System and method for robotic surgery

• US 10,231,739 B1
• Filed: 07/18/2018
• Issued: 03/19/2019
• Est. Priority Date: 08/28/2001
• Status: Expired due to Term

• Current Assignee: Bonutti Skeletal Innovations LLC (Acacia Research Corporation)
• Original Assignee: Bonutti Skeletal Innovations LLC (Acacia Research Corporation)
• Inventors: Bonutti, Peter M.
• Primary Examiner(s): Gibson, Eric S
• Application Number:
  US16/038,279
• Time in Patent Office: 244 Days
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/158 Cutting patella
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1626 Control means; Display units
• CPC Class Codes: A61B 17/1666 for the acetabulum
• CPC Class Codes: A61B 17/1668 for the upper femur A61B17/164 takes precedence
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1717 for applying intramedullary nails or pins
• CPC Class Codes: A61B 17/1721 for applying pins along or parallel to the axis of the femoral neck
• CPC Class Codes: A61B 17/1735 for rasps or chisels
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/1746 for the acetabulum
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/809 with bone-penetrating elements, e.g. blades or prongs bone staples A61B17/0642; intramedullary nails with a plate at an end A61B17/7233
• CPC Class Codes: A61B 2017/00004 : (bio)absorbable, (bio)resorbable or resorptive
• CPC Class Codes: A61B 2017/00557 : inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0268 : for the knee
• CPC Class Codes: A61B 2017/0409 : Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0414 : having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2034/102 : Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/105 : Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/2051 : Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 : Optical tracking systems
• CPC Class Codes: A61B 2046/201 : for extremities, e.g. having collection pouch
• CPC Class Codes: A61B 2046/205 : Adhesive drapes
• CPC Class Codes: A61B 2046/236 : with means for collecting drain fluid, e.g. drain tubes
• CPC Class Codes: A61B 2090/064 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/3614 : using optical fibre
• CPC Class Codes: A61B 2090/366 : using projection of images directly onto the body
• CPC Class Codes: A61B 2090/374 : NMR or MRI
• CPC Class Codes: A61B 2090/376 : using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2217/005 : with suction drainage system
• CPC Class Codes: A61B 2217/007 : with irrigation system
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 42/00 : Surgical gloves; Finger-stalls specially adapted for surgery; Devices for handling or treatment thereof
• CPC Class Codes: A61B 46/00 : Surgical drapes
• CPC Class Codes: A61B 5/4533 : Ligaments
• CPC Class Codes: A61B 5/4851 : Prosthesis assessment or monitoring
• CPC Class Codes: A61B 90/11 : with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/13 : guided by light, e.g. laser pointers
• CPC Class Codes: A61B 90/30 : Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61F 2/30721 : Accessories
• CPC Class Codes: A61F 2/30724 : Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
• CPC Class Codes: A61F 2/30767 : Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/30771 : applied in original prostheses, e.g. holes or grooves
• CPC Class Codes: A61F 2/34 : Acetabular cups
• CPC Class Codes: A61F 2/38 : for elbows or knees
• CPC Class Codes: A61F 2/3859 : Femoral components
• CPC Class Codes: A61F 2/3868 : with sliding tibial bearing
• CPC Class Codes: A61F 2/3872 : Meniscus for implantation between the natural bone surfaces
• CPC Class Codes: A61F 2/3877 : Patellae or trochleae
• CPC Class Codes: A61F 2/389 : Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2/4609 : of acetabular cups
• CPC Class Codes: A61F 2/461 : of knees
• CPC Class Codes: A61F 2/4684 : Trial or dummy prostheses
• CPC Class Codes: A61F 2002/2817 : Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
• CPC Class Codes: A61F 2002/2835 : Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/30079 : magnetic
• CPC Class Codes: A61F 2002/30326 : differing in height or in length
• CPC Class Codes: A61F 2002/30331 : made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2002/30364 : Rotation about the common longitudinal axis
• CPC Class Codes: A61F 2002/30387 : Dovetail connection
• CPC Class Codes: A61F 2002/30398 : Sliding
• CPC Class Codes: A61F 2002/30433 : using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
• CPC Class Codes: A61F 2002/30507 : using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30761 : Support means for artificial cartilage, e.g. cartilage defect covering membranes
• CPC Class Codes: A61F 2002/30883 : dovetail-shaped
• CPC Class Codes: A61F 2002/30892 : parallel
• CPC Class Codes: A61F 2002/3092 : having an open-celled or open-pored structure
• CPC Class Codes: A61F 2002/30934 : Special articulating surfaces
• CPC Class Codes: A61F 2002/30975 : made of two halves
• CPC Class Codes: A61F 2002/3401 : with radial apertures, e.g. radial bores for receiving fixation screws
• CPC Class Codes: A61F 2002/3403 : Polar aperture
• CPC Class Codes: A61F 2002/3895 : unicompartimental
• CPC Class Codes: A61F 2002/4631 : the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2002/4677 : using a guide wire
• CPC Class Codes: A61F 2210/009 : magnetic
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0033 : made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2220/0041 : using additional screws, bolts, dowels or rivets, e.g. connecting screws
• CPC Class Codes: A61F 2250/0037 : differing in height or in length
• CPC Class Codes: A61F 2310/00011 : Metals or alloys
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: A61F 2310/00029 : Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
• CPC Class Codes: A61F 2310/00131 : Tantalum or Ta-based alloys
• CPC Class Codes: A61F 2310/00365 : Proteins; Polypeptides; Degradation products thereof
• CPC Class Codes: A61G 13/0045 : specially adapted for hand or wrist surgeries
• CPC Class Codes: A61G 13/0054 : specially adapted for back or spinal surgeries
• CPC Class Codes: A61G 13/0063 : specially adapted for knee surgeries
• CPC Class Codes: A61G 13/0072 : specially adapted for shoulder surgeries
• CPC Class Codes: A61G 13/0081 : specially adapted for hip surgeries
• CPC Class Codes: A61G 13/1245 : Knees, upper or lower legs
• CPC Class Codes: A61G 13/125 : Ankles or feet
• CPC Class Codes: A61M 1/77 : Suction-irrigation systems aspiration tips supplying fluids A61M1/85; specific for negative pressure wound therapy A61M1/92; combined with tracheal tubes A61M16/0463

