Device for holding a transmitter arrangement that interacts with an image or signal acquisition device of an operating room navigation system

Abstract

The invention relates to a device (2) for holding a transmitter arrangement (6) cooperating with an image or signal acquisition device (4) of a surgical navigation system on the patient during surgery, comprising a base part (16) and at least one fastening means (18) which is to be inserted into a bone (8) of the patient in order to position the base part (16) in a fixed orientation to the bone (8) during surgery, and a joint arrangement (21) held on the base part; according to the invention, it is proposed that the joint arrangement (21) be designed with a head (30) having a spherical shape in its basic geometry and a shaft (32) extending away from it and carrying the transmitter arrangement (6), and with a two-component receiving part (24) for the head (30), with respect to which the head (30) and thus the transmitter arrangement (6) can be fixed in a desired orientation to the bone (8).and that the head (30) has radially outwardly projecting, in particular rounded, projections or radially inwardly dipping, in particular dome-shaped recesses (48) or planar facet sections (42) on its surface (39), and that the receiving part (24) for the head (30) has an inner section (38) that is at least partially complementary in form to it, such that the head (30) can be fixed in a discrete selectable orientation relative to the receiving part (24), wherein the projections, the recesses (48) or the facet sections (42) are distributed over the surface (39) of the head (30) such that adjacent discrete selectable orientations enclose an angle measured from the center of the sphere of at most 15° to each other.

Description

[0001] The invention relates to a device for holding an active or passive transmitter arrangement, which interacts with an image or signal acquisition device of an operating room navigation system, on the patient in an operating room situation, comprising a base part and at least one fastening means, which is to be inserted into a bone of the patient, in particular into a femur or tibia in the case of endoprosthetic hip or knee joint replacement, in order to arrange the base part in a fixed orientation to the bone during the operating room situation, and a joint arrangement held on the base part.

[0002] Such a device is known from the applicant, wherein the joint arrangement is pivotable and lockable about two axes. However, only four rotational positions are possible around the upward-pointing axis.

[0003] The present invention is based on the objective of further improving a device of the type described above in such a way that it can be manufactured in a cost-effective manner, and that the surgeon has even greater freedom in the surgical situation when arranging the base part of the device on the patient's bone, and that the device should also be easy and safe to operate.

[0004] This problem is solved in a device of the aforementioned type according to the invention by the fact that the joint arrangement is designed with a head that is spherical in its basic geometry and a shaft extending away from it and carrying the transmitter arrangement, and with a two-component receiving part for the head, with respect to which the head and thus the transmitter arrangement can be fixed in a desired orientation to the bone, and that the head has radially outwardly projecting, in particular rounded, projections or radially inwardly dipping, in particular dome-shaped recesses or planar facet sections, and that the receiving part for the head has an inner section that is at least partially complementary in shape to this, such that the head can be fixed in a discretely selectable orientation to the receiving part, wherein the projections,the depressions or facet sections are distributed over the surface of the head in such a way that adjacent discrete selectable orientations enclose an angle of at most 15° to each other, measured from the center of the sphere.

[0005] Therefore, the joint arrangement should not aim for a perfectly spherical surface geometry with concentric clamping, as the applicant considers this insufficient to prevent unintentional adjustments after initial fixation. Particularly with relatively low clamping force, it cannot be guaranteed that the desired orientation will not shift. Instead, a positive-locking connection between the head and the two-component receiving part of the joint arrangement should be used to achieve backlash-free orientation and fixation of the device.Because the discrete selectable orientations have an angle of at most 15°, in particular at most 12° and preferably at most 10°, a great deal of freedom can be achieved in positioning the base part on the bone in order to align the head with the transmitter arrangement so that a plane in which the multiple transmitters are located is oriented approximately orthogonally to the main axis of the image acquisition device.

[0006] The at least one fastening device may be an anchor, a screw or a threaded stud which can be fixed in place in a clamping receptacle on the base part, so that after the fastening device has been inserted into the patient's bone, the base part can be fixed in place on it.

[0007] Furthermore, it proves advantageous that at least one fastening element has such a length that the base part can be arranged at a distance of 5.0 - 50 mm from the bone surface.

[0008] As already indicated, it proves advantageous if the transmitter arrangement carries at least three, in particular four, transmitters arranged on intersecting legs in one plane, one leg being formed by the shaft extending away from the head or being directly or indirectly attachable to it.

