Patent ID: 12213686

DETAILED DESCRIPTION

The present disclosure describes technical solutions to various technical problems facing knee arthroplasty procedures. To address technical problems facing knee arthroplasty resection validation, the present subject matter provides a tracked knee arthroplasty instrument for objective measurement of resection depth. By performing a precise comparison between the location of the tracked knee arthroplasty instrument and a reference location, the knee arthroplasty instrument measures and validates each tibial and femoral resection. To address technical problems facing validation of joint laxity following knee arthroplasty, the tracked knee arthroplasty instrument is shaped to validate the flexion gap and extension gap. When the tracked knee arthroplasty instrument is inserted between the resected tibial plateau and femoral head, the instrument shape validates whether the desired flexion gap and extension gap have been achieved.

In an example PKA surgical procedure, a tibia is resected, the tracked knee arthroplasty instrument is used to validate the resection and check flexion gap and extension gap, the femur is resected, and the tracked knee arthroplasty instrument is again used to validate the resection and check gaps. The use of the tracked knee arthroplasty instrument to validate resections and check gaps ensures that bone gaps and soil tissue allow for sufficient space for an implant and sufficient space in the postoperative elongated leg. In addition to validating resections and checking gaps, the use of the tracked knee arthroplasty instrument provides information regarding limb alignment and tactile feel of the resected surfaces.

The tracked knee arthroplasty instrument may be used with a robotic surgical device. In an example, a robotic surgical device may perform a tibial or femoral resection, and the tracked knee arthroplasty instrument may be used by a surgeon or by the robotic surgical device to validate resections and check gaps. In an example, the robotic surgical device may position resection surgical tools to prepare for the resection, a surgeon may perform a tibial or femoral resection, and the tracked knee arthroplasty instrument may be used by a surgeon or by the robotic surgical device to validate resections and check gaps. The robotic surgical system and tracked knee arthroplasty instrument may use a combination of one or more coordinate systems or tracked positioning systems. In an example, the tracked knee arthroplasty instrument is tracked using an optical tracking system, the robotic surgical device uses a robotic device coordinate system, and a surgical plan management system translates the tracked knee arthroplasty instrument position and robotic surgical device position into a common coordinate system viewable by the surgeon.

In the drawings, which are not necessarily drawn to scale, like numerals may describe similar components in different views. Like numerals having different letter suffixes may represent different instances of similar components. The drawings illustrate generally, by way of example, but not by way of limitation, various embodiments discussed in the present document.

FIG.1is a perspective view of a tracked knee arthroplasty system100, in accordance with some embodiments. System100includes an arthroplasty validation instrument110, where instrument110includes one or more articular contact surfaces that may be placed in contact with a resected tibial surface. In an example, a horizontal resection validation surface on the bottom surface (not shown) of instrument110may be placed on the tibial plateau horizontal resection150. Similarly, a vertical resection validation surface on the distant surface (not shown) of instrument110may be placed on the vertical resection155(e.g., tibial sagittal resection).

The thickness (e.g., height) of instrument110separates the top surface from the horizontal resection validation surface on the bottom surface (not shown) of instrument110. This gap validation thickness may be used to validate the gap between the tibial plateau horizontal resection150and the femoral head160.FIG.1shows the gap validation thickness being used to validate the extension gap while the knee is in flexion, though the gap validation thickness may also be used to validate the flexion gap while the knee is in extension.

Instrument110may be attached to a manual manipulation device120. The manipulation device120may include grooves, a grip, or other surface to improve the ability of a surgeon to manipulate the instrument110. The instrument110or the manipulation device120may include an orientation mechanism (e.g., detent, keying surface) to ensure the instrument110and manipulation device120are attached in a reliable and precise configuration. In an example, the instrument110includes a threaded aperture and the manipulation device120includes a threaded socket, and a threaded screw130is attached through the instrument110into the manipulation device120.

The manipulation device120may be attached to a location tracking device140, such as an optical tracker. The tracking device140may be used by an optical tracking system to determine the precise location of the instrument110. In an example, once the instrument110is positioned against the horizontal resection150and against the vertical resection155, the tracking device140may be used to validate the horizontal resection150and the vertical resection155. The validation of the horizontal resection150may include determining a resection cut depth, a varus or valgus angle, a resection slope, or other horizontal resection geometry. The validation of the vertical resection155may include determining a resection rotation, a resection medial-lateral offset, or other vertical resection geometry.

In another example, the position of the instrument110may be tracked to ensure the instrument110is inserted to a sufficient depth between the tibial plateau horizontal resection150and the native femoral head160or a distal femoral resection, where the gap validation thickness (e.g., height) of instrument110is used to validate the gap between the tibial plateau horizontal resection150and the native femoral head160or a distal femoral resection. The optical system may determine the position of the tracking device140relative to another tracked position, such as relative to an optical tracker fixedly attached to the patient tibia, relative to a registration pointer attached to a robotic arm, or relative to another tracked position.

FIGS.2A-2Bare perspective views of a tracked knee arthroplasty system200, in accordance with some embodiments. System200includes an arthroplasty validation instrument210attached to a manual manipulation device220, such as using a threaded screw130threaded through instrument210into manipulation device220. Instrument210may include a proximate portion225that is proximate to the manipulation device220, and may include a distal portion215that is distal from the manipulation device220.