Abstract

Systems and methods for performing surgery on a bone using a navigation subsystem having a locating device and a robotic subsystem having a cutting tool.

Claims

1. A system for performing an arthroplasty surgery on a femur and tibia, the system comprising:

a robotic subsystem including a base, a support column having an upper end portion rotatable relative to the base, a main arm pivotally attached to the upper end portion of the support column and having an outer end portion, a secondary arm pivotally mounted to the outer end portion of the main arm and defining a longitudinal axis, a mounting section rotatable about the longitudinal axis and including a mounting flange rotatable about a mounting axis, motors and controls supported by the base, and a cutting tool mounted to the mounting section;

a navigation subsystem in communication with the robotic subsystem, the navigation subsystem including a plurality of reflective locating devices;

a control unit in communication with the robotic subsystem;

a display in communication with the control unit;

wherein the navigation subsystem is configured to provide the robotic subsystem, during the surgery, with information relating to positions of the femur and tibia thereby enabling separate tracking of the femur and tibia when the femur and tibia move during the surgery and the navigation subsystem is configured to cooperate with the robotic subsystem to determine a position of the cutting tool relative to the femur and tibia to guide movement of the cutting tool relative to the femur and tibia to cut away material from the femur and tibia,

wherein the control unit is configured to receive information relating to the position of the cutting tool relative to the femur and tibia such that movement of the cutting tool relative to the femur during the surgery is viewable on the display and movement of the cutting tool relative to the tibia during the surgery is viewable on the display, wherein the plurality of reflective locating devices includes a first plurality of reflective locating devices for attaching to the femur and a second plurality of reflective locating devices for attaching to the tibia;

an optically created guide including a three-dimensional image having visible light beams; and

a support assembly including a flat surface to engage a foot of a patient and a pneumatically actuated piston and cylinder assembly operable to raise and lower the foot of the patient.

2. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism including the main arm and the secondary arm acting as an adaptive arm, wherein the robotic mechanism is configured to perform the arthroplasty surgery without being coupled to an operating table,

wherein the cutting tool comprises an oscillating saw coupled to the robotic mechanism and configured to resect a portion of the tibia and the femur of the patient through a limited incision in a leg of the patient, the robotic mechanism configured to control movement of the saw during the resection;

a computer coupled to the robotic mechanism and configured to control the robotic mechanism, the robotic mechanism configured to position a prosthetic implant relative to at least one of the tibia and femur, wherein the prosthetic implant includes at least one of an implant bearing surface and an arcuate shape, and includes an ingrowth surface,

wherein at least one of the plurality of reflective locating devices is positionable through skin of the patient into engagement with tissue in the patient,

wherein the navigation subsystem includes an optical system coupled to the computer, the optical system configured to determine a location of at least one bone relative to other tissue in the patient, wherein the optical system is configured to provide location information of the at least one bone to the computer for use by the robotic mechanism;

an electric motor coupled to the robotic mechanism and the computer, the electric motor configured to facilitate movement of the robotic mechanism;

a position sensor configured to provide movement information of the prosthetic implant relative to at least one of the tibia and femur;

an adaptive arm interface coupled to the adaptive arm and the computer, the adaptive arm interface configured to operate the computer;

a force transmitting member coupled to the electric motor, the force transmitting member configured to enable implantation of the prosthetic implant into at least one of the tibia and femur,

wherein the robotic subsystem is configured to determine stability of a joint in which the arthroplasty surgery is performed; and

at least one marker positionable on the body of the patient, the at least one marker configured to be detected by the robotic subsystem to provide location information, wherein the display is configured to provide imaging of the bone.

3. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism, wherein the robotic mechanism is configured to perform the arthroplasty surgery without being coupled to an operating table;

wherein the cutting tool is coupled to the robotic mechanism and configured to resect a portion of a bone of the patient through a limited incision in skin of the patient, the robotic mechanism configured to control movement of the cutting tool during the resection, wherein the bone is at least one of the femur and tibia;

a computer coupled to the robotic mechanism and configured to control the robotic mechanism, the robotic mechanism configured to position a prosthetic implant relative to the bone, wherein the prosthetic implant includes at least one of an implant bearing surface and an arcuate shape and includes an ingrowth surface,

wherein at least one of the plurality of reflective locating devices is positionable through skin of the patient into engagement with tissue in the patient,

wherein the navigation subsystem includes an optical system coupled to the computer, the optical system configured to determine a location of at least one bone relative to other tissue in the patient, wherein the optical system is configured to provide location information of the at least one bone to the computer for use by the robotic mechanism;

a position sensor configured to provide movement information of the robotic mechanism relative to the bone;

an interface coupled to the computer, the interface configured to operate the computer;

a motor configured to facilitate movement of the robotic mechanism;

a force transmitting member coupled to the motor, the force transmitting member configured to enable implantation of the prosthetic implant into the bone,

wherein the robotic subsystem is configured to determine stability of a joint in which the arthroplasty surgery is performed; and

at least one marker positionable on the body of the patient, the at least one marker configured to be detected by the robotic subsystem to provide location information, wherein the display is configured to provide imaging of the bone.

4. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism including the main arm and the secondary arm acting as an adaptive arm, the robotic mechanism configured to position a prosthetic implant relative to the bone through a limited incision in skin of the patient, wherein the prosthetic implant includes an implant bearing surface, and a portion having an arcuate shape and includes an ingrowth surface;

a computer configured to control the robotic mechanism,

wherein at least one of the plurality of reflective locating devices is positionable through skin of the patient into engagement with tissue in the patient,

wherein the navigation subsystem includes an optical system coupled to the computer, the optical system configured to determine a location of at least one bone relative to other tissue in the patient, wherein the optical system is configured to provide location information of the at least one bone to the computer for use by the robotic mechanism;

a position sensor configured to provide movement information of the prosthetic implant relative to the bone;

an adaptive arm interface coupled to the adaptive arm and the computer, the adaptive arm interface configured to operate the computer, wherein the arthroplasty surgery is performed on a leg of the patient,

wherein the display is configured to provide imaging of the bone;

at least one marker positionable on the body of the patient, the at least one marker configured to be detected by the robotic subsystem to provide location information;

an electric motor coupled to the robotic mechanism and configured to move the robotic mechanism; and

a force measurement assembly coupled to the computer, the force measurement assembly configured to measure a resistance force.

5. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism having a force transmitting member, wherein the robotic mechanism is configured to perform a surgical procedure without being coupled to an operating table;

a computer connected with the robotic mechanism,

wherein the navigation subsystem comprises;

an optical sensing system connected with the computer,

wherein the plurality of reflective locating devices are positionable through skin of a patient into one or more tissues of the patient, wherein each of the plurality of reflective locating devices has a reflective end visible to the optical sensing system,

wherein the optical system is configured to determine location information of a bone relative to tissue based on at least one of the plurality of reflective locating devices, and

wherein the optical system is configured to provide the determined location information of the bone to the computer for use by the robotic mechanism;

the cutting tool configured to resect at least a portion of a joint surface of a bone in the patient, wherein the robotic mechanism is configured to control movement of the cutting tool during resection of the joint surface in preparation for receipt of an arthroplasty component,

wherein the force transmitting member of the robotic mechanism is configured to position the arthroplasty component in the body of the patient, to cover at least a portion of the resected joint surface; and

a position sensor connected with the force transmitting member and the computer, the position sensor configured to provide a position of the force transmitting member,

wherein the bone is at least one of the tibia, femur, or portion of a spine, wherein the joint is at least one of a shoulder, hip, knee, and spine, wherein the robotic mechanism is configured to check stability of the joint in at least one of flexion, extension, and rotation, wherein the computer is connected to the force transmitting member by a motor, and wherein the force transmitting member is configured to position the arthroplasty component into the joint surface with a continuous insertion stroke.

6. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism having a force transmitting member, wherein the robotic mechanism is configured to perform a surgical procedure without being coupled to an operating table;

a computer connected with the robotic mechanism,

wherein the navigation subsystem comprises;

an optical sensing system connected with the computer,

wherein the plurality of reflective locating devices are positionable through skin of a patient into one or more tissues of the patient, wherein each of the plurality of reflective locating devices has a reflective end visible to the optical sensing system,

wherein the optical system is configured to determine location information of a bone relative to tissue based on at least one of the plurality of reflective locating devices, and

wherein the optical system is configured to provide the determined location information of the bone to the computer for use by the robotic mechanism;

the cutting tool configured to resect at least a portion of a joint surface of a bone in the patient, wherein the robotic mechanism is configured to control movement of the cutting tool during resection of the joint surface in preparation for receipt of an arthroplasty component,

wherein the force transmitting member of the robotic mechanism is configured to position the arthroplasty component in the body of the patient, to cover at least a portion of the resected joint surface; and

a force measurement assembly connected with the force transmitting member and the computer, the force measurement assembly having an output indicative of a resistance encountered by the force transmitting member, wherein the computer is configured to provide an indication to a user of the resistance encountered by the force transmitting member.

7. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism having a force transmitting member;

a computer connected with the robotic mechanism,

wherein the navigation subsystem comprises;

an optical sensing system connected with the computer,

wherein the plurality of reflective locating devices are configured to couple to one or more tissues of a patient, wherein each of the plurality of reflective locating devices has a reflective end visible to the optical sensing system,

wherein the optical system is configured to determine location information of a bone relative to tissue based on at least one of the plurality of reflective locating devices;

the cutting tool configured to resect at least a portion of the tibia in the patient through a incision in a leg of a patient, wherein the robotic mechanism is configured to control movement of the cutting tool during resection of the tibia in preparation for receipt of an implant covering at least a portion of the tibia,

wherein the force transmitting member of the robotic mechanism is configured to position the implant in the body of the patient, to cover at least a portion of the resected tibia,

wherein the navigation subsystem includes a transmitter positionable with respect to a portion of the body and communicatively connected with the force transmitting member,

wherein at least one of the plurality of reflective locating devices is configured to determine a position relative to the tibia,

wherein at least one of the plurality of reflective locating devices includes a fiber optic element; and

a position sensor connected with the force transmitting member and the computer, the position sensor configured to provide an output indicative of a position of the force transmitting member,

wherein the robotic mechanism is configured to check stability of the tibia in at least one of flexion, extension, and rotation, and

wherein the force transmitting member is configured to position the implant into the resected tibia with a continuous insertion stroke.

8. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism having a force transmitting member;

a computer connected with the robotic mechanism,

wherein the navigation subsystem comprises;

an optical sensing system connected with the computer,

wherein the plurality of reflective locating devices are configured to couple to one or more tissues of a patient, wherein each of the plurality of reflective locating devices has a reflective end visible to the optical sensing system,

wherein the optical system is configured to determine location information of a bone relative to tissue based on at least one of the plurality of reflective locating devices;

the cutting tool configured to resect at least a portion of the tibia in the patient through a incision in a leg of a patient, wherein the robotic mechanism is configured to control movement of the cutting tool during resection of the tibia in preparation for receipt of an implant covering at least a portion of the tibia,

wherein the force transmitting member of the robotic mechanism is configured to position the implant in the body of the patient, to cover at least a portion of the resected tibia; and

a force measurement assembly connected with the force transmitting member and the computer, the force measurement assembly having an output indicative of a resistance encountered by the force transmitting member, wherein the computer is configured to provide an indication to a user of the resistance encountered by the force transmitting member.

9. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism having a force transmitting member, wherein the robotic mechanism is configured to perform a surgical procedure without being coupled to an operating table;

a computer connected with the robotic mechanism,

wherein the navigation subsystem comprises;

an optical sensing system connected with the computer,

wherein the plurality of reflective locating devices are configured to couple to one or more tissues of a patient, wherein each of the plurality of reflective locating devices has a reflective end visible to the optical sensing system,

wherein the optical system is configured to determine location information of a bone relative to tissue based on at least one of the plurality of reflective locating devices;

the cutting tool configured to resect at least a portion of the femur in the patient, wherein the robotic mechanism is configured to control movement of the cutting tool during resection of the femur in preparation for receipt of an implant covering at least a portion of the femur,

wherein the force transmitting member of the robotic mechanism is configured to position an implant in the body of the patient, to cover at least a portion of the resected femur, wherein the robotic mechanism is configured to check stability of the femur in at least one of flexion, extension, and rotation; and

a position sensor connected with the force transmitting member and the computer, the position sensor configured to provide an output indicative of a position of the force transmitting member.

10. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism having a force transmitting member, wherein the robotic mechanism is configured to perform a surgical procedure without being coupled to an operating table;

a computer connected with the robotic mechanism,

wherein the navigation subsystem comprises;

an optical sensing system connected with the computer,

wherein the plurality of reflective locating devices are configured to couple to one or more tissues of a patient, wherein each of the plurality of reflective locating devices has a reflective end visible to the optical sensing system,

wherein the optical system is configured to determine location information of a bone relative to tissue based on at least one of the plurality of reflective locating devices;

the cutting tool configured to resect at least a portion of the femur in the patient, wherein the robotic mechanism is configured to control movement of the cutting tool during resection of the femur in preparation for receipt of an implant covering at least a portion of the femur,

wherein the force transmitting member of the robotic mechanism is configured to position an implant in the body of the patient, to cover at least a portion of the resected femur; and

a force measurement assembly connected with the force transmitting member and the computer, the force measurement assembly having an output indicative of a resistance encountered by the force transmitting member, wherein the computer is configured to provide an indication to a user of the resistance encountered by the force transmitting member.

11. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism, the robotic mechanism configured to perform a surgical procedure without being coupled to an operating table;

a computer connected with the robotic mechanism;

the cutting tool coupled to the robotic mechanism and configured to resect at least a portion of a joint surface of a bone in the patient through a incision of a patient, and

wherein the navigation subsystem comprises;

an optical sensing system connected with the computer,

wherein the plurality of reflective locating devices are configured to couple to one or more tissues of the patient,

wherein each of the plurality of reflective locating devices has a reflective end visible to the optical sensing system,

wherein the optical system is configured to determine location information of a bone relative to tissue based on at least one of the plurality of reflective locating devices,

wherein the robotic mechanism comprises a force transmitting member wherein the force transmitting member of the robotic mechanism is configured to position an implant in the body of the patient; and

a position sensor connected with the force transmitting member and the computer, the position sensor having an output indicative of a position of the force transmitting member,

wherein the implant includes at least one of an arthroplasty component, a fastener, a scaffold, a viable tissue component, and a graft.

12. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism having a force transmitting member, the robotic mechanism configured to perform a surgical procedure without being coupled to an operating table;

a computer connected with the robotic mechanism,

wherein the navigation subsystem includes an optical sensing system connected with the computer,

wherein the plurality of reflective locating devices are configured to couple to one or more tissues of a patient, wherein at least one of the plurality of reflective locating devices is recognizable by the optical sensing system when coupled to the one or more tissues of the patient,

wherein the optical system is configured to determine location information of a bone relative to tissue based on at least one of the plurality of reflective locating devices,

wherein the force transmitting member of the robotic mechanism is configured to position an arthroplasty component in the body of the patient to cover at least a portion of the resected bone,

wherein the computer is configured to provide an indication to a user of a resistance encountered by the force transmitting member; and

a position sensor connected with the force transmitting member and the computer, the position sensor configured to provide an output indicative of a position of the force transmitting member,

wherein the arthroplasty component includes at least one of a portion of a knee replacement, a component configured to be implanted on at least one of the tibia and femur, a component configured to be implanted in at least a portion of at least one of a shoulder and a hip, an implant configured to be positioned on the spine, a scaffold with viable tissue components, and

wherein the arthroplasty component is positioned through a cannula.

13. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism having a force transmitting member, the robotic mechanism configured to perform a surgical procedure without being coupled to an operating table;

a computer connected with the robotic mechanism,

wherein the navigation subsystem includes an optical sensing system connected with the computer,

wherein the plurality of reflective locating devices are configured to couple to one or more tissues of a patient, wherein each of the plurality of reflective locating devices has a reflective end visible to the optical sensing system, wherein the optical system is configured to determine location information of a bone relative to tissue based on at least one of the plurality of reflective locating devices;

the cutting tool configured to resect at least a portion of a first bone of a joint in a patient and at least a portion of a second bone of the joint in the patient, wherein at least one of the computer and the robotic mechanism is configured to control movement of the cutting tool during resection of at least one of the first and second bones of the joint in preparation for receipt of an arthroplasty component,

wherein the first bone is the femur and the second bone is the tibia or wherein the joint includes vertebra of the spine;

a force measurement assembly connected with the force transmitting member and the computer, the force measurement assembly having an output indicative of a resistance encountered by the force transmitting member; and

a position sensor connected with the force transmitting member and the computer, the position sensor having an output indicative of a position of the force transmitting member.

14. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism, wherein the robotic mechanism is configured to perform the arthroplasty surgery without being coupled to an operating table;

the cutting tool coupled to the robotic mechanism for resecting a portion of a bone of the patient through an incision in skin of the patient, the robotic mechanism configured to control movement of the cutting tool during the resection;

a computer coupled to the robotic mechanism and configured to control the robotic mechanism,

wherein the plurality of reflective locating devices are positionable into engagement with tissue in the patient,

wherein the navigation subsystem includes an optical system coupled to the computer, the optical system configured to determine a location of at least one bone relative to other tissue in the patient, wherein the optical system is configured to provide location information of the at least one bone to the computer for use by the robotic mechanism;

a position sensor configured to provide movement information of the robotic mechanism relative to the bone;

an interface coupled to the computer, the interface configured to operate the computer, wherein the bone is at least one of the femur and tibia; and

a motor configured to facilitate movement of the robotic mechanism.

15. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism, wherein the robotic mechanism is configured to perform the arthroplasty surgery without being coupled to an operating table;

the cutting tool coupled to the robotic mechanism for resecting a portion of a bone of the patient through an incision in skin of the patient, the robotic mechanism configured to control movement of the cutting tool during the resection;

a computer coupled to the robotic mechanism and configured to control the robotic mechanism,

wherein the plurality of reflective locating devices are positionable into engagement with tissue in the patient,

wherein the navigation subsystem includes an optical system coupled to the computer, the optical system configured to determine a location of at least one bone relative to other tissue in the patient, wherein the optical system is configured to provide location information of the at least one bone to the computer for use by the robotic mechanism;

a position sensor configured to provide movement information of the robotic mechanism relative to the bone;

an interface coupled to the computer, the interface configured to operate the computer, wherein the cutting tool is one of an oscillating saw and a reciprocating saw;

a prosthetic implant including at least one of an implant bearing surface and an arcuate shape; and

a screw configured to couple to one or more tissues of the patient.

16. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism configured to perform arthroplasty surgery without being coupled to an operating table;

a prosthetic implant,

wherein the cutting tool comprises a saw coupled to the robotic mechanism for resecting a portion of one of the tibia and the femur of the patient through an incision in a leg of the patient, the robotic mechanism configured to control movement of the saw during the resection by use of an electric motor;

a computer coupled to the robotic mechanism and configured to control the robotic mechanism,

wherein the plurality of reflective locating devices are positionable into engagement with tissue of the patient,

wherein the navigation subsystem includes an optical system coupled to the computer, the optical system configured to determine a location of at least one bone relative to other tissue in the patient, wherein the optical system is configured to provide location information of the at least one bone to the computer for use by the robotic mechanism;

a position sensor configured to provide movement information of the robotic mechanism relative to at least one of the tibia and femur;

an interface coupled to the computer, the interface configured to operate the computer, wherein the robotic subsystem is configured to determine stability of a joint in which the arthroplasty surgery is performed, wherein the prosthetic implant includes at least one of an implant bearing surface and an arcuate shape, or wherein the prosthetic implant includes an ingrowth surface; and

a force transmitting member coupled to the electric motor.

17. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism configured to perform arthroplasty surgery without being coupled to an operating table;

a prosthetic implant,

wherein the cutting tool comprises a saw coupled to the robotic mechanism for resecting a portion of one of the tibia and the femur of the patient through an incision in a leg of the patient, the robotic mechanism configured to control movement of the saw during the resection by use of an electric motor;

a computer coupled to the robotic mechanism and configured to control the robotic mechanism,

wherein the plurality of reflective locating devices are positionable into engagement with tissue of the patient,

wherein the navigation subsystem includes an optical system coupled to the computer, the optical system configured to determine a location of at least one bone relative to other tissue in the patient, wherein the optical system is configured to provide location information of the at least one bone to the computer for use by the robotic mechanism;

a position sensor configured to provide movement information of the robotic mechanism relative to at least one of the tibia and femur;

an interface coupled to the computer, the interface configured to operate the computer, wherein the display is configured to be visible to the operating surgeon and is configured to provide an image of a location where the robotic mechanism is being utilized in performance of the arthroplasty surgery on the patient; and

a fastener configured to couple to one or more tissues of the patient, wherein the fastener comprises a screw, and wherein the saw is one of an oscillating saw and a reciprocating saw.

18. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism, the robotic mechanism configured to perform a surgical procedure without being coupled to an operating table and to control movement of the cutting tool coupled to the robotic mechanism during resection of at least a portion of a joint surface of a bone in the patient through an incision of a patient; and

a computer connected with the robotic mechanism,

wherein the navigation subsystem comprises;

an optical sensing system connected with the computer,

wherein the plurality of reflective locating devices are configured to couple to one or more tissues of the patient, wherein each of the plurality of reflective locating devices has a reflective end visible to the optical sensing system,

wherein the optical system is configured to determine location information of a bone relative to tissue based on at least one of the plurality of reflective locating devices,

wherein the robotic mechanism is configured to check stability of the joint in at least one of flexion, extension, and rotation,

wherein the robotic mechanism is configured to check stability of the tibia in at least one of flexion, extension, and rotation,

wherein the display is configured to be visible to the operating surgeon and configured to provide an image of a location where the robotic mechanism is being utilized in performance of a surgical procedure on the patient,

wherein the cutting tool is one of an oscillating saw or reciprocating saw, and

wherein the robotic mechanism is operable to tension an anchor secured to body tissue with a predetermined force.

19. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism, the robotic mechanism configured to perform a surgical procedure without being coupled to an operating table and to control movement of the cutting tool coupled to the robotic mechanism during resection of at least a portion of a joint surface of a bone in the patient through an incision of a patient;

a computer connected with the robotic mechanism,

wherein the navigation subsystem comprises;

an optical sensing system connected with the computer, and

wherein the plurality of reflective locating devices are configured to couple to one or more tissues of the patient,

wherein each of the plurality of reflective locating devices has a reflective end visible to the optical sensing system,

wherein the optical system is configured to determine location information of a bone relative to tissue based on at least one of the plurality of reflective locating devices,

wherein the robotic mechanism comprises a force transmitting member, wherein the computer is configured to provide an indication to a user of a resistance encountered by the force transmitting member;

a position sensor connected with the force transmitting member and the computer, the position sensor configured to provide a position of the force transmitting member,

wherein an implant includes an arthroplasty component, wherein the arthroplasty component includes a portion of a knee prosthesis; and

a fastener configured to couple to one or more tissues of the patient, wherein the fastener comprises a screw.

