U.S. patent application number 17/070433 was filed with the patent office on 2021-01-28 for device for sensing implant location and impingement.
The applicant listed for this patent is Zimmer, Inc.. Invention is credited to Derek Dalbey, Rida Hariri, Kenneth D. Johannaber, John Minck, JR..
Application Number | 20210022874 17/070433 |
Document ID | / |
Family ID | 1000005150370 |
Filed Date | 2021-01-28 |
![](/patent/app/20210022874/US20210022874A1-20210128-D00000.png)
![](/patent/app/20210022874/US20210022874A1-20210128-D00001.png)
![](/patent/app/20210022874/US20210022874A1-20210128-D00002.png)
![](/patent/app/20210022874/US20210022874A1-20210128-D00003.png)
![](/patent/app/20210022874/US20210022874A1-20210128-D00004.png)
![](/patent/app/20210022874/US20210022874A1-20210128-D00005.png)
![](/patent/app/20210022874/US20210022874A1-20210128-D00006.png)
![](/patent/app/20210022874/US20210022874A1-20210128-D00007.png)
![](/patent/app/20210022874/US20210022874A1-20210128-D00008.png)
![](/patent/app/20210022874/US20210022874A1-20210128-D00009.png)
![](/patent/app/20210022874/US20210022874A1-20210128-D00010.png)
View All Diagrams
United States Patent
Application |
20210022874 |
Kind Code |
A1 |
Johannaber; Kenneth D. ; et
al. |
January 28, 2021 |
DEVICE FOR SENSING IMPLANT LOCATION AND IMPINGEMENT
Abstract
Embodiments of a system and method for assessing hip
arthroplasty component movement are generally described herein. A
method may include receiving data from a sensor embedded in a
femoral head component, the femoral head component configured to
fit in an acetabular component, determining information about a
magnetic field from the data, and outputting an indication of an
orientation, coverage, or a force of the femoral head component
relative to the acetabular component.
Inventors: |
Johannaber; Kenneth D.;
(Reno, NV) ; Minck, JR.; John; (Reno, NV) ;
Hariri; Rida; (Reno, NV) ; Dalbey; Derek;
(Reno, NV) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Zimmer, Inc. |
Warsaw |
IN |
US |
|
|
Family ID: |
1000005150370 |
Appl. No.: |
17/070433 |
Filed: |
October 14, 2020 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
15800915 |
Nov 1, 2017 |
10842636 |
|
|
17070433 |
|
|
|
|
62416435 |
Nov 2, 2016 |
|
|
|
62514257 |
Jun 2, 2017 |
|
|
|
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61F 2002/4666 20130101;
A61F 2/34 20130101; A61F 2002/4668 20130101; A61B 2018/00773
20130101; A61B 5/05 20130101; A61F 2002/3067 20130101; A61F
2002/30079 20130101; A61F 2002/2828 20130101; A61F 2002/4658
20130101; A61F 2/32 20130101; A61F 2002/3611 20130101; A61F
2002/482 20130101; A61F 2002/4698 20130101; A61F 2/3609 20130101;
A61B 5/4571 20130101; A61F 2002/3625 20130101; A61F 2002/3055
20130101; A61F 2/4684 20130101; A61F 2/4657 20130101; A61B 5/4851
20130101; A61B 5/0031 20130101; A61F 2002/4696 20130101; A61B
5/7445 20130101 |
International
Class: |
A61F 2/34 20060101
A61F002/34; A61F 2/32 20060101 A61F002/32; A61B 5/00 20060101
A61B005/00; A61F 2/46 20060101 A61F002/46; A61B 5/05 20060101
A61B005/05; A61F 2/36 20060101 A61F002/36 |
Claims
1-20. (canceled)
21. A non-transitory machine-readable medium including instructions
for presenting a user interface, which when executed by a
processor, cause the processor to: receive coverage data from a
sensor of a first implant securable to a first bone and a second
implant securable to a second bone; determine a first coverage
condition from a first perspective based on the coverage data;
determine a second coverage condition from a second perspective
based on the coverage data; output for display a first visual
indication on the user interface representing the first coverage
condition; and output for display a second visual indication on the
user interface representing the second coverage condition.
22. The machine-readable medium of claim 21, wherein the first
visual indication and the second visual indication are outputted
for concurrent display.
23. The machine-readable medium of claim 21, wherein the first
visual indication includes a visual representation of the first
implant and an impingement indicator.
24. The machine-readable medium of claim 21, further comprising
instructions that cause the processor to: determine a coverage
percentage of the first implant relative to the second implant
based on the coverage data; and output for display the coverage
percentage on the user interface.
25. The machine-readable medium of claim 24, wherein the first
perspective represents inferior-superior (I-S) coverage of the
first implant with respect to the second implant and the second
perspective represents anterior-posterior (A-P) coverage of the
first implant with respect to the second implant.
26. The machine-readable medium of claim 24, wherein the first
visual indication signifies whether a first angle is within an I-S
limit and the second visual indication signifies whether a second
angle is within an A-P limit.
27. The machine-readable medium of claim 26, further comprising
instructions that cause the processor to: display the first visual
indication in a first color when the first angle is within the I-S
limit; display the first visual indication in a second color when
the first angle is not within the I-limit; display the second
visual indication in the first color when the second angle is
within the A-P limit; and display the second visual indication in
the second color when the second angle is not within the A-P
limit
28. The machine-readable medium of claim 21, further comprising
instructions that cause the processor to: receive force data from
the sensor of the first implant; determine a force applied to the
first implant or the second implant based on the force data; and
output for display, on the user interface, a force visual
indication of the determined force.
29. The machine-readable medium of claim 28, wherein the force
visual indication signifies whether the force applied is within
preset force limits.
30. The machine-readable medium of claim 29, wherein the force
visual indication signifies whether the applied force is within
force limit by changing color.
31. A non-transitory machine-readable medium including instructions
for presenting a user interface, which when executed by a
processor, cause the processor to: receive coverage data from a
sensor of a first implant securable to a first bone and a second
implant securable to a second bone; determine a first coverage
condition from a first perspective based on the coverage data;
determine a second coverage condition from a second perspective
based on the coverage data; output for display a first visual
indication on the user interface representing the first coverage
condition; and output for display, concurrently with the first
visual indication, a second visual indication on the user interface
representing the second coverage condition.
32. The machine-readable medium of claim 31, further comprising
instructions that cause the processor to: receive force data from
the sensor of the first implant; determine a force applied to the
first implant or the second implant based on the force data; and
output for display, on the user interface, a force visual
indication of the determined force.
33. The machine-readable medium of claim 32, wherein the first
visual indication signifies whether a first angle is within an
angular range defined by the upper angle coverage limit and the
lower angle coverage limit.
34. The machine-readable medium of claim 31, which when executed by
a processor, further cause the processor to: output for display, on
the user interface, a force visual indication based on a force
applied to the first implant or the second implant.
35. The machine-readable medium of claim 34, which when executed by
a processor, further cause the processor to: output for display, on
the user interface, a force scale manipulatable to set an upper
force limit and a lower force limit.
36. The machine-readable medium of claim 32, wherein the force
visual indication signifies whether the force applied is within a
force range defined by the upper force limit and the lower force
limit.
37. A method of presenting information on a user interface, the
method comprising: receiving coverage data from a sensor of a first
implant securable to a first bone and a second implant securable to
a second bone; displaying a first visual indication on the user
interface representing a first coverage condition from a first
perspective based on the coverage data; and displaying a second
visual indication on the user interface representing a second
coverage condition from a second perspective based on the coverage
data; receiving force data from the sensor of the first implant or
the second implant; displaying a force visual indication based on a
force applied to the first implant or the second implant; and
displaying a coverage percentage on the user interface representing
the first coverage condition and the second coverage condition.
