Abstract: Methods and systems of augmenting an implant intraoperatively and preparing a cone for revision surgical procedure are disclosed. A system includes a cutting device, a tracking and navigation system and a cutting system in operable communication with the cutting device and the tracking and navigation system. The cutting device includes a communication system, a cutting element, and a plurality of optical trackers. The tracking and navigation system is configured to detect a location of optical trackers. The control system is configured to cause the tracking and navigation system to detect the location of the cutting device, determine a revised shape for an implant cavity, cause the cutting device to cut the implant cavity to the revised shape, select a shape for a cone to be placed in the revised implant cavity, and machine the cone to the selected shape.

Abstract: A method for optimizing a knee arthroplasty surgical procedure includes receiving pre-operative data comprising (i) anatomical measurements of the patient, (ii) soft tissue measurements of the patient's anatomy, and (iii) implant parameters identifying an implant to be used in the knee arthroplasty surgical procedure. An equation set is selected from a plurality of pre-generated equation sets based on the pre-operative data. During the knee arthroplasty surgical procedure, patient-specific kinetic and kinematic response values are generated and displayed using an optimization process. The optimization process includes collecting intraoperative data from one or more surgical tools of a computer-assisted surgical system, and using the intraoperative data and the pre-operative data to solve the equation set, thereby yielding the patient-specific kinetic and kinematic response values. A visualization is then provided of the patient-specific kinetic and kinematic response values on the displays.

Abstract: A tensioner tool for assessing joint laxity is disclosed. The tensioner tool comprises a pair of pivotally coupled arms, each arm comprising a proximal handle portion, a distal portion, and an insertion tip selectively coupled to the distal portion. The pair of arms pivot between a compressed configuration for insertion within the joint and an expanded configuration for distraction of the joint by applying a force to the handles, thus spreading the insertion tips. The tensioner tool also comprises a force sensor configured to measure the force applied to the handle portion and a positional sensor configured to measure a separation distance between the pair of arms. The tensioner tool also comprises a processor configured to calculate a distraction force at the insertion tips based on the measured force and to calculate a tip distance between the insertion tips based on the measured separation distance.

Abstract: Systems and methods for virtual implant placement to implement joint gap planning are discussed. For example, a method can include operations for receiving a first implant parameter set based on a surgical plan that was generated while moving the joint through a range of motion. The method can include generating a first set of candidate implant parameter sets that are the result of an incremental change, relative to the first implant parameter set, to at least one parameter of the first parameter set. The method can include calculating a result for at least one candidate implant parameter set and providing a graphical representation of the result according to at least one candidate implant parameter set. The result can be color-coded to correlate to a candidate implant parameter set. The display can include color-coded user interface controls to allow a user to execute incremental changes corresponding to candidate implant parameter sets.

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.

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.

Abstract: Methods and systems for identifying and determining the size and orientation of a reamed portion of a patient's bone are disclosed. A tracking array and/or point probe may be inserted into an adapter device. The adapter device comprising a plurality of openings, having various connection means therein, such that when the tracking array is inserted into the adapter, a secure and robust connection is created. A reamer, stem, or similar tool may then be inserted into the opposing side of the adapter, during which, a secure and robust connection is created between the adapter and the tool. Thus, through the use of Computer Assisted Surgery Systems, a more accurate representation of the patient's anatomy can be obtained.

Abstract: Methods and systems of augmenting an implant intraoperatively and preparing a cone for revision surgical procedure are disclosed. A system includes a cutting device, a tracking and navigation system and a cutting system in operable communication with the cutting device and the tracking and navigation system. The cutting device includes a communication system, a cutting element, and a plurality of optical trackers. The tracking and navigation system is configured to detect a location of optical trackers. The control system is configured to cause the tracking and navigation system to detect the location of the cutting device, determine a revised shape for an implant cavity, cause the cutting device to cut the implant cavity to the revised shape, select a shape for a cone to be placed in the revised implant cavity, and machine the cone to the selected shape.

Abstract: A system and device (110) for determining bone laxity. For example, the system includes a tracked probe (300) comprising at least one probe marker (310) and a computer assisted surgical (CAS) system (100). The CAS system includes a navigation system (130) and a processing device (110) operably connected to the navigation system and a computer readable medium configured to store one or more instructions that, when executed, cause the processing device to receive location information from the navigation system, generate (820) a surgical plan comprising a post-operative laxity assumption (720), collect (850) first motion information related to movement of the joint through a first range of motion, collect (860) second motion information related to movement of the joint through a second range of motion, determine (870) a post-operative laxity (710), and compare the post-operative laxity and the post-operative laxity assumption to determine laxity results.

Abstract: A joint tensioning device and methods of use thereof are disclosed. The joint tensioning device includes a flexing arm and a loading arm having a tensioning tip and a loading tip, respectively, configured for insertion into a joint. The flexing arm is coupled to the loading arm such that, during use, the loading arm may be adjusted to separate the tensioning tip and the loading tip to apply a distraction force to the joint. A strain gauge measures strain applied to the flexing arm based on the applied distraction force. The measured strain is used to determine the amount of force applied to the joint. The force data is employed in surgical planning to determine the amount of joint laxity when a particular load is applied to the joint.

