Systems and methods for bone preparation for orthopedic surgery

Abstract

Devices, systems, and related methods for implant-specific preparation of bone surfaces comprise obtaining implant surface mapping parameters associated with an implant selected for installation in a patient. Bone preparation during a surgical procedure is based at least in part on the implant surface mapping parameters. The implant surface mapping parameters may be incorporated into a surgical plan associated with a navigation system and may be used to control a robotic surgical guide.

Description

SYSTEMS AND METHODS FOR BONE PREPARATION FOR ORTHOPEDIC SURGERYBACKGROUND

[0001] Orthopedic surgeries often involve the installation of implants that function as replacement joint surfaces. Total and partial knee, shoulder, and hip replacements are widely performed examples. In many of these procedures, the implants are intended to fit closely with a patient’s surgically prepared bone surfaces and will be cemented to or fuse without cement to these bone surfaces. Well matched contours between the bone facing surfaces of the implants and implant facing surfaces of the bone are important for fostering the success of these procedures.

[0002] It should be noted that this Background is not intended to be an aid in determining the scope of the claimed subject matter nor be viewed as limiting the claimed subject matter to implementations that solve any or all of the disadvantages or problems presented above. The discussion of any technology, documents, or references in this Background section should not be interpreted as an admission that the material described is prior art to any of the subject matter claimed herein.SUMMARY

[0003] In one embodiment, a method of implant specific preparation of bone for orthopedic surgery comprises obtaining implant surface mapping parameters of bonemating surfaces of a specific implant selected to be implanted onto the bone, and performing a bone preparation based at least in part on the obtained implant surface mapping parameters. In various embodiments, the implant surface mapping parameters may be obtained utilizing non-contact sensors (e.g. a camera) to determine one or more of the implant surface mapping parameters, from a code associated with the implant provided by the implant manufacturer, or from positioning a stylus associated with a navigation system on one or more locations on the implant. In some embodiments, the method comprises controlling a surgical robot to perform the bone preparation by resecting portions of the bone based at least in part on the implant surface mapping parameters. A surgical plan may be generated and / or updated based at least in part on the implant surface mapping parameters. The implant surface mapping parameters may comprise one or more distances between one or more surface features of the implant and / or one or more angles between one or more surface features of the implant.

[0004] In another embodiment, a system for orthopedic surgery comprises a surgical robot, a controller coupled to the surgical robot, and a computer assisted surgery system comprising a memory having stored therein implant surface mapping parameters of bonemating surfaces of a specific implant selected to be implanted onto the bone. In this embodiment, the computer assisted surgery system may comprise a surgical plan associated with a surgical planning system, and wherein the computer assisted surgery system is configured to cause the surgical robot to assist the performance of implantspecific resections to a bone.

[0005] In another embodiment, a method of providing an implant for orthopedic surgery comprises measuring physical characteristics of bone mating surfaces of the implant to define one or more implant surface mapping parameters for the implant, associating the implant surface mapping parameters with the implant or the packaging thereof, and delivering the implant to a health care facility for installation in a patient.

[0006] In another embodiment, a surgical kit comprises one or more implants and information associated with implant surface mapping parameters for at least one of the one or more implants.

[0007] In another embodiment, a method of performing a plurality of bone resections in an orthopedic surgery comprises performing one or more resections of a set of resections associated with a surgical plan for the orthopedic surgery, measuring a location and / or orientation of at least one of the one or more performed resections with respect to patient anatomy, and performing one or more additional resections of the set of resections based at least in part on the measured locations and / or orientations. In some embodiments, the method may comprise updating a surgical plan by changing a planned location and / or orientation of at least one of the additional resections of the set of resections. The updated surgical plan may in some embodiments be based at least in part on implant specific surface mapping parameters.

[0008] It is understood that various configurations of the subject technology will become apparent to those skilled in the art from the disclosure, wherein various configurations of the subject technology are shown and described by way of illustration. As will be realized, the subject technology is capable of other and different configurations and its several details are capable of modification in various other respects, all without departing from the scopeof the subject technology. Accordingly, the summary, drawings and detailed description are to be regarded as illustrative in nature and not as restrictive.BRIEF DESCRIPTION OF THE DRAWINGS

[0009] Various embodiments are discussed in detail in conjunction with the Figures described below, with an emphasis on highlighting the advantageous features. These embodiments are for illustrative purposes only and any scale that may be illustrated therein does not limit the scope of the technology disclosed. These drawings include the following figures, in which like numerals indicate like parts.