38. The method of claim 37, wherein the first visual indication is
determined based on magnetic field data produced by a sensor of the
first component based on interaction between the sensor and a
magnet of the second component.
39. The method of claim 38, wherein the sensor is a Hall effect
sensor.
40. The method of claim 37, wherein the first implant is a femoral
implant and the second implant is an acetabular implant.
Description
CLAIM OF PRIORITY
[0001] This application is a continuation of U.S. patent
application Ser. No. 15/800,915, filed on Nov. 1, 2017, which
claims the benefit of U.S. Provisional Patent Application Ser. No.
62/416,435, filed on Nov. 2, 2016, and also claims the benefit of
U.S. Provisional Patent Application Ser. No. 62/514,257, filed on
Jun. 2, 2017, the benefit of priority of each of which is claimed
hereby, and each of which are incorporated by reference herein in
its entirety.
BACKGROUND
[0002] Dislocation, leg length discrepancy, and general instability
are the leading complications with total hip arthroplasty. These
problems are difficult to anticipate and often are not detectable
using traditional methods during or immediately after surgery. Some
methods to attempt to detect these issues include running a finger
along an acetabular cup during range of motion trials to detect
impingement. Other methods for cup alignment target a standard
inclination or anteversion angle, which may not be appropriate for
all patients. Additionally, other methods for determining coverage
are often inaccurate. Surgeons typically use tactile feedback such
as palpating, articulating with a finger behind the joint, to
assess coverage subjectively.
BRIEF DESCRIPTION OF THE DRAWINGS
[0003] In the drawings, which are not necessarily drawn to scale,
like numerals may describe similar components in different views.
Like numerals having different letter suffixes may represent
different instances of similar components. The drawings illustrate
generally, by way of example, but not by way of limitation, various
embodiments discussed in the present document.
[0004] FIG. 1 illustrates a hip arthroplasty system with a sensor
in a trunnion in accordance with some embodiments.
[0005] FIGS. 2A-2C illustrate a hip arthroplasty system with
sensors arranged in two intersecting arcs within a femoral head in
accordance with some embodiments.
[0006] FIGS. 3A-3D illustrate femoral implants including
representations of a degree of separation of an acetabular
component to a femoral head in accordance with some
embodiments.
[0007] FIGS. 4A-4D illustrate visual indications of a degree of
impingement of an acetabular component to a femoral head in
accordance with some embodiments.
[0008] FIG. 5 illustrates a user interface for setting joint force
and proximity angle limits in accordance with some embodiments.
[0009] FIGS. 6A-6B illustrate user interfaces for displaying joint
forces and proximity angles in accordance with some
embodiments.
[0010] FIG. 7 illustrates a system for assessing hip arthroplasty
component movement in accordance with some embodiments.
[0011] FIG. 8 illustrates a flow chart showing a technique for
assessing hip arthroplasty component movement in accordance with
some embodiments.
[0012] FIG. 9 illustrates generally an example of a block diagram
of a machine upon which any one or more of the techniques discussed
herein may perform in accordance with some embodiments.
[0013] FIG. 10 illustrates an adjustable trunnion in accordance
with some embodiments.
[0014] FIG. 11 illustrates an assembled view of a femoral head
component in accordance with some embodiments.
[0015] FIG. 12 illustrates a combined adjustable trunnion and
femoral head component system in accordance with some
embodiments.
[0016] FIG. 13 illustrates an exploded view of a femoral head
component in accordance with some embodiments.
[0017] FIG. 14 illustrates a sectional view of a portion of a
femoral head component in accordance with some embodiments.
[0018] FIG. 15 illustrates a graphical user interface for
displaying impingement information in accordance with some
embodiments.
[0019] FIG. 16 illustrates a flow chart showing a technique for
outputting impingement information in accordance with some
embodiments.
DETAILED DESCRIPTION
[0020] Systems and methods for assessing hip arthroplasty component
movement are described herein. The systems and methods herein
assess joint stability, range of motion, and risk of impingement to
help prevent postoperative impingement or dislocation, such as in
cases of total hip arthroplasty. The systems and methods described
herein may provide a risk of impingement intraoperatively. Data
received from the systems and methods described herein may be used
to determine how impingement position affects outcomes and also
used to modify assessment and surgical techniques to improve
outcomes. In an example, the systems and methods described herein
may be used with a ball and socket joint (e.g., in a shoulder
surgical procedure).
[0021] Total hip arthroplasty includes a femoral implant and an
acetabular component, such as a cup or liner that interact at a
joint. The femoral implant includes a femoral head to fit into the
acetabular component. In an example, the systems and methods
described herein provide a quantified value of a proximity of the
neck or trunnion of the femoral implant to the acetabular
component. While the systems and methods herein describe
implant-to-implant impingement, they may also be used to describe
implant-to-bone and bone-to-bone impingement.
[0022] The surgeon may use an output of the disclosed systems and
methods intraoperatively while putting a joint through a range of
motion test to capture a fit of the acetabular component to the
femoral head at different points in the range of motion. The output
may include a risk-level for postoperative impingement. The output
may include an indicator of a patient-specific assessment of
acetabular component to femoral head. In an example, the output may
include an indicator of impingement, as well as an indicator of
risk of impingement through proximity sensing. The systems and
methods described herein may be used around the perimeter of the
acetabular component, including at points that may not be
accessible to a surgeon visibly or with a finger, such as during a
range of motion test.
[0023] In an example, data may be collected from a system
intraoperatively and postoperatively to determine a level of
success for preventing impingement, dislocation, or other
complications. The data may be used in a feedback system applying
techniques (e.g., adaptive or customized approaches, such as those
which may involve machine learning) to improve precision of the
system or outcomes for a patient. In an example, a sensor may be
used to collect data that may be used to establish patient-specific
surgical techniques or postoperative care. Data output may include
proximity to impingement at certain points in a range of motion
trial. If risk of impingement is high, postoperative guidance may
include longer recovery with limited activity requirements. The
machine learning techniques may be used to establish a standard or
customized acetabular component position algorithm.
[0024] In an example, a surgeon may use an output of the systems
and methods described herein while performing range of motion tests
with a joint to capture an orientation and extent of coverage
between the femoral head and the acetabular component, such as at
different points in the range of motion. The output may be used to
map the coverage to the range of motion position, which may
indicate risk factors for dislocation. The output may be used to
assess laxity during a shuck test (e.g., distraction of the joint),
or the output may be used to define precursors for impingement.
[0025] FIG. 1 illustrates a hip arthroplasty system 100 with a
sensor 108 in a trunnion 110 in accordance with some embodiments.
The hip arthroplasty system 100 includes a femoral implant 102
(which may be a femoral trial), with a femoral head 112 at a distal
end of the femoral implant. The femoral implant includes the
trunnion 110 with the sensor 108. The femoral head 112 is
configured to fit in an acetabular component 104. The acetabular
component 104 includes a plurality of magnets (e.g., 106A and 106B)
or a magnet ring. The plurality of magnets (e.g., 106A and 106B) or
the magnet ring may be removable from the acetabular component 104.
The acetabular component 104 may be a cup or a liner. In an
example, one or more of the acetabular component 104, the femoral
head 112, the trunnion 110, or other components described herein
may be implant components, trial components, testing components, or
the like.
[0026] The hip arthroplasty system 100 may be used to indicate a
possibility of impending impingement between the implant neck
(e.g., the trunnion 110) and the acetabular component 104. The
sensor 108 may include a Hall effect sensor, a reed switch, a
magnetometer or another type of proximity sensor, to detect a
distance between the trunnion 110 and the acetabular component 104
(e.g., the plurality of magnets 106A, 106B, etc.). The plurality of
magnets (e.g., 106A, 106B, etc.) or a magnet ring on the acetabular
component 104 may supplies a reference magnetic field, to be
measured or detected by the sensor 108. In an example, the
plurality of magnets (e.g., 106A or 106B) may be embedded in a ring
and attached to the acetabular component 104, such as with surgical
glue, tension, screws, or other attachment means. In another
example, the ring may have a continuous sheet magnet.
