Intraoperative systems and methods for determining and providing for display a virtual image overlaid onto a visual image of a bone
Example methods and systems may be used intraoperatively to help surgeons perform accurate and replicable surgeries, such as knee arthroplasty surgeries. An example system combines real time measurement and tracking components with functionality to compile data collected by the hardware to register a bone of a patient, calculate an axis (e.g., mechanical axis) of the leg of the patient, assist a surgeon in placing cut guides, and verify a placement of an inserted prosthesis.
1. A system comprising:
a measurement device to collect information of a surface of a bone of a limb of a patient, to track one or more reference points positioned on one or more bones or an anatomy of the patient, and to track one or more reference points positioned on a surgical device;
one or more processors; and
data storage including instructions executable by the one or more processors for performing functions comprising:
receiving pre-operative imaging of at least a portion of the limb of the patient;
aligning the pre-operative imaging with the collected information of the surface of the bone;
determining a visual model of the bone based on the aligned pre-operative imaging with the collected information of the surface of the bone;
recognizing a position and a movement of the bone in physical space based on the tracked reference points positioned on the one or more of the bone or the anatomy of the patient and causing the visual model of the bone to reflect the position and the movement of the bone in physical space;
recognizing a position and a movement of the surgical device in physical space based on the tracked reference points positioned on the surgical device; and
providing for display a virtual image overlaid onto the visual model of the bone, wherein the virtual image includes information for assisting in placement of the surgical device at a position on the bone based on the position and the movement of the surgical device in physical space.
2. The system of claim 1 , wherein the one or more processors perform the functions intraoperatively during surgery.
3. The system of claim 1 , wherein the measurement device tracks the one or more reference points positioned on one or more of a distal anterior tibial crest of the patient, a medial malleoli of the patient, a lateral malleoli of the patient, a reference off a medial third or other portion of the tibial tubercle of the patient, a base of an anterior cruciate ligament of the patient, and a posterior cruciate ligament and intercondylar eminences of the patient.
4. The system of claim 1 , wherein the function of providing for display the virtual image comprises:
receiving a live image of the bone;
providing for display the live image of the bone; and
displaying a virtual cutting plane onto the live image of the bone.
5. The system of claim 1 , wherein the one or more processors further perform functions comprising:
providing a virtual view of a resection on the bone.
6. The system of claim 1 , wherein the function of providing for display the virtual image further comprises:
providing for display a graphic illustrating placement of a prosthesis in relation to the bone.
7. The system of claim 1 , wherein the function of providing for display the virtual image further comprises:
providing for display information indicating one or more of a lateral gap of a knee of the patient, a medial gap of the knee of the patient, a valgus alignment of the knee of the patient, a flexion of a femoral cut, and a slope of a tibial cut.
8. The system of claim 1 , wherein the function of providing for display the virtual image comprises:
displaying the virtual image including placement of the surgical device, a graphic illustrating placement of a prosthesis in relation to the bone, and information indicating one or more of a lateral gap, a medial gap, and a valgus alignment of a knee of the patient with placement of the prosthesis.
9. The system of claim 1 , further comprising:
a guide positioning device attached to the patient and for adjusting the surgical device along one or more axes as well as along one or more of a pitch, a roll, and a yaw, and
wherein the measurement device tracks a position of the guide positioning device.
10. The system of claim 1 , further comprising:
one or more cameras for capturing a live image of the bone; and
wherein the function of providing for display the virtual image comprises further providing for display the virtual image overlaid on the live image of the bone.
11. The system of claim 1 , wherein at least a portion of the limb of the patient or a foot of the patient is rigidly positioned within a positioning device, and wherein the measurement device tracks a reference point positioned on the positioning device, and the one or more processors further perform functions comprising:
recognizing the position and the movement of the bone in physical space based on the tracked reference point positioned on the positioning device due to alignment of the limb of the patient or the foot of the patient within the positioning device.
12. The system of claim 1 , wherein the one or more processors further perform functions comprising:
determining an axis of the limb based on reference points positioned on a medial malleoli of the patient, a lateral malleoli of the patient, and a base of an anterior cruciate ligament of the patient; and
providing for display the axis of the limb.
13. The system of claim 1 , wherein the one or more processors further perform functions comprising:
calculating an axis of the limb based on the visual model and the position and the movement of the bone in physical space,
wherein the axis is one of a mechanical axis, a kinematic axis, or an anatomical axis.
14. The system of claim 13 , wherein the function of calculating the axis of the limb comprises:
determining a median point between a medial malleoli of the patient and a lateral malleoli of the patient; and
determining a virtual line from the median point up to a point at the base of an anterior cruciate ligament of the patient.
15. The system of claim 13 , wherein the function of calculating the axis of the limb comprises:
receiving data of an ankle of the patient;
determining peaks of sides of the ankle from at least two points based on the data of the ankle of the patient;
determining a median point between the peaks of the ankle; and
determining a virtual line from the median point up to a point at the base of an anterior cruciate ligament of the patient.