[0009] For the positive locking of the head with respect to the receiving part, it is not necessary for the multi-component receiving part to completely enclose the head, as this would also restrict its pivotability with the attached shaft. Rather, it proves advantageous and sufficient if, viewed in a section plane enclosing the shaft, the receiving part encompasses the head at an angle of at least 120°, in particular at least 130°, in particular at least 140°, in particular at most 170°, in particular at most 160°, and in particular at most 150°, and viewed in a section plane extending orthogonally to the shaft, encompasses the head at an angle of at least 30°, in particular at least 40°, and at most 90°, in particular at most 80°, in particular at most 70°, and in particular at most 60°.

[0010] In principle, it is also conceivable and sufficient if the receiving part or each component of the receiving part has only a form-complementary inner section which can engage with projections, recesses, or faceted sections of the head in a form-fitting and force-fit clamping or fixing connection. However, it would also be conceivable that the entire inner surface of the respective component of the receiving part is form-complementary to the surface of the head.

[0011] Furthermore, it may be provided that the components of the receiving part can be tightened against each other, in particular by means of a screw connection, a toggle or lever mechanism, and it is further advantageous if the components can be tightened against each other and released from each other without tools, i.e. purely by manual operation.

[0012] According to one embodiment of the invention, the head has recesses on its surface, wherein the recesses can be, in particular, cylindrical, conical, or dome-shaped. Accordingly, at least one projection is provided in the inner section of the receiving part, which can engage wholly or partially in a recess positioned opposite it in the head when the components of the receiving part, including the head, are forced or tightened against each other.

[0013] For this purpose, a screw connection, a toggle mechanism or a toggle lever mechanism can be advantageously used.

[0014] According to a further embodiment of the invention, it proves advantageous that the head has recesses on its surface, wherein the recesses on the head can be cylindrical, conical, or dome-shaped, and that the inner section of the receiving part has at least one projection with a curved, in particular spherically curved, free end, and that the radius of curvature of the spherically curved free end is larger than the radius of the recesses in the area of ​​the head's surface. Thus, because the nominal size of the free end of the projection of the receiving part is larger than the nominal size of the recesses on the surface of the head, self-centering between the head and the receiving part can be achieved, which proves to be convenient and therefore advantageous in practical use.

[0015] According to a further embodiment, the inner section of the receiving part may be provided with radially inward-facing, force-actuated adjusting pins that are slidable within the receiving part and can each at least partially engage in a radially inward-facing, particularly dome-shaped, recess in the head to fix the head in a discretely selectable orientation relative to the receiving part. The use of force-actuated adjusting pins, particularly spring-loaded adjusting pins, allows for convenient operation when adjusting or setting the head within the receiving part, provided the adjusting pins are rounded.

[0016] Here too, it can prove advantageous for the adjusting pins to have a curved, in particular ball-shaped, free end and for the radius of curvature of the curved free end to be larger than the radius of the recesses in the area of ​​the surface of the head.

[0017] According to a further development which can be described as particularly advantageous, it is proposed that the two-component receiving part preferably has inwardly opening rinsing channels in each of the components in order to be able to clean an intermediate space between the receiving part and the head by introducing rinsing fluid outside the surgical situation.

[0018] Further features, details and advantages of the invention will become apparent from the attached patent claims and the graphic representation and subsequent description of preferred embodiments of the device according to the invention.

[0019] The drawing shows: Fig. 1 a schematic representation of a device according to the invention for holding a transmitter arrangement on the patient in an operating situation; Fig. 2 a joint arrangement of the device according to Fig. 1 in perspective view; Fig. 3 a perspective view of a component of a receiving part of the joint arrangement according to Fig. 2; Fig. 4 a perspective view of a head of the joint arrangement according to Fig. 2 with flat facet sections; Fig. 5 a perspective view of a further embodiment of a head of a further joint arrangement; Fig. 6 a schematic representation of an embodiment of a joint arrangement; and Fig. Figure 7 schematically illustrates different nominal dimensions for partially interlocking projections and recesses in a receiving part and a ball of a joint arrangement.

[0020] Fig. Figure 1 shows a schematic representation of a device, designated overall by reference numeral 2, for holding a transmitter arrangement 6, which interacts with an image or signal acquisition device 4, on the patient during surgery, specifically on a bone 8 of the patient to be treated. The transmitter arrangement 6 preferably comprises a plurality of active or passive transmitters 10 arranged in an array in a plane, which in this case is formed by two arms 12 of the transmitter arrangement 6 to which the transmitters 10 are fixed. Signals emanating from or reflected by the transmitters 10 are acquired by the image or signal acquisition device 4 and further processed in a computing unit of the surgical navigation system, whereupon evaluations, treatment suggestions, and similar information are displayed to the surgeon on a display, which is schematically designated by reference numeral 14.

