Abstract: A system and method are described herein for creating planar bone cuts on a bone to receive a total knee arthroplasty (TKA) femoral implant. The system includes a robotic surgical device, a computing system, and one or more contingent manual instruments. A surgical plan is generated having instructions for the robotic surgical device to create six or more planar bone cuts on the bone. The robotic surgical device executes the instructions, and in the event the robotic procedure is aborted before completing the six or more planar cuts, the one or more contingent manual instruments are used to create any remaining planar bone cuts. The one or more contingent manual instruments may include a plurality of uniquely arranged guide slots to assist a user in creating one or more remaining planar bone cuts.

Abstract: A system and process for performing orthopedic surgery is provided that uses a tibial trial system in total knee arthroplasty for assessing optimal internal-external rotation and posterior tibial slope, and for measuring the rotation of a tibial trial throughout flexion-extension to determine and mark the best position for the final tibial component. The tibial trial system determines the internal-external location on a patient specific basis with improved component placement well within the present manual methods. One particular advantage to the tibial trial system is to assess the natural internal-external rotation that the tibial component will experience relative to the femoral component during flexion-extension as opposed to simply recording and balancing forces on a static tibial trial. The invention disclosed herein may also be adapted to be used with a computer assisted surgical device. Such surgical devices include active, semi-active, and haptic devices as well as articulating drill and saw systems.

Abstract: A system and process for performing orthopedic surgery is provided that uses a patient's existing implant as a registration tool in an orthopedic surgical procedure. The systems and processes may be used with computer assisted systems or navigation systems to aid in the removal of bone, bone cement, or a bone prosthesis, typically a bone prosthesis used in hip replacement surgery, knee replacement surgery, and the like. The removal of the prosthesis may be done by conventional methods, with navigation systems, robotic assistance or articulating hand held systems. The removal of bone and/or bone cement may be performed with navigated systems, robotic systems, articulating hand-held systems and combinations thereof.

Abstract: A calibration device is provided having a body with an exterior surface configured for placement about a tool such that the body rotates about a tool axis. One or more fiducial marker is positioned on the exterior surface and in communication with a tracking system. A fixed fiducial marker array is provided that is also in communication with the tracking system. A calibration tool defines the tool axis relative to the fiducial marker array. A surgical system is also provided with a tracking module that calculates a center point of the rotation or a normal vector to the circular path to define a tool axis orientation. A method of using the surgical system and defining a tool axis relative to a fiducial marker array is provided. A system for defining a robot link orientation or tracking a tool a medical procedure and a fiducial marker array are provided.

Abstract: A computer-implemented method to improve the point collection process during registration of a bone for a computer-assisted surgical procedure is provided. Based on bone digitization data, a simulation is performed to confirm the accuracy of the registration for different digitization regions. Results are tested to identify which digitization regions meet a predefined accuracy requirement. The resulting information is used to perform a computer-assisted surgical procedure. A computerized simulation method for registration of a bone for a computer-assisted surgical procedure is also provided based on processor executing random stroking an expected exposed surface of a bone model with multiple of stroke curves to cover most of the bone model surface with uniform noise and a random sample consensus is applied to remove outlying point to yield the best registration results, to find the top subset as to overlap. A method to perform computer-assisted surgery is also provided.

Abstract: A system and method are provided for improving the positioning of a target anatomy relative to a robot to perform a medical procedure. The system and method is especially advantageous for complex procedures that require a large operational workspace and/or several manipulator orientation changes to execute a surgical plan in its entirety such as total knee arthroplasty (TKA), as well as any of a wide variety of other surgical procedures, orthopedic or otherwise, including hip arthroplasty, ligament reconstruction, and shoulder arthroplasty. Dynamic and controlled repositioning of the target anatomy promotes robotic surgical system access in a way that any static positioning of the target anatomy cannot thereby speeding a surgical process and extending the spatial range of operation of the robot and tools carried thereon.