[0027] In an example, a plurality of sensors may be used to collect
data. The sensor 108 may be embedded into the trunnion 110, which
may be disposable or reusable. In an example, the trunnion 110 may
include a printed circuit board for receiving the sensor data,
forwarding the sensor data, or processing the sensor data.
[0028] The sensor 108 may be positioned at a perimeter of the
trunnion 110. The sensor 108 may output a voltage in response to
magnetic field strength, such as a field emanating from one or more
of the plurality of magnets (e.g., 106A or 106B). As the trunnion
110 is rotated toward the magnetic ring, the voltage output may
increase, indicating the closer distance. The hip arthroplasty
system 100 may be calibrated to output a voltage as a distance
offset (such as in millimeters, inches, or degrees, etc.) to output
an indicator of how close the trunnion 110 is to the acetabular
component 104 or whether there is a risk of impingement. The output
may be consistent for the entire circumference of the acetabular
component 104. For example, an assessment may be made as to whether
an adjustment is needed in the acetabular component 104 position
relative to a high-risk area, such as during a range of motion
assessment.
[0029] FIGS. 2A-2C illustrate a hip arthroplasty system 200A-200C
with sensors (e.g., sensor 204A, 204B, 204C, etc.) arranged in two
intersecting arcs within a femoral head 202 in accordance with some
embodiments. The femoral head 202 may be connected to a trunnion
206 of a femoral implant. The femoral head 202 may be configured to
fit into an acetabular component 212. The acetabular component 212
may include a magnetic ring 208 or a plurality of magnets. The
magnetic ring 208 or the plurality of magnets may be removable or
embedded in the acetabular component 212.
[0030] In FIG. 2C, the hip arthroplasty system 200C is shown with
the acetabular component 212 hidden to illustrate the interaction
of the magnetic ring 208 with the plurality of sensors (e.g., 204C)
at interaction points 210A-210D. From the interaction points
210A-210D, the hip arthroplasty system 200C may be used to
determine an angle of impingement of the acetabular component 212
(using the magnetic ring 208) to the trunnion 206.
[0031] In an example, the femoral head 202 includes two
circumferential rings of Hall effect sensors (e.g., 204A, 204B,
204C), the sensors to output a proximity to a magnetic field. The
magnetic field may be supplied by the magnetic ring 208, which may
be removable from the acetabular component or may be embedded in
the acetabular component. In an example, the Hall effect sensors
may experience a spike (e.g., output an increased voltage from a
first state) when near the magnetic field. The interaction points
210A-210D may correspond with four different sensors in the femoral
head 202, each of which may experience a spike or output a higher
voltage than the remaining sensors. The voltage output may be
directly proportional to the strength of the magnetic field. As a
result, the sensor closest to the magnetic ring may return the
largest voltage spike. The interaction points 210A-210D represent
points where the Hall effect sensors cross the magnetic ring 208.
These four interaction points 210A-210D may be used to create a
plane, which may be used to provide a coverage map of the femoral
head 202 in the acetabular component.
[0032] In an example, the femoral head 202 may include two
perpendicular rows of position sensors (e.g., Hall effect sensors
or magnetometers) that interact (e.g., magnetically) with the
magnetic ring 208 attached to the acetabular component (e.g., a
liner, cup, or shell). The output from the sensors may be sent to a
system to interprets the output and perform a data analysis. The
data analysis may be used to determine whether an impingement has
occurred or is likely to occur postoperatively. By placing two
perpendicular arcs of sensors along the femoral head 202 from an
edge to an opposite edge along a half-circumference, and placing
the magnetic ring 208 on the perimeter of the opening of the
acetabular component, the hip arthroplasty system 200A-200C
facilitates the output of the four interaction points 210A-210D,
which correspond to the sensors that are closest to the magnet.
Since the location of each sensor on the femoral head 202 is known,
the interaction points 210A-210D may be converted into a plane that
can be interpreted as coverage between the femoral head 202 and the
acetabular component. The plane may be tracked, such as in
real-time, for example as the joint runs through range of motion
trials.
[0033] In an example, the hip arthroplasty system 200A-200C may be
used to identify issues intraoperatively. For example, separation
of the femoral head 202 and the acetabular component may be
identified via translation, such as when the interaction points
210A-210D translate instead of rotate. This is described in further
detail below in FIGS. 3A-3B.
[0034] In another example, impingement or impingement risk may be
identified, such as when an interaction point e.g., 210A is high
and an opposite interaction point, e.g., 210C is low on the femoral
head 202. This is described in further detail below in FIGS.
4A-4B.
[0035] FIGS. 3A-3D illustrate femoral implants (e.g., 300A-300D) or
trials including representations of a degree of separation of an
acetabular component (hidden for clarity) to a femoral head 302 in
accordance with some embodiments. The femoral implant 300A
illustrates an interaction between the femoral head 302 and a
magnetic ring 308 (representative of the acetabular component). The
interaction includes a plurality of interaction points (e.g.,
304A-304C). In FIG. 3A, the interaction points (e.g., 304A-304C)
may be used to determine that the femoral head 302 is fully
inserted into the acetabular component (as represented by the
magnetic ring 308). For example, the interaction points 304A-304C
are at a level of a third sensor from bottom (e.g., closest to the
trunnion of the femoral head 302) at three sides of the femoral
head 302. The location of the interaction points 304A-304C indicate
that the femoral head 302 is fully inserted in the acetabular
component and in a non-flexed and non-rotated position.
[0036] The femoral implant 300B illustrates an interaction between
the femoral head 302 and a magnetic ring 308 (representative of the
acetabular component). The interaction includes a plurality of
interaction points (e.g., 312A-312C). In contrast to FIG. 3A, FIG.
3B shows the interaction points (e.g., 312A-312C) at a different
altitude of insertion. The interaction points (e.g., 312A-312C)
detected in the real representation 300B may be used to determine
that the femoral head 302 is not fully inserted into the acetabular
component (as represented by the magnetic ring 308). For example,
the interaction points 312A-312C are at a level of a fourth sensor
from bottom (e.g., closest to the trunnion of the femoral head 302)
at three sides of the femoral head 302. The location of the
interaction points 312A-312C indicate that the femoral head 302 is
not fully inserted in the acetabular component and that separation
has occurred.
[0037] The femoral implant 300C shows the femoral head 302 fitting
in the acetabular component. The femoral head 302 includes a
plurality of sensors that interact with the magnetic ring 308 at
interaction points (e.g., 314A-314C). The interaction points (e.g.,
314A-314C) may be used to determine an angle of fit for the
acetabular component with the femoral head 302.
[0038] For example, the interaction points 314A-314C are located at
positions coincident with sensors at the three sides visible in
FIG. 3C of the femoral head 302. Further, the location of
interaction point 314C is at a sensor below an upper limit sensor,
such that interaction point 314A is also at a sensor. The location
of the interaction points 314A-314C indicate that the femoral head
302 is rotating properly within the acetabular component. When the
rotation that is shown in the femoral implant 300C is at an extreme
range of motion (e.g., a leg is fully flexed, fully straightened,
etc.), then over rotation and impingement are unlikely to have
occurred or may be unlikely to occur.
[0039] The femoral implant 300D shows the femoral head 302 fitting
in the acetabular component. The femoral head 302 includes a
plurality of sensors that interact with the magnetic ring 308 at
interaction points (e.g., 316A-316B). The interaction points (e.g.,
316A-316B) may be used to determine an angle of fit for the
acetabular component with the femoral head 302. In the femoral
implant 300D, the fit is shown within a predefined limit at the
interaction point 316B and outside a predefined limit at the
interaction point 316A.
