560 results about "Orthopaedic procedures" patented technology

The invention provides a shoulder joint replacement surgery navigation system and method, and relates to the technical field of computers, and the system comprises a controller and a navigation positioning device; the controller is in communication connection with the navigation positioning device; the controller comprises a preoperative planning module, a preoperative simulation module and an intra-operative execution module. According to the navigation system and method for the shoulder joint replacement surgery, by combining the preoperative medical image of the affected bone and the medical image of the healthy bone corresponding to the affected bone, the healthy form of the affected bone can be reflected more accurately under the condition that the affected bone has bone defect and / or abnormal form, and then prosthesis planning can be conducted based on the three-dimensional bone model of the affected bone, so that the patient experience is improved. The preoperative surgical planning is more objective and quantified, the movement range of the shoulder joint on the operative side of the patient after the prosthesis to be implanted is implanted into the affected bone can be simulated based on the parameter information of the prosthesis to be implanted, the accuracy and rationality of the prosthesis planning are further improved, and the accuracy and reliability of the orthopedic surgery are remarkably improved.

The invention provides an orthopedic surgery navigation method, device and system, electronic equipment and a storage medium, and relates to the technical field of computers.The method comprises the steps that a three-dimensional bone model of a diseased bone is generated based on a first image and a second image, and surgery parameters corresponding to the diseased bone are obtained based on the three-dimensional bone model and all bony mark points on the three-dimensional bone model, on the basis of the corresponding relation between all the bony mark points on the three-dimensional bone model and all the bony mark points on the affected bone, the affected bone and the three-dimensional bone model are registered, the mapping relation between the affected bone and the three-dimensional bone model and / or the first image is established, and surgical navigation is conducted on the basis of the surgical parameters corresponding to the affected bone and the mapping relation. According to the orthopedic surgery navigation method, device and system, the electronic equipment and the storage medium provided by the invention, more objective and quantitative preoperative surgery planning can be realized under the condition that the diseased bone of the patient has bone defect and / or abnormal shape, and more accurate diseased bone space positioning can be realized in the orthopedic surgery.

The invention belongs to the field of medical materials. The invention provides a porous artificial bone and a preparation method thereof, the components of the porous artificial bone comprise absorbable macromolecules and an orthopedic inorganic implant material, the mass ratio of the absorbable macromolecules to the orthopedic inorganic implant material is 1: 0.1-2, the porous artificial bone has a through porous structure, the porosity is greater than 70%, and the pore size distribution range is less than 500 [mu] m. The porous artificial bone has a pore structure and mechanical properties beneficial to bone regeneration, the pore diameter is stable, the mechanical properties are appropriate, after the porous artificial bone is implanted into a defect part, the bone volume is always increased, the increase rate of regenerated bone tissue is remarkably improved, the effect of bone conduction is effectively achieved, bone regeneration is very beneficial, and animal experiments prove that the porous artificial bone has a good application prospect. The material can be used for filling and repairing various bone defects in orthopedic surgery. The preparation method is simple, stable and effective, can be absorbed, is low in cost, has great market potential, and is simple, stable and effective compared with a conventional artificial bone preparation method at present.

The invention relates to the technical field of orthopedic surgery, in particular to a system for automatically planning a screw channel range, which comprises a medical image acquisition module used for receiving and preprocessing CT, MRI and other medical images from medical equipment; the three-dimensional reconstruction module is used for performing three-dimensional reconstruction on the preprocessed two-dimensional medical image to generate a three-dimensional skeleton model; the multi-constraint path planning module is used for planning a candidate path set meeting anatomical and mechanical constraints in the three-dimensional skeleton model; the parameter calculation module is used for calculating path information of the candidate path set; and the visualization module draws a screw channel based on the path information and displays related parameters. The method has the advantages that the candidate path set meeting various anatomy and mechanical constraints can be planned in the three-dimensional skeleton model, the path length and the path included angle are calculated according to the candidate path set, the screw channel is drawn based on the path information, and the accuracy and safety of surgical planning are improved.

