EP-4734871-A1 - APPARATUS, SYSTEM, AND METHOD FOR BONE LOSS COMPENSATION OF A PATIENT'S KNEE JOINT DURING AN ORTHOPAEDIC SURGICAL PROCEDURE

EP4734871A1EP 4734871 A1EP4734871 A1EP 4734871A1EP-4734871-A1

Abstract

An apparatus, system, and method for compensating for bone loss of a patient's knee joint during the performance of an orthopaedic surgical procedure includes determining an estimated amount of bone loss of a bone of a patient's knee joint, determining an anatomical distance between a femoral anatomical feature of a patient's femur and a tibial anatomical feature of a patient's tibia, and adjusting the determined anatomical distance based on the estimated amount of bone loss. The determined anatomical distance is indicative of a ligament length of a collateral ligament of the patient's knee joint. The bone loss may be estimated based on, for example, a surface curve fitting algorithm applied to a three-dimensional model of the bone, a defined bone loss amount provided by a user, or a comparison of the three-dimensional model of the bone to a statistical shape model that approximates the bone in a healthy state.

Inventors

ROCK, MICHAEL J.
FREEMAN, ROBERT
PREUTENBORBECK, Martin

Assignees

DePuy Ireland Unlimited Company

Dates

Publication Date: 20260506
Application Date: 20240626

Claims (20)

