Joint monitoring for ligament tensioning for joint replacement surgery

Abstract

A device may monitor movement between a first side of the joint and a second side of the joint. A device may correlate the movement between the first side of the joint and the second size of the joint to a tension of at least one ligament comprising the joint. A device may reconfigure the joint by modification of a bone structure of the joint, wherein the reconfiguring is at least in part based on the tension of the at least one ligament.

Description

JOINT MONITORING FOR LIGAMENT TENSIONING FOR JOINTREPLACEMENT SURGERYCROSS REFERENCE TO RELATED APPLICATIONS

[0001] The present application claims priority to U.S. Provisional Patent Application No. 63 / 681,669 filed on August 9, 2024, entitled “JOINT MONITORING FOR LIGAMENT TENSIONING FOR JOINT REPLACEMENT SURGERY,” the entirety of which is incorporated by reference herein.Background

[0002] Arthroplasty is a common procedure performed to repair diseased or damaged joints. Also referred to as joint replacement, arthroplasty often involves implantation of replacement hardware into a joint to replicate with such hardware the interfaces of the joint. Such procedures can be performed for most joints in the body including shoulder replacement, knee replacement, hip replacement, or other commonly performed arthroplasties.Summary

[0003] In some aspects, the techniques described herein relate to a method for arthroplasty of a joint with measured ligament tension, including: monitoring movement between a first side of the joint and a second side of the joint; correlating the movement between the first side of the joint and the second size of the joint to a tension of at least one ligament including the joint; and reconfiguring the joint by modification of a bone structure of the joint, wherein the reconfiguring is at least in part based on the tension of the at least one ligament.

[0004] In some aspects, the techniques described herein relate to a system for arthroplasty of a joint with measured ligament tension, including: a sensor disposed relative to the joint, the sensor operative to monitor movement between a first side of the joint and a second side of the joint; and a tension determining module in operative communication with the sensor to determine a tension of at least one ligament including the joint; wherein the tension determining module is operative to determine the tension of the at least one ligament in response to reconfiguration of the joint by modification of a bone structure of the joint, and wherein the reconfiguration of the joint is at least in part based on the tension of the at least one ligament.Holzer Patel Drennan 1 Attorney Docket No.: 708039PCT

[0005] This Summary is provided to introduce a selection of concepts in a simplified form that are further described below in the Detailed Description. This Summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used to limit the scope of the claimed subject matter.

[0006] Other implementations are also described and recited herein.Brief Description of the Figures

[0007] FIG. 1 illustrates an example schematic representation of a joint having a sensor for monitoring ligament tension.

[0008] FIG. 2 illustrates an example of a knee joint having a sensor for monitoring ligament tension.

[0009] FIG. 3 illustrates an example of a knee joint during an arthroplasty procedure monitored by a sensor, in which bone is removed to accommodate replacement hardware.

[0010] FIG. 4 illustrates an example of a knee joint monitored by a sensor and having replacement hardware disposed in the joint.

[0011] FIG. 5 illustrates an example of a knee joint monitored by a sensor and having replacement hardware disposed in the joint, where the replacement hardware is moveable by kinetic positioners to control ligament tension.

[0012] FIG. 6 illustrates an example of a sensor that may be engaged with a knee joint.

[0013] FIG. 7 illustrates an example method for use of a sensor to monitor ligament tension during an arthroplasty procedure.Detailed Description

[0014] While the invention is susceptible to various modifications and alternative forms, specific embodiments thereof have been shown by way of example in the drawings and are herein described in detail. It should be understood, however, that it is not intended to limit the invention to the particular form disclosed, but rather, the invention is to cover all modifications, equivalents, and alternatives falling within the scope of the invention as defined by the claims.

[0015] A joint, also known as an articulation, is a point where two bones meet in the skeletal system. Joints are supported by connective tissues like cartilage, tendons, ligaments, and sometimes nerves. Joints can be classified based on their function and composition. Synarthroses are immovable joints that provide structural support, like the sutures in the skull. Amphiarthroses are joints having limited movement and offer a mix of stability andHolzer Patel Drennan 2 Attorney Docket No.: 708039PCTmotion, such as the joints between vertebrae. Diarthroses, also known as synovial joints, allow free movement in various directions, like hip and shoulder joints. Joints are commonly categorized by their range of motion. Fibrous joints are generally immovable, like the sutures of the skull, and are held together by dense connective tissue. Cartilaginous joints allow slight movement and are connected entirely by cartilage, like the joints between the ribs and the sternum. Synovial joints are the most common and movable type of joint, which include ball- and-socket joints that allow for rotational movement, like the hip and shoulder joints; hinge joints that permit bending and straightening motions, like elbows and knees; pivot joints that allow for rotational movement around a single axis, like the joint between the first and second vertebrae in the neck; saddle joints that enable movement along two planes, like the thumb joint; condyloid joints, which allow movement but no rotation, like the wrist; and gliding joints that permit bones to glide past one another, like in the ankles.