As shown inFIG.2A, the proximate portion225may be thicker than the distal portion215. The use of different thicknesses may be used to validate different gap sizes, such as validating a posterior gap on a posterior portion of a tibial plateau resection and a larger anterior gap on an anterior portion of the tibial plateau resection. Instrument210may include a transition region235between the proximate portion225and the distal portion215. The transition region235may facilitate insertion of the instrument210between the tibial plateau horizontal resection150and the femoral head160, such as by providing a linear sigmoid, or other smooth transition between the proximate portion225and the distal portion215.

As shown inFIG.2B, the proximate portion225may be wider than the distal portion215. The wider proximate portion225may be used to provide a mechanical stop, such as by providing a stop against an anterior tibial surface when inserted between the tibial plateau horizontal resection150and the femoral head160.

FIG.3is a perspective view of a tracked knee arthroplasty system300, in accordance with some embodiments, System300includes a proximate portion325of an arthroplasty validation instrument, which may be inserted into a patient incision350. The proximate portion325may be attached to a manual manipulation device220. The manipulation device320may include a pointed tip portion340that is received within a tip receptacle within proximate portion325. Once the pointed tip portion340is seated correctly within the tip receptacle, the manipulation device320may be secured to the proximate portion325using a threaded screw330.

FIG.4is a perspective view of a tracked knee arthroplasty system400, in accordance with some embodiments. System400includes an arthroplasty validation instrument410, where instrument410includes one or more articular contact surfaces that may be placed in contact with a resected tibial surface. A horizontal resection validation surface on the bottom surface (not shown) of instrument410may be placed on the tibial plateau horizontal resection450. Similarly, a vertical resection validation surface on the distant surface (not shown) of instrument410may be placed on the vertical resection455(e.g., tibial sagittal resection). Instrument410may be attached to a manual manipulation device420, such as using a threaded screw430threaded through instrument410into the manipulation device420, Manipulation device420may be connected to an optical tracker or other tracking device (not shown).

The thickness of instrument410separates the top surface from the horizontal resection validation surface on the bottom surface (not shown) of instrument410. This gap validation thickness may be used to validate the gap between the tibial plateau horizontal resection450and the resected femoral head460.FIG.4shows the gap validation thickness being used to validate the extension gap while the knee is in flexion, though the gap validation thickness may also be used to validate the flexion gap while the knee is in extension.

Instrument410includes an anterior stop440. When fully inserted, the anterior stop440rests against the tibial anterior cortex470. The anterior stop440may be used to minimize or prevent instrument410from migrating during drilling, pinning, impaction, or other surgical procedures. When used with a tracking device, the anterior stop440may be used to provide key cortex location information or other tracking information, which may be used to make more precise recuts in imageless cases. This tracking information may reduce or prevent the need for discrete (e.g., dedicated) digitization or registration pointer checks.

Instrument410may include one or more structural features to provide additional validation information. The length of instrument410may be used to locate the tibial posterior cortex while validating the tibial plateau resection plane. In an example, instrument410may include distal tibial hooks, distal tibial stops, or other mechanical features (not shown) extending beyond the end of instrument410to locate the posterior cortex. This determined location of the posterior cortex may assist in finding additional reference locations for anatomic landmarking, such as to define the tibial internal and external rotation coordinate system at the plane of the tibial resection. The combination of distal tibial hook and the anterior stop440may be used to provide information about the geometry of the tibia, which may be used to size the tibia. In an example, instrument410may include medial or lateral tibial side hooks or other mechanical features (not shown) extending to either side of instrument410. The side hooks may be used to map the size and geometry of the medial cortex or lateral cortex. This cortex information may be used for femoral sizing, such as selecting standard or narrow femoral head implants. In an example, instrument410may include a distal trochlea stylus (not shown), which might be used to locate or map the femoral trochlea (e.g., intercondylar fossa of femur). The trochlea stylus may provide anterior reference information, which may be used to improve femoral sizing or notching information within a resection. Information from the anterior stop440or one or more tibial hooks may be used to validate resections or update anatomic information. In an example, anatomic information may be gathered through preoperative digitization of the bone, and the preoperatively gathered information may be updated using intraoperative information gathered from the anterior stop440or one or more tibial hooks. This updated information may be used to refresh or improve surgical plans intraoperatively while reducing or minimizing additional intraoperative surgical procedure steps.

FIG.5is a tibial resection diagram500, in accordance with some embodiments. A surgeon may use an arthroplasty validation instrument to determine that the depth or slope of the primary cut510(e.g., initial tibial resection) is insufficient, and that a secondary cut520(e.g., secondary resection) may be needed. To change the slope of a tibial resection, the secondary cut520must begin at a lower point on the tibial anterior cortex to ensure a full resection. The starting points of the primary cut510and the secondary cut520may be separated by a cut bias530. To minimize the number of additional tibial resections, the cut bias530may be selected to be the smallest bias that is sufficiently large to perform the secondary cut520. This may be particularly useful when performing a secondary cut520where there is insufficient information available about the location of the tibial anterior cortex, such as in imageless arthroplasty procedures. The bias selection may be improved by determining information about the location of the anterior cortex, such as using the anterior stop440to provide cortex location information.