[0010] FIG. 1 A illustrates a prepared femur and a femoral implant prior to being installed on the femur during a TKA procedure;

[0011] FIG. 1 B is a side view of a femur illustrating a set of five resections that may be performed in a TKA procedure;

[0012] FIG. 2A illustrates a perspective view of a femoral implant, in accordance with some example embodiments;

[0013] FIG. 2B illustrates a side view of the implant of FIG. 2A;

[0014] FIG. 3 is a block diagram of a computer assisted surgery system for performing orthopedic surgeries including implant specific bone preparation in accordance with some embodiments;

[0015] FIG. 4 illustrates a bone mounted cut guide robot that may be used in the system of FIG. 3 controlled in accordance with implant specific surface mapping parameters;

[0016] FIG. 5 is a flow diagram of a process for implant-specific preparation of bone in that may be performed by the system of FIG. 3;

[0017] FIG. 6A is the side view of FIG. 2B with contour lines along the bone engagement surfaces of the implant;

[0018] FIG. 6B illustrates exemplary physical relationships between the bone engagement surfaces of the implant;

[0019] FIG. 7 illustrates a package for an implant containing encoded surface mapping parameters thereon;

[0020] FIG. 8 illustrates a first method of intraoperative determination of implant surface mapping parameters;

[0021] FIG. 9 illustrates a second method of intraoperative determination of implant surface mapping parameters;

[0022] FIGs. 10A, 10B, 10C, and 10D illustrate resection deviations from a surgical plan and measurements thereof;;

[0023] FIG. 1 1 is a flow diagram of a method of compensating for the resection deviations illustrated in FIGs. 10B and 10D.DETAILED DESCRIPTION

[0024] The following description and examples illustrate some exemplary implementations, embodiments, and arrangements of the disclosed invention in detail. Those of skill in the art will recognize that there are numerous variations and modifications of this invention that are encompassed by its scope. Accordingly, the description of a certain example embodiment should not be deemed to limit the scope of the present invention. Implementations of the technology described herein are directed generally to improved devices, systems and methods of implant-specific machining and preparation of femoral resections utilizing robotic systems for orthopedic surgery.

[0025] In many orthopedic procedures, routinely achieving accurate, intimate mating between bone interfaces and implants can be challenging because both the inherent implant manufacturing tolerances of the internal geometry of the bone-interfacing planes of an implant can contribute to errors to the actual bone-implant mating. For example, in a total knee arthroplasty (TKA) procedure, several cuts are performed to configure the end of the femur for attachment of an implant. In press-fit TKA, biologic ingrowth is expected between the implant and bone interfaces during approximately the first six months after surgery. This requires highly accurate, intimate bone resections that mate with femoral and tibial implants at the time of implantation.

[0026] Novel systems and methods to address the above-described problem(s), as described below, may be implemented intraoperatively or preoperatively, in either press-fit or cemented preparation scenarios. In some cases, such systems and methods may comprise or utilize a robotic positioning & resection system to resect surfaces of a patient’s bone relative to actual mating surface planes of an implant to ensure an optimized fit. By obtaining, capturing or determining actual relative orientations of each of the actual mating surface planes of a specific individual implant, errors that would otherwise be caused by the above-described inherent implant manufacturing tolerances of the internal geometry of the implant bone-interfacing planes may be eliminated.

[0027] Discussion now turns to embodiments of implant specific machining and / or preparation of bone resections utilizing a distributable robotic system for orthopedic surgery. Such embodiments desirably reduce or eliminate bone-implant mating errors caused by inherent implant manufacturing tolerances of implants.