[0016] Joint replacement, or arthroplasty, is a surgical procedure where a damaged joint is replaced with a prosthesis. The general steps include assessment to determine the need for joint replacement based on pain, disability, and non-response to other treatments; preparation, including pre-surgical evaluations and patient education; the surgical procedure comprising removal of damaged joint parts and replacement with a prosthesis, which could be metal, plastic, or ceramic; and recovery, including post-operative care, physical therapy, and rehabilitation to regain strength and mobility. Joint replacement can significantly improve the quality of life for individuals with severe joint pain and mobility issues, allowing them to return to their daily activities with less discomfort.

[0017] However, the problem of unknown or improper ligament tension in joint replacement surgery is a significant concern for orthopedic surgeons. Proper tension in the ligaments is crucial for the stability and function of the joint post-surgery. If the tension is too high, it can lead to restricted movement and pain; if it's too low, it can result in joint instability. During surgery, the tension of the ligaments must be carefully balanced. However, this can be challenging due to several factors, including pre-existing conditions like arthritis that can alter the normal anatomy and tension of ligaments. In addition, surgical alterations, including the process of fitting prosthetic components, can change the length and tension of ligaments. Furthermore, during the healing process post-surgery can affect ligament tension as scar tissue forms and muscles adapt.

[0018] To address these issues, surgeons may use intraoperative tensioning devices to adjust tension, perform ligament release procedures to reduce excessive tension, or apply ligament grafts to lengthen ligaments that are too short. Traditionally, postoperative imagingHolzer Patel Drennan 3 Attorney Docket No.: 708039PCTand physical examination help in assessing the ligament tension and ensuring the joint functions correctly. If issues arise, such as ligament tears, impingement, or joint instability, they may be managed with physical therapy, medication, or in some cases, revision surgery. However, post-operative assessment and treatment of improper ligament tension is less advantageous than measuring and controlling ligament tension during an arthroplasty procedure.

[0019] As such, the present disclosure generally relates to devices and associated methods of use that may assist in determining ligament tension during a joint replacement surgery to provide better outcomes and avoid the negative effects of improper ligament tension in a surgically repaired joint. The systems described herein may generally include a monitoring device including one or more sensors that may monitor movement of the joint before, during, and / or after surgical repair of a joint. Such motion sensors may monitor any number of degrees of freedom through which the joint is capable of movement such that the state of the ligaments comprising a joint are monitored. In this regard, while certain examples are described herein, any joint may be monitored using the principles described herein. Also, while ligament tension is described herein throughout, it may be appreciated that any connective tissue associated with the joint undergoing arthroplasty may be monitored in the manner described herein. As such, in addition to ligament tension, the present disclosure may be utilized to monitor tension in tendons, fascia, cartilage or other collagen based connective tissue without limitation.

[0020] The monitored movement of the joint may be correlated to ligament tension to allow for surgeon to monitor ligament tension during a joint replacement surgery. That is, in some examples, movement of the joint may be monitored to provide a correlated ligament tension. This may be provided to a surgeon during a procedure to allow for monitoring and control of the ligament tension during the arthroplasty procedure.

[0021] In addition, the present disclosure may implement non-contact or non-motion- based monitoring of the tension in ligaments in a joint during surgery. For example, a number of optical approaches are described in which light is utilized to determine ligament tension. Such approaches may be utilized during a procedure to assist a surgeon in determining or setting an appropriate ligament tension for joints being replaced. Further still, the present disclosure may include methods for enhanced joint replacement surgery in which the systems described herein may be utilized during the procedure in conjunction with kinetic devices that may be operative to position replacement hardware within the joint. Such kinetic devices may be manipulated by the surgeon to position replacement hardware in a manner such that theHolzer Patel Drennan 4 Attorney Docket No.: 708039PCTligament tension in the joint is set at a desired level as monitored by the systems described herein. In other approaches, the surgeon may modify the removed portion of bone in the joint to accommodate replacement hardware such that the resulting ligament tension is set in the desired level.