[0021] The device 2 comprises a schematically depicted base part 16, which can be fixed to the patient's bone 8 at a selectable distance from the bone by means of two exemplary fastening means 18 in the form of threaded studs 20. This is achieved by means of a respective clamping screw 22, which fixes the base part 16 relative to the respective threaded stud 20.

[0022] The device 2 further comprises a joint arrangement 21 with a two-component receiving part 24, the two components 26, 28 of which each form a type of clamping jaw for a head 30 that is spherical in its basic geometry. A shaft 32 extends from the head 30, which, in the schematic representation, transitions into a leg 12 of the transmitter arrangement 6. The two components 26, 28 of the receiving part 24 can be moved towards or away from each other by means of a threaded spindle 34, so that the head 30 can be brought into a clamping position in the receiving part 24 or released again.

[0023] The in Fig. The head 30, shown only schematically, has on its surface 36 radially outwardly projecting, in particular rounded, projections or radially inwardly dipping, in particular dome-shaped recesses or planar facet sections. Depending on the design, one and / or the other component 26, 28 of the receiving part 24 comprises an inner section 38 that is at least partially complementary in form to it, such that the head 30 can be set in a multitude of discretely selectable orientations relative to the receiving part 24. Adjacent discretely selectable orientations enclose an angle of at most 15° between them, measured from the center of the sphere.

[0024] Fig. Figure 2 illustrates a first embodiment of the device 2 according to the invention in a purely schematic representation of the joint arrangement 21 with the two-component receiving part 24, the head 30 with a shaft 32 leading to the transmitter arrangement 6. In this embodiment, the head 30 comprises flat faceted sections 40 on its surface 39. The two components 26, 28 of the receiving part 24 each comprise an inner section 38 shaped to complement them, which in top view is Fig. Figure 3 is shown for component 26. It can be seen that the inner section also has facet sections 42 that are complementary in shape to the facet sections 40. Additionally, a variant is realized and indicated here in which rinsing channels 44 are formed in the receiving part 24, opening onto the inner section 38 of the receiving part 24. In this way, a space between the receiving part 24 and the head 30 can be rinsed. Furthermore, the Fig. 2 and Fig. 3 the adjusting screw or threaded spindle 34 or a recess 46 for this purpose in the receiving part 24. Fig. Figure 4 further illustrates the head 30 with its flat facet sections 40.

[0025] Fig. Figure 5 illustrates another embodiment of the device according to the invention, in which the head 30 is formed with radially inwardly extending, dome-shaped recesses 48, reminiscent of the surface structure of a golf ball. In the exemplary case shown, the recesses 48 are spherical domes, but this is not mandatory. To ensure a positive-locking and clamping fixation of the head 30 in a Fig. To realize the receiving part 24, which is only schematically depicted in Figure 6, a radially inwardly extending projection 50 is provided in the respective inner section 38 of the components 26, 28 of the receiving part 24. When the head 30 is positioned accordingly, this projection 50 is able to engage in the recesses 48 on the surface 39 of the head 30. In the exemplary case shown, the projections 50 are formed by free ends 52 of force-bearing pins 54, which is schematically indicated by the representation of a spring element 56.

[0026] Finally, it clarifies Fig. Figure 7 again schematically shows that a nominal dimension or radius of curvature of inwardly extending projections 50 on the receiving part 24 can be larger than a nominal dimension of inwardly dipping recesses 48 on the head 30. This allows a self-centering effect to be achieved.

[0027] The device 2 according to the invention, described here in its various embodiments, proves to be user-friendly and can be used in the operating room with minimal susceptibility to malfunctions. The arrangement of the interlocking recesses, projections, or faceted sections on the sphere, on the one hand, and the partially complementary shape of the inner section of the receiving component, on the other, allows for the selection and fixing of a multitude of discretely selectable orientations of the sphere and thus of the transmitter arrangement. This enables the selection of an orientation that, while not stepless, is available in a narrow grid.

