# US 11,992,270 B2 · Systems and methods for planning and performing image free implant revision surgery

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- Number: US 11,992,270 B2
- Document ID: US11992270B2
- Status: Granted
- Kind: B2
- Application number: 18/088,135
- Filed: 2022-12-23
- Published: 2023-04-27
- Granted: 2024-05-28
- Earliest claimed: 2014-12-01
- Assignees: Blue Belt Technologies, Inc.
- Applicants: Blue Belt Technologies, Inc.
- Inventors: Branislav Jaramaz; Alberto Gregori
- Web page: https://patentgrep.com/patent/US11992270B2

## CPC

- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 5/065: {Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe}
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 34/30: Surgical robots
- A61B 34/35: for telesurgery
- G06T 17/10: Constructive solid geometry [CSG] using solid primitives, e.g. cylinders, cubes
- G06T 19/20: Editing of three-dimensional [3D] images, e.g. changing shapes or colours, aligning objects or positioning parts
- G16H 50/50: for simulation or modelling of medical disorders
- A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones}
- A61B 2034/107: {Visualisation of planned trajectories or target regions}
- A61B 2034/108: {Computer aided selection or customisation of medical implants or cutting guides}
- A61B 2034/2055: {Optical tracking systems}
- A61B 2034/2063: {Acoustic tracking systems, e.g. using ultrasound}
- A61B 2034/2068: {using pointers, e.g. pointers having reference marks for determining coordinates of body points}
- G06T 2210/41: Medical
- G06T 2219/2021: Shape modification
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G06T: IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

Systems and methods for planning and performing image free implant revision surgery are discussed. For example, a method for generating a revision plan can include collecting pre-defined parameters characterizing a target bone, generating a 3D model, collecting a plurality of surface points, and generating a reshaped 3D model. Generating the 3D model of the target bone can be based on a first portion of the pre-defined parameters. Generating the reshaped 3D model can be done based on the plurality of surface points collected from a portion of the surface of the target bone.

## Claims

### Claim 1

A method of revising a total hip arthroplasty, the method comprising:
preparing, using a portion of a surgical instrument, a virtual three-dimensional model of an existing implant within a target bone selected from the group consisting of a femur, an acetabulum, and a combination thereof, wherein the surgical instrument comprises a point probe, a first tracking array, and a cutting burr;
removing the existing implant from the target bone;
installing a second tracking array on a portion of the target bone;
preparing, using the point probe, a virtual three-dimensional model of the target bone following removal of the existing implant;
removing an unwanted portion of the target bone;
preparing, using the point probe, a virtual three-dimensional model of the target bone following removal of the unwanted portion;
generating a surgical plan using a surgical system, wherein the surgical plan comprises:
removing, using the cutting burr of the surgical instrument, a portion of the target bone according to a bone refinement plan,
selecting and planning a fit of a revision implant and, optionally, at least one augment, and
wherein the surgical plan is based on at least one of the virtual three-dimensional model of the existing implant within the target bone, the virtual three-dimensional model of the target bone following removal of the existing implant, and the virtual three-dimensional model of the target bone following removal of the unwanted portion;
tracking a three-dimensional location and an orientation of each of the surgical instrument, the target bone, and the revision implant using a surgical navigation system; and
implanting the revision implant and, optionally, the at least one augment, according to the surgical plan.

### Claim 2 (depends on 1)

The method of claim 1, further comprising tracking alignment of:
(i) the target bone; and
(ii) at least one of: the virtual three-dimensional model of the existing implant within the target bone, the virtual three-dimensional model of the target bone following removal of the existing implant, and the virtual three-dimensional model of the target bone following removal of the unwanted portion using the surgical navigation system.

### Claim 3 (depends on 1)

The method of claim 1, further comprising collecting range-of-motion data and displaying the range-of-motion data virtually.

### Claim 4 (depends on 1)

The method of claim 1, further comprising calculating a hip center by collecting data while rotating a target bone around a hip joint.

### Claim 5

A system for revising a total hip arthroplasty, the system comprising:
a tracking system comprising a tracking sensor;
a surgical instrument comprising a cutting burr and a tracking array, wherein the tracking system is configured to monitor a current three-dimensional surgical instrument position and a current three-dimensional position of a target bone selected from the group consisting of a femur, an acetabulum, and a combination thereof;
a control system comprising a communication interface and at least one processor coupled to a memory device, wherein the control system is coupled to the tracking system and is configured to receive tracking information identifying the current three-dimensional surgical instrument position and the current three-dimensional position of the target bone; and
a revision total hip implant and, optionally, at least one augment.

### Claim 6 (depends on 5)

The system of claim 5 wherein the memory device includes instructions that, when executed by the at least one processor, cause the control system to perform an operation selected from the group consisting of collecting at least one pre-defined parameter, generating a virtual three-dimensional model, collecting a plurality of surface points, generating a reshaped virtual three-dimensional model, generating a virtual revision plan for preparing the target bone for implantation of a revision implant, and combinations thereof.

### Claim 7 (depends on 6)

The system of claim 6, wherein the at least one pre-defined parameter characterizes an aspect of the target bone.

### Claim 8 (depends on 7)

The system of claim 7, wherein generating the three-dimensional model comprises using the at least one pre-defined parameter to model a shape of at least a portion of the target bone.

### Claim 9 (depends on 6)

The system of claim 6, wherein generating the reshaped three-dimensional model comprises:
collecting the plurality of surface points over a portion of the target bone surface associated with an implant revision procedure; and
generating the reshaped three-dimensional model based on the three-dimensional model and the plurality of surface points.

### Claim 10 (depends on 5)

The system of claim 5, wherein the memory device includes instructions that, when executed by the at least one processor, cause the control system to use at least one pre-defined parameter to align a three-dimensional model of the target bone within a working coordinate system.

### Claim 11 (depends on 5)

The system of claim 5, wherein the surgical instrument further comprises at least one of a burr guard, a plate probe attachment, and a point probe.

### Claim 12 (depends on 5)

The system of claim 5, wherein the tracking system is an optical tracking system.