Abstract: Methods, devices and systems for the planning and execution of computer-assisted robotic surgery are provided. The methods include methods to collect information about bones and prostheses, use the information to create virtual models and simulations, optionally receive input based on user discretion in generating the cut file, and to generate instruction for the execution of cut paths during the surgery. The system and devices include computers and peripherals and set-ups to link the components together into functional systems.

Abstract: Tools and methods are used for aligned total knee arthroplasty (TKA) of anatomically or kinematically aligned knee. A block tool system references a distal femoral cut to provide a guide for the tibial cut. The block tool system can be used with the leg in full extension or in flexion. The block tools system includes a femur positioning block, an alignment arm coupled to the femur block, a femural cutting block, a tibial positioning block and a tibial cutting block.

Abstract: A manufacturing method of a bone cutting assist device includes generating a bone cutting assist device model representing the bone cutting assist device including a fitting surface that fits a surface of a bone model, a cutting slit that guides a cutting jig, a first guide hole for inserting a first rod model, and second guide holes for inserting second rod models. The manufacturing method also includes outputting three-dimensional manufacturing data representing the generated bone cutting assist device model, and manufacturing the bone cutting assist device according to the outputted three-dimensional manufacturing data.

Abstract: An orthopedic device for a shoulder joint includes a patient-specific alignment guide. The alignment guide includes a cap having a three-dimensional engagement surface customized in a pre-operative plan by computer imaging to be complementary and closely mate and conform to a humeral head of a proximal humerus of a patient. The alignment guide includes a tubular element extending from the cap and defining a longitudinal guiding bore for guiding an alignment pin at a patient-specific position and orientation determined in the pre-operative plan, and an orientation feature on the cap. The orientation feature is designed to orient the cap relative to the humeral head when the orientation feature is aligned with a landmark of the proximal humerus.

Abstract: A varus-valgus alignment instrument includes a body having a bone contact surface for contacting a distal femur and an opening extending through the body and bone contact surface. The opening is sized to receive an elongate shaft therein. An alignment member is moveably attached to the body and has first and second openings therethrough. The first and second openings are sized to receive the elongate shaft and are interchangeably positioned in alignment with the opening of the body.

Abstract: An implantable orthopedic stability device is disclosed. The device can have a contracted and an expanded configuration. A method of using the device between adjacent vertebral body surfaces for support and/or fixation of either or both of the adjacent vertebrae is also disclosed.

Abstract: An implantable orthopedic stability device is disclosed. The device can have a contracted and an expanded configuration. A method of using the device between adjacent vertebral body surfaces for support and/or fixation of either or both of the adjacent vertebrae is also disclosed.

Abstract: An implant for stabilizing two separated bone portions relative to each other an implant includes a peg, a bridge assembly and a securing element. The peg and bridge assembly include at least two peg portions and a bridge portion, wherein the bridge portion is arranged between the peg portions and wherein the peg and bridge portions are rigidly connected. The peg and bridge assembly is positioned relative to the bone portions such that one peg portion extends into the bone tissue of each one of the bone portions and the bridge portion extends across the gap separating the bone portions. The securing element is anchored in the bone tissue of one of the bone portions, its proximal end extending through an opening in an assembly portion extending parallel to a bone surface or across a notch in a proximal edge of an assembly portion.

Abstract: Embodiments are described herein for determining anatomical landmarks on a patient by virtue of anatomical landmarks being called up from a database with an anatomical model and being converted into individual body dimensions and an individual position of the patient. As a result, anatomical landmarks may be called up from a database, calculated individually for the patient and used as an item of reference location information. The positioning of the patient table is thus considerably accelerated, wherein the accuracy is also improved. Thus, the item of reference location information may be calculated individually for the same patient in a different position or a different patient with different body dimensions by virtue of this item of reference location information being recalculated by the conversion rule for the respective patient.

Abstract: An orthopedic implant system includes a set of provisional orthopedic implants having different implant sizes, in which each provisional implant facilitates an intraoperative selection of the next-smallest implant size without removing the provisional implant from the bone. All of the implant sizes share a common sagittal configuration of distal and anterior bone contacting surfaces, but have variable sagittal configurations only in the posterior bone contacting surfaces. Thus, where a relatively larger femoral provisional component is mounted to a femur, changing to a smaller provisional component (i.e., “downsizing”) can be accomplished by recutting only two of five original femoral cuts. Cut slots provided in each provisional implant are sized and positioned to correspond to the posterior bone contacting surface geometry of the next-smallest provisional implant size.

