WO2004028343A2 - Method and apparatus for controlling a surgical burr in the performance of an orthopaedic procedure - Google Patents

Method and apparatus for controlling a surgical burr in the performance of an orthopaedic procedure Download PDF

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Publication number
WO2004028343A2
WO2004028343A2 PCT/US2003/029996 US0329996W WO2004028343A2 WO 2004028343 A2 WO2004028343 A2 WO 2004028343A2 US 0329996 W US0329996 W US 0329996W WO 2004028343 A2 WO2004028343 A2 WO 2004028343A2
Authority
WO
WIPO (PCT)
Prior art keywords
surgical
burr
processor
surgical burr
orthopaedic
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2003/029996
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English (en)
French (fr)
Other versions
WO2004028343A3 (en
Inventor
Mark A. Heldreth
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
DePuy Products Inc
Original Assignee
DePuy Products Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by DePuy Products Inc filed Critical DePuy Products Inc
Priority to JP2004540199A priority Critical patent/JP4731908B2/ja
Priority to EP03754856A priority patent/EP1542600B1/en
Priority to AT03754856T priority patent/ATE508694T1/de
Priority to AU2003272660A priority patent/AU2003272660B2/en
Publication of WO2004028343A2 publication Critical patent/WO2004028343A2/en
Publication of WO2004028343A3 publication Critical patent/WO2004028343A3/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1613—Component parts
    • A61B17/1626—Control means; Display units
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2072—Reference field transducer attached to an instrument or patient