FIG.6is a tibial resection slope graph600, in accordance with some embodiments. Graph600depicts an example primary cut610and a secondary cut620. In a conventional TKA surgery, the rotation point for the posterior slope is set at the anterior aspect of the tibia, so, the surgeon does not need to worry about increased resection depth for an increased slope recut. For a PKA surgery, the posterior slope is set based on the middle of the tibial plateau, so a secondary cut to change the slope will always include an increase in the resection depth630(e.g., secondary cut bias) to ensure a full resection.

The slope and depth of the secondary cut620may be adjustable to provide a desired slope while remaining consistent with other surgical parameters. In an example, a PKA surgical plan may have an associated maximum allowed parallel recut640, which may correspond with a worst-case slope and depth change650. Table 1 shows various combinations of tibial resection depth and slope. In particular, Table 1 shows a minimum increase in depth required to provide a full resection, and shows the maximum increase in resection depth that will result in a resection within 3 mm distal to the primary cut on the anterior/posterior side (e.g., maximum allowed parallel recut).

TABLE 1Tibial Resection Depth and SlopeChange inMinimumMinimum change inMaximum increase inSlope (withchange inresection depthresection depth (forrespect toresectionrequired forminimum resectionfirst cut)depthfull resectiondepth change)0°0.00 mm3 mm2°0.721.1 mm3.7 mm4°1.432.17 mm4.4 mm5°1.792.71 mm4.8 mm6°2.153.26 mm5.1 mm8°2.884.36 mm5.9 mm10°3.615.5 mm6.6 mm

FIG.7is a diagram of a knee arthroplasty graphical user interface (GUI)700, in accordance with some embodiments. GUI700may be used to display information about planned or measured arthroplasty resection depths or angles. GUI700may include an anterior view710of the femoral head720and the proximal tibia730. Similarly, GUI700may include a medial view715of the femoral head725and the proximal tibia735. The anterior view710may have an associated anterior view control740, and the medial view715may have an associated medial view control745, which may be used to rotate the view of the femur and tibia displayed within GUI700. The anterior view710may have an associated anterior tibial control750, and the medial view715may have an associated medial tibial control755, which may be used to change the flexion angle or modify tibial slope or resection. GUI700may also provide information about distal resection depth760, proximal resection depth765, proximal resection slope angles770, posterior slope angles775, hip-knee-ankle (HKA) axis angles780, plan laxity measurements785, and a flexion angle790.

The display of information, bone views, or other portions within GUI700may be modified to indicate whether one or more steps in the knee arthroplasty surgical procedure have been completed. For example, the proximal resection depth765may be presented in a first color to indicate a sufficient resection depth, and the proximal tibia730and proximal resection angle770may be presented in a second color to indicate additional surgical procedure steps are needed to provide the planned resection slope. In another example, the proximal resection depth765may be presented in a first color to indicate the depth is based on a depth validated by an arthroplasty validation instrument, and the proximal tibia730and proximal resection angle770may be presented in a second color to indicate the displayed resection slope angle is using outdated information.

FIGS.8A-8Dare diagrams of an augment cut validation800, in accordance with some embodiments.FIG.8Ashows a patient tibia with a partial implant810, such as may be used in a PKA surgical procedure.FIG.8Bshows a horizontal revision surgery tibia cut820and a deeper augment cut830. A surgeon may use the revision surgery when a portion of the knee has bad bone quality, where the surgeon can remove the bad bone quality region with an augment implant to provide a stable surface for the femoral implant.FIG.8Cshows the revision surgery with an augment implant840and a revision implant850. WhileFIG.8Cshows a revision surgery with a correct augment implant cut depth,FIG.8Dshows a revision surgery with an insufficient augment implant cut depth, resulting in a gap860. To determine whether the augment implant cut depth is sufficient, an augment cut validation device may be used, such as shown inFIG.9A.

FIGS.9A-9Care diagrams of an augment cut validation device900, in accordance with some embodiments. The augment cut validation device900may be used to determine whether a revision surgery augment resection and horizontal resection are cut to a correct depth. As shown inFIG.9A, augment cut validation device900may include a tracker mount910and a base920. One or more slide-in augment spacers930,935may be attached to base920. In an example, each augment spacer930,935may have a flange940that slides within base channel925and one or more detents945to secure the augment spacer930,935in a fixed position relative to the augment cut validation device900. As shown inFIG.9B, an augment cut validation device900may have an extended base for validating a surface on a larger bone. As shown inFIG.9C, variously sized augment spacers950may be used. In various examples, the augment spacers950may include incremental sizes, such as 5 mm, 10 mm, 15 mm, or other sizes. In an example, two different sized augment spacers950may be used to validate a first cut dept of a resected surface of a horizontal resection and a deeper cut depth of a resected surface of an augment resection.

