Abstract: Examples of robotically controlled planar cutting systems and methods for controlling cutting systems to prepare bone tissue in surgical procedures, are generally described herein. Applicable surgical procedures for the robotically controlled cutting systems and methods include procedures involving the preparation (e.g., removal, surfacing) of bone tissue, such as is performed in knee arthroplasties. In an example, a robotically controlled planar cutting system can include a housing, a cutting element disposed in the housing, and a cutting control mechanism in communication with a robotic controller to control operation of the cutting element to machine a planar surface. The cutting element can be exposed and retracted relative to the housing and can include a plurality of cutting implements arranged to machine the planar surface.

Abstract: The patient specific instrument (PSI) assembly for guiding a surgical tool on a tibia during a knee replacement surgery includes an extra-medullary portion at a distal end, an elongated rod connected at a distal end to the extra-medullary portion and extending in a direction along a mechanical axis of the tibia, and an upper mounting portion at a proximal end. The extra-medullary portion has a pair of spaced apart malleoli clamping elements with a size and/or relative position that is patient-specific for engaging respective ones of the lateral and medial malleoli. The upper mounting portion including a base body connected to a proximal end of the elongated rod and a surgical guide having guide openings extending therethrough and anchor element(s) on the upper mounting portion in locations adapted to overlay a peripheral contour of the tibia. The peripheral contour of the tibia including an anterior surface of the proximal tibia.

Abstract: Patient-specific instrumentation for use when performing articular joint repair is provided. A patient-specific jig is adapted to be positioned over a bone at an articular surface thereof for assisting in preparing the bone surface for reception of a prosthesis. The jig comprises a bone contacting portion adapted to matingly contact a portion of the articular surface of the bone and a cutting slot adapted to receive therein a saw blade for resecting the articular surface of the bone. The cutting slot may be press-fitted into the opening of a cut guide. A patient-specific plate and a patient-specific rotational guide are also provided for guiding a positioning of the prosthesis over the resected surface of the bone. A method for manufacturing the patient-specific jig is further provided.

Abstract: A system for creating at least one model of a bone and implanted implant comprises a processing unit; and a non-transitory computer-readable memory communicatively coupled to the processing unit and comprising computer-readable program instructions executable by the processing unit for: obtaining at least one image of at least part of a bone and of an implanted implant on the bone, the at least one image being patient specific, obtaining a virtual model of the implanted implant using an identity of the implanted implant, overlaying the virtual model of the implanted implant on the at least one image to determine a relative orientation of the implanted implant relative to the bone in the at least one image, and generating and outputting a current bone and implant model using the at least one image, the virtual model of the implanted implant and the overlaying.

Abstract: Embodiments of a system and method for digitizing locations within a coordinate system are generally described herein. A device may include a sleeve including a sleeve tracking marker and a tracked probe portion including an array of tracking markers and a probe tip. Movement of the probe tip relative to the sleeve between at least a first position and a second position may be monitored by tracking the sleeve tracking marker relative to at least one tracking marker of the array of tracking markers.

Abstract: Methods and surgical system for performing a surgical procedure. The surgical system includes a robotic system with a robotic arm having a surgical instrument attached thereto. A computer system of the robotic system receives at least one image and forms a model of a surgical area. A computer operated tracking system of the robotic system obtains position data related to a patient's bone from tracking elements. Based on the model of the surgical area and the tracked bone position, the robotic arm then performs the surgical procedure with the surgical instrument, and the robotic system adjusts the procedure as a result of the tracked bone position.

Abstract: A patient-specific cutting assembly comprises a model file including geometrical data of a bone of the patient, of an intramedullary canal of the bone, and a planned orientation of a cutting block. A fixing rod is adapted to be longitudinally inserted in and extending partially from the intramedullary canal. A patient-specific cutting block is connectable to the fixing rod. The patient-specific cutting block includes a structure having a patient specific geometry corresponding to the model file of the patient, the structure configured to be connected to a portion of the fixing rod projecting from the bone in a unique coupling orientation. A cutting guide is connected to the structure, the cutting guide being in the planned orientation when the structure is connected to the portion of the fixing rod projecting from the bone.