The embodiment of the invention is applicable to the technical field of computer-aided medical treatment and osteotomy, and provides an osteotomy control system, computer-aided medical equipment and a computer program product, the osteotomy control system comprises a data processing unit, an optical positioning system and mechanical arm equipment; wherein the optical positioning system is used for collecting three-dimensional image information of an operation area of a patient and a tool at the tail end of the mechanical arm and transmitting the three-dimensional image information to the data processing unit; the data processing unit is used for calculating relative position information between the mechanical arm tail end tool and the osteotomy safety boundary according to the three-dimensional image information, and generating a control instruction when the mechanical arm tail end tool exceeds the osteotomy safety boundary; the mechanical arm equipment is used for applying acting force to the mechanical arm tail end tool according to the control instruction, and the mechanical arm tail end tool is prevented from exceeding the osteotomy safety boundary. By the adoption of the osteotomy control system, the safety and osteotomy precision of orthopedic surgery can be improved, and the operation burden of doctors is reduced.

The invention belongs to the technical field of orthopedic surgery navigation, discloses a communication and positioning integrated orthopedic surgery navigation method and system based on multi-dimensional perception, and aims to solve the problems that in an existing orthopedic navigation technology, optical navigation is prone to being shielded, multipath interference of UWB positioning is serious, and real-time performance is insufficient. Comprising the steps of obtaining measurement values including positioning data of a UWB positioning module, ranging data of a laser ranging module and an attitude angle of an IMU module; according to the method, extended Kalman filtering is adopted, positioning data of a UWB positioning module, ranging data of a laser ranging module and an attitude angle of an IMU module are taken as state vectors, dynamic adjustment of credibility is realized by adjusting a process noise matrix of a state equation and a measurement noise matrix of a measurement equation according to task characteristics, and the credibility of the UWB positioning module is improved according to data of different credibility. And resolving the pose state of the tail end of the surgical instrument. The method has the advantages of high positioning precision, high response speed, high environmental adaptability and high resource efficiency.

The invention discloses an artificial intelligence-based postoperative rehabilitation auxiliary monitoring system for orthopedic surgery. The system comprises a data acquisition module, a rehabilitation progress evaluation module, a motion analysis module, a risk early warning module, an optimization system module and a personalized rehabilitation module. The invention belongs to the technical field of rehabilitation monitoring, and particularly relates to an orthopedic surgery postoperative rehabilitation auxiliary monitoring system based on artificial intelligence. According to the scheme, motion analysis is adopted, postures are decomposed into a standard state and an error state, modeling errors are considered, a posture updating equation is calculated to reflect actual posture changes, and the actual posture changes are compared with the updated standard state; estimating and correcting the error state in real time, and adjusting a rehabilitation treatment scheme; system optimization is adopted, attention mechanism processing is carried out, data features are extracted, training efficiency is improved, positive model parameters are updated by minimizing prediction errors, a reverse model is optimized, a curiosity loss function is constructed, curiosity-driven exploration is achieved, internal rewards are introduced, and the rehabilitation effect and efficiency are improved.

The embodiment of the invention is suitable for the technical field of computer-aided medical treatment, and provides an orthopedic surgery robot system and a computer program product, and the orthopedic surgery robot system comprises an orthopedic surgery robot and a flexible pressure sensor connected with the orthopedic surgery robot; wherein the flexible pressure sensor is used for collecting first data of the knee joint in the operation process and transmitting the first data to the orthopedic operation robot, and the first data at least comprises stress information of the knee joint in the operation process; the orthopedic surgery robot is used for obtaining second data corresponding to the first data in the surgery process, visual knee joint stress distribution information is generated according to the first data and the second data, the knee joint stress distribution information is displayed through the display interface, and the second data at least comprises the flexion and extension angle and the joint gap of the knee joint. By the adoption of the orthopedic surgery robot system, the stress condition of the knee joint in the surgery process can be accurately monitored, and accurate mechanical feedback is provided for the surgery.

An orthopedic surgical robot system (100) and an orthopedic surgical robot operating method. The system comprises: a preoperative planning module (101) for acquiring image data of a surgical site, reconstructing a three-dimensional model of the surgical site on the basis of the image data, and determining a preoperative planning result on the basis of the three-dimensional model; a control module (102) for acquiring the preoperative planning result, and on the basis of the preoperative planning result, controlling a navigator (103) and a robotic arm (104) to perform surgical registration, alignment, and surgical operations; and an evaluation module (105) for performing post-operative evaluation on the surgical site after the surgical operation. The orthopedic surgical robot system (100) can improve the degree of integration of an orthopedic surgical robot, and is applied to different orthopedic surgical scenes.