Abstract: A method for operating a medical-robotic device is provided. The robotic device includes a number of components able to be moved autonomously in an environment of the robotic device. Planning data for an autonomous movement or constraint of at least one subset of the movable components is provided to the robotic device. A movement or constraint of the corresponding movable components to be carried out autonomously by the robotic device is planned based on the planning data provided. The planned movement or constraint is visually presented. A way for an operator to exert influence on the planned movement or constraint is provided, and the movement or constraint is autonomously carried out as a function of the influence exerted.

Abstract: Systems, instruments or devices, and methods or procedures are described in which a scalpet array is applied to a target site with the use of a pattern. The scalpet array comprises scalpets positioned on a device. Skin pixels are incised at the target site via application of a load through the scalpet array. A recipient site is prepared by positioning the pattern at the recipient site and applying the scalpet array to generate skin defects. The incised skin pixels are applied at the skin defects of the recipient site.

Abstract: Systems and methods for mechanosynthesis including those that avoid the need for a bootstrap process, avoid the need to build tips via mechanosynthesis, avoid the need for charging tips with feedstock during a build sequence, avoid the need to dispose of reaction byproducts, reduce the design complexity of new tips, and reduce or avoid the need for multiple positional means or tip switching.

Abstract: External fixator assemblies, systems, and methods thereof. An external fixator system may include a plurality of fixator assemblies configured to connect a plurality of pins, for example, positioned on opposite sides of a fractured bone, with one more rods. The fixator assemblies may include a plurality of clamp assemblies which are configured to rotate relative to one another when the fixator assembly is in an unlocked position.

Abstract: A pedicle depth measuring apparatus comprises an outer tubular member comprising a first end and a second end. A head member is joined to the second end. The head member comprises a base surface comprising an opening. An inner member is slidable within the outer tubular member. The inner member comprises a first end and a second end, the second end being slidable through the opening. The second end further comprises a marker disposed at a distal end. The marker comprises a material that is radiographically distinguishable, in which a placement of the marker within a cannulation of a patient's pedicle is observable. An indicator member is operable for indicating a distance between the marker and the base surface, in which the distance indicates a choice of a size of a pedicle screw to be installed for mitigating damage to the patient's nerve root.

Abstract: Resection shift guides and methods providing anterior, posterior, clockwise, or counterclockwise adjustment of a 4-in-1 cut guide along a planar resected surface of a femur are disclosed. A resection shift guide can include a base member and a block member. The base member can include first and second arms. The block member can include a first end, rotatably coupled with the first arm, a second end, rotatably coupled with the second arm, and at least three surfaces extending between the first and second ends. Each of the at least three surfaces can include two or more drill holes arranged differently than drill holes of the other surfaces. A method can include removing a 4-in-1 cut guide from two original femoral lumens, drilling two adjusted femoral lumens using a resection shift guide, removing the resection shift guides, and attaching the 4-in-1 cut guide to the two adjusted femoral lumens.

Abstract: A computer implemented method for determining the 3-dimensional shape of an implant to be implanted into a subject includes obtaining a computer readable image including a defective portion and a non-defective portion of tissue in the subject, superimposing on the image a shape to span the defective portion, and determining the 3-dimensional shape of the implant based on the shape that spans the defective portion.

Abstract: A surgical apparatus, system and methodology are provided that may be utilized to treat a plurality of medical conditions. A robotic apparatus may be utilized in the treatment of a medical condition or to assist a medical professional in a surgical procedure. Additionally, the robotic apparatus and system may be utilized during a surgical procedure to provide guidance and to narrow the margin of error. In an exemplary embodiment, a scan may first be performed on a patient to determine a plurality of surgically necessary characteristics, such as bone density, locations, and the like. A virtual treatment plan may be provided by the system. An active and/or passive robotic apparatus may be provided to assist in the surgical technique. The robotic apparatus may be an active robotic which includes surgical tools whereby the medical professional may perform the surgical technique with the assistance of the active robotic apparatus.

