Instruments for navigated orthopedic surgeries
Devices, systems, and methods for computer-assisted navigation and/or robot-assisted surgery. Navigable instrumentation, which are capable of being navigated by a surgeon using the surgical robot system, allow for the navigated movement of instruments or other surgical devices. The instruments may be suitable for procedures involving navigated and/or robotic total knee arthroplasty, for example.
1 . A system for computer-assisted navigation during surgery, the system comprising:
a navigation system including a computer, a display coupled to the computer, and a camera coupled to the computer and configured to detect tracking markers;
a first dynamic reference base (DRB) including a first reference array with a plurality of tracking markers detectable by the camera, the first DRB configured to attach to and track a femur;
a second DRB including a second reference array with a plurality of tracking markers detectable by the camera, the second DRB configured to attach to and track a tibia; and
a tensor including:
a body defining a central longitudinal axis;
first and second superior distraction paddles;
a paddle adjuster configured to move the first and second superior distraction paddles relative to the body;
an inferior distraction paddle;
a shaft connected to the paddle adjuster and positioned along the central longitudinal axis, the paddle adjuster configured to move the first and second superior distraction paddles relative to the inferior distraction paddle; and
a spring positioned around the shaft between the body and the paddle adjuster;
wherein as the paddle adjuster is adjusted, the computer automatically determines gap information based on the 3-dimensional positions of the tracking markers of the first and second DRBs which are tracked by the camera, and displays on the display the determined gap information, and
wherein the tensor includes a pivotable ligament balance indicator positioned on the body, wherein the first superior distraction paddle is connected to a first end of the ligament balance indicator with a first rod, and the second superior distraction paddle is connected to the opposite end of the ligament balance indicator with a second rod, the first rod and second rod are separate rods spaced apart from each other.
2 . The system of claim 1 , wherein the paddle adjuster includes a distraction knob and rotation of the distraction knob translates the superior distraction paddles outwardly and away from the inferior distraction paddle, thereby providing a gap between the superior and inferior distraction paddles.
3 . The system of claim 1 , wherein the spring includes one and only one spring that applies force to both the first and second superior distraction paddles.
4 . The system of claim 1 , wherein the tensor includes a pivotable ligament balance indicator positioned on the body, wherein the first superior distraction paddle is connected to a first end of the ligament balance indicator with a first rod, and the second superior distraction paddle is connected to the opposite end of the ligament balance indicator with a second rod.
5 . The system of claim 4 , wherein:
when the first and second superior paddles are distracted by the paddle adjuster, a distraction force F DISTRACTION is applied against the inferior distraction paddle, a force F LCL is applied against the first superior distraction paddle, and a force F MCL is applied against the second superior distraction paddle, and
wherein if the ligaments are in balance where F LCL =F MCL , the ligament balance indicator indicates the balance, or if the ligaments are not in balance where F LCL <F MCL Or F LCL >F MCL , then the ligament balance indicator indicates the imbalance.
6 . The system of claim 1 , wherein as the paddle adjuster is adjusted, the computer automatically and continuously determines the changing gap information based on the 3-dimensional positions of the tracking markers of the first and second DRBs which are tracked by the camera, and displays on the display the continuously determined changing gap information.
7 . The system of claim 6 , wherein the computer automatically determines whether any planned cut of the tibia or femur needs to be adjusted.
8 . The system of claim 1 , wherein the computer automatically:
determines whether any planned cut of the tibia or femur needs to be adjusted; and
displays on the display a modified cut plane of the tibia or femur in a 3-D graphical representation.
9 . A system for computer-assisted surgery, the system comprising:
a navigation system including a computer, a display coupled to the computer, and a camera coupled to the computer and configured to detect tracking markers;
a robot having a plurality of arms and an end effector adapted to be coupled to the arms, the end effector configured to hold a bone cutter for cutting along a plurality of cut planes that have been programmed by the computer;
a first dynamic reference base (DRB) including a first reference array with a plurality of tracking markers detectable by the camera, the first DRB configured to attach to and track a femur;
a second DRB including a second reference array with a plurality of tracking markers detectable by the camera, the second DRB configured to attach to and track a tibia; and
a tensor including:
a body;
first and second superior distraction paddles;
a paddle adjuster configured to move the superior distraction paddles relative to the body;
an inferior distraction paddle;
a shaft connected to the paddle adjuster and positioned along the central longitudinal axis, the paddle adjuster configured to move the first and second superior distraction paddles relative to the inferior distraction paddle; and
a spring positioned around the shaft between the body and the paddle adjuster;
wherein as the paddle adjuster is adjusted, the computer automatically determines gap information based on the 3-dimensional positions of the tracking markers of the first and second DRBs which are tracked by the camera, and displays on the display the determined gap information, and
wherein the tensor includes a pivotable ligament balance indicator positioned on the body, wherein the first superior distraction paddle is connected to a first end of the ligament balance indicator with a first rod, and the second superior distraction paddle is connected to the opposite end of the ligament balance indicator with a second rod, the first rod and second rod are separate rods spaced apart from each other.
10 . The system of claim 9 , wherein the paddle adjuster includes a distraction knob and rotation of the distraction knob translates the superior distraction paddles outwardly and away from the inferior distraction paddle, thereby providing a gap between the superior and inferior distraction paddles.
11 . The system of claim 9 , wherein the spring includes one and only one spring that applies force to both the first and second superior distraction paddles.
12 . The system of claim 9 , wherein the tensor includes a pivotable ligament balance indicator positioned on the body, wherein the first superior distraction paddle is connected to a first end of the ligament balance indicator with a first rod, and the second superior distraction paddle is connected to the opposite end of the ligament balance indicator with a second rod.
13 . The system of claim 12 , wherein:
when the first and second superior paddles are distracted by the paddle adjuster, a distraction force F DISTRACTION is applied against the inferior distraction paddle, a force F LCL is applied against the first superior distraction paddle, and a force F MCL is applied against the second superior distraction paddle, and
wherein if the ligaments are in balance where F LCL =F MCL , the ligament balance indicator indicates the balance, or if the ligaments are not in balance where F LCL <F MCL Or F LCL >F MCL , then the ligament balance indicator indicates the imbalance.
14 . The system of claim 9 , wherein as the paddle adjuster is adjusted, the computer automatically and continuously determines the changing gap information based on the 3-dimensional positions of the tracking markers of the first and second DRBs which are tracked by the camera, and displays on the display the continuously determined changing gap information.
15 . The system of claim 9 , wherein the computer automatically determines whether any programmed cut plane of the tibia or femur needs to be adjusted.
16 . The system of claim 9 , wherein the computer automatically:
determines whether any planned cut of the tibia or femur needs to be adjusted; and
displays on the display a modified cut plane of the tibia or femur in a 3-D graphical representation.