A femur-first orthopaedic surgical procedure may include using a surgical navigation system to perform one or more initial measurements on a femur of a patient, a tibia of the patient, or both and to develop a surgical plan for the orthopaedic surgical procedure based on the one or more initial measurements, performing a first resection of the femur, using the surgical navigation system to perform one or more later measurements of the tibia that were inaccessible prior to the first resection of the femur and to confirm the surgical plan based on the one or more later measurements of the tibia, performing a tibial resection of the tibia based on a planned tibial resection plane of the surgical plan after confirming the surgical plan, and performing additional resections of the femur based on planned femoral resection planes of the surgical plan after confirming the surgical plan.

The invention discloses a spring probe system for rapid registration of articular cartilage based on 3D printing, and relates to the technical field of medical imaging and orthopedic surgery navigation. The problem that the joint registration precision is insufficient due to the fact that cartilage cannot be developed in traditional CT imaging is solved. Through personalized customization of the 3D printing guide plate, convenient installation of positioning holes, adjustability of the spring probe assembly and real-time data monitoring, and automatic data processing of the intelligent registration module, manual operation is reduced, the operation efficiency is improved, the spring probe assembly is reasonable in structure and adjustable in elastic force, stable operation of the system in an operation is guaranteed, and the operation safety is improved. Multi-position CT scanning is combined with an advanced image processing and registration technology, an accurate initial model is constructed, a spring probe assembly collects data and is combined with an elastic deformation compensation model to correct registration errors in real time, the registration accuracy is improved, reliable support is provided for orthopedic surgery navigation, the surgery success rate can be improved, and patient wounds and surgery risks are reduced.

The invention discloses a personalized orthopedic surgery planning method based on machine learning, and relates to the technical field of personalized medical treatment, and the method comprises the steps: collecting medical data of a patient, generating a personalized basic data set of the patient, building a risk prediction model, and obtaining a predicted surgical risk score; preprocessing the basic data set, and extracting features of the skeleton structure of the patient based on a deep learning algorithm; training the personalized orthopedic surgery planning model, optimizing the historical patient data based on the personalized orthopedic surgery planning model, and predicting an optimal surgery plan; and outputting a personalized operation scheme according to the trained machine learning model. According to the method, machine learning and personalized orthopedic surgery planning are combined, a personalized surgery scheme is customized for each patient, the most suitable surgery scheme is provided for the patient in combination with historical data and the risk prediction model, the surgical treatment effect and the life quality of the patient are remarkably improved, and the method has wide clinical application prospects.

The invention discloses a multifunctional coating capable of forming a long-term stable endogenous electric field to promote antibiosis, and a preparation method and application thereof, and belongs to the technical field of biological functional modification. According to the coating, through the elaborately designed Ta / Ag heterostructure, long-term stable generation of an endogenous electric field is achieved, the antibacterial performance is enhanced, osseointegration is promoted, and the problem of drug resistance is avoided; the coating does not need external electrical stimulation, so that the operation process is simplified, and the clinical application risk is reduced; due to the Ta material, the osseointegration capacity is improved, and Ag has broad-spectrum and efficient antibacterial performance. The TC4-Ta / Ag group has excellent charge storage capacity and a stable electric field, and the long-term osseointegration effect is remarkably improved; according to the preparation method of the coating, the coating which is stable in structure and not prone to falling off can be obtained, the long-term stable antibacterial performance is kept, the coating has wide application prospects in the field of titanium alloy bone implants, a new solution is provided for orthopedic surgery and implant treatment, and the treatment effect and life quality of patients are improved.

Systems and methods for planning and assisting orthopaedic surgical procedures include a computer system and a robotic surgical device. The computer system receives multiple surgeon preferences, including target values and boundary values for surgical parameters of the orthopaedic surgical procedure. A surgeon uses the computer system to perform bony registration and leg-alignment registration for anatomy of a patient. The computer system determines a surgical plan for the orthopaedic surgical procedure based on the surgeon preferences, the bony registration, and the leg-alignment registration. The surgical plan includes planned values associated with the surgical parameters that are within the boundary values of the surgeon preferences. Determining the surgical plan may include automatically adjusting tibial coronal alignment, femoral coronal alignment, femoral flexion, femoral rotation, distal femoral resection height, proximal tibial resection height, and / or distal femoral resection height. The computer system may control the robotic surgical device according to the surgical plan.

