CN104083182A

CN104083182A - Shaping sensor module and system for determining joint force of knee joints of patient

Info

Publication number: CN104083182A
Application number: CN201310110963.2A
Authority: CN
Inventors: J.T.舍尔曼; M.J.罗克; M.贝尔塔佐尼; M.J.***姆
Original assignee: DePuy Products Inc
Current assignee: DePuy Products Inc; DePuy Synthes Products Inc
Priority date: 2013-04-01
Filing date: 2013-04-01
Publication date: 2014-10-08

Abstract

The invention provides orthopedic equipment for determining the joint force of knee joints of a patient. The orthopedic equipment comprises a tibia plate and a handle part, wherein the tibia plate is positioned in the knee joint of the patient, and the handle part extends from the tibia plate; the tibia plate comprises a sensor array which is positioned in the tibia plate and generates sensor signals for indicating the joint force of knee joint of the patient. The orthopedic equipment further comprises a control circuit, wherein the control circuit can control a displayer positioned on the handle part so as to provide inner-side and outer-side balanced visual indication of the joint force. In some embodiments, a plurality of tibia testing parts as well as relative adapters can be coupled to the tibia plate.

Description

For determining shaping sensor assembly and the system of the kneed joint of patient power

The cross reference of related U.S. patent application

Cross reference is by Jason T.Sherman (DEP6414USNP; 265280-217043) submit on March 31st, 2012, name is called the U.S. utility patent application serial number 13/436854 of " ORTHOPAEDIC SURGICAL SYSTEM FOR DETERMINING JOINT FORCES OF A PATIENT ' S KNEE JOINT "; By Jason T.Sherman (DEP6234USNP; 265280-208915) submit on March 31st, 2012, name is called the U.S. utility patent application serial number 13/436859 of " SYSTEM AND METHOD FOR VALIDATING AN ORTHOAPEDIC SURGICAL PLAN "; Submit on March 31st, 2009 by Jason T.Sherman, name is called the U.S. utility patent application serial number 12/415,225 of " DEVICE AND METHOD FOR DISPLAYING JOINT FORCE DATA "; Submit on March 31st, 2009 by Mick Rock, name is called the U.S. utility patent application serial number 12/415,290 of " METHOD FOR PERFORMING AN ORTHOPAEDIC SURGICAL PROCEDURE "; Submit on March 31st, 2009 by Jason T.Sherman, name is called the U.S. utility patent application serial number 12/415,172 of " DEVICE AND METHOD FOR DETERMINING FORCES OF A PATIENT ' S JOINT "; Submit on March 31st, 2009 by Jason Sherman, name is called the U.S. utility patent application serial number 12/415,365 of " SYSTEM AND METHOD FOR DISPLAYING JOINT FORCE DATA "; And submit on March 31st, 2009 by Jason T.Sherman, name is called the U.S. utility patent application serial number 12/415,350 of " DEVICE AND METHOD FOR DETERMINING FORCES OF A PATIENT ' S KNEE JOINT "; Described patent separately entirety is integrated with herein by reference.

Technical field

The present invention relates generally to plastic surgery's apparatus, more particularly, relates to system, equipment and the method determining and show joint force data.

Background technology

Plastic surgeon by cosmetic prosthesis patients with implantation body for example to correct or skeleton and/or soft tissue loss, wound and/or the textured bone of reduction of patient.Cosmetic prosthesis can be replaced a part or the whole joint in patient joint.For example, cosmetic prosthesis can be replaced patient's knee joint, buttocks, shoulder, ankle or other joints.The in the situation that of knee prosthesis, shaping knee-joint prosthesis can comprise tibia support, femoral component and be positioned at tibia support and femoral component between polymer plug-in unit or bearing.In some cases, knee-joint prosthesis can also comprise patellar prosthesis parts, and it is fixed to patient and carries out the patella rear side that operation is prepared.

In plastic surgery operations, first surgeon prepares patient's skeleton to hold cosmetic prosthesis.For example, the in the situation that of knee prosthesis plastic surgery operations, surgeon can excise tibia support by a part for attached patient's proximal tibia, femoral component by a part for attached patient's distal femur, and/or patella parts are by a part for attached patient's patella.In this type of operation, surgeon can attempt balance or distribute joint power joint motions with the kinematic similitude of natural joint with generation in patient joint.For this reason, surgeon can utilize surgical experience and use the applicable joint dynamic balance of hands " impression ".In addition or alternatively, plastic surgeon can use surgical instruments (for example, using balancer for ligaments in replacement knee in arthroplasty) to assist balance or distribute joint power.

In addition, in some surgical operations of for example Wicresoft's plastic operation and so on, the ability that surgeon can rely on Computer assisted surgery (CAOS) system to improve surgeon to observe operative region, thereby improve the alignment of skeleton facet, and improve the repeatability of this type of facet.Computer assisted surgery system, by the image of the surgical procedure of carrying out and the rendering image of patient's associated bone are for example shown, assists surgeon to carry out plastic surgery operations.In addition, Computer assisted surgery (CAOS) system is by following the tracks of and showing that the position of patient's skeleton, implant and/or surgical technique and tools provides surgical navigation.

Summary of the invention

According to an aspect, the orthopedic device that is used for the joint power of measuring patient joint can comprise the tibial plate being shaped between proximal tibia and the distal femur that is positioned at patient, be positioned at the sensor array in tibial plate, be fixed to the elongate shaft portion of tibial plate and restriction longitudinal axis, described longitudinal axis departs from the front side of tibial plate to the second-class split axle of rear side, be fixed to the first display away from the shank end of tibial plate, and be positioned at the circuit in shank.Tibial plate can have substantially smooth upper surface and smooth lower surface substantially.Sensor array can be configured to generate the sensor signal of the joint power of instruction between patient's tibia and femur.In certain embodiments, sensor array can comprise the multiple outsides-front side senser of outside-front side force component of the multiple inner sides-front side senser of inner side-front side force component of measuring joint power, multiple inner sides-rear side senser of measuring inner side-posterior forces component of joint power, measurement joint power and the multiple outsides-rear side senser of outside-posterior forces component of measurement joint power.In addition, in certain embodiments, each in inner side-front side senser and outside-front side senser can have substantially equal surface area, and each in inner side-rear side senser and outside-rear side senser has substantially equal surface area.Circuit can be configured to receive from the sensor signal of sensor array, and controls display so that the vision instruction of medial-lateral balance of joint power to be provided.

In certain embodiments, tibial plate can comprise the plate top enclosure with the first medial wall that limits the first center positioning hole, and has the plate bottom enclosure of the second medial wall that limits the second center positioning hole.In this type of embodiment, the first hole and the second hole can fluid communication with each other, partly to limit with respect to the upper surface of tibial plate and lower surface by the Vertical Channel of tibial plate.In addition, in this type of embodiment, sensor array can comprise center positioning hole, and it further limits by the Vertical Channel of tibial plate.

Some embodiment, sensor array can comprise multiple capacitive pressure transducers.In addition, sensor array can comprise inner sensors group and outer sensors group.In this type of embodiment, each in inner sensors group and outer sensors group can by the most front side senser, last side senser and be positioned at the most front corresponding side senser and last side senser between four additional sensors form.In addition, in certain embodiments, the surface area of each in inner side-front side and outside-front side senser is less than each the surface area in inner side-rear side and outside-rear side senser.For example, in a specific embodiment, each in inner side-front side and outside-front side senser has and equals approximately 0.174 inch ²surface area, and each in inner side-rear side and outside-rear side has and equals approximately 0.187 inch ²surface area.In another specific embodiment, each in inner side-front side and outside-front side senser has and equals approximately 0.243 inch ²surface area, and each in inner side-rear side and outside-rear side has and equals approximately 0.263 inch ²surface area.

In certain embodiments, orthopedic device also can comprise the second display being fixed to away from the elongate shaft portion end of tibial plate.In this type of embodiment, elongate shaft portion can comprise shank top enclosure and shank bottom enclosure.Shank top and shank bottom enclosure can be coupled to each other, make the inner surface of shank top enclosure towards the corresponding inner surface of shank bottom enclosure.In addition, the first display can be fixed to the end of shank top enclosure, and second display can be fixed to the end of shank bottom enclosure.

In addition, in certain embodiments, the first display can comprise multiple light emitting diodes, and circuit can be configured to the total power value in inner side of the inner side component of (i) definite instruction joint power, (ii) the total power value in outside of the outside component of definite instruction joint power, and (iii) so that the multiple light emitting diodes of mode control of the medial-lateral balance of indicating joint power to be provided.In addition, circuit can be configured to control multiple light emitting diodes, to show at least nine illumination arrangement of separating corresponding to nine medial-lateral range of balance that separate.Circuit also can be configured to add up to the total power value in inner side and the total power value in outside, to determine total power value, determine inner side percent value according to the total power value in inner side and total power value, determine outside percent value according to the total power value in outside and total power value, and according to inner side percent value and outside percent value, so that the multiple light emitting diodes of mode control of the medial-lateral balance of indicating joint power to be provided.

In certain embodiments, circuit can comprise the wireless transmitter that is configured to the joint force data between transmission instruction patient's tibia and femur.In addition, in certain embodiments, circuit can comprise power supply and user control, and described user control is operable so that circuit is placed in to on-state from off state.In this type of embodiment, circuit can be configured to from off state is placed in on-state, keeping on-state, until power supply exhausts.

According to another aspect, the sensor assembly of measuring the joint power in patient joint can comprise upper case and lower case.Upper case can comprise shank upper case and tibial plate upper case.Similarly, lower case can comprise shank lower case and tibial plate lower case.Lower case can be coupled to upper case, makes the inner surface of lower case towards the corresponding inner surface of upper case.Sensor assembly also can comprise the sensor array being positioned between tibial plate lower case and tibial plate upper case.Sensor array can be configured to generate the sensor signal of the joint power of instruction between patient's tibia and femur.Sensor array can comprise the multiple front side senser of the front side force component of measuring joint power and measure the multiple rear side senser of the posterior forces component of joint power.Each in rear side senser can have each the surface area being greater than in front side senser.

Sensor assembly also can comprise the first display that is fixed to shank upper case and the second display that is fixed to shank lower case.In addition, sensor assembly can comprise the circuit being positioned between shank upper case and shank lower case.Circuit can be configured to receive from the sensor signal of sensor array and control the first display and second display illuminates with one in multiple illumination arrangement.Each illumination arrangement can corresponding joint power the separately scope of medial-lateral balance.

In certain embodiments, tibia upper case and tibia lower case can comprise the medial wall that limits center positioning hole separately.In the time that upper case is coupled to lower case, passage can be cooperated to limit in the medial wall of tibia upper case and lower case.In addition, in certain embodiments, sensor array comprises inner sensors group and outer sensors group.Each in inner sensors group and outer sensors group can comprise the most front side senser, last side senser and be positioned at the most front corresponding side senser and last side senser between four additional sensors.

In addition, in certain embodiments, circuit can be configured to control the first display and second display, to show at least nine illumination arrangement of separating.Each illumination arrangement can corresponding joint power the separately scope of medial-lateral balance.In certain embodiments, circuit also can comprise the wireless transmitter that is configured to the joint force data between transmission instruction patient's tibia and femur.In addition, in certain embodiments, circuit can comprise power supply and user control, and described user control is operable so that circuit is placed in to on-state from off state.In this type of embodiment, circuit can be configured to from off state is placed in on-state, keeping on-state, until power supply exhausts.