[0028] Although the below described systems and methods are applicable to a wide variety of orthopedic surgeries, a femoral implant for TKA procedure will be described in detail herein. Referring now to FIGs. 1A and 1 B, in this example, a femur 10 is fitted with an implant 18 on an end thereof. In many such procedures, the end of the femur is prepared with five resected surfaces, labeled 12, 13, 14, 15, and 16 in FIGs. 1A and 1 B. The implant 18 has inner faces which are generally aligned with these five prepared femoral bone surfaces. The implant 18 with these five inner faces is illustrated in more detail in FIGs. 4A through 4D.

[0029] FIG. 1 B is a side view showing example TKA resections. The TKA resections may include an anterior resection 12, a distal resection 14, and a posterior resection 16. Connecting these resections may be an anterior chamfer resection 13, and a posterior chamfer resection 15.

[0030] FIG. 2A is a perspective view showing bone-mating surfaces of an implant 18, in accordance with some example embodiments. FIG. 2B is a side view of implant 18. Implant 18 comprises a tibia-facing, arcuate surface and a plurality of bone-mating surfaces 22, 23, 24, 25, and 26. For example, implant 18 comprises a distal bone-mating plane surface 24, an anterior bone-mating plane surface 22, a posterior bone-mating plane surface 26, a distal-anterior chamfered bone-mating plane surface 23, and a distal-posterior chamfered bone-mating plane surface 25. These plane surfaces are intended to mate with and be affixed to the distal resection 14, anterior resection 12, posterior resection 16, anterior chamfer resection 13, and posterior resection 15 illustrated in FIGs. 1 A and 1 B respectively.

[0031] As discussed above, implant 18 is illustrated as a femoral implant for a TKA procedure. However, the present disclosure is not so limited and implants are also contemplated for any other bone or joint such as shoulders, hips, ankles, etc.

[0032] Usually, when performing a TKA, a surgeon has a variety of implants of different sizes to choose from during the surgical procedure and will make the femoral resections in accordance with the nominal dimensions of the implant size to be used. However, implants of the same nominal size can differ in the distances between corners and face angles dueto manufacturing tolerances. It is one aspect of the systems and methods described herein that surface mapping parameters for an individual specific implant of a particular size and selected for implantation in a given surgery are obtained and used in planning and performing the bone preparation for implant installation. In this way, errors that can be introduced into the bone-implant interface after installation are reduced because differences between implants, even those of the same nominal size, are accounted for when preparing the bone to receive the implant.

[0033] FIGs. 3 and 4 illustrate a system for orthopedic surgery that may be used to implement the inventive concepts described herein. The system of FIG. 3 forms all or part of a computer assisted surgery system comprising a surgical tool guide 41 coupled to a surgical robot 40 that assists a surgeon in operating a surgical tool 47 to perform surgical operations on one or more bones 10 and / or 1 1 . The surgical tool 47 may, for example, be a saw, a burr, a drill, or the like. The surgical tool guide 41 is coupled to a surgical tool guide drive assembly 43 which is mountable via a bone mount 44 to a bone 10 and / or 1 1 . In the specific example described herein, one bone 10 may be a femur and another bone 11 may be a tibia. The drive assembly 43 positions and / or orients the surgical tool guide 41 in accordance with a surgical plan 34 developed prior to and / or during the orthopedic surgery procedure being performed. The surgical plan 34 is stored in a computer system 30 that comprises a navigation system 32, a display 37, and a user interface 39 that allows tracking of the bones 10 and / or 1 1 , surgical tool guide 41 , and / or other components of the system so that the surgeon can operate the surgical tool 47 with the assistance of the surgical tool guide 41 in accordance with the surgical plan 34 stored in the computer system 30.

[0034] Surgical navigation trackers 101 , 102, 103, 104, and 105 may be affixed to various components of the surgical system and to various locations of the patient anatomy. In the example of FIG. 3, bone mounts 44 and 46 have navigation trackers 101 and 104 affixed thereto respectively. The surgical tool guide 41 has navigation tracker 105 affixed thereto. Femur 10 and tibia 1 1 have navigation trackers 102 and 103 affixed thereto. These navigation trackers comprise features such as spheres or indicia that can be localized in 3 dimensions using, for example, a stereoscopic camera emitting infrared light which can determine a 3D position of prominent structures or markings provided on the navigation trackers 101 , 102, 103, 104, 105. Navigation system 32 uses these trackers to generatean anatomic reference frame into which the surgical robot 40 and surgical tool guide 41 are placed and tracked. The navigation system 32 interacts with a surgical planning system 34 to orient preoperative and / or intraoperative imaging and anatomical models within the anatomic reference frame. In this way, a surgical plan defining bone resections can be executed by the system on the patients physical anatomy during surgery. As illustrated in FIG. 3, the system may further include a scanner 82 and / or a stylus 92 which as described further below may be used to acquire implant specific mapping parameters for use during the orthopedic surgery.

