Methods and systems for implanting a joint implant
Methods, systems, and devices for treating osteochondral defects (OCDs) are disclosed. The disclosed methods and systems include collecting joint surface data using image-free methods, generating a three-dimensional (3D) healthy bone model based on the joint surface data and a database of healthy bone anatomies, defining the OCD boundary on the joint, generating a 3D implant model based on the 3D healthy bone model and the OCD boundary, manufacturing an implant based on the 3D implant model, generating an implantation plan, the resected cavity on the joint. The implant includes a 3D-printed titanium alloy substrate having a first and second porous layer separated by a nonporous layer. A polymer material is over-molded onto the second porous layer and treated to exhibit properties that mimic cartilage, while the first porous layer allows the implant to fuse to patient bone.
1. A method of placing an implant to treat a defect associated with an articular surface of a joint of a patient, the method comprising:
receiving first data associated with the articular surface, the first data indicating a surface geometry of the articular surface;
generating, using the first data, a bone model corresponding to bone tissue associated with the articular surface;
defining a geometry of the defect;
generating, using the bone model and the geometry of the defect, an implant model configured to treat the defect;
receiving an implant corresponding to the implant model;
generating an implantation plan for the implant, wherein the implantation plan comprises at least one of a size, a shape, a location, or an orientation of a cavity at the articular surface that is configured to receive the implant;
creating an incision at the joint of the patient;
resecting the articular surface to create the cavity;
placing the implant into the cavity;
prior to closing the incision, using an instrumented probe to map a post-implantation articular surface that is formed at least partially by the implant to create a post-implantation surface map of the articular surface, wherein the post-implantation surface map comprises a post-implantation surface geometry of the articular surface;
receiving healthy bone anatomy data from a database;
comparing the post-implantation surface map with the healthy bone anatomy data to assess a congruency of the implant with a portion of the articular surface surrounding the implant to determine, whether a modification to the implant is needed for the implant to be congruent with the articular surface; and
when it is determined that the modification to the implant is needed for the implant to be congruent with the articular surface, shaving or planing an implant articular surface of the implant so that the implant is congruent with the articular surface of the joint.
2. The method of claim 1 , wherein receiving the first data comprises collecting, using an instrumented probe configured to be identified by a tracking system to map a surface, first surface point data associated with the articular surface.
3. The method of claim 1 , wherein receiving the first data comprises receiving a preoperative image of the articular surface.
4. The method of claim 1 , wherein generating the implantation plan comprises:
orienting the implant model with respect to the bone model; and
determining the location and the orientation of the cavity according to an implant model orientation of the implant model with respect to the bone model.
5. The method of claim 1 , wherein the implant comprises a tissue-interfacing surface configured to encourage bone growth into the implant.
6. The method of claim 1 , wherein receiving the implant comprises at least one of manufacturing the implant according to the implant model or selecting the implant that best corresponds to the implant model from a plurality of pre-existing implants.
7. The method of claim 1 , wherein comparing the post-implantation surface map with the healthy bone anatomy data comprises using overlapping metrics, which uses a Dice similarity coefficient.
8. The method of claim 1 , further comprising shaving or planing an implant articular surface of the implant, according to whether the modification is needed to the implant for the implant to be congruent with the articular surface.
9. The method of claim 8 , wherein:
the implant articular surface comprises a synthetic cartilage surface; and
shaving or planing the implant articular surface comprises shaving or planing the synthetic cartilage surface until the synthetic cartilage surface smoothly interfaces with surrounding bone tissue of the articular surface of the joint.
10. The method of claim 1 , wherein comparing the post-implantation surface map with the healthy bone anatomy data comprises using volume and surface metrics, which include assessing maximum and mean distance errors.