Definitions

  • the present disclosure relates generally to a computer-aided surgical system for use in the performance of an orthopaedic procedure.
  • a number of navigation systems for navigating a surgical burr have heretofore been developed.
  • Such navigation systems have included active and passive robotic arms.
  • the arm either actively positions the burr in the correct position relative to the bone (irrespective of the surrounding soft tissue) or provides "passive" resistance to the burr being directed outside of the prescribed planned volume.
  • the burr is rigidly attached to a robotic jointed arm which may, in some cases, intrude into the sterile field and interrupt the surgeon's work flow.
  • adoption of such robotic technologies has been slow.
  • a system for use in the performance of an orthopaedic surgical procedure couples a computer aided surgical navigation system to the speed control of a surgical burr.
  • the position of the surgical burr may be tracked by the navigation system relative to a predetermined volume and or geometry of bone to be removed as part of a pre-surgical plan.
  • the speed of the burr is modulated.
  • the burr is thereby constrained to remove only the amount of bone previously planned by the surgeon.
  • feedback is provided to the navigation system as to which bone has been removed.
  • the volume and/or geometry of removed bone is then highlighted by the navigation system to the user (i.e., the surgeon).
  • a method of operating a surgical burr during performance of an orthopaedic procedure includes monitoring the position of the surgical burr during the procedure and adjusting operation of the surgical burr based thereon.
  • the speed of the surgical burr is increased or decreased based on the position of the burr.
  • FIG. 1 is a simplified block diagram of a surgical control system for use in the performance of an orthopaedic surgical operation
  • FIG. 2 is a flowchart of an exemplary control routine for operating the system of FIG. 1.
  • the present disclosure relates to a control system for coupling a computer aided surgical navigation system to the speed control of a surgical burr.
  • the position of the surgical burr is tracked by the navigation system relative to a predetermined volume and/or geometry of bone to be removed as part of a pre- surgical plan.
  • the control system modulates the burr speed.
  • the burr is thereby constrained to remove only the amount of bone previously planned by the surgeon.
  • feedback is provided to the navigation system as to which bone has been removed.
  • the volume and/or geometry of removed bone is then highlighted by the navigation system to the user (i.e., the surgeon).
  • a surgical control system 10 having a computer-based surgical navigation system 12 and a computer-controlled surgical burr system 14.
  • the control system 10 is operable to guide the position of a surgical burr 16 by tracking its position, while also controlling operation of the burr 16 based on its tracked position. In other words, the control system 10 monitors position of the burr 16 and then adjusts operation of the burr 16 based thereon.
  • the surgical navigation system 12 is configured to optically or electromagnetically track the position of the burr 16.
  • the surgical navigation system 12 may be embodied as any type of navigation system such as the surgical navigation systems commercially available from BrainLAB AG of Heimstetten, Germany.
  • the navigation system 12 may also be embodied as any one or more of the navigation systems (or combination thereof) disclosed in U.S. Patent Nos. 6,514,259; 6,434,507; 6,428,547; 6,424,856; 6,351,659; 6,223,067; 6,187,018; 6,178,345; 5,889,834; 5,769,861; 5,702,406; 5,643,268; and 5,628,315, along with U.S. Patent Application Publication No. 2002/0038118 Al, each of which is hereby incorporated by reference.
  • the burr system 14, may be embodied as any type of commercially available electronically-controlled surgical burr system.
  • the burr system 14 may be embodied as any one or more of the burr systems (or combination thereof) disclosed in U.S. Patent Nos. 6,329,778; 6,090,123; 6,017,354; and 5,712,460, each of which is hereby incorporated by reference.
  • both the components of the navigation system 12 and a controller 18 of the burr system 14 are electrically coupled to a system controller 20.
  • the system controller 20 is, in essence, the master computer responsible for interpreting electrical signals sent by the navigation system 12 and for communicating with the burr controller 18 for controlling operation of the burr 16.
  • the system controller 20 of the present disclosure is operable to, amongst many other things, monitor output signals from the navigation system 12 indicative of the position of the burr 16 relative to a predetermined boundary or location.
  • any of the numerous control signals generated by the navigation system 12 during operation thereof may be communicated to the system controller 20 for use by the controller 20 as a feedback mechanism for controlling operation of the burr 16.
  • one or more software and/or hardware interfaces may be utilized to facilitate the communication link between the navigation system 12, the burr controller 18, and the system controller 20.
  • a software and/or hardware scheme may be utilized to handshake the systems associated with the navigation system 12 to the burr controller 18.
  • the system controller 20 includes a number of electronic components commonly associated with control units which are utilized in the control of electromechanical systems.
  • the system controller 20 may include, amongst other components customarily included in such devices, a processor such as a microprocessor and a memory device such as a hard drive or a programmable readonly memory device (“PROM”) including erasable PROM's (EPROM's or EEPROM's).
  • the memory device is utilized to store, amongst other things, instructions in the form of, for example, a software routine (or routines) which, when executed by the processor, allows the system controller 20 to control operation of the surgical bun- 16.
  • the system controller 20 also includes an analog interface circuit (not shown).
  • the analog interface circuit converts the output signals from the various components associated with the surgical system 10 into a signal which is suitable for presentation to an input of the microprocessor of the system controller 20.
  • an analog interface circuit by use of an analog-to-digital (A/D) converter (not shown) or the like, converts the analog signals generated by the navigation system 12 into a digital signal for use by the microprocessor of the system controller 12.
  • A/D converter may be embodied as a discrete device or number of devices, or may be integrated into the microprocessor of the system controller 12. It should also be appreciated that if any one or more of the outputs signals from the navigation system 12 are in the form of a digital output signal, the analog interface circuit may be bypassed.
  • the analog interface circuit of the system controller 18 converts signals from the microprocessor of the system controller 18 into an output signal which is suitable for presentation to the burr controller 18.
  • the analog interface circuit by use of a digital-to-analog (D/A) converter (not shown) or the like, converts the digital signals generated by the microprocessor into analog signals for use by the burr controller 18.
  • D/A converter may be embodied as a discrete device or number of devices, or may be integrated into the microprocessor of the system controller 20. It should also be appreciated that if the burr controller 18 is operable on a digital input signal, the analog interface circuit may be bypassed.
  • the data transmission from the navigation system 12 to the system controller 20 may be by hardwire (either remote or resident on the navigation system 12) or wireless such as by use of a radio frequency transmission.
