JP6735273B2 - 移植片に基づく、関節全置換術のためのプランニング、デジタル化、および登録 - Google Patents
移植片に基づく、関節全置換術のためのプランニング、デジタル化、および登録 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/14—Surgical saws ; Accessories therefor
- A61B17/15—Guides therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/14—Surgical saws ; Accessories therefor
- A61B17/15—Guides therefor
- A61B17/154—Guides therefor for preparing bone for knee prosthesis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1675—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the knee
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1703—Guides or aligning means for drills, mills, pins or wires using imaging means, e.g. by X-rays
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
- A61F2/389—Tibial components
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/461—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of knees
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/102—Modelling of surgical devices, implants or prosthesis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
- A61F2002/3069—Revision endoprostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2002/4632—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using computer-controlled surgery, e.g. robotic surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2002/4632—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using computer-controlled surgery, e.g. robotic surgery
- A61F2002/4633—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using computer-controlled surgery, e.g. robotic surgery for selection of endoprosthetic joints or for pre-operative planning
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Dentistry (AREA)
- Robotics (AREA)
- Transplantation (AREA)
- Physical Education & Sports Medicine (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Pathology (AREA)
- Radiology & Medical Imaging (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Description
本出願は、2014年12月8日に出願された、米国仮出願第62/088,896号の優先権の利益を主張するものであり;その内容は、参照により本明細書に援用される。
本発明は、概して、コンピューター支援の外科的システムの分野に関し、より具体的には、コンピューター支援の関節全置換術を行なうための新規かつ有用な方法に関する。
患者の現在の移植片の継ぎ目を復元するための修正TKR手順のための本発明の方法の実施態様の実施では、手順は、術前プロトコル、術中プロトコル:登録、および術中プロトコル:外科的手順を含む、3ステップのプロトコルで行なわれる。
機械軸に垂直な新たな継ぎ目を作成するための修正TKRのための本発明の方法の実施態様の実施では、手順は、術前プロトコル、術中プロトコル:登録、および術中プロトコル:外科的手順を含む3ステッププロトコルで行なわれ得る。
股関節移植片を復元するための修正THRのための本発明の方法の実施態様の実施では、手順は、術前プロトコル、および、登録および外科的手順を有する術中プロトコルを含む、プロトコルステップにおいて行なわれ得る。
A)標準的な転子骨切り術(1)、転子スライド骨切り術(2)、または拡張転子骨切り術(3)が、図3に示されるように行なわれるかどうか選択するステップ
B)以下を登録するステップ
i.移植片および骨の最も優位に露出した交差をデジタル化する(だいたい、図3にドットがある箇所)
ii.必要な場合は、骨切り術の領域内にいくつかの穴をあけて、登録の改善のために、移植片に沿って追加の点をデジタル化する
iii.大腿骨の側部シャフトに沿って、転子骨切り術の「末端」または遠位、エンドポイントをデジタル化する、または、骨の表面上の骨切り術のパスをデジタル化する。
iv.デジタル化された移植片を公称3−Dモデルに対して登録して、その結果、デジタル化された移植片と製造元の3−Dモデルとの間の変換行列を提供する。
v.デジタル化された移植片と患者のDICOMデータとの間の変換行列を計算して、その結果、患者の手術される骨全体を術前プランのセットに対して登録する
C)移植片を除去するステップ
D)残存する骨ストックを測定して、適切なプランを選択するステップ
E)新たな移植片の3−Dモデルを用いて、ロボット外科的システムが、術前プランによって、患者の大腿骨を切断するステップ
F)任意のさらなる骨の準備を手作業で行なうステップ
G)所望の移植片を挿入するステップ。
Claims (4)
- 外科的システムであって:
設置された補綴を有する骨の医用デジタル画像と通信(DICOM)データのセットを受信することが可能な入力装置;
前記の設置された補綴の製造仕様書および三次元(3D)モデルを含むデータベース;
前記の設置された補綴上の複数のポイントをデジタル化することが可能な光学的または機械的デジタイザープローブ;および、
前記の設置された補綴をセグメント化して、前記の製造元の3Dモデルを前記のセグメント化された設置された補綴に登録して、その変換行列を作成して、前記3Dモデルを前記の設置された補綴上にデジタル化された複数のポイントに登録して;および
前記の設置された補綴と前記患者の前記DICOMデータとの間の変換行列を計算して、外科的手順を行なうことが可能な、コンピュータープロセッサユニット(CPU)
を備える、
外科的システム。 - 請求項1の外科的システムであって、
ナビゲートシステム、ロボットシステム、または連接型ハンドヘルドシステムのうちの1つからなる、コンピューター制御支援の外科的デバイスをさらに備える、
外科的システム - 請求項1の外科的システムであって、
手術前に前記外科的手順を計画することが可能な術前プランニングワークステーション(12)をさらに備える、
外科的システム。 - 請求項2の外科的システムであって、
前記のコンピューター制御支援の外科的デバイスは、ロボットシステム(20)で構成される、
外科的システム。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201462088896P | 2014-12-08 | 2014-12-08 | |
US62/088,896 | 2014-12-08 | ||
PCT/US2015/064258 WO2016094298A1 (en) | 2014-12-08 | 2015-12-07 | Implant based planning, digitizing, and registration for total joint arthroplasty |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2017536169A JP2017536169A (ja) | 2017-12-07 |
JP6735273B2 true JP6735273B2 (ja) | 2020-08-05 |
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ID=56108013
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2017522914A Active JP6735273B2 (ja) | 2014-12-08 | 2015-12-07 | 移植片に基づく、関節全置換術のためのプランニング、デジタル化、および登録 |
Country Status (7)
Country | Link |
---|---|
US (2) | US10194991B2 (ja) |
EP (1) | EP3229722B1 (ja) |
JP (1) | JP6735273B2 (ja) |
KR (1) | KR102468791B1 (ja) |
CN (1) | CN106999245B (ja) |
AU (1) | AU2015360839B2 (ja) |
WO (1) | WO2016094298A1 (ja) |
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AU2015360839B2 (en) | 2019-09-12 |
CN106999245A (zh) | 2017-08-01 |
EP3229722A1 (en) | 2017-10-18 |
EP3229722B1 (en) | 2023-03-22 |
US10194991B2 (en) | 2019-02-05 |
WO2016094298A1 (en) | 2016-06-16 |
JP2017536169A (ja) | 2017-12-07 |
US10806517B2 (en) | 2020-10-20 |
US20170360509A1 (en) | 2017-12-21 |
KR102468791B1 (ko) | 2022-11-17 |
AU2015360839A1 (en) | 2017-05-11 |
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