WO2005089681A2 - Device for assisting a surgeon in the selection of a femoral and/or tibial implant for the preparation of a prosthesis, and implant selection method used in said device - Google Patents

Device for assisting a surgeon in the selection of a femoral and/or tibial implant for the preparation of a prosthesis, and implant selection method used in said device

Info

Publication number
WO2005089681A2
WO2005089681A2 PCT/FR2005/000332 FR2005000332W WO2005089681A2 WO 2005089681 A2 WO2005089681 A2 WO 2005089681A2 FR 2005000332 W FR2005000332 W FR 2005000332W WO 2005089681 A2 WO2005089681 A2 WO 2005089681A2
Authority
WO
Grant status
Application
Patent type
Prior art keywords
means
data
measuring
femoral
ligament
Prior art date
Application number
PCT/FR2005/000332
Other languages
French (fr)
Other versions
WO2005089681A3 (en )
Inventor
Gérard GOVAL
François Gougeon
Original Assignee
Sofinordest, S.A.S.
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

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4657Measuring instruments used for implanting artificial joints
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06Measuring instruments not otherwise provided for
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/14Surgical saws ; Accessories therefor
    • A61B17/15Guides therefor
    • A61B17/154Guides therefor for preparing bone for knee prosthesis
    • A61B17/155Cutting femur
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025Joint distractors
    • A61B2017/0268Joint distractors for the knee
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06Measuring instruments not otherwise provided for
    • A61B2090/061Measuring instruments not otherwise provided for for measuring dimensions, e.g. length
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06Measuring instruments not otherwise provided for
    • A61B2090/064Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10Computer-aided planning, simulation or modelling of surgical operations
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/45For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4528Joints
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/45For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4533Ligaments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/38Joints for elbows or knees
    • A61F2/3859Femoral components
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/38Joints for elbows or knees
    • A61F2/389Tibial components
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4632Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using computer-controlled surgery, e.g. robotic surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4657Measuring instruments used for implanting artificial joints
    • A61F2002/4658Measuring instruments used for implanting artificial joints for measuring dimensions, e.g. length
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4657Measuring instruments used for implanting artificial joints
    • A61F2002/4666Measuring instruments used for implanting artificial joints for measuring force, pressure or mechanical tension
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4688Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor having operating or control means
    • A61F2002/4696Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor having operating or control means optical
    • A61F2002/4697Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor having operating or control means optical visual

Abstract

The invention relates to a device for assisting a surgeon in the selection of a femoral and/or tibial implant for the preparation of a knee prosthesis placement, and to the method of selecting a femoral and/or tibial implant used in said device. According to the invention, the device comprises: means (2) for storing data relating to the anatomy of the patient and data relating to femoral and tibial implants; means (3) for moving the tibia and the femur away from one another, such that the inner and outer ligaments can be placed under tension; first means (9) for measuring the distance between the tibia and the femur; second means (10) for measuring the ligament tension in relation to the inner and outer ligaments; data-transmission means (13); data-processing means (14); and means (16) for displaying the output data.