[0035] FIG. 4 illustrates a specific implementation of a suitable bone mountable cut guide robot 40 with two motors 42 and two rotatable output shafts as part of the drive assembly 43. In FIG. 4, the bone mountable cut guide robot 40 is mounted to a femur 10, and in the exemplary surgical procedure described herein the computer system 30 including the navigation system 32 and surgical planning system 34 control the motors 42 via the motor drive controller 38 to position the cut guide 41 into the desired positions to perform the five femoral resections described above in accordance with the surgical plan 34.

[0036] As illustrated in both FIG. 3 and FIG. 4, implant specific surface mapping parameters 36 may be used in the orthopedic surgery system to improve the implant to bone interface fit obtained during the surgical procedure.

[0037] FIG. 5 illustrates a flow chart of a process for implant specific preparation of bone, according to some example embodiments. Block 52 includes obtaining implant surface mapping parameters of one or more bone-mating surfaces of a specific individual implant to be implanted onto the bone. Block 54 includes creating or updating a surgical plan based on the obtained implant surface mapping parameters. In some embodiments such creating or updating also takes into consideration a surgeon’s selection to perform resection cuts for either a press-fit implantation basis, or for a cement-fit implantation basis. Accordingly, in some embodiments, a process associated with the flowchart of FIG. 5 may include receiving a selection to perform resection cuts for either a press-fit implantation basis, or for a cement- fit implantation basis from a surgeon. Block 56 includes performing bone preparation based on the created or updated surgical plan.

[0038] FIGs. 6A and 6B illustrate surface mapping parameters that can be used to characterize a femoral implant 18 for a TKA. In this example, imaginary lines can be drawn along each of the five faces and transverse to the implant at the corners where the facesmeet. As shown in FIG. 6B, the surface map parameters that define the relevant aspects of the bone interface for a femoral implant of this type include four angles labeled a, b, c, and d in FIG. 6B, and five distances labeled 1 , 2, 3, 4, and 5 in FIG. 6B. The angles correspond to the angles of each corner where faces join. The distances correspond to the anterior-posterior distance and proximal-distal distances between the corners where the faces meet. These nine parameters can be considered in some embodiments “surface mapping parameters” for this type of implant. It will be appreciated that other parameters could be defined that provide an equivalent description of the surface of this type of implant and for other types of implants different surface parameter definitions would be used (e.g. curvature radii for example). In some embodiments, these nine parameters are provided to provide highly accurate guidance for bone preparation for the specific implant being installed.

[0039] In some embodiments, obtaining the implant surface mapping parameters comprises obtaining one or more surface mapping parameters from printed, written, or otherwise encoded information associated physically with the implant itself or packaging for the implant. For example, as illustrated in FIG. 7, the manufacturer of implant 18 may as shown at block 74 of FIG. 7 perform measurements of the implant to generate implant surface mapping parameters, which as described above may include translations and / or orientations of one or more of surfaces from or with respect to one or more predetermined reference points of the implant, for example with respect to distal plane 24 and / or posterior plane 26. These 3-dimensional surface measurements, i.e., angular and translational relationships amongst the surface planes may be different for each particular specific manufactured implant 18, even implants having the same nominal size. The manufacturer may code the implant surface mapping parameters or an indication thereof into a code 78, such as a bar code or QR code, which may be disposed on packaging such as a bag or box 72 containing implant 18. In such embodiments, an intraoperative computer assisted surgery system may be configured to generate a scan of code 78 to obtain the surface mapping parameters for the particular specific implant. As another alternative, a numerical code could be used that is manually input into such an intraoperative computer assisted surgery system. The implant surface mapping parameters may be applied to locations in a surgical kit (e.g. a surgical tray of tools and a plurality implants). In such an embodiment, different codes applicable to different implants could be placed in or on the tray inassociation with specific implants in the kit. When the surgeon picks a specific implant having, for example, a particular desired nominal size and / or configuration, the code could be scanned or otherwise input to the computer assisted surgery system to optimize the surgical plan for the particular selected implant as described above.

