Existing debridement and grafting tools for orthopaedic applications are rigid, preventing the surgeons to access many confined areas and/or limiting their ability in minimally-invasive removal of the lesions. Examples include treatment of bone defects such as metastatic bone disease or severe osteoporosis in areas including the pelvis/acetabulum, femoral neck, peri-and sub-trochanteric regions, shin, foot, as well as treatment of avascular necrosis of the hip, and osteolysis in the pelvis. Osteolysis, for instance, continues to be the primary phenomenon responsible for shortening the expected lifespan of total hip arthroplasty (THA) procedures.
Having debriding and grafting instruments with high dexterity and robotically assisted can help physicians to access the very difficult to reach areas within the pelvis, significantly improving the efficacy of the core decompression procedure. To further improve the precision and effectiveness of the procedure, in situ effective guidance of access routes to the target anatomy and debridement monitoring based on intra-op 3D image data are necessary. Therefore, the proposed image-guided robots will rely on real-time processing the co-registration of a surgical plan with the imaging data captured during the intervention, as well as real-time localization of the instrument relative to the anatomy of surgical interest. The proposed robot systems would comprise three major technical features, namely 1) a dexterous miniaturized manipulator, specially designing a steerable drill; 2) compact robotic arm and corresponding control system that could tele-operate the flexible drill in sufficient degrees-of-freedom, output force, and stiffness for precise debridement; and 3) X-ray based or other image-modality navigation system to guide the tracking and localization of the surgical instruments relative to image coordinates. These three enabling technologies will be integrated together to set out a robotic platform for accessing and navigating the narrow spaces in the pelvis that are not possible before. X-ray based or other image-modality navigation system will serve as a non-invasive GPS to guide the tool to navigate inside the surgical site and monitor the debridement process with precision. The ultimate research objective is to enable the physician to perform more precise and effective debridement and bone grafting with the aid of steerable drilling instruments and intra-op imaging.