According to further aspect, can comprise sensor assembly and hand-held display module for the orthopedic systems of the joint power of measuring patient joint.Sensor assembly can comprise tibial plate, is positioned at the sensor array in tibial plate, is fixed to the elongate shaft portion of tibial plate, is fixed to the first display of shank, and is positioned at the sensor module circuitry in shank.Tibial plate may be molded between the proximal tibia and distal femur that is positioned at patient.In addition, tibial plate can have substantially smooth upper surface and smooth lower surface substantially, and comprises and limiting with respect to upper surface and lower surface by the medial wall of the Vertical Channel of tibial plate.Sensor array can be configured to generate the sensor signal of the joint power of instruction between patient's tibia and femur.Sensor array can comprise the multiple outsides-front side senser of outside-front side force component of the multiple inner sides-front side senser of inner side-front side force component of measuring joint power, multiple inner sides-rear side senser of measuring inner side-posterior forces component of joint power, measurement joint power and the multiple outsides-rear side senser of outside-posterior forces component of measurement joint power.In this type of embodiment, each in inner side-front side senser and outside-front side senser can have substantially equal surface area, and each in inner side-rear side senser and outside-rear side senser can have substantially equal surface area.Sensor module circuitry can be configured to receive from the sensor signal of sensor array, controls display so that the vision instruction of medial-lateral balance of joint power to be provided, and the joint force data of transmission instruction joint power.

Hand-held display module can comprise size set for can be portable shell, be coupled to the display of shell and be positioned at the control circuit in shell.Control circuit can be configured to receive the joint force data from sensor assembly, and on the display of hand-held display module, shows the vision instruction of the medial-lateral balance of joint power.In certain embodiments, the control circuit of hand-held display module can be configured to reveal competence bar on the display of hand-held display module, and on horizontal bar display icon.Picture mark position on horizontal bar can be indicated the medial-lateral balance of joint power.In addition, in certain embodiments, the control circuit of hand-held display module can be configured to determine the medial-lateral balance of instruction joint power and the joint power value of front side-rear lateral balance, and shows vision instruction on the display of medial-lateral balance based on Li Zhi joint, joint power and front side-rear lateral balance.In addition, the control circuit of hand-held display module can be configured to show bar on display.Bar can have corresponding to the first end of inner side with corresponding to second end in outside.So, control circuit can be configured to the first end and second end of the front side-rear lateral balance positioning strip based on joint power.

Brief description of the drawings

Be elaborated with reference to the following drawings especially, wherein:

Fig. 1 is the simplicity of illustration of measuring and show an embodiment of the system of the joint force data in patient joint;

Fig. 2 is the perspective view of an embodiment of the sensor assembly of system in Fig. 1;

Fig. 3 is the top side plan view of sensor assembly in Fig. 2;

Fig. 4 is the bottom side plan view of sensor assembly in Fig. 2;

Fig. 5 is the decomposition diagram of sensor assembly in Fig. 2;

Fig. 6 is the front view of the handle end of sensor assembly in Fig. 2;

Fig. 7 is the chart of an embodiment of the illumination arrangement displaying scheme of the display of sensor assembly in Fig. 2;

Fig. 8 is the simplicity of illustration of an embodiment of the sensor array of sensor assembly in Fig. 2;

Fig. 9 is the simplified block diagram of an embodiment of the circuit of sensor assembly in Fig. 2;

Figure 10 is the simplified flow chart of determining and show an embodiment of the method for the joint force data that can be carried out by sensor assembly in Fig. 2;

Figure 11 is the simplified flow chart that shows an embodiment of the method for the associated joint force data that can be carried out by sensor assembly in Fig. 2;

Figure 12 is the perspective view of an embodiment of the display module of system in Fig. 1;

Figure 13 is the plane graph of display module in Figure 12;

Figure 14 is the simplified block diagram of an embodiment of the circuit of display module in Figure 12;

Figure 15 is the simplified flow chart that shows an embodiment of the method for the associated joint force data that can be carried out by display module in Figure 12;

Figure 16-18 are the exemplary screen shot that can show to user on display module in Figure 12;

Figure 19 is the perspective view that uses an embodiment of the pilot system of sensor assembly in Fig. 2;

Figure 20 A-20E is the perspective view of the adapter of system in Figure 19;

Figure 21 is the perspective view that is coupled to adapter in the Figure 20 of sensor assembly in Fig. 2;

Figure 22 is the cutaway view of adapter and sensor assembly in Figure 21;

Figure 23 is the top plan view that is coupled to spacer block in the Figure 19 of sensor assembly and adapter in Figure 21 with non-rotating orientation;

Figure 24 rotates the top plan view that orientation is coupled to sensor assembly and adapter in Figure 21 and rotates to spacer block in Figure 23 of maximum position of rotation;

Figure 25 rotates orientation to be coupled to sensor assembly and adapter in Figure 21 and to rotate to the top plan view with respect to spacer block in Figure 23 of the contrary maximum position of rotation of Figure 24;

Figure 26 is the bottom plan view with activity tibial trial product in the Figure 19 that rotates keyhole;

Figure 27 is the bottom plan view with the fixed tibial trial target of non-rotating keyhole;

Figure 28 is the simplified block diagram of an embodiment of the Computer Aided Surgery system of system in Fig. 1;

Figure 29 is the simplified flow chart that uses an embodiment of the method for the Computer Aided Surgery system execution plastic surgery operations in Figure 28;

Figure 30 is definite and demonstration can be by the simplified flow chart of an embodiment of the navigation of Computer Aided Surgery system execution in Figure 28 and the method for joint force data;

Figure 31 is definite and demonstration can be by the simplified flow chart of the angle of bend in patient joint of Computer Aided Surgery system execution in Figure 28 and an embodiment of the method for force data;

Figure 32 is the simplified flow chart that uses an embodiment of the method for the system execution plastic surgery operations in Fig. 1;

Figure 33 is the perspective view that uses the patient joint of stretching in the plastic surgery operations of the sensor assembly in Fig. 2;

Figure 34 is the perspective view that uses patient joint in the plastic surgery operations of traction apparatus in Fig. 1 and sensor assembly;

Figure 35 is another perspective view that uses patient joint bending in the plastic surgery operations of the sensor assembly in Fig. 2;

Figure 36 is another perspective view that uses the patient joint of stretching in the plastic surgery operations of the sensor assembly in Fig. 2; And

Figure 37 is another perspective view that uses patient joint bending in the plastic surgery operations of the sensor assembly in Fig. 2.

Detailed description of the invention

Although concept of the present disclosure is easy to have various modification and alternative form, concrete exemplary embodiment of the present invention illustrates by way of example in the accompanying drawings, and will describe in detail in this article.But should be appreciated that herein and unintentionally concept of the present invention is restricted to disclosed concrete form, but contrary, its object is to contain all modifications form, equivalents and the alternative form in the spirit and scope of the invention that claims limit.

In the disclosure about shaping implant as herein described and patient's natural anatomic part has used the term that represents anatomy reference, such as front side, rear side, inner side, outside, upper and lower etc.These terms all have known implication in anatomy and field of orthopedic surgery.Except as otherwise noted, otherwise this type of anatomical reference term using in description and claim is intended to meet its known implication.

Referring now to Fig. 1,, in one embodiment, determine and show that the system 10 of the joint power in patient joint in plastic surgery operations comprises sensor assembly 12 and hand-held display module 14.In certain embodiments, as discussed below, system 10 also can comprise joint traction apparatus 16, and it is configured to hold sensor assembly 12.In addition, in certain embodiments, system 10 can comprise Computer Aided Surgery (CAOS) system 18.As below more detailed discussion, sensor assembly 12 can be configured to insert in patient's knee joint, and the vision instruction of the medial-lateral balance of knee joint power is provided to plastic surgeon.Sensor assembly 12 also can be configured to joint force data to be transferred to hand-held display module 14 and/or to be transferred to Computer Aided Surgery system 18 by wireless communication line 22 by wireless communication line 20.Correspondingly, display module 14 and/or Computer Aided Surgery system 18 can be configured to by joint force data or by its derivative data show to plastic surgeon.In addition, for example, during carrying out plastic surgery operations (wholly or in part), sensor assembly 12 can be coupled to joint traction apparatus 16, to provide the vision of the joint power in patient joint to indicate during traction patient joint.

Referring now to Fig. 2-11,, sensor assembly 12 comprises sensor outer housing 30 and is coupled to the elongate shaft portion 32 of sensor outer housing 30.The size of sensor outer housing 30 is set for and is shaped in the joint that is positioned at patient.In the exemplary embodiment, sensor outer housing 30 is specially tibial plate 34, and it is configured as and can be positioned in patient joint.But in other embodiments, sensor outer housing 30 can be configured to use with together with other joints of patient.

In use, tibial plate 34 be configured to be positioned on the near-end platform of the cut tibia of patient (referring to, as Figure 33-37).As below more detailed discussion, tibial plate 34 can be placed on the position of contact patient tibia, also can be placed between two parties on platform or other members.In addition, as below more detailed discussion, tibial plate 34 is designed to use together with adapter 502 (referring to Figure 19) and multiple other plastic surgery's apparatuses, comprises spacer block, static organ/screening apparatus, shaping trial target and/or test assembly.

Sensor assembly 12 can be in patient's left knee joint or right above-knee use.For example, sensor assembly 12 can be by inner side surgical method in the left above-knee use of patient, and in the method, tibial plate 34 is inserted the left knee joint of patient by inner side capsule otch.In such cases, as discussed below, shank 32 extends to outside the capsule otch of inner side.Alternatively, by upset or rotation simply on sensor assembly 12, module 12 can be by outside surgical method in the left above-knee use of patient, and in the method, tibial plate 34 is inserted the left knee joint of patient by outside capsule otch.Equally, in such cases, shank 32 extends to outside the capsule otch of outside.

So, should be appreciated that and can use inner side or outside surgical method at the left knee joint of patient or right above-knee use sensor assembly 12.In order to be more clearly described, the plastic surgery who is below combined with inner side surgical method (using inner side capsule otch to enter patient joint) describes sensor assembly 12 and system 10.But, should be appreciated that this class description is equally applicable to the operation of outside surgical method.So, use concrete anatomy with reference to (as outside and inner side), some structure to be described, and should be appreciated that in module 12 and during for the operation of outside surgical method, can overturn or change this type of reference.For example, in the time of the operation for outside surgical method, " inner side " of tibial plate 34 becomes " outside " of tibial plate 34.

Tibial plate 34 is smooth or substantially smooth, and the general correspondence of the shape having is treated the cosmetic prosthesis shape in patients with implantation body.For example, in the exemplary embodiment, the shape of tibial plate 34 is the knee prostheses of corresponding concrete size roughly.But in other embodiments, plate 34 (or sensor outer housing 30) can have general corresponding to for example shape of the other types cosmetic prosthesis of buttocks prosthese, shoulder prosthesis, ankle prosthese, spinal prostheses or patellar prosthesis.

Exemplary tibial plate 34 comprises bending front side 36, bending outside 38, bending inner side 40 and bending rear side 42, and wherein each is all shaped to the shape of the tibia bearing that approaches shaping knee prostheses.Equally, as discussed above, the embodiment at sensor assembly 12 for the operation of outside surgical method, outside 38 and inner side 40 are respectively outside and inner side.Rear side 42 comprises that rear side recess 43 for example, with the soft tissue (rear side ligamentum cruciatum) that allows tibial plate 34 and be positioned at patient joint around.

Tibial plate 34 comprises medial wall 44, and this medial wall limits by vertical hole or the passage 45 of tibial plate 34.Hole 45 is centrally located in tibial plate 34, and as below more detailed discussion, by molding and be configured to hold adapter 502 (referring to Figure 19), for multiple tibial trial product and test assembly are attached to sensor assembly 12.Referring below to the more detailed discussion of Figure 22, medial wall 44 comprises the part 47 of inside angulation, to promote the attached of adapter 502 or to remove.

Tibial plate 34 also comprises front side aligned hole 46 and rear side aligned hole 48.Front side aligned hole 46 is positioned at the front side (, towards bending front side 36) in hole 45, and rear side aligned hole 48 is positioned at the rear side (, towards rear side recess 43) in hole 45.Aligned hole 46,48 curves inwardly and generally along putting with the concentric circular pendulum in hole 45 in transverse plane (plane, being limited by tibial plate 34).Exemplarily, aligned hole the 46, the 48th, " key entry ", has front side aligned hole 46 to be greater than the width (, inner side is to outside width) of rear side aligned hole 48.As below more detailed discussion, " key entry " of aligned hole 46,48 allows adapter 502 or other apparatuses or equipment to be coupled to sensor assembly 12 with predetermined orientation.Certainly, be to be understood that other features and/or structure can be used in other embodiments, be coupled to provide with " key entry " of sensor assembly 12.For example, in other embodiments, rear side aligned hole 48 can have the width that is greater than front side aligned hole 46, can use locating hole in addition or still less, can use locating hole and/or the analog with difference " key entry " shape.