The utility model provides an automatic sensing device suitable for orthopedic surgery. The automatic sensing device comprises a force sensor, a visual sensor and a drilling module which are used for being assembled on a mechanical arm of a surgical robot. Wherein the drilling module is used for assembling a drilling tool and pushing the drilling tool to execute drilling operation; the force sensor is used for detecting torque information of the drilling tool in the drilling operation; the visual sensor is used for acquiring image data of an operation area; wherein the force sensor, the visual sensor and the drilling module are respectively connected with a control system of the surgical robot; and the control system is used for receiving the moment information and the image data and controlling the drilling module to drill towards the surgical area at the target moment. By means of the device, the position and action of the drilling tool can be accurately controlled so as to assist a doctor in completing an operation, application in complex and fine operations is achieved, the complexity in the operation process is reduced, and the operation time is shortened.

The invention discloses a surgical robot for orthopedic surgery, and relates to the technical field of medical equipment. The device comprises a base, a supporting column is fixedly connected to the top of the base, a transverse frame is installed on the top of the supporting column, a supporting seat is fixedly connected to the front side of the transverse frame, mechanical arm bodies are installed on the two sides of the supporting seat, and drilling machines are arranged at the other ends of the mechanical arm bodies; a mounting assembly is arranged at the bottom of the drilling machine and comprises a mounting shell, and the mounting shell is fixedly connected to the output end of the drilling machine. Through the arrangement of the tool changing assembly, when the drill bits are separated from the mounting column, the falling drill bits can be collected through the collecting box, the position of the rotating disc is adjusted, the multiple sets of drill bits of different specifications are arranged at the top of the rotating disc, and when the drill bits are adjusted to the bottom of the mounting column, the drill bits can be pushed upwards to be inserted into the mounting column; automatic drill bit replacement and rapid installation are completed, and a large amount of operation time can be saved.

An orthopaedic joint replacement system is shown and described. The system includes a number of prosthetic components configured to be implanted into a patient's knee. The system also includes a number of surgical instruments configured for use in preparing the bones of the patient's knee to receive the implants. A number of methods for using the surgical instruments to prepare the bones is also disclosed.

The invention discloses an artificial intelligence assisted femoral neck fracture screw path planning system and method, and the system comprises an image collection module, a structure recognition module, a path planning module, a decision feedback module and a robot execution module, and all the modules achieve the linkage through data and control signal interfaces. Structured and data-driven design reference is provided, unnecessary attempts and repeated operations are reduced, the path design efficiency and standardization level are improved, and the implementation mode has good adaptability, can be compatible with existing multi-brand orthopedic robot platforms, is especially suitable for intelligent screw path planning in femoral neck fracture fixation, and has wide application prospects. The method has remarkable advantages in the aspects of technical innovation and industrial application, and is expected to improve the screw implantation precision, shorten the time consumption in the operation, reduce the track adjustment frequency, reduce the radiation exposure risk, and promote the deep development and clinical transformation of the AI-assisted intelligent path control technology in the field of orthopedic operations.

The invention relates to the technical field of orthopedic surgery, in particular to an orthopedic surgery tracer fixing device which comprises a base, a damping cover is fixedly connected to the surface of the base, two kirschner wire bodies are movably inserted into the base and the damping cover, a mounting groove is formed in the base, and the kirschner wire bodies are arranged in the mounting groove. A kirschner wire locking block is arranged in the center of the interior of the mounting groove, a bolt mounting block is movably connected to one side of the kirschner wire locking block, and a kirschner wire locking bolt is movably connected to one side of the bolt mounting block. The kirschner wire tracer is provided with a base, a kirschner wire body, a mounting groove, a kirschner wire locking block, a bolt mounting block, a kirschner wire locking bolt, a holder, a tracer body, an insertion hole, a movable groove, an adjusting rolling ball, an adjusting rod, a tightening seat, a tightening bolt, a second insertion groove, a positioning pin, a pressure spring, a snap spring and a thrust bearing. The device can be used for installing and fixing the tracer which is simple in structure, low in production and manufacturing cost, high in stability and not prone to damage.

