Optimized cutting tool path for a robotic total knee arthroplasty system and method

Abstract

An active robotic system and method for resection of a proximal tibia and / or distal femur via a sagittal cutting blade to facilitate implantation of a total knee arthroplasty. The system includes an articulating arm, a sagittal cutting blade defining a cutting edge configured to cut while oscillating, and an end effector coupled to an end arm segment of the articulating arm including a drive for oscillating the sagittal cutting blade. The system is configured to autonomously adjust the relative orientation of the arm segments of the articulating arm while the sagittal cutting blade oscillates along a cutting path to autonomously spatially translate the cutting edge of the sagittal cutting blade along a plurality of optimized programmed cutting paths to perform resection of a portion of the patient's proximal tibia and / or distal femur.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application achieves and claims the benefit of priority to U.S. Provisional Application No. 63 / 302,527, entitled "Optimized Cutting Tool Paths for Robotic Total Knee Arthroplasty Resection Systems and Methods," filed January 24, 2022, the entire contents of which are expressly incorporated by reference herein. [Technical field]

[0002] The following disclosure relates generally to an optimized robotic total knee replacement resection cutting method and system. More particularly, the following disclosure relates to an optimized robotic resection cutting path trajectory method and system for total knee replacement. [Background technology]

[0003] Arthroplasty is a well-known surgical procedure in which a diseased and / or damaged natural joint is replaced with an artificial joint. Total knee arthroplasty (TKA) is an orthopedic surgical procedure in which a diseased and / or damaged knee joint is replaced with a prosthetic device.

[0004] The most widely used type of knee prosthesis for implantation in a patient during a TKA procedure includes a femoral component that is attached to the distal femur, a tibial component (or tray) that is attached to the proximal tibia, and an insert (also called a bearing or inlay) that fits between the femoral and tibial components. Portions of the patient's femur and tibia are typically resected to accommodate implantation of the femoral and tibial components of the TKA prosthesis onto / into the patient's femur and tibia, respectively.

[0005] As shown in Figure 1, a TKA generally consists of seven flat cuts: a tibial cut at the proximal tibia, a distal femoral cut, an anterior femoral cut, a posterior (or condylar) femoral cut, a first chamfer cut extending between the anterior femoral cut and the distal femoral cut, a second cut extending between the posterior femoral cut and the distal femoral cut, and a patella cut. As shown in Figure 1, the substantially flat surfaces on the proximal tibia and distal femur formed by the above-mentioned cuts are preferably cooperatively configured to engage corresponding mating surfaces of the respective tibial and femoral components of a knee prosthesis.

[0006] Resection of the proximal tibia and distal femur for a TKA may be performed via a saw blade, such as a sagittal saw blade, configured to cut bone, cartilage, and / or other tissue of a patient (e.g., a mammalian patient). Sagittal saws are advantageous because they can cut material, such as bone or other tissue, at a faster rate than other cutting tools, such as rotary cutting tools.

[0007] 2, a sagittal saw blade 10 is typically a planar saw blade extending longitudinally along an axis XX, with a tang portion at one end, a tip portion including a cutting edge 12, and a body portion extending between the tang portion and the tip portion. The tip portion cutting edge 12 includes a plurality of cutting teeth (and / or abrasives) that are disposed transversely along the plane of the blade 10 (extending along the axis XX) (e.g., linearly or, for example, along an arc having a radius aligned with the axis XX) and define the free end (i.e., axial extent) of the tip portion blade 10.

[0008] The sagittal saw blade 10 is configured to effect cutting through the cutting edge 12 as the blade 10 translates / moves in an oscillating back and forth pattern along an oscillating path 17 in a plane in which the blade 10 is aligned, as shown in FIG. 2, and as the blade 10 translates along a longitudinal / axial cutting direction 15 extending from the tang portion to its tip portion. As a result, when the sagittal saw blade 10 is actuated by a cutting instrument, the cutting edge 12 must move back and forth relative to the material (e.g., tissue or bone) being cut as the blade 10 translates longitudinally or axially. As a result of the movement along the oscillating path 17 and the forward pressure and translation along the longitudinal / axial cutting direction 15 along the cutting path, the teeth of the cutting edge 12 of the sagittal saw blade 10 can cut and separate the bone.

[0009] Due to the arrangement of the vibration path 17 and the longitudinal / axial cutting direction 15, the sagittal cutting blade 10 can only cut when the oscillating teeth move across the material along the vibration path 17. That is, a limitation of the sagittal cutting blade 10 is that it can only cut by moving the toothed cutting edge 12 laterally in the opposite direction across the material (bone), so the sagittal saw blade 10 must only move forward along its axis XX to cut. This prevents the sagittal cutting blade 10 from making side cuts along a lateral direction inclined (e.g. extending perpendicular) to the longitudinal axis XX.

[0010] The inherent limitations of the unidirectional cutting capabilities of a sagittal saw blade 10 become evident when utilizing such a blade 10 in a surgical procedure such as TKA due to practical clinical constraints associated with the surgery, such as avoidance of critical anatomical structures and cutting within bony boundary constraints, etc. Thus, currently only haptic surgical robots utilize superior sagittal cutting blades 10 in surgical environments such as TKA resections.

[0011] A haptic robot relies on a user to provide the overall movement of the sagittal cutting blade 10 in a longitudinal / axial cutting direction 15 along a cutting path (and typically a drive mechanism that operates the sagittal blade 10 along an oscillating path 17). Such haptic surgical robots are therefore configured as manually guided surgical instruments that power the sagittal cutting blade 10 but at best only assist the user in translating the sagittal cutting blade 10 to (and through) the patient. Such haptic surgical robots therefore require the user to physically initiate the cutting of bone or other tissue with the sagittal cutting blade 10. The sagittal cutting blade 10 also requires the user to manually move and direct the sagittal cutting blade 10 along the cutting path through the bone or other tissue (i.e., the robot is not actively performing the cut). For example, some such haptic surgical robots include a handle and trigger that the user manually utilizes to move and direct the oscillating sagittal cutting blade 10 in a longitudinal / axial cutting direction 15 along the cutting path to and through the bone or other tissue. As a result, a user (e.g., a surgeon) must manually provide input to the robot by physically moving the robot.

[0012] It should be noted that some such tactile robotic cutting systems may define cutting and non-cutting areas / zones and actively prevent the user from (e.g., accidentally) translating the oscillating sagittal cutting blade 10 into / through the non-cutting area to protect areas of the patient that should not be cut. However, such robotic systems do not actively or autonomously move the cutting tool through the cutting area, as the user must physically move the oscillating sagittal cutting blade 10 in the longitudinal / axial cutting direction 15 along the cutting path within the cutting area and through the bone or other tissue to the insertion point.

[0013] As such, tactile robotic cutting systems require one or both hands of the user to manually physically guide the cutting tool (and drive mechanism) to and through the cutting path (extending in the longitudinal / axial cutting direction 15). Haptic robotic cutting systems are problematic because surgeons and surgical technicians often do not have both hands readily available during surgical procedures. Because tactile robotic cutting systems require the user to perform the cutting, they are relatively demanding on the user (e.g., surgeon), limit the user's ability to perform other tasks (the user loses the use of at least one hand), and the robotic systems often physically obstruct access to the patient. Furthermore, because current tactile robotic cutting systems require the user to physically define or control the cutting path of the sagittal cutting blade 10, the location, quality, timing, and pattern of cuts made by the sagittal cutting blade 10 are dependent on the skill of the user.

[0014] As such, an active surgical robotic system and associated active surgical robotic methods are desirable that utilize the sagittal cutting blade 10 to fully autonomously follow a predetermined cutting path extending in the longitudinal / axial cutting direction 15 without a user having to physically engage and guide the sagittal cutting blade 10. Such an active surgical robotic system that can perform a TKA resection with the sagittal cutting blade 10 while safely and reliably avoiding critical anatomical structures would be highly desirable. A fully autonomous or active TKA resection robotic system and associated methods that autonomously follows a determined cutting path (e.g., of the sagittal cutting blade 10) would be advantageous in allowing a user (e.g., a surgeon) to perform other tasks.

[0015] To facilitate a fully autonomous or active TKA resection robotic system and associated methods that autonomously follow a determined cutting path of the sagittal cutting blade 10, the present disclosure provides an optimized cutting path extending in a longitudinal / axial cutting direction 15 for active robotic execution via the sagittal cutting blade 10. The disclosed robotic TKA sagittal cutting blade 10 cutting path overcomes the limitations of the sagittal cutting blade 10 (e.g., longitudinal / axial cutting direction 15) and the clinical constraints of active robotic TKA using the sagittal cutting blade 10. The presently disclosed optimized cutting path for the sagittal cutting blade and robotic system facilitates the execution of TKA resection cuts with the sagittal cutting blade 10 via an active / autonomous surgical robotic system. The optimized cutting path thereby provides a TKA resection via an active (i.e., fully autonomous) surgical robotic system that allows the user to use both hands for other tasks and free up workspace around the robotic system while ensuring a safe, accurate, proper, and efficient cut / resection.

[0016] Although certain aspects of the prior art have been discussed to facilitate disclosure of Applicant's invention, Applicant does not in any way reject these technical aspects and it is believed that the present invention may incorporate one or more of the prior art technical aspects.

[0017] Where a document, act or item of knowledge is referenced or discussed in this disclosure, such reference or discussion is not an admission that that document, act or item of knowledge, or any combination thereof, was publicly available, known to the public, part of the common general knowledge, or constitutes prior art under any applicable legal provision, or is relevant to any attempt to solve any problem to which the present specification pertains. Summary of the Invention

[0018] The present invention may address one or more of the problems and shortcomings of current robotic and TKA resection systems and methods. However, it is believed that the present invention will prove useful in addressing other problems and shortcomings in several technical fields. Thus, the claimed invention should not necessarily be construed as limited to addressing any of the particular problems or shortcomings discussed herein.

[0019] The present disclosure generally relates to surgical robots, surgical robotic systems, and related surgical methods that include a controller that allows a user to electronically control parameters of a cutting tool's movement along a prescribed or determined cutting path. The present disclosure provides configurations and methods that facilitate user input to an active or autonomous robotic system to control parameters of a cutting tool's movement along a prescribed or determined cutting path. The surgical robotic systems and related surgical methods provide an electronic controller that provides intuitive user control of the active robot along the active robot's prescribed or determined cutting path.

[0020] In some embodiments, the present disclosure provides a fully autonomous or active TKA resection robotic system and associated methods that autonomously follows an optimized cutting path determined / programmed with the sagittal cutting blade 10. The cutting path is optimized with respect to the limitations of the sagittal cutting blade 10 (e.g., longitudinal / axial cutting direction 15) as well as clinical limitations and considerations related to resection in a TKA procedure (e.g., avoidance of critical structures that cannot be cut, creation of limited access windows and cutting paths).