Description

DEVICE FOR ASSISTANCE IN SURGICAL IMPLANT SELECTION DON FEMORAL AND / OR TIBIAL FOR THE PREPARATION OF A PROSTHESIS AND METHOD FOR SELECTING IMPLANT IMPLEMENTED IN SAID DEVICE The invention relates to an assistance device to surgeons in selecting a femoral implant and / or tibial for the preparation of a knee prosthesis delivery. The invention also relates to a method of selecting femoral implant and / or tibial implemented in the aforementioned device. The assistance device may also facilitate the surgeon's work in the choice of the ligament tension to be applied to the patient or in the determination of plans tibial and femoral cutting on which will position the various components of the knee prosthesis. With current techniques, the installation of a knee prosthesis presents many difficulties for the surgeon. Indeed, a key objective of knee replacement operations is to distribute evenly the stresses that will be placed on the prosthesis. The surgeon must consider including patient data such as, in particular, the relative position of the tibia relative to the femur, or the particular ligament strength of the patient. It must also take into account the geometry existing prostheses on the market. For the surgeon, a great difficulty will be getting once the prosthesis chosen a good balance ligament for the patient both in flexion and extension. Given all interdependent parameters involved, it is understood that the surgeon will be difficult without assistance, select optimum cutting plans, the ligament tension to be applied to internal and external ligaments or select precisely the implant femoral and / or tibial. This has the effect that during installation of the knee prosthesis, the surgeon is regularly forced to make additional cuts or add shims to the elements of the prosthesis, once installed, allows proper knee joint. To facilitate the surgeon's spot, it was proposed assistive devices to the surgeon from measurements taken before the implantation of the prosthesis. These devices comprise spatial referencing means in three dimensions of the femur relative to the tibia, all operating with markers arranged on the patient, said marker being associated with the cameras. The measurements taken from the positioning means are transmitted to a computer which processes the data for displaying the three-dimensional data to assist the surgeon in selecting the prosthesis elements. These devices, however, have various drawbacks, including the fact that at no time can not be measured ligament voltage to be applied to the patient. In addition, these devices using optical systems are complex to implement and it is difficult to achieve with existing optical systems, the precision required in medical applications. The present invention aims to bearing the above drawbacks and provides for this purpose a device for assisting the surgeon allowing the latter to consider the ligament tension own patient. Another object of the present invention is to provide a support device for the surgeon to accurately measure the relative distances of the femur and tibia. Another object of the present invention to provide an assistance device to the surgeon allows it to achieve balanced ligament balance. Another object of the present invention is to determine and display the output data relating to the tibia cutting planes and the femur. The invention thus relates to a device for assisting the surgeon in selecting a femoral plane and / or tibial for the preparation of a knee prosthesis delivery. According to the invention, the assistance device includes: - Data storage means for the patient's anatomy and data on femoral and tibial implants; - means for spacing between the tibia and femur for the tensioning of the inner and outer ligaments; - first means for measuring the spacing between the tibia and femur; - second means for measuring the ligament tension internal and external ligaments; - means for transmitting data obtained by said measuring means; - the measured data processing means and / or stored to the output data obtaining on the ligament tension to be applied and / or the femoral cutting plane to perform and / or dimensions of the femoral and tibial implants to be selected; - display of said data output means. The invention also provides a method of selecting femoral implant and / or tibial implemented in the above apparatus wherein a step is carried out: - measuring the optimum ligament tension; - measurement of the imbalance in extension; - measurement of the imbalance in flexion. Other features and advantages of the invention will become more apparent from reading the following description of a preferred embodiment in which the description is given only as non-limiting and with reference to the accompanying drawings in which: - Figure 1 shows a schematic view of the device according to the invention; - Figures 2 to 6 are output data display examples for assisting the surgeon in accordance with the invention; Referring to Figure 1, one sees that the assistance device 1 comprises means for storing two data on the anatomy of the patient and data related to femoral and tibial implants. The data on the patient's anatomy can be obtained by any means known in the art including a scan of the patient's leg or by radiographs. The patient data include the relative position of the tibia and femur and including the angle of the distal femoral valgus (VFD). This VFD angle may advantageously be calculated from an intramedullary placed at an angle guide HKS chosen and depending on the measure space between the condyles of the femur. 2 The storage means also store data on femoral implants and / or existing tibial, these data can be updated based on the new types of implants or implants of new dimensions. Data on ancillaries are also stored. Said assistance device 1 also comprises spacer means 3 between the tibia and femur for the tensioning of the inner and outer ligaments. In the preferred embodiment shown in Figure 1, the spacing means are constituted by a tensor 4 comprising at least one bracket 5 on which is fixed a pad 6 and tibial déplaçâmes two arms 7,7 '. The two arms 7,7 'can be moved independently along at least one of said bracket 5 by maneuvering means 8 thus removing the two parts of the joint and to the inner and outer ligaments in tension. The assistance device 1 also includes first measuring means 9 of the spacing between the tibia and femur. Said first means for measuring the gauge 9 comprises sensors 11 arranged at the spacer 3 means for determining the distance between each displaceable arms 7,7 'and the tibial pad 6 for determining the corresponding distance between the tibia and femur. The assistance device 1 also comprises second means for measuring the ligament tension 10 of the inner and outer ligaments. Referring to Figure 1, we see that said second measuring means 10 are arranged at each arm 7,7 'of the tensor 4. Advantageously, said second measuring means 10 are