[0040] For example, the location of interaction point 316B is at a
sensor above the upper limit sensor, such that interaction point
316A is not at a sensor. The location of the interaction points
316A-316B may indicate that the femoral head 302 is over rotated
within the acetabular component. The rotation that is shown in the
femoral implant 300D indicates that over rotation may have occurred
and impingement is possible or may occur in the future.
[0041] FIGS. 4A-4D illustrate visual indications (e.g., 401A-401D)
of a degree of impingement of an acetabular component (hidden for
clarity) to a femoral head in accordance with some embodiments. For
example, the full insertion shown in FIG. 3A is represented by a
positive indication 406 in the virtual representation 401A. The
partial insertion shown in FIG. 3B is represented by a negative
indication 410 in the virtual representation 401B. The virtual
representation 401C indicates rotation and provides a real-time
assessment of the mating surface between a femoral head and an
acetabular component (e.g., low risk of impingement), such as those
shown in FIG. 3C.
[0042] In the femoral implant 300C of FIG. 3C, the fit is shown
within predefined limits, and the visual indication 401C of FIG. 4C
illustrates the positive indication 406. In representing the
femoral implant 300D of FIG. 3D, the visual indication 401D
illustrates the negative indication 410 to show that there is a
potential problem with the acetabular component or the femoral head
based on the interaction point 412A of FIG. 3D. The virtual
representation 401D of FIG. 4D indicates that rotation has occurred
and provides a real-time assessment of the mating surface between
the femoral head and the acetabular component (e.g., high risk of
impingement), such as those shown in FIG. 3D.
[0043] FIG. 5 illustrates a user interface 500 for setting joint
force and proximity angle limits in accordance with some
embodiments. The user interface 500 includes a joint force
magnitude scale 502 and a coverage proximity to edge scale 508. The
joint force magnitude scale 502 includes a lower slider 504 and an
upper slider 506 for selecting a joint force magnitude minimum and
maximum, respectively. The coverage proximity to edge scale 508
includes a lower slider 510 and an upper slider 512 for selecting a
coverage proximity angle minimum and maximum, respectively.
[0044] The user interface 500 allows a user to set the joint force
magnitude limits (low and high) and the low limit of the angle
between the liner rim and the central force axis (e.g.,
`coverage`). In an example, the user interface 500 may allow the
user to input basic information about the case or pre-operative
planning requirements. This input may be used, along with the
limits and the data received from sensors intraoperatively to
create a personalized postoperative care plan. The data and input
may be used in a feedback process, along with postoperative
outcomes, to improve the functioning of intraoperative assessments
of femoral head and acetabular component fit. In another example,
limits may be recommended to the user on the user interface 500,
such as machine learned limits from past data, which may, for
example, take into account individual patient information.
[0045] FIGS. 6A-6B illustrate user interfaces 600A and 600B for
displaying joint forces and proximity angles in accordance with
some embodiments. User interface 600A illustrates an example where
an indication of impingement 602 is displayed. The indication of
impingement 602 signifies that a first angle is outside a limit,
such as a coverage proximity angle minimum or maximum (e.g., those
selected on the user interface 500 of FIG. 5). For example, the
angle limit may apply to inferior-superior (I-S) coverage or
abduction-adduction coverage. A second indication 604 shows that a
second angle limit has not been violated, such as a limit applied
to anterior-posterior (A-P) coverage or flex-extension coverage. A
force measurement 606 is also displayed. The force measurement 606
indicates that the force measured is within preset limits. In an
example, the preset limits may be set using surgeon input, such as
the joint force magnitude minimum and maximum established using the
user interface 500 of FIG. 5. In another example, the preset limits
may be set based on prior testing, experimentation, or
manufacturing tolerances. The preset limits may include ranges,
such as 0-10; 10-20; 20-30; 30-40; 40+, etc. The force measurement
606 may be measured by a force sensor integrated into the trunnion
or a sensor force array (e.g., 5 sensors) integrated into the cup.
These sensors may provide overall joint force and force
distribution data.
[0046] The second angle 604 and the force measurement 606 are
within tolerated limits, but the first angle 602 is outside the
first angle limit, indicating a potential problem.
[0047] User interface 600A includes a range of motion top-down
display that illustrates a location of a cup 616 with respect to a
top-view of a cylindrical cross-section 614 of a joint. The
cylindrical cross-section 614 may be broken down into quadrants,
and each quadrant may include a percentage of coverage for a
particular real-time assessment of range of motion of the cup 616.
For example, the indication of impingement 602 may correspond to
the lack of coverage for the two right quadrants (indicated by
"0%"). In an example, the indication of impingement 602 may be
triggered when one or more quadrants have a percentage below a
threshold. In an example, impingement risk may be indicated in the
indication of impingement 602 when an average of the two right
quadrants or the two left quadrants falls below a threshold. The
second indication 604 may be used to indicate a risk of impingement
when an average of the top two quadrants or the bottom two
quadrants falls below a threshold. In another example, a maximum of
the top two or bottom two quadrants may be compared to a threshold
to determine whether there is a risk of impingement in the A-P
coverage. A maximum of the right two or left two quadrants may be
compared to a threshold to determine whether there is a risk of
impingement in the I-S coverage.
[0048] User interface 600B illustrates an example where a first
indication 608 is displayed. The first indication 608 signifies
that a first angle is within a limit, such as a coverage proximity
angle minimum or maximum (e.g., those selected on the user
interface 500 of FIG. 5). For example, the angle limit may apply to
I-S coverage or abduction-adduction coverage. A second indication
610 shows that a second angle limit also has not been exceeded,
such as a limit applied to A-P coverage or flex-extension coverage.
A force measurement 612 is also displayed. The force measurement
612 indicates that the force measured is outside of preset limits
(e.g., the joint force magnitude minimum and maximum established
using the user interface 500 of FIG. 5). The first indication 608
and the second indication 610 are within tolerated limits, but the
force measurement 612 is outside the force limit, indicating a
potential problem. In an example, a potential problem may be
indicated when any one of the two angles or the force are indicated
as landing outside of tolerance limits.
[0049] The user interface 600B includes a second range of motion
top-down display view that illustrates a location of a cup 620 in a
second position (e.g., along a range of motion) with respect to a
second top-view of a cylindrical cross-section 618 of a joint. The
second range of motion view illustrates the cup 620 in coverage
that mostly covers the cylindrical cross-section 618. For example,
the quadrants from upper left to bottom left, clockwise, are 100%,
60%, 30%, and 75%. These quadrant coverage percentages may indicate
that the risk of impingement is relatively low. For example, the
first indication 608 and the second indication 610 may indicate
that the coverage is proper and that there is a relatively low or
no risk of impingement. The coverage indicated by the first
indication 608 or the second indication 610 may correlate with
whether one or more quadrants are above or below a threshold. For
example, the first indication 608 may correspond with the left two
or right two quadrants being, on average, for example, above a
threshold.
[0050] In an example, angles of the cup (616 or 620) in relation to
the cylindrical cross-section (614 or 618) may be interpreted as a
coverage map or coverage percentage breakdown. For example, the
orientation angles may create a centerline vector of the ball (with
the cylindrical cross-section) within the cup. The cylinder of
influence aligned to this vector may be plotted against a fixed
circle to show the directional coverage of the ball within the
cup.
[0051] The coverage concepts shown in FIGS. 600A-600B may be used
to determine and display risks of impaction issues. When impacting
a plastic liner into a fixed metal shell, a surgeon may not have a
good idea of whether the impact is being hit by the impactor handle
in a correct orientation to seat a component correctly. As a
result, the impact may seat the component in a crooked orientation
(e.g., not correctly oriented) and may need further impaction or
correction. The sensors described above herein may be used to
determine and display whether the alignment of the component is
correct before or during impaction.
