BRIEF DESCRIPTION OF THE DRAWINGS
The forgoing and other features of the invention are hereinafter discussed with reference to the drawing.
FIG. 1 illustrates an exemplary adaptor in accordance with the invention, wherein a reference array is attached to the adapter.
FIG. 2 illustrates the adaptor and reference array of FIG. 1 attached to a bone broach.
FIG. 3 is a schematic view of an exemplary adaptor, reference array and broach from a front-facing side.
FIG. 4 is a side view of a front-facing side of the adapter, reference array and instrument, wherein the adaptor is attached to the instrument via oblique outer areas.
FIG. 5 illustrates a bone broach including an exemplary adaptor in accordance with the invention, and a navigation system for providing surgical assistance.
DETAILED DESCRIPTION
FIGS. 1 and 2 show a perspective view of the main components of an exemplary adaptor attaching system for reference arrays, while FIG. 3 provides a schematic view of the adapter attaching system. The adaptor 1 can broadly comprise a reference array mount 20 for mounting a reference array 10 to the adapter 1, an instrument engagement section 30 for coupling the adapter 1 to an instrument, and a coupling mechanism 5 coupling the reference array mount 20 to the instrument engagement section 30. The adapter 1 also may include the reference array 10, which can comprise a plurality of markers 12 mounted on a star-like marker support 11, for example. The adaptor 1, via the instrument engagement section 30, can be clamped to the instrument together with the reference array 10, and is shown in this state in FIG. 2 on a bone broach 2 having a handle 4 and a broaching portion 3.
In the state shown in FIG. 2, the broach 2 can be navigated, for example, in a navigation environment such as is shown in FIG. 5 using a navigation system 40 (which can include a data processing unit 43 and screen output 42). A tracking system 41, such as a camera-based tracking system 41, can be assigned to the navigation system 40. Further discussion with respect to FIG. 5 is provided below.
FIG. 3 illustrates the particulars of an attaching system comprising the instrument 2 (e.g., broach), the adaptor 1 and the reference array 10. The view of the front-facing side shows that the handle 4 of the broach 2 comprises outer walls or sides (e.g., parallel walls), which the instrument engagement section 30 engages on both sides. A longitudinal mid-plane of the broach 2 is indicated by the reference sign 7 and illustrated as a line in this view. On its outer sides, the handle 4 of the broach 2 runs parallel to and is symmetrically about the longitudinal mid-plane 7. Engaging elements 31 and 32, which, for example, can be provided with friction-enhanced surfaces (in this case, corrugated surfaces), engage on the sides of the handle 4 in order to ensure sufficient grip. It is also possible, for example, to use rubber-like inserts. The engaging elements 31 and 32 can have projecting extensions 33 that are in turn attached to the arms 5 of the adaptor 1 such that they can pivot at joint 34. The ability to pivot will be discussed again below with reference to FIG. 4. The arms 5 of the adaptor 1 can intersect (e.g., scissor arms) and can be connected to each other via joint 26. Another linking point 27 is situated at each end of the arms 5. Tension springs 24 and 25 can extend from the linking points 27 and can be held on a guide and terminate at the holding element 21.
The springs 24 and 25 press the holding element 21, which is in turn fastened to the joint 26 via extension 23, into a position between the upper arm parts. At this position, for any opening angle of the arms 5 in the region of the instrument engagement section 30, the plane 6 of the reference array 10 runs perpendicular to the longitudinal mid-plane 7. The reference array 10 can be attached to the holding element 21 via an extension 22, and its markers 12 can be placed on the marker support 11. In the present case, the upper side of the marker support 11 defines a profile of the plane 6, i.e., the reference array plane.
In other words, the coupling mechanism (including the instrument engagement section 30, the arms 5 and the holding element 21), together with their jointed connections and springs 24 and 25, as its individual parts, ensures that the reference array plane 6 is always perpendicular on the longitudinal mid-plane 7 of the broach 2, regardless of how wide the engaging elements 31 and 32 have been opened.
