217499A (en) 1988-08-17 1993-06-08 Minnesota Mining And Manufacturing Company Rim-bearing acetabular component of hip joint prosthesis
US5147408A (en) 1988-10-07 1992-09-15 Pfizer Hospital Products Group, Inc. Prosthetic device and method of implantation
US4892093A (en) 1988-10-28 1990-01-09 Osteonics Corp. Femoral cutting guide
DE3842645A1 (en) 1988-12-14 1990-06-28 Mecron Med Prod Gmbh Saegelehrensystem
US5002545A (en) 1989-01-30 1991-03-26 Dow Corning Wright Corporation Tibial surface shaping guide for knee implants
US4952213A (en) 1989-02-03 1990-08-28 Boehringer Mannheim Corporation Tibial cutting guide
US5098426A (en) * 1989-02-06 1992-03-24 Phoenix Laser Systems, Inc. Method and apparatus for precision laser surgery
US4964862A (en) 1989-08-31 1990-10-23 Micro Strain Company Method of and means for measuring ligament tension
US5053039A (en) 1989-09-14 1991-10-01 Intermedics Orthopedics Upper tibial osteotomy system
US5122144A (en) 1989-09-26 1992-06-16 Kirschner Medical Corporation Method and instrumentation for unicompartmental total knee arthroplasty
DE69026196T2 (en) * 1989-11-08 1996-09-05 George S Allen Mechanical arm for an interactive, image-controlled surgery system
US5246444A (en) 1990-01-08 1993-09-21 Schreiber Saul N Osteotomy device and method
US5078719A (en) 1990-01-08 1992-01-07 Schreiber Saul N Osteotomy device and method therefor
US5449360A (en) 1991-08-23 1995-09-12 Schreiber; Saul N. Osteotomy device and method
US5171244A (en) * 1990-01-08 1992-12-15 Caspari Richard B Methods and apparatus for arthroscopic prosthetic knee replacement
US6770078B2 (en) * 2000-01-14 2004-08-03 Peter M. Bonutti Movable knee implant and methods therefor
US5002578A (en) * 1990-05-04 1991-03-26 Venus Corporation Modular hip stem prosthesis apparatus and method
DE69133634D1 (en) * 1990-10-19 2010-08-26 Univ St Louis System for locating a surgical probe relative to the head
US6347240B1 (en) * 1990-10-19 2002-02-12 St. Louis University System and method for use in displaying images of a body part
GB9026592D0 (en) * 1990-12-06 1991-01-23 Meswania Jayantilal M Surgical instrument
US5263972A (en) 1991-01-11 1993-11-23 Stryker Corporation Surgical handpiece chuck and blade
US5425355A (en) 1991-01-28 1995-06-20 Laserscope Energy discharging surgical probe and surgical process having distal energy application without concomitant proximal movement
US6675040B1 (en) * 1991-01-28 2004-01-06 Sherwood Services Ag Optical object tracking system
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
US5092869A (en) 1991-03-01 1992-03-03 Biomet, Inc. Oscillating surgical saw guide pins and instrumentation system
US5129909A (en) 1991-03-13 1992-07-14 Sutherland Charles J Apparatus and method for making precise bone cuts in total knee replacement
US5197488A (en) 1991-04-05 1993-03-30 N. K. Biotechnical Engineering Co. Knee joint load measuring instrument and joint prosthesis
US5279309A (en) 1991-06-13 1994-01-18 International Business Machines Corporation Signaling device and method for monitoring positions in a surgical operation
US5213312A (en) 1991-08-16 1993-05-25 Great Barrier Industries Ltd. Barrier system and barrier units therefor
US5254119A (en) 1991-08-23 1993-10-19 Schreiber Saul N Osteotomy device and method therefor
GB9123555D0 (en) 1991-11-06 1992-01-02 Attfield Stephen F Tensile balancer
US5470354A (en) 1991-11-12 1995-11-28 Biomet Inc. Force sensing apparatus and method for orthopaedic joint reconstruction
US5342366A (en) 1992-02-19 1994-08-30 Biomet, Inc. Surgical instruments for hip revision
EP0630212B1 (en) 1992-02-20 1998-07-08 Synvasive Technology, Inc. Surgical cutting block
US5289826A (en) 1992-03-05 1994-03-01 N. K. Biotechnical Engineering Co. Tension sensor