Systems and methods for generating patient-specific surgical guides comprising: capturing a first and second images of an orthopedic element in different reference frames using a radiographic imaging technique, detecting spatial data defining anatomical landmarks on or in the orthopedic element using a neural network, applying a mask to the orthopedic element defined by an anatomical landmark, projecting the spatial data from the first image and the second image to define volume data, applying the neural network to the volume data to generate a reconstructed three-dimensional (“3D”) model of the orthopedic element; and calculating dimensions for a patient-specific surgical guide configured to abut the orthopedic element.

The embodiment of the invention provides an intelligent bone drilling self-adaptive control method for a mechanical arm, which comprises the following steps: acquiring displacement deviation of the tail end of a drill bit of an orthopedic surgical robot, obtaining an error change rate through differential calculation, and combining a bone layer type as an input variable of a fuzzy controller and a feeding speed as an output variable; input variables are fuzzified through a membership function, and a fuzzy language variable set is obtained; according to the set and a preset rule base, constructing a multi-rule group structure comprising three types of scenes of free space, cancellous bone and cortical bone, and setting corresponding fuzzy rule subsets for different bone layers; designing a ''minimum-maximum'' rule activation and combination strategy for reasoning by adopting a Mamdani type fuzzy reasoning method according to fuzzification input and a multi-rule group structure, and generating a fuzzification output variable set; and defuzzification is performed through a gravity center method to obtain a continuous speed instruction, and dynamic regulation and control of the drill bit feeding speed are achieved. When approaching a penetration point, the device automatically decelerates and safely stops, so that the safety and accuracy of an operation are effectively guaranteed, and over-drilling injury is prevented.

The present disclosure relates to a surgical robot for orthopedic surgery, comprising a robotic arm device, a positioning and navigation device, and a control device, wherein the robotic arm device comprises at least two robotic arms, and an end effector is arranged at the end of each robotic arm close to an operating zone. The positioning and navigation device comprises an electromagnetic navigation device. The electromagnetic navigation device comprises: a tracking apparatus for electromagnetic tracking, comprising a magnetic field generator used for covering the at least two end effectors and at least two first electromagnetic tracking elements used for respectively tracking the orientations of the at least two end effectors during the surgery; and a reference frame, wherein a second electromagnetic tracking element and a developing body capable of displaying a coordinate position are arranged on the reference frame. The positioning and navigation device further comprises an imaging device used for positioning and navigating the at least two end effectors. The imaging device comprises an infrared coherent imaging navigation device used for positioning the operating zone and the at least two end effectors.

A method of operating an orthopaedic surgical system may include displaying a unique identifier on a visual display of a first device positioned in an operating room, the unique identifier being associated with a digital medical record of a patient positioned in the operating room, capturing the unique identifier with a camera of a second device positioned in the operating room, establishing a unique electronic connection between the second device and the digital medical record of the patient based on the unique identifier, capturing one or more images of the patient with the camera of the second device, transferring the one or more images from the second device to the digital medical record of the patient using the unique electronic connection, and accessing the one or more images with the first device to guide performance of an orthopaedic surgical procedure on the patient.

The utility model discloses a tracer, a surgical instrument and an orthopedic surgical robot, and belongs to the technical field of orthopedic navigation surgical instruments, the tracer comprises a positioner assembly and a rotating assembly, the positioner assembly comprises a positioning reference frame, at least three marking balls are arranged on the front face of the positioning reference frame, and the rotating assembly is arranged on the front face of the positioning reference frame. A connecting shaft is fixedly arranged in the middle of the back face of the positioning reference frame, and the rotating assembly is fixedly arranged at the tail end of the connecting shaft. The rotating assembly comprises a rotating sleeve arranged on the rod portion of the surgical instrument in a sleeving mode and a locking device used for enabling the rotating sleeve to be axially fixed and rotatably connected to the rod portion of the surgical instrument in the circumferential direction. According to the utility model, when a doctor uses a surgical instrument which needs to rotate along the axis of the doctor, the tracer can always face one direction (namely the camera direction), the instrument can be tracked in real time, the purpose of navigating the instrument in real time is achieved, the tracer is suitable for the surgical instrument which rotates along the axis of the doctor, and camera tracking is facilitated.