Abstract: A process and system are provided for placing recovery markers on a bone, prior to surgery, at locations that permit the bone to be re-registered within a desired degree of accuracy. The process includes installing a first recovery marker on the bone, and digitizing a first position with a digitizer probe having a probe tip. Subsequently, a user navigates along a surface of the bone with the probe tip to place a second recovery marker on the bone. A processor calculates a distance between the first recovery marker and the probe tip, and notifies a user when the processor calculates that a probe tip position is at or beyond a pre-determined distance from the first recovery marker. A second recovery marker is installed on the bone at or beyond the pre-determined distance, and is digitized to permit bone re-registration using the first recovery marker and the second recovery marker.

Abstract: A system and method are described herein for installing hardware in a bone outside an end-effector's tool path prior to modifying the bone. The method includes the installation of a first piece of hardware in the bone. The bone and a cut volume to be created in the bone is registered to a computer-assist device. A processor calculates whether the hardware is within the cut volume based on the geometry and POSE of the hardware relative to the POSE of the cut volume. A user is notified if the hardware is at or inside the cut volume based on the calculation. If so, a second piece of hardware is installed in the bone and the calculation is repeated to determine if the second piece of hardware is at or inside the cut volume. The surgical procedure may commence when an installed piece of hardware is installed outside the cut volume.

Abstract: A system and process for performing orthopedic surgery is provided that uses a tibial trial system in total knee arthroplasty for assessing optimal internal-external rotation and posterior tibial slope, and for measuring the rotation of a tibial trial throughout flexion-extension to determine and mark the best position for the final tibial component. The tibial trial system determines the internal-external location on a patient specific basis with improved component placement well within the present manual methods. One particular advantage to the tibial trial system is to assess the natural internal-external rotation that the tibial component will experience relative to the femoral component during flexion-extension as opposed to simply recording and balancing forces on a static tibial trial. The invention disclosed herein may also be adapted to be used with a computer assisted surgical device. Such surgical devices include active, semi-active, and haptic devices as well as articulating drill and saw systems.

Abstract: A method to guide in preparation of a bone relies on an instrument having a shaft with a working end and a stop member. The shaft is free to translate along an axis. Surgical planning data is registered to the bone to determine intra-operative coordinates of the desired axis and depth. The instrument holder is positioned by the bone so the stop member contacts the instrument holder to prevent translating beyond the desired depth. Alternatively, an arm is manipulated to align the instrument with the desired axis. The working end rests on the bone to define a linear separation to the desired depth. By proximally translating the instrument holder to contact the stop member and distally translating the instrument holder along the shaft, the stop member physically stops translating beyond the desired depth. A surgical system for performing the methods is provided; a reamer or impactor are also disclosed.

Abstract: A cutting device is provided that includes an expandable tube having a base and a hollow interior for receiving the implant therein. The expandable tube includes cutting segments extending from the base and terminating to form a distal end of the expandable tube. At least one of the cutting segments has a cutting end with cutting teeth at the distal end of the expandable tube. Spring shaped sections are provided that extend the cutting segments. A method for removing an implant from a target bone is also provided based on the cutting device. A system for removing material directly surrounding an outer surface of an implant in an intramedullary canal of a target bone is also provided based on the cutting device and a sheath. A retractable opening is formed of leaflets at a distal end of the sheath, and a proximal end opposite the distal end.

Abstract: A system, device, and method is provided that improves the point collection process during bone registration for computer-assisted surgical procedures. A user is guided in the point collection process by projecting a set of points directly on the bone with a tracked digitizer probe following a rough registration of the bone. The system, device, and method therefore negates the need for the user to constantly look-up on an instructional display monitor and make the complicated mappings between the displayed instructions on the monitor and the actual bone.