US5603318A (en) * 1992-04-21 1997-02-18 University Of Utah Research Foundation Apparatus and method for photogrammetric surgical localization
US5389101A (en) * 1992-04-21 1995-02-14 University Of Utah Apparatus and method for photogrammetric surgical localization
US5462549A (en) 1992-05-01 1995-10-31 Biomet, Inc. Femoral sizing apparatus
US5423828A (en) 1992-05-14 1995-06-13 Bentwood Place, Inc. Method and apparatus for simplifying prosthetic joint replacements
US5190547A (en) * 1992-05-15 1993-03-02 Midas Rex Pneumatic Tools, Inc. Replicator for resecting bone to match a pattern
US5365996A (en) 1992-06-10 1994-11-22 Amei Technologies Inc. Method and apparatus for making customized fixation devices
US5379133A (en) 1992-06-19 1995-01-03 Atl Corporation Synthetic aperture based real time holographic imaging
US5462548A (en) 1992-07-06 1995-10-31 Pappas; Michael J. Acetabular reamer
US5375588A (en) 1992-08-17 1994-12-27 Yoon; Inbae Method and apparatus for use in endoscopic procedures
US5445642A (en) 1992-09-01 1995-08-29 Depuy Inc. Method for installing a femoral component
US5364401A (en) 1992-10-08 1994-11-15 Wright Medical Technology, Inc. External alignment system for preparing a femur for an implant
US5517990A (en) 1992-11-30 1996-05-21 The Cleveland Clinic Foundation Stereotaxy wand and tool guide
US5403320A (en) * 1993-01-07 1995-04-04 Venus Corporation Bone milling guide apparatus and method
US5551429A (en) * 1993-02-12 1996-09-03 Fitzpatrick; J. Michael Method for relating the data of an image space to physical space
US5507824A (en) 1993-02-23 1996-04-16 Lennox; Dennis W. Adjustable prosthetic socket component, for articulating anatomical joints
DE9422172U1 (en) * 1993-04-26 1998-08-06 Univ St Louis Indication of the position of a surgical probe
US5540694A (en) 1993-06-01 1996-07-30 Joint Medical Products Corporation Instrument for cutting bone
US5474559A (en) 1993-07-06 1995-12-12 Zimmer, Inc. Femoral milling instrumentation for use in total knee arthroplasty with optional cutting guide attachment
US5364402A (en) 1993-07-29 1994-11-15 Intermedics Orthopedics, Inc. Tibial spacer saw guide
US5491510A (en) 1993-12-03 1996-02-13 Texas Instruments Incorporated System and method for simultaneously viewing a scene and an obscured object
US5417688A (en) 1993-12-22 1995-05-23 Elstrom; John A. Optical distal targeting system for an intramedullary nail
US5486178A (en) 1994-02-16 1996-01-23 Hodge; W. Andrew Femoral preparation instrumentation system and method
US5540695A (en) 1994-02-18 1996-07-30 Howmedica Inc. Osteotomy cutting guide
US5527316A (en) * 1994-02-23 1996-06-18 Stone; Kevin T. Surgical reamer
US5598269A (en) 1994-05-12 1997-01-28 Children's Hospital Medical Center Laser guided alignment apparatus for medical procedures
US5597379A (en) 1994-09-02 1997-01-28 Hudson Surgical Design, Inc. Method and apparatus for femoral resection alignment
US5514139A (en) 1994-09-02 1996-05-07 Hudson Surgical Design, Inc. Method and apparatus for femoral resection
US5695501A (en) * 1994-09-30 1997-12-09 Ohio Medical Instrument Company, Inc. Apparatus for neurosurgical stereotactic procedures
EP0950379B1 (en) * 1994-10-07 2004-03-31 St. Louis University Device for use with a surgical navigation system
US5569260A (en) 1994-12-01 1996-10-29 Petersen; Thomas D. Distal femoral resector guide
US5540696A (en) 1995-01-06 1996-07-30 Zimmer, Inc. Instrumentation for use in orthopaedic surgery
US5613969A (en) 1995-02-07 1997-03-25 Jenkins, Jr.; Joseph R. Tibial osteotomy system
US5707370A (en) * 1995-09-19 1998-01-13 Orthofix, S.R.L. Accessory device for an orthopedic fixator
US6351659B1 (en) * 1995-09-28 2002-02-26 Brainlab Med. Computersysteme Gmbh Neuro-navigation system
