The embodiments provide provides devices, instruments, and associated methods for treating joint pain. A joint is evaluated using magnetic resonance imaging to detect any defects in the subchondral bone. For example, using T2-weighted MRI images, bone marrow lesions or edemas can be identified, and using T1-weighted MRI images, associated regions of sclerotic bone adjacent to the bone marrow lesion can be identified. The treatment method may involve introducing a bone void filler material at the site to address the bone marrow lesion or edema, and/or drilling and inserting an implant to address the sclerotic bone, bone marrow lesion or edema, and insufficiency or stress fractures. An access path is mapped to a location in the subchondral region where the insufficiency fracture resides. The access path attempts to preserve an articular surface of the joint. A reinforcing member that stabilizes the insufficiency fracture is then implanted via the access path.

There is provided a surgical instrument for navigated surgeries and systems and methods using such a surgical instrument. The surgical tool comprises a tip; a tool interface, separate from the tip; and an optically trackable target. The tip is configured to probe positions in a space and identify the positions using optical information from the optically trackable target. The tool interface is configured to mate with a surgical tool such that the optical trackable target then provides optical information with which to determine positional information for the surgical tool in the space. In one example, the system provides navigational information during surgery using the surgical instrument, namely, a single integrated tracker instrument with two or more mechanical interfaces for coupling the tracker instrument with anatomical features and/or surgical tools.

Devices and methods for performing a surgical step or surgical procedure with visual guidance using an optical head mounted display are disclosed.

The embodiments provide devices and methods that both strengthen the bone and stimulate the bone. Bone fractures or non-unions are stabilized, integrated or healed, which results in reduction of a bone defect, such as a bone marrow lesion or edema. In addition, the distribution of forces in a joint are restored or altered to relieve pain. In general, a joint is evaluated by taking an image of the joint and one or more subchondral defects are detected. At least one of the subchondral defects may be diagnosed as the source of pain and an extent of treatment for the subchondral defect is determined. The disclosed devices and techniques are particularly suited for treating chronic defects or injuries, where the patient's natural healing response has not resolved the defect. The present disclosure also provides several exemplary treatment modalities for the different extents of treatment needed.

A method for preparing a bone of a joint of a patient includes mounting a patient-specific reference guide on a bone of a joint of a patient. A connecting portion of the reference guide is coupled to a miniaturized numerically controlled instrument having a housing including a controller, a processor and a tool driver. The patient-specific reference guide has a three-dimensional inner surface preoperatively configured to mirror and mate with a corresponding surface of a bone of a joint of a patient in only one position. The patient-specific reference guide is configured to automatically register the numerically controlled instrument to the patient's bone portion intraoperatively. The cutting tool is guided by the controlled with signals from the processor along a patient-specific tool path determined during the preoperative plan for preparing a portion of the bone.

Arthroplasty jigs and related methods are disclosed. Some of the arthroplasty jigs may comprise a jig body that is configured to align with a surface of a bone, and a positioning component. Certain of the methods may comprise providing such an arthroplasty jig, and aligning the jig body with a surface of a bone so that the positioning component provides at least one of a visible, audible, or tactile indication that such alignment has been achieved. Some of the arthroplasty jigs may comprise a jig body that is configured to align with a surface of a bone, and that is marked with identifying information. Certain of the methods may comprise providing an arthroplasty jig comprising a jig body that is configured to align with a surface of a bone, or providing an arthroplasty jig blank, and marking the arthroplasty jig or the arthroplasty jig blank with identifying information.

Systems, methods and software guide arrangement of a robotic system in an operating room. Controller(s) evaluate surgical procedure information and determine a desired placement of the robotic system in the operating room based on evaluation of the surgical procedure information. A localizer determines a current placement of the robotic system in the operating room. A display provides visual representations of the current placement and the desired placement of the robotic system to guide a user on manual placement of the robotic system in the operating room.

Devices and methods for performing a surgical step or surgical procedure with visual guidance using an optical head mounted display are disclosed.

A minimally invasive surgical drill guide includes an elongated drill jig having at least one drill guide opening for defining a location and drill element guide axis for placement of a surgical drill element. The drill jig can have an engagement end with engagement structure. A positioning arm includes an elongated shaft with an axis and a locating end portion shaped to engage a bony part of a patient. The elongated shaft can have engagement structure for engaging to the engagement structure of the drill jig to support the drill jig crosswise relative to the position arm and to support the drill guide opening of the drill jig at a location remote from the axis of the elongated shaft of the positioning arm. The drill jig can be detachable from the positioning arm. A method for minimally invasive surgical drilling is also disclosed.

Methods, systems, and devices for treating osteochondral defects (OCDs) are disclosed. The disclosed methods and systems include collecting joint surface data using image-free methods, generating a three-dimensional (3D) healthy bone model based on the joint surface data and a database of healthy bone anatomies, defining the OCD boundary on the joint, generating a 3D implant model based on the 3D healthy bone model and the OCD boundary, manufacturing an implant based on the 3D implant model, generating an implantation plan, the resected cavity on the joint. The implant includes a 3D-printed titanium alloy substrate having a first and second porous layer separated by a nonporous layer. A polymer material is over-molded onto the second porous layer and treated to exhibit properties that mimic cartilage, while the first porous layer allows the implant to fuse to patient bone.