Abstract: A method for repairing a bone of a patient may include superimposing a first virtual boundary on a virtual bone and superimposing a second virtual boundary on the virtual bone. The method may further include robotically modifying the bone of the patient with a planar tool along a first working boundary to create a first surface. The first working boundary may correspond to the first virtual boundary. The method may further include robotically modifying the bone of the patient with a rotary tool along a second working boundary to create a second surface. The second working boundary may correspond to the second virtual boundary.

Abstract: An orthopedic surgical instrument including a polymer 4-in-1 femoral cutting block having a chamfer cutting slot defined therein, and a chamfer cutting guide assembly secured within the chamfer cutting slot. The chamfer cutting guide assembly includes a first planar surface, a second planar surface spaced apart from, and extending parallel to, the first planar surface, a third planar surface connected to the second planar surface and extending at an angle relative to the first planar surface and a fourth planar surface connected to the first planar surface and extending parallel to the third planar surface. The first planar surface and the second planar surface define a first metallic planar cutting guide, and the third planar surface and the fourth planar surface define a second metallic planar cutting guide. The chamfer cutting guide assembly may include a pair of metallic bushings.

Abstract: An operator telerobotically controls tools to perform a procedure on an object at a work site while viewing real-time images of the work site on a display. Tool information is provided in the operator's current gaze area on the display by rendering the tool information over the tool so as not to obscure objects being worked on at the time by the tool nor to require eyes of the user to refocus when looking at the tool information and the image of the tool on a stereo viewer.

Abstract: Methods, systems and tools are provided for controllable adjustment of a removal rate of cutting edges of rapidly rotating effectors of manually-guided material- and tissue-separating tools without significantly changing the rotation speed of the effectors or the position, orientation or the geometry of the effectors, and in particular, for precisely maintaining work space boundaries during material and tissue removal with effectors in rapidly rotating machine tools in surgery and freehand manufacturing to produce free-form surfaces. The manually-guided material-separating and tissue-separating tools and effectors allow controllable adjustment of the removal rate of the material-separating cutting edges of the effector by mechanically adjusting a position or orientation of at least one cutting edge cover at a constant rotation speed of the effector without appreciable change of the removal movement.

Abstract: A tibia cutting block for performing precise cuts into a tibia comprises an approximately cuboid body with a tibia attachment side and opposing thereto a front side. The body has a cutting guide slot extending from a top side into the body, a blade holding slot extending from a right side or a left side into the body, a first anchoring pin hole which is close to the intersection of a first plane defined by the blade holding slot and a second plane defined by the a cutting guide slot, a second anchoring pin hole distant from the first anchoring pin hole and a reference pin guide. All are penetrating the body from the front side to the tibia attachment side.

Abstract: The present invention relates to an expandable prosthetic implant device for engagement between vertebrae generally comprising an inner member, outer member, gear member and a locking assembly positioned coaxial with respect to each other such that the inner and outer members are moveable relative to each other along an axis. The gear member is axially fixed to the outer member and freely rotatable with respect to the outer member and the gear member threadedly engages a threaded portion of the inner member to translate inner member along the axis. The implant is configured to engage the vertebrae in a predetermined alignment and the gear member includes gear teeth exposed to the exterior and configured to be accessible by a tool member at a plurality of angular positions around the perimeter of the implant device.

Abstract: An implant for stabilizing two separated bone portions relative to each other an implant includes a peg, a bridge assembly and a securing element. The peg and bridge assembly include at least two peg portions and a bridge portion, wherein the bridge portion is arranged between the peg portions and wherein the peg and bridge portions are rigidly connected. The peg and bridge assembly is positioned relative to the bone portions such that one peg portion extends into the bone tissue of each one of the bone portions and the bridge portion extends across the gap separating the bone portions. The securing element is anchored in the bone tissue of one of the bone portions, its proximal end extending through an opening in an assembly portion extending parallel to a bone surface or across a notch in a proximal edge of an assembly portion.

Abstract: The present invention provides systems and methods for performing robotically-assisted surgical procedures on a patient. In particular, a three-component surgical system is provided that includes a non-sterile drive and control component, a sterilizable end effector or surgical tool and an intermediate connector component that includes mechanical elements for coupling the surgical tool with the drive and control component and for transferring motion and electrical signals therebetween. The drive and control component is shielded from the sterile surgical site, the surgical tool is sterilizable and disposable and the intermediate connector is sterilizable and reusable. In this manner, the intermediate connector can be sterilized after a surgical procedure without damaging the motors or electrical connections within the drive and control component of the robotic system.