US5769861A (en) * 1995-09-28 1998-06-23 Brainlab Med. Computersysteme Gmbh Method and devices for localizing an instrument
US5772594A (en) * 1995-10-17 1998-06-30 Barrick; Earl F. Fluoroscopic image guided orthopaedic surgery system with intraoperative registration
US5716361A (en) * 1995-11-02 1998-02-10 Masini; Michael A. Bone cutting guides for use in the implantation of prosthetic joint components
US5704941A (en) * 1995-11-03 1998-01-06 Osteonics Corp. Tibial preparation apparatus and method
US5534366A (en) 1995-11-22 1996-07-09 Motorola, Inc. Modular battery pack
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
GB9623294D0 (en) * 1996-11-08 1997-01-08 Depuy Int Ltd A broach for shaping a medullary cavity in a bone
CA2225375A1 (en) * 1996-12-23 1998-06-23 Mark Manasas Alignment guide for insertion of fluted or keyed orthopedic components
US6205411B1 (en) * 1997-02-21 2001-03-20 Carnegie Mellon University Computer-assisted surgery planner and intra-operative guidance system
DE29704393U1 (en) * 1997-03-11 1997-07-17 Aesculap Ag An apparatus for pre-operative determination of the position data of Endoprothesenteilen
US6821123B2 (en) * 1997-04-10 2004-11-23 Nobel Biocare Ab Arrangement and system for production of dental products and transmission of information
US6016606A (en) * 1997-04-25 2000-01-25 Navitrak International Corporation Navigation device having a viewer for superimposing bearing, GPS position and indexed map information
US6249581B1 (en) * 1997-08-01 2001-06-19 Bitwave Pte. Ltd. Spectrum-based adaptive canceller of acoustic echoes arising in hands-free audio
US6226548B1 (en) * 1997-09-24 2001-05-01 Surgical Navigation Technologies, Inc. Percutaneous registration apparatus and method for use in computer-assisted surgical navigation
US6056756A (en) * 1998-08-11 2000-05-02 Johnson & Johnson Professional, Inc. Femoral tensing and sizing device
DE69922317D1 (en) * 1998-09-29 2005-01-05 Koninkl Philips Electronics Nv Image processing method for medical ultrasound images of bone structure, and a device for computer-assisted surgery
US6030391A (en) * 1998-10-26 2000-02-29 Micropure Medical, Inc. Alignment gauge for metatarsophalangeal fusion surgery
US6331181B1 (en) * 1998-12-08 2001-12-18 Intuitive Surgical, Inc. Surgical robotic tools, data architecture, and use
US6296645B1 (en) * 1999-04-09 2001-10-02 Depuy Orthopaedics, Inc. Intramedullary nail with non-metal spacers
US6200316B1 (en) * 1999-05-07 2001-03-13 Paul A. Zwirkoski Intramedullary nail distal targeting device
US6139544A (en) * 1999-05-26 2000-10-31 Endocare, Inc. Computer guided cryosurgery
US6228092B1 (en) * 1999-07-29 2001-05-08 W. E. Michael Mikhail System for performing hip prosthesis surgery
US6235038B1 (en) * 1999-10-28 2001-05-22 Medtronic Surgical Navigation Technologies System for translation of electromagnetic and optical localization systems
US6344853B1 (en) * 2000-01-06 2002-02-05 Alcone Marketing Group Method and apparatus for selecting, modifying and superimposing one image on another
US20010034530A1 (en) * 2000-01-27 2001-10-25 Malackowski Donald W. Surgery system
US6882982B2 (en) * 2000-02-04 2005-04-19 Medtronic, Inc. Responsive manufacturing and inventory control
US6383188B2 (en) * 2000-02-15 2002-05-07 The Spineology Group Llc Expandable reamer
US6264647B1 (en) * 2000-03-02 2001-07-24 Precifar S.A. Instrument holder for surgical instrument
DE50000335D1 (en) * 2000-04-05 2002-09-05 Brainlab Ag Referencing a patient in a medical navigation system using been irradiated light spots
EP1312025A2 (en) * 2000-04-05 2003-05-21 Therics, Inc. System and method for rapidly customizing a design and remotely manufacturing biomedical devices using a computer system
CA2444491A1 (en) * 2000-05-31 2001-12-06 Nicolas Zirngibl Device for positioning a surgical instrument