FIG. 3 also shows the anteversion angle α, which is the angle between the longitudinal mid-plane 7 and the epicondylar axis of the femur. Reference may again be made here to FIG. 5, which indicates how the epicondylar axis 8 can be ascertained. FIG. 5 shows the end of the femoral bone 10, and the epicondylar axis 8 can be determined by the two epicondylar points 9. While the bone 10 is broached using the broach 2, the longitudinal mid-plane 7 should be in a predetermined relationship to the epicondylar axis 8. The longitudinal plane 7 specifically can be navigated at any time by means of the adaptor 1, without the dimensions of the broach 2 being exactly known.
FIG. 4 shows how the adaptor 1 an adapt to instruments that do not have walls or side areas running in a straight line and/or parallel to the longitudinal mid-axis 7. FIG. 4 shows (again in a front-facing view) an instrument comprising a handle 4′ having an outer contour that narrows in a downward direction but is still symmetrical with respect to the longitudinal mid-plane 7. Due to the jointed 34 provided for the engaging elements 31 and 32, the adaptor 1 adapts to the profile of the handle surface of the instrument. Thus, a mechanism can be integrated that causes the two engaging elements 31 and 32 (e.g., clamping jaws) to move symmetrically. The result is that the longitudinal mid-plane 7 of the handle is always centered, and since the reference array plane 6 and the longitudinal mid-plane 7 are at right angles to each other, the navigation system 40 knows the longitudinal mid-plane 7 of the instrument when it detects the reference array 10, the characteristics of which can be stored in a corresponding database. For this reason, the anteversion angle can always be navigated.
One possible workflow for using a broach 2 when broaching a femur is as follows:
The femur is first prepared, and the adaptor 1 is then placed onto the broach handle 4. It is not necessary to calibrate the device as a whole, since in its configuration, the adaptor 1 is known to the navigation system 40, to which a tracking system 41 is assigned. Due to the configuration of the coupling mechanism 5, and since the engaging elements 31 and 32 (e.g., clamping jaws) and the reference array mount are arranged in a joint, the adaptor 1 aligns itself to the mid-plane of the broach handle 4, which is then perpendicular to the reference array plane 6. Since the geometry and dimensions of the reference array 10 are known to the navigation system 40, it is possible to simply determine the location of the longitudinal mid-plane 7 with respect to the reference array plane.
In the next step, the broach 2, together with its handle 4, can be aligned to the planned anteversion angle, wherein the surgeon takes the device as a whole and moves it to the proximal end of the femur, which has already been prepared for broaching. Since it is possible to navigate the planes, the surgeon can easily align the instrument to the planned anteversion angle. Aligning the planes is sufficient in this case; it is not necessary to navigate the instrument as a whole in terms of its geometry and dimensions.
The adaptor 1 then can be removed to perform the broaching process. When the adaptor 1 is removed, it no longer gets in the way of the broaching work. Moreover, the clamping adaptor can be very easily removed and re-attached to re-verify the working angle, and this specifically shows another advantage of the adaptor configuration.
Removing the adaptor is advantageous for the actual broaching work, since very large forces can occur. Verification and further work with the adaptor removed can be repeated until broaching is complete and the correct, planned anteversion angle has been achieved.
Although the invention has been shown and described with respect to a certain preferred embodiment or embodiments, it is obvious that equivalent alterations and modifications will occur to others skilled in the art upon the reading and understanding of this specification and the annexed drawings. In particular regard to the various functions performed by the above described elements (components, assemblies, devices, compositions, etc.), the terms (including a reference to a “means”) used to describe such elements are intended to correspond, unless otherwise indicated, to any element which performs the specified function of the described element (i.e., that is functionally equivalent), even though not structurally equivalent to the disclosed structure which performs the function in the herein illustrated exemplary embodiment or embodiments of the invention. In addition, while a particular feature of the invention may have been described above with respect to only one or more of several illustrated embodiments, such feature may be combined with one or more other features of the other embodiments, as may be desired and advantageous for any given or particular application.
Patent Application
20080045972