[0040] In some other embodiments, obtaining the implant surface map comprises generating the implant surface mapping parameters based on one or more images of the implant acquired intraoperatively. For example, as illustrated in FIG. 8, camera(s) 82 provided as part of an intra operative navigation system are configured to capture one or more images of implant 18. Accordingly, the surgeon may hold the implant such that resection surface planes 22, 23, 24, 25, and 26 are facing a wearable camera or cameras 82 in communication with a navigation system 32. The camera or cameras 82 may capture the one or more implant images. Implant surface mapping parameters may be obtained with image processing techniques that recognize edges and surfaces and can determine distances and angles from the image data.

[0041] In another embodiment illustrated in FIG. 9, obtaining the implant surface mapping parameters comprises generating the implant surface mapping parameters based on digitized indications of physical 3-dimensional locations determined by a tip of a stylus 92 placed at predetermined positions (denoted by white circles such as 94a and 94b in FIG. 9) on each of the implant surface planes . For example, the surgeon may place a tip of stylus 92 in each of a plurality of predetermined positions on each of the implant surface planes. These positions may be referenced to each other to provide the implant surface mapping parameters such as the distances and angles described in FIG. 6B.

[0042] As noted above, the principles of the invention are especially applicable to computer aided robotic surgeries. For example, referring back to FIGs. 3 and 4, a surgical robot 40 may comprise a tool guide 41 for assisting a surgeon in placing a tool 47 such as a saw blade for making the resections to the femur 10 in a TKA procedure. In the example of FIGs. 3 and 4, motors 42 are attached to the femur on a bone mount 44. Computer controlled rotation of the shafts of the motors 42 provides the surgical navigation system control over the position and orientation of the saw guide 41. The saw guide 41 is sequentially positioned by the navigation system in the five different positions and orientations, and the surgeon uses the saw guide 41 to accurately position a saw blade to make the resections in accordance with a surgical plan stored by the navigation system.As illustrated in FIGs. 3 and 4, the implant surface mapping parameters 36 obtained, for example, by one of the methods set forth above, are input into the system 30, which in turn drives the surgical robot controller 38 that controls the motors 42 of the surgical robot 40 to position the saw guide 41 in accordance with a surgical plan that takes into account the implant surface dimensions and orientations associated with the specific implant selected for installation in the patient.

[0043] When a surgical plan and associated resections are performed as described above taking into account implant specific mapping parameters, it can be especially important that the resections themselves are performed accurately. Even when performed with computer assisted robotic methods, the resections performed will contain some deviations from a surgical plan. FIG. 10A illustrates a femur 10 having two of the total set of five resections performed in accordance with a surgical plan. Specifically, FIG. 10A shows a femur 10 with an anterior resection 12a performed and a distal resection 14a performed. In FIG. 10A, the two resections 12a and 14a are shown performed essentially exactly in accordance with a surgical plan. FIG. 10B shows an example of an anterior resection 12b and a distal resection 14b that have a slightly rotated orientation in the direction of arrow 105 and slightly distally shifted location in the direction of arrow 103 from the locations defined in the surgical plan. In some cases, the rotational offset from the surgical plan may be for example 0.5 to 5 degrees, and the linear shift from the surgical plan may be for example 0.1 to 1 mm. Deviations such as these may be insignificant to success of the surgery from an anatomical joint functionality perspective, but they can still result in mismatches between resection surfaces and corresponding implant mating surfaces. Such mismatches can themselves degrade the performance of the implant especially over time and joint use by the patient after the procedure is complete.