In certain embodiments, tibial plate 34 can comprise that front side is to rear side shaft labelling 41, for example track, and it provides the front side of tibial plate 34 to the vision instruction of the second-class split axle 59 of rear side.In use, plastic surgeon or other health cares supplier can usage flag 41 help the tibial plate 34 of aliging in patient's knee joint.In addition, in certain embodiments, tibial plate 34 can comprise adapter labelling 49, for example track, and in the time being coupled to the tibial plate 34 of sensor assembly 12, it provides the vision instruction of the appropriate location of adapter 502.

Can select according to patient's concrete anatomical structure the overall dimension of tibial plate 34.For example, in certain embodiments, can provide the tibial plate 34 of sizes to be applicable to the patient of different statures.Be to be understood that, overall shape and the size of design and option board 34 (with sensor outer housing 30), so that plate 34 or shell 30 are not significantly dangled with respect to patient's related bone anatomical structure, and make plate 34 or shell 30 Ye Buhuidui surrounding soft tissues cause negative effect.

Shank 32 comprises a pair of display 50,52 of the far-end 54 that is coupled to shank 32.Another end 56 of shank 32 relative far-ends 54 is coupled to tibial plate 34.In the exemplary embodiment of Fig. 2, shank 32 and tibial plate 34 are substantially overall in structure.But in other embodiments, tibial plate 34 can removably be coupled to shank 32 by suitable bonder or analog.

As shown in Figures 3 and 4, elongate shaft portion 32 is extended from the side of tibial plate 34 and restriction departs from the front side of tibial plate 34 to the longitudinal axis 57 of the second-class split axle 59 of rear side, and the angle 55 that is greater than 0 degree is limited between axis 57,59.In the exemplary embodiment, shank 32 (use sensor assembly 12 the operation of outside surgical method time, it is outside) extension from inner side 40.Should be appreciated that because extend the side of shank 32 slave plates 34, therefore tibial plate 34 can be positioned in patient's knee joint and without making patient's SLP or turning up.That is to say, can, in the situation that making patient's patella keep natural place, tibial plate 34 be correctly positioned between patient's proximal tibia and distal femur.

According to plastic surgeon, by the concrete surgical method using, surgeon can turn to suitable orientation by sensor assembly 12, and tibial plate 34 is inserted in patient's knee joint by relevant capsule otch.In arbitrary orientation, shank 32 all extends to outside capsule otch, and at least one in display 50,52 is visible to plastic surgeon.For example, if plastic surgeon uses inner side surgical method at the left knee joint of patient, plastic surgeon can be by the sensor assembly of orientation positions shown in Fig. 3 12, with after making tibial plate 34 insert knee joint and when display 50 is visible to surgeon, shank 32 extends from the inner side (by inner side capsule otch) of patient's knee joint.Alternatively, if plastic surgeon uses outside surgical method at the left knee joint of patient, plastic surgeon can be by the sensor assembly of orientation positions shown in Fig. 4 12, with after making tibial plate 34 insert knee joint and when display 52 is visible to surgeon, shank 32 extends from the outside (by outside capsule otch) of patient's knee joint.

As discussed above, sensor assembly 12 is configured to, during carrying out plastic surgery operations, surgeon is played to assosting effect.So, sensor assembly 12 comprises the shell 58 of being made up of biocompatible material.For example, shell 58 can be made up of biocompatible plastic or polymer.In a specific embodiment, sensor assembly 12 is configured to disposable, so, provides with sterile form.For example, can provide sensor assembly 12 with aseptic packaging.But, be removably coupled in the embodiment of shank 32 in tibial plate 34, tibial plate 34 can be designed to disposablely, and shank 32 can be able to be configured to by autoclaving steps or similar step reusable.

As shown in Figure 5, the shell 58 of sensor assembly 12 comprises upper case coupled to each other 60 and lower case 62.In certain embodiments, upper case 60 and lower case 62 are mirror image each other.Upper case 60 comprises inner surface 61, in the time that shell 60,62 is coupled to each other, described inner surface in the face of or the inner surface 63 of the shell 62 that in other words faces toward.In addition, upper case 60 comprises tibial plate upper case 64 and shank upper case 66.Similarly, lower case 62 comprises tibial plate lower case 68 and shank lower case 70.Tibial plate upper case 64 has smooth or smooth outer surface 65 substantially, and comprises the medial wall 72 that partly limits the vertical hole 45 that extends through tibial plate 34.Similarly, tibial plate lower case 68 has smooth or smooth outer surface 69 substantially, and comprises the medial wall 74 that partly limits vertical hole 45.

Display 50 is coupled to the far-end 54 of upper case 60, and display 52 is coupled to the far-end 54 of lower case 62.As shown in Figure 6, each in display 50,52 is exemplarily specially a line light emitting diode or light emitting diode matrix.But in other embodiments, display 50,52 can be specially the other types display of for example liquid crystal display, segment displays and/or similar display.In the exemplary embodiment of Fig. 6, each in display 50,52 comprises five light emitting diodes that separate 80,82,84,86,88.As below more detailed discussion, in the time that the kneed medial-lateral of patient joint power is roughly equal, center light emitting diode 84 illuminates.In addition, in the time that joint, the kneed inner side of patient power is greater than joint, outside power predetermined threshold amount, light emitting diode 80 and/or 82 illuminates, in the time that joint, the kneed outside of patient power is greater than joint, inner side power predetermined threshold amount, light emitting diode 86 and 88 illuminates (same supposition adopts inner side surgical method).As shown in Figure 6, the light emitting diode 80,82,84,86,88 of display 50,52 is arranged so that the inner side 40 of light emitting diode 80,82 corresponding to tibial plate 34, light emitting diode 86,88 is corresponding to the outside 38 of tibial plate 34, and regardless of being orientated (no matter being, that upper case 60 or lower case 62 face up).

As below more detailed discussion, light emitting diode 80,82,84,86,88 can illuminate with one in multiple illumination arrangement according to predetermined displaying scheme, thereby indicates for surgeon provides the vision of relevant medial-lateral joint dynamic balance.By activating or illuminating one or more in light emitting diode 80,82,84,86,88, plastic surgeon can visually determine which side in patient joint is applied to larger power, and this power is with respect to the general magnitude of patient's knee joint opposite side.For example, an exemplary displaying scheme is rendered as the chart 170 in Fig. 7, and it comprises nine illumination arrangement of separating.According to exemplary displaying scheme 170, if side thrust component between 85%-100%, and outside forces component is between 0%-15%, so only light emitting diode 80 illuminates.But, if side thrust component between 75%-84%, and outside forces component is between 16%-25%, light emitting diode 80 and 82 all illuminates so.If side thrust component is between 65%-74%, and outside forces component is between 26%-35%, so only light emitting diode 82 illuminates.If side thrust component is between 55%-64%, and outside forces component is between 36%-45%, light emitting diode 82 and 84 all illuminates so.If side thrust component is between 46%-54%, and outside forces component is between 46%-54%, so only light emitting diode 84 illuminates, the balance of the relative equality of this instruction inner side and outside forces.If side thrust component is between 36%-45%, and outside forces component is between 55%-64%, light emitting diode 84 and 86 all illuminates so.If side thrust component is between 26%-35%, and outside forces component is between 65%-74%, so only light emitting diode 86 illuminates.If side thrust component is between 26%-35%, and outside forces component is between 75%-84%, light emitting diode 86 and 88 all illuminates so.And, if side thrust component between 0%-15%, and outside forces component is between 85%-100%, so only light emitting diode 88 illuminates.The vision instruction of relative inner-outside joint balance of the joint power of patient's knee is provided for plastic surgeon by this way.Certainly, in other embodiments, can control and put bright display 50,52 with other displaying schemes.

Sensor assembly 12 comprise be positioned in tibial plate 34 and with the sensor array 90 that is positioned at control circuit 92 communicative couplings in shank 32.Sensor array 90 " folder " is between upper case sheet 60 and lower case sheet 62, and comprise the hole 91 of centralized positioning, in the time that the upper case 60 of the shell 58 of sensor assembly 12 and lower case 62 are coupled, vertically hole or passage 45 extend through the hole 91 of described centralized positioning.In the time that the upper case 60 of the shell 58 of sensor assembly 12 and lower case 62 are coupled, front side aligned hole 46 and rear side aligned hole 48 also extend through hole 91.Upper case 60 and lower case 62 are to separate on space, to allow sensor array 90 to be applied to the joint force compresses of tibial plate 34.For example, as shown in Figure 6, upper case 64 comprises outward flange 94, and lower case 66 comprises outward flange 96, and it spatially separates by distance 98 and outward flange 94 of upper case 64.In the time that tibial plate 34 is applied to joint power, along with sensor 90 is compressed, outward flange 94,96 moves towards each other.

Sensor array 90 comprises the multiple pressure transducers or the sensor element 100 that are configured to generate the sensor signal of indicating the joint power that is applied to sensor array 90.In the exemplary embodiment, pressure transducer 100 is specially capacitive pressure transducer, but can be specially in other embodiments the sensor of other types.The pressure transducer 100 of sensor array 90 can concrete configuration be arranged.For example, in an embodiment as shown in Figure 8, sensor array 90 comprise be configured to inner side-front side component of measuring joint power one group of inner side-front side senser 180, be configured to outside-front side component of measuring joint power one group of outside-front side senser 182, be configured to one group of inner side-rear side senser 184 of inner side-rear side component of measuring joint power and be configured to one group of outside-rear side senser 186 of outside-rear side component of measuring joint power.Exemplarily, the sensor 106 that inner side-front side senser group 180 comprises the most front side senser 102, locates and locate towards the inner side 190 of sensor array 90 at the most front side senser 102 rear sides and towards the sensor 104 of sensor array 90 centralized positionings with at the most front side senser 102 rear sides.The sensor 112 that outside-front side senser group 182 comprises the most front side senser 108, locates and locate towards the outside 192 of sensor array 90 at the most front side senser 108 rear sides and towards the sensor 110 of sensor array 90 centralized positionings with at the most front side senser 108 rear sides.Inner side-rear side senser group 184 comprises last side senser 114, side senser 114 rear sides and towards the sensor 116 of sensor array 90 centralized positionings and in the end side senser 114 rear sides location and the sensor 118 of locating towards the inner side 190 of sensor array 90 in the end.Outside-rear side senser group 186 comprises last side senser 120, side senser 120 rear sides and towards the sensor 122 of sensor array 90 centralized positionings and in the end side senser 120 rear sides location and the sensor 124 of locating towards the outside 192 of sensor array 90 in the end.

Inner side-front side senser group 180 and outside-front side senser group 182 forms side senser 194 before a group, and inner side-rear side senser group 184 and side senser 195 after outside-rear side senser group 186 forms a group.Similarly, inner side-front side senser group 180 and inner side-rear side senser group 184 forms one group of inner sensors 196, and outside-front side senser group 182 and outside-rear side senser group 186 form one group of outer sensors 197.In the exemplary embodiment of Fig. 8, each in inner side-front side senser 180 has and equates with each the surface area in outside-front side senser 182 or equal surface area substantially.Similarly, each in inner side-rear side senser 184 has and equates with the surface area of outside-rear side senser 186 or equal surface area substantially.In addition, in certain embodiments, each in front side senser 194 has each the surface area being less than in rear side senser 195.For example, in a specific embodiment, each in front side senser 194 has and equals approximately 0.174 inch ²surface area, and each in rear side senser 195 has and equals approximately 0.187 inch ²surface area.In addition, in another specific embodiment, each in front side senser 194 has and equals approximately 0.243 inch ²surface area, and each in rear side senser 195 has and equals approximately 0.263 inch ²surface area.Certainly, in other embodiments, sensor array 90 can comprise sensor or the sensing element that add or still less with similar or different size, location and/or orientation.