  • the data transmission from the system controller 20 to the burr controller 18 may be by hardwire (either remote or resident on the controller 12) or wireless such as by use of a radio frequency transmission.
  • the system controller 20 monitors the output from the navigation system 12 as to the relative position of the burr to the bone at a sampling rate in the range of, for example, 1000 hz to 1 hz.
  • the relative position of the burr 16 to the preplanned surgical profile is then utilized by the system controller 20 to adjust the bun- speed based upon a preprogrammed acceleration/deceleration profile.
  • Such a acceleration/deceleration response profile executed by the system controller 20 may be in the form of either a fixed relation or, alternatively, the profile may be altered by the user (e.g., the surgeon) by the use of a digital or analog electronic input device for modifying the profile characteristics.
  • the controller 20 sends an output in the form of a modulating signal to the burr controller 18.
  • the burr controller 18 may respond to the output from the system controller 20 by adjusting the electrical current applied to the burr motor, adjusting hydraulic pressure applied to the burr turbine, adjusting pneumatic pressure applied to the burr turbine, and/or actuating of an electromagnetic coupling/decoupling clutch between the burr and the burr turbine.
  • the burr controller 18 utilizes the output signals from the system controller 20 to adjust operation of the burr 16. More specifically, based on output from the system controller 20, the burr controller 18 adjusts speed of the burr 16.
  • such control methods may be combined so as to provide for smooth acceleration/deceleration of the burr 16, along with rapid deceleration of the bun- 16.
  • control system 10 of the present disclosure may be utilized to control operation of the surgical burr 16 during performance of a surgical procedure.
  • the position of the burr 16 may be compared to a predetermined (i.e., planned) working volume and/or geometry by the navigation system 12 during an orthopaedic surgical procedure.
  • a visual/audio cue on a burr hand piece begins to inform the surgeon of the same.
  • the burr 16 enters a specified distance from the volume and/or geometry boundary, such information is relayed to the burr controller 18 so that the burr controller 18 can execute a preprogrammed speed vs.
  • the burr 16 reaches full speed as it passes through the volume and/or geometry boundary. As the burr 16 begins to exit the working volume and/or geometry from the inside, a visual/audio cue is again generated for the surgeon and a deceleration process is initiated by the burr controller 18.
  • the navigation system 12 since the navigation system 12 is, by its design, tracking the burr 16 relative to the patient's anatomy, the system 12 is able to determine which volume and/or geometry of the bone has been removed. This information may be visually presented to the surgeon on a display monitor 22 thereby allowing the surgeon to monitor his or her progress relative to certain anatomical structures.
  • the system controller 20 utilizes inputs in the form of (1) position of the surgical burr 16 and bone anatomy as tracked by the navigation system 12, and (2) the predetermined volume and/or geometry of bone to be removed by the burr 12 as defined in the pre-operative plan and stored either in the navigation system 12 or the system controller 20.
  • the system controller 20 generates an electronic control signal which is communicated to the burr controller 18 thereby causing the burr controller 18 to operated the burr 16 at a preprogrammed burr speed (including a predetermined acceleration/deceleration rate) based upon the proximity and relative position of the burr 16 to the preplanned burring profile.
  • the control system also generates data indicative of the volume and/or geometry of bone actually removed by the burr 16 and presents such data as a visual representation to the surgeon via the display monitor 22.
  • FIG. 2 A flowchart of an exemplary control routine 100 for operating the surgical control system 10 is shown in FIG. 2.
  • the routine 100 commences with step 102 in which the position of the surgical burr 16 is determined.
  • the system controller 20 communicates with the navigation system 12 to determine the present location of the surgical burr 16 within the body of the patient.
  • the routine 100 then advances to step 104.
  • step 104 the present location of the surgical burr 16 (as determined in step 102) is analyzed in light of a predetermined volume and/or geometry of bone to be removed by the burr 12 as defined in the pre-operative plan and stored either in the navigation system 12 or the system controller 20.
  • a boundary is defined around the portion of the volume and/or geometry of the bone to be removed during generation of the pre-operative plan.
  • An electronic file indicative of the image of such a boundary superimposed over the volume and/or geometry of the bone to be removed is stored in a memory device associated with either the navigation system 12 or the system controller 20.
  • the controller 20 analyzes the position of the surgical burr 16 relative to the boundary around the portion of the volume and/or geometry of the bone to be removed. Once the burr's position has been analyzed, an output signal is generated, and the routine 100 is advanced to step 106.
  • the controller 20 adjusts operation of the surgical burr 16 based on the analysis of the burr's position. Specifically, based on the analysis of the position of the burr 16 (as analyzed in step 104), the speed of the surgical burr 16 is adjusted (e.g., either increased or decreased). For example, as the burr 16 enters a specified distance from the volume and/or geometry boundary, the system controller 20 communicates with the burr controller 18 so that the burr controller 18 can execute a preprogrammed speed vs. distance algorithm thereby accelerating the burr 16. The burr 16 reaches full speed as it passes through the volume and/or geometry boundary.
  • a deceleration process is initiated by the burr controller 18. If the burr 16 exits the boundary, the system controller 20 may communicate to the burr controller 18 to cease operation of the bun- 16 so as to prevent the removal of bone material outside of the boundary. In any event, once the controller 20 has adjusted the speed of the surgical burr 16 in step 106, the routine 100 loops back to step 102 to continue closed- loop control of the operation of the burr 16 based on the position of the surgical burr 16.
  • the system and method described herein render the shaping of bone by burring more reproducible, hence, enabling bone conserving implants, while at the same time eliminating expensive bone cutting jigs.
  • the design of the orthopaedic implant to be implanted into the surgical site prepared by the burr may be configured to accommodate non-planar cuts while still providing for reproducible bone apposition.
  • the need for jig systems is eliminated.
  • system and method described herein facilitates creation of an override function by causing the burr to shut off (or drop to a safe speed) when the burr is inadvertently maneuvered outside of the intended volume.
  • the ability to simultaneously track the amount of bone removed enhances the surgeon's efficiency during the procedure.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
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  • Oral & Maxillofacial Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Robotics (AREA)
  • Surgical Instruments (AREA)
PCT/US2003/029996 2002-09-26 2003-09-24 Method and apparatus for controlling a surgical burr in the performance of an orthopaedic procedure Ceased WO2004028343A2 (en)