[0021] Thus, the optimized cutting path for the sagittal cutting blade and robotic system of the present disclosure facilitates the performance of TKA resection cuts with the sagittal cutting blade 10 via an active / autonomous surgical robotic system. The optimized cutting path provides a TKA resection (and other similar orthopedic surgical procedures or resections) with an active surgical robotic system that allows the user to use both hands for other tasks, free up workspace around the robotic system, perform resections at higher speeds compared to resections with haptic robotic systems and / or rotary cutting tools, perform difficult cuts with greater precision than haptic robotic systems, and generally place less demands on the user than haptic robotic systems. The active / autonomous TKA resection surgical robotic system and method of the present disclosure is configured to spatially translate the sagittal cutting blade 10 through a series of ordered coordinates (i.e., cutting paths) that are optimized for the sagittal cutting blade 10 and the anatomical structures associated with each particular TKA resection. For example, the active / autonomous TKA resection surgical robotic system and method utilizes an optimized cutting path that unexpectedly enables the sagittal cutting blade 10 but avoids critical anatomical structures.

[0022] In one aspect, the present disclosure provides an active robotic system, the system comprising: an articulating arm with a plurality of arm segments defining a longitudinal axis, an adjustable joint coupled between adjacent arm segments configured to adjust an orientation of an axis of the adjacent arm segments, a sagittal cutting blade defining a cutting edge configured to cut while oscillating along an oscillation path extending on a plane defined by the blade, and an end effector coupled to an end arm segment of the plurality of arm segments and the sagittal cutting blade, the end effector comprising a powered drive that oscillates the sagittal cutting blade along the oscillation path. The robotic system is configured to autonomously adjust relative orientations of the arm segments of the articulating arm while the sagittal cutting blade oscillates along the cutting path to autonomously spatially translate a cutting edge of the sagittal cutting blade along a plurality of optimized programmed cutting paths to perform resection of a portion of a patient's proximal tibia and / or distal femur via the sagittal cutting blade and facilitate implantation of respective femoral and tibial components of a total knee replacement therein.

[0023] In some embodiments, the plurality of optimized programmed cutting paths includes a first series of cutting paths configured to form a tibial resection on the proximal tibia while preventing damage to the patient's patellar tendon, medial collateral ligament (MCL), lateral collateral ligament (LCL), and posterior cruciate ligament (PCL). In some such embodiments, the first series of cutting paths is configured to enter a joint space between the patient's proximal tibia and distal femur via an entry area on an anterior medial bone region, and a cutting path trajectory of the first series of cutting paths extends between the patient's MCL and patellar tendon. In some such embodiments, the first series of cutting paths includes a first counterclockwise anterior-to-posterior trajectory cutting path that extends in an arc along the lateral bone border of the proximal tibia and a second anterior-to-posterior clockwise trajectory cutting path that extends in an arc along the medial bone border of the proximal tibia. In some such embodiments, the first series of cutting paths further includes at least one third cutting path extending between the first and second cutting paths of the first series of cutting paths to remove a portion of the proximal tibia extending between the first and second cutting paths to form a tibial resection.

[0024] In some embodiments, the plurality of optimized programmed cutting paths includes a second series of cutting paths configured to form a distal femoral resection at the medial and lateral condyles of the distal femur while preventing damage to the patient's quadriceps tendon, MCL, hamstrings tendon, and LCL. In some such embodiments, the second series of cutting paths is configured to enter a joint space between the patient's proximal tibia and distal femur via an anterior entry region of the posterior femur, and a cutting path trajectory of the second series of cutting paths extends through the cutting path from anterior to posterior. In some such embodiments, the second series of cut paths includes a first partial series of cut paths extending through a portion of the medial condyle of the distal femur, the first partial series of cut paths including a first counterclockwise anterior-to-posterior trajectory cut path through a medial side of the medial condyle that extends in an arc along the medial bony border of the distal femur, and a second clockwise anterior-to-posterior trajectory cut path through a lateral side of the medial condyle that extends in an arc along the lateral bony border of the distal femur. In some such embodiments, the first partial series of cut paths further includes at least one third cut path trajectory extending anterior-to-posterior of the first partial series of cut paths and between the first and second cut paths to remove a portion of the distal femur extending between the first and second cut paths to form a distal femoral resection at the medial condyle. In some such embodiments, the second series of cutting paths includes a second partial series of cutting paths extending through a portion of the lateral condyle of the distal femur, the second partial series of cutting paths including a third counterclockwise anterior-to-posterior orbital cutting path through the medial side of the lateral condyle of the distal femur extending in an arc along the medial bony border of the distal femur, and a fourth generally clockwise anterior-to-posterior orbital cutting path through the lateral side of the lateral condyle of the distal femur extending along the lateral bony border of the distal femur.

[0025] In some embodiments, the plurality of optimized programmed cutting paths includes a third series of cutting paths configured to form a posterior femoral resection at the medial and lateral condyles of the posterior femur while preventing damage to the patient's quadriceps tendon, MCL, hamstring tendon, and LCL. In some such embodiments, the third series of cutting paths is configured to enter a joint space between the patient's proximal tibia and distal femur via a distal entry region of the posterior femur, and a cutting path trajectory of the third series of cutting paths extends through the cutting path in a distal to proximal direction. In some such embodiments, the third series of cutting paths includes a third partial series of cutting paths extending through a portion of the medial condyle of the posterior femur, the third partial series of cutting paths including a first clockwise, distal-to-proximal substantially linear trajectory cutting path through a medial side of the medial condyle extending substantially linearly along the medial bony border of the posterior femur, and a second counterclockwise, distal-to-proximal substantially linear trajectory cutting path through a lateral side of the medial condyle extending substantially linearly along the lateral bony border of the posterior femur. In some such embodiments, the third series of cut paths includes a fourth partial series of cut paths extending through a portion of the lateral condyle of the posterior femur, the fourth partial series of cut paths including a third clockwise proximal-to-distal trajectory cut path through a medial side of the lateral condyle of the posterior femur extending substantially linearly along the medial bony border of the posterior femur, and a fourth generally counterclockwise distal-to-proximal substantially linear trajectory cut path through a lateral side of the lateral condyle of the posterior femur extending substantially linearly along the lateral bony border of the posterior femur.

[0026] In some embodiments, the plurality of optimized programmed cutting paths includes a fourth series of cutting paths configured to form posterior chamfer resections on the medial and lateral condyles of the femur extending between the posterior-distal femur while preventing damage to the patient's quadriceps tendon, MCL, and LCL. In some such embodiments, the fourth series of cutting paths is configured to enter a joint space between the patient's proximal tibia and distal femur via a distal entry region of the posterior-distal femur, and a cutting path trajectory of the fourth series of cutting paths extends through the cutting path in a distal to proximal direction. In some such embodiments, the fourth series of cutting paths includes a fifth partial series of cutting paths extending through a portion of the medial condyle of the posterior-distal femur, the fifth partial series of cutting paths including a first clockwise, distal-to-proximal substantially linear trajectory cutting path through a medial side of the medial condyle extending substantially linearly along the medial bone boundary of the posterior-distal femur, and a second counterclockwise, distal-to-proximal substantially linear trajectory cutting path through a lateral side of the medial condyle extending substantially linearly along the lateral bone boundary of the posterior-distal femur. In some such embodiments, the fourth series of cutting paths includes a sixth partial series of cutting paths extending through a portion of the lateral condyle of the posterior-distal femur, and the fourth partial series of cutting paths includes a third clockwise proximal-to-distal trajectory cutting path through a medial side of the lateral condyle of the posterior-distal femur extending substantially linearly along the medial bone boundary of the posterior-distal femur, and a fourth generally counterclockwise distal-to-proximal substantially linear trajectory cutting path through a lateral side of the lateral condyle of the posterior-distal femur extending substantially linearly along the lateral bone boundary of the posterior-distal femur.

[0027] In some embodiments, the plurality of optimized programmed cutting paths includes a fifth series of cutting paths configured to form anterior cut resections in the medial and lateral condyles of the femur extending between the anterior-distal femur while preventing damage to the patient's quadriceps tendon, MCL, and LCL. In some such embodiments, the fifth series of cutting paths is configured to enter a joint space between the patient's proximal tibia and distal femur via a distal entry region of the anterior-distal femur, and a cutting path trajectory of the fifth series of cutting paths extends through the cutting path in a distal to proximal direction. In some such embodiments, the fifth series of cutting paths includes a seventh partial series of cutting paths extending through a portion of the medial condyle of the anterior-distal femur, and the seventh partial series of cutting paths includes a first distal to proximal substantially linear trajectory cutting path through the medial condyle. In some such embodiments, the fifth series of cutting paths includes an eighth partial series of cutting paths extending through a portion of the lateral condyle of the anterior-distal femur, and the eighth partial series of cutting paths includes a second distal-to-proximal substantially straight trajectory cutting path through the lateral condyle.

[0028] In some embodiments, the plurality of optimized programmed cutting paths includes a sixth series of cutting paths configured to form anterior femoral resections at the medial and lateral condyles of the anterior femur while preventing damage to the patient's quadriceps tendon, MCL, hamstring tendon, and LCL. In some such embodiments, the sixth series of cutting paths is configured to enter a joint space between the patient's proximal tibia and distal femur via a distal entry region of the anterior femur, and a cutting path trajectory of the sixth series of cutting paths extends through the cutting path in a distal to proximal direction. In some such embodiments, the sixth series of cutting paths includes a ninth partial series of cutting paths extending through a portion of the medial condyle of the anterior femur, and the ninth partial series of cutting paths includes a first substantially straight distal to proximal trajectory cutting path through the medial condyle. In some such embodiments, the sixth series of cutting paths includes a tenth partial series of cutting paths extending through a portion of the lateral condyle of the anterior femur, the tenth partial series of cutting paths including a second clockwise substantially linear distal-to-proximal trajectory cutting path through the medial side of the lateral condyle extending substantially linearly along the medial bony border of the anterior femur, and a third counterclockwise proximal-to-distal trajectory cutting path through the lateral side of the lateral condyle extending in an arc along the lateral bony border of the anterior femur.

[0029] In some embodiments, the plurality of optimized programmed cutting paths are programmed into a memory of the robotic system, and in some such embodiments, the robotic system is configured to autonomously execute the plurality of optimized programmed cutting paths via the sagittal cutting blade without a user physically guiding the sagittal cutting blade.

[0030] In another aspect, the present disclosure provides a method for resecting a portion of a patient's proximal tibia and / or distal femur to facilitate implantation of femoral and tibial components, respectively, of a total knee arthroplasty, the method including utilizing any of the robotic systems described above to autonomously execute at least some of a plurality of optimized programmed cutting paths to autonomously resect at least a portion of the proximal tibia and / or distal femur.