Abstract: A spinal implant comprises a first member including a surface that extends between a first portion and a second portion. The first member defines a first implant cavity adjacent the first portion and a second implant cavity adjacent the second portion. The first implant cavity is spaced from the second implant cavity. The surface defines a medial cavity. A second member is movable relative to the first member. The second member includes a first end aligned with the medial cavity and a second end configured to penetrate tissue. Systems and methods are disclosed.

Abstract: A stemless humeral component for replacing the humeral head of a patient's humerus includes a support flange having a number of cantilevered legs extending distally away from a bottom surface thereof. Instruments and methods for surgically installing the stemless humeral component are also disclosed.

Abstract: A method for automatically monitoring the penetration behavior of a trocar held by a robotic arm and monitoring system is provided. The method and system automatically monitors the penetration behavior of a trocar held by a robotic arm and/or an instrument guided through the trocar into a body cavity through an incision in the surface of the body of a patient during a surgical procedure. At least one measured value is recorded, by which a change in a force effect on the surface of the body of the patient may be determined, and automatic evaluation of the measured value with regard to a reference measured value is conducted. Comparison of the change in the measured value or the change in the force effect with a threshold value is made, and an indication in the event of the threshold value being exceeded is outputted.

Abstract: A light diffuser, which is particularly suitable for introducing diffuse light into a tissue, is produced by interpenetration of a diffuser material in a liquid state into a boundary layer of a porous shaping material, by which process a diffuser surface is formed having a surface structure which represents essentially a negative of the pore structure of the shaping material and includes undercut structures induced by a surface tension. The light diffuser is e.g. produced by introducing a diffuser blank including material that is liquefiable through mechanical vibration into the shaping material and simultaneously stimulating it with mechanical vibrations, such that the liquefiable material liquefies at least there where it is in contact with the shaping material and is pressed into the shaping material. An in situ production of the diffuser is particularly advantageous for photodynamic therapy in bone tissue.

Abstract: An orthopedic implant system includes a set of provisional orthopedic implants having different implant sizes, in which each provisional implant facilitates an intraoperative selection of the next-smallest implant size without removing the provisional implant from the bone. All of the implant sizes share a common sagittal configuration of distal and anterior bone contacting surfaces, but have variable sagittal configurations only in the posterior bone contacting surfaces. Thus, where a relatively larger femoral provisional component is mounted to a femur, changing to a smaller provisional component (i.e., “downsizing”) can be accomplished by recutting only two of five original femoral cuts. Cut slots provided in each provisional implant are sized and positioned to correspond to the posterior bone contacting surface geometry of the next-smallest provisional implant size.

Abstract: A rod connector for joining a first rod and a second rod includes bore holes that are offset and/or non-parallel to each other. The rod connector provides an offset or non-parallel connection between the rods that allows for the rods to match the contour of a patient's body without requiring bending of the rods. The rod connector may include a first bore hole for receiving the first spinal rod and a second bore hole for receiving the second spinal rod that is adjustable relative to the first bore hole to adjust the position and/or orientation of the second spinal rod relative to the first spinal rod. The rod connector may comprise a first housing component defining the first bore hole and a second housing component that is movable relative to the first housing component and defining the second bore hole.

Abstract: Various methods and devices are provided for a graft fixation device for fixing a graft member within a bone tunnel. In one embodiment, a graft fixation device is provided having a radially expandable sheath adapted to be disposed within a bone tunnel, and a sheath expander adapted to be received within the radially expandable sheath to expand the sheath and thereby anchor a graft between the sheath and the bone tunnel. In an exemplary embodiment, the graft fixation device is particularly useful to affix a graft within a femoral tunnel.

Abstract: The invention relates to a medical work station which has a medical instrument which is intended to be inserted at least partially into the interior of a lying being for treating the latter, an imaging device which is set up to create image data records of the interior of the living being during the treatment, and a robot. The robot includes a robot arm having a plurality of members situated one after another, on which the imaging device or the medical instrument may be situated, and a control device intended for moving the robot arm, which is set up to move the robot arm in such a way that the imaging device attached to the robot arm follows a motion of the medical instrument, or the medical instrument attached to the robot arm follows a motion of the imaging device.