[0022] Turning to FIG. 1, a schematic view of a joint 100 is represented. The joint 100 may generally comprise a first bone 102 and a second bone 104. The first bone 102 and the second bone 104 may move relative to one another and be attached by way of a first ligament 106 and a second ligament 108. The joint 100 described in FIG. 1 is intended to generally depict any joint in the body without limitation. That is, FIG. 1 is intended to present a generic description of components of the present disclosure without describing any particular joint in the body. As such, any of the foregoing types of joints in the body may be represented by the joint 100 in FIG. 1, such that the particular structures described are not intended to be limiting. Thus, for example, while a first ligament 106 and a second ligament 108 are shown, fewer or additional ligaments comprising the joint may be present.

[0023] A monitoring device 110 may be disposed relative to the joint 100 to monitor aspects of the joint 100 including the tension of the first ligament 106 and / or second ligament 108 before, during, or after replacement of all or a portion of the joint 100. The monitoring device 110 may include a first portion 112 that may be generally stationary with respect to the first bone 102. In this regard, the first portion 112 may be affixed relative to the first bone 102. In one example, the first portion 112 may be secured to the skin of the patient to undergo co-movement with the first bone 102. For instance, the first portion 112 may comprise a portion of a sleeve or other covering that is disposed at the skin of the patient in a manner such that the first portion 112 generally is fixed relative the first bone 102. In other examples, the first portion 112 may be securely affixed to the first bone 102 (e.g., through orthopedic implants, wires, or other installed fixtures).

[0024] A second portion 114 may be provided that is stationary with to respect the second bone 104. Any of the foregoing description with respect to the first portion 112 relative to the first bone 102 may be generally applicable to the second portion 114 and the second bone 104. That is, the second portion 114 may be generally stationary respect to the second bone 104 (e.g., by way of attachment at the skin of the patient or by being affixed thereto).

[0025] The first portion 112 and the second portion 114 may be connected via a first connecting portion 116 and / or a second connecting portion 118. In the example where the monitoring device 110 comprises a shell, sleeve, or other type of device worn by the patient, the first connecting portion 116 and the second connecting portion 118 may form a portion ofHolzer Patel Drennan 5 Attorney Docket No.: 708039PCTthe shell or other structures. In this regard, the first connecting portion 116 and / or the second connecting portion 118 may include sensors that may monitor the position of the first portion 112 relative to the second portion 114. As the first portion 112 is stationary with respect to the first bone 102 and the second portion 114 is stationary with respect to the second bone 104, movement of the joint 100 may be monitored by monitoring the relative motion between the first portion 112 in the second portion 114. For example, as shown in FIG. 1, two degrees of freedom may be monitored including a first range of motion 130 and a second range of motion 132. In this regard, the first range of motion 130 may correspond to bending of the joint 100 and the second range of motion 132 may correspond to the rotation of the joint 100.

[0026] With reference to FIG. 6, one example of a monitoring device 600 that may be worn by a patient is illustrated. The monitoring device 600 may include a first portion 602 and a second portion 604. In the example of the monitoring device 600 shown, a joint 612 monitored is the knee joint. In this regard, the first portion 602 may be stationary with respect to the femur of the patient. In this regard, straps 608 may be used to secure the first portion 602 with respect to the femur. The second portion 604 may be secured to the lower leg (comprising the tibia and fibula) through straps 610. In this regard, a sensor 606 may be disposed at a hinge between the first portion 602 and the second portion 604. The sensor 606 may monitor articulation, rotation, or other movement of the joint 612. Thus, the sensor 606 may at least in part connect the first portion 602 and the second portion 604 to monitor the joint 612.

[0027] With returned reference to FIG. 1, as an alternative to one or more sensors being disposed within the first connecting portion 116 or the second connecting portion 118, external sensors may be operative to monitor the position of the first portion 112 and the second portion 114. For example, sensors disposed externally to the joint 100 and monitoring device 110 may be utilized that may detect the relative position of the first portion 112 and second portion 114 to describe the articulation of the joint 100 in a manner that fully describes the degrees of freedom of the joint 100.