20. The system of claim 1, wherein the robotic subsystem further comprises:

a robotic mechanism having a force transmitting member, the robotic mechanism configured to perform a surgical procedure without being coupled to an operating table;

a computer connected with the robotic mechanism,

wherein the navigation subsystem includes an optical sensing system connected with the computer,

wherein the plurality of reflective locating devices are configured to couple to one or more tissues of a patient, wherein each of the plurality of reflective locating devices has a reflective end visible to the optical sensing system, wherein the optical system is configured to determine location information of a bone relative to tissue based on at least one of the plurality of reflective locating devices;

the cutting tool being suitable for use in resecting at least a portion of a first bone of a joint in a patient and at least a portion of a second bone of the joint in the patient, wherein at least one of the computer and the robotic mechanism is configured to control movement of the cutting tool during resection of at least one of the first and second bones of the joint in preparation for receipt of an arthroplasty component, wherein the computer is configured to provide a resistance indication to a user of the system;

a position sensor connected with the force transmitting member and the computer, the position sensor configured to provide a position of the force transmitting member,

wherein the robotic mechanism is configured to check stability of the joint in at least one of flexion, extension, and rotation,

wherein the display is configured to be visible to the operating surgeon and configured to provide an image of a location where the robotic mechanism is being utilized in performance of a surgical procedure on the patient,

wherein the robotic mechanism is operable to tension an anchor secured to body tissue with a predetermined force,

wherein the arthroplasty component includes a portion of a knee replacement; and

a screw configured to couple to one or more tissues of the patient.

21. A method for performing an arthroplasty surgery on a femur and tibia of a knee joint, the method comprising:

providing a robotic subsystem including a base, a support column having an upper end portion rotatable relative to the base, a main arm pivotally attached to the upper end portion of the support column and having an outer end portion, a secondary arm pivotally mounted to the outer end portion of the main arm and defining a longitudinal axis, a mounting section rotatable about the longitudinal axis and including a mounting flange rotatable about a mounting axis, motors and controls supported by the base, and a cutting tool mounted to the mounting section;

providing a navigation subsystem in communication with the robotic subsystem, the navigation subsystem including a plurality of reflective locating devices;

providing a control unit in communication with the robotic subsystem;

providing a display in communication with the control unit,

wherein the navigation subsystem provides the robotic subsystem, during the surgery, with information relating to positions of the femur and tibia thereby enabling separate tracking of the femur and tibia when the femur and tibia move during the surgery and the navigation subsystem cooperates with the robotic subsystem to determine a position of the cutting tool relative to the femur and tibia to guide movement of the cutting tool relative to the femur and tibia to cut away material from the femur and tibia,

wherein the control unit receives information relating to the position of the cutting tool relative to the femur and tibia such that movement of the cutting tool relative to the femur during the surgery is viewable on the display and movement of the cutting tool relative to the tibia during the surgery is viewable on the display, wherein the plurality of reflective locating devices includes a first plurality of reflective locating devices attached to the femur and a second plurality of reflective locating devices attached to the tibia;

providing an optically created guide including a three-dimensional image having visible light beams; and

providing a support assembly including a flat surface to engage a foot of a patient and a pneumatically actuated piston and cylinder assembly operable to raise and lower the foot of the patient.

22. The method of claim 21, further comprising:

coupling an oscillating saw to a robotic mechanism, wherein the cutting tool comprises the oscillating saw, wherein the robotic subsystem includes the robotic mechanism and wherein the robotic mechanism includes the main arm and the secondary arm acting as an adaptive arm and an electric motor coupled to the robotic mechanism, wherein the electric motor is configured to facilitate movement of the robotic mechanism, wherein the oscillating saw is configured to resect a portion of a bone of the patient, and wherein the robotic mechanism is configured to control movement of the saw during the resection;

coupling a computer to the robotic mechanism, the computer coupled to an optical system configured to determine a location of at least one bone relative to other tissue in the patient, wherein the navigation subsystem includes the optical system, wherein the computer is configured to control the robotic mechanism, and wherein the robotic mechanism is configured to position a prosthetic implant relative to the bone;

providing a position sensor configured to provide movement information of the prosthetic implant relative to the bone; and

coupling an adaptive arm interface to the adaptive arm and the computer, wherein the adaptive arm is configured to operate the computer, wherein the bone on which the arthroplasty surgery is performed is at least one of the femur and the tibia.

23. The method of claim 21, further comprising:

preparing a patient'"'"'s femur and tibia for receiving one or more surgical implants in the arthroplasty surgery including;

placing some of the plurality of reflective locating devices into engagement with the patient'"'"'s femur and tibia such that reflective ends of the plurality of reflective locating devices are disposed outside the patient'"'"'s body;

operating a robotic mechanism included in the robotic subsystem, the robotic mechanism connected with a computer through a robotic arm interface and configured to operate without being coupled to an operating table;

sensing movement of the reflective ends of the plurality of reflective locating devices with an optical sensing system connected with the computer and robotic mechanism, wherein the navigation subsystem includes the optical sensing system;

determining relative positions of the femur and the tibia with the optical sensing system;

displaying an image of a location on the femur or tibia where the robotic mechanism is being utilized on the patient on the display which is visible to a surgeon operating the robotic mechanism; and

transmitting force from a force transmitting member of the robotic mechanism to body tissue, wherein the force transmitting member is the cutting tool and at least one of the femur and tibia are resected with the cutting tool and wherein the robotic mechanism limits movement of the cutting tool during the resection, wherein the step of operating a robot mechanism is performed by manually moving the robotic mechanism and wherein the step of operating a robot mechanism is performed automatically by providing instructions to the robotic arm interface.