Referring now to Fig. 9,, control circuit 92 comprises processor 130 and memory device 132.Processor 130 can be specially any type processor that is configured to carry out function described herein.For example, processor 130 can be specially the set of integrated circuit or the electronic device of separation.In addition, processor can be monokaryon or polycaryon processor.Although only show a processor 130 in Figure 10, should be appreciated that in other embodiments, control circuit 92 can comprise the Attached Processor of any amount.Memory device 132 can be specially one or more read only memory devices and/or direct access storage device.For example, memory device 132 can be specially or comprise electrically erasable read only memory devices (EEPROM), dynamic random access memory device (DRAM), synchronous dynamic random-access memory device (SDRAM), double data rate dynamic random access memory device (DDR SDRAM) and/or other volatibility or non-volatile memory device.In addition, although only show a memory device in Fig. 9, in other embodiments, control circuit 92 can comprise additional memory device.

Processor 130 is by signal path 134 and memory device 132 communicative couplings.Signal path 134 can be specially the signal path that is configured to promote any type of communicating by letter between processor 130 and memory device 132.For example, signal path 134 can be specially the wire rod, printed circuit board wiring, conductive hole, bus of any amount, device and/or analog between two parties.Processor 130 is also by signal path 136 and sensor array 90 communicative couplings.Similar with signal path 134, signal path 136 can be specially the signal path that is configured to promote any type of communicating by letter between processor 130 and sensor array 90, comprises the wire rod, printed circuit board wiring, conductive hole, bus of for example any amount, device and/or analog between two parties.In addition, signal path 136 can comprise the bonder 138 (referring to Fig. 5) that is configured to the plug end 140 of holding sensor array 90.

Control circuit 92 also comprises power supply 142 and line related control circuit 144.Power supply 142 can be specially size and set the many batteries that are engaged in sensor assembly 12 for.Power supply 142 is by signal path 146 and power control circuit 144 electric coupling, and power control circuit 144 is by his equipment electric coupling of signal path 148 and processor 130 and control circuit 92.Signal path 146,148 can be specially the signal path of any type, comprises the wire rod, printed circuit board wiring, conductive hole, bus of for example any amount, device and/or analog between two parties.Power circuit 144 can comprise power supply control, distribution and filtering circuit, and is configured to provide or distribute other devices or the parts of electric power to processor 130 and control circuit 92 from power supply 142.As below more detailed discussion, power circuit 144 can be configured to beaten " opening " afterwards and until power supply 142 power continuously to processor 130 and the miscellaneous part of control circuit 92 while exhausting., in certain embodiments, at first, by after module 12 dozens " opening ", user can not close " closing " sensor assembly 12.This type of is functional for example guarantees that sensor assembly 12 can not re-use in subsequent surgical operation.

Control circuit 92 also comprises the user control 150 with processor 130 communicative couplings by signal path 152.User control 150 is specially and is positioned on display 50,52 and can selects the power knob 154 (referring to Fig. 6) that sensor assembly 12 is opened by user.But in the exemplary embodiment, control circuit 92 is configured to after sensor assembly 12 is opened, and prevents or limits user by the ability of power knob 154 or other control closure sensor modules 12.That is to say, be configured to be held open state once control circuit 92 is opened, until the electric weight of power supply 142 exhausts.This type of configuration can guarantee that sensor assembly 12 is for single plastic surgery operations, and cannot in Repeated Operation, reuse.

Signal path 152 is similar with signal path 134, the signal path that is configured to promote any type of communicating by letter between user control 150 and processor 130 be can be specially, the wire rod, printed circuit board wiring, conductive hole, bus of for example any amount, device and/or analog between two parties comprised.

Control circuit 92 also comprises that display circuit 156 is for driving and/or control display 50,52.Display circuit 156 passes through signal path 158 and processor 130 communicative couplings, and by signal path 160 and display 50,52 communicative couplings.Similar with signal path 134 discussed above, signal path 158,160 can be specially the signal path that is configured to respectively to promote any type of communicating by letter between processor 130 and display circuit 156 and display circuit 156 and display 50,52.For example, signal path 158,160 can be specially the wire rod, printed circuit board wiring, conductive hole, bus of any amount, device and/or analog between two parties.As discussed above, in the exemplary embodiment, display 50,52 is specially the layout of light emitting diode 80,82,84,86,88.

In certain embodiments, sensor assembly 12 is configured to force data to be transferred to display module 14 and/or Computer assisted surgery (CAOS) system 18.In this type of embodiment, control circuit 92 comprises transmitter circuit 162 and feeler 164.Transmitter circuit 162 passes through signal path 166 and processor 130 communicative couplings, and by signal path 168 and feeler 164 communicative couplings.Signal path 166,168 can be specially the signal path that is configured to respectively to promote any type of communicating by letter between transmitter circuit 162 and processor 130 and feeler 164.For example, similar with signal path 134, signal path 166,168 can be specially the wire rod, printed circuit board wiring, conductive hole, bus of any amount, device and/or analog between two parties.Transmitter circuit 162 can be configured to use wireless communication protocol, standard or the technology of any type, and joint force data is transferred to display module 14 and/or Computer assisted surgery (CAOS) system 18.For example, transmitter circuit 162 can be configured to use for example code division multiple access of wireless network protocol, cellular communication protocol (CDMA) agreement, agreement or other wireless communication protocols, standard or technology.

Referring now to Figure 10 and 11,, in use, control circuit 92 is configured to manner of execution 200, for determining the joint force data in patient joint and providing the vision of the kneed joint of patient power medial-lateral balance to indicate.Method 200 starts from square frame 202, and wherein control circuit 92 is initialised.For example, in square frame 202, control circuit 92 can carry out any amount systems inspection, remove processor 130 any depositor and/or carry out other initialization and/or integrity checking.In addition, in certain embodiments, control circuit 92 is configured in square frame 204 to carry out the signal exchange routine with hand-held display device 14 and/or Computer Aided Surgery (CAOS) system 18.During signal exchange routine, control circuit 92 and hand-held display device 14 and/or Computer Aided Surgery (CAOS) system 18 can be configured to determine communication protocol and/or in other words set up the signal procedure of any type, for future autobiography sensor module 12 joint force data be transferred to equipment 14 or system 18.

In square frame 206, control circuit 92 receives from the sensor signal of sensor array 90 or data.As discussed above, in the time that plate 34 is positioned in patient's knee joint, sensor array 90 generates instruction and is applied to the sensor signal of the joint power of tibial plate 34.In square frame 208, the sensor signal of the processor 130 of control circuit 92 based on being received by sensor 90 determined joint force data.The joint force data instruction kneed joint of patient power.In certain embodiments, joint force data can be specially particular joint power value, for example, joint, inner side force component value, joint, outside force component value, anterior articulation force component value and/or posterior joint force component value, each power is all determined with newton or similar power unit.In this type of embodiment, joint, inner side force component can be based on determining from the sensor signal of inner sensors group 196, and joint, outside force component can be based on determining from the sensor signal of outer sensors group 197.In addition, anterior articulation force component can be based on front side senser group 194, and the sensor signal that posterior joint force component can be based on from rear side senser group 195.Subsequently, in square frame 210, display 50,52 is controlled or in other words activated to control circuit 92, to be presented at joint force data definite in square frame 208.For example, determine that therein in the embodiment of one or more particular joint power, processor 130 can show definite joint power or its labelling on display 50,52.

In addition or alternatively, control circuit 92 can be configured to determine the medial-lateral balance of joint power, and on display 50,52 in square frame 208,210, shows the labelling of this type of medial-lateral balance.For example, as shown in Figure 11, control circuit 92 can manner of execution 220, for determining the medial-lateral balance of the kneed joint of patient power.In square frame 222, the sensor signal of control circuit 92 based on being received by inner sensors group 196 determined inner side joint force data.Similarly, in square frame 224, the sensor signal of control circuit 92 based on being received by outer sensors group 197 determined outside joint force data.Inner side and outside joint force data can be specially the particular joint power definite with newton, maybe can be specially its some expressions.For example, in certain embodiments, measure inner side and outside joint force data with electric capacity.In addition, should be appreciated that square frame 222 and 224 can be by arbitrary order execution.

In square frame 226, control circuit 92 is determined the relative inner-outer lateral balance of patient joint power.For this reason, control circuit 92 compares side thrust data and outside forces data.For example, in one embodiment, control circuit 92 is configured to by side thrust data and outside forces data are sued for peace and determined total power value.Control circuit 92 passes through subsequently to determine inner side percent value by side thrust data divided by total power value, and passes through to determine outside percent value by outside forces data divided by total power value.So, if the inner side in patient joint and outside forces are balances, inner side percent value will be defined as approximately 50% so, and outside percent value will be defined as approximately 50%.Certainly, in certain embodiments, control circuit 92 can be configured to only determine in inner side percent value and outside percent value, and remaining that is known or determines by simple deduction from 100%.

In square frame 228, control circuit 92 activates or controls display 50,52 so that the vision instruction of relative inner-outer lateral balance of joint power in patient joint to be provided.For example, be specially in the embodiment of light emitting diode at display 50,52, control circuit 92 is configured to activate or illuminates one or more light emitting diodes so that the vision instruction of medial-lateral balance of joint power to be provided.Control circuit 92 can use any displaying scheme or illumination arrangement that the correct instruction of this type of joint power is provided to plastic surgeon.For example, in a specific embodiment, control circuit 92 is configured to control display 50,52 according to the displaying scheme 170 illustrating and discuss above with regard to Fig. 7.

In this way, sensor assembly 12 provides the relative inner in patient joint and the instruction of the vision of outside forces to plastic surgeon.As below more detailed discussion, plastic surgeon can be carried out equilibrating operation in the current balance of outside forces in monitoring by display 50,52 in patient's knee joint, to obtain concrete patient's expectation balance.In addition, because sensor assembly 12 all has display 50,52 in every side, so no matter surgeon is the left knee joint of patient or right above-knee performing an operation, all can be plastic surgeon provides the vision instruction of joint power.

Again referring to Figure 12, except activating display 50,52 to provide the visual notification of the joint power in square frame 210, sensor assembly 12 also can be configured to transmit the joint force data in square frame 212.As discussed above, sensor assembly 12 can be transferred to joint force data hand-held display device 14 and/or Computer assisted surgery (CAOS) system 18 in square frame 212.The joint force data of transmission can be specially the particular joint power of for example measuring with newton, can be maybe its expression.For example, the sensor signal being received by sensor array 90 or the electrical representation of this type of signal level can be transmitted in square frame 212.Alternatively, sensor assembly 12 can transmit the joint force data of definite medial-lateral balance of the joint power in instruction patient joint.

Referring now to Figure 12-18,, hand-held display module 14 comprises that size is set for by plastic surgeon and is held in hands and carrying out the shell 300 using in plastic surgery operations.In this way, display module 14 is configured to mobilizable.Display module 14 also comprises the display 302 being coupled with the upside 304 of shell 300.Multiple user's load buttons 306,308,310 are also positioned on the upside 304 of shell 300 of display 302 belows.Display module 14 also comprises power knob 312.In the exemplary embodiment of Figure 20-26, power knob 312 is positioned at the below of load button 306,308,310 row, but in other embodiments, button 306,308,310,312 can be positioned to other configurations and/or orientation.

As discussed above, hand-held display module 14 is configured to the labelling that combined sensor module 12 is used to receive joint force data from module 12 and shows the joint power in instruction patient joint at display 302.Similar with sensor assembly 12, display module 14 can be configured to the relative inner-outer lateral balance of the joint power of determining patient joint, and on display 302, shows the labelling of this type of balance.In addition, display module 14 can be configured to the relative front side-rear lateral balance of the joint power of determining patient joint, and on display 302, shows the labelling of this type of balance.In addition, display module 14 is also configured to carry out other functions, for example, according on display 302 show content store patient joint power screenshotss and data and these type of data are downloaded on other equipment.