DE10031887B4 (en) * 2000-06-30 2008-02-07 Stryker Leibinger Gmbh & Co. Kg System for implantation of knee joint prostheses
JP3735751B2 (en) 2000-07-05 2006-01-18 株式会社エム・エム・ティー Repair and treatment apparatus of the bone
DE10033723C1 (en) * 2000-07-12 2002-02-21 Siemens Ag Surgical instrument position and orientation visualization device for surgical operation has data representing instrument position and orientation projected onto surface of patient's body
DE20012877U1 (en) * 2000-07-26 2001-12-06 Stryker Trauma Gmbh locking nail
US6558421B1 (en) * 2000-09-19 2003-05-06 Barry M. Fell Surgically implantable knee prosthesis
EP1190676B1 (en) * 2000-09-26 2003-08-13 BrainLAB AG Device for determining the position of a cutting guide
EP1190675B1 (en) * 2000-09-26 2004-04-28 BrainLAB AG System for navigation-assisted orientation of elements on a body
FR2816200A1 (en) * 2000-11-06 2002-05-10 Praxim Determination of the position of a knee prosthesis
US6718194B2 (en) * 2000-11-17 2004-04-06 Ge Medical Systems Global Technology Company, Llc Computer assisted intramedullary rod surgery system with enhanced features
CA2334495A1 (en) * 2001-02-06 2002-08-06 Surgical Navigation Specialists, Inc. Computer-aided positioning method and system
US20050113846A1 (en) * 2001-02-27 2005-05-26 Carson Christopher P. Surgical navigation systems and processes for unicompartmental knee arthroplasty
CA2342709A1 (en) * 2001-03-23 2002-09-23 Dentalmatic Technologies Inc. Methods for dental restoration
FR2826254B1 (en) * 2001-06-25 2004-06-18 Aesculap Sa Device for positioning a cutting plane of a cutting guide for a bone
US6728599B2 (en) * 2001-09-07 2004-04-27 Computer Motion, Inc. Modularity system for computer assisted surgery
US6764492B2 (en) * 2001-09-10 2004-07-20 Zimmer Technology, Inc. Bone impaction instrument
US6712823B2 (en) * 2001-12-14 2004-03-30 Wright Medical Technology Inc. Humeral head resection guide
US7634306B2 (en) * 2002-02-13 2009-12-15 Kinamed, Inc. Non-image, computer assisted navigation system for joint replacement surgery with modular implant system
US7427200B2 (en) * 2002-04-16 2008-09-23 Noble Philip C Computer-based training methods for surgical procedures
US6993374B2 (en) * 2002-04-17 2006-01-31 Ricardo Sasso Instrumentation and method for mounting a surgical navigation reference device to a patient
JP2005523766A (en) * 2002-04-30 2005-08-11 オルトソフト インコーポレイテッド Decision on the femoral cut in knee surgery
US20040030237A1 (en) * 2002-07-29 2004-02-12 Lee David M. Fiducial marker devices and methods
US7166114B2 (en) * 2002-09-18 2007-01-23 Stryker Leibinger Gmbh & Co Kg Method and system for calibrating a surgical tool and adapter thereof
EP1545368B1 (en) * 2002-10-04 2009-03-11 Orthosoft Inc. Computer-assisted hip replacement surgery
US20050021037A1 (en) * 2003-05-29 2005-01-27 Mccombs Daniel L. Image-guided navigated precision reamers
WO2005053559A1 (en) * 2003-11-25 2005-06-16 Smith & Nephew, Inc. Methods and apparatuses for providing a navigational array
US20050113659A1 (en) * 2003-11-26 2005-05-26 Albert Pothier Device for data input for surgical navigation system
US7787923B2 (en) * 2003-11-26 2010-08-31 Becton, Dickinson And Company Fiber optic device for sensing analytes and method of making same

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5748767A (en) * 1988-02-01 1998-05-05 Faro Technology, Inc. Computer-aided surgery apparatus
US5408409A (en) * 1990-05-11 1995-04-18 International Business Machines Corporation Image-directed robotic system for precise robotic surgery including redundant consistency checking
US5880976A (en) * 1997-02-21 1999-03-09 Carnegie Mellon University Apparatus and method for facilitating the implantation of artificial components in joints
