IP Library › Granted Patent US 12,295,772
Granted Patent B2
US 12,295,772 · App. 18/611,186 · Granted May 13, 2025

Systems and methods for intra-operative image analysis

Inventors: Noah D. Wollowick (Westport, CT); Andrew J. Cooper (Largo, FL)
Assignee: DePuy Synthes Products, Inc.
A61B6/505A61B6/12A61B6/5235A61B34/10G06T7/0014G06T7/33A61B6/463A61B2034/108A61B2034/2068G06T2207/10116G06T2207/30008G06T2207/30052
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Quick Facts
Patent No.
US 12,295,772
App. No.
18/611,186
Granted
May 13, 2025
Kind
B2
Abstract

A system and method that acquire (i) at least a reference image including one of a preoperative image of a surgical site with skeletal and articulating bones and a contralateral image on an opposite side of the patient from the surgical site and (ii) at least an intraoperative image of the site after an implant has been affixed to the articulating bone. The system generates at least one reference landmark point on at least one anatomical feature on the articulating bone in the reference image and at least one intraoperative landmark point on that anatomical feature in the intraoperative image. The reference and intraoperative images are compared and differences between the orientation of the articulating bone in the two images are utilized to analyze at least one of offset and length differential.

Claims (58)

1. A method comprising:

acquiring a preoperative image of a patient's hip joint, the preoperative image depicting at least (i) a femoral feature point on a femur of the patient and (ii) a plurality of pelvic feature points on a pelvis of the patient,

acquiring an intraoperative image depicting at least (i) the femoral feature point on the patient's femur, (ii) the plurality of pelvic feature points on the patient's pelvis, and (iii) a trial prosthesis positioned in the patient's hip joint,

digitally registering the femoral feature point in the preoperative image,

digitally registering a longitudinal axis of the patient's femur in the preoperative image,

digitally registering the plurality of pelvic feature points in the preoperative image,

digitally registering the femoral feature point in the intraoperative image,

digitally registering the longitudinal axis of the patient's femur in the intraoperative image,

digitally registering the plurality of pelvic feature points in the intraoperative image,

digitally registering a center of rotation in the intraoperative image,

determining an angular difference between (i) a preoperative orientation of the digitally registered longitudinal axis in the preoperative image relative to the digitally registered plurality of pelvic feature points in the preoperative image and (ii) an intraoperative orientation of the digitally registered longitudinal axis in the intraoperative image relative to the digitally registered plurality of pelvic feature points in the intraoperative image,

determining a corrected femoral feature point in the intraoperative image using the digitally registered femoral feature point in the intraoperative image, the digitally registered center of rotation in the intraoperative image, and the determined angular difference,

predicting a post-operative leg length differential, offset, or both using a positional difference between (i) a preoperative location of the digitally registered femoral feature point in the preoperative image relative to the digitally registered plurality of pelvic feature points in the preoperative image and (ii) an intraoperative location of the corrected femoral feature point in the intraoperative image relative to the digitally registered plurality of pelvic feature points in the intraoperative image,

displaying the predicted post-operative leg length differential, offset, or both to a surgeon operating on the patient's hip joint,

selecting a final prosthesis to be implanted in the patient's hip joint based on the predicted post-operative leg length differential, offset, or both, and

implanting the final prosthesis in the patient's hip joint.

2. The method of claim 1 , wherein selecting the final prosthesis to be implanted in the patient's hip joint comprises selecting a final prosthesis that is the same size as the trial prosthesis.

3. The method of claim 1 , wherein selecting the final prosthesis to be implanted in the patient's hip joint comprises selecting a final prosthesis that is a different size than the trial prosthesis.

4. The method of claim 1 , wherein digitally registering the longitudinal axis in the intraoperative image comprises aligning a digital template over a femoral component of the prosthesis depicted in the intraoperative image.

5. The method of claim 4 , wherein digitally registering the longitudinal axis in the preoperative image comprises aligning the digital template over a medullary canal of the patient's femur depicted in the preoperative image.

6. The method of claim 1 , wherein:

digitally registering the plurality of pelvic feature points in the preoperative image comprises positioning a line that connects a pubic symphysis point in the preoperative image to an anterior superior iliac spine point in the preoperative image, and

digitally registering the plurality of pelvic feature points in the intraoperative image comprises positioning a line that connects the pubic symphysis point in the intraoperative image to the anterior superior iliac spine point in the intraoperative image.

7. The method of claim 6 , wherein:

digitally registering the plurality of pelvic feature points in the preoperative image further comprises digitally registering a pelvic tear drop point in the preoperative image, and

digitally registering the plurality of pelvic feature points in the intraoperative image further comprises digitally registering the pelvic tear drop point in the intraoperative image.

8. The method of claim 1 , wherein digitally registering the center of rotation in the intraoperative image comprises positioning a circle around an acetabular cup of the prosthesis depicted in the intraoperative image.

9. The method of claim 1 , wherein digitally registering the center of rotation in the intraoperative image comprises aligning a digital template over an acetabular cup of the prosthesis depicted in the intraoperative image.

10. The method of claim 1 , further comprising aligning the preoperative image and the intraoperative image using the digitally registered pluralities of pelvic feature points, prior to determining the positional difference.

11. The method of claim 10 , wherein aligning the preoperative image and the intraoperative image comprises rescaling at least one of the preoperative image or the intraoperative image.

