Surgical plan options for robotic machining

Abstract

A method of performing surgery on a bone includes providing a robotically controlled bone preparation system and creating at least one hole in the bone with the robotically controlled bone preparation system prior to machining the bone. The bone hole aligns with a hole or a post in a guide for a manual cutting tool. If the robot fails during surgery, or if the surgeon does not wish to complete the procedure with the robot, the guide is attached to the bone after aligning the guide hole with the bone hole. The surgery is completed manually after the guide is attached to the bone, and the robot is not used after the guide is attached to the bone.

1 . A method of performing surgery on a bone comprising:
 providing a robotically controlled bone preparation system capable of preparing the bone according to a preoperative surgical plan pursuant to which an implant is to be coupled to the prepared bone in a preoperatively planned position and orientation; and   machining at least one contingency preparation in the bone with the robotically controlled bone preparation system, wherein the position of the at least one contingency preparation in the bone corresponds to a portion of a guide for guiding a manual cutting tool such that the guide could be used to prepare the bone according to the preoperative surgical plan; and   completing the surgery according to the preoperative plan by either using the robotically controlled bone preparation system or manually using the guide in association with the contingency preparation.   
     
     
         2 . The method of  claim 1 , wherein the contingency preparation is a hole. 
     
     
         3 . The method of  claim 2 , further comprising the step of removing at least one anatomical landmark of the bone after the step of creating at least one contingency hole in the bone, wherein the at least one anatomical landmark would have been used in determining a position and orientation of the guide with respect to the bone. 
     
     
         4 . The method of  claim 3 , further comprising the step of attaching the guide to the bone after aligning the portion of the guide with the at least one contingency hole. 
     
     
         5 . The method of  claim 4 , wherein the portion of the guide is either a guide hole or a guide post. 
     
     
         6 . The method of  claim 4 , wherein the guide includes a tracker for use with a surgical navigation system. 
     
     
         7 . The method of  claim 4 , further comprising the step of completing the surgery manually after the step of attaching the guide to the bone, wherein the robotically controlled bone preparation system is not used after the guide is attached to the bone. 
     
     
         8 . The method of  claim 7 , wherein the step of completing the surgery manually includes manually debulking the femur and tibia facilitated by a surgical navigation system. 
     
     
         9 . The method of  claim 2 , wherein the step of creating at least one contingency hole in the bone comprises creating at least one contingency hole in a femur and at least one contingency hole in a tibia. 
     
     
         10 . A method of performing surgery on a bone comprising:
 providing a robotically controlled bone preparation system to prepare the bone according to a preoperative surgical plan;   operating the robotically controlled bone preparation system to machine the bone to have features corresponding to features of a manual cutting guide; and   coupling the manual cutting guide to the bone.   
     
     
         11 . The method of  claim 9 , further comprising the step of operating the robotically controlled bone preparation system to further machine the bone such that at least one anatomical landmark is modified prior to coupling the manual cutting guide to the bone. 
     
     
         12 . The method of  claim 10 , wherein the step of coupling the manual cutting guide to the bone occurs after the robotically controlled bone preparation system has at least partially failed to machine the bone according to the preoperative surgical plan. 
     
     
         13 . The method of  claim 10 , wherein the step of operating the robotically controlled bone preparation system to machine the bone includes creating at least one hole in the bone. 
     
     
         14 . The method of  claim 13 , wherein the at least one hole in the bone corresponds to at least one hole or post in the manual cutting guide. 
     
     
         15 . The method of  claim 14 , further comprising the step of attaching the manual cutting guide to the bone after aligning the at least one guide hole or post with the at least one hole in the bone. 
     
     
         16 . The method of  claim 15 , wherein the guide includes a tracker for use with a surgical navigation system. 
     
     
         17 . The method of  claim 15 , further comprising the step of completing the surgery manually after the step of attaching the guide to the bone, wherein the robotically controlled bone preparation system is not used after the guide is attached to the bone. 
     
     
         18 . The method of  claim 17 , wherein the step of completing the surgery manually includes manually debulking the femur and tibia facilitated by a surgical navigation system. 
     
     
         19 . A method of performing surgery on a bone comprising:
 providing a robotically controlled bone preparation system to make bone resections;   operating the robotically controlled bone preparation system to machine the bone to have features corresponding to features of a guide for guiding a manual cutting tool;   coupling the guide to the bone; and   resecting the bone with the manual cutting tool guided by the guide.   
     
     
         20 . The method of  claim 19 , wherein the step of operating the robotically controlled bone preparation system to machine the bone includes creating at least one hole in the bone. 
     
     
         21 . The method of  claim 20 , wherein the at least one hole in the bone corresponds to at least one hole or post in the guide. 
     
     
         22 . The method of  claim 21 , further comprising the step of attaching the guide to the bone after aligning the at least one guide hole or post with the at least one hole in the bone. 
     
     
         23 . The method of  claim 22 , further comprising the step of completing the surgery manually after the step of attaching the guide to the bone, wherein the robotically controlled bone preparation system is not used in the surgery after the guide is attached to the bone. 
     
     
         24 . The method of  claim 23 , wherein the guide includes a tracker for use with a surgical navigation system. 
     
     
         25 . The method of  claim 23 , wherein the completed surgery is a total knee arthroplasty. 
     
     
         26 . The method of  claim 25 , wherein the step of creating at least one hole in the bone comprises creating at least two holes in a femur and at least two holes in a tibia. 
     
     
         27 . The method of  claim 26 , wherein the step of attaching the guide to the bone comprises attaching a femoral resection guide to the femur. 
     
     
         28 . The method of  claim 26 , wherein the step of attaching the guide to the bone comprises attaching a tibial resection guide to the tibia. 
     
     
         29 . The method of  claim 23 , wherein the completed surgery is a partial knee arthroplasty. 
     
     
         30 . The method of  claim 29 , wherein the step of creating at least one hole in the bone comprises creating at least two holes in a femur and at least two holes in a tibia. 
     
     
         31 . The method of  claim 30 , wherein the step of attaching the guide to the bone comprises attaching a femoral resection guide to the femur. 
     
     
         32 . The method of  claim 31 , wherein the step of completing the surgery manually includes manually resecting the femur facilitated by a surgical navigation system. 
     
     
         33 . The method of  claim 28 , wherein the step of attaching the guide to the bone comprises attaching a tibial resection guide to the tibia. 
     
     
         34 . The method of  claim 33 , wherein the step of completing the surgery manually includes manually resecting the tibia facilitated by a surgical navigation system. 
     
     
         35 . A method of performing surgery on a bone comprising:
 providing a robotically controlled bone preparation system to make bone resections;   operating the robotically controlled bone preparation system to machine the bone to have features corresponding to features of a surgical instrument, wherein the robotic machining has at least one of increased accuracy, reproducibility, and speed compared to manual resections; and   manually completing the surgery on the bone without further use of the robotically controlled bone preparation system, including the step of manually coupling the surgical instrument to the bone.