US6694168B2 (en) * 1998-06-22 2004-02-17 Synthes (U.S.A.) Fiducial matching using fiducial implants
US6554837B1 (en) * 1998-06-29 2003-04-29 Plus Endoprothetik Ag Device and method for inserting a prosthetic knee
US6692447B1 (en) * 1999-02-16 2004-02-17 Frederic Picard Optimizing alignment of an appendicular
US6725082B2 (en) * 1999-03-17 2004-04-20 Synthes U.S.A. System and method for ligament graft placement
US6702821B2 (en) * 2000-01-14 2004-03-09 The Bonutti 2003 Trust A Instrumentation for minimally invasive joint replacement and methods for using same
US6685711B2 (en) * 2001-02-28 2004-02-03 Howmedica Osteonics Corp. Apparatus used in performing femoral and tibial resection in knee surgery
US7001346B2 (en) * 2001-11-14 2006-02-21 Michael R. White Apparatus and methods for making intraoperative orthopedic measurements

Cited By (115)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8608748B2 (en) 2006-02-27 2013-12-17 Biomet Manufacturing, Llc Patient specific guides
US9345548B2 (en) 2006-02-27 2016-05-24 Biomet Manufacturing, Llc Patient-specific pre-operative planning
US9480490B2 (en) 2006-02-27 2016-11-01 Biomet Manufacturing, Llc Patient-specific guides
US8070752B2 (en) 2006-02-27 2011-12-06 Biomet Manufacturing Corp. Patient specific alignment guide and inter-operative adjustment
US9480580B2 (en) 2006-02-27 2016-11-01 Biomet Manufacturing, Llc Patient-specific acetabular alignment guides
US8133234B2 (en) 2006-02-27 2012-03-13 Biomet Manufacturing Corp. Patient specific acetabular guide and method
US9522010B2 (en) 2006-02-27 2016-12-20 Biomet Manufacturing, Llc Patient-specific orthopedic instruments
US8241293B2 (en) 2006-02-27 2012-08-14 Biomet Manufacturing Corp. Patient specific high tibia osteotomy
US9173661B2 (en) 2006-02-27 2015-11-03 Biomet Manufacturing, Llc Patient specific alignment guide with cutting surface and laser indicator
US8282646B2 (en) * 2006-02-27 2012-10-09 Biomet Manufacturing Corp. Patient specific knee alignment guide and associated method
US9339278B2 (en) 2006-02-27 2016-05-17 Biomet Manufacturing, Llc Patient-specific acetabular guides and associated instruments
US9113971B2 (en) 2006-02-27 2015-08-25 Biomet Manufacturing, Llc Femoral acetabular impingement guide
US9539013B2 (en) 2006-02-27 2017-01-10 Biomet Manufacturing, Llc Patient-specific elbow guides and associated methods
US9662127B2 (en) 2006-02-27 2017-05-30 Biomet Manufacturing, Llc Patient-specific acetabular guides and associated instruments
US20080161815A1 (en) * 2006-02-27 2008-07-03 Biomet Manufacturing Corp. Patient Specific Knee Alignment Guide And Associated Method
US8377066B2 (en) 2006-02-27 2013-02-19 Biomet Manufacturing Corp. Patient-specific elbow guides and associated methods
US9700329B2 (en) 2006-02-27 2017-07-11 Biomet Manufacturing, Llc Patient-specific orthopedic instruments
US9289253B2 (en) 2006-02-27 2016-03-22 Biomet Manufacturing, Llc Patient-specific shoulder guide
US9662216B2 (en) 2006-02-27 2017-05-30 Biomet Manufacturing, Llc Patient-specific hip joint devices
US8900244B2 (en) 2006-02-27 2014-12-02 Biomet Manufacturing, Llc Patient-specific acetabular guide and method
US8864769B2 (en) 2006-02-27 2014-10-21 Biomet Manufacturing, Llc Alignment guides with patient-specific anchoring elements
US8828087B2 (en) 2006-02-27 2014-09-09 Biomet Manufacturing, Llc Patient-specific high tibia osteotomy
US9913734B2 (en) 2006-02-27 2018-03-13 Biomet Manufacturing, Llc Patient-specific acetabular alignment guides
US8535387B2 (en) 2006-02-27 2013-09-17 Biomet Manufacturing, Llc Patient-specific tools and implants
US8568487B2 (en) 2006-02-27 2013-10-29 Biomet Manufacturing, Llc Patient-specific hip joint devices
