The future of orthopedics is personal.
Improved visualization of the surgical site, compact and collaborative tools designed to facilitate the insertion of the next generation of orthopedic implants.
Mass customizing joint replacement
Personalized implants that solve real clinical and business problems.
- Monogram is developing a patient specific femoral knee component for optimized kinematic alignment.
- The polyethylene plastic spacer and locking mechanism are based on widely available generic designs and pre-operatively sized from patient data.
- The 3D printed proprietary tibial component features precision matched fins designed to maximize stability at the extremities and optimized under-surface curvature designed to minimize shear forces along the bone-implant interface.
- The surgical cavities are precision milled with our state-of-the-art 6 degree-of-freedom surgical robot for high accuracy placement of the tibial component.
Implants that perfectly match every patient
High accuracy visualization The Monogram solution starts with a high resolution CT scan (0.625mm slice thickness). This gives us the inputs we need to generate the implants and cut paths will help the surgeon visualize the surgical site.
Personalized Implant Fabrication The Monogram implants are 3D printed from biocompatible medical grade titanium alloy. Our implants are subject to all the same rigorous testing as conventional implants.
State-of-the-art Robotic Execution Monogram implants are designed to minimize micro-motion and reduce drift for optimized joint restoration. Our implants requires precise bone preparation for perfect fit.
Next Gen Execution By combining high precision implant with high precision navigated robotic execution Monogram believes surgeons will be able to more accurately restore patient anatomy while mitigating the risks inherent to manual execution and generic implants.
Generation of the surgical plan
The high resolution CT scan drives the personalized implant design, robotic execution, and accurate intra-operative visualization of the surgical procedure.
Surgeon planning station interface
AI Driven Remote Pre-operative Interface
Powered by sophisticated propriety image processing that utilize machine learning and geometric modeling algorithms the implants, robotic cut paths and surgical procedure are generated and optimized by the surgeon.
Implants get made
Automated Design and Fabrication of Implants
The Monogram implants are designed to maximize cortical contact and accurately restore patient anatomy. Simulations of the modeled implants are run to ensure optimized function of the restored joint.
Bone cavity gets milled
High accuracy bone preparation for implants
The Monogram platform generates the robotic plan. We utilize a state-of-the-art 7 degree of freedom to prepare the cavity for the implant. The robot is much more accurate than a surgeon.
Implant gets inserted
The high precision implant is inserted into the high precision cavity for near high precision restoration of patient anatomy.
How Our Technology Works
The Monogram technology is built on the simple idea that everyone is unique and our implants should be too.
A lot of the risks and challenges inherent to traditional implants can be mitigated with technology.
Solving Real Problems
- For Knees
- For Hips
- For Robotics
A better approach for knees
50% of early revision total knee arthroplasties related to instability, malalignment or malposition, and failure of fixation. Utilizing preoperative planning and surgical robotics Monogram has reinvented it’s knee design to address these primary modes of failure. Our test report conducted in collaboration with the University of Nebraska Medical Center is available on request.
The leading press fit tibial tray had 270% higher varus-valgus drift and 17% higher varus-valgus cycle range. Initial stability is important for natural fixation, long term alignment and can be linked to pain.
A leading implant had 171% higher axial subsidence drift and 51% higher axial subsidence cycle range. The Monogram tibia is designed to drive fixation at the periphery of the implant.
A better approach to hips
The readmission rate for hip replacements is between 8 and 13% with mechanical loosening, periprosthetic fracture and dislocation leading causes of preventable surgical re-admissions. Monogram has tested it’s hip design to address these primary modes of failure in collaboration with the UCLA Orthopaedics Research Laboratory. Our test report conducted in collaboration with the University of Nebraska Medical Center is available on request.
The implant used as the generic control had on average 634% higher final cyclic displacement. The lateral and anterior displacement were measured proximally and distally.
Passed Mechanical Testing
In collaboration with Empirical Testing we ran simulated ISO 7206-4 and ISO 7206-6 mechanical tests on 3D printed hip specimens and passed. We believe this helps validate our manufacturing method.
A better approach to robotics
Monogram is utilizing a state-of-the-art surgical robot to help prepare the bone cavities required for the insertion of our proprietary implants. Cut paths are generated with the help of sophisticated algorithms that ensure timely and safe execution. We use sophisticated robotic controls to visualize the surgical site and plan execution.
Monogram has successfully milled high accuracy cavities for both hips and knees and continues to work on other joints.
The mean cortical contact for a generic hip was only 4.9%. The Monogram implants had 7.7 times more cortical contact, or on average 37.8% of the implant surface area.
Cost Savings for Patients
Inventory, Inventory, Inventory
The average orthopedic company turns inventory only 1.23 times per year vs. the S&P average of 8.10 times.
Every minute in the OR costs the hospital $62. By utilizing active milling with optimized cut path generation Monogram is able to efficiently prepare bone cavities.
Average sterile processing costs between $0.35 and $0.51 per instrument with approximately 15-25 instruments per tray.
The average revision cost is $31,136 to $54,553 with 6-14 days average length of stay.
The average implant sits on the shelf for 9.8 months. 3D printing facilitates a just-in-time-inventory solution.
Up to 40% of device reps time is spent on logistics and inventory tasks. The average total compensation for medical device sales rep in 2018 was $152,2508.
Micromotion of Tibial Baseplate
In collaboration with the University of Nebrasksa Medical Center Monogram tested the tibial component of our patient specific knee against the most clinically and commercially tibia in history with more than 2 million implantations worldwide. More data on the performance of our knee is available upon request.
Femoral Stem Cyclic Displacement
Together with the UCLA Biomechanics Laboratory Monogram tested the micromotion of their hip implant against a generic equivalent. The generic implant had 634% more cyclic displacement than the Monogram implant which nearly perfectly restored the axis and center of rotation.