Method and apparatus for treating a joint, including the treatment of cam-type femoroacetabular impingement in a hip joint and pincer-type femoroacetabular impingement in a hip joint

Patent metadata

Field	Value
Publication number	US-11612402-B2
Application number	US-202117143091-A
Country	US
Kind code	B2
Filing date	Jan 6, 2021
Priority date	Nov 18, 2016
Publication date	Mar 28, 2023
Grant date	Mar 28, 2023

Abstract

A computer visual guidance system for guiding a surgeon through an arthroscopic debridement of a bony pathology, wherein the computer visual guidance system is configured to: (i) receive a 2D image of the bony pathology from a source; (ii) automatically analyze the 2D image so as to determine at least one measurement with respect to the bony pathology; (iii) automatically annotate the 2D image with at least one annotation relating to the at least one measurement determined with respect to the bony pathology so as to create an annotated 2D image; and (iv) display the annotated 2D image to the surgeon so as to guide the surgeon through the arthroscopic debridement of the bony pathology.

First claim

What is claimed is:

1. An arthroscopic visual guidance system for guiding a surgeon through an arthroscopic removal of bone, wherein the arthroscopic visual guidance system comprises an intra-operative imaging device, an electronic communication interface, a display, and at least one processor that is configured to:
(i) image the bone during a bone removal procedure using the intra-operative imaging device to produce a first intraoperative image;
(ii) automatically annotate, by the at least one processor, the intraoperative image with at least one anatomic measurement relating to the bone so as to create an annotated image;
(iii) display, by the display, the annotated image to the surgeon so as to guide the surgeon through the arthroscopic removal of the bone;
(iv) image the bone during a bone removal procedure using the intra-operative imaging device to produce a second intraoperative image showing partial removal of the bone;
(v) automatically annotate, by the processor, the second intra-operative image with at least anatomic measurement determined with respect to the bone so as to create a second annotated image; and
(vi) display, by the display, in real-time the second annotated image to the surgeon so as to guide the surgeon through the arthroscopic removal of the bone.

2. The arthroscopic visual guidance system of claim 1 , wherein the intra-operative imaging device comprises an intra-operative X-ray device.

3. The arthroscopic visual guidance system of claim 1 , wherein the arthroscopic visual guidance system is configured to be used iteratively during the arthroscopic removal of the bone.

4. The arthroscopic visual guidance system of claim 1 , wherein the at least one annotation comprises a first resection line for indicating a proposed resection of the bone.

5. The arthroscopic visual guidance system of claim 4 , wherein the at least one annotation comprises a second resection line for indicating a smooth transition between the proposed resection of the bone and an adjacent portion of bone.

6. The arthroscopic visual guidance system of claim 1 , wherein the arthroscopic visual guidance system further comprises an input device, and wherein the system is configured to:
detect, by the input device, an input from the surgeon indicating an adjustment to at least one annotation;
in response to detecting the input, generate, by the processor, a surgeon-adjusted annotated image; and
display, by the display, the surgeon-adjusted annotated image.

7. The arthroscopic visual guidance system of claim 1 , wherein the arthroscopic visual guidance system comprises a general purpose computer having input and output functionality.

8. The arthroscopic visual guidance system of claim 7 , wherein the arthroscopic visual guidance system comprises a touchscreen tablet.

9. The arthroscopic visual guidance system of claim 8 , wherein the touchscreen tablet is located in the sterile field and covered by a sterile drape.

10. The arthroscopic visual guidance system of claim 1 , wherein the arthroscopic visual guidance system is configured to guide the surgeon through the arthroscopic removal of the bone in order to treat cam-type femoroacetabular impingement.

11. The arthroscopic visual guidance system of claim 10 , wherein the bone comprises a cam pathology, and further wherein the arthroscopic visual guidance system is configured to automatically analyze, by the processor, the image so as to determine at least one measurement with respect to the cam pathology and automatically annotate the intraoperative image with at least one annotation relating to the at least one measurement determined with respect to the cam pathology.

12. The arthroscopic visual guidance system of claim 11 , wherein the at least one measurement determined with respect to the cam pathology comprises an Alpha Angle measurement, and further wherein annotating the intraoperative image with at least one annotation relating to the at least one measurement determined with respect to the cam pathology comprises adding an Alpha Angle line to the image.

13. The arthroscopic visual guidance system of claim 12 , wherein the arthroscopic visual guidance system is configured to determine the Alpha Angle measurement by: determining a line which originates at the center of the femoral head and extends through the middle of the femoral neck; determining a second line which originates at the center of the femoral head and passes through the location which signifies the start of the cam pathology; and calculating the angle between the two lines.

14. The arthroscopic visual guidance system of claim 12 , wherein annotating the image with at least one annotation relating to the at least one measurement determined with respect to the cam pathology comprises inserting a target Alpha Angle line into the image.

15. The arthroscopic visual guidance system of claim 14 , wherein the at least one annotation comprises a first resection line for indicating a proposed resection of the cam pathology and a second resection line for indicating a smooth transition between the proposed resection of the cam pathology and adjacent bone.

16. The arthroscopic visual guidance system of claim 15 , wherein the first resection line starts at the Alpha Angle line and ends at the target Alpha Angle line, and the second resection line starts at the end of the first resection line and extends down the femoral neck.

17. The arthroscopic visual guidance system of claim 1 , wherein the at least one annotation comprises:
a circle inscribing the femoral head;
a centerpoint of the circle inscribing the femoral head;
a line originating at the center of the femoral head and extending along the centerline of the femoral neck;
an Alpha Angle line originating at the center of the femoral head and passing through the location at the start of the cam pathology;
a line showing the target Alpha Angle; and
a resection curve.

18. The arthroscopic visual guidance system of claim 17 , wherein the arthroscopic visual guidance system further comprises an input device, and wherein the system is configured to:
detect, by the input device, an input from the surgeon indicating an adjustment to at least one annotation;
in response to detecting the input, generate, by the processor, a surgeon-adjusted annotated image; and
display, by the display, the surgeon-adjusted annotated image.

19. The arthroscopic visual guidance system of claim 18 , wherein the display and the input device form a touchscreen device, and further wherein the input indicating an adjustment to at least one annotation is detected on the display of the touchscreen device.

20. The arthroscopic visual guidance system of claim 1 , wherein the arthroscopic visual guidance system is configured to guide the surgeon through the arthroscopic removal of the bone in order to treat pincer-type femoroacetabular impingement.

21. The arthroscopic visual guidance system of claim 20 , wherein the bone comprises a pincer pathology, and further wherein the arthroscopic visual guidance system is configured to automatically analyze, by the processor, the image so as to determine at least one measurement with respect to the pincer pathology and automatically annotate the image with at least one annotation relating to the at least one measurement determined with respect to the pincer pathology.

22. The arthroscopic visual guidance system of claim 21 , wherein the at least one measurement determined with respect to the pincer pathology

Assignees

• Stryker Corp

Inventors

• Fouts Brian
• Woolford Brady
• Zeh Christopher

Classifications

• G06T11/00 Primary

  Two-dimensional [2D] image generation · CPC title

• G06T11/60

  Creating or editing images; Combining images with text · CPC title

• A61B2090/3966

  Radiopaque markers visible in an X-ray image · CPC title

• A61B34/20

  Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis · CPC title

• A61B2017/1602

  Mills · CPC title