[0031] It is to be understood that all combinations of the foregoing aspects and the additional concepts described in more detail below (unless such concepts are mutually inconsistent) are considered to be part of the subject matter of the present invention and to achieve the advantages disclosed herein.

[0032] These and other objects, features and advantages of the present disclosure will become apparent from the following detailed description of the various aspects of the disclosure, taken in conjunction with the accompanying drawings. [Brief description of the drawings]

[0033] These and other features, aspects, and advantages of the present disclosure will be better understood from the following detailed description taken in conjunction with the accompanying drawings, which are not necessarily drawn to scale, and in which like reference numerals represent like aspects throughout the drawings.

[0034] [Figure 1] 1 illustrates an example of a proximal tibia and distal femur total knee arthroplasty (TKA) resection according to one or more aspects of the present disclosure. [Diagram 2] FIG. 1 illustrates a top view of a sagittal cutting blade coupled to an attachment mechanism in one example, in accordance with one or more aspects of the present disclosure. [Diagram 3] 4 illustrates a perspective view of a TKA resection active robotic system utilizing the sagittal cutting blade of FIG. 3 in one example, in accordance with one or more aspects of the present disclosure. [Figure 4] FIG. 4 illustrates an elevated perspective view of an arm segment, an end effector, and a sagittal cutting blade of the active robotic system of FIG. 3 in one example, according to one or more aspects of the present disclosure. [Figure 5A] 4 illustrates an exemplary first series of programmed sagittal cutting paths for the active robotic system of FIG. 3 for forming the TKA resection of FIG. 1 in accordance with one or more aspects of the present disclosure. [Figure 5B] 4 illustrates an exemplary first series of programmed sagittal cutting paths for the active robotic system of FIG. 3 for forming the TKA resection of FIG. 1 in accordance with one or more aspects of the present disclosure. [Figure 6A] 10 illustrates an exemplary second series of programmed sagittal cutting paths for the active robotic system of FIG. 3 for forming the TKA resection of FIG. 1 in accordance with one or more aspects of the present disclosure. [Figure 6B] 10 illustrates an exemplary second series of programmed sagittal cutting paths for the active robotic system of FIG. 3 for forming the TKA resection of FIG. 1 in accordance with one or more aspects of the present disclosure. [Figure 7A] 10 illustrates an exemplary third series of programmed sagittal cutting paths for the active robotic system of FIG. 3 for forming the TKA resection of FIG. 1 in accordance with one or more aspects of the present disclosure. [Figure 7B] 10 illustrates an exemplary third series of programmed sagittal cutting paths for the active robotic system of FIG. 3 for forming the TKA resection of FIG. 1 in accordance with one or more aspects of the present disclosure. [Figure 8A] 10 illustrates an exemplary fourth series of programmed sagittal cutting paths for the active robotic system of FIG. 3 for forming the TKA resection of FIG. 1 in accordance with one or more aspects of the present disclosure. [Figure 8B] 10 illustrates an exemplary fourth series of programmed sagittal cutting paths for the active robotic system of FIG. 3 for forming the TKA resection of FIG. 1 in accordance with one or more aspects of the present disclosure. [Figure 9A] 10 illustrates an exemplary fifth series of programmed sagittal cutting paths for the active robotic system of FIG. 3 for forming the TKA resection of FIG. 1 in accordance with one or more aspects of the present disclosure. [Figure 9B]10 illustrates an exemplary fifth series of programmed sagittal cutting paths for the active robotic system of FIG. 3 for forming the TKA resection of FIG. 1 in accordance with one or more aspects of the present disclosure. [Figure 10A] 10 illustrates an exemplary sixth series of programmed sagittal cutting paths for the active robotic system of FIG. 3 for forming the TKA resection of FIG. 1 in accordance with one or more aspects of the present disclosure. [Figure 10B] 10 illustrates an exemplary sixth series of programmed sagittal cutting paths for the active robotic system of FIG. 3 for forming the TKA resection of FIG. 1 in accordance with one or more aspects of the present disclosure. [Figure 11] 1 illustrates a graphical representation of a computer system and associated devices for incorporating and / or using aspects described herein, in one example, according to one or more aspects of the present disclosure. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0035] Aspects of the present disclosure as well as specific examples, features, advantages, and details thereof are described more fully below with reference to non-limiting examples shown in the accompanying drawings. Descriptions of well-known materials, manufacturing tools, processing techniques, and the like are omitted so as not to unnecessarily obscure the relevant details. It should be understood, however, that the detailed description and specific examples, while illustrating aspects of the present disclosure, are given by way of illustration only and not by way of limitation. Various substitutions, modifications, additions, and / or arrangements within the spirit and / or scope of the underlying inventive concept will be apparent to those skilled in the art from this disclosure.

[0036] Approximate language used herein throughout this disclosure may be applied to modify any quantitative expression that may be permissibly varied without resulting in a change in the relevant basic function. Thus, values ​​modified with terms such as "about" or "substantially" are not limited to the exact value specified. For example, these terms may refer to ±5% or less, such as ±2% or less, such as ±1% or less, such as ±0.5% or less, such as ±0.2% or less, such as ±0.1% or less, such as ±0.05% or less. In some cases, approximate language may correspond to the precision of the instrument for measuring the value. Any examples of operating or configuration parameters are not exclusive of other parameters of the disclosed embodiments.

[0037] The terms used herein are for the purpose of describing particular examples only and are not intended to be limiting. As used herein, the singular forms "a," "an," and "the" are intended to include the plural unless otherwise stated. Furthermore, reference to "one example" is not intended to be interpreted as excluding the existence of additional examples that also incorporate the recited features. Furthermore, unless expressly stated to the contrary, the terms "comprising" (any form of "comprise" such as "comprises" and "comprising"), "have" (any form of "have" such as "has" and "having"), "include" (any form of "include" such as "includes" and "including"), and "contain" (any form of "contain" such as "contains" and "containing") are used as open-ended linking verbs. As a result, any example of "comprises," "has," "includes," or "contains" one or more steps or elements includes such one or more steps or elements, but is not limited to having only such one or more steps or elements.

[0038] As used herein, the terms "may" and "may be" modify another verb by expressing one or more of the following: the possibility of occurring within a set of circumstances; the possession of a specified property, characteristic, or function; and / or the ability, function, or possibility associated with the modified verb. Thus, the use of "may" and "may be" indicates that the modified term is clearly appropriate, possible, or appropriate for the indicated ability, function, or use, but contemplates that in some circumstances the modified term may not be appropriate, possible, or appropriate. For example, this distinction between where in some circumstances an event or capability can be expected, but where in other circumstances the event or capability cannot be made to occur, is captured by the terms "may" and "may be."

[0039] The term "coupled" and similar terms are used herein to refer to both direct and indirect connections. As used herein, unless otherwise specified, the term "throughout" (and any other form of "throughout") means at least a substantial portion, such as at least 95% or at least 99%. Thus, as used herein, the term "throughout" (and any other form of "throughout") is not limited to 100% unless otherwise specified. As used herein, the term "layer" refers to

[0040] When used herein with respect to bones or bone portions (e.g., extending along a bone border), terms and phrases such as "border," "edge," "periphery," and the like should be understood (and are so utilized herein) to refer to a portion of the bone that is located immediately adjacent or proximate to the outer edge, border, or margin of the bone or bone portion. Note that such a bone portion may include the respective bone outer edge, margin, or margin, or may be slightly spaced from but substantially near the respective bone outer edge, margin, or margin, such as within 6 mm, 5 mm, 4 mm, 3 mm, 2 mm, or 1 mm of the respective bone outer edge, margin, or margin.

[0041] The components, aspects, features, configurations, arrangements, uses, etc. described, illustrated, or otherwise disclosed herein with respect to any particular embodiment may be equally applied to any other embodiment disclosed herein.

[0042] As shown in Figures 3 and 4, a robot or robotic system 20 according to the present disclosure can include, among other things, an articulated robotic arm 13, an end effector 14, and a sagittal cutting blade 10. As shown in Figures 3 and 4, the robotic system 20 can be configured as a surgical robot. For example, the surgical robot 20 can be biocompatible and configured to be sterilized to the extent required in a surgical environment. However, in other embodiments, the robot 20 can be configured as an industrial or other non-surgical robotic device or system.

[0043] The term "surgical robot" as used herein with respect to exemplary robot / robotic system embodiments is not meant to be limiting, and any and all descriptions herein of "surgical robot" etc. apply to robots / robotic systems in general or industrial or other non-surgical robots / robotic systems as well. However, it should be noted that the sagittal cutting paths provided herein have particular application to a surgical active / autonomous robotic system 10 for TKA resection.

[0044] The robotic system 20 may be operatively connected to a computer system (e.g., memory, processor, etc.) that controls the movement of the sagittal cutting blade 10 along one or more determined, defined, or programmed cutting paths, e.g., via the movement of the articulated arm 13 and possibly the operation of the end effector 14, as shown, for example, in FIG. 11 . For example, in some embodiments, the robotic system 20 may comprise a control unit having programming and potentially a user interface (UI). The control unit may include at least one processing circuit, at least one input / output device, and at least one storage device or memory in which at least one database or cutting instructions are stored. The control unit may have a control algorithm or programming code for controlling the position of the sagittal cutting blade 10 (e.g., via the joint angles between the segments of the articulated arm 13). The control algorithm or programming code may be a default control algorithm or may include input, e.g., from a UI and / or another interface.

[0045] As shown in Figures 3 and 4, the articulating arm 13 may extend from a base and may include multiple rigid arm or body segments / pieces and multiple joints connecting adjacent segments (and the first or base segment to the base). The multiple joints may include, for example, four, five, or six individual segments coupled to each other via three, four, or five joints, respectively. In some other embodiments, the articulating arm 13 may include at least two segments and at least one joint coupling at least two segments to each other, or more than six segments and more than five joints coupling the segments to each other.

[0046] Each arm segment of the articulated arm 13 can define an axial axis extending along its longitudinal length. The joints may be configured to allow the arm segments to rotate about their axes and / or angularly articulate relative to one another such that the axes of adjacent segments are angularly offset. In some embodiments, one or more of the joints may be configured to allow multiple degrees of freedom between adjacent arm segments (and potentially the base segment and the base). In some such embodiments, at least one of the joints may be configured to provide six degrees of freedom.