US8591516B2 (en) 2006-02-27 2013-11-26 Biomet Manufacturing, Llc Patient-specific orthopedic instruments
US9918740B2 (en) 2006-02-27 2018-03-20 Biomet Manufacturing, Llc Backup surgical instrument system and method
US8603180B2 (en) 2006-02-27 2013-12-10 Biomet Manufacturing, Llc Patient-specific acetabular alignment guides
US8608749B2 (en) 2006-02-27 2013-12-17 Biomet Manufacturing, Llc Patient-specific acetabular guides and associated instruments
US9005297B2 (en) 2006-02-27 2015-04-14 Biomet Manufacturing, Llc Patient-specific elbow guides and associated methods
US8979936B2 (en) 2006-06-09 2015-03-17 Biomet Manufacturing, Llc Patient-modified implant
US8092465B2 (en) 2006-06-09 2012-01-10 Biomet Manufacturing Corp. Patient specific knee alignment guide and associated method
US8298237B2 (en) 2006-06-09 2012-10-30 Biomet Manufacturing Corp. Patient-specific alignment guide for multiple incisions
US9861387B2 (en) 2006-06-09 2018-01-09 Biomet Manufacturing, Llc Patient-specific knee alignment guide and associated method
US8858561B2 (en) 2006-06-09 2014-10-14 Blomet Manufacturing, LLC Patient-specific alignment guide
US9795399B2 (en) 2006-06-09 2017-10-24 Biomet Manufacturing, Llc Patient-specific knee alignment guide and associated method
US8398646B2 (en) 2006-06-09 2013-03-19 Biomet Manufacturing Corp. Patient-specific knee alignment guide and associated method
US9993344B2 (en) 2006-06-09 2018-06-12 Biomet Manufacturing, Llc Patient-modified implant
US8473305B2 (en) 2007-04-17 2013-06-25 Biomet Manufacturing Corp. Method and apparatus for manufacturing an implant
US9907659B2 (en) 2007-04-17 2018-03-06 Biomet Manufacturing, Llc Method and apparatus for manufacturing an implant
US8407067B2 (en) 2007-04-17 2013-03-26 Biomet Manufacturing Corp. Method and apparatus for manufacturing an implant
US8486150B2 (en) 2007-04-17 2013-07-16 Biomet Manufacturing Corp. Patient-modified implant
US8265949B2 (en) 2007-09-27 2012-09-11 Depuy Products, Inc. Customized patient surgical plan
US8398645B2 (en) 2007-09-30 2013-03-19 DePuy Synthes Products, LLC Femoral tibial customized patient-specific orthopaedic surgical instrumentation
US10028750B2 (en) 2007-09-30 2018-07-24 DePuy Synthes Products, Inc. Apparatus and method for fabricating a customized patient-specific orthopaedic instrument
US8361076B2 (en) 2007-09-30 2013-01-29 Depuy Products, Inc. Patient-customizable device and system for performing an orthopaedic surgical procedure
US8377068B2 (en) 2007-09-30 2013-02-19 DePuy Synthes Products, LLC. Customized patient-specific instrumentation for use in orthopaedic surgical procedures
US8357111B2 (en) 2007-09-30 2013-01-22 Depuy Products, Inc. Method and system for designing patient-specific orthopaedic surgical instruments
US8343159B2 (en) 2007-09-30 2013-01-01 Depuy Products, Inc. Orthopaedic bone saw and method of use thereof
US8357166B2 (en) 2007-09-30 2013-01-22 Depuy Products, Inc. Customized patient-specific instrumentation and method for performing a bone re-cut
US8974460B2 (en) * 2008-10-22 2015-03-10 Blue Ortho Device for controlled adjustment of a surgical positioning unit
US20110218546A1 (en) * 2008-10-22 2011-09-08 Blue Ortho Device for controlled adjustment of a surgical positioning unit
US8170641B2 (en) 2009-02-20 2012-05-01 Biomet Manufacturing Corp. Method of imaging an extremity of a patient
US20100286710A1 (en) * 2009-05-05 2010-11-11 Blue Ortho Device and Method For Instrument Adjustment in Computer Assisted Surgery
US9168106B2 (en) 2009-05-05 2015-10-27 Blue Ortho Device and method for instrument adjustment in computer assisted surgery
US9839433B2 (en) 2009-08-13 2017-12-12 Biomet Manufacturing, Llc Device for the resection of bones, method for producing such a device, endoprosthesis suited for this purpose and method for producing such an endoprosthesis