12. The method of claim 10 , wherein determining the angular difference comprises calculating an angle between the digitally registered longitudinal axis in the preoperative image and the digitally registered longitudinal axis in the intraoperative image, after the preoperative image and the intraoperative image have been aligned using the digitally registered pluralities of pelvic feature points.

13. The method of claim 1 , wherein determining the angular difference comprises:

superimposing the preoperative image and the intraoperative image such that the digitally registered femoral feature point in the preoperative image and the digitally registered femoral feature point in the intraoperative image are aligned, and

rotating the preoperative image or the intraoperative image about the femoral feature point until the patient's femur in the preoperative image and the patient's femur in the intraoperative image are aligned.

14. The method of claim 13 , wherein the femoral feature point is located on a greater trochanter of the patient's femur.

15. The method of claim 13 , wherein determining the angular difference further comprises adjusting a transparency of at least one of the preoperative image or the intraoperative image.

16. The method of claim 13 , wherein determining the angular difference further comprises recording, as the angular difference, an amount that the preoperative image or the intraoperative image was rotated to align the patient's femur in the preoperative image and the patient's femur in the intraoperative image.

17. The method of claim 13 , wherein determining the angular difference further comprises, after the patient's femur in the preoperative image and the patient's femur in the intraoperative image have been aligned, determining a rotational displacement between the digitally registered plurality of pelvic feature points in the preoperative image and the digitally registered plurality of pelvic feature points in the intraoperative image.

18. One or more non-transitory computer-readable media storing instructions that, when executed by a processor, cause the processor to:

acquire a preoperative image of a patient's hip joint, the preoperative image depicting at least (i) a femoral feature point on a femur of the patient and (ii) a plurality of pelvic feature points on a pelvis of the patient,

acquire an intraoperative image depicting at least (i) the femoral feature point on the patient's femur, (ii) the plurality of pelvic feature points on the patient's pelvis, and (iii) a trial prosthesis inserted in the patient's hip joint,

digitally register the femoral feature point in the preoperative image,

digitally register a longitudinal axis of the patient's femur in the preoperative image,

digitally register the plurality of pelvic feature points in the preoperative image,

digitally register the femoral feature point in the intraoperative image,

digitally register the longitudinal axis of the patient's femur in the intraoperative image,

digitally register the plurality of pelvic feature points in the intraoperative image,

digitally register a center of rotation in the intraoperative image,

determine an angular difference between (i) a preoperative orientation of the digitally registered longitudinal axis in the preoperative image relative to the digitally registered plurality of pelvic feature points in the preoperative image and (ii) an intraoperative orientation of the digitally registered longitudinal axis in the intraoperative image relative to the digitally registered plurality of pelvic feature points in the intraoperative image,

determine a corrected femoral feature point in the intraoperative image using the digitally registered femoral feature point in the intraoperative image, the digitally registered center of rotation in the intraoperative image, and the determined angular difference,

predict a post-operative leg length differential, offset, or both using a positional difference between (i) a preoperative location of the digitally registered femoral feature point in the preoperative image relative to the digitally registered plurality of pelvic feature points in the preoperative image and (ii) an intraoperative location of the corrected femoral feature point in the intraoperative image relative to the digitally registered plurality of pelvic feature points in the intraoperative image,

initiate display of the predicted post-operative leg length differential, offset, or both to a surgeon operating on the patient's hip joint,

receive an input indicating the surgeon's selection of a final prosthesis in response to the predicted post-operative leg length differential, offset, or both, and

initiate display of guidance for the surgeon to implant the final prosthesis in the patient's hip joint in response to the input.

19. The one or more non-transitory computer-readable media of claim 18 , wherein the instructions, when executed by the processor, cause the processor to determine the angular difference by:

superimposing the preoperative image and the intraoperative image such that the digitally registered femoral feature point in the preoperative image and the digitally registered femoral feature point in the intraoperative image are aligned, and

recording, as the angular difference, an amount that the preoperative image or the intraoperative image is rotated in order to align the patient's femur in the preoperative image and the patient's femur in the intraoperative image.

20. The one or more non-transitory computer-readable media of claim 18 , wherein the instructions, when executed by the processor, cause the processor to determine the angular difference by determining a rotational displacement between the digitally registered plurality of pelvic feature points in the preoperative image and the digitally registered plurality of pelvic feature points in the intraoperative image, after the digitally registered longitudinal axis in the preoperative image and the digitally registered longitudinal axis in the intraoperative image have been aligned.

Assignments (2)
ASSIGNMENT OF ASSIGNOR'S INTEREST Recorded May 17, 2024
From: WOLLOWICK, NOAH D.; COOPER, ANDREW J.
To: JOINTPOINT, INC.
Reel/Frame 067446/0721 →
ASSIGNMENT OF ASSIGNOR'S INTEREST Recorded May 17, 2024
From: JOINTPOINT, INC.
To: DEPUY SYNTHES PRODUCTS, INC.
Reel/Frame 067447/0221 →
Continuity (11)
Continuation 16938912 · Jul 24, 2020
Continuation 14995057 · Jan 13, 2016
Continuation In Part 14630300 · Feb 24, 2015
Provisional Application 62105183 · Jan 19, 2015
Provisional Application 62080953 · Nov 17, 2014
Provisional Application 62051238 · Sep 16, 2014
Provisional Application 62016483 · Jun 24, 2014
Provisional Application 61980659 · Apr 17, 2014
Provisional Application 61948534 · Mar 5, 2014
Provisional Application 61944520 · Feb 25, 2014
Related Publication 20240245375A1 · Jul 25, 2024
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