[0028] In any regard, the movement of the joint 100 is monitored by the monitoring device 110 and may be utilized to characterize tension in the first ligament 106 and / or the second ligament 108. For example, positions of first bone 102 relative to the second bone 104 may be correlated to ligament tension in the first ligament 106 and / or second ligament 108 such that upon monitoring the movement of the joint 100, the tension of the ligaments may be determinedHolzer Patel Drennan 6 Attorney Docket No.: 708039PCT

[0029] In another example, the ligament tension of the first ligament 106 and / or the second ligament 108 may be monitored using optical techniques. In this regard, the monitoring device 110 may include a first optical sensor 120 and / or a second optical sensor 126. The first optical sensor 120 may be operative to generate a light emission 124 and detect a response to the light emission 124 interacting with the first ligament 106. Similarly, the second optical sensor 126 may generate a light emission 128 that is incident upon the second ligament 108. The second optical sensor 126 may also monitor a response signal based on the incidence the light emission 128 on the second ligament 108. The light emission 124 and light emission 128 may be incident upon the first ligament 106 and second ligament 108, respectively. In this regard, the ligaments may be exposed surgically such that the light emission 124 and light emission 128 are incident on the exposed ligaments. Alternatively, the first optical sensor 120 and second optical sensor 126 may utilize a spectrum of light that may penetrate the soft tissue and a response may be monitored in the ligaments in situ without being surgically exposed.

[0030] As shown in FIG. 1, in some examples, the first optical sensor 120 may be incorporated into the second connecting portion 118 and the second optical sensor 126 may be incorporated into the first connecting portion 116. However, the first optical sensor 120 and / or second optical sensor 126 may be disposed relative to the first ligament 106 and second ligament 108 in any other manner that allows monitoring of the ligaments. For example, returning to FIG. 6, the sensor 606 may include an optical sensor disposed to monitor the ligaments in the joint 612.

[0031] The use of an optical sensor (such as the first optical sensor 120 and second optical sensor 126) to measure ligament tension is a sophisticated technique that provides accurate, real-time data on the forces exerted by ligaments. This technology is particularly useful in biomechanical research and can be applied in clinical settings, such as during joint replacement surgery, to ensure proper ligament tension. Some examples of these approaches include confocal chromatic imaging that uses confocal microscopy, which can provide high- resolution images of ligament fibers. It's capable of measuring minute changes in ligament strain by detecting shifts in the light spectrum as the ligament stretches. Another approach includes shearography, which is an optical method that measures the deformation of an object's surface. When applied to ligaments, it can detect changes in surface strain patterns, which correlate with internal tension. Also, digital image correlation is a non-contact optical technique that analyzes the movement between two images taken at different times. By comparing these images, it can calculate the strain on the ligament. This later approach mayHolzer Patel Drennan 7 Attorney Docket No.: 708039PCTbe combined with monitoring of the movement of the joint to correlate ligament tension based on monitored movement of the joint.

[0032] FIG. 2 illustrates another example of a joint 200 that may be monitored using a monitoring device 250. In this illustrated example, the joint 200 comprises a knee joint. In this regard, a femur 202 may comprise a first bone of the joint 200. The joint 200 may connect the femur 202 with a tibia 204 and a fibula 206. A patella 208 is illustrated, but the patellar tendon has been omitted for clarity. However, the tension of the patellar tendon may also be monitored even though not shown. The joint 200 may comprise a number of ligaments connecting the femur 202 and the tibia 204 / fibula 206. Specifically, a lateral collateral ligament 210, an anterior cruciate ligament 212, a posterior cruciate ligament 214, and a medial collateral ligament 216 are depicted. Also shown is the lateral and medial meniscus 218.

[0033] FIG. 2 also illustrates the monitoring device 250 disposed relative to the joint 200. The monitoring device 250 includes a first portion 252 and a second portion 254, which are connected by way of a first connecting portion 256 and a second connecting portion 258. This arrangement is similar to that described in FIG. 1, and all aspects described with respect to FIG. 1 are incorporated here. Specifically, the first portion 252 may be stationary relative to the femur 202. The second portion 254 may be stationary with respect to the tibia 204 and fibula 206. As such, the movement of the joint 200 may be described by monitoring relative motion between the first portion 252 and the second portion 254. As such, the first connecting portion 256 and / or second connecting portion 258 may include sensors that monitor such movement between the first portion 252 and the second portion 254.