The invention discloses an orthopedic surgery planning and real-time navigation method and system based on artificial intelligence and multi-modal image fusion. The method comprises the following steps: receiving and fusing preoperative multi-modal image data of a patient, and automatically segmenting a key structure by using a deep learning model to generate a three-dimensional virtual model; an optimal operation path is planned through an artificial intelligence model according to the three-dimensional virtual model; the spatial positions of the surgical instrument and the target skeleton area of the patient are tracked in real time through an electromagnetic positioning system, and real-time spatial position data and the three-dimensional virtual model are registered and are fused, overlapped and displayed on a surgical navigation screen; the relative position deviation between the tip of the surgical instrument and the optimal surgical path and the key tissue safety area is calculated in real time, and an early warning is given to a surgeon according to the relative position deviation. The optimal operation path can be accurately and objectively generated so as to ensure the adaptability of the operation path and the patient. Therefore, doctors can pay attention to the operation process specifically, and the operation stability and reliability are improved.

The invention relates to the technical field of medical instruments, in particular to an incision traction device for orthopedic surgery. Comprising a support, the support is connected with two sliding supporting blocks in a sliding mode, the sliding supporting blocks are connected with a first sliding rail in a sliding mode, the first sliding rail is connected with a first sliding block in a sliding mode, the first sliding block is connected with a second sliding rail in a sliding mode, the second sliding rail is provided with an arc-shaped groove, and the arc-shaped groove of the second sliding rail is connected with an arc-shaped frame in a sliding mode; and the number of the third sliding rails is two, the two third sliding rails are fixedly connected to the adjacent arc-shaped frames correspondingly, the third sliding rails are slidably connected with two second sliding blocks, the second sliding blocks are rotatably connected with rolling frames, and the two rolling frames of the same third sliding rail are jointly and fixedly connected with an extrusion plate. The arc-shaped frame slides along the arc-shaped groove in the second sliding rail, the two extrusion plates open the incision of the patient along the rotating path, the moving path of the extrusion plates extruding the inner side of the incision of the patient is short, and the pulling force on the inner side of the incision of the patient is reduced.

The invention relates to the technical field of orthopedic surgery, and discloses an orthopedic surgery real-time navigation system based on multi-modal image fusion and artificial intelligence. The multi-modal image fusion module is used for generating a three-dimensional skeleton and soft tissue fusion model for surgical navigation; the artificial intelligence analysis module is used for determining a fracture line, a screw implantation angle and a cutting track; the intraoperative tracking module is used for generating a real-time correction instruction; the verification updating module is used for carrying out rationality verification on the real-time correction instruction; if the inspection is not passed, an alarm mechanism is triggered, instantaneous motion state parameters of the surgical instrument are collected, the instantaneous motion state parameters are compared with the cutting track, and the correction instruction is updated according to the comparison result; and the execution module is used for driving the surgical instrument to execute the surgical operation according to the updating correction instruction. According to the invention, manual operation errors can be effectively reduced.

The invention discloses a drilling aiming device for orthopedic surgery, relates to the technical field of orthopedic surgery, and provides the following scheme that the drilling aiming device comprises cross rods, a rectangular mounting plate is arranged between a pair of cross rods, pressure sensors are mounted at the four corners of the mounting plate, and first electric push rods are connected between the stress ends of the pressure sensors and the cross rods; a vertical sleeve is slidably connected to the mounting plate, a rotating cylinder is rotatably connected to the mounting plate, a slidable scale ring is rotatably connected to the rotating cylinder, a supporting frame is mounted below the cross rod, and an abutting block is connected to the supporting frame; the leg is clamped through the abutting block, stability is improved, the mounting plate is pulled in any direction, under the action of the pressure sensor, the first electric push rod shrinks or stretches, the movement angle of the mounting plate is conveniently controlled manually, the scale ring rotates during punching, when the zero scale on the scale ring reaches the pointer, it is indicated that the punching depth is the needed depth, and the punching efficiency is improved. The punching depth is effectively limited, and operation is convenient.

Systems, devices, and methods are disclosed for acquiring and providing information about orthopedic features of a body using acoustic energy. In some aspects, an acoustic orthopedic tracking system includes portable acoustic transducers to obtain orthopedic position information for feeding the information to an orthopedic surgical system for surgical operations.

A surgical instrument system includes a commonly-sized orthopaedic surgical instrument assembly for use in implanting a femoral component, along with a number of orthopaedic surgical instrument assemblies having varying sizes of instruments of use in implanting a tibial tray component and a patella component.