As shown in Figure 14, hand-held display module 14 comprises the control circuit 320 being positioned in shell 300.Control circuit 320 comprises processor 322 and memory device 324.Processor 322 can be specially any type processor that is configured to carry out function described herein.For example, processor 322 can be specially the set of integrated circuit or the electronic device of separation.In addition, processor can be monokaryon or polycaryon processor.Although only show a processor 322 in Figure 14, should be appreciated that in other embodiments, control circuit 320 can comprise the Attached Processor of any amount.Memory device 324 can be specially read only memory devices and/or direct access storage device.For example, memory device 324 can be specially or comprise electrically erasable read only memory devices (EEPROM), dynamic random access memory device (DRAM), synchronous dynamic random-access memory device (SDRAM), double data rate dynamic random access memory device (DDR SDRAM) and/or other volatibility or non-volatile memory device.In addition, although only show a memory device in Figure 14, in other embodiments, control circuit 320 can comprise additional memory device.

Processor 322 is by signal path 326 and memory device 324 communicative couplings.Signal path 326 can be specially the signal path that is configured to promote any type of communicating by letter between processor 322 and memory device 324.For example, signal path 326 can be specially the wire rod, printed circuit board wiring, conductive hole, bus of any amount, device and/or analog between two parties.

Processor 322 also passes through signal path 328 and user's load button 306,308,310 communicative couplings, and by signal path 344 and power indicator 314 communicative couplings.Similar with signal path 326, signal path 328,344 can be specially the signal path that is configured to respectively to promote any type of communicating by letter between processor 322 and user's load button 306,308,310 and power indicator 314.For example, signal path 328,344 can comprise the wire rod, printed circuit board wiring, conductive hole, bus of any amount, device and/or analog between two parties.User's load button 306,308,310 is software or " soft " button, can determine according to the concrete screen showing on display 302 function of each button.

Control circuit 320 also comprises external power source input circuit 330, such as rechargeable battery of rechargable power supplies 332 etc. and power circuit 334.External power source input circuit 330 is configured to hold for example plug of " wall charger " of charger, and by signal path 336 and rechargable power supplies 332 communicative couplings.Rechargable power supplies 332 is by signal path 338 and power circuit 334 communicative couplings.Power circuit 334 passes through signal path 340 and processor 332 communicative couplings, and by signal path 342 and power knob 312 communicative couplings.Signal path 336,338,340,342 can be specially the signal path of any type, comprises the wire rod, printed circuit board wiring, conductive hole, bus of for example any amount, device and/or analog between two parties.Power circuit 334 can comprise power supply control, distribution and filtering circuit, and is configured to provide or distribute other devices or the parts of electric power to processor 322 and control circuit 320 from rechargable power supplies 332.

Control circuit 320 also comprises that display circuit 346 is for driving and/or control display 392.Display circuit 346 passes through signal path 348 and processor 332 communicative couplings, and by signal path 350 and display 302 communicative couplings.Signal path 348,350 can be specially the signal path that is configured to respectively to promote any type of communicating by letter between processor 322 and display circuit 346 and display circuit 346 and display 302.For example, signal path 348,350 can be specially the wire rod, printed circuit board wiring, conductive hole, bus of any amount, device and/or analog between two parties.

As discussed above, hand-held display module 14 is configured to receive the joint force data from sensor assembly 12.So, control circuit 320 comprises acceptor circuit 352 and feeler 354.Acceptor circuit 352 passes through signal path 356 and processor 322 communicative couplings, and by signal path 358 and feeler 354 communicative couplings.Signal path 356,358 can be specially the signal path that is configured to respectively to promote any type of communicating by letter between acceptor circuit 352 and processor 322 and feeler 354.For example, signal path 356,358 can be specially the wire rod, printed circuit board wiring, conductive hole, bus of any amount, device and/or analog between two parties.Acceptor circuit 352 can be configured to use wireless communication protocol, standard or the technology of any type, to receive the joint force data from sensor assembly 12.For example, as above discussed with regard to sensor assembly 12, display module 14 can be configured for example code division multiple access of wireless network protocol, cellular communication protocol (CDMA) agreement, agreement or other wireless communication protocols, standard or technology, to communicate by letter with sensor assembly 12.

Control circuit 320 also comprises USB (universal serial bus) (USB) interface 360.USB interface 360 is by signal path 362 and processor 322 communicative couplings, and described signal path 362 can be specially the signal path that is configured to promote any type of communicating by letter between USB interface 360 and processor 322.For example, signal path 362 can be specially the wire rod, printed circuit board wiring, conductive hole, bus of any amount, device and/or analog between two parties.USB interface 360 can be for downloading to other equipment (as computer) by data (as joint force data or screenshotss data) from display module 14.In addition, USB interface 360 can be for upgrading software or the firmware of control circuit 320.

Referring now to Figure 23-26,, in use, control circuit 320 is configured to manner of execution 400 to determine the joint force data that patient joint is relevant and to display it to plastic surgeon.Method 400 starts from square frame 402, and wherein control circuit 320 is initialised.For example, in square frame 402, control circuit 320 can carry out any amount systems inspection, remove processor 322 any depositor and/or carry out other initialization and/or integrity checking.In addition, in certain embodiments, control circuit 320 is configured in square frame 404 to carry out the information exchange routine with sensor assembly 12.During this signal exchange routine, control circuit 320 and sensor assembly 12 can be configured to determine communication protocol and/or in other words set up the signal procedure of any type, for future autobiography sensor module 12 joint force data be transferred to EM equipment module 14.

In square frame 406, control circuit 320 receives the joint force data from sensor assembly 12.As discussed above, joint force data is the instruction of the indicated patient's knee joint power of the sensor signal that generates of the sensor array 90 of sensor assembly 12.In square frame 408, the joint force data of control circuit 320 based on receiving in square frame 406 determined inner side joint power value and joint, outside power value.Joint, inner side power value is based on inner sensors group 196, and joint, outside power value is based on outer sensors group 197.In square frame 410, control circuit 320 is determined the medial/lateral balance of the joint power in patient joint based on inner side and outer joint power value.As discussed above, medial/lateral balance can be represented by percent value.The medial/lateral balance of joint power shows on the display 302 in square frame 412 subsequently.For example, as shown in the screenshotss 450,452,454 in Figure 24,25 and 26, joint, inner side force component percent value 430 shows towards the side 460 of the inner side of display 302 design, and joint, outside force component percent value 432 shows towards the side 462 of the outside of display 302 design.

In square frame 414,416, control circuit 320 is determined the pattern that plastic surgeon is selected.In the exemplary embodiment, plastic surgeon can select wherein on display 302, only to show the first mode of the labelling of the medial-lateral balance of patient joint power, or wherein in display 302, shows the second pattern of the medial-lateral of patient joint power and the labelling of front side-rear lateral balance.User can be by selecting suitable user's load button 306,308,310 to change between two patterns.

If plastic surgeon has been selected only medial-lateral pattern, method 400 is advanced into square frame 418 so, wherein on display 302, shows the labelling of the medial-lateral balance of the kneed joint of patient power.In order to realize this point, as shown in Figure 16, screen display content 450 is presented on the display 302 of display module 14.Screen display content 450 comprises background image 470, and it is exemplarily specially the image of the near-end of cut tibia.Control circuit 320 shows balance strip 472 on background image 470, and on balance strip 472, indicates the position display icon 474 of patient joint power relative inner-outer lateral balance.For example, in exemplary screen displays content 450, outside 462 towards screen display content 450 (is a side in the outside of the corresponding cut tibia image 470 of display 302, it is the right side of corresponding display 302 exemplarily) display icon 474 on balance strip 472, be specially round rectangle.The outside forces component of the total joint of this normal indication patient knee joint power is greater than joint, inner side force component.Icon 474 is far away apart from balance strip 472 center, and corresponding inner side or outside forces component are just larger.In certain embodiments, background image 470 comprises " balance " icon 476, exemplarily be specially round rectangle profile, it is positioned on background image 470, while making icon 474 be positioned at the border of icon 476, joint, the inner side power of patient's knee joint and joint, outside dynamic balance or within predetermined threshold each other.In addition, in certain embodiments, screen display content 450 can comprise total power packing 434, depends on the concrete configuration of display 450, and described total power packing 434 can increase or reduce but filling or unfilled along with total dynamic balance.

But, if plastic surgeon has been selected medial-lateral and front side-rear side pattern, method 400 is advanced into square frame 420 so, wherein on display 302, show that the medial-lateral of patient's knee joint power and the labelling of front side-rear lateral balance are in order to realize this point, as shown in Figure 17, screen display content 452 is presented on the display 302 of display module 14.Screen display content 450 comprises the background image 470 that covers balance strip 472 thereon.Again, control circuit 320 is display icon 474 on balance strip 472, the relative inner-outer lateral balance of the joint power in instruction patient joint.But, in addition, according to the corresponding front side-inside end 480 of rear lateral balance positioning balance bar 472 and the outside end 482 of balance strip 472.For example, the inside end 480 towards the rear side 464 of display 302 or the front side 466 positioning balance bars 472 of display 302 according to the front side of joint, inner side power-rear lateral balance.As discussed above, the front side of joint, inner side force component-rear lateral balance can be based on determining from the sensor signal of inner side-front side senser group 180 and inner side-rear side senser group 184.Similarly, the outside end 482 towards the rear side 464 of display 302 or the front side 466 positioning balance bars 472 of display 302 according to the front side of joint, outside power-rear lateral balance.As discussed above, the front side of joint, outside force component-rear lateral balance can be based on determining from the sensor signal of outside-front side senser group 182 and outside-rear side senser group 186.

In the exemplary screen displays content 452 of Figure 18, the inside end 480 of balance strip 472 is positioned to towards the front side 466 of display 302, and the outside end 482 of balance strip 472 is positioned to the rear side 464 towards display 302.The front side force component of this type of location instruction side thrust component is greater than the posterior forces component of side thrust component, and the posterior forces component of outside forces component is greater than the front side force component of outside forces component.End 480,482 is far away apart from front side-back center, and corresponding front side or posterior forces component are just larger.

Again referring to Figure 15, once the appropriate flags of joint dynamic balance has been presented on display 302, control circuit 320 just determines whether plastic surgeon is intended to obtain the snapshot of the current displaying contents in square frame 422 now.Plastic surgeon can be by selecting suitable user's load button 306,308,310 to obtain the snapshot of display 302.In addition, snapshot is stored in the memory device 324 in square frame 424, and can from display module 14, downloads subsequently.

In the time of storage snapshot, icon 484 occurs in the lower right corner of display 302.Except icon 484, in certain embodiments, in the time of storage snapshot, corresponding VE line 486 is presented on display 302.Balanced line 486 provides the vision instruction of the medial-lateral balance of the joint power showing in associated storage snapshot.Further, if plastic surgeon has been selected medial-lateral and front side-rear side pattern, front side-rear side balanced line 488 is presented on display 302 so.Balanced line 488 provides the vision instruction of the front side-rear lateral balance of the kneed inner side of the patient who shows in associated storage snapshot and outside forces.

With reference now to 19-27,, in certain embodiments, sensor assembly 12 can use together with tibial trial system 500.Tibial trial system 500 comprises adapter 502 and is configured to be positioned at the one or more tibial trial parts on the adapter 502 in tibial plate 34, as discussed in more detail.In the exemplary embodiment, the tibial trial parts of system 500 can comprise for example one or more test pad 504, the tibia bearing surface trial target 505 that can be coupled to test pad 504 and/or one or more tibia bearing trial target 506.In certain embodiments, discuss referring below to Figure 26 and 27, tibia bearing trial target 506 can be configured to hold adapter 502, and tibia bearing surface trial target 505 is configured to be coupled to selected test pad 504.For example, tibia bearing surface trial target 505 can comprise molding and be positioned to be accommodated in a pair of lug or the projection (not shown) in a pair of corresponding aperture 508 of test pad 504, so that tibia bearing testing surface trial target 505 is coupled to test pad 504, thereby form module tibia bearing trial target.

