ADJUSTABLE ENDOPROSTHESIS

Abstract

The present application relates to an endoprosthesis, including a first member which is connected to a patient's bone; a second member which is adjustably coupled to the first member by a coupling device; wherein the coupling device is configured to generate a movement of the second member relative to the first member. The present application also relates to an artificial joint including such an endoprosthesis and to an endoprosthesis placement system including such an endoprosthesis or artificial joint and a projection device which is configured to project visible light markings, acquired from pre-operational and/or intra-operational patient data, onto the patient and/or the endoprosthesis, thus enabling visible alignment markings of the endoprosthesis to be aligned with respect to projected visible light markings so as to allow a proper adjustment of the endoprosthesis.

Claims

1-16. (canceled)

17. A computer-implemented method of adjusting a joint endoprosthesis, the joint endoprosthesis comprising a first component and a second component, the first component comprising a mounting portion configured to be mounted to a first bone and an adjustable portion configured to cooperate with the second component, the adjustable portion comprising a first sector and a second sector that are independently movable with respect to each other, the second component configured to be mounted to a second bone, the method comprising: determining, by a computer system, a planned pose for the joint endoprosthesis; determining, by the computer system, an implanted pose of the joint endoprosthesis; determining, by the computer system, an adjustment to at least one of the first sector or the second sector to cause the joint endoprosthesis to assume the planned pose from the implanted pose; and providing, by the computer system, instructions for making the determined adjustment to the joint endoprosthesis.

18. The method of claim 17, wherein providing the instructions comprises displaying, by the computer system, the instructions for making the determined adjustment to the joint endoprosthesis.

19. The method of claim 17, wherein the adjustment comprises at least one of a translational movement or a rotational movement applied to at least one of the first sector or the second sector.

20. The method of claim 17, wherein determining the implanted pose of the joint endoprosthesis comprises tracking, by the computer system, a tracking reference affixed to the first component.

21. The method of claim 17, wherein: the joint endoprosthesis comprises a knee joint endoprosthesis; the first component comprises a tibial component of the knee joint endoprosthesis; and the second component comprises a femoral component of the knee joint endoprosthesis.

22. The method of claim 17, wherein: the joint endoprosthesis comprises a hip joint endoprosthesis; the first component comprises a stem component of the hip joint endoprosthesis; and the second component comprises a cup component of the hip joint endoprosthesis.

23. The method of claim 17, wherein: the adjustable portion is coupled to the mounting portion by a coupling assembly; and the adjustment is determined based on a known correlation between movement of the adjustable portion relative to the mounting portion when the coupling assembly is actuated to cause movement of at least one of the first sector or the second sector.

24. A method of performing a surgical procedure to implant a joint endoprosthesis, the method comprising: implanting the joint endoprosthesis in a patient in an implanted pose, the joint endoprosthesis comprising a first component and a second component, the first component comprising a mounting portion configured to be mounted to a first bone and an adjustable portion configured to cooperate with the second component, the adjustable portion comprising a first sector and a second sector that are independently movable with respect to each other, the second component configured to be mounted to a second bone; determining a planned pose for the joint endoprosthesis; determining an adjustment to at least one of the first sector or the second sector to cause the joint endoprosthesis to assume the planned pose from the implanted pose; and actuating at least one of the first sector or the second sector to make the determined adjustment to the joint endoprosthesis.

25. The method of claim 24, further comprising: rigidly affixing the joint endoprosthesis in the planned pose after at least one of the first sector or the second sector has been actuated.

26. The method of claim 25, wherein rigidly affixing the joint endoprosthesis in the planned pose comprises applying a curable substance into the joint endoprosthesis to prevent any further movement of the first sector or the second sector.

27. The method of claim 26, wherein the curable substance comprises bone cement.

28. The method of claim 24, wherein at least one of the first sector or the second sector are actuated manually to make the determined adjustment to the joint endoprosthesis.

29. The method of claim 24, wherein at least one of the first sector or the second sector are actuated by a motor assembly to make the determined adjustment to the joint endoprosthesis.

30. The method of claim 24, wherein the adjustment comprises at least one of a translational movement or a rotational movement applied to at least one of the first sector or the second sector.

31. The method of claim 24, wherein determining the implanted pose of the joint endoprosthesis comprises tracking, by a medical navigation system, a tracking reference affixed to the first component.

32. The method of claim 24, wherein: the joint endoprosthesis comprises a knee joint endoprosthesis; the first component comprises a tibial component of the knee joint endoprosthesis; and the second component comprises a femoral component of the knee joint endoprosthesis.

33. The method of claim 24, wherein: the joint endoprosthesis comprises a hip joint endoprosthesis; the first component comprises a stem component of the hip joint endoprosthesis; and the second component comprises a cup component of the hip joint endoprosthesis.

34. The method of claim 24, wherein: the adjustable portion is coupled to the mounting portion by a coupling assembly; and the adjustment is determined based on a known correlation between movement of the adjustable portion relative to the mounting portion when the coupling assembly is actuated to cause movement of at least one of the first sector or the second sector.

Description

[0036] In the following, preferred embodiments of the present invention are described with the aid of the enclosed figures. The present invention can comprise any of the disclosed features, individually or in any suitable combination.

