`
`Whatis claimed is:
`
`1.
`
`A system for performing an arthroplasty surgery on a femurandtibia, 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 mountedto 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 includinga 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 femurand 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 andtibia to guide movementofthe cutting tool
`
`relative to the femur and tibia to cut away material from the femurandtibia,
`
`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 movementofthe cutting tool relative to
`
`the femur during the surgery is viewable on the display and movementofthe 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 thetibia;
`
`an optically created guide including a three-dimensional image havingvisible light
`
`beams; and
`
`a support assembly includinga flat surface to engage a foot of a patient and a
`
`187
`
`
`
`pneumatically actuated piston and cylinder assembly operable to raise and lowerthe 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 ofthe tibia and the femurof the patient through a limited
`
`incision in the leg of the patient, the robotic mechanism configured to control movementof 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 bonerelative 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 movementof the robotic mechanism;
`
`a position sensor configured to provide movementinformation 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 membercoupledto the electric motor, the force transmitting member
`
`configured to enable implantation of the prosthetic implantinto at least one of the tibia and
`
`femur,
`
`wherein the robotic subsystem is configured to determine stability of a joint in which the
`
`188
`
`
`
`arthroplasty surgery is performed; and
`
`at least one markerpositionable 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 boneof the patient through a limited incision in the skin of the patient, the robotic
`
`mechanism configured to control movementof the cutting tool during the resection, wherein the
`
`boneis at least one of the femurandtibia;
`
`a computer coupled to the robotic mechanism and configured to control the robotic
`
`mechanism, the robotic mechanism configured to position a prosthetic implantrelative to the
`
`bone, wherein the prosthetic implant includesat 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 the location of at least one bonerelative to other
`
`tissue in the patient, wherein the optical system is configured to provide location information of
`
`the at least one bone to the computerfor use by the robotic mechanism;
`
`a position sensor configured to provide movementinformation 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 movementof the robotic mechanism;
`
`a force transmitting membercoupled 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 markerpositionable on the body of the patient, the at least one marker
`
`189
`
`
`
`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 implantrelative to the bone
`
`through a limited incision in the 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 the location of at least one bonerelative to other
`
`tissue in the patient, wherein the optical system is configured to provide location information of
`
`the at least one bone to the computerfor use by the robotic mechanism;
`
`a position sensor configured to provide movementinformation 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 ofthe patient,
`
`wherein the display is configured to provide imaging of the bone;
`
`at least one markerpositionable 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 movethe robotic
`
`mechanism; and
`
`a force measurement assembly coupled to the computer, the force measurement assembly
`
`configured to measurea 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;
`
`190
`
`
`
`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 the
`
`skin of a patient into one or moretissues of the patient, wherein each of the
`
`plurality of reflective locating devices hasa reflective end visible to the optical
`
`sensing system,
`
`wherein the optical system is configured to determine location information of a
`
`bonerelative 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 movementof 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 componentin the body ofthe patient, to coverat 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 boneis 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
`
`checkstability 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 memberpositions the arthroplasty componentinto 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,
`
`19]
`
`
`
`wherein the navigation subsystem comprises:
`
`an optical sensing system connected with the computer,
`
`wherein the plurality of reflective locating devices are positionable through the
`
`skin of a patient into one or moretissues 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
`
`bonerelative 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 movementof 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 componentin the body ofthe patient, to coverat 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 moretissues of a patient, wherein each ofthe 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
`
`192
`
`
`
`bonerelative to tissue based onat least one ofthe plurality ofreflective locating
`
`devices;
`
`the cutting tool configured to resect at least a portion of the tibia in the patient through a
`
`incision in the leg of a patient, wherein the robotic mechanism is configured to control
`
`movementofthe 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 includesa 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
`
`determinea 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 memberpositions 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 moretissues of a patient, wherein each ofthe 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
`
`193
`
`
`
`bonerelative 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 the leg of a patient, wherein the robotic mechanism is configured to control
`
`movementofthe 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 moretissues of a patient, wherein each ofthe 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
`
