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Robot systeem van Monogram personaliseert gewrichtsvervangende operaties

Monogram robot-assisted system personalizes joint replacements procedures

Monogram Orthopaedics has developed a revolutionary approach to joint replacements that is supported by an LBR Med to deliver better care. Combining customized implants and high-tech robotic milling, the company has created an optimized solution designed to meet each patient's unique needs.

Studies show that nearly 1 in 5 people are not happy with their knee replacements. And it's not hard to figure out why. Little has changed in the approach to these surgeries in the last 50 years, leaving patients treated with crude instruments and one-size-fits-all implants. These shortcomings prompted Monogram Orthopaedics founder and Chief Medical Officer, Dr. Douglas Unis, to look for a better way to address these needs. While there were other surgical robots on the market, he soon realized a unique opportunity to develop a superior robotic system - a navigated CT-based (personalized surgical plan) robotic system that utilizes a new way of thinking about implants.

LBR iiwa Med
©Monogram

Bringing joint replacement surgery into the 21st century with a better robotic system

The workflow of the Monogram robotic system is patient-centric from beginning to end. Starting with a CT-scan, the Texas-based company uses its proprietary software to autogenerate a customized implant that is 3D printed to match the patient's anatomy. The CT-scan is also used to develop a detailed preoperative plan that allows a KUKA LBR Med to mill the printed implant features precisely. The surgeon inserts the orthopedic implant into the personalized cavity made with precision using the same integrated lightweight robot. This combination eliminates a lot of the variability of outcomes that lead to readmission and dissatisfaction.

A state-of-the-art robotic surgical system for patient-optimized outcomes

The Monogram Orthopaedics navigated robotic system comes with a KUKA LBR Med equipped with a high-efficiency rotary cutting system and tracking cameras to mitigate any line-of-sight issues. The robot executes all of its cuts autonomously (with surgeon oversight).  Monogram has implemented a "closed-loop" architecture to provide real-time tracking of the end-effector position for safety.  Monogram also leverages kinematic redundancy to avoid interoperative boundaries. The system utilizes automated digital image analysis algorithms to link 3D printing and robotics together, enabling it to provide personalized implants that would have been unimaginable until recently.

The LBR Med, in our opinion, is the best commercial robot for medical purposes on the market.  Its performance, testing, and paperwork that comes with it are going to make our lives much easier.

BenjaminSexson, Chief Executive Officer, Monogram Orthopaedics
©Monogram

Next-generation implants that minimize the risk of loosening

Currently, over 90% of joint replacement surgeries use cemented implants. Generic implants don't perfectly restore the individual patient's anatomy. Monogram only uses uncemented, or press-fit, implants in their joint replacements. Monogram can optimize and customize how the implant fits into the bone by leveraging their preoperative planning and 3D printing capabilities and combining those with their surgical robot. The result is a highly stable implant that enables bone to grow, or fuse, into the implant, providing improved stability and a healthier replacement overall.

©Monogram

For their next step, Monogram Orthopaedics is looking to gain 510 (k) clearance from the FDA. They are also hoping to showcase the system at either the 2021 or 2022 American Academy of Orthopedic Surgeons (AAOS) Annual Meeting.

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