Methods and apparatus for orthopedic surgical navigation and alignment

Abstract

Methods and apparatus for orthopedic surgical navigation and alignment techniques and instruments.

1 . An apparatus for guiding the resection of a patient's bone during arthroplasty, said apparatus comprising: 
 a resection guide adapted for guiding a cutting device relative to a patient's bone during arthroplasty; and    an alignment guide coupled to said resection guide and adapted for attachment to the patient's bone, said alignment guide including: 
 a first assembly for positioning said resection guide along a translational path;  
 a second assembly for positioning said resection guide along a first rotational path and a second rotational path.  
   
   
   
       2 . The apparatus of  claim 1 , wherein said first and second rotational paths are about different axes.  
   
   
       3 . The apparatus of  claim 1 , wherein said axes are transverse to each other.  
   
   
       4 . The apparatus of  claim 1 , wherein said first and second assemblies each include a locking device for securing said resection guide along said translational path and said first and second rotational paths.  
   
   
       5 . The apparatus of  claim 1 , further including an anchoring pin adapted to secure said alignment guide to a patient's bone.  
   
   
       6 . The apparatus of  claim 1 , wherein the second assembly comprises a second assembly for positioning along said first rotational path, and a third assembly for positioning said resection guide along said second rotational path.  
   
   
       7 . The apparatus of  claim 1 , wherein the second assembly comprises a second assembly for positioning said resection guide along a first rotational path and along a second rotational path.  
   
   
       8 . The apparatus of  claim 1 , further including a plane probe.  
   
   
       9 . An apparatus for guiding the resection of a patient's bone during arthroplasty, said apparatus comprising: 
 a resection guide adapted for guiding a cutting device relative to a patient's bone during arthroplasty; and    an alignment guide adapted for positioning said resection guide along a translational path and along a plurality of rotational paths.    
   
   
       10 . The apparatus of  claim 9 , wherein said plurality of rotational paths are about different axes.  
   
   
       11 . The apparatus of  claim 9 , wherein said axes are transverse to each other.  
   
   
       12 . The apparatus of  claim 9 , wherein said alignment guide includes first and second assemblies each including at least one locking device.  
   
   
       13 . The apparatus of  claim 12 , wherein said locking device of said first assembly is adapted for securing said resection guide along said translational path.  
   
   
       14 . The apparatus of  claim 12 , wherein said locking device of said second assembly is adapted for securing said resection guide along said plurality of rotational paths.  
   
   
       15 . The apparatus of  claim 14 , wherein said second assembly includes a pair of locking devices, each of said locking devices adapted for securing said resection guide along separate rotational paths.  
   
   
       16 . The apparatus of  claim 9 , further including an anchoring pin adapted to secure said alignment guide to a patient's bone.  
   
   
       17 . The apparatus of  claim 9 , further including a plane probe.  
   
   
       18 . An apparatus for guiding the resection of a bone during arthroplasty, comprising: 
 anchoring means for anchoring the apparatus to the bone;    a resection guide coupled to said anchoring means; and    means for locating the resection guide relative to the anchoring means.    
   
   
       19 . The apparatus of  claim 18 , wherein said means for locating provides three degrees of freedom including two rotations and one translation.  
   
   
       20 . The apparatus of  claim 19 , wherein said three degrees of freedom include flexion-extension, varus-valgus, and proximal-distal.  
   
   
       21 . The apparatus of  claim 18 , further comprising a plane probe, said plane probe including a planar surface and coupling means for coupling said plane probe to a computer navigation tracker.  
   
   
       22 . The apparatus of  claim 18 , wherein said means for locating further comprises means for selectively locking the position of said resection guide with three degrees of freedom.  
   
   
       23 . The apparatus of  claim 18 , wherein said anchoring means need not be removed from the bone prior to resection.  
   
   
       24 . The apparatus of  claim 18 , wherein said apparatus is adapted for use in resecting femurs and tibias.  
   
   
       25 . An alignment guide for positioning an instrument with respect to a bone, comprising: 
 a bone anchor having a first end and a second end, and attached to a bone at said first end; and    a first member and a second member;    wherein said first member is attached to said second end of said bone anchor; and    wherein said second member is associated with said first member to facilitate universal motion of said second member with respect to said first member for positioning said instrument.    
   
   
       26 - 200 . (canceled)  
   
   
       201 . A positioning block for use in total knee replacement surgery, permitting five degrees-of-freedom movement relative to a bone element to which it is fixed, the positioning block comprising: 
 a rotational mounting element being removably engagable to the bone element such that the mounting element is selectively rotatable relative to the bone element, about three substantially perpendicular axes of rotation; and    a guide body portion being engaged with the mounting element such that it is translatable relative thereto along a proximal-distal axis and an anterior-posterior axis, while being rotationally fixed relative to the mounting element such that the guide body portion and the mounting element rotate together relative to the bone element.    
   
   
       202 . The apparatus of  claim 201 , wherein the positioning block comprises an attachment point permitting engagement of at least one of a cutting and drilling guide block to the positioning block.  
   
   
       203 . The apparatus of  claim 202 , wherein the at least one of a cutting and drilling guide block is a conventionally employed instrument used in non-computer assisted total knee replacement surgery.  
   
   
       204 . The apparatus of  claim 202 , wherein the at least one of a cutting and drilling guide block can be positioned at a fixed distance relative to the positioning block.  
   
   
       205 . The apparatus of  claim 201 , wherein the positioning block comprises at least one of a cutting and a drilling guide portion integrally incorporated therewith.  
   
   
       206 . A positioning block permitting at least two independently adjustable degrees-of-freedom relative to a bone element to which it is attached, the positioning block comprising: 
 a bone anchoring element being fastenable to the bone element;    a cutting tool guide element operatively engagable with a cutting tool and adjustably engagable with the bone anchoring element such that selective displacement in at least two degrees-of-freedom relative to the bone element is permitted, enabling the cutting tool to be disposed in a desired position and orientation for cutting the bone element; and    at least two independent adjustment mechanisms, each being adjustable in substantial isolation for respectively displacing the cutting tool guide element in one of the at least two degrees-of-freedom.    
   
   
       207 . The apparatus of  claim 206 , wherein the cutting tool guide element is engaged to the bone element such that movement in five degrees-of-freedom relative thereto is selectively possible.  
   
   
       208 . The apparatus of  claim 206 , wherein the independent adjustment mechanisms provide substantially isolated adjustment of the cutting tool guide element in at least one rotational degree-of-freedom and at least one translational degree-of-freedom.  
   
   
       209 - 226 . (canceled)