As discussed above, adapter 502 is configured to coupling or is in other words connected to the tibial plate 34 of sensor assembly 12.As shown in Figure 20 A-20E, adapter 502 comprises the hub 510 of the top side 514 with bottom side 512 and relative bottom side 512, and in the time that adapter 502 and tibial plate 34 are coupled, described bottom side 512 contacts or in other words face tibial plate 34.Exemplarily, hub 510 has circle or connects rotund shape.But, in other embodiments, as discussed in more detail, can form and there is the hub 510 that is configured to other geometries that promote attached rotatable tibial trial parts rotation.In addition, exemplary adapter 502 is formed by plastic material, but can form by having enough elastic other materials, to allow clip to be coupled to tibial plate 34 and any tibial trial parts, keeps during use this type of coupling simultaneously.

On one group, fixation clamp 516 upwards extends from top side 514.Each upper fixation clamp 516 comprises the elongate rod 518 that is attached to hub 510, and is attached to antelabium or the protrusion 520 of the far-end of elongate rod 518.Elongate rod 518 is upwards extended from hub 510, and the antelabium 520 being associated stretches out from the far-end of elongate rod 518.Each in upper fixation clamp 516 curves inwardly at transverse plane (that is, in the time that adapter 502 and tibial plate 34 are coupled, the plane of tibial plate 34), and is arranged as general restriction circle.In addition, each antelabium or protrusion 520 have bending or circular outer surface.As discussed in more detail, upper fixation clamp 516 molding and be configured to promote spacer block 832 and/or joint traction apparatus 16 surgery perioperative attached and dismounting.Although exemplary adapter 502 comprises three upper fixation clamps 516, can use in other embodiments upper fixation clamp 516 additional or still less.

Similar with upper fixation clamp 516, fixation clamp 522 is from bottom side 512 to downward-extension under one group.Each lower fixation clamp 522 comprises the elongate rod 524 that is attached to hub 510, and is attached to antelabium or the protrusion 526 of the far-end of elongate rod 524.Elongate rod 524 is from hub 510 to downward-extension, and the antelabium 526 being associated stretches out from the far-end of elongate rod 524.Each in lower fixation clamp 522 curves inwardly at transverse plane (that is, in the time that adapter 502 and tibial plate 34 are coupled, the plane of tibial plate 34), and is arranged as general restriction circle.In addition, each antelabium or protrusion 526 have the many smooth outer surfaces substantially that intersect at chosen angle.Be to be understood that in other embodiments, protrusion 526 can comprise bending or circular outer surface.As discussed in more detail, lower fixation clamp 522 molding and being configured to promote the attached and dismounting of adapter 502 and the tibial plate 34 of sensor assembly 12.In order to realize this point, lower fixation clamp 522 is accommodated in the vertical hole 45 of tibial plate 34.Although exemplary adapter 502 comprises three lower fixation clamps 522, can use in other embodiments lower fixation clamp 522 additional or still less.

Upper fixation clamp 516 and lower fixation clamp 522 are " key entries ", and adapter 502 is configured to the single vertical orientated tibial plate 34 that is coupled to.In the exemplary embodiment, upper fixation clamp 516 is greater than lower fixation clamp 522, and fixation clamp 516 can not be inserted in the vertical hole 45 of tibial plate 34.For example, general circle 550 (referring to Figure 20 E) that limit of upper fixation clamp 516, its diameter is greater than the circle 552 (referring to Figure 20 D) generally being limited by lower fixation clamp 522.Certainly, other structures or feature can be in other embodiment, so that adapter 502 and tibial plate 34 " key entry ".

As shown in Figure 20 B, adapter 502 also comprises front side alignment lug 530 and rear side alignment lug 532, and it is from bottom side 514 to downward-extension.As discussed in more detail, in the time that adapter 502 is coupled to tibial plate 34, alignment lug 530,532 is configured to be accommodated in the corresponding aligned hole 46,48 (referring to Figure 19) of tibial plate.Alignment lug the 530, the 532nd, " key entry ", is configured to the single-orientated tibial plate 34 that is attached to adapter 502.For example, in the exemplary embodiment, the width that front side alignment lug 530 has or arc length 534 are greater than width or the arc length 536 (referring to Figure 20 D) of rear side alignment lug 532.Similarly, as discussed above, the width that the front side aligned hole 46 of tibial plate 34 has or arc length are greater than width or the arc length of rear side aligned hole 48.So, only alignment lug 530 in front side is accommodated in front side aligned hole 46 and rear side alignment lug 532 is accommodated in the orientation in rear side aligned hole 48 therein, and adapter 502 is just configured to be attached to tibial plate 34.Each in alignment lug 530,532 curves inwardly at transverse plane, and comprise respectively angulation side 538,540, it promotes the excessive-torque that response applies adapter 502, the automatic dismantling of adapter 502 from tibial plate 34, as discussed in more detail.

Adapter 502 also comprises anti-rotation key or projection 542, and this anti-rotation key or projection stretch out from hub 510.Anti-rotation key 542 comprises the bottom surface 544 coplanar with the bottom side 512 of hub 510, makes in the time that adapter 502 is coupled to sensor assembly 12, and anti-rotation key 542 rests in tibial plate 34, or contacts or in other words face tibial plate 34.In the exemplary embodiment, anti-rotation key 542 has rectangular shape, but can have other shapes in other embodiments.As discussed in more detail, anti-rotation key 542 prevents or retrains the rotation of inactive tibial trial parts, and the rotation of restraint tibial trial parts.

As discussed above, adapter 502 is configured to be attached to the tibial plate 34 of sensor assembly 12, as shown in Figure 21.In order to realize this point, lower fixation clamp 522 is inserted in the vertical hole 45 of tibial plate 34, and adapter 502 is alignd, make alignment lug 530 in front side be accommodated in the front side aligned hole 46 of tibial plate 34 and rear side alignment lug 532 is accommodated in rear side aligned hole 48, as shown in Figure 22.Lower fixation clamp 522 is configured to slightly curve inwardly, to allow the attached of adapter 502 and tibial plate 34.After successfully inserting, lower fixation clamp 522 recovers its vertical or subvertical position, so that the amount that lifts off resistance to be provided, thereby makes adapter 502 be fixed to tibial plate 34.As shown in Figure 22, antelabium or protrusion 526 contact the cross section 47 of the inside angulation of the medial wall 44 of tibial plate 34, and it is provided for the amount that lifts off resistance of adapter 502.But if excessive-torque is applied to adapter 502, so by lower fixation clamp 522 is inwardly exerted pressure, the cross section 47 of the inside angulation of the medial wall 44 of tibial plate 34 promotes the dismounting of adapter 502, as discussed in more detail.

As shown in Figure 23-25, test pad 504 can be fixed (Figure 23) or movable (Figure 24 and 25) orientation and is coupled to adapter 502 and sensor assembly 12.For the ease of this type of orientation, test pad 504 comprises that size sets and be shaped to the centre bore 560 of the hub 510 that holds adapter 502 for.In addition, test pad 504 comprises the anti-rotation hole 562 being communicated with centre bore 560 fluids separately and the hole 564 that can rotate.As shown in Figure 23, anti-rotation hole 562 has the width 566 of the anti-rotation key 542 that is slightly greater than adapter 502, and anti-rotation key 542 can be accommodated in anti-rotation hole 562.The hole 564 that can rotate on the contrary, has the arc length 568 that is generally trapezoidal shape and is substantially greater than anti-rotation key 542 width.

As shown in Figure 23, test pad 504 can fixed orientation be coupled to adapter 502 and sensor assembly 12, and the anti-rotation key 542 of adapter 502 is accommodated in the anti-rotation hole 562 of test pad 504.Because anti-rotation hole 562 is only greater than anti-rotation key 542 slightly, so retrain or in other words prevent the basic rotation of test pad 504 with respect to tibial plate 34.Alternatively, as shown in Figure 34 and 35, test pad 504 can movable orientation be coupled to adapter 502 and sensor assembly 12, and the anti-rotation key 542 of adapter 502 is accommodated in the hole that can rotate 564 of test pad 504.Because the hole 564 that can rotate is significantly greater than anti-rotation key 542, so promote or in other words allow the rotation of test pad 504 with respect to tibial plate 34.

In fixed or movable orientation, excessive-torque causes that to applying of adapter 502 adapter 502 dismantles from tibial plate 34.That is, in the time that adapter 502 is applied to excessive-torque, the angulation side 538,540 of alignment lug 530,532 engages the corresponding angulation side of aligned hole 46,48, and this generation lifts off power.The power that lifts off impels lower fixation clamp 522 inwardly to push by the cross section 47 of the inside angulation of the medial wall 44 of tibial plate 34 then.So, adapter 502 automatic dismantling from tibial plate 34.By this way, can avoid the infringement for adapter 502 and sensor assembly 12.

As discussed above, tibia bearing trial target 506 can be configured to be coupled to adapter 502.Tibia bearing trial target 506 can be specially fixed or movable bearing test product.For example, as shown in Figure 26, movable tibia bearing trial target 570 comprises that size sets and be shaped to the centre bore 572 of the hub 510 that holds adapter 502 for, and the hole that can rotate 574 being communicated with centre bore 572 fluids.Similar with the hole that can rotate 564 of test pad 504, the hole 574 that can rotate has the arc length 576 that is generally trapezoidal shape and is substantially greater than anti-rotation key 542 width.So, in the time that movable tibia bearing trial target 570 is coupled to adapter 502 and sensor assembly 512, promotion or in other words permission activity tibia bearing trial target 570 are with respect to the rotation of the tibial plate 34 of sensor assembly 512.

Alternatively, tibia bearing trial target 506 can be specially fixed tibial bearing test product 580 as shown in Figure 27.Fixed tibial bearing test product 580 comprise that size sets and be shaped to the centre bore 582 of the hub 510 that holds adapter 502 for, and the anti-rotation hole 584 being communicated with centre bore 582 fluids.Similar with the anti-rotation hole 562 of test pad 504, the width that anti-rotation hole 584 has is greater than the width of the anti-rotation key 542 of adapter 502 slightly, and anti-rotation key 542 can be accommodated in anti-rotation hole 562.So, in the time that fixed tibial bearing test product 580 are coupled to adapter 502 and sensor assembly 512, retrain or in other words prevent the rotation of fixed tibial bearing test product 580 with respect to the tibial plate 34 of sensor assembly 512.

Referring now to Figure 28-31,, in certain embodiments, sensor assembly 12 is configured for together with Computer assisted surgery (CAOS) system 18 and uses.In this type of embodiment, sensor assembly 12 is configured to joint force data to be transferred to system 18.As shown in Figure 28, Computer assisted surgery (CAOS) system 18 comprises computer 600, display 602 and camera unit 604.Computer 600 passes through signal path 606 and display 602 communicative couplings, and by signal path 608 and camera unit 604 communicative couplings.Signal path 606,608 can be specially the signal path that is configured to respectively any type that promotes the telecommunication between computer 600 and display 602 and computer 600 and camera unit 604.For example, signal path can be specially the wire rod, printed circuit board wiring, conductive hole, bus of any amount, device and/or analog between two parties.

Display 602 can be specially the equipment of any type, for example liquid crystal display, cathode ray tube (CRT) display or similar devices.In addition, in certain embodiments, display 602 can be specially " new line " display.In this type of embodiment, signal path 606 can be specially wired or wireless signal path.Camera unit 604 comprises two or more photographing units 610, in the visual field 614 of the reflective array 620 that its arrangement makes the associated bone that is coupled to patient 612 in photographing unit 610.

Computer 600 comprises processor 622, memory device 624 and receptor or acceptor circuit 626.Processor 622 can be specially any type processor that is configured to carry out function described herein.For example, processor 622 can be specially the set of integrated circuit or the electronic device of separation.In addition, processor can be monokaryon or polycaryon processor.Although only show a processor 622 in Figure 28, should be appreciated that in other embodiments, computer 600 can comprise the Attached Processor of any amount.Memory device 624 can be specially read only memory devices and/or direct access storage device.For example, memory device 624 can be specially or comprise electrically erasable read only memory devices (EEPROM), dynamic random access memory device (DRAM), synchronous dynamic random-access memory device (SDRAM), double data rate dynamic random access memory device (DDR SDRAM) and/or other volatibility or non-volatile memory device.In addition, although only show a memory device in Figure 28, in other embodiments, computer 600 can comprise additional memory device.