FIG.10is a diagram of an augment cut validation tracker device1000, in accordance with some embodiments. The augment cut validation tracker device1000includes a tracker mount1010that attaches to a tracker attachment1020, which is fixedly attached to an optical tracker1040. The augment cut validation tracker device1000includes one or more augment spacers1030that may be used to validate a revision surgery augment resection and horizontal resection. In an example, surgeon may position the augment cut validation tracker device1000such that the augment spacers1030are in contact with an augment resection and horizontal resection of a patient tibia1050, and the optical tracker1040may be used to determine the depth of the augment resection and horizontal resection by comparing a measured location of the optical tracker1040against a known location of the tibia1050. Similarly, the augment cut validation tracker device1000may be used to compare the augment resection depth to the horizontal resection depth, such as by determining that a vertical axis of the optical tracker1040is offset from the vertical axis of the tibia1050.

FIG.11illustrates a flow chart showing a knee arthroplasty technique1100, in accordance with some embodiments. Technique1100may include outputting1110control instructions to cause a robotic surgical device to assist in a resection of a patient tibia or femur. The resection may include a tibial plateau resection, which may include a resected horizontal surface and a resected vertical surface. The resection may include an augment resection, which may include a resected augment surface and a resected revision implant surface.

Technique1100includes positioning1120a knee arthroplasty validation device to contact the horizontal resection and to contact the vertical resection. Positioning of the knee arthroplasty validation device may include outputting control instructions to cause the robotic surgical device to position the knee arthroplasty validation device. The knee arthroplasty validation device may include a horizontal resection validation surface, a vertical resection validation surface, one or more augment spacers, and an optical tracker fixedly attached to the knee arthroplasty validation device. The vertical resection validation surface may be orthogonal to the horizontal resection validation surface, and a substantially planar gap validation surface. The gap validation surface may be substantially parallel to the horizontal resection validation surface and separated from the horizontal resection validation surface by a gap validation thickness. The gap validation thickness may be used to validate a flexion gap and an extension gap.

Technique1100includes validating1130, using processing circuitry of the robotic surgical device, the horizontal resection based on a tracked validation position of the optical tracker. Technique1100may include validating1135, using processing circuitry of the robotic surgical device, the vertical resection based on a tracked validation position of the optical tracker. Technique1100may include validating1145, using processing circuitry of the robotic surgical device, an augment resection based on a tracked validation position of the optical tracker.

Technique1100may include validating1140a flexion gap or an extension gap. Validating1140the flexion gap may include comparing the gap validation thickness of the knee arthroplasty validation device against the flexion gap formed by the patient tibia and a corresponding patient femur in flexion. Validating1140the extension gap may include comparing the gap validation thickness of the knee arthroplasty validation device against the extension gap formed by the patient tibia and the corresponding patient femur in extension.

Technique1100may include instructing1150the robotic surgical device to assist in a distal femoral resection of corresponding patient femur. Technique1100may include disposing1160the knee arthroplasty validation device against the distal femoral resection and instructing the robotic surgical device to validate the distal femoral resection based on a tracked femoral position of the knee arthroplasty validation device.

Technique1100may include a surgeon positioning1170the knee arthroplasty validation device and receiving a validation initiation input from the surgeon. The validation input may initiate the validation of the horizontal resection and the vertical resection.

Technique1100may include comparing1180the validation position of the knee arthroplasty validation device against a tracked tibial position. The tracked tibial position may be based on an optical tibial tracker fixedly attached to the patient tibia. The tracked tibial position may be based on a registration position of a registration pointer, where the registration pointer is fixedly attached to a robotic arm of the robotic surgical device.

FIG.12illustrates an example of a block diagram of a machine1200upon which any one or more of the techniques (e.g., methodologies) discussed herein may perform in accordance with some embodiments. In alternative embodiments, the machine1200may operate as a standalone device or may be connected (e.g., networked) to other machines. In a networked deployment, the machine1200may operate in the capacity of a server machine, a client machine, or both in server-client network environments. The machine1200may be a personal computer (PC), a tablet PC, a personal digital assistant (PDA), a mobile telephone, a web appliance, a network router, switch or bridge, or any machine capable of executing instructions (sequential or otherwise) that specify actions to be taken by that machine. Further, while only a single machine is illustrated, the term “machine” shall also be taken to include any collection of machines that individually or jointly execute a set (or multiple sets) of instructions to perform any one or more of the methodologies discussed herein, such as cloud computing, software as a service (SaaS), other computer cluster configurations.

Examples, as described herein, may include, or may operate on, logic or a number of components, modules, or like mechanisms. Such mechanisms are tangible entities (e.g., hardware) capable of performing specified operations when operating. In an example, the hardware may be specifically configured to carry out a specific operation (e.g., hardwired). In an example, the hardware may include configurable execution units (e.g., transistors, circuits, etc.) and a computer readable medium containing instructions, where the instructions configure the execution units to carry out a specific operation when in operation. The configuring may occur under the direction of the execution units or a loading mechanism. Accordingly, the execution units are communicatively coupled to the computer readable medium when the device is operating. For example, under operation, the execution units may be configured by a first set of instructions to implement a first set of features at one point in time and reconfigured by a second set of instructions to implement a second set of features.

