Methods of accessing joints for arthroscopic procedures

Patent metadata

Field	Value
Publication number	US-11832893-B2
Application number	US-202017060892-A
Country	US
Kind code	B2
Filing date	Oct 1, 2020
Priority date	Oct 1, 2019
Publication date	Dec 5, 2023
Grant date	Dec 5, 2023

Abstract

A method of establishing access to a hip joint is disclosed. Pre-operative images of the hip joint are processed to produce a first three-dimensional model (pelvis) and a second three-dimensional model (femur). Data from the first probe and data from the second probe are collected and processed to produce a third three-dimensional model (pelvis) and a fourth three-dimensional model (femur), respectively. The first and third three-dimensional models are aligned to produce a first aligned model (pelvis), and the second and fourth three-dimensional models are aligned to produce a second aligned model (femur). A target location is determined between the first and second aligned models, and an entry vector cone is determined from the target location. A navigated guide wire is inserted along the entry vector cone to the target location.

First claim

What is claimed is:

1. A method of establishing access to a hip joint, the method comprising:
obtaining pre-operative images of the hip joint, comprising at least a portion of a pelvis and at least a portion of a femur;
generating, based on the pre-operative images, a first three-dimensional model of the hip joint;
collecting, using a first probe, three-dimensional location data for at least the portion of the pelvis;
generating, based on the three-dimensional location data, a third three-dimensional model;
collecting, using a second probe, additional three-dimensional location data for at least the portion of the femur;
generating, based on the additional three-dimensional location data, a fourth three-dimensional model;
aligning the third three-dimensional model with the first three-dimensional model to produce a first aligned model;
aligning the fourth three-dimensional model with the second three-dimensional model to produce a second aligned model;
identifying, based on the first and second aligned models, a target location;
determining, based on the target location, an entry vector cone from the target location to a surface of the hip joint; and
inserting a navigated guide wire from the surface of the hip joint along the entry vector cone to the target location.

2. The method of claim 1 , further comprising storing the first three-dimensional model and the second three-dimensional model on a server.

3. The method of claim 1 , further comprising displaying the first aligned model and the second aligned model on a display.

4. The method of claim 1 , further comprising calculating a navigation plan using the entry vector cone and the target location.

5. The method of claim 1 , further comprising displaying the entry vector cone and the target location on a display.

6. The method of claim 1 , wherein the first probe and the second probe are independently selected from the group consisting of an ultrasound probe and a surgical probe having a tracking assembly.

7. The method of claim 1 , wherein at least one of the first probe and the second probe is affixed to a robotic arm.

8. The method of claim 7 , wherein the robotic arm is selected from the group consisting of a passive robotic arm and an active robotic arm.

9. The method of claim 1 , wherein the first three-dimensional model and the second three-dimensional model each comprise a high-resolution point cloud.

10. The method of claim 1 , wherein the third three-dimensional model and the fourth three-dimensional model each comprise a point cloud having lower resolution than the first and second three-dimensional models, respectively.

11. The method of claim 1 , wherein the pre-operative images are selected from the group consisting of radiographs, magnetic resonance images, computed tomography images, and a combination thereof.

12. The method of claim 1 , wherein processing the pre-operative images comprises segmenting the pre-operative images.

13. The method of claim 12 , wherein segmenting the pre-operative images comprises using a computerized segmentation algorithm.

14. The method of claim 1 , where the portion of the pelvis comprises at least one bony landmark selected from the group consisting of an anterior superior iliac spine (ASIS), a pubic crest, a superior pubic ramus, and a combination thereof.

15. The method of claim 1 , wherein the portion of the femur comprises at least one bony landmark selected from the group consisting of a femoral neck, a greater trochanter, a proximal femoral shaft, and a combination thereof.

16. The method of claim 1 , further comprising at least one of placing the patient in a supine position, distracting the hip joint, dislocating the hip joint, applying suction to the hip joint, and fixing a position of the hip joint prior to collecting the three-dimensional location data for at least the portion of the pelvis or at least the portion of the femur.

17. The method of claim 1 , wherein inserting the guide wire further comprises displaying a trajectory of the guide wire.

18. The method of claim 17 , wherein displaying the trajectory of the guide wire comprises displaying the trajectory of the guide wire in near-real time.

19. The method of claim 1 , further comprising replacing the navigated guide wire with a portal guide wire.

20. The method of claim 1 , wherein the operations of obtaining pre-operative images, collecting three-dimensional location data for at least the portion of the pelvis, and collecting three-dimensional location data for at least the portion of the pelvis are each performed without using fluoroscopy.

Assignees

• Smith & Nephew Inc
• Smith & Nephew Asia Pacific Pte Ltd
• Smith & Nephew Orthopaedics Ag
• Smith & Nephew Asia Pacific Ple Ltd

Inventors

• Quist Brian
• Santangelo Stephen

Classifications

• A61B34/20 Primary

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

• A61B5/0035

  adapted for acquisition of images from more than one imaging mode, e.g. combining MRI and optical tomography · CPC title

• A61B5/055

  involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging · CPC title

• A61B17/025

  Joint distractors · CPC title

• A61B34/10

  Computer-aided planning, simulation or modelling of surgical operations · CPC title