Abstract: A locking tack for attaching a bone fixation device to a bone includes (a) an elongated body including a distal portion formed of a weldable material and sized to be received within a bore through a portion of a target bone and a proximal portion which, when the distal portion is in a desired position within a target bone, extends out of the bone; (b) a channel extending longitudinally through the elongated body from a proximal end thereof to a channel distal end within the distal portion of the elongated body; and (c) an engaging feature at a distal end of the channel configured to engage an extraction mechanism so that forces applied to the extraction mechanism are transmitted to the distal end of the elongated body.

Abstract: A robot includes a base, a first arm that rotates around a first rotation axis, a second arm that rotates around a second rotation axis extending in a direction different than the first rotation axis, a third arm that rotates around a third rotation axis extending in a direction parallel to the second rotation axis, a first inertia sensor at the first arm, a second (a) inertia sensor at the third arm, a first angle sensor at a first drive source, a third angle sensor at a third drive source, and the drive sources rotate the respective arms. Angular velocities from the first inertia sensor and the first angle sensor are fed back to a first drive source control unit. Angular velocities from the second (a) inertia sensor and the third angle sensor are fed back to a second drive source control unit.

Abstract: A process and system for performing orthopedic surgery to create a series of channels with a subject's bone to allow a reduced pressure system to be applied directly to the bone-implant interface to enhance bone healing is provided. The process for to promote healing of a bone of a subject includes creating a three-dimensional model of the bone; preoperatively planning a location of an implant relative to the model; creating a plan for the location of precision channels that reach the bone-implant interface based on the model and the implant; resurfacing the bone to fit the implant into or onto the bone based on the preoperative plan; and milling the precision channels into the bone in the location to promote healing of the bone and/or bone implant interface; and applying a pressure reduction system at the bone-implant interface to promote bone healing.

Abstract: A tibial tray component includes a tibial tray portion with a post portion protruding from a bone-contacting side of the tibial tray portion. The tibial tray portion may include ribs extending along the bone-facing side in areas of high stress during the gait cycle. The post portion may include at least one fin projecting outwardly from the post portion and extending along a portion of the length of the post portion. A cut block assembly includes a cut block and at least one pin. The cut block may include several mounting locations for the pin. The pin may include an anti-rotation portion and a tapered free end.

Abstract: An instrumentation kit for use in preparing a shoulder to receive a glenoid component in one embodiment includes at least one combination device, the combination device including a boring section configured to form a first bore in a glenoid, a drive section operably connected to the boring section, a reaming section positioned proximally from the boring section and operably connected to the drive section, the reaming section configured to ream a portion of the glenoid, and at least one drill guide configured to guide a drill bit and positioned so as to guide the drill bit to form a second bore at a location spaced apart from the first bore, wherein the reaming section and the boring section are positioned with respect to each other such that the boring section forms the first bore and the reaming section simultaneously reams a portion of the glenoid adjacent to the first bore.

Abstract: An implant is insertable in the joint space to separate bones of the joint. The implant has two endplates each configured to engage a separate articulating bone of the joint, and a threaded member positioned between the two endplates and configured to increase the space between the two endplates when the threaded member is rotated. A rotatable gear is engaged with the threaded member, and is engageable with a rotating gear of a connected implantation tool, so that rotation of the gear on the tool causes rotation of the threaded member and expansion of the implant to separate the bones. Connector portions on the tool and the implant may be rotated together to securely engage the implant and the tool so that the gears of the tool and the implant can be rotated using an actuator outside of the body, when the implant is inside the body.

Abstract: A method for performing a surgical procedure on a patient using a robotic system and a navigation system. The robotic system includes a cutting tool. The navigation system has at least one locating device to track a portion of the patient during the surgical procedure. The navigation system provides information as to a position of the portion of the patient. An optical cutting guide is projected onto the portion of the patient to enable cutting of the portion of the patient with the cutting tool of the robotic system while the optical cutting guide is projected onto the portion of the patient.