[0044] To address this issue, these rotational and linear shifts can be compensated for if necessary as illustrated in FIGs. 10C and 10D. As shown in these figures, after the first two resections are made, planar navigation tracker probes 102a and 102b can be attached to the resection surfaces. The navigation system can register these trackers 102a, 102b and make a new and independent measurement of the location and / or orientation of the resected surfaces accurately to determine their deviation, if any, from the surgical plan. If such a rotation and / or linear shift is measured, the system may perform the remaining resections 13b, 15b, and 16b with an identical rotation and / or shift. When this is done, thefull set of resections will still accurately match the mating surfaces of the specific implant being installed during the procedure.

[0045] FIG. 1 1 is a flowchart of an exemplary method of performing an orthopedic surgery. At block 112, one or more resections of a set of resections defined by a surgical plan are performed. At block 114, the location and / or orientation of at least one of these performed resections is measured. At block 1 16, at least one additional resection of the set of resections are performed based at least in part on the measured locations and / or orientations of the initial performed one or more resections. In some implementations, an initial surgical plan is updated based at least in part on the measurements of the first resections, and at least one of the remaining resections is performed in accordance with the updated surgical plan rather than the initial surgical plan.

[0046] Although the procedures described above with reference to FIGs. 10A-10D and 11 are especially useful when combined with the specific implant mapping parameters described above, these procedures can also be useful in traditional cases where nominal implant surface characteristics are used and still provide benefits in providing a well- matched implant to bone interface.General Interpretive Principles for the Present Disclosure

[0047] Various aspects of the novel systems, apparatuses, and methods are described more fully hereinafter with reference to the accompanying drawings. The teachings disclosure may, however, be embodied in many different forms and should not be construed as limited to any specific structure or function presented throughout this disclosure. Rather, these aspects are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the disclosure to those skilled in the art. Based on the teachings herein one skilled in the art should appreciate that the scope of the disclosure is intended to cover any aspect of the novel systems, apparatuses, and methods disclosed herein, whether implemented independently of or combined with any other aspect of the disclosure. For example, a system or an apparatus may be implemented, or a method may be practiced using any one or more of the aspects set forth herein. In addition, the scope of the disclosure is intended to cover such a system, apparatus or method which is practiced using other structure, functionality, or structure and functionality in addition to or other than the various aspects of the disclosure set forth herein. It should be understood that any aspect disclosedherein may be set forth in one or more elements of a claim. Although some benefits and advantages of the preferred aspects are mentioned, the scope of the disclosure is not intended to be limited to particular benefits, uses, or objectives. The detailed description and drawings are merely illustrative of the disclosure rather than limiting, the scope of the disclosure being defined by the appended claims and equivalents thereof.

[0048] With respect to the use of plural vs. singular terms herein, those having skill in the art can translate from the plural to the singular and / or from the singular to the plural as is appropriate to the context and / or application. The various singular / plural permutations may be expressly set forth herein for sake of clarity.

[0049] When describing an absolute value of a characteristic or property of a thing or act described herein, the terms “substantial,” “substantially,” “essentially,” “approximately,” and / or other terms or phrases of degree may be used without the specific recitation of a numerical range. When applied to a characteristic or property of a thing or act described herein, these terms refer to a range of the characteristic or property that is consistent with providing a desired function associated with that characteristic or property.

[0050] In those cases where a single numerical value is given for a characteristic or property, it is intended to be interpreted as at least covering deviations of that value within one significant digit of the numerical value given.

[0051] If a numerical value or range of numerical values is provided to define a characteristic or property of a thing or act described herein, whether or not the value or range is qualified with a term of degree, a specific method of measuring the characteristic or property may be defined herein as well. In the event no specific method of measuring the characteristic or property is defined herein, and there are different generally accepted methods of measurement for the characteristic or property, then the measurement method should be interpreted as the method of measurement that would most likely be adopted by one of ordinary skill in the art given the description and context of the characteristic or property. In the further event there is more than one method of measurement that is equally likely to be adopted by one of ordinary skill in the art to measure the characteristic or property, the value or range of values should be interpreted as being met regardless of which method of measurement is chosen.