16. The system of claim 13 , wherein the function of calculating the axis of the limb comprises:
receiving data of the limb of the patient;
extrapolating, based on the data of the limb of the patient, a point of rotation of a hip of the patient during movement of the limb based on tracked reference points positioned on a distal end of a femur; and
determining a virtual line from the point of rotation of the hip up to a point at the base of an anterior cruciate ligament of the patient.
17. The system of claim 1 , further comprising:
wherein the measurement device is one or more cameras for capturing live images.
18. A method comprising:
receiving information, collected by a measurement device, of a surface of a bone of a limb of a patient;
receiving pre-operative imaging of at least a portion of the limb of the patient;
aligning the pre-operative imaging with the collected information of the surface of the bone;
determining a visual model of the bone based on the aligned pre-operative imaging with the collected information of the surface of the bone;
recognizing a position and a movement of the bone in physical space based on tracked reference points positioned on the one or more of the bone or the anatomy of the patient and causing the visual model of the bone to reflect the position and the movement of the bone in physical space;
recognizing a position and a movement of a surgical device in physical space based on tracked reference points positioned on the surgical device; and
providing for display a virtual image overlaid onto the visual model of the bone, wherein the virtual image includes information for assisting in placement of the surgical device at a position on the bone based on the position and the movement of the surgical device in physical space.
19. The method of claim 18 , further comprising:
receiving the information of the surface of the bone as exposed from the limb of the patient in real time during surgery.
20. The method of claim 18 , wherein receiving the information, collected by the measurement device, of the surface of the bone of the limb of the patient comprises:
receiving the information using a scanning tool in real time during surgery.
21. The method of claim 18 , further comprising:
providing a virtual view of a resection on the bone.
22. The method of claim 18 , further comprising:
displaying the virtual image including placement of the surgical device, a graphic illustrating placement of a prosthesis in relation to the bone, and information indicating one or more of a lateral gap, a medial gap, and a valgus alignment of a knee of the patient with placement of the prosthesis.
23. The method of claim 18 , wherein at least a portion of the limb of the patient or a foot of the patient is rigidly positioned within a positioning device, and the method further comprises:
tracking a reference point positioned on the positioning device; and
recognizing the position and the movement of the bone in physical space based on the tracked reference point positioned on the positioning device due to alignment of the limb of the patient or the foot of the patient within the positioning device.
24. The method of claim 18 , further comprising:
calculating an axis of the limb based on the visual model and the position and the movement of the bone in physical space,
wherein the axis is one of a mechanical axis, a kinematic axis, or an anatomical axis.
25. A non-transitory computer-readable medium having stored thereon instructions that when executed by a computing device that includes one or more processors causes the computing device to perform functions comprising:
receiving information, collected by a measurement device, of a surface of a bone of a limb of a patient;
receiving pre-operative imaging of at least a portion of the limb of the patient;
aligning the pre-operative imaging with the collected information of the surface of the bone;
determining a visual model of the bone based on the aligned pre-operative imaging with the collected information of the surface of the bone;
recognizing a position and a movement of the bone in physical space based on tracked reference points positioned on the one or more of the bone or the anatomy of the patient and causing the visual model of the bone to reflect the position and the movement of the bone in physical space;
recognizing a position and a movement of a surgical device in physical space based on tracked reference points positioned on the surgical device; and
providing for display a virtual image overlaid onto the visual model of the bone, wherein the virtual image includes information for assisting in placement of the surgical device at a position on the bone based on the position and the movement of the surgical device in physical space.
26. The non-transitory computer-readable medium of claim 25 , wherein the function of providing for display the virtual image comprises:
receiving a live image of the bone;
providing for display the live image of the bone; and
displaying a virtual cutting plane onto the live image of the bone.
27. The non-transitory computer-readable medium of claim 25 , wherein the function of providing for display the virtual image comprises:
receiving the data of the bone as exposed from the limb of the patient in real time during surgery.
28. The non-transitory computer-readable medium of claim 25 , wherein the function of receiving the information, collected by the measurement device, of the surface of the bone of the limb of the patient comprises:
receiving the information using a scanning tool in real time during surgery.
29. The non-transitory computer-readable medium of claim 25 , wherein the function of providing for display the virtual image comprises:
providing a virtual view of a resection on the bone.
30. The non-transitory computer-readable medium of claim 25 , wherein the function of providing for display the virtual image comprises:
displaying the virtual image including placement of the surgical device, a graphic illustrating placement of a prosthesis in relation to the bone, and information indicating one or more of a lateral gap, a medial gap, and a valgus alignment of a knee of the patient with placement of the prosthesis.
31. The non-transitory computer-readable medium of claim 25 , wherein at least a portion of the limb of the patient or a foot of the patient is rigidly positioned within a positioning device, and wherein the functions further comprise:
tracking a reference point positioned on the positioning device; and
recognizing the position and the movement of the bone in physical space based on the tracked reference point positioned on the positioning device due to alignment of the limb of the patient or the foot of the patient within the positioning device.
32. The non-transitory computer-readable medium of claim 25 , wherein the functions further comprise:
calculating an axis of the limb based on the visual model and the position and the movement of the bone in physical space,
wherein the axis is one of a mechanical axis, a kinematic axis, or an anatomical axis.