[0052] FIG. 7 illustrates a system 700 for assessing hip
arthroplasty component movement in accordance with some
embodiments. The system includes processing circuitry 702 coupled
to memory 704 and a display 706. The processing circuitry 702 is in
communication with a femoral implant 712 (e.g., a transceiver
component of the femoral implant 712 or a sensor 716). The femoral
implant 712 includes the sensor 716 and a femoral head 714. The
femoral head 714 is configured to fit within an acetabular
component 708. The acetabular component 708 includes a magnetic
component 710, such as a plurality of magnets or a magnetic ring.
The acetabular component may include a cup liner or a shell.
[0053] In an example, the magnetic component 710 emits a magnetic
field. The sensor 716 of the femoral implant 712 may be used to
detect the magnetic field. The processing circuitry 702 may be used
to receive information from the sensor 716 about the magnetic
field. The processing circuitry 702 may be used to output an
indication of a fit of the femoral head 714 in the acetabular
component 708. The indication may include an angle (e.g., potential
impingement), a risk of impingement, a force exerted by the femoral
head 714 on the acetabular component 708, an insertion measurement,
a risk factor for dislocation, a risk-level for postoperative
impingement, a patient-specific assessment of alignment of the
acetabular component 708 (e.g., with respect to the femoral head
714), or the like. The processing circuitry 702 may output the
indication using the display 706. The display 706 may include a
heads-up display (e.g., projected on a surgical drape, a patient,
goggles, glasses, etc.), an augmented reality display (e.g., using
glasses, goggles, etc.), a display screen (e.g., a computer
monitor, a mobile device, etc.), or the like. In another example,
the processing circuitry 702 may output the indication using an
audible alert, haptic feedback, or the like.
[0054] In an example, the information from the sensor may include a
voltage based on proximity of the sensor 716 to the magnetic field.
The voltage may be directly proportional to a strength of the
magnetic field. The processing circuitry 702 may receive, prior to
receiving the information, predefined impingement criteria, such as
a joint force magnitude limit or a low limit proximity angle. In an
example, the impingement criteria may include preoperative set
points, such as to establish a level of insertion. In an example,
the indication may include a visual indication of impingement or
lack of impingement based on the preoperative set points and the
magnetic field.
[0055] In an example, the sensor 716 includes a Hall effect sensor,
a reed switch, a proximity sensor, a magnetometer, or the like. In
an example, the femoral implant 712 may include a plurality of
sensors, for example, arranged in two intersecting arcs on within
the femoral head 714, arranged in a grid on or within the femoral
head 714, arranged in circles (e.g., concentric circles or rings at
different heights of the femoral head 714), etc. In another
example, the sensor 716 may be embedded in a trunnion of the
femoral implant 712. In an example, the system 700 may be
pre-calibrated during manufacturing, so as to allow a surgeon to
plug-and-play the system 700.
[0056] FIG. 8 illustrates a flow chart showing a technique 800 for
assessing hip arthroplasty component movement in accordance with
some embodiments. The technique 800 includes an operation 802 to
receive data from a sensor embedded in a femoral implant, such as
in a trunnion of the femoral implant or in a femoral head of the
femoral implant. The femoral head may be configured to fit in an
acetabular component. The technique 800 includes an operation 804
to determine information about a magnetic field from the data, the
magnetic field emanating from a magnet of the acetabular
component.
[0057] The technique 800 includes an operation 806 to output an
indication of a fit of a femoral head in the acetabular component,
a combined version angle, a proximity, a coverage percentage, or
the like. The indication may include an angle (e.g., potential
impingement), a risk of impingement, a force exerted by the femoral
head on the acetabular component, an insertion measurement, a risk
factor for dislocation, a risk-level for postoperative impingement,
a patient-specific assessment of alignment of the acetabular
component (e.g., with respect to the femoral head), or the like.
The technique 800 may include outputting the indication using a
heads-up display (e.g., projected on a surgical drape, a patient,
goggles, glasses, etc.), an augmented reality display (e.g., using
glasses, goggles, etc.), a display screen (e.g., a computer
monitor, a mobile device, etc.), an audible alert, haptic feedback,
non-contact indications, or the like.
[0058] FIG. 9 illustrates generally an example of a block diagram
of a machine 900 upon which any one or more of the techniques
(e.g., methodologies) discussed herein may perform in accordance
with some embodiments. In alternative embodiments, the machine 900
may operate as a standalone device or may be connected (e.g.,
networked) to other machines. In a networked deployment, the
machine 900 may operate in the capacity of a server machine, a
client machine, or both in server-client network environments. The
machine 900 may be a personal computer (PC), a tablet, a personal
digital assistant (PDA), a mobile telephone, a web appliance, or
any machine capable of executing instructions (sequential or
otherwise) that specify actions to be taken by that machine.
Further, while only a single machine is illustrated, the term
"machine" shall also be taken to include any collection of machines
that individually or jointly execute a set (or multiple sets) of
instructions to perform any one or more of the methodologies
discussed herein, such as cloud computing, software as a service
(SaaS), other computer cluster configurations.
[0059] Examples, as described herein, may include, or may operate
on, logic or a number of components, modules, or like mechanisms.
Such mechanisms are tangible entities (e.g., hardware) capable of
performing specified operations when operating. In an example, the
hardware may be specifically configured to carry out a specific
operation (e.g., hardwired). In an example, the hardware may
include configurable execution units (e.g., transistors, circuits,
etc.) and a computer readable medium containing instructions, where
the instructions configure the execution units to carry out a
specific operation when in operation. The configuring may occur
under the direction of the executions units or a loading mechanism.
Accordingly, the execution units are communicatively coupled to the
computer readable medium when the device is operating. For example,
under operation, the execution units may be configured by a first
set of instructions to implement a first set of features at one
point in time and reconfigured by a second set of instructions to
implement a second set of features.
[0060] Machine (e.g., computer system) 900 may include a hardware
processor 902 (e.g., a central processing unit (CPU), a graphics
processing unit (GPU), a hardware processor core, any combination
thereof, or other processing circuitry), a main memory 904 and a
static memory 906, some or all of which may communicate with each
other via an interlink (e.g., bus) 908. The machine 900 may further
include a display unit 910, an alphanumeric input device 912 (e.g.,
a keyboard), and a user interface (UI) navigation device 914 (e.g.,
a mouse). In an example, the display unit 910, alphanumeric input
device 912 and UI navigation device 914 may be a touch screen
display. The machine 900 may additionally include a storage device
(e.g., drive unit) 916, a signal generation device 918 (e.g., a
speaker), a network interface device 920, and one or more sensors
921, such as a global positioning system (GPS) sensor, compass,
accelerometer, or other sensor. The machine 900 may include an
output controller 928, such as a serial (e.g., universal serial bus
(USB), parallel, or other wired or wireless (e.g., infrared (IR),
near field communication (NFC), etc.) connection to communicate or
control one or more peripheral devices.
[0061] The storage device 916 may include a machine readable medium
922 that is non-transitory on which is stored one or more sets of
data structures or instructions 924 (e.g., software) embodying or
utilized by any one or more of the techniques or functions
described herein. The instructions 924 may also reside, completely
or at least partially, within the main memory 904, within static
memory 906, or within the hardware processor 902 during execution
thereof by the machine 900. In an example, one or any combination
of the hardware processor 902, the main memory 904, the static
memory 906, or the storage device 916 may constitute machine
readable media.
[0062] While the machine readable medium 922 is illustrated as a
single medium, the term "machine readable medium" may include a
single medium or multiple media (e.g., a centralized or distributed
database, or associated caches and servers) configured to store the
one or more instructions 924.