[0052] It will be understood by those within the art that terms used herein, and especially in the appended claims (e.g., bodies of the appended claims) are intended as “open” termsunless specifically indicated otherwise (e.g., the term “including” should be interpreted as “including but not limited to,” the term “having” should be interpreted as “having at least,” the term “includes” should be interpreted as “includes but is not limited to,” etc.).

[0053] It will be further understood by those within the art that if a specific number of an introduced claim recitation is intended, such an intent will be explicitly recited in the claim, and in the absence of such recitation no such intent is present. For example, as an aid to understanding, the following appended claims may contain usage of the introductory phrases “at least one” and “one or more” to introduce claim recitations. However, the use of such phrases should not be construed to imply that the introduction of a claim recitation by the indefinite articles “a” or “an” limits any particular claim containing such introduced claim recitation to embodiments containing only one such recitation, even when the same claim includes the introductory phrases “one or more” or “at least one” and indefinite articles such as “a” or “an” (e.g., “a” and / or “an” should typically be interpreted to mean “at least one” or “one or more”); the same holds true for the use of definite articles used to introduce claim recitations. In addition, even if a specific number of an introduced claim recitation is explicitly recited, those skilled in the art will recognize that such recitation should typically be interpreted to mean at least the recited number (e.g., the bare recitation of “two recitations,” without other modifiers, typically means at least two recitations, or two or more recitations).

[0054] In those instances where a convention analogous to “at least one of A, B, and C” is used, such a construction would include systems that have A alone, B alone, C alone, A and B together without C, A and C together without B, B and C together without A, as well as A, B, and C together. It will be further understood by those within the art that virtually any disjunctive word and / or phrase presenting two or more alternative terms, whether in the description, claims, or drawings, should be understood to contemplate the possibilities of including one of the terms, either of the terms, or both terms. For example, the phrase “A or B” will be understood to include A without B, B without A, as well as A and B together.”

[0055] Various modifications to the implementations described in this disclosure can be readily apparent to those skilled in the art, and generic principles defined herein can be applied to other implementations without departing from the spirit or scope of this disclosure. Thus, the disclosure is not intended to be limited to the implementations shown herein but is to be accorded the widest scope consistent with the claims, the principles and the novel features disclosed herein. The word “exemplary” is used exclusively herein to mean “servingas an example, instance, or illustration.” Any implementation described herein as “exemplary” is not necessarily to be construed as preferred or advantageous over other implementations.

[0056] Certain features that are described in this specification in the context of separate implementations also can be implemented in combination in a single implementation. Conversely, various features that are described in the context of a single implementation also can be implemented in multiple implementations separately or in any suitable subcombination. Moreover, although features can be described above as acting in certain combinations and even initially claimed as such, one or more features from a claimed combination can in some cases be excised from the combination, and the claimed combination can be directed to a sub-combination or variation of a sub-combination.

[0057] The methods disclosed herein comprise one or more steps or actions for achieving the described method. The method steps and / or actions may be interchanged with one another without departing from the scope of the claims. In other words, unless a specific order of steps or actions is specified, the order and / or use of specific steps and / or actions may be modified without departing from the scope of the claims.

Claims

WHAT IS CLAIMED IS:

1. A method of implant specific preparation of bone for orthopedic surgery, the method comprising: obtaining implant surface mapping parameters of bone-mating surfaces of a specific implant selected to be implanted onto the bone; and performing a bone preparation based at least in part on the obtained implant surface mapping parameters.

2. The method of claim 1 , comprising using non-contact sensors to determine one or more surface mapping parameters of the implant.

3. The method of any preceding claim, comprising obtaining one or more implant surface mapping parameters from a code associated with the implant provided by the implant manufacturer.

4. The method of any preceding claim, comprising obtaining one or more implant surface parameters from positioning a stylus associated with a navigation system on one or more locations on the implant.

5. The method of any preceding claim, further comprising generating or updating a surgical plan in a computer assisted surgery system based at least in part on the obtained implant surface mapping parameters.

6. The method of claim 5, further comprising: providing, to the computer assisted surgery system, an implantation basis selection to perform resection cuts for a press fit implantation basis or for a cement fit implantation basis; and generating or updating the surgical plan based at least in part on the implantation basis selection.

