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US 10,238,454 B2Granted
Fluoroscopy-based technique to measure intraoperative cup anteversion
AssigneeFriedrich Boettner
InventorsFriedrich Boettner, Matthieu Zingg
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Abstract
Direct anterior approach (DAA) with the patient lying supine has facilitated the use of intraoperative fluoroscopy and allows for standardized positioning of the patient. The method disclosed herein uses intraoperative fluoroscopy to measure acetabular component anteversion and more particularly, a method for measuring/calculating intraoperative cup (acetabular component) anteversion is provided based on the measured acetabular component abduction angle and a c-arm tilt angle (CaT).
Claims20
A fluoroscopy-based method for measuring intraoperative acetabular cup anteversion during total hip arthroplasty utilizing a direct anterior approach (DAA) comprising the steps of:
- (A) processing, by a computing device configured by executing code stored in non-transitory processor readable media, an anterior posterior image of a pelvis that includes an initially positioned acetabular cup, to measure an abduction angle of the acetabular cup, wherein the anterior posterior image is taken by a fluoroscopy image capture device configured with a C-arm;
- (B) processing, by the computing device, an external pelvic oblique image that includes the acetabular cup and that is taken by the fluoroscopy image capture device and positioned relative to a plane of the acetabular cup's rim to detect whether a plane of an image amplifier of the fluoroscopy image capture device is positioned perpendicular to the plane of the acetabular cup's rim;
- (i) where the plane of the image amplifier of the fluoroscopy image capture device is detected, by the computing device, to be not positioned perpendicular to the plane of the acetabular cup's rim:
- (a) transmitting, by the computing device, an instruction to move the C-arm to a different position and in a direction away from a hip of a patient that is being replaced with an implant including the acetabular cup;
- (b) processing, by the computing device, a subsequently captured external pelvic oblique image that includes the acetabular cup and that is taken by the fluoroscopy image capture device to detect whether the plane of the image amplifier is positioned perpendicular to the plane of the acetabular cup's rim;
- and
- (c) repeating, by the computing device, steps (A) and (B);
- and
- (ii) where the plane of the image amplifier of the fluoroscopy image capture device is detected, by the computing device, to be positioned perpendicular to the plane of the acetabular cup's rim:
- (a) recording, by the computing device, a C-arm tilt angle when the C-arm is in a position in which the plane of the image amplifier is perpendicular to the plane of the acetabular cup's rim;
- (b) calculating, by the computing device, an anteversion angle based on the measured abduction angle and the recorded C-arm tilt angle;
- (c) determining, by the computing device, whether the calculated anteversion angle is within a predetermined acceptable range;
- and
- (d) where the calculated anteversion angle is outside of the predetermined acceptable angle, repeating, by the computing device, steps (a)-(d) until the calculated anteversion angle is within the predetermined acceptable range.
11 more elements
A fluoroscopy-based system for measuring intraoperative acetabular cup anteversion during total hip arthroplasty utilizing a direct anterior approach (DAA), the system comprising:
- a computing device configured with a processor and non-transitory processor readable memory that includes programming code that, when executed, configures the processor to:
- (A) process an anterior posterior image of a pelvis that includes an initially positioned acetabular cup, to measure an abduction angle of the acetabular cup, wherein the anterior posterior image is taken by a fluoroscopy image capture device configured with a C-arm;
- (B) process an external pelvic oblique image that includes the acetabular cup and that is taken by the fluoroscopy image capture device and positioned relative to a plane of the acetabular cup's rim to detect whether a plane of an image amplifier is positioned perpendicular to the plane of the acetabular cup's rim;
- (i) where the plane of the image amplifier of the fluoroscopy image capture device is detected to be not positioned perpendicular to the plane of the acetabular cup's rim:
- (a) transmit an instruction to move the C-arm to a different position and in a direction away from a hip of a patient that is being replaced with an implant including the acetabular cup;
- (b) process a subsequently captured external pelvic oblique image that includes the acetabular cup and that is taken by the fluoroscopy image capture device to detect whether the plane of the image amplifier is positioned perpendicular to the plane of the acetabular cup's rim;
- and
- (c) repeat steps (A) and (B);
- and
- (d) where the plane of the image amplifier of the fluoroscopy image capture device is detected to be positioned perpendicular to the plane of the acetabular cup's rim:
- (a) record a C-arm tilt angle when the C-arm is in a position in which the plane of the image amplifier is perpendicular to the plane of the acetabular cup's rim;
- (b) calculate an anteversion angle based on the measured abduction angle and the recorded C-arm tilt angle;
- (c) determine whether the calculated anteversion angle is within a predetermined acceptable range;
- and
- (d) where the calculated anteversion angle is outside of the predetermined acceptable angle, repeat steps (a)-(d) until the calculated anteversion angle is within the predetermined acceptable range.
12 more elements
A fluoroscopy-based system for measuring intraoperative acetabular cup anteversion during total hip arthroplasty utilizing a direct anterior approach (DAA), the system comprising:
- a computing device configured with a processor and non-transitory processor readable memory that includes programming code that, when executed, configures the processor to:
- (A) process an anterior posterior image of a pelvis that includes an initially positioned acetabular cup, to measure an abduction angle of the acetabular cup, wherein the anterior posterior image is taken by a fluoroscopy image capture device configured with a C-arm;
- (B) process an external pelvic oblique image that includes the acetabular cup and that is taken by the fluoroscopy image capture device and positioned relative to a plane of the acetabular cup's rim to detect whether the shape of acetabular cup's rim appears linear;
- (i)where the shape of acetabular cup's rim does not appear linear:
- (a) transmit an instruction to move the C-arm to a different position and in a direction away from a hip of a patient that is being replaced with an implant including the acetabular cup;
- (b) process a subsequently captured external pelvic oblique image that includes the acetabular cup and that is taken by the fluoroscopy image capture device to detect whether the shape of acetabular cup's rim appears linear;
- and
- (c) repeat steps (A) and (B);
- and
- (ii) where the shape of acetabular cup's rim appears linear:
- (a) record a C-arm tilt angle when the C-arm is in a position in which the shape of acetabular cup's rim appears linear;
- (b) calculate an anteversion angle based on the measured abduction angle and the recorded C-arm tilt angle;
- (c) determine whether the calculated anteversion angle is within a predetermined acceptable range;
- and
- (d) where the calculated anteversion angle is outside of the predetermined acceptable angle, repeat steps (a)-(d) until the calculated anteversion angle is within the predetermined acceptable range.
12 more elements
Dependencies are inferred from the claim text.