[0034] Also shown is a first optical sensor 260 and a second optical sensor 264. As described above, the first optical sensor 260 may emit a light 262 that may be incident on one or more of the ligaments of the joint 200. The second optical sensor 264 may also emit a light 266 that may be incident on one or more of the ligaments of the joint 200. For example, the first optical sensor 260 may monitor the lateral collateral ligament 210 and the anterior cruciate ligament 212 and the second optical sensor 264 may monitor the medial collateral ligament 216 and the posterior cruciate ligament 214.

[0035] With further reference to FIG. 3, the joint 200 is shown in which a portion of the femur 202 and the tibia 204 is surgically removed. This may create a first osteotomy 268 at the tibia 204 and a second osteotomy 270 at the femur 202. The first osteotomy 268 and second osteotomy 270 may provide a prepared surface for placement of replacement hardware. For example, with further reference to FIG. 4, a tibial prosthesis 272 may beHolzer Patel Drennan 8 Attorney Docket No.: 708039PCTdisposed at the first osteotomy 268 and a femoral prosthesis 274 may be located at the second osteotomy 270. It may be appreciated that the placement and orientation created by the first osteotomy 268 and tibial prosthesis 272 relative to the second osteotomy 270 and femoral prosthesis 274 may alter the structure of the joint 200. In this regard, monitoring of the tension in the lateral collateral ligament 210, anterior cruciate ligament 212, posterior cruciate ligament 214, and / or medial collateral ligament 216 may be useful when creating the first osteotomy 268 and / or second osteotomy 270 or when placing the tibial prosthesis 272 and / or femoral prosthesis 274. Thus, a surgeon may use the monitoring device 250 to monitor the ligament tension in the joint 200 when performing the surgery for placement of the tibial prosthesis 272 and femoral prosthesis 274 to achieve a desired ligament tension in the joint 200.

[0036] With further reference to FIG. 5, rather than relying on the physical alteration of the joint 200, one or more kinetic positioners may be utilized to control the relative orientation of the tibial prosthesis 272 and femoral prosthesis 274. For example, a first kinetic positioner 276 may be disposed relative to the femoral prosthesis 274 (e.g. between the femur 202 and the femoral prosthesis 274) to alter the position of the femoral prosthesis 274. Similarly, a second kinetic positioner 278 may be disposed relative to the tibial prosthesis 272 (e.g., between the tibia 204 and the tibial prosthesis 272). The first kinetic positioner 276 and / or second kinetic positioner 278 may include pneumatic positioners, mechanically mobile wedges, or other device capable of moving the prosthesis relative to the bone. As such, the surgeon may manipulate the first kinetic positioner 276 and / or second kinetic positioner 278 while monitoring ligament tension in the joint 200 to achieve a desired or acceptable tension.

[0037] FIG. 7 illustrates an example method 700 for monitoring ligament tension during an arthroplasty procedure. The method 700 includes a positioning operation 702 in which a sensor is positioned adjacent to the joint to be replaced. As described above, the sensor may include an external sensor for monitoring the joint or may include a monitoring device such as those described above. The method 700 also includes a monitoring operation 704 in which the joint is monitored. The monitoring operation 704 may occur prior to, during, or after the arthroplasty procedure. Moreover, the method 700 may include a determining operation 706 in which the ligament tension may be determined. As noted above, the determining operation 706 may use correlated movement of the joint to ligament tension or direct measurement (e.g., through optical means).Holzer Patel Drennan 9 Attorney Docket No.: 708039PCT

[0038] The method 700 also includes a reconfiguring operation 708 in which the joint is reconfigured. This may include osteotomy of the bones comprising the joint or other surgical operation to prepare the joint for receipt of replacement hardware. As such, the method 700 may also include a positioning operation 710 in which replacement hardware is positioned into the joint. As noted above, the positioning operation 710 may include placement of prosthesis or other replacement hardware. Moreover, the positioning operation 710 may also include use of kinetic positioners to dispose the replacement hardware in a desired position in the joint. As such, the method 700 may also include a confirmation operation 712 in which the ligament tension is confirmed to be a desired or acceptable tension. In this regard, the confirmation operation 712 may include use of the monitoring operation 704 and determining operation 706 to provide feedback to the surgeon of the ligament tension in the joint. In turn, the positioning operation 710 may be performed while monitoring the ligament tension in the confirmation operation 712.