constituted by at least two sensors force 12 distributed over the length of each arm 7,7 'for measuring the force exerted on each arm 7,7' corresponding to the ligament tension of each ligament. At the level of force sensors 12 may be selected to advantage of sensors Piezo-type or strain gauges. In the preferred embodiment, two force sensors are used 12 of each arm 7,7 ', in this way measuring the force exerted by comparing measurements made by each of said sensors 12 to overcome problems of the arrows level of each displaceable arm or the point of application of force on each arm 7,7 'relative to the condyle head of the femur. However, consideration will be given to another embodiment of the device according to the invention is a higher number of sensors 12 for each arm 7,7 'is still a single sensor per arm 7.7. Said support device further comprises data transmission means 13 obtained by said measuring means 9,10. These 13 data transmission means are of the wire type. However, it will also consider ways of transmitting data 13 radio guy. These transmission means 13 enable to transmit the set of measured data to the processing means 14. Said processor means 14 are advantageously located in a central unit 15, the latter also involving the storage means 2. Said means 14 processing the measured data and / or stored allow the output data obtaining on the ligament tension to be applied and / or femoral cutting planes to produce and / or optimum dimensions of the femoral and tibial implants to be selected. It will also display the expected ligament tension with the values ​​and data for cutting and implant dimensions. To this end, said processing means 14 using a program based on the stored data and the data measured during the different steps of assist. Said device also comprises display means 16 of said output data. The display means 16 can display the output data such as graphics. Of course, one could also consider posting the data only in text. Referring primarily to Figures 5 and 6 show examples of graphs displayed by said display means 16. The invention also relates to a method of selecting femoral implant and / or tibial implemented in the device support 1 as described above. In this selection process, the following steps are performed: - a measure of the optimum ligament tension; - a measure of the imbalance in extension; - a measure of imbalance in flexion. Prior to carrying out the above steps, the tibia has been cut along a resection plane so as to constitute the seat of the tibial implant. Different anatomical data were also measured and in particular the anterior-posterior thickness of the femoral condylar distance and the distal femoral valgus angle and the HKS. The step of measuring the optimum ligament tension involves using spacer means 3 to distend the tibia and the femur when the knee is flexed to a threshold value K ligament stiffness and measuring the ligament tension corresponding to this threshold value K. the method also includes performing a measurement of the imbalance in extension, this step is to stretch the tibia and the femur when the knee is extended until internally and externally the optimum ligament tension and to measure the internal and external distances YI YE matching so as to determine if the joint, placed in extension, is clamped internally or externally or balanced. According to the method, it also performs a measurement of the imbalance in flexure which comprises distending the tibia and femur as the knee is flexed until internally and externally the optimum ligament tension and measuring inner and outer spacing XI XE matching so as to determine if the joint placed in bending is clamped internally, externally or balanced. The assistance device surgeon to display graphs corresponding to the unbalance measuring steps in extension or flexion and for example, graphics of the type of Figures 2 to 4. It is important to note here that if the difference between the XI and XE displayed value is too great, the surgeon will perform a balancing internal / external bending. So if XI exceeds XE plus a constant El surgeon will perform an external release and it will in this case to re-measure the imbalance in flexion. If, against XI is less than the same constant XE more El, the surgeon will make an inside release. It should be emphasized if desired, the surgeon may compensate by rotation of the femur if the YI value measured in the step of measuring the extension imbalance is less than the value YE and if the difference between YI YE and is less than the difference between XE and XI. There will also be the opportunity to offset when XI is less than XE and YI is greater than or equal to YE. When these operations are, if necessary, performed, it proceeds to a new measure of the imbalance in flexion for the new XE and XI values. The surgeon may also perform an internal / external balancing extension in the case where the difference between YI values ​​and YE are too important. To do this, it performs an internal release if YI is less than YE plus a constant El or outside release if YI exceeds YE plus a constant E2. In the same manner as for balancing internal / external bending will require a new measurement of the imbalance in extension so as to determine new YE and YI values. From the different values ​​XI, XE and YE, YI, the program then calculates the X and Y values ​​with X = (XE + XI) / 2 and = Y (YE + YI) / 2 with VFD equal to the angle of the valgus distal femoral and rot equal to the angle of rotation of the femur that the surgeon has chosen in internal original imbalance / external bending. From these data and data relating to the sizes of implants or to possible cuts thicknesses at the posterior cut of the femur and the distal section, the program offers via the display means in different data surgeon so that it can achieve optimum of the knee prosthesis pose. The program calculates, in a preferred embodiment: - the thickness of the femoral posterior cut according to the equation: CP = femur size - size femoral implant, - the size of the polyethylene according to the equation: P = X + CP - IFP - AND with: CP = thickness of the posterior cut, thickness = IFP posterior femoral implant and tibial implant thickness =, - the size of the distal section according to the equation CD = IFD + P + AND + Y with: IFD = size distal femoral implant, P = thickness of the polyethylene, ET = thickness tibial implant, - the rotational angle of the femur, - the ligament tension expected taking into account the values ​​of the other data displayed. All output data is then displayed and the surgeon can either use the data directly before laying or impose additional constraints, for example, if he wants a particular posterior cut, in which case he introduced these constraints and stimulus the program. Of course, other embodiments the human scope of art could have been contemplated without departing from the scope of the invention defined by the claims below.

