# US 11,896,321 B2 · Systems and methods to register patient anatomy or to determine and present measurements relative to patient anatomy

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- Number: US 11,896,321 B2
- Document ID: US11896321B2
- Status: Granted
- Kind: B2
- Application number: 18/129,698
- Filed: 2023-03-31
- Published: 2023-07-27
- Granted: 2024-02-13
- Earliest claimed: 2014-10-29
- Assignees: Intellijoint Surgical Inc.
- Applicants: Intellijoint Surgical Inc.
- Inventors: Richard Tyler Fanson; Eric Ryterski; Armen Garo Bakirtzian; Andre Novomir Hladio
- Web page: https://patentgrep.com/patent/US11896321B2

## CPC

- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 5/6847: {mounted on an invasive device}
- A61B 17/1703: {using imaging means, e.g. by X-rays}
- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 46/10: specially adapted for instruments{, e.g. microscopes}
- A61B 90/06: {Measuring instruments not otherwise provided for}
- A61B 90/30: Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
- A61B 90/361: {Image-producing devices, e.g. surgical cameras}
- G06T 7/337: {involving reference images or patches}
- G06T 7/74: {involving reference images or patches}
- A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones}
- A61B 2034/2048: {using an accelerometer or inertia sensor}
- A61B 2034/2055: {Optical tracking systems}
- A61B 2034/2057: {Details of tracking cameras}
- A61B 2034/2065: {Tracking using image or pattern recognition}
- A61B 2034/2068: {using pointers, e.g. pointers having reference marks for determining coordinates of body points}
- A61B 2034/2072: {Reference field transducer attached to an instrument or patient}
- A61B 2090/061: {for measuring dimensions, e.g. length}
- A61B 2090/064: {for measuring force, pressure or mechanical tension}
- A61B 2090/067: {for measuring angles}
- A61B 2090/364: {Correlation of different images or relation of image positions in respect to the body}
- A61B 2090/373: {using light, e.g. by using optical scanners}
- A61B 2090/3937: {Visible markers}
- A61B 2090/3983: {Reference marker arrangements for use with image guided surgery}
- G06T 2207/30008: Bone
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G06T: IMAGE DATA PROCESSING OR GENERATION, IN GENERAL

## Abstract

Systems and methods are disclosed for use in electronic guidance systems for surgical navigation. A sensor is provided with an optical sensor, to provide optical information, and a measuring sensor, to provide measurements for determining a direction of gravity. The sensor communicates optical information and measurements to an inter-operative computing unit. In an embodiment, the inter-operative computing unit receives first optical information for a registration device and a patient anatomy and a measurement to determine a direction of gravity to perform a registration step. The inter-operative computing unit receives second optical information for the patient anatomy and an object and determines and presents measurements relative to the anatomy. The measurements relative to the anatomy are determined from the second optical information, and in relation to the registration of the anatomy of the patient.

## Claims

### Claim 1

A system comprising:
a sensor comprising an optical sensor configured to provide optical information, and a measuring sensor configured to provide measurements for determining a direction of gravity;
a first target configured to attach to an anatomy of a patient and configured to provide positional information in up to six degrees of freedom to the optical sensor;
a second target configured to attach in a known positional relationship to an object, the second target configured to provide positional information in up to six degrees of freedom to the optical sensor; and
an intra-operative computing unit configured to:
receive first optical information for the first target and second target, and measurements for determining the direction of gravity, wherein the first optical information and the measurements received from the sensor are for a registration step performed for a registration, the first optical information comprising information for the second target attached to a registration device to determine at least one axis relative to the anatomy;
receive second optical information for the first target and second target, the second optical information received from the sensor for a subsequent step of a surgical procedure, the second optical information comprising information for the second target attached to a bone of the anatomy of the patient, a surgical tool for the surgical procedure, or an implant for the surgical procedure; and
determine and present measurements relative to the anatomy for the surgical procedure, wherein the measurements relative to the anatomy are determined from the second optical information, and in relation to the registration of the anatomy of the patient.

### Claim 2 (depends on 1)

The system of claim 1, wherein the intra-operative computing unit is configured to determine a registration coordinate frame for the anatomy of the patient based on the direction of gravity, the position and orientation of the first target and the at least one axis for the registration step.

### Claim 3 (depends on 1)

The system of claim 1 comprising the registration device.

### Claim 4 (depends on 1)

The system of claim 1, wherein the registration device comprises an elongate element configured to extend along an axis of the anatomy.

### Claim 5 (depends on 1)

The system of claim 1, wherein the registration device comprises a probe tip configured to contact an anatomical point of the anatomy.