1. A method for compensating for bone loss of a patient's knee joint during the performance of an orthopaedic surgical procedure, the method comprising: determining, by a computer system, an estimated amount of bone loss of a bone of a patient's knee joint based on a three-dimensional model of the bone, wherein the bone comprises at least one of a femur and a tibia of the patient's knee joint; determining, by the computer system, an anatomical distance between a femoral anatomical feature located on the patient's femur and a tibial anatomical feature located on the patient's tibia at a plurality of degrees of flexion of the patient's knee joint while the femur of the patient's knee joint is in contact with the tibia of the patient's knee joint, wherein the anatomical distance is indicative of a ligament length of a collateral ligament of the patient's knee joint; and adjusting, by the computer system, the determined anatomical distance at each degree of flexion based on the estimated amount of bone loss of the bone of the patient's knee joint.
2. The method of claim 1, wherein determining the estimated amount of bone loss of the bone of the patient's knee joint comprises: applying, by the computer system, a surface curve fitting algorithm to the three-dimensional model of the bone; and determining, by the computer system, the estimated amount of bone loss based on a difference between a damaged surface of the bone of the patient's knee joint as indicated in the three-dimensional model and a corresponding surface defined by the surface curve fitting algorithm.
3. The method of any of claims 1 and 2, wherein determining the estimated amount of bone loss of the bone of the patient's knee joint comprises: receiving, by the computer system, a defined bone loss amount provided by a user of the computer system; and determining, by the computer system, the estimated amount of bone loss based on the defined bone loss amount.
4. The method of claim 3, wherein receiving the defined bone loss amount comprises receiving, by the computer system, a defined bone loss amount for a plurality of locations of a damaged surface of the bone of the patient's knee joint from the user of the computer system, wherein each location of the plurality of locations of the damaged surface contacts the other one of the femur or the tibia of the patient's knee joint at a corresponding degree of flexion of the patient's knee.
5. The method of any preceding claim, wherein determining the estimated amount of bone loss of the bone of the patient's knee joint comprises: updating the three-dimensional model of the bone of the patient's knee joint to include indicia of a damaged surface of the bone; obtaining a three-dimensional statistical shape model of a reference bone corresponding to the bone of the patient's knee joint, wherein the reference bone does not include the damaged surface; adjusting a set of parameters of the three-dimensional statistical shape model to approximate the bone of the patient's knee joint in a healthy state that does not include the damaged surface; and comparing the three-dimensional model of the bone of the patient's knee joint including the indicia of the damaged surface to the three-dimensional statistical shape model to determine the estimated amount of bone loss of the bone of the patient's knee joint.
6. The method of any preceding claim, wherein determining the anatomical distance between the femoral anatomical feature and the tibial anatomical feature comprises determining an anatomical distance between an attachment point of the collateral ligament on the patient's femur and an attachment point of the collateral ligament on the patient's tibia.
7. The method of claim 6, wherein determining the anatomical distance between the attachment point of the collateral ligament on the patient's femur and the attachment point of the collateral ligament on the patient's tibia comprises determining an anatomical distance that is indicative of a length of a medial collateral ligament or a lateral collateral ligament of the patient's knee joint while the patient's knee joint is moved through a range of flexion with the femur of the patient's knee joint in contact with the tibia of the patient's knee joint.
8. The method of any of claims 1-5, wherein determining the anatomical distance between the tibial anatomical feature and the femoral anatomical feature comprises determining an anatomical distance between an attachment point of the collateral ligament on the patient's femur and a planned cutting plane of the patient's tibia in each degree of flexion of the plurality of degrees of flexion of the patient's knee.
9. The method of claim 8, wherein adjusting the determined anatomical distance of the collateral ligament comprises increasing the determined anatomical distance between the attachment point of the collateral ligament on the patient's femur and the planned cutting plane of the patient's tibia at each degree of flexion of the plurality of degrees of flexion of the patient's knee.
10. The method of any of claims 1-5, wherein adjusting the determined anatomical distance comprises adjusting an estimated length of a medial collateral ligament or a lateral collateral ligament of the patient's knee joint at each degree of flexion based on the estimated amount of bone loss of the bone of the patient's knee joint.
11. The method of any preceding claim, further comprising: determining, by the computer system, a cutting plane of the bone of the patient's knee joint based on the adjusted determined anatomical distance; and performing an orthopaedic bone resection on the bone of the patient's knee joint using the determined cutting plane as a reference for the orthopaedic bone resection.
12. The method of claim 11, wherein adjusting the determined anatomical distance comprises adjusting the determined anatomical distance by an adjustment amount that is based on the estimated amount of bone loss of the bone of the patient's knee joint; and further comprising determining, by the computer system, an initial cutting plane of the bone of the patient's knee joint, wherein determining the cutting plane of the bone of the patient's knee joint based on the adjusted determined anatomical distance comprises moving the initial cutting plane by the adjustment amount to define a final cutting plane, and wherein performing the orthopaedic bone resection comprises performing the orthopaedic bone resection on the bone of the patient's knee joint using the final cutting plane as a reference for the orthopaedic bone resection.
13. An orthopedic surgical planning system for compensating for bone loss of a patient's knee joint during the performance of an orthopaedic surgical procedure, the orthopedic surgical planning system comprising: at least one processor; and at least one memory device having stored therein a plurality of instructions that, when executed by the at least one processor, cause the orthopedic surgical planning system to: determine an estimated amount of bone loss of a bone of a patient's knee joint based on a three-dimensional model of the bone, wherein the bone comprises at least one of a femur and a tibia of the patient's knee joint; determine an anatomical distance between a femoral anatomical feature located on the patient's femur and a tibial anatomical feature located on the patient's tibia at a plurality of degrees of flexion of the patient's knee joint while the femur of the patient's knee joint is in contact with the tibia of the patient's knee joint, wherein the anatomical distance is indicative of a ligament length of a collateral ligament of the patient's knee joint; and adjust the determined anatomical distance at each degree of flexion based on the estimated amount of bone loss of the bone of the patient's knee joint.
14. The orthopedic surgical planning system of claim 13, wherein to determine the estimated amount of bone loss of the bone of the patient's knee joint comprises to: apply a surface curve fitting algorithm to the three-dimensional model of bone; and determine the estimated amount of bone loss based on a difference between a damaged surface of the bone of the patient's knee joint as indicated in the three-dimensional model and a corresponding surface defined by the surface curve fitting algorithm.
15. The orthopedic surgical planning system of any of claims 13 and 14, wherein to determine the estimated amount of bone loss of the bone of the patient's knee joint comprises to: receive a defined bone loss amount provided by a user of the computer system; and determine the estimated amount of bone loss based on the defined bone loss amount.
16. The orthopedic surgical planning system of any of claims 13-15, wherein to determine the estimated amount of bone loss of the bone of the patient's knee joint comprises to: update the three-dimensional model of the bone of the patient's knee joint to include indicia of a damaged surface of the bone; obtain a three-dimensional statistical shape model of a reference bone corresponding to the bone of the patient's knee joint, wherein the reference bone does not include the damaged surface; adjust a set of parameters of the three-dimensional statistical shape model to approximate the bone of the patient's knee joint in a healthy state that does not include the damaged surface; and compare the three-dimensional model of the bone of the patient's knee joint including the indicia of the damaged surface to the three-dimensional statistical shape model to determine the estimated amount of bone loss of the bone of the patient's knee joint.
17. The orthopedic surgical planning system of any of claims 13-16, wherein to determine the anatomical distance between the tibial anatomical feature and the femoral anatomical feature comprises to determine an anatomical distance between an attachment point of the collateral ligament on the patient's femur and a planned cutting plane of the patient's tibia in each degree of flexion of the plurality of degrees of flexion of the patient's knee.
18. The orthopaedic surgical planning system of any of claims 13-15, wherein to adjust the determined anatomical distance comprises to adjust the determined anatomical distance by an adjustment amount that is based on the estimated amount of bone loss of the bone of the patient's knee joint; and wherein the plurality of instructions, when executed by the at least one processor, further cause the orthopedic surgical planning system to determine an initial cutting plane of the bone of the patient's knee joint; and adjust the initial cutting plane by the adjustment amount to define a final cutting plane.
19. A method for compensating for bone loss of a patient's knee joint during the performance of an orthopaedic surgical procedure, the method comprising: determining an estimated amount of bone loss of a femur a patient's knee joint based on a three-dimensional model of the femur; determining an estimated length of a collateral ligament of the patient's knee joint by determining an anatomical distance between an attachment point of the collateral ligament on the femur of the patient's knee joint and a planned cutting plane of a tibia of the patient's knee joint; and increasing the determined anatomical distance based on the estimated amount of bone loss of the femur of the patient's knee joint.
20. The method of claim 19, wherein increasing the determined anatomical distance comprises increasing the determined anatomical distance by an adjustment amount that is based on the estimated amount of bone loss of the femur of the patient's knee joint; and further comprising: determining an initial cutting plane of the femur of the patient's knee joint; adjusting the initial cutting plane by the adjustment amount to define a final cutting plane; and performing an orthopaedic bone resection on the femur of the patient's knee joint using the final cutting plane as a reference for the orthopaedic bone resection.