US9393028B2 (en) 2009-08-13 2016-07-19 Biomet Manufacturing, Llc Device for the resection of bones, method for producing such a device, endoprosthesis suited for this purpose and method for producing such an endoprosthesis
US10052110B2 (en) 2009-08-13 2018-08-21 Biomet Manufacturing, Llc Device for the resection of bones, method for producing such a device, endoprosthesis suited for this purpose and method for producing such an endoprosthesis
US8632547B2 (en) 2010-02-26 2014-01-21 Biomet Sports Medicine, Llc Patient-specific osteotomy devices and methods
US9456833B2 (en) 2010-02-26 2016-10-04 Biomet Sports Medicine, Llc Patient-specific osteotomy devices and methods
US9066727B2 (en) 2010-03-04 2015-06-30 Materialise Nv Patient-specific computed tomography guides
US9579112B2 (en) 2010-03-04 2017-02-28 Materialise N.V. Patient-specific computed tomography guides
US9579106B2 (en) 2010-03-31 2017-02-28 New York Society For The Relief Of The Ruptured And Crippled, Maintaining The Hospital For Special Surgery Shoulder arthroplasty instrumentation
US9271744B2 (en) 2010-09-29 2016-03-01 Biomet Manufacturing, Llc Patient-specific guide for partial acetabular socket replacement
US9968376B2 (en) 2010-11-29 2018-05-15 Biomet Manufacturing, Llc Patient-specific orthopedic instruments
US9241745B2 (en) 2011-03-07 2016-01-26 Biomet Manufacturing, Llc Patient-specific femoral version guide
US9445907B2 (en) 2011-03-07 2016-09-20 Biomet Manufacturing, Llc Patient-specific tools and implants
US9743935B2 (en) 2011-03-07 2017-08-29 Biomet Manufacturing, Llc Patient-specific femoral version guide
US9717510B2 (en) 2011-04-15 2017-08-01 Biomet Manufacturing, Llc Patient-specific numerically controlled instrument
US8715289B2 (en) 2011-04-15 2014-05-06 Biomet Manufacturing, Llc Patient-specific numerically controlled instrument
US9675400B2 (en) 2011-04-19 2017-06-13 Biomet Manufacturing, Llc Patient-specific fracture fixation instrumentation and method
US9474539B2 (en) 2011-04-29 2016-10-25 Biomet Manufacturing, Llc Patient-specific convertible guides
US8956364B2 (en) 2011-04-29 2015-02-17 Biomet Manufacturing, Llc Patient-specific partial knee guides and other instruments
US9743940B2 (en) 2011-04-29 2017-08-29 Biomet Manufacturing, Llc Patient-specific partial knee guides and other instruments
US8668700B2 (en) 2011-04-29 2014-03-11 Biomet Manufacturing, Llc Patient-specific convertible guides
US8903530B2 (en) 2011-06-06 2014-12-02 Biomet Manufacturing, Llc Pre-operative planning and manufacturing method for orthopedic procedure
US8532807B2 (en) 2011-06-06 2013-09-10 Biomet Manufacturing, Llc Pre-operative planning and manufacturing method for orthopedic procedure
US9757238B2 (en) 2011-06-06 2017-09-12 Biomet Manufacturing, Llc Pre-operative planning and manufacturing method for orthopedic procedure
US9687261B2 (en) 2011-06-13 2017-06-27 Biomet Manufacturing, Llc Drill guides for confirming alignment of patient-specific alignment guides
US9084618B2 (en) 2011-06-13 2015-07-21 Biomet Manufacturing, Llc Drill guides for confirming alignment of patient-specific alignment guides
US9668747B2 (en) 2011-07-01 2017-06-06 Biomet Manufacturing, Llc Patient-specific-bone-cutting guidance instruments and methods
US9173666B2 (en) 2011-07-01 2015-11-03 Biomet Manufacturing, Llc Patient-specific-bone-cutting guidance instruments and methods
US8764760B2 (en) 2011-07-01 2014-07-01 Biomet Manufacturing, Llc Patient-specific bone-cutting guidance instruments and methods
US8597365B2 (en) 2011-08-04 2013-12-03 Biomet Manufacturing, Llc Patient-specific pelvic implants for acetabular reconstruction
