A Robotic Flexible Drill and Its Navigation System for Total Hip Arthroplasty

This paper presents a robotic flexible drill and its navigation system for total hip arthroplasty (THA). The new robotic system provides an unprecedented and unique capability to perform curved femoral milling under the guidance of a multimodality navigation system. The robotic system consists of three components. Firstly, a flexible drill manipulator comprises multiple rigid segments that act as a sheath to a flexible shaft with a drill/burr attached to the end. The second part of the robotic system is a hybrid tracking system that consists of an optical tracking system and a position tracking system. Optical tracking units are used to track the surgical objects and tools outside the drilling area, while a rotary encoder placed at each joint of the sheath is synchronized to provide the position information for the flexible manipulator with its virtual object. Finally, the flexible drill is integrated into a computer-aided navigation system. The navigation system provides real time guidance to a surgeon during the procedure. The flexible drill system is then able to implement THA by bone milling. The final section of this paper is an evaluation of the flexible and steerable drill and its navigation system for femoral bone milling in sawbones.

[1]  Ryan A. Beasley.  Medical Robots: Current Systems and Research Directions , 2012, J. Robotics.

[2]  Philip E Riches,et al.  Accuracy of a freehand sculpting tool for unicondylar knee replacement , 2014, The international journal of medical robotics + computer assisted surgery : MRCAS.

[3]  Robert Rohling,et al.  Hand-held steerable needle device , 2003, IEEE/ASME Transactions on Mechatronics.

[4]  J Rachinger,et al.  An automated robotic approach with redundant navigation for minimal invasive extended transsphenoidal skull base surgery. , 2005, Minimally invasive neurosurgery : MIN.

[5]  R. Brown,et al.  A computerized tomography-computer graphics approach to stereotaxic localization. , 1979, Journal of neurosurgery.

[6]  N. Sugano.  Computer-assisted orthopedic surgery , 2003, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[7]  F Langlotz,et al.  Computer Assistance for Pelvic Osteotomies , 1998, Clinical orthopaedics and related research.

[8]  P. Cinquin,et al.  Computer-assisted spine surgery: a technique for accurate transpedicular screw fixation using CT data and a 3-D optical localizer. , 1995, Journal of image guided surgery.

[9]  J. Ding,et al.  Inroads Toward Robot-Assisted Cochlear Implant Surgery Using Steerable Electrode Arrays , 2010, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[10]  Umesh Tiwari,et al.  Fiber grating sensors in medicine: Current and emerging applications , 2011 .

[11]  B Jaramaz,et al.  Image Guided Navigation System to Measure Intraoperatively Acetabular Implant Alignment , 1998, Clinical orthopaedics and related research.

[12]  H Löwenheim,et al.  Trends and Perspectives in Minimally Invasive Surgery in Otorhinolaryngology‐Head and Neck Surgery , 1997, The Laryngoscope.

[13]  R. Kober,et al.  Technique and first clinical results of robot-assisted total knee replacement. , 2002, The Knee.

[14]  Jess H Lonner,et al.  Indications for unicompartmental knee arthroplasty and rationale for robotic arm-assisted technology. , 2009, American journal of orthopedics.

[15]  J M Sikorski,et al.  Computer-assisted orthopaedic surgery: do we need CAOS? , 2003, The Journal of bone and joint surgery. British volume.

[16]  B. Jaramaz,et al.  Precision freehand sculpting for unicondylar knee replacement: design and experimental validation , 2012, Biomedizinische Technik. Biomedical engineering.

[17]  S. J. Harris,et al.  The first clinical application of a "hands-on" robotic knee surgery system. , 2001, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[18]  L Kinzl,et al.  Spinal navigation in cervical fractures--a preliminary clinical study on Judet-osteosynthesis of the axis. , 2001, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[19]  Robert Rohling,et al.  Hand-held steerable needle device , 2005 .

[20]  Daniel Kendoff,et al.  Robotic arm-assisted unicompartmental knee arthroplasty: preoperative planning and surgical technique. , 2009, American journal of orthopedics.

[21]  Russell H. Taylor,et al.  Spatial Motion Constraints Using Virtual Fixtures Generated by Anatomy , 2007, IEEE Transactions on Robotics.

[22]  H Bergmann,et al.  Positioning of dental implants using computer-aided navigation and an optical tracking system: case report and presentation of a new method. , 1999, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[23]  W. Bargar,et al.  Primary and Revision Total Hip Replacement Using the Robodoc® System , 1998, Clinical orthopaedics and related research.

[24]  Hideki Yoshikawa,et al.  Comparison between hand rasping and robotic milling for stem implantation in cementless total hip arthroplasty. , 2006, The Journal of arthroplasty.

[25]  A. Schulz,et al.  Results of total hip replacement using the Robodoc surgical assistant system: clinical outcome and evaluation of complications for 97 procedures , 2007, The international journal of medical robotics + computer assisted surgery : MRCAS.

[26]  Maria Chiara Carrozza,et al.  A novel mechatronic tool for computer-assisted arthroscopy , 2000, IEEE Transactions on Information Technology in Biomedicine.

[27]  L. Nolte,et al.  Basic principles of CAOS. , 2004, Injury.

[28]  Russell H. Taylor,et al.  A Curved-Drilling Approach in Core Decompression of the Femoral Head Osteonecrosis Using a Continuum Manipulator , 2017, IEEE Robotics and Automation Letters.

[29]  A. Malvisi,et al.  Computer- and Robot-Assisted Total Knee Replacement: Analysis of a New Surgical Procedure , 2000, Annals of Biomedical Engineering.

[30]  Haptic robotics enable a systems approach to design of a minimally invasive modular knee arthroplasty. , 2009, American journal of orthopedics.

[31]  B. Jaramaz,et al.  Navigation in Minimally Invasive Total Knee Arthroplasty and Total Hip Arthroplasty , 2006 .