Abstract: Patient-specific guides for the Latarjet procedure, as well as surgical systems and methods of performing the Latarjet procedure to treat glenohumeral instability using such patient-specific guides are disclosed. A patient-specific coracoid guide and a patient-specific glenoid guide may be configured based on preoperatively generated three-dimensional models of the patient's shoulder anatomy. Guides may be configured for coracoid graft preparation and glenoid decortication. The coracoid graft may be placed in the desired position based on three-dimensional (3D) preoperative planning.

Abstract: A system for assessing laxity of a joint of a patient is disclosed. The system comprises a tensioner tool having a substantially rigid portion that may be inserted within the joint to apply a force against a bone surface thereof. The system further comprises a tensioner sock having a flexible body with an opening to receive the tensioner tool and a sensor array disposed on the flexible body. Each sensor of the sensor array is configured to contact the bone surface and detect a pressure when the force is applied against the bone surface. The system further comprises a processor configured to receive the detected pressure from each sensor and calculate the force applied to the bone surface based on the detected pressures.

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.

Abstract: A system (100) and device (300) for mounting and tracking a tracker array during a surgical procedure are described. For example, the system includes a surgical navigation system (700) including a position tracking system (702) configured to track one or more tracker arrays, and a device (300) for mounting a tracker array (306) onto a patient during the surgical procedure. The device includes an intramedullary (IM) canal component (304) configured to be inserted into an IM canal (310) within a bone (312). The device further includes a tracker pin (308) configured to penetrate at least a portion of the bone and engage an inserted end (411, 413) of the IM canal component, and a tracker array (306) affixed to the tracker pin. The IM canal component is configured to engage the IM canal of the bone to stabilize the tracker array during the surgical procedure.

Abstract: Methods and systems for identifying and determining the size and orientation of a reamed portion of a patient's bone are disclosed. A tracking array and/or point probe may be inserted into an adapter device. The adapter device comprising a plurality of openings, having various connection means therein, such that when the tracking array is inserted into the adapter, a secure and robust connection is created. A reamer, stem, or similar tool may then be inserted into the opposing side of the adapter, during which, a secure and robust connection is created between the adapter and the tool. Thus, through the use of Computer Assisted Surgery Systems, a more accurate representation of the patient's anatomy can be obtained.

Abstract: Patient-specific guides for the Latarjet procedure, as well as surgical systems and methods of performing the Latarjet procedure to treat glenohumeral instability using such patient-specific guides are disclosed. A patient-specific coracoid guide and a patient-specific glenoid guide may be configured based on preoperatively generated three-dimensional models of the patient's shoulder anatomy. Guides may be configured for coracoid graft preparation and glenoid decortication. The coracoid graft may be placed in the desired position based on three-dimensional (3D) preoperative planning.

Abstract: A system and device (110) for determining bone laxity. For example, the system includes a tracked probe (300) comprising at least one probe marker (310) and a computer assisted surgical (CAS) system (100). The CAS system includes a navigation system (130) and a processing device (110) operably connected to the navigation system and a computer readable medium configured to store one or more instructions that, when executed, cause the processing device to receive location information from the navigation system, generate (820) a surgical plan comprising a post-operative laxity assumption (720), collect (850) first motion information related to movement of the joint through a first range of motion, collect (860) second motion information related to movement of the joint through a second range of motion, determine (870) a post-operative laxity (710), and compare the post-operative laxity and the post-operative laxity assumption to determine laxity results.

Abstract: An implant positioning device and a method of using the device are described. The positioning device includes an end effector configured to contact an implant component during a surgical procedure, the end effector connected to an actuator for imparting an impact force to the implant component during the surgical procedure, a motor mechanically connected to the actuator and configured to move the actuator to produce one or more impacts on the end effector, thereby imparting the impact force to the implant component, and a control circuit coupled to the motor. The control circuit is configured to generate at least one motor control signal, transfer the at least one motor control signal to the motor, and, as a result of the at least one motor control signal, cause the motor to move the actuator to produce one or more impacts on the end effector.

Abstract: Systems and methods for navigation and control of an implant positioning device are discussed. For example, a method can include operations for accessing an implant plan, establishing a 3-D coordinate system, receiving tracking information, generating control signals, and sending the control signals to the implant positioning device. The implant plan can include location and orientation data describing an ideal implant location and orientation in reference to an implant host. The 3-D coordinate system can provide spatial orientation for the implant positioning device and the implant host. The tracking information can identify current location and orientation data within the 3-D coordinate system for the implant positioning device and implant host during a procedure. The control signals can control operation of the implant positioning device to assist a surgeon in positioning the implant according to the implant plan.

Abstract: A surgical robotic arm (520) for use with an external vision system (512) includes onboard control and at least four degrees of articulation. The robotic arm (520) can position various tools (534) in the surgical theatre responsive to positional feedback In from the vision system (512). Exemplary tools (534) include a handpiece (519) that includes a motorized bun or saw, a cutting guide (542) for a handheld saw, or a laser to actively define a resection area for a surgeon. The tool (534) or a reference point on the arm (520) relative to the tool (534) includes fiducial marks to register the position of the tool (534) with the vision system (512). Exemplary (534) are especially suited for knee and hip arthroplasty and can be moved under processor or manual control.