Machine (e.g., computer system)1200may include a hardware processor1202(e.g., a central processing unit (CPU), a graphics processing unit (GPU), a hardware processor core, or any combination thereof), a main memory1204and a static memory1206, some or all of which may communicate with each other via an interlink (e.g., bus)1208. The machine1200may further include a display unit1210, an alphanumeric input device1212(e.g., a keyboard), and a user interface (IA) navigation device1214(e.g., a mouse). In an example, the display unit1210, alphanumeric input device1212and UI navigation device1214may be a touch screen display. The display unit1210may include goggles, glasses, an augmented reality (AR) display, a virtual reality (VR) display, or another display component. For example, the display unit may be worn on a head of a user and may provide a heads-up-display to the user. The alphanumeric input device1212may include a virtual keyboard (e.g., a keyboard displayed virtually in a VR or AR setting.

The machine1200may additionally include a storage device (e.g., drive unit)1216, a signal generation device1218(e.g., a speaker), a network interface device1220, and one or more sensors1221, such as a global positioning system (GPS) sensor, compass, accelerometer, or other sensor. The machine1200may include an output controller1228, such as a serial (e.g., universal serial bus (USB), parallel, or other wired or wireless (e.g., infrared (IR), near field communication (NFC), etc.) connection to communicate or control one or more peripheral devices.

The storage device1216may include a machine readable medium1222that is non-transitory on which is stored one or more sets of data structures or instructions1224(e.g., software) embodying or utilized by any one or more of the techniques or functions described herein. The instructions1224may also reside, completely or at least partially, within the main memory1204, within static memory1206, or within the hardware processor1202during execution thereof by the machine1200. In an example, one or any combination of the hardware processor1202, the main memory1204, the static memory1206, or the storage device1216may constitute machine readable media.

While the machine readable medium1222is illustrated as a single medium, the term “machine readable medium” may include a single medium or multiple media (e.g., a centralized or distributed database, or associated caches and servers) configured to store the one or more instructions1224.

The term “machine readable medium” may include any medium that is capable of storing, encoding, or carrying instructions for execution by the machine1200and that cause the machine1200to perform any one or more of the techniques of the present disclosure, or that is capable of storing, encoding or carrying data structures used by or associated with such instructions. Non-limiting machine readable medium examples may include solid-state memories, and optical and magnetic media. Specific examples of machine readable media may include: non-volatile memory, such as semiconductor memory devices (e.g., Electrically Programmable Read-Only Memory (EPROM), Electrically Erasable Programmable Read-Only Memory (EEPROM)) and flash memory devices; magnetic disks, such as internal hard disks and removable disks; magneto-optical disks; and CD-ROM and DVD-ROM disks.

The instructions1224may further be transmitted or received over a communications network1226using a transmission medium via the network interface device1220utilizing any one of a number of transfer protocols (e.g., frame relay, internet protocol (IP), transmission control protocol (TCP), user datagram protocol (UDP), hypertext transfer protocol (HTTP), etc.). Example communication networks may include a local area network (LAN), a wide area network (WAN), a packet data network (e.g., the Internet), mobile telephone networks (e.g., cellular networks), Plain Old Telephone (POTS) networks, and wireless data networks (e.g., Institute of Electrical and Electronics Engineers (IEEE) 802.11 family of standards known as Wi-Fi®, as the personal area network family of standards known as Bluetooth® that are promulgated by the Bluetooth Special Interest Group, peer-to-peer (P2P) networks, among others. In an example, the network interface device1220may include one or more physical jacks (e.g., Ethernet, coaxial, or phone jacks) or one or more antennas to connect to the communications network1226. In an example, the network interface device1220may include a plurality of antennas to wirelessly communicate using at least one of single-input multiple-output (SIMO), multiple-input multiple-output (MIMO), or multiple-input single-output (MISO) techniques. The term “transmission medium” shall be taken to include any intangible medium that is capable of storing, encoding, or carrying instructions for execution by the machine1200, and includes digital or analog communications signals or other intangible medium to facilitate communication of such software.