[0047] The articulating arm 13 may further comprise a motor, actuator or other adjustment device configured to adjust the axial rotation and / or angular orientation between adjacent segments. In this manner, the robotic system 20 may control the positioning of the articulating arm 13 to translate the sagittal cutting blade 10 three-dimensionally in space relative to a workpiece (e.g., a patient's tibia and femur, etc.) to ultimately cut one or more portions of the workpiece (e.g., a proximal tibia and a distal femur). As described above, the robotic system 20 may include control software that, among other things, directs or commands the articulating arm 13 of the robotic system 20 to adjust in a particular manner (i.e., joint adjustments) to achieve a determined, prescribed, or programmed cutting path movement of the sagittal cutting blade 10 optimized for TKA resection with the sagittal cutting blade 10. Stated another way, the robotic system 20 may include control software that instructs or commands the articulated arm 13 of the robotic system 20 to, among other things, adjust in a particular manner (i.e., adjust the joints) to translate the sagittal cutting blade 10 in three-dimensional space along one or more (e.g., a series or multiple) optimized determined, defined, or programmed cutting paths of the sagittal cutting blade 10 to resect along or in accordance with the determined, defined, or programmed cutting paths.

[0048] The optimized cutting path, described in more detail below, allows the path of the sagittal cutting blade 10 to be predetermined, predefined, or preprogrammed in the robotic system 20, such that the user does not dictate the cutting path of the sagittal cutting blade 10 that it travels along to perform the TKA resection.

[0049] The base of the surgical robotic system 20 may be fixed, for example, to the movable cart 16 as shown in FIG. 3 or to the ground, so that the base may provide a fixed reference frame for defining the position, orientation, and movement of the joints and arm segments relative to the base. The base may be used to define a reference frame, such as, for example, a set of three-dimensional axes (e.g., x, y, z) that may be used to define the position, orientation, and movement of the surgical robotic system 20 and objects relative to the surgical robotic system 20. In some embodiments, the movable cart 16 may include one or more reference points 17 (e.g., a reference array) such that a camera system may be utilized to determine the position of the base of the arm 13 (or the entire robot 20) as a reference frame, as shown in FIG. 3. The reference frame defined relative to the base 19 is also known as a world frame, base, base frame, frame, or tool frame. It should be noted that with the position and orientation of the object defined or calculated relative to the fixed reference frame, the object may also be defined in the same reference frame as the robotic system 20, and the surgical robotic system 20 may calculate the position and orientation of the object. Thus, the surgical robotic system 20 can programmably interact with defined objects, positions, and / or orientations. In some embodiments, the system 20 can be configured to recognize (e.g., detect and / or identify) anatomical structures proximate to the bone portion to be cut (e.g., other bones, such as adjacent bones) and prevent the system 20 from cutting such anatomical structures. Thus, the system 20 can have a collision avoidance feature that prevents the system 20 from cutting anatomical structures other than the particular bone portion, for example.

[0050] As shown in Figures 3 and 4, the robotic system 20 can include an end effector 14 coupled (e.g., rotatably coupled) to an end, rearmost, or terminal arm segment 18 of the articulated arm 13, such as via a rotatable connector assembly therebetween. The rotatable connector assembly can be configured such that the end effector 14 is rotatable about a longitudinal axis of the end arm segment 18. As shown in Figure 4, the end effector 14 can be configured such that the axis of the end arm segment 18 and the axis XX of the sagittal cutting blade 10, along which the cutting direction 15 of the sagittal cutting blade 10 extends, are inclined relative to one another. In the illustrated exemplary embodiment, the axis XX of the sagittal cutting blade 10 (and the cutting direction 15 along which the sagittal cutting blade 10 is configured to cut) and the axis of the end arm segment 18 are oriented perpendicular to one another. Similarly, the end effector can define a longitudinal axis that is substantially parallel to the axis XX of the sagittal cutting blade 10 (and the cutting direction 15 in which the sagittal cutting blade 10 is configured to cut) and / or angled (e.g., perpendicular) to the axis of the end arm segment 18, as shown in Figures 3 and 4.

[0051] 3 and 4, because the positions, orientations, and movements of the joints and arm segments relative to the base can be defined, and the angular orientation of the end effector 14 relative to the end arm segment 18 of the articulated arm 13 can be defined, the position and orientation of the sagittal cutting blade 10 extending from the end effector 14 can be calculated or determined by the robotic system 20. It is understood that the exemplary sagittal cutting blade 10 is configured to cut bone or other tissue. In some other embodiments, the sagittal cutting blade 10 may be interchangeable with a different cutting or non-cutting instrument that can function, for example, as a marking device or viewing device.

[0052] As discussed above and shown in FIGS. 2 and 4, the sagittal cutting blade 10 of the exemplary robotic system 20 may include a mounting, tang, or hub portion at a proximal end portion that mates with a mounting mechanism 40 of the end effector 14. For example, the end effector 14 may include a chuck or other mounting mechanism 40 configured to mate with the mounting portion of the sagittal cutting blade 10 and removably secure the sagittal cutting blade 10 and the end effector 14 together. This allows the end effector 14 to physically translate or move the sagittal cutting blade 10 along the cutting path 17 along which the sagittal cutting blade 10 is configured to cut. An axis XX of the sagittal cutting blade 10 may extend through the mounting portion 40 and the end effector 14, and the sagittal cutting blade 10 (and the end effector 14) may extend longitudinally along the axis XX. The end effector 14 may be configured to rotate or provide torque to the sagittal cutting blade 10, for example, to rotate along the cutting path 17 about an oscillation axis.

[0053] As discussed above and shown in FIGS. 2-4, the sagittal cutting blade 10 can comprise a saw blade having a thin, flat, elongated shape with a cutting edge 12 at the distal tip or end of a blade body portion. The thin, flat design can minimize the size of the blade kerf and enable the blade 10 to make precise, straight cuts. The cutting edge 12 may be oriented along a direction that is generally perpendicular to the direction of elongation of the blade and includes multiple teeth and / or abrasives. Thus, as the sagittal cutting blade 10 translates / oscillates along the cutting path 17, the cutting edge 12 can translate in an axial / longitudinal cutting direction 17 along the cutting path such that the cutting edge 12 engages and cuts through a portion of the bone (e.g., the proximal tibia and distal femur) as it translates along the cutting path.

[0054] 2 and 4, in some embodiments, the end effector 14 may be configured to oscillate (i.e., translate back and forth) the sagittal cutting blade 10 in or along an oscillating cutting direction or path 17. As described above, the oscillating cutting path 17 may extend along a plane defined by the blade 10. The sagittal cutting blade 10 performs a cutting action by translating (e.g., at least in part, via the articulated arm 13) in the cutting direction 17 (i.e., longitudinal / axial) extending along the longitudinal axis XX in a direction extending from a joint portion to a tip portion thereof as the blade 10 (and its cutting edge 12) oscillates along the oscillating cutting path 17 (i.e., in a cutting stroke). Due to the movement along the oscillating cutting path 17 applied by the end effector 14 and the forward axial / longitudinal pressure applied by the robotic system 20 (e.g., at least in part, via the articulated arm 13) along the cutting path, the teeth of the cutting edge 12 of the sagittal cutting blade 10 may cut and separate the bone tissue.

[0055] 5A-10B, the robotic system 20 may include a plurality of optimized, determined, prescribed, or programmed cutting paths for the sagittal cutting blade 10 to accomplish bone resections, such as TKA resections of the proximal tibia and distal femur. The optimized cutting paths may be controlled or realized by control software that directs or commands the articulated arm 13 of the robotic system 20 to adjust in a particular manner (i.e., joint adjustments) to translate the sagittal cutting blade 10 in three-dimensional space along the optimized, determined, prescribed, or programmed cutting path of the sagittal cutting blade 10 to cut bone along or in accordance with the optimized, determined, prescribed, or programmed cutting path of the sagittal cutting blade 10. It should be noted that while the robotic system 20 translates (at least in part via the articulated arm 13) the sagittal cutting blade 10 along a determined, defined or programmed cutting path in the longitudinal / axial cutting direction 15, the end effector 14 translates / oscillates the sagittal cutting blade 10 along a cutting path 17.

[0056] As such, the cutting path of the sagittal cutting blade 10 may be pre-determined, pre-defined, or pre-programmed in, for example, the robotic system 20, such that the user does not dictate the cutting path of the sagittal cutting blade 10 along which the sagittal cutting blade 10 moves to perform the TKA bone resection. As such, it should be noted that the cutting path may include an entry location where the sagittal cutting blade 10 first begins cutting the proximal tibia and a portion of the distal femur to enter the bone portion, as well as a three-dimensional spatial path extending from the entry location through the bone portion. In some embodiments, the systems and methods described herein may include a path of the cutting blade 10 such that the cutting blade 10 is oriented / positioned and / or angled most medially in the entry location as the anatomical structures that allow it to be proximate the bone / bone portion (i.e., not damage the anatomical structures proximate the bone / bone portion being cut).

[0057] 5A-10B, in some embodiments, the cutting path includes a spatial path to and through bone portions, such as portions of the proximal tibia and distal femur, to effect the necessary TKA resections (as shown in FIG. 1). Thus, the cutting path may be configured to resect or cut bone according to the requirements of a surgical procedure, such as resecting portions of the proximal tibia and distal femur for a TKA. For example, the cutting path may be configured to resect portions of the proximal tibia and distal femur for cooperation with a TKA proximal tibia and distal femur implant.

[0058] Next, an optimized cutting path of the active / autonomous surgical robotic system for TKA resection via the sagittal cutting blade 12 will be described. It should be noted that numerical terms such as "first", "second", "third", etc. are utilized only for the purpose of referencing the cutting paths to distinguish them from one another, and do not identify a particular order in which the cutting paths are made by the sagittal cutting blade 10 / active robotic system 20.

[0059] It should also be noted that the cutting paths described herein represent the general or overall spatial path of the cutting edge 12 of the sagittal cutting blade 10 as it translates (i.e., during a cutting operation) to and through the respective bone portions via the active / autonomous robotic system 10. A cutting path may be formed or completed by a single continuous cutting motion or advancement of the cutting tool / blade 10 directly along the respective path. A cutting path may also be formed or completed by multiple successive separate cutting motions or advancements of the cutting tool / blade 10 that extend cooperatively along the respective paths. For example, the system 20 may be programmed to execute a series of small advances or intermediate cutting paths (which may or may not be consecutive), each of which removes a small amount of bone along a given vector (i.e., a peck at the bone). The cutting tool / blade 10 may stop, move backwards, or translate between the small advances or intermediate cutting paths, but the collective bone removal of the series of small advances or intermediate cutting paths may form the respective cutting path. Thus, a cutting path as used herein is the overall path or trajectory of the bone portions removed during the cutting operation. The actual movement of the cutting tool / blade 10 that forms the cutting path may or may not extend directly along the cutting path. Thus, the cutting paths disclosed herein do not require the cutting blade 10 to move continuously along a given path or trajectory, but rather represent a generalized direction of bone removal without reference to exactly how the cutting blade 10 cuts / removes the bone tissue, but rather the end result of the overall cutting action. Also, note that the cutting paths may or may not overlap with each other.