7. The method of any preceding claim, comprising controlling a surgical robot to perform the bone preparation by resecting portions of the bone based at least in part on the implant surface mapping parameters.

8. The method of claim 7, wherein the surgical robot comprises a saw guide.

9. The method of any preceding claim, wherein the implant surface mapping parameters comprise one or more distances between one or more surface features of the implant.

10. The method of any preceding claim, wherein the implant surface mapping parameters comprise one or more angles between one or more surface features of the implant.

11. The method of any preceding claim, wherein the obtaining comprises acquiring the implant surface mapping parameters by a computer assisted surgery system.

12. An apparatus for assisting the performance of orthopedic surgery comprising: a surgical robot; a controller coupled to the surgical robot; and a computer aided surgery system coupled to the controller, wherein the computer aided surgery system comprises a memory having stored therein one or more implant surface mapping parameters of bone-mating surfaces of a specific implant selected to be implanted onto the bone.

13. The system of claim 12, wherein the computer aided surgery system comprises a surgical plan that causes the surgical robot to assist the performance of resections to a bone corresponding to the bone mating surfaces of the selected specific implant.

14. The system of any one of claims 12 or 13, wherein the computer aided surgery system comprises a navigation system configured to acquire at least one of the one or more implant surface mapping parameters from the specific implant selected for installation in a patient during a surgical procedure.

15. The system of any one of claims 12 or 13, wherein the navigation system is configured to acquire the implant surface mapping parameters from packaging for the specific implant selected for installation in a patient during a surgical procedure.

16. The system of any one of claims 12 through 15, wherein the bone-mountable robot is configured for attachment to a femur.

17. The system of any one of claims 12 through 16, wherein the implant surface mapping parameters are associated with a femoral implant for use in a TKA procedure.

18. A method of providing an implant for orthopedic surgery, the method comprising: measuring physical characteristics of bone mating surfaces of the implant to define one or more implant surface mapping parameters for the implant; associating the implant surface mapping parameters with the implant and / or the packaging thereof; delivering the implant to a health care facility for installation in a patient.

19. The method of claim 18, wherein the implant is a femoral implant for use in a TKA procedure.

20. A surgical kit comprising one or more orthopedic surgery implants, wherein the surgical kit further comprises encoded information defining implant surface mapping parameters for bone mating surfaces for at least one of the one or more orthopedic surgery implants.21 .The surgical kit of claim 20, wherein the encoded information is placed on the at least one of the one or more orthopedic surgery implants.

22. The surgical kit of claim 20, wherein the surgical kit comprises a plurality of orthopedic surgery implants, and further comprising encoded information defining implant surface mapping parameters for bone mating surfaces for all of the plurality of orthopedic surgery implants at locations on or associated with all of the plurality of orthopedic surgery implants.

23. The surgical kit of any one of claims 20 through 22, wherein the surgical kit comprises a surgical tray for use in a TKA procedure.

24. A method of performing a plurality of bone resections in an orthopedic surgery, the method comprising: performing one or more resections of a set of resections associated with a surgical plan for the orthopedic surgery; measuring a location and / or orientation of at least one of the one or more performed resections with respect to patient anatomy; and performing one or more additional resections of the set of resections based at least in part on the measured locations and / or orientations.

25. The method of claim 24, comprising updating a surgical plan by changing a planned location and / or orientation of at least one of the additional resections of the set of resections.

26. The method of claim 25, wherein the updated surgical plan is based at least in part on implant specific mapping parameters.

27. An apparatus for assisting the performance of orthopedic surgery comprising: a surgical robot; a controller coupled to the surgical robot; anda computer aided surgery system coupled to the controller, wherein the computer assisted surgery system comprises a navigation system and a surgical planning system, and wherein the computer assisted surgery system is configured to control the surgical robot and the navigation system to assist a surgeon to: perform one or more resections of a set of resections associated with a surgical plan for the orthopedic surgery; receive a location and / or orientation of at least one of the one or more performed resections with respect to patient anatomy using the navigation system; and perform one or more additional resections of the set of resections based at least in part on the measured locations and / or orientations.

28. The apparatus of claim 27, further comprising navigation trackers configured to be affixed to planar bone resection surfaces.

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