Actuated positioning device for arthroplasty and methods of use

Abstract

A joint balancing insert with sensors and an actuated mechanism is disclosed. The joint balancing insert is used to balance a joint during arthroplasty surgery, as the sensors provide force, position and angular data relating to the movement of the joint, while the actuated mechanism allows for highly accurate and dynamic adjustments of the joint based on the data from the sensors. Various configurations of actuated mechanisms and sensors may be implemented in the insert to provide for manual or real time control of the insert, and customized interfaces are provided for visualized feedback of adjustments. Sensor data may also be collected and compared with expected or preferred data sets to provide adjustment recommendations and achieve better outcomes based on historical data.

What is claimed is: 
     
         1 . An insert for balancing a joint during repair of the joint, the insert comprising:
 a top plate configured to interface with a first bone structure of a joint;   a bottom plate configured to interface with a second bone structure of the joint opposite the first bone structure;   a plurality of pneumatic bellows disposed between the top plate and the bottom plate and configured to distribute a force across the first bone structure and the second bone structure to balance the joint in flexion and extension;   one or more sensors configured to provide data indicative of a spatial relationship between the top plate and the bottom plate; and   a processor communicatively coupled to the one or more sensors and configured to receive the data from the one or more sensors and determine a distance between the top plate and the bottom plate.   
     
     
         2 . The insert of  claim 1 , wherein the processor is further configured to determine tilt between the top plate and the bottom plate in two axes. 
     
     
         3 . The insert of  claim 2 , wherein the plurality of bellows comprises a first bellows adjacent and in fluid communication with a second bellows. 
     
     
         4 . The insert of  claim 3 , wherein the first bellows and the second bellows are manifolded together with an annular seal located between the first bellows and the second bellows around a first fluid communication hole and a second fluid communication. 
     
     
         5 . The insert of  claim 3 , wherein the first bellows includes four first compartments that are in direct fluid communication, each compartment being located in a quadrant of the first bellows. 
     
     
         6 . The insert of  claim 1  further comprising a bearing disposed between the top plate and the bottom plate and configured to allow the top plate to rotate relative to the bottom plate. 
     
     
         7 . The insert of  claim 6 , wherein the bearing is configured to provide for up to 10 degrees of rotation between the top plate and the bottom plate. 
     
     
         8 . The insert of  claim 1  further comprising a force sensor configured to provide force data indicative of the force applied between the top plate and the bottom plate. 
     
     
         9 . The insert of  claim 1 , wherein the top plate includes a groove on a side opposite the bottom plate, and an articular contact surface within the groove, the articular contact surface being configured to interface and articulate with a condyle of a bone for the joint. 
     
     
         10 . The insert of  claim 1 , wherein the top plate includes a plate portion adjacent the pneumatic bellows and an articular portion fastened to the plate portion, the articular portion being configured to interface and articulate with a condyle of a bone for the joint. 
     
     
         11 . An insert for balancing a joint during repair of the joint, the insert comprising:
 a top plate including
 a plate portion, and 
 an articular portion fastened to the plate portion, the articular portion including a groove opposite the plate portion and an articular contact surface configured to interface and articulate with a first bone structure of the joint; 
   a bottom plate configured to interface with a second bone structure of the joint;   a pneumatic actuator having a plurality of bellows configured to inflate and distribute force across the top plate and the bottom plate; and   one or more sensors for providing data indicative of a spatial relationship between the top plate and the bottom plate.   
     
     
         12 . The insert of  claim 11 , wherein the one or more sensors are coupled to an electronics board configured to obtain spatial data from the one or more sensors and the bottom plate includes one or more magnet recesses adjacent the pneumatic actuator and aligned with the one or more sensors, and wherein the insert includes a magnet located in each magnet recess. 
     
     
         13 . The insert of  claim 11 , wherein the plurality of bellows comprises a first bellows having four first compartments that are in direct fluid communication, each compartment being located in a quadrant of the first bellows, and wherein the plurality of bellows comprises a second bellows having four second compartments that are not in direct fluid communication, each of the second compartments being located adjacent to and in fluid communication with one of the four first compartments. 
     
     
         14 . The insert of  claim 11 , wherein the pneumatic actuator provides a minimum height change for the actuated joint-balancing insert of at least  6 mm. 
     
     
         15 . A joint balancing system for balancing a joint during a surgical procedure, the joint balancing system comprising:
 an insert including
 a top plate configured to interface with a bone structure of a joint, the top plate including a board receiving feature, 
 a bottom plate spaced apart from the top plate and configured to interface with an opposing bone structure of the joint, 
 a pneumatic actuator configured to inflate and distribute a force to the top plate and to the bottom plate, 
 an electronics board located in the board receiving feature and adjacent to the pneumatic actuator, and 
 a sensor coupled to the electronics board and located between the electronics board and the actuator, the sensor configured to sense a spatial relationship between the top plate and the bottom plate; and 
   a controller assembly including
 a controller including
 a housing body formed with an electronics chamber and an accumulation chamber, and 
 a housing electronics board located in the electronics chamber and in electronic communication with the electronics board. 
 
   
     
     
         16 . The insert of  claim 15 , wherein the pneumatic actuator comprises a plurality of bellows having a first bellows adjacent and in fluid communication with a second bellows. 
     
     
         17 . The joint balancing system of  claim 15 , wherein the controller is further configured to measure tilt between the top plate and the bottom plate in two axes. 
     
     
         18 . The joint balancing system of  claim 15 , wherein the controller includes a pressure sensor for determining pressure of a fluid in the pneumatic actuator. 
     
     
         19 . The joint balancing system of  claim 18  further comprising a bearing disposed between the top plate and the bottom plate and configured to allow the top plate to rotate relative to the bottom plate. 
     
     
         20 . The joint balancing system of  claim 19 , wherein the bearing is configured to provide for up to 10 degrees of rotation between the top plate and the bottom plate.