[0060] 1, 5A, and 5B, the optimized determined, prescribed, or programmed (i.e., pre-determined, pre-defined, or pre-programmed) cutting path of the sagittal cutting blade 10 of the active / autonomous TKA surgical robotic system 10 and associated methods of the present disclosure includes an optimized programmed cutting path 175 configured to form a tibial resection at the proximal tibia, as described above. As shown in FIGS. 1 and 5A, the programmed cutting path 175 for forming the tibial resection (at the proximal tibia) is configured to avoid cutting or otherwise damaging the patient's patellar tendon, medial collateral ligament (MCL), lateral collateral ligament (LCL), and posterior cruciate ligament (PCL). As shown in FIGS. 5A and 5B, the cutting path 175 is configured to enter the joint space and engage the proximal tibia via an entry area 180 on the anterior medial bone region, with the trajectory of the cutting path 175 extending between the patient's MCL and patellar tendon.

[0061] As shown in FIG. 5B, the programmed cutting path 175 of the sagittal cutting blade 10 of the active / autonomous TKA surgical robot system 10 and associated method for forming the tibial resection (at the proximal tibia) includes a first counterclockwise trajectory (anterior to posterior) cutting path 175A that extends in an arc along the lateral bone border, and a second clockwise trajectory (anterior to posterior) cutting path 175B that extends in an arc along the medial bone border. Also as shown in FIG. 5B, in some embodiments, the programmed cutting path 175 of the sagittal cutting blade 10 for forming the tibial resection can further include one or more substantially linear and / or arcuate third cutting paths 175C that remove bone not cut via the first and second cutting paths 175A, 175B. In some embodiments, the sagittal cutting blade 10 may be translated along one or more third cutting paths 175C after being translated along the first and second cutting paths 175A, 175B.

[0062] 1, 6A and 6B, the optimized determined, prescribed or programmed cutting path 275 of the sagittal cutting blade 10 of the active / autonomous TKA surgical robotic system 10 and associated methods of the present disclosure includes an optimized programmed cutting path 275 configured to form a distal femoral resection at the distal femur, as described above. As shown in FIGS. 1 and 6A, the programmed cutting path 275 for forming the distal femoral resection (at the distal femur) is configured to avoid cutting or otherwise damaging the patient's quadriceps tendon, MCL and LCL. As shown in FIGS. 6A and 6B, the cutting path 275 is configured to enter the joint space and engage the distal femur from the anterior, with the trajectory of the cutting path 275 extending anterior to posterior therethrough.

[0063] As shown in Figure 6B, the optimized programmed cutting path 275 of the sagittal cutting blade 10 of the active / autonomous TKA surgical robot system 10 and associated method for forming a distal femoral resection (on the distal femur) includes a cutting path 275 through portions of the medial condyle 282 and the lateral condyle 284. As shown in Figure 6B, the optimized programmed cutting path 275 of the sagittal cutting blade 10 through the medial condyle 282 distal femoral resection may include a first counterclockwise trajectory (anterior to posterior) cutting path 275A through the medial side of the medial condyle 282 that arcs along the medial bone border, and a second clockwise trajectory (anterior to posterior) cutting path 275B through the lateral side of the medial condyle 282 that arcs along the lateral bone border. As shown in FIG. 6B, in some embodiments, the optimized programmed cutting path 275 of the sagittal cutting blade 10 through the medial condyle 282 can include one or more additional cutting paths 275E to remove any bone extending between the first cutting path 275A and the second cutting path 275B.

[0064] As also shown in FIG. 6B , the optimized programmed cutting path 275 of the sagittal cutting blade 10 through the lateral condyle 284 for a distal femoral resection may include a third counterclockwise trajectory (anterior to posterior) cutting path 275C through the medial side of the lateral condyle 284 that extends in an arc along the medial bone border, and a fourth generally clockwise trajectory (anterior to posterior) cutting path 275D through the lateral side of the lateral condyle 284 that extends in a straight line (or arc) along the lateral bone border.

[0065] 1, 7A and 7B, the optimized determined, prescribed or programmed cutting path of the sagittal cutting blade 10 of the active / autonomous TKA surgical robotic system 10 and associated methods of the present disclosure includes an optimized programmed cutting path 375 configured to form a posterior femoral resection in the posterior femur, as described above. As shown in FIG. 1 and FIG. 7A, the programmed cutting path 375 for forming the posterior femoral resection (in the posterior femur) is configured to avoid cutting or otherwise damaging the patient's quadriceps tendon, MCL, hamstring tendon and LCL. As shown in FIG. 7A and FIG. 7B, the cutting path 375 is configured to enter the joint space and engage the posterior femur from the distal side, with the trajectory of the cutting path 375 extending distally to proximally therethrough.

[0066] 7A and 7B, the optimized programmed cutting path 375 of the sagittal cutting blade 10 of the active / autonomous TKA surgical robot system 10 and associated method for forming a distal femoral resection (on the distal femur) includes a cutting path 375 through portions of the medial condyle 382 and the lateral condyle 384. As shown in FIG. 7B, the optimized programmed cutting path 375 of the sagittal cutting blade 10 through the medial condyle 382 for the posterior femoral resection may include a first clockwise linear trajectory (distal to proximal) cutting path 375A through the medial side of the medial condyle 382 that extends substantially linearly along the medial bone border, and a second counterclockwise linear trajectory (distal to proximal) cutting path 375B through the lateral side of the medial condyle 382 that extends substantially linearly along the lateral bone border.

[0067] As also shown in FIG. 7B , the optimized programmed cutting path 375 of the sagittal cutting blade 10 through the lateral condyle 384 for the posterior femoral resection may include a third clockwise trajectory (proximal to distal) cutting path 375C through the medial side of the lateral condyle 384 extending substantially linearly along the medial bone border, and a fourth generally counterclockwise linear trajectory (distal to proximal) cutting path 375D through the lateral side of the lateral condyle 384 extending substantially linearly along the lateral bone border.

[0068] 1, 8A and 8B, the optimized determined, prescribed or programmed cutting path of the sagittal cutting blade 10 of the disclosed active / autonomous TKA surgical robotic system 10 and associated methods includes an optimized programmed cutting path 475 configured to form a posterior chamfer resection (between the posterior femoral resection surface and the distal femoral resection surface), as described above. As shown in FIG. 1 and FIG. 8A, the programmed cutting path 475 for forming the posterior chamfer resection is configured to avoid cutting or otherwise damaging the patient's quadriceps tendon, MCL and LCL. As shown in FIG. 8A and FIG. 8B, the cutting path 475 is configured to enter the joint space and engage the medial and lateral condyles from the distal side, with the trajectory of the cutting path 475 extending distally to proximally therethrough.

[0069] 8A and 8B, the optimized programmed cutting path 475 of the sagittal cutting blade 10 of the active / autonomous TKA surgical robotic system 10 and associated method for forming the posterior chamfer resection includes a cutting path 475 through portions of the medial condyle 482 and the lateral condyle 484. As shown in FIG. 8B, the optimized programmed cutting path 475 of the sagittal cutting blade 10 through the medial condyle 482 for the posterior chamfer resection can include a first clockwise linear trajectory (distal to proximal) cutting path 475A through the medial side of the medial condyle 482 that extends substantially linearly along the medial bone boundary, and a second counterclockwise linear trajectory (distal to proximal) cutting path 475B through the lateral side of the medial condyle 482 that extends substantially linearly along the lateral bone boundary.

[0070] As also shown in FIG. 8B , the optimized programmed cutting path 475 of the sagittal cutting blade 10 through the lateral condyle 484 for the posterior chamfer resection may include a third clockwise trajectory (proximal to distal) cutting path 475C through the medial side of the lateral condyle 484 extending substantially linearly along the medial bone border, and a fourth generally counterclockwise linear trajectory (distal to proximal) cutting path 475D through the lateral side of the lateral condyle 484 extending substantially linearly along the lateral bone border.

[0071] 1, 9A, and 9B, the optimized determined, prescribed, or programmed cutting path of the sagittal cutting blade 10 of the disclosed active / autonomous TKA surgical robotic system 10 and associated methods includes an optimized programmed cutting path 575 configured to create an anterior chamfer resection (between the anterior femoral resection surface and the distal femoral resection surface), as described above. As shown in FIG. 1 and 9A, the programmed cutting path 575 for creating the anterior chamfer resection is configured to avoid cutting or otherwise damaging the patient's quadriceps tendon, MCL, and LCL. As shown in FIG. 9A and 9B, the cutting path 575 is configured to enter the joint space and engage the medial and lateral condyles from the distal side, with the trajectory of the cutting path 575 extending distally to proximally therethrough.

[0072] As shown in Figures 9A and 9B, the optimized programmed cutting path 575 of the sagittal cutting blade 10 of the active / autonomous TKA surgical robotic system 10 and associated method for creating an anterior chamfer resection includes a cutting path 575 through portions of the medial condyle 582 and the lateral condyle 584. As shown in Figure 9B, the optimized programmed cutting path 575 of the sagittal cutting blade 10 through the medial condyle 582 for the anterior chamfer resection may include a first substantially straight distal-to-proximal trajectory cutting path 575A. In some embodiments, the first cutting path 575A may be the only cut required to create an anterior chamfer resection in the medial condyle 582, although other linear / ray cutting paths may be utilized as needed.

[0073] 9B, the optimized programmed cutting path 575 of the sagittal cutting blade 10 through the lateral condyle 584 for the anterior chamfer resection may include a second substantially straight distal-to-proximal trajectory cutting path 575B. In some embodiments, the second cutting path 575A may be the only cut required to create the anterior chamfer resection in the lateral condyle 584, although other straight / ray cutting paths may be utilized as desired.

[0074] 1, 10A and 10B, the optimized determined, prescribed or programmed cutting path of the sagittal cutting blade 10 of the disclosed active / autonomous TKA surgical robotic system 10 and associated methods includes an optimized programmed cutting path 675 configured to form an anterior femoral resection through the anterior femur, as described above. As shown in FIGS. 1 and 10A, the programmed cutting path 575 for forming the anterior femoral resection is configured to avoid cutting or otherwise damaging the patient's quadriceps tendon, MCL and LCL. As shown in FIGS. 10A and 10B, the cutting path 675 is configured to enter the joint space and engage the medial and lateral condyles from the distal side, with the trajectory of the cutting path 675 extending distally to proximally therethrough.

[0075] 10A and 10B, the optimized programmed cutting path 675 of the sagittal cutting blade 10 of the active / autonomous TKA surgical robotic system 10 and associated method for creating the anterior femoral resection includes a cutting path 675 through portions of the medial condyle 682 and the lateral condyle 684. As shown in FIG. 10B, the optimized programmed cutting path 675 of the sagittal cutting blade 10 through the medial condyle 682 for the anterior femoral resection may include a first substantially straight distal-to-proximal trajectory cutting path 675A. In some embodiments, the first cutting path 675A may be the only cut required to create the anterior femoral resection at the medial condyle 682, although other straight / ray cutting paths may be utilized as desired.

