# US 12,213,658 B2 · Force-indicating retractor device and methods of use

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- Number: US 12,213,658 B2
- Document ID: US12213658B2
- Status: Granted
- Kind: B2
- Application number: 17/314,558
- Filed: 2021-05-07
- Published: 2021-11-25
- Granted: 2025-02-04
- Earliest claimed: 2018-08-07
- Assignees: Smith & Nephew, Inc.; Smith & Nephew Asia Pacific Pte. Limited; Smith & Nephew Orthopaedics AG
- Applicants: Smith & Nephew, Inc.; Smith & Nephew Asia Pacific Pte. Limited; Smith & Nephew Orthopaedics AG
- Inventors: Branislav Jaramaz; Samuel C. Dumpe; Cedric Corpa De La Fuente; Gary David Carlson, Jr.; Brett J. Bell; Brian W. McKinnon; Daniel Farley
- Web page: https://patentgrep.com/patent/US12213658B2

## CPC

- A61B 17/025: {Joint distractors}
- A61B 90/98: using electromagnetic means, e.g. transponders
- A61B 17/0206: {with antagonistic arms as supports for retractor elements}
- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 34/30: Surgical robots
- A61B 34/76: {Manipulators having means for providing feel, e.g. force or tactile feedback}
- A61B 90/96: using barcodes
- G16H 10/20: for electronic clinical trials or questionnaires
- G16H 10/60: for patient-specific data, e.g. for electronic patient records
- G16H 20/40: relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
- G16H 30/20: for handling medical images, e.g. DICOM, HL7 or PACS
- G16H 30/40: for processing medical images, e.g. editing
- G16H 40/63: for local operation
- G16H 50/50: for simulation or modelling of medical disorders
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 2017/00115: {with audible or visual output}
- A61B 2017/00221: {with wireless transmission of data, e.g. by infrared radiation or radiowaves}
- A61B 2017/00464: {for use with different instruments}
- A61B 2017/0268: {for the knee}
- A61B 2034/101: {Computer-aided simulation of surgical operations}
- A61B 2034/108: {Computer aided selection or customisation of medical implants or cutting guides}
- A61B 2034/2051: {Electromagnetic tracking systems}
- A61B 2034/2055: {Optical tracking systems}
- A61B 2034/2063: {Acoustic tracking systems, e.g. using ultrasound}
- A61B 2034/2065: {Tracking using image or pattern recognition}
- A61B 2034/252: {indicating steps of a surgical procedure}
- A61B 2034/256: {having a database of accessory information, e.g. including context sensitive help or scientific articles}
- A61B 2090/064: {for measuring force, pressure or mechanical tension}
- A61B 2090/365: {augmented reality, i.e. correlating a live optical image with another image}
- A61B 2090/374: {NMR or MRI}
- A61B 2090/376: {using X-rays, e.g. fluoroscopy}
- A61B 2090/378: {using ultrasound}
- A61B 2090/3937: {Visible markers}
- A61B 2090/3945: {Active visible markers, e.g. light emitting diodes}
- A61B 2090/397: {electromagnetic other than visible, e.g. microwave}
- A61B 2090/3983: {Reference marker arrangements for use with image guided surgery}
- A61B 2562/0261: Strain gauges
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

Devices, systems, and methods for measuring a force applied to a joint during a surgical procedure are disclosed. The device includes an insertion tool, a handle, and one or more force indicators. The insertion tool includes an insertion end and a base end. The one or more force indicators may be attached to the insertion tool and the handle. The insertion end of the device may be inserted into a joint during a surgical procedure and used to apply a force to the joint and/or measure the force using the one or more force indicators when the force is applied.

## Claims

### Claim 1

A joint distraction device, comprising:
a first member comprising an insertion end configured to be inserted between a first bone and a second bone of a joint, the insertion end comprising a cavity therein;
a hinge coupled to the first member;
a second member comprising a distal portion and a proximal portion, the second member coupled to the hinge at a position between the distal portion and the proximal portion, wherein the distal portion is configured to be received within the cavity of the insertion end and inserted between the first bone and the second bone when the insertion end is inserted therein;
a third member coupled to the hinge and manipulable to exert a force on the proximal portion of the second member that causes the distal portion to rotate about the hinge and away from the insertion end while the distal portion and the insertion end are inserted between the first bone and the second bone, thereby distracting the first bone from the second bone; and
a disposable force sensor pod configured to be removably coupled to at least one of the second member or the third member.

### Claim 2 (depends on 1)

The joint distraction device of claim 1, wherein the insertion end of the first member is configured to engage the first bone and the distal portion of the second member is configured to engage the second bone; and
wherein the force exerted on the proximal portion of the second member by the third member is proportional to a distraction force provided by the insertion end and the distal portion to distract the first bone from the second bone.

### Claim 3

A surgical system, comprising:
a disposable force sensor pod comprising a mounting feature and at least one of a load cell or a strain gauge;
a computing system configured to be placed in electronic communication with the disposable force sensor pod and receive a force measurement from the disposable force sensor pod; and
a distraction device comprising:
a first member comprising an insertion end configured to be inserted between a first bone and a second bone of a joint, the insertion end comprising a cavity therein;
a hinge rotatably coupled to the first member;
a second member comprising a distal portion and a proximal portion, the second member rotatably coupled to the hinge at a position between the distal portion and the proximal portion, wherein the distal portion is configured to be received within the cavity of the insertion end and inserted between the first bone and the second bone when the insertion end is inserted therein; and
a third member rotatably coupled to the hinge and manipulable to exert a force on the proximal portion of the second member that causes the distal portion to rotate about the hinge and away from the insertion end while the distal portion and the insertion end are inserted between the first bone and the second bone, thereby distracting the first bone from the second bone,
wherein the proximal portion comprises a mount configured to receive the mounting feature to removably couple the disposable force sensor pod to the distraction device.

### Claim 4 (depends on 3)

The system of claim 3, wherein the mount is positioned on a surface of the proximal portion facing the third member.

### Claim 5 (depends on 3)

The system of claim 3, comprising a plurality of replacement disposable force sensor pods.

### Claim 6 (depends on 3)

The system of claim 3, further comprising a tracking system configured to track a pose of the first bone and a pose of the second bone.

### Claim 7 (depends on 6)

The system of claim 6, wherein the computing system is configured to associate, for each of a plurality of time steps, the force measurement from the disposable force sensor pod for the time step with a distraction distance calculated based on the pose of the first bone for the time step and the pose of the second bone for the time step.

### Claim 8 (depends on 7)

The system of claim 7, comprising a display screen, the display screen configured to display a graphical representation of the distraction distance and the force measurement for the plurality of time steps.

### Claim 9 (depends on 8)

The system of claim 8, wherein the computing system is configured to identify at least one of a preferred distraction distance or a ligament stiffness transition point by analyzing the force measurements and the distraction distances for the plurality of time steps.

### Claim 10 (depends on 9)

The system of claim 9, wherein the computing system is configured to generate or modify a surgical plan in accordance with the preferred distraction distance.

### Claim 11 (depends on 10)

The system of claim 10, comprising a robotic device;
wherein the computing system is configured to control the robotic device in accordance with the surgical plan.

### Claim 12 (depends on 3)

The system of claim 3, wherein the electronic communication comprises wireless communication.

### Claim 13 (depends on 3)

The system of claim 3, comprising a disposable cord coupled to the disposable force sensor pod and the computing system, the disposable cord configured to provide a conductive path for the electronic communication.