US9427320B2 (en) 2011-08-04 2016-08-30 Biomet Manufacturing, Llc Patient-specific pelvic implants for acetabular reconstruction
US9603613B2 (en) 2011-08-31 2017-03-28 Biomet Manufacturing, Llc Patient-specific sacroiliac guides and associated methods
US9066734B2 (en) 2011-08-31 2015-06-30 Biomet Manufacturing, Llc Patient-specific sacroiliac guides and associated methods
US9295497B2 (en) 2011-08-31 2016-03-29 Biomet Manufacturing, Llc Patient-specific sacroiliac and pedicle guides
US9439659B2 (en) 2011-08-31 2016-09-13 Biomet Manufacturing, Llc Patient-specific sacroiliac guides and associated methods
US9386993B2 (en) 2011-09-29 2016-07-12 Biomet Manufacturing, Llc Patient-specific femoroacetabular impingement instruments and methods
US9936962B2 (en) 2011-10-27 2018-04-10 Biomet Manufacturing, Llc Patient specific glenoid guide
US9351743B2 (en) 2011-10-27 2016-05-31 Biomet Manufacturing, Llc Patient-specific glenoid guides
US9554910B2 (en) 2011-10-27 2017-01-31 Biomet Manufacturing, Llc Patient-specific glenoid guide and implants
US9301812B2 (en) 2011-10-27 2016-04-05 Biomet Manufacturing, Llc Methods for patient-specific shoulder arthroplasty
US9451973B2 (en) 2011-10-27 2016-09-27 Biomet Manufacturing, Llc Patient specific glenoid guide
US9237950B2 (en) 2012-02-02 2016-01-19 Biomet Manufacturing, Llc Implant with patient-specific porous structure
US9827106B2 (en) 2012-02-02 2017-11-28 Biomet Manufacturing, Llc Implant with patient-specific porous structure
US10034713B2 (en) 2012-07-03 2018-07-31 7D Surgical Inc. Attachments for tracking handheld implements
US20150223941A1 (en) * 2012-08-27 2015-08-13 Conformis, Inc. Methods, Devices and Techniques for Improved Placement and Fixation of Shoulder Implant Components
US9597201B2 (en) 2012-12-11 2017-03-21 Biomet Manufacturing, Llc Patient-specific acetabular guide for anterior approach
US9060788B2 (en) 2012-12-11 2015-06-23 Biomet Manufacturing, Llc Patient-specific acetabular guide for anterior approach
US9204977B2 (en) 2012-12-11 2015-12-08 Biomet Manufacturing, Llc Patient-specific acetabular guide for anterior approach
US9839438B2 (en) 2013-03-11 2017-12-12 Biomet Manufacturing, Llc Patient-specific glenoid guide with a reusable guide holder
US9579107B2 (en) 2013-03-12 2017-02-28 Biomet Manufacturing, Llc Multi-point fit for patient specific guide
US9700325B2 (en) 2013-03-12 2017-07-11 Biomet Manufacturing, Llc Multi-point fit for patient specific guide
US9826981B2 (en) 2013-03-13 2017-11-28 Biomet Manufacturing, Llc Tangential fit of patient-specific guides
US9498233B2 (en) 2013-03-13 2016-11-22 Biomet Manufacturing, Llc. Universal acetabular guide and associated hardware
US9517145B2 (en) 2013-03-15 2016-12-13 Biomet Manufacturing, Llc Guide alignment system and method
US9408616B2 (en) 2014-05-12 2016-08-09 Biomet Manufacturing, Llc Humeral cut guide
US9839436B2 (en) 2014-06-03 2017-12-12 Biomet Manufacturing, Llc Patient-specific glenoid depth control
US9561040B2 (en) 2014-06-03 2017-02-07 Biomet Manufacturing, Llc Patient-specific glenoid depth control
WO2016007492A1 (en) * 2014-07-07 2016-01-14 Smith & Nephew, Inc. Alignment precision
US9833245B2 (en) 2014-09-29 2017-12-05 Biomet Sports Medicine, Llc Tibial tubercule osteotomy
US9826994B2 (en) 2014-09-29 2017-11-28 Biomet Manufacturing, Llc Adjustable glenoid pin insertion guide
US9820868B2 (en) 2015-03-30 2017-11-21 Biomet Manufacturing, Llc Method and apparatus for a pin apparatus

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US20030069591A1 (en) 2003-04-10 application
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CA2496054C (en) 2011-07-19 grant
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US7547307B2 (en) 2009-06-16 grant

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