Abstract: Systems and methods for femoral medial condyle spherical center identification and tracking are described herein. Once the spherical center of the medial condyle is identified, the spherical center is tracked using a pin or internal reference. The spherical center may be used to provide a key kinematic motion reference, such as when the medial condyle is adjusted during a surgical procedure. The tracking may be used to provide optical tracking, inertial tracking, or other tracking. In contrast with surface-mounted optical trackers, the spherical center tracking is not lost during resection (e.g., removal) of a bone surface. Tracking the medial condyle spherical center may reduce or eliminate the need for a surface-mounted optical tracker or preoperative 3 -D modeling or of the joint.

Abstract: A method tracks a tool with respect to a bone in computer-assisted surgery. A reference tracker with a MEMS unit is secured to the bone. The tracker outputs data relating to its orientation. A tool provided with a MEMS unit and secured to the bone is preset with an initial orientation. The tool outputs tracking data related to orientation of the tool once initialized. A trackable frame of reference relating the bone to the orientation of the tracker is created. The MEMS unit of the tool is initialized. A relation between the initial orientation of the tool and the orientation of the tracker at initialization of the MEMS unit of the tool is recorded. Orientational data of the tool relative to the frame of reference of the bone calculated using the relation is displayed. A computer-assisted surgery system for tracking a tool with respect to a bone after an initialization of a MEMS unit is also described.

Abstract: A patient-specific cutting assembly comprises a model file including geometrical data of a bone of the patient, of an intramedullary canal of the bone, and a planned orientation of a cutting block. A fixing rod is adapted to be longitudinally inserted in and extending partially from the intramedullary canal. A patient-specific cutting block is connectable to the fixing rod. The patient-specific cutting block includes a structure having a patient specific geometry corresponding to the model file of the patient, the structure configured to be connected to a portion of the fixing rod projecting from the bone in a unique coupling orientation. A cutting guide is connected to the structure, the cutting guide being in the planned orientation when the structure is connected to the portion of the fixing rod projecting from the bone.

Abstract: Systems and methods may be used to perform robot-aided surgery. A system may include a robotic controller to monitor a position and orientation of an end effector coupled to an end of a robotic arm. The robotic controller may apply a force to a bone using the end effector, such as via a soft tissue balancing component. The robotic controller may determine soft tissue balance using information from a tracking system, such as a position of a first tracker affixed to the bone. The soft tissue balance may be output, such as to a display device.

Abstract: A system and method for tracking an object within a surgical field are described. A system may include a mesh of cameras distributed around the surgical field, the mesh of cameras including, for example at least three cameras. Cameras in the mesh of cameras may be in known positions or orientations relative to the surgical field or may be mobile with position or orientation to be determined by the system. The system may include a computing system communicatively coupled to the mesh of cameras, the computing system including a processor and a memory device. The computing system may be used to generate tracking data for a tracked object from images or image data taken by one or more cameras of the mesh of cameras.

Abstract: Systems and methods may be used to perform robot-aided surgery. A system may include a robotic controller to monitor a position and orientation of an end effector coupled to an end of a robotic arm. The robotic controller may apply a force to a bone using the end effector, such as via a soft tissue balancing component. The robotic controller may determine soft tissue balance using information from a tracking system, such as a position of a first tracker affixed to the bone. The soft tissue balance may be output, such as to a display device.

Abstract: A method for assisting subchondral injection comprising creating a model of bone and soft tissue of a patient. At least one void is modeled in the bone from the model of bone and soft tissue. An injection site is identified from the model of bone and soft tissue and modeling of the at least one void. Data is output for guiding at least in the locating of the injection site and drilling of the bone to reach the void. A patient-specific jig for subchondral injection may be created based on the injection site location.