### Claim 6 (depends on 5)

The system of claim 5, wherein the known positional relationship is between the second target and the probe tip.

### Claim 7 (depends on 6)

The system of claim 6, wherein:
the first optical information comprises information identifying respective locations of two or more anatomical features of the anatomy of the patient; and
the intra-operative computing unit is configured to determine the at least one axis using the known positional relationship and the respective locations of the two or more anatomical features.

### Claim 8 (depends on 7)

The system of claim 7, wherein two of the two or more anatomical features lie on an anterior pelvic plane (APP) of the anatomy.

### Claim 9 (depends on 8)

The system of claim 8, wherein the two of the two or more anatomical features are a left anterior superior iliac spine (ASIS) and a right ASIS.

### Claim 10 (depends on 1)

The system of claim 1, wherein the second target is removably attachable to the registration device.

### Claim 11 (depends on 1)

The system of claim 1, wherein the sensor comprises a handheld sensor to be held in a hand of a user.

### Claim 12 (depends on 1)

The system of claim 1, wherein the sensor is configured to provide the optical information and the measurements for determining the direction of gravity relative to a common frame of reference.

### Claim 13 (depends on 1)

The system of claim 1, wherein the anatomy to which the first target is attached is positioned in a known orientation with respect to the direction of gravity.

### Claim 14 (depends on 1)

The system of claim 1, comprising a display screen and wherein the intra-operative computing unit is configured to present the measurements relative to the anatomy for display by the display screen.

### Claim 15 (depends on 14)

The system of claim 14, wherein the anatomy is a pelvis, and wherein the surgical procedure is a Total Hip Arthroplasty (THA).

### Claim 16 (depends on 15)

The system of claim 15, wherein the measurements relative to the anatomy comprise clinical measurements for real-time acetabular cup alignment in THA.

### Claim 17 (depends on 1)

The system of claim 1, wherein the measuring sensor comprises any one or more of an inclinometer, an accelerometer, a gyroscope and a magnetometer.

### Claim 18

A system comprising:
a first target configured to attach to a pelvis of a patient, the first target configured to provide positional information in up to six degrees of freedom to the optical sensor;
a second target configured to attach in a known positional relationship to an object, the second target configured to provide positional information in up to six degrees of freedom to the optical sensor, the object comprising a femur, a surgical tool or an implant;
a handheld registration device configured to define at least one axis of an anatomy of the patient;
a handheld sensor comprising an optical sensor configured to provide optical information and a measuring sensor configured to provide measurements for determining a direction of gravity; and
an intra-operative computing unit configured to:
receive, from the handheld sensor, first optical information for the first target and second target, and first measurements for determining the direction of gravity, the first optical information and the first measurements received for a registration step to perform a registration, the first optical information comprising information for the second target attached to the registration device to determine at least one axis relative to the anatomy;
receive, from the handheld sensor, second optical information for the first target and second target for a subsequent step of a surgical procedure, the second optical information comprising information for the second target attached to the femur of the patient, the surgical tool comprising an implant tool for a THA procedure or the implant for the THA procedure; and
determine and present measurements relative to the anatomy for the surgical procedure, wherein the measurements relative to the anatomy are determined from the second optical information, and in relation to the registration of the anatomy of the patient.

### Claim 19 (depends on 18)

The system of claim 18, wherein the registration device comprises: i) an elongate element configured to extend along an axis of the anatomy to define the axis; or ii) a probe tip configured for contacting respective locations of two or more anatomical features for defining the axis.

### Claim 20

A computer implemented method executed by a processor of an intra-operative computing unit, the method comprising:
receiving, from a sensor, first optical information for a first target and a second target, and measurements for determining a direction of gravity for a registration step to perform a registration of an anatomy of a patient, the first optical information comprising information for: i) the first target attached to the anatomy of the patient; and ii) the second target attached to a registration device to determine at least one axis relative to the anatomy of the patient, and wherein each of the first target and the second target is configured to provide positional information in up to six degrees of freedom to an optical sensor configured to provide optical information, and wherein the sensor comprises the optical sensor, and a measuring sensor, the measuring sensor configured to provide measurements for determining the direction of gravity;
receiving, from the sensor, second optical information for the first target and second target, the second optical information received for a subsequent step of a surgical procedure, the second optical information comprising information for the second target attached to a bone of the anatomy of the patient, a surgical tool for the surgical procedure, or an implant for the surgical procedure; and
determining and presenting measurements relative to the anatomy of the patient for the surgical procedure, wherein the measurements relative to the anatomy of the patient are determined from the second optical information, and in relation to the registration of the anatomy of the patient.