Each of the following non-limiting examples may stand on its own, or may be combined in various permutations or combinations with one or more of the other examples:Example 1 is a knee arthroplasty validation method for intraoperative validation of cut surfaces, the method comprising: outputting control instructions to cause a robotic surgical device to assist in a tibiofemoral joint resection of a patient tibia or a patient femur, the tibiofemoral joint resection including a horizontal resection; positioning a knee arthroplasty validation device to contact the horizontal resection, the knee arthroplasty validation device including a horizontal resection validation surface and an optical tracker fixedly attached to the knee arthroplasty validation device; validating, using processing circuitry of the robotic surgical device, the horizontal resection based on a tracked validation position of the optical tracker; and triggering an update of a display to indicate completion of the validation.In Example 2, the subject matter of Example 1 includes, validating, using processing circuitry of the robotic surgical device, a vertical resection based on the tracked validation position of the optical tracker; wherein the tibiofemoral joint resection includes a tibial plateau resection of the patient tibia, the tibial plateau resection including the horizontal resection and a vertical resection; and wherein the knee arthroplasty validation device includes a partial knee arthroplasty (PKA) validation device, the PKA validation device including a vertical resection validation surface orthogonal to the horizontal resection validation surface, the vertical resection validation surface to contact and validate the vertical resection.In Example 3, the subject matter of Example 2 includes, validating, using processing circuitry of the robotic surgical device, a PKA flexion gap by comparing a PKA gap validation thickness of the PKA validation device against the PKA flexion gap formed by the patient tibia and the patient femur in flexion; wherein the PKA validation device further includes a substantially planar gap validation surface, the substantially planar gap validation surface substantially parallel to the horizontal resection validation surface and separated from the horizontal resection validation surface by the PKA gap validation thickness,In Example 4, the subject matter of Example 3 includes, validating, using processing circuitry of the robotic surgical device, a PKA extension gap by comparing the PKA gap validation thickness of the PKA validation device against the PKA extension gap formed by the patient tibia and the patient femur in extension.In Example 5, the subject matter of Example 4 includes, instructing the robotic surgical device to assist in a distal femoral resection of the patient femur corresponding to the patient tibia; disposing the PKA validation device against the distal femoral resection; and instructing the robotic surgical device to validate the distal femoral resection based on a tracked femoral position of the PKA validation device.In Example 6, the subject matter of Examples 2-5 includes, validating, using processing circuity of the robotic surgical device, an augment cut validation surface based on the tracked validation position of the optical tracker; wherein the knee arthroplasty validation device includes an augment cut validation device, the augment cut validation device including: a first augment spacer fixedly attached to a first side of the horizontal resection validation surface, the first augment spacer to contact the horizontal resection validation surface; and a second augment spacer fixedly attached to a second side of the horizontal resection validation surface, the second augment spacer to contact the augment cut validation surface.In Example 7, the subject matter of Examples 1-6 includes, wherein the positioning of the knee arthroplasty validation device includes outputting control instructions to cause the robotic surgical device to position the knee arthroplasty validation device.In Example 8, the subject matter of Examples 1-7 includes, wherein the positioning of the knee arthroplasty validation device includes a surgeon positioning the knee arthroplasty validation device, the method further including receiving a validation initiation input from the surgeon, the validation initiation input initiating the validation of the horizontal resection.In Example 9, the subject matter of Examples 1-8 includes, wherein the validation of the horizontal resection validation surface further includes comparing the tracked validation position of the knee arthroplasty validation device against a tracked bone position.In Example 10, the subject matter of Example 9 includes, wherein the tracked bone position is based on an optical bone position tracker fixedly attached to the patient tibia or the patient femur.In Example 11, the subject matter of Examples 9-10 includes, wherein the tracked bone position is based on a registration position of a registration pointer, the registration pointer fixedly attached to a robotic arm of the robotic surgical device.Example 12 is a knee arthroplasty validation system for intraoperative validation of cut surfaces, the system comprising: a robotic surgical device including processing circuitry, the robotic surgical device to assist in a tibiofemoral joint resection of a patient tibia or a patient femur, the tibiofemoral joint resection including a horizontal resection; a knee arthroplasty validation device positioned to contact the horizontal resection, the knee arthroplasty validation device including a horizontal resection validation surface and an optical tracker fixedly attached to the knee arthroplasty validation device; and an optical tracker fixedly attached to the knee arthroplasty validation device; wherein processing circuitry of the robotic surgical device validates the horizontal resection validation surface based on a tracked validation position of the optical tracker and triggers an update of a display to indicate completion of the validation.In Example 13, the subject matter of Example 12 includes, the processing circuitry of the robotic surgical device further to validate a vertical resection based on the tracked validation position of the optical tracker; wherein the tibiofemoral joint resection includes a tibial plateau resection of a patient tibia, the tibial plateau resection including the horizontal resection and a vertical resection; and wherein the knee arthroplasty validation device includes a partial knee arthroplasty (PKA) validation device, the PKA validation device including a vertical resection validation surface orthogonal to the horizontal resection validation surface, the vertical resection validation surface to contact and validate the vertical resection.In Example 14, the subject matter of Example 13 includes, the processing circuitry of the robotic surgical device further to validate, using processing circuitry of the robotic surgical device, a PKA flexion gap by comparing a PKA gap validation thickness of the PKA validation device against the PKA flexion gap formed by the patient tibia and the patient femur in flexion; wherein the PKA validation device further includes a substantially planar gap validation surface, the substantially planar gap validation surface substantially parallel to the horizontal resection validation surface and separated from the horizontal resection validation surface by the