[0063] The term "machine readable medium" may include any medium
that is capable of storing, encoding, or carrying instructions for
execution by the machine 900 and that cause the machine 900 to
perform any one or more of the techniques of the present
disclosure, or that is capable of storing, encoding or carrying
data structures used by or associated with such instructions.
Non-limiting machine readable medium examples may include
solid-state memories, and optical and magnetic media. Specific
examples of machine readable media may include: non-volatile
memory, such as semiconductor memory devices (e.g., Electrically
Programmable Read-Only Memory (EPROM), Electrically Erasable
Programmable Read-Only Memory (EEPROM)) and flash memory devices;
magnetic disks, such as internal hard disks and removable disks;
magneto-optical disks; and CD-ROM and DVD-ROM disks.
[0064] The instructions 924 may further be transmitted or received
over a communications network 926 using a transmission medium via
the network interface device 920 utilizing any one of a number of
transfer protocols (e.g., frame relay, internet protocol (IP),
transmission control protocol (TCP), user datagram protocol (UDP),
hypertext transfer protocol (HTTP), etc.). Example communication
networks may include a local area network (LAN), a wide area
network (WAN), a packet data network (e.g., the Internet), mobile
telephone networks (e.g., cellular networks), Plain Old Telephone
(POTS) networks, and wireless data networks (e.g., Institute of
Electrical and Electronics Engineers (IEEE) 802.11 family of
standards known as Wi-Fi.RTM. or IEEE 802.15.4 family of standards
known as ZigBee)), as the personal area network family of standards
known as Bluetooth.RTM. that are promulgated by the Bluetooth
Special Interest Group, peer-to-peer (P2P) networks, among others.
In an example, the network interface device 920 may include one or
more physical jacks (e.g., Ethernet, coaxial, or phone jacks) or
one or more antennas to connect to the communications network 926.
In an example, the network interface device 920 may include a
plurality of antennas to wirelessly communicate using at least one
of single-input multiple-output (SIMO), multiple-input
multiple-output (MIMO), or multiple-input single-output (MISO)
techniques. The term "transmission medium" shall be taken to
include any intangible medium that is capable of storing, encoding
or carrying instructions for execution by the machine 900, and
includes digital or analog communications signals or other
intangible medium to facilitate communication of such software.
[0065] FIG. 10 illustrates an adjustable trunnion 1000 in
accordance with some embodiments. A trunnion may include a support
shaft, such as a femoral stem, which may be inserted into a femoral
head component. The adjustable trunnion 1000 includes a guide 1002,
which may travel along a groove 1008 of a trunnion head 1010 of the
adjustable trunnion 1000. The trunnion head 1010 may be configured
to receive a femoral head component (e.g., as described below with
respect to FIG. 11). In an example, the guide 1002 may allow the
adjustable trunnion 1000 to expand up to 12 millimeters of total
height in this example. Different expansion hights are within the
scope of the present disclosure. By allowing the adjustable
trunnion 1000 to change heights, a single femoral head component
may be used with the adjustable trunnion 1000 instead of requiring
multiple different trial sizes for the femoral head component.
[0066] The adjustable trunnion 1000 may be adjusted using a height
controller 1006. In an example, the height controller 1006 may be
hand-adjustable or tool-adjustable. For example, the height
controller 1006 may include a turning mechanism to allow a surgeon
to turn the height controller 1006 with a hand to apply a torque,
causing an adjustable shaft 1004 to increase or decrease in height
(e.g., a distance between the trunnion head 1010 and a base
component 1012 of the adjustable trunnion 1000). In another
example, the height controller 1006 may be adjusted by a tool
(e.g., a wrench), which may include a powered component. In an
example, the adjustable shaft 1004 may include a lead screw
mechanism. In yet another example, the height controller 1006 may
be electronically controlled to adjust the height of the adjustable
trunnion 1000 (e.g., receiving an electrical signal may cause the
adjustable shaft 1004 to increase or decrease in height). In this
example, the adjustable trunnion 1000 may be motorized to cause the
adjustment. In certain examples, a wireless controller may control
adjustment height of a powered adjustable trunnion 1000. In another
example, an optical encoder may be used to control adjustment of
the height or accurately determine height after adjustment.
[0067] In an example, the adjustable trunnion 1000 may be used with
a single trial reduction. The adjustable trunnion 1000 may be
dynamically adjusted while a joint force is monitored. In another
example, the adjustable trunnion 1000 may be dynamically adjusted
using a leg length sensor to automatically determine a height fit.
In an example, the adjustable trunnion 1000 may be reusable. In an
example, the femoral component is a trial component. In an example,
the acetabular component is a standard implant selected from a
standard set of implants provided by an implant manufacturer (e.g.,
does not include a sensor or does not include a magnet, or
both).
[0068] In an example, the adjustable trunnion 1000 may not include
any magnets or sensors. In another example, a magnet may be
deployed within the adjustable trunnion 1000, for example, within
the guide 1002. The magnet within the guide 1002 may be used to
determine a height or an offset amount. The height may be sent to a
graphical user interface (e.g., those described with respect to
FIGS. 5 and 6A-6B) for display. The height determined using the
magnet may be used to perform preoperative planning, for example,
to determine a proper leg length for an implant. In an example, the
height may be used intraoperatively, such as to monitor a force on
the adjustable trunnion 1000. In an example, the magnet within the
guide 1002 may be magnetically small enough to avoid interfering
with a hall effect sensor or a magnetometer or other magnets within
a femoral head component. In another example, the magnet within the
guide 1002 may be used to calibrate a hall effect sensor, a
magnetometer, or another sensor or magnet within the femoral head
component.
[0069] FIG. 11 illustrates an assembled view of a femoral head
component 1100 in accordance with some embodiments. In an example,
the femoral head component 1100 may be coupled with the adjustable
trunnion 1000 of FIG. 10 to create a single-use femoral sensor
trial. In an example, the femoral head component 1100 may be
customized to a patient, and disposable after a single use. The
femoral head component 1100 may include a three-dimensional (3D)
magnetometer. The 3D magnetometer may be located within the femoral
head component 1100, and may be used to provide a position or
orientation of the femoral head component 1100, such as with
respect to a cup (e.g., an acetabular cup), for example without
receiving information from the cup. The magnetometer within the
femoral head component 1100 may be compatible with any manufactured
cup, rather than requiring a paired cup component (e.g., as shown
in FIGS. 2A-2C and 3A-3D). In an example, the femoral head
component 1100 may have a standard diameter size, such as 22 mm, 28
mm, 32 mm, 36 mm, etc.
[0070] FIG. 12 illustrates a combined adjustable trunnion 1202 and
femoral head component 1204 system 1200 in accordance with some
embodiments. The adjustable trunnion 1202 may be used with a single
sized-fits-all femoral head component 1204. For example, by
allowing for changes within the adjustable trunnion 1202 for height
of the adjustable trunnion 1202, the femoral head component 1204
may change location based on a shaft of the femoral head component
1204 that fits over a head portion of the adjustable trunnion 1202.
The height adjustments allow for the femoral head component 1204 to
be used in different patients without needing to change the
diameter of the femoral head component 1204. For example, one
current system uses eight different femoral head component sizes
with two different trunnion options. The combined adjustable
trunnion 1202 and femoral head component 1204 system 1200 described
herein allows for a single femoral head component 1204 with
different heights controlled using a single adjustable trunnion
1202.