[0037] FIG. 1 shows a typical artificial knee joint comprising an endoprosthesis in accordance with the invention.

[0038] FIG. 2 shows a first embodiment of the endoprosthesis in accordance with the invention.

[0039] FIG. 3 shows a second embodiment of the endoprosthesis in accordance with the invention, comprising a different coupling mechanism.

[0040] FIG. 4 shows a third embodiment of the endoprosthesis in accordance with the invention, comprising another different coupling mechanism.

[0041] FIG. 5 shows an embodiment of the endoprosthesis in accordance with the invention, comprising alignment markings.

[0042] FIG. 6 shows an embodiment of the endoprosthesis in accordance with the invention, comprising a tracking reference.

[0043] FIG. 1 shows a typical artificial knee joint comprising a femoral component connected to the patient's femur and a tibial component which is connected to the patient's tibia and comprises a stemmed tibial plate which supports a polyethylene (PE) plastic insert arranged between the tibial component and the femoral component of the artificial knee joint.

[0044] The tibial component is formed by the endoprosthesis 1 in accordance with the invention, wherein the stemmed tibial plate forms the first member 2 and the PE insert supported by the tibial plate forms the second member 3.

[0045] The femoral component and the stemmed tibial plate are press-fitted or cemented to the femur and tibia, respectively. If the tibia has been machined inaccurately, the surgeon can compensate for these inaccuracies by adjusting the position of the PE insert with respect to the stemmed tibial plate in order to optimise the functionality and minimise the wear characteristics of the joint components.

[0046] FIG. 2 shows a first embodiment of the endoprosthesis in accordance with the present invention, wherein the first member 2 is formed by a base section or supporting plate of the artificial knee joint shown in FIG. 1, and the second member 3 is divided into four sectors 3a to 3d, wherein the sectors 3a to 3d are connected to each other and respectively comprise the coupling sections 4a to 4d which together form the coupling device 4 but can be actuated independently of each other. As can be seen in the upper, cross-sectional view in FIG. 2, each coupling section is formed by a setting screw which is inserted into a threaded bore of the respective sector 3a to 3d of the second member 3. Thus, for example, tightening the screws 4a and 4c will cause the second member 3 to tilt to the left, while tightening the screws of the coupling sections 4c and 4d will cause the second member 3 to tilt backwards around a horizontal axis in the lower drawing in FIG. 2. However, it is also conceivable for the sectors 3a to 3d to not be connected to each other and therefore able to be moved independently of each other by actuating the corresponding coupling sections 4a to 4d.

[0047] FIG. 3 shows a second embodiment of the endoprosthesis in accordance with the present invention, comprising a different type of coupling device 4. This coupling device 4 comprises four extender wheels 4a to 4d, wherein the second member 3 is divided into two sectors 3a and 3b and each sector 3a, 3b can be independently moved by means of two respective extender wheels 4a, 4b or 4c, 4d. As opposed to the setting screws of the coupling sections 4a to 4d of the first embodiment shown in FIG. 2, the extender wheels 4a to 4d according to this embodiment are actuated from the side of the endoprosthesis and not from the top surface.

[0048] FIG. 4 shows a third embodiment of the endoprosthesis in accordance with the present invention, comprising another different coupling device 4 which comprises two coupling sections 4a and 4b which respectively comprise wedges which are arranged between the first member 2 and the corresponding independent sectors 3a and 3b of the second member 3 and can be moved translationally. The wedges of the coupling device 4 can be moved independently of each other in the directions indicated by the arrows in FIG. 4 so as to raise or lower the corresponding sectors 3a and 3b with respect to the first member 2.

[0049] FIG. 5 shows another embodiment of the endoprosthesis in accordance with the present invention, in which two independent screws are provided in order to generate a translational movement of the second member 3 with respect to the subjacent first member 2 (not shown), in the directions indicated by the arrows shown in FIG. 5.

[0050] It should be noted that any of the variants and/or configurations of the embodiments shown in FIGS. 2 to 5 or any other suitable variants and/or configurations of a coupling device and/or second member can be combined sequentially or in parallel so as to move the second member 3 with respect to the first member 2 in a desired manner. The first member 2 shown in FIG. 3 could for example form the second member 3 shown in FIG. 4, and vice versa.

[0051] FIG. 5 also shows another feature of the present invention, namely a visible alignment marking 6 which is located on the second member 3 and is to be aligned with a projected marking 8 projected by a laser 7. In the example shown in FIG. 5, the alignment marking 6 does not match the projected marking 8 (distance exaggerated in the figure), hence the surgeon has to move the second member 3 to the right and also upwards, by actuating the screws of the coupling sections 4a and 4b, in order to obtain the desired geometry of the endoprosthesis.

[0052] FIG. 6 shows another embodiment of the endoprosthesis in accordance with the present invention, wherein a tracking reference 5 which is visible to and can be tracked by a surgical tracking system is attached to the second member 3. Since the spatial position of the tracking reference 5 is known to a medical navigation system, the position of the second member 3 and the geometry of the endoprosthesis 1 is also known in real time, such that a surgeon is always aware of the current geometry of the endoprosthesis.