Priority Applications (4)

Application Number Priority Date Filing Date Title
JP2004540199A JP4731908B2 (ja) 2002-09-26 2003-09-24 整形外科処置中に外科バーを制御するための方法及び装置
EP03754856A EP1542600B1 (en) 2002-09-26 2003-09-24 Apparatus for controlling a surgical burr in the performance of an orthopaedic procedure
AT03754856T ATE508694T1 (de) 2002-09-26 2003-09-24 Gerät zur kontrolle einer chirurgischen fräse bei der durchführung eines orthopädischen eingriffs
AU2003272660A AU2003272660B2 (en) 2002-09-26 2003-09-24 Method and apparatus for controlling a surgical burr in the performance of an orthopaedic procedure

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US41369202P 2002-09-26 2002-09-26
US60/413,692 2002-09-26

Publications (2)

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WO2004028343A2 true WO2004028343A2 (en) 2004-04-08
WO2004028343A3 WO2004028343A3 (en) 2004-08-12

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US (1) US7022123B2 (https=)
EP (1) EP1542600B1 (https=)
JP (1) JP4731908B2 (https=)
AT (1) ATE508694T1 (https=)
AU (1) AU2003272660B2 (https=)
WO (1) WO2004028343A2 (https=)

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US11135014B2 (en) 2011-09-02 2021-10-05 Stryker Corporation Surgical instrument including housing, a cutting accessory that extends from the housing and actuators that establish the position of the cutting accessory relative to the housing
US11896314B2 (en) 2011-09-02 2024-02-13 Stryker Corporation Surgical instrument including housing, a cutting accessory that extends from the housing and actuators that establish the position of the cutting accessory relative to the housing
US12279830B2 (en) 2011-09-02 2025-04-22 Stryker Corporation Surgical instrument including housing, a cutting accessory that extends from the housing and actuators that establish the position of the cutting accessory relative to the housing

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EP1542600A4 (en) 2009-11-25
AU2003272660B2 (en) 2008-03-20
WO2004028343A3 (en) 2004-08-12
JP2006500993A (ja) 2006-01-12
US20040097948A1 (en) 2004-05-20
EP1542600B1 (en) 2011-05-11
JP4731908B2 (ja) 2011-07-27
AU2003272660A1 (en) 2004-04-19
EP1542600A2 (en) 2005-06-22
ATE508694T1 (de) 2011-05-15
US7022123B2 (en) 2006-04-04

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