[0071] FIG. 13 illustrates an exploded view of a femoral head
component 1300 in accordance with some embodiments. The femoral
head component 1300 may include a tracking ball or magnetic sphere
1302, a 3D magnetometer 1304, a 2D hall effect sensor 1306, and a
printed circuit board (PCB)/battery assembly 1308. The PCB/battery
assembly 1308 may include control circuitry to control the
magnetometer 1304, the hall effect sensor 1306, or the like. The
PCB/battery assembly 1308 may include a battery to power the
magnetometer 1304, the hall effect sensor 1306, or the like. For
example, the PCB/battery assembly 1308 may be used to initialize
the hall effect sensor 1306 or the magnetometer 1304. The
PCB/battery assembly 1308 may include a transceiver or other
communication device for sending information to a remote device
(e.g., a computer, a tablet, a mobile device, etc.), such as
magnetometer information. For example, the transceiver or other
communication device may send magnetometer information for
displaying an angle of the femoral head component 1300, for example
with respect to an acetabular component (e.g., as shown and
described with respect to FIG. 6A-6B or 15).
[0072] The femoral head component 1300 may include a cap component
1310 and a base component 1312. The cap component 1310 may be
configured to couple with the base component 1312, such as using
tension to prevent decoupling. The base component 1312 may be
configured to include a groove, slot, or aperture, such as to
receive a head portion of a trunnion (e.g., the adjustable trunnion
of FIG. 10 or 12).
[0073] In an example, the magnetometer 1304 may include a plurality
of magnetometers in an array. The magnetometer 1304 may be used to
determine a relative tilt or angle of the femoral head component
1300 or rotation of the femoral head component 1300. The hall
effect sensor 1306 may be used to calibrate the magnetometer 1304
with the tracking ball or magnetic sphere 1302 or the cap component
1310. For example, the hall effect sensor 1306 may be initialized
(e.g., using the PCB/battery assembly 1308 or an external button or
controller. At initialization, the femoral head component 1300 may
be held in a position representing an origin or zero location using
the hall effect sensor 1306. An output magnetic field may be read
from the magnetometer 1304 at the origin or zero location. When the
femoral head component 1300 is moved, a new output magnetic field
reading from the magnetometer 1304 may be compared to the origin or
zero location reading to determine a change in magnetic field. The
change in magnetic field may be used to determine an angle of the
femoral head component 1300, such as with respect to an acetabular
component.
[0074] FIG. 14 illustrates a sectional view 1400 of a portion of a
femoral head component 1402 in accordance with some embodiments.
The portion of the femoral head component 1402 includes a groove
1406, for example to receive a portion of a trunnion (e.g., the
adjustable trunnion of FIG. 10 or 12). The portion of the femoral
head component 1402 includes a force sensor 1404. In an example,
the force sensor 1404 may detect load transferred through the
femoral head component 1402 into a trunnion (e.g., the adjustable
trunnion of FIG. 10 or 12). A force measured by the force sensor
1404 may be used to determine an offset selection (e.g., a height
of the adjustable trunnion). In an example, the force measured by
the force sensor 1404 may be used to detect impingement or
subluxation, for example, when the force is zero. In an example,
the force measured by the force sensor 1404 may be used to detect a
high or an unusual load, such as during a range of motion test. The
force measured by the force sensor 1404 may be output, such as on
the graphical user interface 1500 of FIG. 15.
[0075] FIG. 15 illustrates a graphical user interface 1500 for
displaying impingement information (e.g., at user interface
elements 1502, 1504, 1506, or 1508), force information, or range of
motion information in accordance with some embodiments. In the
example shown in FIG. 15, the user interface element 1502
illustrates a lack of impingement (e.g., less than 2 millimeter
impingement) at the inferior-posterior quadrant. The user interface
element 1504 illustrates a potential impingement (e.g., 2
millimeter impingement) at the superior-posterior quadrant (also
seen at the inferior-anterior quadrant). The user interface element
1506 illustrates impingement (e.g., greater than 2 millimeter
impingement) at the superior-anterior quadrant. The user interface
element 1506 illustrates a subluxation warning when subluxation is
detected indicating impingement. The graphical user interface 1500
may be displaying range of motion, force, or impingement
information, such as during a range of motion test.
[0076] FIG. 16 illustrates a flow chart showing a technique 1600
for outputting impingement information in accordance with some
embodiments. The technique 1600 includes an operation 1602 to
receive data from a magnetometer embedded in a femoral head
component of an implant, the data including magnetic field
information. The technique 1600 includes an operation 1604 to
determine a range of motion for the implant based on the data. The
technique 1600 includes an operation 1606 to output an indication
of the range of motion on a graphical user interface. The technique
1600 includes an decision operation 1608 to determine whether there
is a risk of impingement. In an example, determining risk of
impingement may be performed before, during, after, or in
replacement of, determining a range of motion.
[0077] In response to determining that there is no risk of
impingement, the technique 1600 includes an operation 1610 to
output that there is no risk of impingement. In response to
determining that there is a potential risk of impingement, the
technique 1600 may include an operation to output that there is a
risk of impingement. In response to determining that there is a
potential risk of impingement, the technique 1600 includes a
decision operation 1612 to determine whether there is an actual
impingement. In another example, actual impingement may be tested
separately from risk of impingement or may be tested before testing
for risk of impingement. In response to determining that there is
no actual impingement at decision operation 1612, the technique
1600 includes outputting that there is no actual impingement at
operation 1614. In response to determining that there is actual
impingement, the technique 1600 includes an operation 1616 to
output impingement information, such as by identifying a location
on the femoral head (e.g., using a GUI), that impingement has
occurred.
Various Notes & Examples
[0078] Each of these non-limiting examples may stand on its own, or
may be combined in various permutations or combinations with one or
more of the other examples.
[0079] Example 1 is a system for assessing orientation and dynamics
of a hip arthroplasty component, the system comprising: an
acetabular component including a magnetic component to emit a
magnetic field; a femoral component including: a femoral head
configured to be accommodated by the acetabular component; and a
sensor to detect the magnetic field; and processing circuitry to:
receive information from the sensor about the magnetic field;
determining a relative orientation of the femoral component with
respect to the acetabular component based at least in part on the
information received from the sensor; and output an indication
based on the relative orientation.
[0080] In Example 2, the subject matter of Example 1 includes,
wherein the sensor is a Hall effect sensor and the information from
the sensor includes a measured voltage based on proximity of the
sensor to the magnetic field.
[0081] In Example 3, the subject matter of Example 2 includes,
wherein the measured voltage is directly proportional to a strength
of the magnetic field.
[0082] In Example 4, the subject matter of Examples 1-3 includes,
wherein the processing circuitry is further to receive predefined
criteria including impingement criteria, joint force criteria, or
an orientation angle prior to receiving the information.
[0083] In Example 5, the subject matter of Example 4 includes,
wherein the predefined criteria includes a lower or upper magnitude
limit for each of the predefined criteria.
[0084] In Example 6, the subject matter of Examples 4-5 includes,
wherein the joint force criteria, the orientation angle, or the
impingement criteria includes preoperative set points.
[0085] In Example 7, the subject matter of Example 6 includes,
wherein the indication includes a visual indication of impingement
or lack of impingement based on a comparison between the
preoperative set points and the relative orientation.
[0086] In Example 8, the subject matter of Examples 1-7 includes,
wherein the indication includes a coverage of the femoral component
over the acetabular component and a force imparted by the femoral
component on the acetabular component.
[0087] In Example 9, the subject matter of Examples 1-8 includes,
wherein the sensor includes at least one of a Hall effect sensor, a
reed switch, a proximity sensor, or a magnetometer.
[0088] In Example 10, the subject matter of Examples 1-9 includes,
wherein the sensor includes a plurality of sensors arranged in two
intersecting arcs within the femoral head.
[0089] In Example 11, the subject matter of Examples 1-10 includes,
wherein the sensor is embedded in a trunnion of the femoral
component.
[0090] In Example 12, the subject matter of Examples 1-11 includes,
wherein the magnetic component is removable from the acetabular
component.
[0091] In Example 13, the subject matter of Examples 1-12 includes,
wherein the magnetic component is a magnetic ring.
