Methods and systems for planning and performing an osteotomy

Patent metadata

Field	Value
Publication number	US-9770302-B2
Application number	US-201213725706-A
Country	US
Kind code	B2
Filing date	Dec 21, 2012
Priority date	Dec 21, 2012
Publication date	Sep 26, 2017
Grant date	Sep 26, 2017

Abstract

A method for performing an open wedge osteotomy includes providing a fixation plate defining a first aperture and a second aperture and creating a first hole and a second hole in a bone. The fixation plate is coupled to the bone by aligning the first aperture of the fixation plate and the first hole of the bone and inserting a fastener through the first aperture and into the first hole. A cut is created through at least a portion of the bone to create a first resected surface and a second resected surface after creating the first hole and the second hole. The method further includes moving the first resected surface and the second resected surface relative to each other until the second aperture of the fixation plate is aligned with the second hole of the bone. The fixation plate is coupled to the bone by inserting a second fastener through the second aperture of the fixation plate and into the second hole of the bone.

First claim

What is claimed is:

1. A method for performing an open or closed wedge osteotomy using a force feedback device, comprising:
obtaining, by a processing circuit associated with a computer, a three-dimensional representation of a tibia and a femur of a knee joint of a patient;
determining, by the processing circuit associated with the computer, using the three-dimensional representation a current alignment angle of the knee joint, wherein the current alignment angle is a current angle between a line connecting a femoral head center of the femur and a medial tibial spine of the tibia and a line connecting the medial tibial spine of the tibia to a tibial-ankle center of the tibia;
wherein said lines intersect at an intersecting point at the medial tibial spine, and wherein said lines are not collinear, and wherein said current alignment angle is measured at said intersecting point between said lines;
calculating, by the processing circuit, a correction angle for the tibia or the femur of the knee joint, by correlating the current alignment angle to a desired alignment angle, wherein the desired alignment angle is a desired angle between the line connecting the femoral head center of the femur and the medial tibial spine of the tibia and the line connecting the medial tibial spine of the tibia to the tibial-ankle center of the tibia;
wherein said desired alignment angle is measured at said intersecting point between said lines, and wherein said desired alignment angle differ from said current alignment angle;
wherein the processing circuit comprises a computer-readable storage medium having instructions stored thereon, that when executed by the processing circuit cause the processing circuit to determine the current alignment angle and calculate the correction angle;
receiving, by the processing circuit, information comprising parameters related to a fixation plate, the fixation plate defining a first aperture and a second aperture:
determining, by the processing circuit, planned virtual boundaries in the three-dimensional representation of the tibia or femur, representing a first hole in the tibia or femur, a second hole in the tibia or femur, and a cut through at least a portion of the tibia or femur to create a first resected surface and a second resected surface, wherein the planned virtual boundaries are based at least in part on at least one of the parameters related to the fixation plate and the calculated correction angle, and wherein the planned virtual boundaries correspond with working boundaries of the tibia or femur in physical space;
tracking movement in the physical space of a cutting tool, by a navigation system associated with the computer, such that movement of the cutting tool in the physical space is correlated with movement of a virtual tool displayed by the processing circuit;
providing, by the processing circuit, force feedback to the cutting tool while the cutting tool creates the first hole and the second hole in the tibia or the femur, the force feedback is based on the relationship between the virtual tool and the planned virtual boundaries, to constrain the cutting tool from crossing the working boundaries;
coupling the fixation plate to the tibia or the femur by aligning the first aperture of the fixation plate and the first hole of the tibia or the femur and inserting a fastener through the first aperture and into the first hole;
providing, by the processing circuit, force feedback to the cutting tool while the cutting tool creates the cut through at least a portion of the tibia or the femur to create the first resected surface and the second resected surface after creation of the first hole and the second hole, the force feedback based on the relationship between the virtual tool and the planned virtual boundaries, to constrain the cutting tool from crossing the working boundaries; and
moving the first resected surface and the second resected surface relative to each other until the second aperture of the fixation plate is aligned with the second hole of the bone, whereby the correction angle is formed between the first resected surface and the second resected surface; and coupling the fixation plate to the bone by inserting a second fastener through the second aperture of the fixation plate and into the second hole of the bone.

2. The method of claim 1 , wherein the step of moving the first resected surface and the second resected surface relative to each other includes distracting the first and second resected surfaces away from each other.

3. The method of claim 1 , further comprising: tracking a pose of the tibia and the femur in physical space, using the navigation system.

4. The method of claim 1 , wherein the at least one parameter related to the fixation plate is a function of a distance between the first and second apertures.

5. The method of claim 1 , wherein the force feedback device is a haptic device and wherein providing force feedback comprises providing haptic feedback to a user.

Assignees

• Mako Surgical Corp

Inventors

• Kang Hyosig
• Kasodekar Snehal

Classifications

• A61B2090/3983

  Reference marker arrangements for use with image guided surgery · CPC title

• A61B2034/2055

  Optical tracking systems · CPC title

• A61B2034/108

  Computer aided selection or customisation of medical implants or cutting guides · CPC title

• A61B2034/105

  Modelling of the patient, e.g. for ligaments or bones · CPC title

• A61B34/70

  Manipulators specially adapted for use in surgery · CPC title