Description

APPARATUS, SYSTEM, AND METHOD FOR BONE LOSS COMPENSATION OF A PATIENT'S KNEE JOINT DURING AN ORTHOPAEDIC SURGICAL PROCEDURE CROSS-REFERENCE TO RELATED APPLICATIONS [0001] This application claims priority to U.S. Patent Application Serial No. 18/217,224, which was filed on June 30, 2023 and is expressly incorporated by reference into the present application. TECHNICAL FIELD [0002] The present disclosure relates generally to computer-assisted surgery systems for use in the performance of orthopaedic surgical procedures, and more particularly to technologies for compensating for bone loss of a patient's boney anatomy during a knee orthopaedic surgical procedure. BACKGROUND [0003] Joint arthroplasty is a well-known surgical procedure by which a diseased and/or damaged natural joint is replaced by a prosthetic joint, which may include one or more orthopaedic implants. For example, in a knee arthroplasty surgical procedure, a patient's natural knee joint is partially or totally replaced by a prosthetic knee joint. A typical prosthetic knee joint includes a tibial tray, a femoral component, and a polymer insert or bearing positioned between the tibial tray and the femoral component. [0004] To facilitate the replacement of the natural joint with a prosthetic joint, orthopaedic surgeons may use a variety of orthopaedic surgical instruments such as, for example, surgical saws, cutting guides, reamers, broaches, drill guides, drills, positioners, insertion tools and/or other surgical instruments. For example, a surgeon may prepare a patient's tibia to receive the tibial tray by resecting the proximal tibia with a surgical saw, and the surgeon may prepare the patient's femur to receive the femoral component by performing multiple resections of the distal femur with an appropriate orthopaedic surgical instrument, such as a surgical saw, burr, or the like. A surgeon may use manual instruments such as cutting blocks or other cutting guides to perform various resections in an orthopaedic procedure. Alternatively, or in addition, a surgeon may use a computer- assisted surgical navigation system, such as a robotic-assisted surgical system, to perform the various resections in the orthopaedic procedure. [0005] Typically, an orthopaedic surgeon may perform some amount of preoperative and/or intra-operative planning to, for example, determine a positioning of the knee prosthesis. In situations in which the patient's boney anatomy has suffered significant bone loss (e.g., due to disease or trauma), the determination of the positioning of the prosthesis can be complicated due to the bone loss. SUMMARY [0006] According to an aspect of the present disclosure, a method for compensating for bone loss of a patient's knee joint during the performance of an orthopaedic surgical procedure may include determining, by a computer system, an estimated amount of bone loss of a bone of a patient's knee joint based on a three- dimensional model of the bone; determining, by the computer system, an anatomical distance between a femoral anatomical feature located on the patient's femur and a tibial anatomical feature located on the patient's tibia at a plurality of degrees of flexion of the patient's knee joint while the femur of the patient's knee joint is in contact with the tibia of the patient's knee joint; and adjusting, by the computer system, the determined anatomical distance at each degree of flexion based on the estimated amount of bone loss of the bone of the patient's knee joint. The bone may include the femur and/or the tibia of the patient's knee joint, and the anatomical distance may be indicative of a ligament length of a collateral ligament of the patient's knee joint. [0007] In some embodiments, determining the estimated amount of bone loss of the bone of the patient's knee joint may include applying, by the computer system, a surface curve fitting algorithm to the three-dimensional model of the bone; and determining, by the computer system, the estimated amount of bone loss based on a difference between a damaged surface of the bone of the patient's knee joint as indicated in the three-dimensional model and a corresponding surface defined by the surface curve fitting algorithm. Additionally or alternatively, determining the estimated amount of bone loss of the bone of the patient's knee joint may include receiving, by the computer system, a defined bone loss amount provided by a user of the computer system; and determining, by the computer system, the estimated amount of bone loss based on the defined bone loss amount. In such embodiments, receiving the defined bone loss amount may include receiving, by the computer system, a defined bone loss amount for a plurality of locations of a damaged surface of the bone of the patient's knee joint from the user of the computer system and each location of the plurality of locations of the damaged surface may contact the other one of the femur or the tibia of the patient's knee joint a