PKA gap validation thickness.In Example 15, the subject matter of Example 14 includes, wherein the substantially planar gap validation surface validates a PKA extension gap by comparing the PKA gap validation thickness of the PKA validation device against the PKA extension gap formed by the patient tibia and the patient femur in extension.In Example 16, the subject matter of Example 15 includes, wherein in response to receipt of control instructions, the robotic surgical device is further to: assist in a distal femoral resection of patient femur corresponding to the patient tibia; and validate the distal femoral resection based on a tracked femoral position of the PKA validation device disposed against the distal femoral resection.In Example 17, the subject matter of Examples 12-16 includes, the processing circuitry of the robotic surgical device further to validate, using processing circuitry of the robotic surgical device, an augment cut validation surface based on the tracked validation position of the optical tracker; wherein the knee arthroplasty validation device includes an augment cut validation device, the augment cut validation device including: a first augment spacer fixedly attached to a first side of the horizontal resection validation surface, the first augment spacer to contact the horizontal resection validation surface; and a second augment spacer fixedly attached to a second side of the horizontal resection validation surface, the second augment spacer to contact the augment cut validation surface.In Example 18, the subject matter of Examples 12-17 includes, wherein in response to receipt of control instructions, the control instructions further cause the robotic surgical device to position the knee arthroplasty validation device.In Example 19, the subject matter of Examples 12-18 includes, wherein the positioning of the knee arthroplasty validation device includes a surgeon positioning the knee arthroplasty validation device, the processing circuitry of the robotic surgical device further to receive a validation initiation input from the surgeon, the validation initiation input initiating the validation of the horizontal resection.In Example 20, the subject matter of Examples 12-19 includes, wherein the validation of the horizontal resection validation surface further includes comparing the tracked validation position of the knee arthroplasty validation device against a tracked bone position.In Example 21, the subject matter of Example 20 includes, an optical bone position tracker fixedly attached to the patient tibia or the patient femur, wherein the tracked bone position is based on the optical bone position tracker.In Example 22, the subject matter of Examples 20-21 includes, a registration pointer fixedly attached to a robotic arm of the robotic surgical device, wherein the tracked bone position is based on a registration position of a registration pointer.Example 23 is at least one non-transitory machine-readable storage medium, comprising a plurality of instructions that, responsive to being executed with processor circuitry of a computer-controlled device, cause the computer-controlled device to: output control instructions to cause a robotic surgical device to assist in a tibiofemoral joint resection of a patient tibia or a patient femur, the tibiofemoral joint resection including a horizontal resection; position a knee arthroplasty validation device to contact the horizontal resection, the knee arthroplasty validation device including a horizontal resection validation surface and an optical tracker fixedly attached to the knee arthroplasty validation device; validate, using processing circuitry of the robotic surgical device, the horizontal resection based on a tracked validation position of the optical tracker; and trigger an update of a display to indicate completion of the validation.In Example 24, the subject matter of Example 23 includes, the instructions further causing the computer-controlled device to validate, using processing circuitry of the robotic surgical device, a vertical resection based on the tracked validation position of the optical tracker; wherein the tibiofemoral joint resection includes a tibial plateau resection of the patient tibia, the tibial plateau resection including the horizontal resection and a vertical resection; and wherein the knee arthroplasty validation device includes a partial knee arthroplasty (PKA) validation device, the PKA validation device including a vertical resection validation surface orthogonal to the horizontal resection validation surface, the vertical resection validation surface to contact and validate the vertical resection.in Example 25, the subject matter of Example 24 includes, the instructions further causing the computer-controlled device to validate, using processing circuitry of the robotic surgical device, a PKA flexion gap by comparing a PKA gap validation thickness of the PKA validation device against the PKA flexion gap formed by the patient tibia and the patient femur in flexion; wherein the PKA validation device further includes a substantially planar gap validation surface, the substantially planar gap validation surface substantially parallel to the horizontal resection validation surface and separated from the horizontal resection validation surface by the PKA gap validation thickness.In Example 26, the subject matter of Example 25 includes, the instructions further causing the computer-controlled device to validate, using processing circuitry of the robotic surgical device, a PKA extension gap by comparing the PKA gap validation thickness of the PKA validation device against the PKA extension gap formed by the patient tibia and the patient femur in extension.In Example 27, the subject matter of Example 26 includes, instructing the robotic surgical device to assist in a distal femoral resection of the patient femur corresponding to the patient tibia; disposing the PKA validation device against the distal femoral resection; and instructing the robotic surgical device to validate the distal femoral resection based on a tracked femoral position of the PKA validation device.In Example 28, the subject matter of Examples 24-27 includes, the instructions further causing the computer-controlled device to validate, using processing circuitry of the robotic surgical device, an augment cut validation surface based on the tracked validation position of the optical tracker; wherein the knee arthroplasty validation device includes an augment cut validation device, the augment cut validation device including: a first augment spacer fixedly attached to a first side of the horizontal resection validation surface, the first augment spacer to contact the horizontal resection validation surface; and a second augment spacer fixedly attached to a second side of the horizontal resection validation surface, the second augment spacer to contact the augment cut validation surface.In Example 29, the subject matter of Examples 23-28 includes, wherein the positioning of the knee arthroplasty validation device includes outputting control instructions to cause the robotic surgical device to position the knee arthroplasty validation device.In Example 30, the subject matter of Examples 23-29 includes, wherein the positioning of the knee arthroplasty validation device includes a surgeon positioning the knee arthroplasty validation device, the instructions further causing the computer-controlled device to receive a