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Innovation in orthoapedics has been slow and inefficient. Large interdependent, oligopolistic companies are not incentivized to innovate and dominate the market with implants that are almost indistinguishable.
Survey: 36% of TKA patients would not have undergone the surgery knowing what it did for them (10 years later)
1 in 5 patients are not satisfied with the results of their total knee replacement
Rate of re-admission:
Approximately 50%-75% are surgical.
Rate of re-admission:
Implants Designed for Stability
Monogram implants are smaller, less invasive, and more stable.
Robotic Surgical Assistants
Monogram’s navigated surgical robot features several enhancements that will improve surgical experiences including:
The Monogram technology platform is a series of algorithms that auto-segments images and auto-generates implants that will be integrated into a navigated robotic system for surgery. This process automates the design and insertion of high conforming implants from the raw images using automated digital image analysis algorithms. The navigated robot will then execute optimized auto-generated cut paths that surgically prepare the corresponding cavities to facilitate insertion of the implant.
Monogram’s navigated robot features several enhancements that will improve user experience compared to robots currently in use. Specifically, the Monogram robot will feature tracking cameras mounted directly on the robot to mitigate line-of-sight issues. The robot will feature seven degrees-of-freedom (used to measure range of motion) with control algorithms that leverage kinematic redundancy to avoid inoperative boundaries and optimize surgical execution. The robot will also utilize complex tracking capabilities for soft-tissue avoidance.
Monogram implants are designed such that cortical contact and stability are maximized while remaining insertable and designed to reconstruct the native patient anatomy as closely as possible. Monogram will commercialize the first patient specific hip and knee to address the primary clinical shortcomings of their generic counterparts.
Our goal is to combine state-of-the-art software with world class hardware to deliver a robotic system that addresses the major clinical concerns today - cost, time, and a lack of control or real-time adjustment.
Monogram is taking the capabilities of surgical robotics to the next level. We start with the surgical plan which is run through an optimization and simulation engine to make sure the cuts are being executed as safely and time-efficiently as possible. But we don’t stop there. Rather than relying solely on a pre-operative surgical plan Monogram leverages the kinematic redundancy of the robot to allow for intraoperative obstacle avoidance and real-time tissue tracking. With the ability to simultaneously track 6 objects in real time Monogram allows for the integration of “smart tools” into the surgical theater. What was once an ordinary retractor is now a virtual boundary.
Monogram’s software solution is constantly re-optimizing to real world scenarios. The system is designed for hyper-efficiency down to the fine details. Rather than relying on conventional, cart based optical navigation, Monogram is exploring robot mounted camera systems that eliminate line of site issues and reduce cost and portability issues.
We believe that precision implants with precision insertion are the future of orthopaedics. Monograms principal competitive advantage will be our ability to produce customized, robotically inserted orthopaedic implants rapidly and at scale. The product solution architecture we are developing enables rapid fabrication and mass personalization of robotically inserted, patient specific orthopaedic implants.
Currently, Monogram is the only orthopaedic company to broadly offer robotic technology in combination with surgical navigation for the insertion of patient specific orthopaedic implants. Monogram is designing additively manufactured (AM) patient matched titanium hip stems and tibial knee implants that will require robotically milled complementary cavities.
Monogram was started in 2016 by Dr. Douglas Unis, an attending orthopaedic surgeon for the Mount Sinai Health System, after being awarded a $30k grant from the prestigious ELabNYC biotech startup incubator. Dr. Unis has a deep passion for patient well-being. After years of consulting with several strategic companies, Dr. Unis grew frustrated by the slow pace of innovation and a lack of focus on implant design. Dr. Unis realized that surgical readmissions and implant failures were only in part driven by the surgical method. The implants themselves had significant design limitations that could be vastly improved with new manufacturing methods and robotic insertion.
With an unassailable belief that the answer lies in in the thoughtful synthesis of machine learning (AI), robotics, and 3D printing, Dr. Unis recruited a team of highly energized engineers, medtech, and entrepreneurs to realize his vision.