Automated Patellar Tracking in Total Knee Arthroplasty
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Solution Overview
Problem
Current total knee arthroplasty (TKA) procedures lack sophisticated tools for patellar replacement, relying on free-hand techniques that do not account for the biomechanics of the patellofemoral joint, leading to high cognitive load on surgeons and a significant risk of post-operative complications such as patellofemoral instability and chronic pain.
Innovation Solution
A method and system for automating patellar replacement by using patient-specific imaging data to create a 3D model of the patella, characterizing its morphology, selecting implant parameters, and optimizing the position and orientation of the implant through biomechanical simulations, thereby reducing the reliance on free-hand techniques and improving surgical accuracy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If free-hand techniques are used for patellar replacement, then surgical flexibility is maintained, but measurement precision and manufacturing precision deteriorate
Solution Approach 1:
The patent replaces manual mechanical measurement tools (calipers) with an image-based measurement system. Pre-operative imaging data (CT or MRI) is processed to automatically calculate patellar thickness and morphology, eliminating the need for intraoperative manual measurements and providing precise, reproducible measurements without compromising surgical flexibility.
Solution Approach 2:
The system performs all patellar measurements, morphology characterization, and implant sizing calculations in the pre-operative planning phase. This preliminary action allows surgeons to have all measurement and planning decisions made before surgery, eliminating the need for complex intraoperative measurements while maintaining surgical flexibility during the actual procedure.
2Productivity
If free-hand patellar resection is performed, then surgical speed is maintained, but manufacturing precision and reliability deteriorate
Solution Approach 1:
The system performs comprehensive pre-operative planning including determining the precise resection depth, orientation, and implant size based on patient-specific anatomy. The surgical guide translates this pre-determined plan into accurate resection, allowing the surgeon to perform the procedure quickly without compromising precision.
Solution Approach 2:
A patient-specific surgical guide acts as an intermediary between the pre-operative plan and the actual resection. The guide incorporates all planning decisions and provides mechanical constraints that ensure accurate resection depth and orientation, enabling fast execution with high precision.
3Device complexity
If conventional patellar replacement tools are used, then device complexity is minimized, but adaptability and measurement precision deteriorate
Solution Approach 1:
The patent replaces simple mechanical tools with a computer-based planning system that processes imaging data to characterize patient-specific patellar morphology. The system automatically adapts to individual anatomical variations in patellar thickness, shape, and orientation, providing customized implant sizing and resection parameters without requiring complex intraoperative adjustments.
Solution Approach 2:
The system uses demographic information (age, sex, ancestry) and imaging data to determine optimal implant parameters such as thickness, size, and positioning. These parameters are automatically adjusted based on patient-specific anatomy and population-based normative data, enabling the system to adapt to diverse anatomical variations while maintaining straightforward surgical execution.
4Ease of operation
If manual patellar thickness measurement is performed intra-operatively, then real-time adjustment capability is maintained, but measurement precision and reliability deteriorate
Solution Approach 1:
The system replaces unreliable manual intraoperative measurements with pre-operative image-based measurements that provide consistent, reproducible results. The imaging-based approach eliminates variability introduced by manual measurement techniques while allowing surgeons to review and adjust the plan before surgery.
Solution Approach 2:
All thickness measurements are performed in the pre-operative phase using high-quality imaging data, ensuring accurate and consistent measurements are established before surgery. This preliminary measurement approach maintains reliability while still allowing for adjustments during planning, eliminating the need for repeated intraoperative measurements.
Data Source
AI summary
A method of planning a patellar replacement for a patient is provided. Input related to patient anatomy is received (e.g., demographic information) and imaging data is obtained from 2D or 3D medical imaging Biomechanical measurements of the patellofemoral joint are determined including a mechanical axis and pre-operative leg deformity. A 3D model of the patient anatomy is generated based on the input, and the 3D model is characterized in terms of the morphology of the patella. An implant is sized and fitted to the 3D model and implant position and orientation are optimized based on the biomechanics. Results are outputted as a patient report or a surgical plan to a computing device and/or a storage medium. A tracker unit for tracking a patella bone is also provided. The tracker unit comprises a support configured to penetrate the patella and a fiducial marker for detection by a tracking system.