Surgical manipulator with linkage mechanism for anterior cruciate ligament reconstruction

This paper describes a surgical manipulator designed with regard to its safety and sterilization in medical setting of anterior cruciate ligament (ACL) reconstruction. The manipulator system consists of two five-bar linkage mechanisms, an optical tracking device, and a user interface of surgical navigation. We designed and fabricated a prototype manipulator and evaluated the performance of the system by a set of experiments. The accuracy evaluation showed that the average backlash of the 4 link axes was 4.14deg and the accuracy of the pitch and yaw angle of the K-wire are 1.55deg plusmn 2.74deg and -2.48deg plusmn 2.92deg. This system enables intrinsic safety and ease of sterilization due to limitations in the range of movement. Furthermore, the system achieves reliability because of the simplicity of both its mechanism and its user interface. The manipulator has the potential to be used in minimally invasive ACL reconstruction surgery, although further improvements and experiments remain to be carried out.