`bonerelative 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 femurin the patient, wherein
`
`the robotic mechanism is configured to control movementof 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
`
`194
`
`
`
`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 moretissues of a patient, wherein each ofthe 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
`
`bonerelative 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 femurin the patient, wherein
`
`the robotic mechanism is configured to control movementof 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;
`
`195
`
`
`
`a computer connected with the robotic mechanism;
`
`the cutting tool coupled to the robotic mechanism and configuredto 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 moretissues of the patient,
`
`wherein eachofthe 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
`
`bonerelative 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 memberof 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 includesat least one of an arthroplasty component, a fastener, a
`
`scaffold, a viable tissue component, anda 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
`
`moretissues of a patient, wherein at least one of the plurality of reflective locating devicesis
`
`recognizable by the optical sensing system when coupled to the one or moretissues of the
`
`patient,
`
`196
`
`
`
`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 componentin the body of the patient to coverat least a portion of the
`
`resected bone,
`
`wherein the computer is configured to provide an indication to a user of the 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 componentincludesat 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 anda hip,
`
`an implant configured to be positioned on the spine, a scaffold with viable tissue components,
`
`and
`
`wherein the arthroplasty componentis 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
`
`moretissues of a patient, wherein each ofthe 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 bonerelative to tissue based on at least one ofthe plurality
`
`of reflective locating devices;
`
`the cutting tool configured to resect at least a portion ofa first bone of a joint in a patient
`
`and at least a portion of a second boneofthe joint in the patient, wherein at least one of the
`
`computer and the robotic mechanism is configured to control movementof the cutting tool
`
`197
`
`
`
`during resection of at least one of the first and second bones ofthe joint in preparation for receipt
`
`of an arthroplasty component,
`
`wherein the first bone is the femur and the second boneis 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 the skin of the patient, the robotic mechanism configured to control
`
`movementofthe 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 the location of at least one bonerelative to other
`
`tissue in the patient, wherein the optical system is configured to provide location information of
`
`the at least one bone to the computerfor use by the robotic mechanism;
`
`a position sensor configured to provide movementinformation of the robotic mechanism
`
`relative to the bone;
`
`an interface coupled to the computer, the interface configured to operate the computer,
`
`wherein the boneis at least one of the femur andtibia; and
`
`a motor configuredto facilitate movementof the robotic mechanism.
`
`15.
`
`The system of claim 1, wherein the robotic subsystem further comprises:
`
`198
`
`
`
`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 the skin of the patient, the robotic mechanism configured to control
`
`movementofthe 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 the location of at least one bonerelative to other
`
`tissue in the patient, wherein the optical system is configured to provide location information of
`
`the at least one bone to the computerfor use by the robotic mechanism;
`
`a position sensor configured to provide movementinformation 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 moretissues 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 femurof the patient through an incision in the leg of the
`
`patient, the robotic mechanism configured to control movementof 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,
`
`199
`
`
`
`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 bonerelative to other tissue
`
`in the patient, wherein the optical system is configured to provide location information ofthe at
`
`least one bone to the computer for use by the robotic mechanism;
`
`a position sensor configured to provide movementinformation 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 includesat least one of an
`
`implant bearing surface and an arcuate shape, wherein at least one of the prosthetic implants
`
`includes an ingrowth surface; and
`
`a force transmitting membercoupledto 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 femurof the patient through an incision in the leg of the
`
`patient, the robotic mechanism configured to control movementof 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 bonerelative to other tissue
`
`in the patient, wherein the optical system is configured to provide location information ofthe at
`
`least one bone to the computer for use by the robotic mechanism;
`
`200
`
`
`
`a position sensor configured to provide movementinformation 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 visible to the operating surgeon and provides an imageofthe location
`
`where the robotic mechanism is being utilized in the performanceof 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 movementofthe cutting tool coupled
`
`to the robotic mechanism during resection ofat 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 moretissues 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
`
`bonerelative 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 visible to the operating surgeon and provides an image ofthe
`
`location where the robotic mechanism is being utilized in the performanceofa surgical
`
`procedure on the patient,
`
`wherein the cutting tool is one of an oscillating saw or reciprocating saw, and
`
`201
`
`
`
`wherein the robotic mechanism is operable to tension an anchorsecured to body tissue
`
`with a predetermined force.
`
`19.
`
`The system of claim 1, wherein the robotic subsystem fu