Mini Bone-Attached Robot for Joint Arthroplasty

描述（由申请人提供）： 医疗机器人有可能彻底改变骨骼解剖结构的外科手术。它可以帮助外科医生比机械导向器或徒手切割更准确地准备骨骼。它可以通过减少手术错误来帮助改善患者的预后。然而，在骨科领域，由于机器人尺寸、手术时间和软组织困难等各种问题，医疗机器人并不十分成功。我们建议利用一个微型机器人铣削装置，直接连接到骨头来克服这些困难。 意识到微创手术的潜力，植入物行业目前正在重新设计植入物，并与外科医生一起重新检查外科手术。可以预期，下一代植入物将更小，更适合于微创手术的最终发展。膝关节成形术中的这种手术的一个示例是膝关节的髌股关节表面置换。在不失一般性的情况下，我们将检查机器人在提高髌股关节镜检查股骨部件准备的准确性方面的能力。从工程角度来看，该程序模拟了未来一代骨科关节成形术，其中需要将骨表面加工成更复杂的形状，不是平面或球形，而是复杂表面。因此，这项研究所展示的技术并不局限于髌股关节手术，而是适用于许多其他领域。 我们建议开发一种微型机器人，将刚性直接固定在骨头上。机器人本身将直接扫描股骨的形状，无需术前成像或术中配准和跟踪骨骼。通过髌骨跟踪方向的额外输入，我们将自动优化植入物的计划位置，以确保其与周围健康软骨正确对齐和一致。一致性是该手术的一个要求，以确保髌骨部件不会撞击股骨部件的边缘并导致植入物早期失效。然后机器人将铣出腔体到计划位置的1mm内，确保完全覆盖该区域并具有定义的表面均匀性。 通过验证所提出的机器人产生的结果，首先是蜡块，然后是塑料骨模型，猪骨，最后是尸体膝盖，我们将证明机器人可以提供精确放置植入物所需的精度。股骨部件的这种精确放置应减少撞击、髌骨轨迹不良和部件松动的可能性，并改善患者结局。

DESCRIPTION (provided by applicant): Medical robotics has the potential to revolutionize how surgical procedures on bony anatomy are performed. It can assist surgeons by preparing bones much more accurately than mechanical guides or freehand cutting. It can help improve patient outcomes by decreasing surgical errors. In the orthopaedics community, though, medical robots have not been very successful due to a variety of issues ranging from robot size, to surgical time, and soft-tissue difficulties. We propose to overcome these difficulties by utilizing a miniature robotic milling device that attaches directly to the bone. Realizing the potential of minimally invasive procedures, the implant industry is currently in the process of redesigning implants and, together with surgeons, reexamining surgical procedures. It can be expected that the next generation of implants will be smaller and more suitable for eventual development of less invasive procedures. One example of such procedures in knee arthroplasty is patellofemoral resurfacing of the knee. Without lose of generality we will examine the capability of the robot in improving the accuracy of the femoral-component preparation for patellofemoral arthroscopy. From engineering point of this procedure simulates the future generation of orthopaedic arthroplasty where there will be a need to machine bone surface into a more complex shape that is not planar or spherical but complex surfaces. Therefore, the technology demonstrated by this research, though, will not be specific to the patellofemoral procedure, and will be adaptable to many other areas. We propose to develop a miniature robot that will be rigidly affixed directly to the bone. The robot itself will scan the shape of the femur directly, removing any need for preoperative imaging or intraoperative registration and tracking of the bone. With the additional input of the direction of patellar tracking, we will automatically optimize the planned position of the implant to ensure that it is properly aligned and congruent with the surrounding healthy cartilage. Congruency is a requirement for this procedure to make certain that the patellar component does not impinge on the edge of the femoral component and lead to early failure of the implant. The robot will then mill out the cavity to within 1mm of the planned location, guaranteeing complete coverage of the area with a defined surface uniformity. By validating the results generated with the proposed robot, first on wax blocks and then plastic bone phantoms, porcine bones, and finally on cadaver knees, we will show that the robot can deliver the accuracy required to precisely place the implant. This precise placement of the femoral component should reduce the possibility of impingement, patellar maltracking, and component loosening, and improve patient outcomes.