Abstract: Systems and methods for determining position and orientation of a bone of an anatomical feature are described. These include the use of a wearable holder configured to be mounted about an outer-skin surface of the anatomical feature, such that the anatomical feature and the bone are positioned in fixed relation with respect to the wearable holder when the wearable holder is mounted about the anatomical feature. Reference marker arrays are fixedly mounted to the wearable holder, each being positioned on the wearable holder to identify a landmark of the bone within the wearable holder when the wearable holder is mounted to the anatomical feature. The position and orientation of the reference markers are trackable to determine position and orientation of the wearable holder in a reference coordinate system, thereby enabling position and orientation of the landmarks on the bone to be determined.

Abstract: A method tracks a tool with respect to a bone in computer-assisted surgery. A reference tracker with a MEMS unit is secured to the bone. The tracker outputs data relating to its orientation. A tool provided with a MEMS unit and secured to the bone is preset with an initial orientation. The tool outputs tracking data related to orientation of the tool once initialized. A trackable frame of reference relating the bone to the orientation of the tracker is created. The MEMS unit of the tool is initialized. A relation between the initial orientation of the tool and the orientation of the tracker at initialization of the MEMS unit of the tool is recorded. Orientational data of the tool relative to the frame of reference of the bone calculated using the relation is displayed. A computer-assisted surgery system for tracking a tool with respect to a bone after an initialization of a MEMS unit is also described.

Abstract: A system for tracking at least one bone in robotized computer-assisted surgery, comprises a processing unit and a non-transitory computer-readable memory communicatively coupled to the processing unit and comprising computer-readable program instructions executable by the processing unit for: obtaining backscatter images of the at least one bone from a tracking device in a coordinate system; generating a three-dimensional geometry of a surface of the at least one bone from the backscatter images, the three-dimensional geometry of the surface being in the coordinate system; determining a position and orientation of the at least one bone in the coordinate system by matching the three-dimensional geometry of the surface of the at least one bone to a three-dimensional model of the bone; controlling an automated robotized variation of at least one of a position and orientation of the tracking device as a function of a processing of the backscatter images; and continuously outputting the position and orientation of

Abstract: A method of creating a patient specific instrument (PSI) for use in knee replacement surgery is described which includes performing at least two two-dimensional X-ray scans of a bone, each of the X-ray scans being taken from different angular positions, generating a digital bone model of the bone based on the X-ray scans, planning the PSI based on the digital bone model, including determining locations for one or more anchor points on the PSI which are adapted to abut a surface of the bone, the determined locations of the anchor points being disposed on the PSI at locations corresponding to areas of expected high accuracy on the digital bone model generated by the X-ray scans. The areas of expected high accuracy include at least a peripheral bone contour in at least one of the angular position of the X-ray scans. A suite of such PSI instruments is also described.

Abstract: A method for determining a mechanical axis of a tibia using a tibial digitizer is disclosed. The method includes: determining an upper reference point on a tibial plateau corresponding to an entry point of the mechanical axis; fastening an upper mounting end of the tibial digitizer to the tibial plateau at the upper reference point; and fastening a lower mounting end of the tibial digitizer to medial and lateral malleoli of the ankle, by inwardly displacing opposed caliper arms of a self-centering malleoli engaging mechanism toward each other in a common plane until the caliper arms abut the malleoli. A lower reference point located at a midpoint between the medial and lateral malleoli is then determined by identifying a corresponding midpoint between the caliper arms when they are clamped onto the medial and lateral malleoli.

Abstract: Systems and methods may be used to perform robot-aided surgery. A system may include a display device and a computing device including a memory device with instructions. The instructions can cause the system to access surgical data, calculate medial and lateral gap data, calculate a recommended component set, and generate a graphical user interface. Accessing surgical data can include accessing soft tissue data indicative of at least tension in soft tissues surrounding a surgical location. The graphical user interface can include an interactive trapezoidal graphic overlaid onto a graphical representation of a distal femur and a proximal tibia. The interactive trapezoidal graphic can include a graphical representation of a medial total gap, a lateral total gap, and a recommended spacer size. The interactive trapezoidal graphic can update in response to adjustments in implant parameters to assist in surgical planning.