[0092] In Example 14, the subject matter of Examples 1-13 includes,
wherein to output the indication, the processing circuitry is to
output the indication using a heads-up display, an augmented
reality display, or a display screen.
[0093] In Example 15, the subject matter of Examples 1-14 includes,
wherein the indication includes a risk-level for postoperative
impingement or an alert of an impingement.
[0094] In Example 16, the subject matter of Examples 1-15 includes,
wherein the indication includes a patient-specific assessment of
alignment of the acetabular component including the relative
orientation.
[0095] Example 17 is a method for assessing orientation or dynamics
of a hip arthroplasty component, the method comprising: receiving,
at processing circuitry, data from a sensor embedded in a femoral
component, the femoral component including a femoral head
configured to be accommodated by an acetabular component;
determining, at the processing circuitry, information about a
magnetic field from the data, the magnetic field emanating from a
magnetic component integrated with the acetabular component; and
outputting, from the processing circuitry, an indication indicative
of a relative orientation of the femoral component with respect to
the acetabular component based on the information about the
magnetic field.
[0096] In Example 18, the subject matter of Example 17 includes,
wherein the indication includes a risk-level for postoperative
impingement or an alert of an impingement.
[0097] Example 19 is at least one machine-readable medium including
instructions for assessing orientation or dynamics of a hip
arthroplasty component that, when executed by a machine, cause the
machine to: receive data from a sensor embedded in a femoral
component, the femoral component including a femoral head
configured to be accommodated by an acetabular component; determine
information about a magnetic field from the data, the magnetic
field emanating from a magnetic component integrated with the
acetabular component; and output an indication indicative of a
relative orientation of the femoral component with respect to the
acetabular component, the indication based at least in part on the
information about the magnetic field.
[0098] In Example 20, the subject matter of Example 19 includes,
wherein the indication includes a patient-specific assessment of
alignment of the acetabular component including a visual indication
of the relative orientation.
[0099] Example 21 is a system for assessing orientation and
dynamics of a hip arthroplasty component, the system comprising: a
femoral head component including: a magnetometer to: obtain initial
magnetic field information; and obtain updated magnetic field
information when the femoral head component is moved during a range
of motion test; and a hall effect sensor to: register an initial
orientation based on the initial magnetic field information; and a
processor to: determine a relative orientation of the femoral head
component in reference to an acetabular component based on a change
between the initial and the updated magnetic field information
using the initial orientation; and output an indication based on
the relative orientation.
[0100] In Example 22, the subject matter of Example 21 includes,
wherein the processor is further to receive, prior to receiving the
information, predefined criteria including impingement criteria,
joint force criteria, or an orientation angle.
[0101] In Example 23, the subject matter of Example 22 includes,
wherein the predefined criteria includes a lower or upper magnitude
limit for each of the predefined criteria.
[0102] In Example 24, the subject matter of Examples 22-23
includes, wherein the joint force criteria, the orientation angle,
or the impingement criteria includes preoperative set points.
[0103] In Example 25, the subject matter of Example 24 includes,
wherein the processor is further to output a visual indication of
impingement or lack of impingement based on the preoperative set
points and the relative orientation.
[0104] In Example 26, the subject matter of Examples 21-25
includes, wherein the femoral head component further includes a
force sensor to detect a force imparted on the femoral head
component by a trunnion at the relative orientation.
[0105] In Example 27, the subject matter of Example 26 includes,
wherein to output the indication, the processor is further to
output information indicating coverage of the femoral head
component over the acetabular component and the force imparted on
the femoral head component by the trunnion.
[0106] In Example 28, the subject matter of Examples 26-27
includes, wherein the trunnion is an adjustable trunnion configured
to include a changeable shaft length between a head portion
configured to receive the femoral head component and a base
portion.
[0107] In Example 29, the subject matter of Example 28 includes,
wherein the changeable shaft length is controlled by a height
controller to extend the head portion away from the base
portion.
[0108] In Example 30, the subject matter of Examples 21-29
includes, wherein to output the relative orientation includes to
output the relative orientation to a heads-up display, an augmented
reality display, or a display screen.
[0109] In Example 31, the subject matter of Examples 21-30
includes, wherein the relative orientation includes a
patient-specific assessment of alignment of the acetabular
component.
[0110] In Example 32, the subject matter of Examples 21-31
includes, wherein the femoral component is a trial component and
the acetabular component is a standard implant selected from a
standard set of implants provided by an implant manufacturer.
[0111] In Example 33, the subject matter of Examples 21-32
includes, wherein the femoral head component further includes the
processor and wireless communication circuitry.
[0112] In Example 34, the subject matter of Examples 21-33
includes, wherein the femoral head component further includes a
battery to power the processor.
[0113] Example 35 is a method for assessing orientation and
dynamics of a hip arthroplasty component, the method comprising:
using processing circuitry to: obtain initial magnetic field
information using a magnetometer within a femoral head component;
register an initial position based on the initial magnetic field
information using a hall effect sensor within the femoral head
component; obtain updated magnetic field information using the
magnetometer; determine a change in orientation from the initial
position of the femoral head component relative to an acetabular
component based on a change between the initial and the updated
magnetic field information; and output an indication based on the
relative orientation.
[0114] In Example 36, the subject matter of Example 35 includes,
wherein using the processing circuitry further includes
determining, based at least in part on the relative orientation, a
risk-level for postoperative impingement, and wherein the
indication includes the risk-level for postoperative
impingement.
[0115] In Example 37, the subject matter of Examples 35-36
includes, wherein using the processing circuitry further includes
determining, based at least in part on the relative orientation, a
patient-specific assessment of alignment of the acetabular
component, and wherein the indication includes output of the
patient-specific assessment of alignment of the acetabular
component.
[0116] Example 38 is a system for assessing orientation and
dynamics of a hip arthroplasty component, the system comprising: a
femoral head component including: a magnetometer to: obtain initial
magnetic field information; and obtain updated magnetic field
information when the femoral head component is moved during a range
of motion test; and a hall effect sensor to: register an initial
orientation based on the initial magnetic field information; and an
output device to: output an indication based on a change in
relative orientation from the initial orientation of the femoral
head component in reference to an acetabular component, the change
in relative orientation corresponding to a change from the initial
magnetic field information to the updated magnetic field
information.
[0117] In Example 39, the subject matter of Example 38 includes,
wherein the output device is one of a display device including a
user interface, a haptic feedback device, or a speaker to play an
audible alert.
[0118] In Example 40, the subject matter of Examples 38-39
includes, wherein to output the indication, the output device is to
output a visual indication of impingement or lack of impingement
based on the magnetic field and preoperatively determined limits on
one or more of an impingement criteria, a joint force criteria, or
an orientation angle.
[0119] Example 41 is at least one machine-readable medium including
instructions that, when executed by processing circuitry, cause the
processing circuitry to perform operations to implement of any of
Examples 1-40.
[0120] Example 42 is an apparatus comprising means to implement of
any of Examples 1-40.
[0121] Example 43 is a system to implement of any of Examples
1-40.
[0122] Example 44 is a method to implement of any of Examples
1-40.
[0123] Method examples described herein may be machine or
computer-implemented at least in part. Some examples may include a
computer-readable medium or machine-readable medium encoded with
instructions operable to configure an electronic device to perform
methods as described in the above examples. An implementation of
such methods may include code, such as microcode, assembly language
code, a higher-level language code, or the like. Such code may
include computer readable instructions for performing various
methods. The code may form portions of computer program products.
Further, in an example, the code may be tangibly stored on one or
more volatile, non-transitory, or non-volatile tangible
computer-readable media, such as during execution or at other
times. Examples of these tangible computer-readable media may
include, but are not limited to, hard disks, removable magnetic
disks, removable optical disks (e.g., compact disks and digital
video disks), memory cards or sticks, random access memories
(RAMs), read only memories (ROMs), and the like.
* * * * *