Patient-Specific Foot Osteotomy Guide for Precision Alignment
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Solution Overview
Problem
Conventional surgical techniques face challenges in accurately locating and positioning osteotomy cuts, fixation guides, and implants in complex bone anatomy, particularly in small bones like those in the ankle, foot, or hand, due to limitations in translating patient-specific anatomy models into real-world surgical procedures.
Innovation Solution
A patient-specific resection guide is designed with multiple resection features and a bone attachment feature, which is determined based on a bone model derived from medical imaging. This guide includes features such as resection channels and bone engagement surfaces tailored to the patient's anatomy, allowing for precise osteotomy and implant placement.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If conventional surgical techniques are used, then surgical procedures can be performed, but accuracy and precision in locating and positioning osteotomy cuts and implants are insufficient
Solution Approach 1:
Patient-specific instruments are designed and fabricated before surgery based on pre-operative imaging data (CT or MRI scans). These instruments incorporate patient-specific anatomical surface features that are registered to the pre-operative bone model, enabling precise translation of the virtual surgical plan to the actual surgical procedure. The preliminary fabrication of custom instruments with integrated positioning features resolves the contradiction by establishing accurate reference frames before the surgical procedure begins.
Solution Approach 2:
Patient-specific instruments are created as physical copies or representations of the patient's unique bone anatomy derived from imaging data. The instruments incorporate digital models and surface registrations that replicate the patient's specific anatomical features, allowing the virtual surgical plan to be accurately transferred to the physical surgical field. This copying approach enables precise localization of osteotomy cuts and implant positioning by matching the instrument's registered surface features to the actual bone anatomy.
2Manufacturing precision
If patient-specific instruments are designed based on pre-operative imaging, then surgical precision is improved, but device complexity and customization requirements increase
Solution Approach 1:
Patient-specific instruments are designed as multi-functional devices that integrate multiple surgical functions into single instruments. For example, a patient-specific cutting guide may simultaneously provide osteotomy localization, cutting depth control, and implant positioning features. This multi-functionality reduces the number of separate custom instruments needed, thereby reducing overall device complexity while maintaining high surgical precision through the integrated patient-specific features.
Solution Approach 2:
The patient-specific instrument system is segmented into modular components, each with specific functions (e.g., surface registration features, cutting guides, implant positioning features). This segmentation allows the complex custom instrument to be broken down into manageable functional modules, facilitating manufacturing, sterilization, and surgical use while maintaining the overall precision benefits of the customized system.
3Loss of substance
If minimal bone removal is performed to achieve successful fusion, then bone preservation is improved, but surgical accuracy requirements increase
Solution Approach 1:
The patient-specific instruments incorporate image-guided positioning systems that replace traditional mechanical measurement and localization methods. By using pre-operative imaging data and surface registration technology, the system provides digital guidance for bone resection, eliminating the need for extensive intraoperative mechanical measurements and trial resections. This substitution enables minimal bone removal while achieving the required surgical accuracy through digital planning and guidance.
Solution Approach 2:
The optimal bone resection plan is determined in advance through pre-operative imaging and virtual surgical planning. Patient-specific cutting guides are fabricated before surgery based on this preliminary plan, allowing the surgeon to proceed directly to the pre-determined resection parameters without intraoperative trial and error. This preliminary planning and instrument fabrication enables minimal bone removal while ensuring the required accuracy for successful fusion.
Data Source
AI summary
An apparatus, system, and method are disclosed for remediating a condition present in a patient. In some implementations, a resection guide includes a first resection feature that guides a cutting tool to form a first osteotomy in a bone, the first resection feature extends along a first trajectory. A second resection feature guides a cutting tool to form a second osteotomy in the bone, the second resection feature extends along a second trajectory. A third resection feature guides a cutting tool to form a third osteotomy in the bone, the third resection feature extends along a third trajectory. At least one of the trajectories is determined based on a bone model of a portion of the bone, which bone model is based on medical imaging of the patient's foot. The device also includes a bone attachment feature to secure the resection guide to the bone.