[0076] As also shown in FIG. 10B , the optimized programmed cutting path 675 of the sagittal cutting blade 10 through the lateral condyle 684 for the anterior femoral resection may include a second clockwise linear (proximal to distal) trajectory cutting path 675B that extends through the medial side of the lateral condyle 684 in a substantially straight line along the medial bone border, and a third counterclockwise (proximal to distal) trajectory cutting path 675C that extends through the lateral side of the lateral condyle 684 in an arc along the lateral bone border.

[0077] It should be understood that the above description is intended to be illustrative and not limiting. For example, the exemplary embodiments and / or aspects thereof described above can be used in combination with each other. Furthermore, many modifications can be made to adapt a particular configuration in accordance with the teachings of the various examples without departing from their scope. For example, it is expressly disclosed that the order of the cutting paths can be changed and / or the resection sequence can be completed in any order.

[0078] Additionally, the specific configurations and operation of the cutting paths of the active surgical robotic systems and methods may be modified without departing from the spirit and scope of the present disclosure. For example, similar cutting paths may be utilized with other knee resections and / or with resections of bones other than the proximal tibia and distal femur without departing from the spirit and scope of the present disclosure.

[0079] The processes described herein may be performed by one or more computer systems, such as, by way of example, one or more systems that are or communicate with a robotic system, such as an articulation joint, an end effector, a controller, a camera system, a tracking system, and / or an AR system thereof. FIG. 11 illustrates an example of such a computer system and associated apparatus for incorporating and / or using aspects described herein. The computer system may also be referred to herein as a data processing device / system, a computing device / system / node, or simply a computer. The computer system may be based on one or more of a variety of system architectures and / or instruction set architectures, such as those provided by Intel Corporation (Santa Clara, Calif., USA) or ARM Holdings Public Limited (Cambridge, UK), by way of example.

[0080] FIG. 11 illustrates a computer system 700 in communication with an external device 712. The computer system 700 includes one or more processors 702, such as, for example, a central processing unit (CPU). The processor may include functional components used to execute instructions, such as functional components for fetching program instructions from a location such as a cache or main memory, decoding the program instructions, executing the program instructions, accessing memory for instruction execution, and writing results of executed instructions. The processor 702 may also include registers used by one or more of the functional components. The computer system 700 also includes memory 704, input / output (I / O) devices 708, and I / O interfaces 710, which may be coupled to the processor 702 and each other via one or more buses and / or other connections. The bus connections represent any one or more of several types of bus structures, including a memory bus or memory controller, a peripheral bus, an accelerated graphics port, and a processor or local bus using any of a variety of bus architectures. By way of example and not limitation, such architectures include Industry Standard Architecture (ISA), Micro Channel Architecture (MCA), Enhanced ISA (EISA), Video Electronics Standards Association (VESA) Local Bus, and Peripheral Component Interconnect (PCI).

[0081] Memory 704 may be or include, by way of example, a main or system memory (e.g., random access memory), a storage device such as a hard drive, flash media, or optical media, and / or a cache memory used to execute program instructions. Memory 704 may include, by way of example, a cache, such as a shared cache, which may be coupled to a local cache (e.g., an L1 cache, an L2 cache, etc.) of processor 702. Additionally, memory 704 may be or include at least one computer program product having a set of (e.g., at least one) program module, instructions, code, etc. configured to perform the functions of the embodiments described herein when executed by one or more processors.

[0082] The memory 704 can store an operating system 705 and other computer programs 706, such as one or more computer programs / applications that execute to perform aspects described herein. In particular, the programs / applications can include computer readable program instructions that can be configured to perform the functions of embodiments of the aspects described herein.

[0083] Examples of I / O devices 708 include, but are not limited to, microphones, speakers, global positioning system (GPS) devices, RGB and / or IR cameras, lights, accelerometers, gyroscopes, magnetometers, sensor devices configured to sense light, proximity, heart rate, body and / or ambient temperature, blood pressure, and / or skin resistance, registration probes, and activity monitors. As shown, the I / O devices may be incorporated into the computer system, although in some embodiments the I / O devices may be considered external devices (212) coupled to the computer system via one or more I / O interfaces 710.

[0084] The computer system 700 may communicate with one or more external devices 712 through one or more I / O interfaces 710. Exemplary external devices include a keyboard, a pointing device, a display, and / or any other device that allows a user to interact with the computer system 700. Other exemplary external devices include any device that allows the computer system 700 to communicate with one or more other computing systems or peripheral devices, such as a printer. A network interface / adapter is an exemplary I / O interface that allows the computer system 700 to communicate with one or more networks, such as a local area network (LAN), a general wide area network (WAN), and / or a public network (e.g., the Internet), providing communication with other computing devices or systems, storage devices, and the like. Ethernet-based (such as Wi-Fi) interfaces and Bluetooth® adapters are just examples of currently available types of network adapters for use in computer systems (BLUETOOTH is a registered trademark of Bluetooth SIG, Inc., Kirkland, Washington, USA).

[0085] Communications between the I / O interface 710 and the external device 712 may occur via a wired and / or wireless communication link 711, such as an Ethernet-based wired or wireless connection. Exemplary wireless connections include cellular, Wi-Fi, Bluetooth, proximity-based, near-field, or other types of wireless connections. More generally, the communications link 711 may be any suitable wireless and / or wired communications link for communicating data.

[0086] A particular external device 712 may include one or more data storage devices capable of storing one or more programs, one or more computer readable program instructions, and / or data, etc. The computer system 700 may include and / or be coupled to and in communication with removable / non-removable, volatile / non-volatile computer system storage media (e.g., as a computer system external device). For example, this may include and / or be coupled to non-removable non-volatile magnetic media (typically referred to as a "hard drive"), a magnetic disk drive for reading and writing removable non-volatile magnetic disks (e.g., a "floppy disk"), and / or an optical disk drive for reading and writing removable non-volatile optical disks, such as CD-ROMs, DVD-ROMs, or other optical media.

[0087] Computer system 700 can operate with numerous other general purpose or special purpose computing system environments or configurations. Computer system 700 can take any of a variety of forms, well-known examples of which include, but are not limited to, personal computer (PC) systems, server computer systems such as messaging servers, thin clients, thick clients, workstations, laptops, handheld devices, mobile devices / computers such as smartphones, tablets, and wearable devices, multiprocessor systems, microprocessor-based systems, telephony equipment, network equipment (such as edge equipment), virtualization devices, storage controllers, set-top boxes, programmable consumer electronics, network PCs, minicomputer systems, mainframe computer systems, distributed cloud computing environments that include any of the above systems or devices, and the like.

[0088] Various input devices may be provided, such as a camera that may be used to capture images or video. The camera may be used by the device to obtain an image / video of the material being cut and / or a view of the cutting tool, e.g., to capture an image / video of the scene.

[0089] One or more microphones, proximity sensors, light sensors, accelerometers, speakers, GPS devices, and / or other input devices (unnumbered) may additionally be provided. Electronic components such as a processor, memory, and / or electronic circuitry including a communication device such as cellular, short-range wireless (e.g., Bluetooth), or Wi-Fi circuitry for connecting to remote devices may be included. A power source such as a battery that provides power to the components of the system may also be incorporated. A physical port (not shown) used to connect the device to a computer power source (to recharge the battery) and / or any other external device such as a controller. Such physical ports may be of any standardized or proprietary type, such as a Universal Serial Bus (USB).

[0090] Aspects of the present invention may be systems, methods, and / or computer program products, any of which may be configured to perform or facilitate the aspects described herein.

[0091] In some embodiments, aspects of the invention may take the form of a computer program product that may be embodied as a computer readable medium. The computer readable medium may be a tangible storage device / medium having computer readable program code / instructions stored thereon. Exemplary computer readable media include, but are not limited to, electronic, magnetic, optical, or semiconductor storage devices or systems, or any combination thereof. Exemplary embodiments of computer readable media include hard drives or other mass storage devices, electrical connections with wires, random access memory (RAM), read only memory (ROM), erasable programmable read only memory such as EPROM or flash memory, optical fiber, portable computer disks / diskettes such as compact disk read only memory (CD-ROM) or digital versatile disk (DVD), optical storage device, magnetic storage device, or any combination thereof. The computer readable medium may be readable by a processor, processing unit, or the like to retrieve data (e.g., instructions) from the medium for execution. In certain examples, the computer program product is or includes one or more computer readable media that contain / store computer readable program code for providing and facilitating one or more aspects described herein.

[0092] As discussed above, program instructions contained or stored on a computer-readable medium may be retrieved and executed by any of a variety of suitable components, such as a processor of a computer system, to cause the computer system to operate and function in a particular manner. Such program instructions for performing operations to implement, achieve, or facilitate aspects described herein may be written in any desired programming language, or compiled from written code. In some embodiments, such programming languages ​​include object-oriented and / or procedural programming languages, such as C, C++, C#, Java, and the like.

[0093] Program code may include one or more program instructions obtained for execution by one or more processors. The computer program instructions may be provided to one or more processors of, for example, one or more computer systems to produce a machine, which when executed by the one or more processors performs, achieves, or facilitates aspects of the invention, such as the operations or functions depicted in the flowcharts and / or block diagrams described herein. Thus, each block or combination of blocks in the flowchart illustrations and / or block diagrams depicted and described herein may, in some embodiments, be implemented by computer program instructions.

[0094] Many other examples will be apparent to those of skill in the art upon reviewing the above description, and therefore, the scope of the various examples should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.

[0095] While dimensions and types of materials may be described herein, they are intended to define some parameters of the various examples, and they are by no means limiting to all examples, but are merely illustrative.

[0096] In the appended claims, the terms "including" and "in which" are used as the plain English equivalents of the terms "comprising" and "wherein," respectively. Moreover, in the following claims, terms such as "first," "second," and "third" are used merely as guarantee labels and are not intended to impose numerical, structural, or other requirements on their objects.

[0097] The form of the term "based on" in this specification encompasses relationships in which an element is partially based and relationships in which an element is completely based. The form of the term "defined" encompasses relationships in which an element is partially defined and relationships in which an element is completely defined. Furthermore, the limitations of the following claims are not written in means-plus-function form and are not intended to be interpreted under the sixth paragraph of 35 U.S.C. 112 unless and until such limitations of claims expressly use the phrase "means for" followed by a description of the functional cavity of further structure. It should be understood that not all such objects or advantages set forth above may necessarily be achieved in accordance with any particular example. Thus, for example, one skilled in the art will recognize that the devices, systems, and methods described herein may be implemented or performed in a manner that achieves or optimizes one advantage or advantages as taught herein without necessarily achieving other objects or advantages as may be taught or suggested herein.

