Patient-Specific Ankle Arthroplasty Guides With Intra-Operative Feedback
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Solution Overview
Problem
Existing Patient-Specific Instruments (PSIs) for total ankle arthroplasty lack flexibility and intra-operative feedback, often failing to account for patient-specific anatomical deviations and soft tissue tension, leading to potential misalignment and mispositioning of implants.
Innovation Solution
The development of Patient-Specific Instruments (PSIs) that allow for flexibility during arthroplasty operations by providing tibial and talar PSIs contoured to fit individual patient anatomy, with intra-operative assessment capabilities and the use of Augmented Reality (AR) for navigation, enabling surgeons to adapt procedures to actual bone positions.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Manufacturing precision
If existing PSI systems are used to guide implant positioning, then preoperative virtual planning can be replicated, but the system lacks flexibility to accommodate intra-operative anatomical deviations and soft tissue tension
Solution Approach 1:
The PSI system transitions from a static, preoperative planning tool to a dynamic, intra-operative adaptive system. The PSI is designed with adjustable components that allow real-time modification of implant positioning based on actual anatomical conditions observed during surgery, including soft tissue tension and bone geometry variations.
Solution Approach 2:
The system incorporates intra-operative feedback mechanisms where the PSI provides real-time information about the actual anatomical geometry and implant positioning. This feedback loop allows the surgeon to adjust the positioning based on observed deviations from preoperative planning, ensuring accurate final placement despite anatomical variations.
2Device complexity
If existing PSI systems rely on single type of landmarks, then the system structure is simplified, but the system fails when landmarks are difficult to expose, damaged, or abnormal
Solution Approach 1:
The PSI system incorporates multiple types of landmarks and attachment methods that can be universally applied to different anatomical conditions. The system can switch between various landmark types (anatomical landmarks, artificial landmarks, surface-based attachment) depending on the specific patient anatomy and surgical conditions, ensuring reliable PSI fitting regardless of landmark availability or quality.
3Ease of operation
If existing PSI systems do not provide intra-operative feedback, then the system is simpler to operate, but surgeons have limited options when talus cannot be positioned as planned
Solution Approach 1:
The PSI system incorporates intra-operative feedback mechanisms that provide real-time information about implant positioning accuracy and anatomical alignment. This feedback enables surgeons to make informed decisions and adjustments during surgery, offering multiple options when the initial positioning plan needs modification due to anatomical variations or soft tissue constraints.
Data Source
AI summary
Devices and methods provided for joint arthroscopy contemplate and enable the provision of patient specific instruments (PSI). The devices and anatomical features of a patient are rendered adjustable by the provision of guide elements and features to account for and enable repositioning of the anatomical features during surgery. Where the joint arthroscopy involves ankle arthroplasty, a PSI system includes a tibial PSI operable to be coupled to a tibia and a talar PSI operable to be coupled to a talus. Pins pass through the tibial PSI into the tibia and through the talar PSI into the talus. The tibia and talus are aligned based on the tibial PSI, the talar PSI, the pins, and optionally a connection guide operable to receive, or be coupled to, the pins. The tibial PSI and the talar PSI allow for the transfer of pre-operative planning to intra-operative procedures.