Claims

[1] Device (2) for holding a transmitter arrangement (6) cooperating with an image or signal acquisition device (4) of an operating room navigation system on the patient in an operating room situation, comprising a base part (16) and at least one fastening means (18) which is to be inserted into a bone (8) of the patient, in particular into a femur or tibia in the case of endoprosthetic hip or knee replacement, in order to position the base part (16) in a fixed orientation to the bone (8) during the operating room situation, and a joint arrangement (21) held on the base part, characterized by, that the joint arrangement (21) is formed with a head (30) having a spherical shape in its basic geometry and a shaft (32) extending away from it and carrying the transmitter arrangement (6), and with a two-component receiving part (24) for the head (30), with respect to which the head (30) and thus the transmitter arrangement (6) can be fixed in a desired orientation to the bone (8), and that the head (30) has radially outwardly projecting, in particular rounded, projections or radially inwardly dipping, in particular dome-shaped recesses (48) or planar facet sections (42) on its surface (39), and that the receiving part (24) for the head (30) has an inner section (38) that is at least partially complementary in shape to this, such that the head (30) can be fixed in a discretely selectable orientation to the receiving part (24), wherein the projections,the recesses (48) or the facet sections (42) are distributed over the surface (39) of the head (30) such that adjacent discrete selectable orientations enclose an angle to each other of at most 15° measured from the center of the sphere. [2] Device (2) according to claim 1, characterized by , that adjacent discrete selectable orientations enclose an angle measured from the center of the sphere of at most 12°, in particular of at most 10°, to each other. [3] Device (2) according to claim 1 or 2, characterized by , that at least one fastening element (18) is an anchor, a screw or a threaded stud (20) which can be fixed in a clamping receptacle on the base part (16) so that after insertion of the fastening element (18) into the bone (8) the base part (16) can be fixed in place on it. [4] Device (2) according to claim 1, 2 or 3, characterized by, that at least one fastening element (18) has such a length that the base part (16) can be arranged at a distance of 5.0 - 50 mm from the bone surface. [5] Device (2) according to one or more of the preceding claims, characterized by , that the transmitter arrangement (6) carries at least three, in particular four transmitters, which are arranged on intersecting legs (12) in a plane, wherein one leg (12) is formed by the shaft (32) extending away from the head (30) or can be attached directly or indirectly to it. [6] Device (2) according to one or more of the preceding claims, characterized by, that the receiving part (16), when viewed in a section plane enclosing the shaft (32), encompasses the head (30) at an angle of at least 120°, in particular at least 130°, in particular at least 140°, in particular at most 170°, in particular at most 160°, in particular at most 150°, and, when viewed in a section plane extending orthogonally to the shaft (32), encompasses the head (30) at an angle of at least 30°, in particular at least 40° and at most 90°, in particular at most 80°, in particular at most 70°, in particular at most 60°. [7] Device (2) according to one or more of the preceding claims, characterized by , that the components (26, 28) of the receiving part (24) can be tightened against each other, in particular by means of a screw connection, a toggle or toggle lever mechanism. [8] Device (2) according to one or more of the preceding claims, characterized by, that the head (30) has recesses (48) on its surface (39) and that the recesses (48) in the head (30) are in particular cylindrical, conical or dome-shaped and that at least one projection (50) is provided in the inner section (38) of the receiving part (24) which can engage wholly or partially in a recess (48) of the head (30) positioned opposite it when the components (26, 28) of the receiving part (24) are forced or tightened against each other including the head (30). [9] Device (2) according to claim 8, characterized by , that the at least one projection (50) is formed with a curved, in particular spherically curved, free end (52) and that a radius of curvature of the spherically curved free end is greater (52) than a radius of the depressions (48) in the area of ​​the surface of the head (30). [10] Device (2) according to one or more of the preceding claims, characterized by, that in the inner section (38) of the receiving part (24) force-bearing adjusting pins (54) protrude radially inwards, which are slidable in the receiving part (24) and which can each at least partially immerse in a radially inwards, in particular dome-shaped recess (48) at the head (30) in order to fix the head (30) in a discrete selectable orientation to the receiving part (24). [11] Device (2) according to claim 10, characterized by , that the adjusting pins (54) have a curved, in particular ball-shaped, curved free end (52) and that a radius of curvature of the curved free end (52) is larger than a radius of the recesses (48) in the area of ​​the surface (39) of the head (30). [12] Device (2) according to one or more of the preceding claims, characterized by, that the two-component receiving part (24) preferably has inwardly opening rinsing channels (44) in each of the components (26, 28) in order to be able to clean an intermediate space between receiving part (24) and head (30) by introducing rinsing fluid outside the surgical situation.

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