[0039] The method 700 may include a completion operation 714 in which the surgical intervention is concluded. This may include securing the replacement hardware, restoring soft tissue, incision closing, or other steps. In turn, the method 700 may also include a postoperative monitoring operation 716. The post-operative monitoring operation 716 may include performing the monitoring operation 704 and / or determining operation 706 after conclusion of the completion operation 714 to monitor post-operative ligament tension. As such, the same monitoring device may be used during the post-operative monitoring operation 716 to monitor and / or confirm the ligament tension post-op. As such, portions of the method 700 may be iteratively performed during or after the surgical intervention to monitor ligament tension.

[0040] In some aspects, the techniques described herein relate to a method for arthroplasty of a joint with measured ligament tension, including: monitoring movement between a first side of the joint and a second side of the joint; correlating the movement between the first side of the joint and the second side of the joint to a tension of at least one ligament including the joint; and reconfiguring the joint by modification of a bone structure of the joint, wherein the reconfiguring is at least in part based on the tension of the at least one ligament.

[0041] In some aspects, the techniques described herein relate to a method, further including: affixing a sensor relative to the joint, the sensor being operative for the monitoring of the movement between the first side of the joint and the second side of the joint.Holzer Patel Drennan 10 Attorney Docket No.: 708039PCT

[0042] In some aspects, the techniques described herein relate to a method, wherein the sensor measures at least rotational movement of the joint and angular movement of the joint.

[0043] In some aspects, the techniques described herein relate to a method, further including: using a non-contact sensor to measure the tension of the at least one ligament.

[0044] In some aspects, the techniques described herein relate to a method, wherein the non-contact sensor is an optical sensor for determining the tension of the at least one ligament.

[0045] In some aspects, the techniques described herein relate to a method, further including: installing replacement hardware into the joint.

[0046] In some aspects, the techniques described herein relate to a method, wherein the replacement hardware is installed based on the tension of the at least one ligament.

[0047] In some aspects, the techniques described herein relate to a method, wherein the replacement hardware is placed relative to bones including the joint to achieve a desired tension of the at least one ligament.

[0048] In some aspects, the techniques described herein relate to a method, further including: adjusting a kinetic positioner disposed within the joint to manipulate the replacement hardware to achieve the desired tension of the at least one ligament.

[0049] In some aspects, the techniques described herein relate to a method, wherein the joint is a knee joint.

[0050] In some aspects, the techniques described herein relate to a system for arthroplasty of a joint with measured ligament tension, including: a sensor disposed relative to the joint, the sensor operative to monitor movement between a first side of the joint and a second side of the joint; and a tension determining module in operative communication with the sensor to determine a tension of at least one ligament including the joint; wherein the tension determining module is operative to determine the tension of the at least one ligament in response to reconfiguration of the joint by modification of a bone structure of the joint, and wherein the reconfiguration of the joint is at least in part based on the tension of the at least one ligament.

[0051] In some aspects, the techniques described herein relate to a system, wherein the sensor includes a senor-equipped shell affixed to anatomy of a patient on the first side and the second side of the joint to monitor angular movement and rotational movement of the joint.

[0052] In some aspects, the techniques described herein relate to a system, wherein the sensor include a non-contact sensor to measure the tension of the at least one ligament.Holzer Patel Drennan 11 Attorney Docket No.: 708039PCT

[0053] In some aspects, the techniques described herein relate to a system, wherein the non-contact sensor is an optical sensor for determining the tension of the at least one ligament.

[0054] In some aspects, the techniques described herein relate to a system, further including: replacement hardware for installation into the joint during the reconfiguration of the joint.

[0055] In some aspects, the techniques described herein relate to a system, wherein the replacement hardware is installed based on the tension of the at least one ligament.

[0056] In some aspects, the techniques described herein relate to a system, wherein the replacement hardware is placed relative to bones including the joint to achieve a desired tension of the at least one ligament.

[0057] In some aspects, the techniques described herein relate to a system, wherein the replacement hardware includes a kinetic positioner disposed within the joint to manipulate the replacement hardware to achieve a desired tension of the at least one ligament.

[0058] In some aspects, the techniques described herein relate to a system, wherein the joint is a knee joint.

[0059] While this specification contains many specific implementation details, these should not be construed as limitations on the scope of any technologies or of what may be claimed, but rather as descriptions of features specific to particular implementations of the particular described technology. Certain features that are described in this specification in the context of separate implementations can also be implemented in combination in a single implementation. Conversely, various features that are described in the context of a single implementation can also be implemented in multiple implementations separately or in any suitable sub-combination. Moreover, although features may be described above as acting in certain combinations and even initially claimed as such, one or more features from a claimed combination can in some cases be excised from the combination, and the claimed combination may be directed to a sub-combination or variation of a sub-combination.