Acceptor circuit 626 can be configured to use wireless communication protocol, standard or the technology of any type, to receive the joint force data from sensor assembly 12.For example, as above discussed with regard to sensor assembly 12, computer 600 can be configured to use for example code division multiple access of wireless network protocol, cellular communication protocol (CDMA) agreement, agreement or other wireless communication protocols, standard or technical communication, to communicate by letter with sensor assembly 12.

In use, Computer assisted surgery (CAOS) system 18 can be configured to position by following the tracks of and show reflective array 620 patient's related bone anatomical structure that is coupled (as patient's tibia and femur) provides navigation for surgical operation, and operating amount of travel is provided.In addition, Computer assisted surgery (CAOS) system 18 can be configured to receive joint force data and show the joint force data in patient joint or other labellings of joint power at display 602 from sensor assembly 12.

In order to realize this point, computer 600 executing methods 700 are for carrying out plastic surgery operations as shown in Figure 29.Method 700 starts from square frame 702, and wherein system 18 is initialised.For example, in square frame 702, computer 600 can carry out any amount systems inspection, remove processor 622 any depositor and/or carry out other initialization and/or integrity checking.In addition, any amount of setting, the parameter that can in square frame 702, set up and carry out CAOS system 18 are selected and calibration.For example, can in square frame 702, select the video setting of display 602, can select the language that shown by computer 600, and can calibrate the touch screen (if applicable) of display device 602.

In square frame 704, select the option of plastic surgery operations and parameter to select by surgeon.This Class Options can comprise the type (as complete knee joint shaping) of the plastic surgery operations that will carry out, type (as structure, model, size, fixed type etc.), the operating sequence (as first tibia or first femur) etc. of the shaping implant that will use.Once plastic surgery operations arranges in square frame 704, patient's skeleton is just deposited with in square frame 706.In order to realize this point, relevant skeleton (for example patient's tibia and the femur) coupling by reflective array 620 with patient.In addition, carry out the profile of this type of skeleton of registration by applicable registration tools.For this reason, multiple regions that the skeleton of registration is wanted in the contact of the indicator end of this type of instrument.In order to respond registration, computer 600 can show the rendering image of skeleton, wherein determines position and the orientation of skeleton according to be coupled reflective array, and determines the profile of skeleton according to the point of registration.In addition, in square frame 706, can use the one or more surgical technique and tools of Computer assisted surgery (CAOS) system registration.

Once relevant skeleton has been deposited with in square frame 706, computer 600 is just cooperated image and the correlation navigation data (location of for example operation tool) of the operating procedure that shows plastic surgery operations in square frame 708 with camera unit 604.In order to realize this point, square frame 708 can comprise any amount of sub-step, and wherein each surgical procedure is shown to plastic surgeon together with correlation navigation data with sequential order.In addition, in square frame 710, computer 600 receives the joint force data from sensor assembly 12.As discussed above, joint force data is the instruction of the indicated patient's knee joint power of the sensor signal that generates of the sensor array 90 of sensor assembly 12.

In square frame 712, computer 600 shows joint force data or by its other derivative data, it indicates the joint power in patient joint on display 602.Computer 600 can be configured to determine one or more joints power value based on the joint force data in square frame 712.For example, similar with hand-held display module 14, computer 600 can be configured to determine inner side joint force component value and joint, outside force component value based on the joint force data receiving in square frame 710.Again, the sensor signal of this type of joint, inner side power value based on being received by pressure transducer 102,104,106,108,120,124, and joint, outside power value is based on inner sensors group 196 and outer sensors group 197.In certain embodiments, computer 600 can also be determined average medial/lateral power value based on joint, inner side power value and joint, outside power value.In this type of embodiment, on the display 602 in square frame 712, show subsequently joint, inner side power value, joint, outside power value and average joint power value.In addition, computer 600 can be configured to determine based on joint force data medial-lateral and/or the front side-rear lateral balance of joint power, and to show the labelling of joint dynamic balance with the similar mode of hand-held display module 14 on display 602.For example, computer 600 can present and the similar displaying contents of displaying contents 450,452,454 that above illustrates and describe with regard to Figure 16,17 and 18 in square frame 412.

In certain embodiments, Computer assisted surgery (CAOS) system 18 can be configured to determine joint force data and navigation data and by data show on display 602.For example, computer 600 executing methods 720 are for showing and joint force data as relevant in the navigation data of Figure 30 illustrated.Method 720 comprises that its Computer 600 receives the square frame 722 from the joint force data of sensor assembly 12.Again, joint force data is the instruction of the indicated patient's knee joint power of the sensor signal that generates of the sensor array 90 of sensor assembly 12.In square frame 724, the joint force data of computer 600 based on receiving in square frame 722 determined inner side, outside and/or balanced articulation power value.

Determine simultaneously with joint power value in square frame 722, computer 600 is determined the relevant skeleton of patient in square frame 724, for example patient's femur and the location of tibia and orientation in those embodiment of patient's knee joint experience plastic surgery operations therein.Subsequently, in square frame 728, computer 600 is presented at the knee joint image in joint power value and square frame 728 definite in square frame 722.So, computer 600 can be for display case as the bending of the inner side of patient's knee joint and lateral condyle with stretch gap, and show relevant inner side, outside and/or the average joint power value of patient's knee joint simultaneously.By monitoring bending and stretching gap and associated joint power value, plastic surgeon can be determined suitable gap or the joint power size of concrete plastic operation.

In addition, in certain embodiments, computer 600 is also configured to according to patient's skeleton orientation and other anatomical structure data of location positioning definite in square frame 726, and shows these type of anatomical structure data and associated joint power value.For example, in one embodiment, computer 600 can be configured to determine patient's knee joint in turn over/valgus angle, and show relevant inner side and joint, outside power.In addition, computer 600 can be configured to determine based on inner side and outside forces value the condyle loading, and the condyle being loaded by plastic surgeon identification on display 602.Further, in certain embodiments, computer 600 can be configured to the analog of storing anatomical data, joint power value and/or other surgical data for example implant size of type, patient's identification data and/or be bonded to each other in memory device 624 or other memory devices.

In certain embodiments, computer 600 is also configured to determine and show the chart of angle of bend and associated joint power value.In order to realize this point, computer 600 is manner of execution 730 as shown in Figure 31.Method 730 comprises that its Computer 600 receives the square frame 732 from the joint force data of sensor assembly 12.Again, joint force data is the instruction of the indicated patient's knee joint power of the sensor signal that generates of the sensor array 90 of sensor assembly 12.In square frame 734, the joint force data of computer 600 based on receiving in square frame 732 determined inner side, outside and/or balanced articulation power value.

Determine simultaneously with the joint power value in square frame 732, computer 600 is determined the angle of bend of patient's knee joint in square frame 736.In order to realize this point, computer 600 is determined the located in connection of patient's tibia and femur and is determined the angle of bend limiting in centre based on these location.In square frame 738, computer 600 is stored in joint force data definite in square frame 734 and definite angle of bend data in square frame 738.The method is by square frame 732,734,736 repeated collection data with in each or each predefined curved angle of expecting in bending range.Collect after these type of data, method 730 advances to square frame 740, and its Computer 600 can show the chart of joint power value with respect to angle of bend.This chart can comprise that inner side and joint, outside power value maybe can comprise average joint power value, specifically depend on the parameter setting of plastic surgeon.

Referring now to Figure 32-37,, as discussed above, during carrying out plastic surgery operations, sensor assembly 12 can be for monitoring the relative inner-outer lateral balance of patient joint power.For example, shown in Figure 32 about using sensor assembly 12 to execute the operation method 800 of total knee arthroplasty.Method 800 starts from square frame 802, excises therein patient's proximal tibia 900.By excision patient's tibia 900, on proximal tibia, set up plane surface or the platform after excision.In certain embodiments, for example, not using in the embodiment of Computer assisted surgery (CAOS) system 18, can in square frame 804, excise patient's distal femur 902.

In square frame 806, patient's knee joint stretches to be placed.Subsequently, in square frame 808, patient's knee joint is pulled in the time of stretching, extension and joint dynamic balance.For this reason, plastic surgeon can be placed the tibial plate 34 of sensor assembly 12 in patient's knee joint.Particularly, as shown in Figure 33, tibial plate 34 is placed on the cut platform 850 of patient's near end of thighbone.Tibial plate 34 can be placed on the position of contact patient tibia, also can be placed on film or other between two parties on member.As shown in Figure 33, spacer block 832 can be for expecting span by patient's knee joint traction, and it can be coupled to sensor assembly 12 by the upper fixation clamp 516 of adapter 502 in certain embodiments.Alternatively, sensor assembly 12 can be coupled to joint traction apparatus 16, and traction apparatus can insert patient's knee joint and go forward side by side line operate with the extremely amount of expectation of traction joint.Typically, patient's knee joint is pulled the necessary amount in joint space (the cut platform 850 of patient's tibia is roughly parallel to the cut far-end of patient's femur) of setting up essentially rectangular in the time stretching.

Set up behind the joint space of essentially rectangular, plastic surgeon just can balance inner side and joint, outside power.For this reason, plastic surgeon can carry out that ligament loosens or equilibrating operation reduces inner side or the outside forces of patient's knee joint.While carrying out this operation, plastic surgeon can monitor the display 50,52 of sensor assembly 12 and/or hand-held display module 14, to loosen which side and inner side and outside forces when roughly equal (for example, when middle light emitting diode 84 illuminates) to determine.Certainly, the standard such as degree of deformity before soft tissue injury degree based on such as patient age, Gender, patient joint, patient's operation on joint, plastic surgeon can determine that whether the joint dynamic balance (for example, 45%-55% medial-lateral joint dynamic balance) that can select is in addition desirable for concrete patient.In addition, at some embodiment, for example, use therein in those embodiment of Computer assisted surgery (CAOS) system 18, can in square frame 810, excise patient's distal femur 902.

After the medial-lateral joint power in the patient joint of stretching at plastic surgeon appropriate balance, in square frame 812, patient's arthrogryposis is placed.Subsequently, in square frame 814, in the time of bending, patient's knee joint is drawn to the expectation balance to joint power.In order to realize this point, plastic surgeon can be placed on the tibial plate of sensor assembly 12 34 on the cut platform 850 of patient's proximal tibia 900 again.Tibial plate 34 can be placed on the position of contact patient tibia, also can be placed on film or other between two parties on member.Plastic surgeon can use for example traction apparatus 16 or other traction apparatuss to draw patient's knee joint, so that each condyle of patient's femur is drawn to different amounts, until inner side and joint, outside power are roughly equal.By balance inner side and joint, outside power, femur can be rotated.

Draw to the expectation medial-lateral joint balance realizing in square frame 814 in patient's joint, in square frame 816, patient's distal femur 902 has been carried out to many other excision otch.In order to realize this point, as shown in Figure 34, cutting cube 860 can be coupled to joint traction apparatus 16, and carries out front side femoral cut, rear side femoral cut and/or inclined-plane cutting, simultaneously bending traction patient's joint for the distal femur 902 to patient.In a specific embodiment, the arrangement of cutting module 860 makes that femur front side and posterior incisions are roughly parallel to tibia otch patient's knee joint is as discussed above while being pulled under case of bending.In other embodiments, the arrangement of cutting module 860 can make the corresponding concrete angle of expecting implant of angle of femur front side and posterior incisions.So, carry out femur front side and rear side cutting during to desired locations at femoral rotation.Can also be in front side or rear side regulate the position of cutting module 860 bent gap to be set for shaping implant.

