Robotic Bone Milling for Cartilage Implant Fixation
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Solution Overview
Problem
Current methods for repairing articular cartilage defects lack precision in locating and creating accurate shapes for securely fixing cartilage replacements to subchondral bone, leading to inadequate integration and potential progression to osteoarthritis, necessitating premature joint replacement.
Innovation Solution
A system that uses robotic milling to create a custom three-dimensional shape in the bone based on virtual models, allowing for precise placement and secure fixation of a cartilage replacement implant with both cartilage and bone layers, ensuring seamless integration and minimizing healthy tissue removal.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If conventional bone plug removal methods are used, then cartilage replacement can be performed, but precision in locating and creating accurate shapes for secure fixation is insufficient
Solution Approach 1:
The system creates a virtual three-dimensional model of the bone and cartilage defect from scan data, then uses this digital model as a template to guide the robotic milling process. The robotic system replicates the precise digital geometry in the actual bone, ensuring accurate shape creation and secure fixation of the cartilage replacement implant.
2Area of stationary object
If more healthy cartilage is removed to create larger bone plugs, then more cartilage replacement surface is achieved, but unnecessary healthy tissue is lost
Solution Approach 1:
The robotic milling system creates a custom-shaped cavity that precisely matches the geometry of the cartilage defect and implant. This localized, precise removal allows the surgeon to remove only the necessary amount of bone and cartilage to accommodate the implant, avoiding unnecessary removal of healthy surrounding tissue while still achieving adequate replacement surface area.
3Adaptability or versatility
If manual bone shaping methods are used, then the procedure is simpler, but the ability to create specific custom shapes based on individual cartilage defects is limited
Solution Approach 1:
The system replaces manual mechanical bone shaping with a robotic milling system guided by virtual three-dimensional models. This substitution enables precise creation of custom shapes that match individual cartilage defects, as the robotic system can accurately follow complex digital geometries that would be difficult or impossible to create with manual tools alone.
4Reliability
If cartilage replacement is not securely fixed to subchondral bone, then integration is poor, but achieving secure fixation requires precise custom shaping
Solution Approach 1:
The system uses scan data to create virtual three-dimensional models, then uses these models to guide the robotic milling process in real-time. This closed-loop approach ensures the created cavity precisely matches the planned geometry, providing optimal fit and secure fixation of the cartilage replacement to the subchondral bone, thereby improving integration reliability.
Data Source
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Figure 3A~6
AI summary
A process and system for performing orthopaedic surgery to create a series of channels with a subject's bone to allow a reduced pressure system to be applied directly to the bone-implant interface to enhance bone healing is provided. The process for to promote healing of a bone of a subject includes creating a three-dimensional model of the bone; preoperatively planning a location of an implant relative to the model; creating a plan for the location of precision channels that reach the bone-implant interface based on the model and the implant; resurfacing the bone to fit the implant into or onto the bone based on the preoperative plan; and milling the precision channels into the bone in the location to promote healing of the bone and/or bone implant interface; and applying a pressure reduction system at the bone-implant interface to promote bone healing.