Abstract: A system and method for intra-operatively measuring or verifying the placement of an implant within a bone in joint arthroplasty procedures are described herein. Pre-operative bone data of the patient is collected. A user plans the position of one or more implants relative to the pre-operative bone data. Intra-operatively, the patients bone is registered to the pre-operative bone data and to a computer-assist device. The bone is prepared and a physical implant is installed with the bone. A plurality of points are digitized on at least one of the physical implant or an apparatus associated with the physical implant. The computer-assist device calculates any errors between the planned position and orientation (POSE) of the implant relative to the actual POSE of the physical implant using the digitized points. The system may further notify a user of any errors and provide instructions to minimize the errors.

Abstract: A fiducial attachment device for securement of one or more fiducials to a bone is provided that includes a bracket body having a first hole adapted to receive a first bone pin at a non-parallel angle ? and having a second hole adapted to receive a second bone pin at a non-parallel angles ??, the angles ? and ?? being relative to a center line of said bracket body between the first hole and the second hole. The bracket body sometimes having an aperture therein for knob attachment. A fiducial attachment member extends away from the bracket body, where a distal end of the fiducial attachment member is an attachment point for the one or more fiducials. A method of using the fiducial attachment device is also provided. A system for using a fiducial attachment device of during a surgical procedure is also provided.

Abstract: A modular wrist guide is provided that aids a user in operating a hand-held surgical instrument to accurately perform surgical procedures including but not limited to joint arthroplasty. The modular wrist guide acts to constrain the orientation of a hand-held surgical instrument, or a user's wrist relative to the user's forearm to perform a procedure according to a surgical plan. A forearm embracing member is designed to secure the user's forearm to the modular wrist guide.

Abstract: A process and system for computer assisted orthopedic procedure is provided with a plurality of options to plan, execute, and monitor the creation of a cavity to receive a prosthetic based on clinical needs and pre-operative imaging data. A phantom made of materials of known densities is used to normalize CT image intensity values to estimate bone density. The process and system controls the speed, cutter engagement, orientation, and shape of the cavity so produced based on the normalized bone density values.

Abstract: An optical tracking system includes at least one tracking array for generating and optically transmitting data between 1 and 2,000 MB/s. At least one tracker for optically receiving the optically transmitted data between 1 and 2,000 MB/s is also provided. The tracking system is used not only for tracking objects and sending tracking information quickly but also providing the user or other components in an operating room with additional data relevant to an external device such as a computer assisted device. Orthopedic surgical procedures such as total knee arthroplasty (TKA) are performed more efficiently and with better result with the optical tracking system.

Abstract: A debris clearing system is provided that includes a tool having a suctioning intake positioned on an axis of the tool. A controller actuates the suctioning intake along the length of the axis of the tool. The suctioning intake is actuated while the tool is being operated and proximal to a surgical site on a patient's anatomy. A method of use is also provided for suctioning debris from a surgical field during a procedure.

Abstract: A method and system are provided to intraoperatively adjust the dimensions of a pre-operatively planned implant cavity to improve implant fit in a bone. The method includes obtaining a preoperative image data set of the bone. A surgical plan is generated using the image data set and/or a three-dimensional (3-D) bone model of the patient's bone generated from the image data set. Intraoperatively, the patient's bone is exposed and registered to the surgical plan and a computer assisted surgical system. The computer assisted surgical system having a cutting tip and a force sensor for sensing actual forces exerted on the cutting tip as an initial cut is created on the bone at a first bone region. Based on the difference between the actual cutting force and the expected cutting force in the plan, the dimensions of the cavity are adjusted accordingly.

Abstract: An optical tracking system includes at least one tracking array for generating and optically transmitting data between 1 and 2,000 MB/s. At least one tracker for optically receiving the optically transmitted data between 1 and 2,000 MB/s is also provided. The tracking system is used not only for tracking objects and sending tracking information quickly but also providing the user or other components in an operating room with additional data relevant to an external device such as a computer assisted device. Orthopedic surgical procedures such as total knee arthroplasty (TKA) are performed more efficiently and with better result with the optical tracking system.