[0098] Although the present disclosure has been described in detail in connection with only a limited number of examples, it should be readily understood that the present disclosure is not limited to such disclosed examples. Rather, the present disclosure can be modified to incorporate any number of variations, alterations, substitutions, or equivalent arrangements not previously described, but which are commensurate with the spirit and scope of the present disclosure. Furthermore, while various examples have been described, it should be understood that aspects of the present disclosure may include only one or some of the described examples. Also, while some disclosures are described as having a specific number of elements, it should be understood that the examples can be practiced with fewer or more than the specified number of elements.

[0099] It is to be understood that all combinations of the foregoing and additional concepts described in more detail below (unless such concepts are mutually inconsistent) are considered to be part of the inventive subject matter disclosed herein, and in particular, all combinations of claimed subject matter appearing at the end of this disclosure are considered to be part of the inventive subject matter disclosed herein.

Claims

1. 1. An active robotic system, comprising: an articulating arm comprising a plurality of arm segments defining a longitudinal axis and an adjustable joint coupled between adjacent arm segments and configured to adjust an orientation of the axis of the adjacent arm segments; a sagittal cutting blade defining a cutting edge configured to cut while oscillating along an oscillation path extending in a plane defined by the blade; an end effector coupled to an end arm segment of the plurality of arm segments and to the sagittal cutting blade, the end effector including a powered drive for oscillating the sagittal cutting blade along the oscillation path; The robotic system is configured to autonomously adjust the relative orientation of the arm segments of the articulating arm while the sagittal cutting blade oscillates along a plurality of optimized, programmed cutting paths to autonomously spatially translate the cutting edge of the sagittal cutting blade along the cutting paths to perform resection of a portion of a patient's proximal tibia and / or distal femur via the sagittal cutting blade and facilitate implantation of respective femoral and tibial components of a total knee arthroplasty therein.

2. 2. The robotic system of claim 1, wherein the plurality of optimized programmed cutting paths comprises a first series of cutting paths configured to create a tibial resection on the proximal tibia while preventing damage to the patient's patellar tendon, medial collateral ligament (MCL), lateral collateral ligament (LCL), and posterior cruciate ligament (PCL).

3. 3. The robotic system of claim 2, wherein the first series of cutting paths is configured to enter the joint space between the patient's proximal tibia and the distal femur via an entry region on an anteromedial bone region, and the trajectory of the cutting path of the first series of cutting paths extends between the patient's MCL and patellar tendon.

4. 4. The robotic system of claim 3, wherein the first series of cutting paths includes a first counterclockwise anterior-to-posterior orbital cutting path that extends in an arc along a lateral bony border of the proximal tibia and a second anterior-to-posterior clockwise orbital cutting path that extends in an arc along a medial bony border of the proximal tibia.

5. 5. The robotic system of claim 4, wherein the first series of cutting paths further includes at least one third cutting path extending between the first and second cutting paths of the first series of cutting paths to remove a portion of the proximal tibia extending between the first and second cutting paths to form the tibial resection.

6. 6. The robotic system of claim 5, wherein the plurality of optimized programmed cutting paths includes a second series of cutting paths configured to create distal femoral resections at the medial and lateral condyles of the distal femur while preventing damage to the patient's quadriceps tendon, MCL, hamstrings tendon, and LCL.

7. 7. The robotic system of claim 6, wherein the second series of cutting paths is configured to enter the joint space between the patient's proximal tibia and the distal femur via an anterior entry area of ​​the posterior femur, and the trajectory of the cutting paths of the second series of cutting paths extends through the cutting paths from anterior to posterior.

8. 8. The robotic system of claim 7, wherein the second series of cutting paths includes a first partial series of cutting paths extending through a portion of the medial condyle of the distal femur, the first partial series of cutting paths including a first counterclockwise anterior-to-posterior orbital cutting path through a medial side of the medial condyle that extends in an arc along a medial bony border of the distal femur and a second clockwise anterior-to-posterior orbital cutting path through a lateral side of the medial condyle that extends in an arc along a lateral bony border of the distal femur.

9. 9. The robotic system of claim 8, wherein the first partial series of cutting paths further includes at least one third cutting path trajectory extending anterior to posterior and between the first and second cutting paths of the first partial series of cutting paths to remove a portion of the distal femur extending between the first and second cutting paths to form a distal femoral resection at a medial condyle.

10. 10. The robotic system of claim 9, wherein the second series of cutting paths includes a second partial series of cutting paths extending through a portion of the lateral condyle of the distal femur, the second partial series of cutting paths including a third counterclockwise anterior-to-posterior orbital cutting path through a medial side of the lateral condyle of the distal femur that extends in an arc along a medial bony border of the distal femur, and a fourth generally clockwise anterior-to-posterior orbital cutting path through a lateral side of the lateral condyle of the distal femur that extends along a lateral bony border of the distal femur.

11. 11. The robotic system of claim 10, wherein the plurality of optimized programmed cutting paths includes a third series of cutting paths configured to create posterior femoral resections at the medial and lateral condyles of the posterior femur while avoiding damage to the patient's quadriceps tendon, MCL, hamstrings tendon, and LCL.

12. 12. The robotic system of claim 11, wherein the third series of cutting paths are configured to enter the joint space between the patient's proximal tibia and the distal femur via a distal entry region of the posterior femur, and the trajectory of the cutting paths of the third series of cutting paths extends through the cutting paths in a distal to proximal direction.

13. 13. The robotic system of claim 12, wherein the third series of cutting paths includes a third partial series of cutting paths extending through a portion of the medial condyle of the posterior femur, the third partial series of cutting paths including a first clockwise, distal-to-proximal substantially linear trajectory cutting path through a medial side of the medial condyle extending substantially linearly along a medial bone boundary of the posterior femur, and a second counterclockwise, distal-to-proximal substantially linear trajectory cutting path through a lateral side of the medial condyle extending substantially linearly along a lateral bone boundary of the posterior femur.

14. 14. The robotic system of claim 13, wherein the third series of cutting paths includes a fourth partial series of cutting paths extending through a portion of the lateral condyle of the posterior femur, the fourth partial series of cutting paths including a third clockwise proximal-to-distal trajectory cutting path through a medial side of the lateral condyle of the posterior femur extending substantially linearly along a medial bone border of the posterior femur and a fourth generally counterclockwise distal-to-proximal substantially linear trajectory cutting path through a lateral side of the lateral condyle of the posterior femur extending substantially linearly along a lateral bone border of the posterior femur.

15. 15. The robotic system of claim 14, wherein the plurality of optimized programmed cutting paths includes a fourth series of cutting paths configured to create posterior chamfer resections on the medial and lateral condyles of the femur extending between the posterior-distal femur while preventing damage to the patient's quadriceps tendon, MCL, and LCL.

16. 16. The robotic system of claim 15, wherein the fourth series of cutting paths are configured to enter the joint space between the patient's proximal tibia and the distal femur via a distal entry region of the posterior-distal femur, and the trajectory of the cutting path of the fourth series of cutting paths extends through the cutting path in a distal to proximal direction.

17. 17. The robotic system of claim 16, wherein the fourth series of cutting paths includes a fifth partial series of cutting paths extending through a portion of the medial condyle of the posterior-distal femur, the fifth partial series of cutting paths including a first clockwise, distal-to-proximal substantially linear trajectory cutting path through a medial side of the medial condyle extending substantially linearly along a medial bone boundary of the posterior-distal femur, and a second counterclockwise, distal-to-proximal substantially linear trajectory cutting path through a lateral side of the medial condyle extending substantially linearly along a lateral bone boundary of the posterior-distal femur.

18. 18. The robotic system of claim 17, wherein the fourth series of cutting paths includes a sixth series of cutting paths extending through a portion of the lateral condyle of the posterior-distal femur, and the fourth partial series of cutting paths includes a third clockwise proximal-to-distal trajectory cutting path through a medial side of the lateral condyle of the posterior-distal femur extending substantially linearly along a medial bone boundary of the posterior-distal femur, and a fourth generally counterclockwise distal-to-proximal substantially linear trajectory cutting path through a lateral side of the lateral condyle of the posterior-distal femur extending substantially linearly along a lateral bone boundary of the posterior-distal femur.

19. 20. The robotic system of claim 18, wherein the plurality of optimized programmed cutting paths includes a fifth series of cutting paths configured to create anterior cut resections on the medial and lateral condyles of the femur extending between the anterior-distal femur while preventing damage to the patient's quadriceps tendon, MCL, and LCL.

20. 20. The robotic system of claim 19, wherein the fifth series of cutting paths are configured to enter the joint space between the patient's proximal tibia and the distal femur via a distal entry region of the anterior-distal femur, and the trajectory of the cutting path of the fifth series of cutting paths extends through the cutting path in a distal to proximal direction.

21. 21. The robotic system of claim 20, wherein the fifth series of cutting paths includes a seventh partial series of cutting paths extending through a portion of the medial condyle of the anterior-distal femur, the seventh partial series of cutting paths including a first distal-to-proximal substantially linear trajectory cutting path through the medial condyle.

22. 22. The robotic system of claim 21, wherein the fifth series of cutting paths includes an eighth partial series of cutting paths extending through a portion of the lateral condyle of the distal anterior femur, the eighth partial series of cutting paths including a second distal-to-proximal substantially linear trajectory cutting path through the lateral condyle.

23. 23. The robotic system of claim 22, wherein the plurality of optimized programmed cutting paths includes a sixth series of cutting paths configured to create anterior femoral resections at the medial and lateral condyles of the anterior femur while avoiding damage to the patient's quadriceps tendon, MCL, hamstrings tendon, and LCL.

24. 24. The robotic system of claim 23, wherein the sixth series of cutting paths are configured to enter the joint space between the patient's proximal tibia and the distal femur via a distal entry region of the anterior femur, and the trajectory of the cutting paths of the sixth series of cutting paths extends through the cutting paths in a distal to proximal direction.

25. 25. The robotic system of claim 24, wherein the sixth series of cutting paths includes a ninth partial series of cutting paths extending through a portion of the medial condyle of the anterior femur, the ninth partial series of cutting paths including a first substantially straight distal-to-proximal trajectory cutting path through the medial condyle.

26. 26. The robotic system of claim 25, wherein the sixth series of cutting paths includes a tenth partial series of cutting paths extending through a portion of the lateral condyle of the anterior femur, the tenth partial series of cutting paths including a second clockwise substantially linear distal-to-proximal trajectory cutting path through the medial side of the lateral condyle extending substantially linearly along a medial bony border of the anterior femur, and a third counterclockwise proximal-to-distal trajectory cutting path through the lateral side of the lateral condyle extending in an arc along a lateral bony border of the anterior femur.