validation initiation input from the surgeon, the validation initiation input initiating the validation of the horizontal resection.In Example 31, the subject matter of Examples 23-30 includes, wherein the validation of the horizontal resection validation surface further includes comparing the tracked validation position of the knee arthroplasty validation device against a tracked bone position.In Example 32, the subject matter of Example 31 includes, wherein the tracked bone position is based on an optical bone position tracker fixedly attached to the patient tibia or the patient femur.In Example 33, the subject matter of Examples 31-32 includes, wherein the tracked bone position is based on a registration position of a registration pointer, the registration pointer fixedly attached to a robotic arm of the robotic surgical device.Example 34 is a knee arthroplasty validation apparatus for intraoperative validation of cut surfaces, the apparatus comprising: means for outputting control instructions to cause a robotic surgical device to assist in a tibiofemoral joint resection of a patient tibia or a patient femur, the tibiofemoral joint resection including a horizontal resection; means for positioning a knee arthroplasty validation device to contact the horizontal resection, the knee arthroplasty validation device including a horizontal resection validation surface and an optical tracker fixedly attached to the knee arthroplasty validation device; means for validating, using processing circuitry of the robotic surgical device, the horizontal resection based on a tracked validation position of the optical tracker; and means for triggering an update of a display to indicate completion of the validation.In Example 35, the subject matter of Example 34 includes, means for validating, using processing circuitry of the robotic surgical device, a vertical resection based on the tracked validation position of the optical tracker; wherein the tibiofemoral joint resection includes a tibial plateau resection of the patient tibia, the tibial plateau resection including the horizontal resection and a vertical resection; and wherein the knee arthroplasty validation device includes a partial knee arthroplasty (PKA) validation device, the PKA validation device including a vertical resection validation surface orthogonal to the horizontal resection validation surface, the vertical resection validation surface to contact and validate the vertical resection.In Example 36, the subject matter of Example 35 includes, means for validating, using processing circuitry of the robotic surgical device, a PKA flexion gap by comparing a PKA gap validation thickness of the PKA validation device against the PKA flexion gap formed by the patient tibia and the patient femur in flexion; wherein the PKA validation device further includes a substantially planar gap validation surface, the substantially planar gap validation surface substantially parallel to the horizontal resection validation surface and separated from the horizontal resection validation surface by the PKA gap validation thickness.In Example 37, the subject matter of Example 36 includes, means for validating, using processing circuitry of the robotic surgical device, a PKA extension gap by comparing the PKA gap validation thickness of the PKA validation device against the PKA extension gap formed by the patient tibia and the patient femur in extension.In Example 38, the subject matter of Example 37 includes, means for instructing the robotic surgical device to assist in a distal femoral resection of the patient femur corresponding to the patient tibia; means for disposing the PKA validation device against the distal femoral resection; and means for instructing the robotic surgical device to validate the distal femoral resection based on a tracked femoral position of the PKA validation device.In Example 39, the subject matter of Examples 35-38 includes, means for validating, using processing circuitry of the robotic surgical device, an augment cut validation surface based on the tracked validation position of the optical tracker; wherein the knee arthroplasty validation device includes an augment cut validation device, the augment cut, validation device including: a first augment spacer fixedly attached to a first side of the horizontal resection validation surface, the first augment spacer to contact the horizontal resection validation surface; and a second augment spacer fixedly attached to a second side of the horizontal resection validation surface, the second augment spacer to contact the augment cut validation surface.In Example 40, the subject matter of Examples 34-39 includes, wherein the means for positioning of the knee arthroplasty validation device includes means for outputting control instructions to cause the robotic surgical device to position the knee arthroplasty validation device.In Example 41, the subject matter of Examples 34-40 includes, wherein the means for positioning of the knee arthroplasty validation device includes a surgeon positioning the knee arthroplasty validation device, the apparatus further including means for receiving a validation initiation input from the surgeon, the validation initiation input initiating the validation of the horizontal resection.In Example 42, the subject matter of Examples 34-41 includes, wherein the validation of the horizontal resection validation surface further includes means for comparing the tracked validation position of the knee arthroplasty validation device against a tracked bone position.In Example 43, the subject matter of Example 42 includes, wherein the tracked bone position is based on an optical bone position tracker fixedly attached to the patient tibia or the patient femur.In Example 44, the subject matter of Examples 42-43 includes, wherein the tracked bone position is based on a registration position of a registration pointer, the registration pointer fixedly attached to a robotic arm of the robotic surgical device.Example 45 is at least one machine-readable medium including instructions that, when executed by processing circuitry, cause the processing circuitry to perform operations to implement of any of Examples 1-44.Example 46 is an apparatus comprising means to implement of any of Examples 1-44.Example 47 is a system to implement of any of Examples 1-44.Example 48 is a method to implement of any of Examples 1-44.

Method examples described herein may be machine or computer-implemented at least in part. Some examples may include a computer-readable medium or machine-readable medium encoded with instructions operable to configure an electronic device to perform methods as described in the above examples. An implementation of such methods may include code, such as microcode, assembly language code, a higher-level language code, or the like. Such code may include computer readable instructions for performing various methods. The code may form portions of computer program products. Further, in an example, the code may be tangibly stored on one or more volatile, non-transitory, or non-volatile tangible computer-readable media, such as during execution or at other times. Examples of these tangible computer-readable media may include, but are not limited to, hard disks, removable magnetic disks, removable optical disks (e.g., compact disks and digital video disks), magnetic cassettes, memory cards or sticks, random access memories (RAMs), read only memories (ROMs), and the like.