Abstract: A pair of bone plates adapted for attachment to cranial bone segments, the cranial plates being mounted to a distraction mechanism such that the cranial plates can be separated gradually in very small increments. Each of the cranial plates is mounted to the distraction mechanism with a ball and socket connector assembly, such that each of the plates can move in multiple directions and orientations relative to the distraction mechanism to better accommodate a convex, planar or concave surface topography presented during the distraction procedure.

Abstract: A spinal implant comprises a first member and a second member. A rotatable element defines an axis and is engageable to rotate the members about the axis. An actuator is rotatable for translating a part thereof to move the members between a first, contracted configuration and a second, expanded configuration. Systems and methods of use are disclosed.

Abstract: The invention relates to a method for creating a surgical resection plan for treating a pathological deformity of a bone.

Abstract: A patient tissue includes a primary patient tissue area and an anatomically differentiated bordering secondary patient tissue area. An apparatus is at least partially customized responsive to preoperative imaging of the patient tissue. Means are provided for mating with the primary patient tissue area in a preselected relative orientation. Means are provided for fixing a first landmark to the primary patient tissue area in at least one of a predetermined marking location and a predetermined marking trajectory. Means are provided for fixing a second landmark to the secondary patient tissue area in at least one of a predetermined marking location and a predetermined marking trajectory. A method of associating a plurality of landmarks with a patient tissue is also provided.

Abstract: A surgical apparatus, system and methodology are provided that may be utilized to treat a plurality of medical conditions. A robotic apparatus may be utilized in the treatment of a medical condition or to assist a medical professional in a surgical procedure. Additionally, the robotic apparatus and system may be utilized during a surgical procedure to provide guidance and to narrow the margin of error. In an exemplary embodiment, a scan may first be performed on a patient to determine a plurality of surgically necessary characteristics, such as bone density, locations, and the like. A virtual treatment plan may be provided by the system. An active and/or passive robotic apparatus may be provided to assist in the surgical technique. The robotic apparatus may be an active robotic which includes surgical tools whereby the medical professional may perform the surgical technique with the assistance of the active robotic apparatus.

Abstract: A delivery system is disclosed having an implant retainer configured to releasably hold an implant unit and maintain the implant unit in a fixation location relative to target tissue in a subject's body during an implantation procedure. A first suture guide portion may be disposed on a first side of the implant retainer and configured to guide a suture needle during the implantation procedure. A second suture guide portion may be disposed on a second side of the implant retainer, opposite the first side, and configured to guide the suture needle after the suture needle exits the first suture guide portion.

Abstract: The invention relates to a self-tapping and self-boring osteosynthesis screw for compressive orthopaedic surgery, characterised in that, in the bone engagement regions, at both the distal portion (A1a) and at the proximal portion (A2a), the sum of the angles defining the outer taper of the shank (f) and the taper of the crest line of the screw thread pitch (P) is higher than 45°, and in that the leading portion (i.e. the most distal one) of each thread includes a plurality of cutting edges (AR) obtained by stock removal.

Abstract: The present invention provides tools and methods designed to aid in the placement of artificial facet joints at virtually all spinal levels. One aspect of the present invention is a measurement tool for installing an artificial cephalad facet joint including a fixation measurement element and a support arm element. This measurement tool assists in the selection and/or configuration of an artificial cephalad facet joint for implantation in a patient. Another aspect is a measurement tool for installing a caudad facet joint including a stem element and a trial caudad bearing surface element. This measurement tool assists in the selection and/or configuration of a caudad facet joint for implantation in a patient. Yet another aspect is a measurement tool holder including a measurement surface connected to a holder element. This tool holder assists in determining the measurements obtained with the caudad facet joint measurement tool.

Abstract: A vertebral attachment system and method for retaining a spinal vertebra (25) on a rod (2) employ a device (1) including a body (3) for attachment to the rod, a flexible strip (4) for linking the vertebra to the attachment body and a means (5) for adjustably locking the flexible strip on the attachment body. The attachment body (3) is made of a single part having a U-shaped cross-section, for passing the rod between the bottom wall (10) of the U and the adjustable locking means. The adjustable locking means (5) consists of a linking part (18) connecting the opposite ends of the two arms (6, 7) of the U, arranged such as to compress the rod against the wall. The arms (6, 7) each include a recess (14) opposite thereof, located on the bottom side of the U, for passing the two ends of the strip between the bottom and the rod in order to form a loop for attachment to a vertebra.