27. The plurality of optimized programmed cutting paths includes at least two successive cuts, the cuts comprising: a first series of cutting paths configured to create a tibial resection in the proximal tibia while avoiding damage to the patient's patellar tendon, medial collateral ligament (MCL), lateral collateral ligament (LCL), and posterior cruciate ligament (PCL); a second series of cutting paths configured to create distal femoral resections at the medial and lateral condyles of the distal femur while avoiding damage to the patient's quadriceps tendon, MCL, hamstrings tendon, and LCL; a third series of cutting paths configured to create posterior femoral resections at the medial and lateral condyles of the posterior femur while avoiding damage to the patient's quadriceps tendon, MCL, hamstrings tendon, and LCL; a fourth series of cutting paths configured to create posterior chamfer resections on the medial and lateral condyles of the femur extending between the posterior-distal femur while preventing damage to the patient's quadriceps tendon, MCL, and LCL; a fifth series of cutting paths configured to create anterior cut resections on the medial and lateral condyles of the femur extending between the anterior-distal femur while preventing damage to the patient's quadriceps tendon, MCL, and LCL; and a sixth series of cutting paths configured to create anterior femoral resections on the medial and lateral condyles of the anterior femur while avoiding damage to the patient's quadriceps tendon, MCL, hamstrings tendon, and LCL.

28. 28. The robotic system of claim 27, wherein the plurality of optimized programmed cutting paths includes at least three sequences of cuts including the first, second, third, fourth, fifth and sixth sequences of cut paths.

29. 28. The robotic system of claim 27, wherein the plurality of optimized programmed cutting paths includes at least four sequences of cuts including the first, second, third, fourth, fifth and sixth sequences of cut paths.

30. 28. The robotic system of claim 27, wherein the plurality of optimized programmed cutting paths includes at least five sequences of cuts including the first, second, third, fourth, fifth and sixth sequences of cut paths.

31. 28. The robotic system of claim 27, wherein the plurality of optimized programmed cutting paths includes each of the first, second, third, fourth, fifth and sixth series of cutting paths.

32. 2. The robotic system of claim 1, wherein the plurality of optimized programmed cutting paths includes a second series of cutting paths configured to create distal femoral resections at the medial and lateral condyles of the distal femur while preventing damage to the patient's quadriceps tendon, MCL, hamstrings tendon, and LCL.

33. 33. The robotic system of claim 32, wherein the second series of cutting paths is configured to enter the joint space between the patient's proximal tibia and the distal femur via an anterior entry region of the posterior femur, and the trajectory of the cutting paths of the second series of cutting paths extends through the cutting paths from anterior to posterior.

34. 33. The robotic system of claim 32, wherein the second series of cutting paths includes a first partial series of cutting paths extending through a portion of the medial condyle of the distal femur, the first partial series of cutting paths including a first counterclockwise anterior-to-posterior orbital cutting path through a medial side of the medial condyle that extends in an arc along a medial bony border of the distal femur and a second clockwise anterior-to-posterior orbital cutting path through a lateral side of the medial condyle that extends in an arc along a lateral bony border of the distal femur.

35. 35. The robotic system of claim 34, wherein the first partial series of cutting paths further includes at least one third cutting path trajectory extending anterior to posterior and between the first and second cutting paths of the first partial cutting path to remove a portion of the distal femur extending between the first and second cutting paths to form a distal femoral resection at a medial condyle.

36. 33. The robotic system of claim 32, wherein the second series of cutting paths includes a second partial series of cutting paths extending through a portion of the lateral condyle of the distal femur, the second partial series of cutting paths including a third counterclockwise anterior-to-posterior orbital cutting path through a medial side of the lateral condyle of the distal femur that extends in an arc along a medial bony border of the distal femur, and a fourth generally clockwise anterior-to-posterior orbital cutting path through a lateral side of the lateral condyle of the distal femur that extends along a lateral bony border of the distal femur.

37. 2. The robotic system of claim 1, wherein the plurality of optimized programmed cutting paths includes a third series of cutting paths configured to create posterior femoral resections at the medial and lateral condyles of the posterior femur while preventing damage to the patient's quadriceps tendon, MCL, hamstrings tendon, and LCL.

38. 38. The robotic system of claim 37, wherein the third series of cutting paths are configured to enter the joint space between the patient's proximal tibia and the distal femur via a distal entry region of the posterior femur, and the trajectory of the cutting paths of the third series of cutting paths extends through the cutting paths in a distal to proximal direction.

39. 38. The robotic system of claim 37, wherein the third series of cutting paths includes a third partial series of cutting paths extending through a portion of the medial condyle of the posterior femur, the third partial series of cutting paths including a first clockwise, distal-to-proximal substantially linear trajectory cutting path through a medial side of the medial condyle extending substantially linearly along a medial bone boundary of the posterior femur, and a second counterclockwise, distal-to-proximal substantially linear trajectory cutting path through a lateral side of the medial condyle extending substantially linearly along a lateral bone boundary of the posterior femur.

40. 38. The robotic system of claim 37, wherein the third series of cutting paths includes a fourth partial series of cutting paths extending through a portion of the lateral condyle of the posterior femur, the fourth partial series of cutting paths including a third clockwise proximal-to-distal trajectory cutting path through a medial side of the lateral condyle of the posterior femur extending substantially linearly along a medial bone border of the posterior femur, and a fourth generally counterclockwise distal-to-proximal substantially linear trajectory cutting path through a lateral side of the lateral condyle of the posterior femur extending substantially linearly along a lateral bone border of the posterior femur.

41. 2. The robotic system of claim 1, wherein the plurality of optimized programmed cutting paths includes a fourth series of cutting paths configured to create posterior chamfer resections on the medial and lateral condyles of the femur extending between the posterior-distal femur while preventing damage to the patient's quadriceps tendon, MCL, and LCL.

42. 42. The robotic system of claim 41, wherein the fourth series of cutting paths are configured to enter the joint space between the patient's proximal tibia and the distal femur via a distal entry region of the posterior-distal femur, and the trajectory of the cutting path of the fourth series of cutting paths extends through the cutting path in a distal to proximal direction.

43. 42. The robotic system of claim 41, wherein the fourth series of cutting paths includes a fifth partial series of cutting paths extending through a portion of the medial condyle of the posterior-distal femur, the fifth partial series of cutting paths including a first clockwise, distal-to-proximal substantially linear trajectory cutting path through a medial side of the medial condyle extending substantially linearly along a medial bone boundary of the posterior-distal femur, and a second counterclockwise, distal-to-proximal substantially linear trajectory cutting path through a lateral side of the medial condyle extending substantially linearly along a lateral bone boundary of the posterior-distal femur.

44. 42. The robotic system of claim 41, wherein the fourth series of cutting paths includes a sixth series of cutting paths extending through a portion of the lateral condyle of the posterior-distal femur, and the fourth partial series of cutting paths includes a third clockwise proximal-to-distal trajectory cutting path through a medial side of the lateral condyle of the posterior-distal femur extending substantially linearly along a medial bone boundary of the posterior-distal femur, and a fourth generally counterclockwise distal-to-proximal substantially linear trajectory cutting path through a lateral side of the lateral condyle of the posterior-distal femur extending substantially linearly along a lateral bone boundary of the posterior-distal femur.

45. 2. The robotic system of claim 1, wherein the plurality of optimized programmed cutting paths includes a fifth series of cutting paths configured to create anterior cut resections on the medial and lateral condyles of the femur extending between the anterior-distal femur while preventing damage to the patient's quadriceps tendon, MCL, and LCL.

46. 46. ​​The robotic system of claim 45, wherein the fifth series of cutting paths are configured to enter the joint space between the patient's proximal tibia and the distal femur via a distal entry region of the anterior-distal femur, and the trajectory of the cutting path of the fifth series of cutting paths extends through the cutting path in a distal to proximal direction.

47. 46. ​​The robotic system of claim 45, wherein the fifth series of cutting paths includes a seventh partial series of cutting paths extending through a portion of the medial condyle of the anterior-distal femur, the seventh partial series of cutting paths including a first distal-to-proximal substantially linear trajectory cutting path through the medial condyle.

48. 46. ​​The robotic system of any of claims 45, wherein the fifth series of cutting paths includes an eighth partial series of cutting paths extending through a portion of the lateral condyle of the distal anterior femur, the eighth partial series of cutting paths including a second distal-to-proximal substantially linear trajectory cutting path through the lateral condyle.

49. 2. The robotic system of claim 1, wherein the plurality of optimized programmed cutting paths includes a sixth series of cutting paths configured to create anterior femoral resections at the medial and lateral condyles of the anterior femur while avoiding damage to the patient's quadriceps tendon, MCL, hamstrings tendon, and LCL.

50. 50. The robotic system of claim 49, wherein the sixth series of cutting paths are configured to enter the joint space between the patient's proximal tibia and distal femur via a distal entry region of the anterior femur, and the trajectory of the cutting paths of the sixth series of cutting paths extends through the cutting paths in a distal to proximal direction.

51. 50. The robotic system of claim 49, wherein the sixth series of cutting paths includes a ninth partial series of cutting paths extending through a portion of the medial condyle of the anterior femur, the ninth partial series of cutting paths including a first substantially straight distal-to-proximal trajectory cutting path through the medial condyle.

52. 50. The robotic system of claim 49, wherein the sixth series of cutting paths includes a tenth partial series of cutting paths extending through a portion of the lateral condyle of the anterior femur, the tenth partial series of cutting paths including a second clockwise substantially linear distal-to-proximal trajectory cutting path through the medial side of the lateral condyle extending substantially linearly along a medial bony border of the anterior femur, and a third counterclockwise proximal-to-distal trajectory cutting path through the lateral side of the lateral condyle extending in an arc along a lateral bony border of the anterior femur.

53. The robotic system of claim 1 , wherein the plurality of optimized programmed cutting paths are programmed into a memory of the robotic system.

54. 54. The robotic system of claim 53, wherein the robotic system is configured to autonomously execute the plurality of optimized programmed cutting paths via the sagittal cutting blade without a user physically guiding the sagittal cutting blade.

55. The robotic system of claim 1 , wherein the robotic system is configured to continuously and autonomously spatially translate the cutting edge of the sagittal cutting blade along each cutting path.

56. 10. The robotic system of claim 1, wherein the robotic system is configured to autonomously spatially translate the cutting edge of the sagittal cutting blade along a series of distinct paths that collectively extend along a respective cutting path.

57. resecting a portion of the patient's proximal tibia and / or distal femur; A method for facilitating implantation of femoral and tibial components of a total knee arthroplasty, comprising:

57. A method comprising utilizing a robotic system as described in any one of claims 1 to 56 to autonomously execute at least some of the plurality of optimized programmed cutting paths to autonomously resect at least a portion of the proximal tibia and / or distal femur.

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