[0060] Similarly, while operations are depicted in the drawings in a particular order, this should not be understood as requiring that such operations be performed in the particular order shown or in sequential order, or that all illustrated operations be performed, to achieve desirable results. In certain circumstances, multitasking and parallel processing may be advantageous. Moreover, the separation of various system components in the implementations described above should not be understood as requiring such separation in all implementations, and it should be understood that the described program components andHolzer Patel Drennan 12 Attorney Docket No.: 708039PCTsystems can generally be integrated together in a single software product or packaged into multiple software products.

[0061] Thus, particular implementations of the subject matter have been described. Other implementations are within the scope of the following claims. In some cases, the actions recited in the claims can be performed in a different order and still achieve desirable results. In addition, the processes depicted in the accompanying figures do not necessarily require the particular order shown, or sequential order, to achieve desirable results. In certain implementations, multitasking and parallel processing may be advantageous.

[0062] A number of implementations of the described technology have been described. Nevertheless, it will be understood that various modifications can be made without departing from the spirit and scope of the recited claims.Holzer Patel Drennan 13 Attorney Docket No.: 708039PCT

Claims

What is claimed is:

1. A method for arthroplasty of a joint with measured ligament tension, comprising: monitoring movement between a first side of the joint and a second side of the joint; correlating the movement between the first side of the joint and the second side of the joint to a tension of at least one ligament comprising the joint; and reconfiguring the joint by modification of a bone structure of the joint, wherein the reconfiguring is at least in part based on the tension of the at least one ligament.

2. The method of claim 1, further comprising: affixing a sensor relative to the joint, the sensor being operative for the monitoring of the movement between the first side of the joint and the second side of the joint.

3. The method of claim 2, wherein the sensor measures at least rotational movement of the joint and angular movement of the joint.

4. The method of claim 1, further comprising: using a non-contact sensor to measure the tension of the at least one ligament.

5. The method of claim 4, wherein the non-contact sensor is an optical sensor for determining the tension of the at least one ligament.

6. The method of claim 1, further comprising: installing replacement hardware into the joint.

7. The method of claim 6, wherein the replacement hardware is installed based on the tension of the at least one ligament.

8. The method of claim 7, wherein the replacement hardware is placed relative to bones comprising the joint to achieve a desired tension of the at least one ligament.

9. The method of claim 8, further comprising: adjusting a kinetic positioner disposed within the joint to manipulate the replacement hardware to achieve the desired tension of the at least one ligament.Holzer Patel Drennan 14 Attorney Docket No.: 708039PCT10. The method of claim 1, wherein the joint is a knee joint.

11. A system for arthroplasty of a j oint with measured ligament tension, comprising: a sensor disposed relative to the joint, the sensor operative to monitor movement between a first side of the joint and a second side of the joint; and a tension determining module in operative communication with the sensor to determine a tension of at least one ligament comprising the joint; wherein the tension determining module is operative to determine the tension of the at least one ligament in response to reconfiguration of the joint by modification of a bone structure of the joint, and wherein the reconfiguration of the joint is at least in part based on the tension of the at least one ligament.

12. The system of claim 11, wherein the sensor comprises a senor-equipped shell affixed to anatomy of a patient on the first side and the second side of the joint to monitor angular movement and rotational movement of the joint.

13. The system of claim 11, wherein the sensor comprise a non-contact sensor to measure the tension of the at least one ligament.

14. The system of claim 13, wherein the non-contact sensor is an optical sensor for determining the tension of the at least one ligament.

15. The system of claim 11, further comprising: replacement hardware for installation into the joint during the reconfiguration of the joint.

16. The system of claim 15, wherein the replacement hardware is installed based on the tension of the at least one ligament.

17. The system of claim 16, wherein the replacement hardware is placed relative to bones comprising the joint to achieve a desired tension of the at least one ligament.Holzer Patel Drennan 15 Attorney Docket No.: 708039PCT18. The system of claim 16, wherein the replacement hardware comprises a kinetic positioner disposed within the joint to manipulate the replacement hardware to achieve a desired tension of the at least one ligament.

19. The system of claim 11, wherein the joint is a knee joint.Holzer Patel Drennan 16 Attorney Docket No.: 708039PCT

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