Alternatively, in certain embodiments, according to anatomical structure references such as such as postartis, Whiteside line and/or Transepicondylar axis, while being predefined in bending, rotate femur.Carry out the cutting of femur front side, the cutting of femur rear side and/or inclined-plane cutting according to the predetermined patient's of being rotated in distal femur 902 of femur.As shown in figure 35, spacer block 854 can be for checking or verify this type of femoral cut.In addition, surgeon can loosen to carry out balance or limit the medial-lateral joint power of expecting with ligament.In this type of embodiment, plastic surgeon can also be verified that the ligament of carrying out in the time of bending does not loosen and can cause negative effect to the joint dynamic balance of extended configuration.

After the final excision of patient's distal femur completes, in square frame 818, verify the kneed joint of patient dynamic balance.In order to realize this point, plastic surgeon can utilize the tibial trial system 500 of describing above with reference to Figure 19-27.For example, as shown in Figure 36 and 37, test pad 504 can be positioned on the adapter 502 on sensor assembly 12, and tibia surface trial target 505 can be fixed to test pad 504.Test femoral component 864 can also temporarily be coupled to patient's distal femur 902.Patient's knee joint can move by multiple angle of bend as shown in Figure 37 subsequently, plastic surgeon monitors the associated joint dynamic balance as shown in by the display 50,52 of sensor assembly 12 or the display 302 of display module 14 simultaneously, maintains from start to finish and expects joint dynamic balance to verify in patient's arthrogryposis.Be to be understood that test pad 504 can fixation test orientation or movement test arranged in orientation in the tibial plate 34 of sensor assembly 12, as above described with regard to Figure 23-25.In other embodiments, fixed or movable tibia bearing trial target 506 can use with adapter 502 together with sensor assembly 12.

Above in conjunction with to joint force measurement, determine and demonstration system 10 has been described.This type of joint power is the joint pressure of corresponding patient joint to localized area roughly.So, be to be understood that, in other embodiments, sensor assembly 12, hand-held display module 14 and Computer Aided Surgery system 18 can be configured to measure, determine and show except the power of patient joint or the relative joint pressure of alternative patient of patient joint power.For example, in one embodiment, can determine according to the known region of each sensor of the pressure transducer of sensor array 90 or sensor element 100 pressure in patient joint.

Although the present invention has been carried out to detailed diagram and description in accompanying drawing and above-mentioned detailed description of the invention; but this type of diagram and description should be considered as exemplary; instead of restrictive; should be understood that; only illustrate and described exemplary embodiment, and all changes and modification in essential scope of the present invention all should be protected.

Multiple features of equipment described herein, system and method make the present invention have multiple advantages.The alternate embodiment that it should be noted in the discussion above that equipment of the present invention, system and method can not comprise all described features, but still can have the beneficial effect of at least some advantage of these features.Those of ordinary skill in the art can easily design its oneself equipment, the embodiment of system and method, these equipment, system and method can be integrated one or more in feature of the present invention, and fall in the spirit and scope of the invention that are defined by the following claims.

Claims

1. for measuring the orthopedic device of joint power in patient joint, described orthopedic device comprises:

Be shaped to the tibial plate between proximal tibia and the distal femur that is positioned at patient, described tibial plate has substantially smooth upper surface and smooth lower surface substantially;

Be positioned in described tibial plate and be configured to generate the sensor array of sensor signal of the joint power between instruction patient's tibia and femur, described sensor array comprises the multiple inner sides-front side senser of inner side-front side force component of measuring described joint power, measure the multiple inner sides-rear side senser of inner side-posterior forces component of described joint power, measure described joint power outside-front side force component multiple outsides-front side senser and measure the multiple outsides-rear side senser of outside-posterior forces component of described joint power, each in described inner side-front side senser and outside-front side senser has substantially equal surface area, and each in described inner side-rear side senser and outside-rear side senser has substantially equal surface area,

The elongate shaft portion that is fixed to described tibial plate and restriction longitudinal axis, described longitudinal axis departs from the front side of described tibial plate to the second-class split axle of rear side;

Be fixed to the first display away from the shank end of described tibial plate; And

Be positioned at the circuit in described shank, described circuit is configured to receive from the sensor signal of described sensor array, and controls described the first display so that the vision instruction of medial-lateral balance of described joint power to be provided.

2. orthopedic device according to claim 1, wherein said tibial plate comprises the plate top enclosure with the first medial wall that limits the first center positioning hole, and there is the plate bottom enclosure of the second medial wall that limits the second center positioning hole, described the first hole and the second hole fluid communication with each other, partly to limit with respect to the upper surface of described tibial plate and lower surface by the Vertical Channel of described tibial plate.

3. orthopedic device according to claim 2, wherein said sensor array comprises that further restriction is by the center positioning hole of the Vertical Channel of described tibial plate.

4. orthopedic device according to claim 1, wherein said sensor array comprises multiple capacitive pressure transducers.

5. orthopedic device according to claim 1, wherein said sensor array comprises inner sensors group and outer sensors group, each in described inner sensors group and outer sensors group by the most front side senser, last side senser and be positioned at the most front corresponding side senser and last side senser between four additional sensors form.

6. orthopedic device according to claim 1, the surface area of each in wherein said inner side-front side and outside-front side senser is less than each the surface area in described inner side-rear side and outside-rear side senser.

7. orthopedic device according to claim 1, each in wherein said inner side-front side and outside-front side senser has and equals approximately 0.174 inch ²surface area, and each in described inner side-rear side and outside-rear side has and equals approximately 0.187 inch ²surface area.

8. orthopedic device according to claim 1, each in wherein said inner side-front side and outside-front side senser has and equals approximately 0.243 inch ²surface area, and each in described inner side-rear side and outside-rear side has and equals approximately 0.263 inch ²surface area.

9. orthopedic device according to claim 1, also comprises the second display being fixed to away from the elongate shaft portion end of described tibial plate, and

Wherein said elongate shaft portion comprises shank top enclosure and shank bottom enclosure, and described shank top enclosure and shank bottom enclosure are coupled to each other, makes the inner surface of described shank top enclosure towards the corresponding inner surface of described shank bottom enclosure,

Wherein said the first display is fixed to the end of described shank top enclosure, and described second display is fixed to the end of described shank bottom enclosure.

10. orthopedic device according to claim 1, wherein:

Described the first display comprises multiple light emitting diodes, and

Described circuit is configured to the total power value in inner side of the inner side component of the described joint of (i) definite instruction power, (ii) the total power value in outside of the outside component of the described joint of definite instruction power, and (iii) so that the multiple light emitting diodes of mode control of the medial-lateral balance of indicating described joint power to be provided.

11. orthopedic devices according to claim 10, wherein said circuit is configured to control multiple light emitting diodes, to show at least nine illumination arrangement of separating corresponding to nine medial-lateral range of balance that separate.

12. orthopedic devices according to claim 10, wherein said circuit is configured to:

The total power value of total described inner side power value and described outside is sued for peace to determine total power value,

Determine inner side percent value according to the total power value in described inner side and described total power value;

Determine outside percent value according to the total power value in described outside and described total power value; And

According to described inner side percent value and described outside percent value, so that the multiple light emitting diodes of mode control of the medial-lateral balance of indicating described joint power to be provided.

13. orthopedic devices according to claim 1, wherein said circuit comprises the wireless transmitter of the described joint force data between tibia and the femur that is configured to transmission instruction patient.

14. orthopedic devices according to claim 1, wherein said circuit comprises power supply and user control, described user control is operable so that described circuit is placed in to on-state from off state, wherein said circuit is configured to from described off state is placed in described on-state, keeping described on-state, until described power supply exhausts.

Measure the sensor assembly of the joint power in patient joint for 15. 1 kinds, described sensor assembly comprises:

There is the upper case of shank upper case and tibial plate upper case;

The lower case with shank lower case and tibial plate lower case, described lower case is coupled to described upper case, makes the inner surface of described lower case towards the corresponding inner surface of described upper case;

Be positioned between described tibial plate lower case and described tibial plate upper case and be configured to the sensor array of the sensor signal that generates the joint power of instruction between described patient's tibia and femur, described sensor array comprises the multiple front side senser of the front side force component of measuring described joint power and measures the multiple rear side senser of the posterior forces component of described joint power, and each in described rear side senser has each the surface area being greater than in described front side senser;

Be fixed to first display and the second display that is fixed to described shank lower case of described shank upper case; And

Be positioned at the circuit between described shank upper case and described shank lower case, described circuit receives from the sensor signal of described sensor array and controls described the first display and second display illuminates with one in multiple illumination arrangement, the wherein separately scope of the medial-lateral balance of the corresponding described joint of each illumination arrangement power.

16. orthopedic devices according to claim 15, wherein tibia upper case and described tibia lower case comprise the medial wall that limits center positioning hole separately, in the time that described upper case is coupled to described lower case, passage is cooperated to limit in the medial wall of described tibia upper case and lower case.

17. orthopedic devices according to claim 15, wherein said sensor array comprises inner sensors group and outer sensors group, each in described inner sensors group and outer sensors group by the most front side senser, last side senser and be positioned at the most front corresponding side senser and last side senser between four additional sensors form.

18. orthopedic devices according to claim 15, wherein said circuit is configured to control described the first display and second display, to show at least nine illumination arrangement of separating, the wherein separately scope of the medial-lateral balance of the corresponding described joint of each illumination arrangement power.

19. orthopedic devices according to claim 15, wherein said circuit comprises the wireless transmitter that is configured to the described joint force data between the transmission described patient's tibia of instruction and femur.

20. orthopedic devices according to claim 15, wherein said circuit comprises power supply and user control, described user control is operable so that described circuit is placed in to on-state from off state, wherein said circuit is configured to from described off state is placed in described on-state, keeping described on-state, until described power supply exhausts.

21. 1 kinds for measuring the orthopedic systems of joint power in patient joint, and described orthopedic systems comprises:

Sensor assembly, described sensor assembly comprises:

(i) be shaped to the tibial plate between proximal tibia and the distal femur that is positioned at patient, described tibial plate has substantially smooth upper surface and smooth lower surface substantially, and comprise and limiting with respect to described upper surface and lower surface by the medial wall of the Vertical Channel of described tibial plate

(ii) be positioned in described tibial plate and be configured to the sensor array of the sensor signal that generates the joint power of instruction between described patient's tibia and femur, described sensor array comprises the multiple inner sides-front side senser of inner side-front side force component of measuring described joint power, measure the multiple inner sides-rear side senser of inner side-posterior forces component of described joint power, measure described joint power outside-front side force component multiple outsides-front side senser and measure the multiple outsides-rear side senser of outside-posterior forces component of described joint power, each in described inner side-front side senser and outside-front side senser has substantially equal surface area, and each in described inner side-rear side senser and outside-rear side senser has substantially equal surface area,

(iii) be fixed to the elongate shaft portion of described tibial plate,

(iv) be fixed to the first display of described shank, and

(v) be positioned at the sensor module circuitry in described shank, described sensor module circuitry is configured to receive the sensor signal from described sensor array, control described display so that the vision instruction of medial-lateral balance of described joint power to be provided, and the joint force data of the described joint of transmission instruction power; And

Hand-held display module, described hand-held display module comprises:

(i) size is set shell that can be hand-held for,

(ii) be coupled to the display of described shell, and

(iii) be positioned at the control circuit in described shell, described control circuit is configured to receive the joint force data from described sensor assembly, and on the display of described hand-held display module, shows the vision instruction of the medial-lateral balance of described joint power.

22. orthopedic systems according to claim 21, the control circuit of wherein said hand-held display module is configured to:

Reveal competence bar on the display of described hand-held display module,

Display icon on described horizontal bar, the picture mark position on wherein said horizontal bar is indicated the medial-lateral balance of described joint power.

23. orthopedic systems according to claim 21, the control circuit of wherein said hand-held display module is configured to:

Determine the medial-lateral balance of the described joint of instruction power and the joint power value of front side-rear lateral balance, and

On the medial-lateral balance of described joint power and the display of front side-rear lateral balance, show vision instruction based on described joint power value.

24. orthopedic systems according to claim 23, the control circuit of wherein said hand-held display module is configured to show bar on described display, described has corresponding to the first end of inner side with corresponding to second end in outside, and described control circuit is configured to the first end and second end of described of front side-rear lateral balance location based on described joint power.