24. The method of claim 21, further comprising:

preparing the patient'"'"'s femur and tibia for receiving one or more surgical implants in the arthroplasty surgery including;

placing some of the plurality of reflective locating devices into engagement with the patient'"'"'s femur and tibia such that reflective ends of the plurality of reflective locating devices are disposed outside the patient'"'"'s body;

manually operating a robotic mechanism included in the robotic subsystem, the robotic mechanism connected with a computer through a robotic arm interface;

sensing movement of the reflective ends of the plurality of reflective locating devices with an optical sensing system connected with the computer and robotic mechanism, wherein the navigation subsystem includes the optical sensing system;

determining relative positions of the femur and the tibia with the optical sensing system;

displaying an image of a location on the femur or tibia where the robotic mechanism is being utilized on the patient on the display which is visible to a surgeon operating the robotic mechanism; and

resecting at least one of the femur and tibia with the cutting tool coupled to the robotic mechanism, wherein the step of displaying an image includes displaying a three-dimensional image.

25. The method of claim 21, further comprising:

preparing the patient'"'"'s femur and tibia for receiving one or more surgical implants in the arthroplasty surgery;

placing some of the plurality of reflective locating devices into engagement with the patient'"'"'s femur and tibia such that reflective ends of the plurality of reflective locating devices are disposed outside the patient'"'"'s body;

manually operating a robotic mechanism included in the robotic subsystem, the robotic mechanism connected with a computer through a robotic arm interface;

sensing movement of the reflective ends of the plurality of reflective locating devices with an optical sensing system connected with the computer and robotic mechanism, wherein the navigation subsystem includes the optical sensing system;

determining relative positions of the femur and the tibia with the optical sensing system;

displaying an image of a location on the femur or tibia where the robotic mechanism is being utilized on the patient on the display which is visible to a surgeon operating the robotic mechanism; and

resecting at least one of the femur and tibia with the cutting tool coupled to the robotic mechanism, wherein, during the resecting step, the robotic mechanism receives inputs that control movement of the cutting tool, wherein the robotic mechanism is configured to control resection without being coupled to an operating table;

providing a surgical implant and displaying a position of the surgical implant in the patient'"'"'s body;

positioning a screw in the patient'"'"'s femur or tibia;

using manual effort to position the one or more surgical implants relative to bone; and

determining a stability of the knee joint in which the arthroplasty surgery is performed.

26. The method of claim 21, further comprising:

preparing a patient'"'"'s body for receiving a surgical implant utilizing a robotic mechanism including;

placing some of the plurality of reflective locating devices into engagement with one or more tissues of the patient'"'"'s body such that reflective ends of the plurality of reflective locating devices are disposed outside the patient'"'"'s body;

manually operating a robotic mechanism, the robotic mechanism connected with a computer through a robotic arm interface;

sensing movement of the reflective ends of the plurality of reflective locating devices with an optical sensing system connected with the computer and robotic arm interface, wherein the navigation subsystem includes the optical sensing system;

determining relative positions of tissues in the patient'"'"'s body with the optical sensing system;

displaying an image of a location where the robotic mechanism is being utilized on the patient on the display which is visible to a surgeon operating the robotic mechanism;

transmitting force from a force transmitting member of the robotic mechanism to body tissue; and

indicating a position of the force transmitting member relative to the body tissue with a position sensor connected with the force transmitting member and the computer, wherein the image provided on the display is a three-dimensional image and wherein the force transmitting member further comprises the cutting tool.

27. The method of claim 21, further comprising:

preparing a patient'"'"'s body for receiving a surgical implant utilizing a robotic mechanism including;

placing some of the plurality of reflective locating devices into engagement with one or more tissues of the patient'"'"'s body such that reflective ends of the plurality of reflective locating devices are disposed outside the patient'"'"'s body;

manually operating a robotic mechanism, the robotic mechanism connected with a computer through a robotic arm interface;

sensing movement of the reflective ends of the plurality of reflective locating devices with an optical sensing system connected with the computer and robotic arm interface, wherein the navigation subsystem includes the optical sensing system;

determining relative positions of tissues in the patient'"'"'s body with the optical sensing system;

displaying an image of a location where the robotic mechanism is being utilized on the patient on the display which is visible to a surgeon operating the robotic mechanism;

transmitting force from a force transmitting member of the robotic mechanism to body tissue; and

indicating a position of the force transmitting member relative to the body tissue with a position sensor connected with the force transmitting member and the computer, wherein the arthroplasty surgery is a knee arthroplasty surgery;

determining a stability of a knee joint in which the knee arthroplasty surgery is performed;

resecting a bone during the knee arthroplasty surgery, wherein the robotic mechanism limits movement of the cutting tool during the step of resecting a bone, wherein, during the step of resecting, one of the femur and the tibia are resected and the surgical implant is a knee prosthesis, wherein the robotic mechanism is configured to control resection without being coupled to an operating table;

positioning a fastener in the patient'"'"'s body, wherein the fastener is a screw; and

providing a view on the display of the implant being positioned in a desired manner in the patient'"'"'s body.