Claims

CLAIMS 1. An aid the surgeon in selecting a femoral implant and / or tibial for the preparation of a knee prosthesis delivery characterized in that it comprises: - data storage means (2) on the patient's anatomy and data on femoral and tibial implants; - means for spacing (3) between the tibia and femur for the tensioning of the inner and outer ligaments; - first measuring means (9) of the spacer for determining the distance between the tibia and the femur; - second measuring means (10) of the ligament tension internal and external ligaments; - transmitting means (13) of the data obtained by said first and second measuring means (9,10); - processing means (14) measured data and / or stored for obtaining output data relating to the ligament tension to be applied and / or the femoral cutting plane to perform and / or dimensions of the femoral and tibial implants to be selected; - display means (16) said output data. 2. Device according to claim 1 characterized in that said spacer means (3) are constituted by a tensor (4) having a jib (5) to which is attached a tibial pad 6 and two displaceable arm (7,7 ' ) apart along the stem (5) by operating means (8) for move the two parts of the joint and to the tension in ligaments. 3. Device according to claim 2 characterized in that said measuring means (10) are disposed at each arm (7,7 ') of the tensor (4). 4. Device according to claim 3, characterized in that the second measuring means 10 are constituted by at least two sensors (12) distributed force along the length of each arm (7,7 ') for measuring the force exerted on each arm (7,7 ') corresponding to the ligament tension. 5. Apparatus according to any preceding claim characterized in that the transmission means (13) data are wired. 6. Apparatus according to any preceding claim characterized in that the display means (16) are used to display the output data in graphical form. 7. A method of selecting tibial implants and / or femoral implemented in the device according to any one of claims 1 to 6, characterized in that one carries out the following steps: - measuring the optimum ligament tension ; - a measure of the imbalance in extension; - a measure of imbalance in flexion. 8. The method of claim 8, characterized in that the step of measuring the ligament tension is to distend the tibia and the femur when the knee is flexed to a value K edge and measuring the ligament tension corresponding to said threshold value K. 9. process according to claim 8, characterized in that the step of measuring the extension imbalance is to distend the tibia and the femur when the knee is extended until the internal and external optimum ligament tension and measuring the spacings YI YE and external matching so as to determine if the joint placed in extension is clamped or unbalanced. 10. Method according to either of claims 8 and 9 characterized in that the step of measuring the flexural imbalance is to distend the tibia and the femur when the knee is flexed until internally and externally the optimum ligament tension and measuring the internal and external distances Xi Xe matching so as to determine if the joint placed in bending is clamped or balanced.
PCT/FR2005/000332 2004-02-23 2005-02-11 Device for assisting a surgeon in the selection of a femoral and/or tibial implant for the preparation of a prosthesis, and implant selection method used in said device WO2005089681A3 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
FR0401800 2004-02-23
FR0401800A FR2866556B1 (en) 2004-02-23 2004-02-23 Device the surgeon to assist in the selection of a femoral implant and / or tibial for the preparation of a prosthesis and method of operation in the apparatus cited above

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WO2005089681A3 true WO2005089681A3 (en) 2005-12-01

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EP1707159A1 (en) * 2005-03-31 2006-10-04 DePuy Products, Inc. Apparatus for use in balancing ligaments in a joint
WO2010022272A1 (en) * 2008-08-20 2010-02-25 Synvasive Technology, Inc. Sensing force during partial and total knee replacement surgery
US9381011B2 (en) 2012-03-29 2016-07-05 Depuy (Ireland) Orthopedic surgical instrument for knee surgery
US9439656B2 (en) 2008-10-30 2016-09-13 Synvasive Technology, Inc. System for positioning a cutting guide in knee surgery
US9622761B2 (en) 2008-10-23 2017-04-18 Synvasive Technology, Inc. Knee balancing for revision procedures
US9649119B2 (en) 2009-03-31 2017-05-16 Depuy Ireland Unlimited Company Method for performing an orthopaedic surgical procedure
US9980735B2 (en) 2008-10-30 2018-05-29 Synvasive Technology, Inc. Force sensing distal femoral alignment system and method of use
US9993354B2 (en) 2012-05-16 2018-06-12 Synvasive Technology, Inc. Sensing force during partial and total knee replacement surgery

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US8062236B2 (en) 2006-02-02 2011-11-22 Tyco Healthcare Group, Lp Method and system to determine an optimal tissue compression time to implant a surgical element
US9629626B2 (en) * 2006-02-02 2017-04-25 Covidien Lp Mechanically tuned buttress material to assist with proper formation of surgical element in diseased tissue

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