This Surgical Robot Can Flawlessly Implant a 3D-Printed Joint Replacement

Monogram Orthopedics takes a unique approach to joint replacement. The company's robotic arm installs joint implants that have been 3D-printed to fit each patient's specific bone structure with hand-in-glove precision. The company says its system will enable surgeons to replace joints with flawlessly fitted implants and through less-invasive procedures—reducing rates of infection, dislocation and implant failure, and dramatically improving patient outcomes.

With $16.7 million in capital and its growing list of preorders, Monogram expects to turn a profit by the end of 2021. Here, we'll take a deeper dive into Monogram's technology to see how this company is poised to transform the world's joint replacement market.

Generic Implants Come at a High Cost for Patients

Traditional hip and knee replacements can be inefficient, subject to error and prone to failure. Even today's most cutting-edge implants are mass-produced. These implants are installed after surgeons measure a joint's proportions, then cut away at the afflicted bone with saws and jigs. Once they've made room for the implant, surgeons glue it in place with bone cement, which is capable of cracking after surgery. In fact, implants themselves can also be prone to mechanical failure, forcing thousands of patients to return to hospitals for further operations.

These problems are well-known to the medical community. While many implant failures happen due to mechanical problems, many are still related to the core problems of instability, poor positioning and cement breakage.

All these issues can be mitigated with technologies like 3D mapping and printing, which have helped solve similar problems in other medical fields and today, doctors and patients are increasingly seeking more personalized, precise implant solutions. That's where Monogram's technology comes in.

Personalized Implants Deliver Better Patient Outcomes

In contrast to its competitors' generic products, Monogram's custom-printed implants use each patient's individual bone structure as a blueprint. The company's personalized manufacturing process starts with a CT scan of the joint to be replaced. Data from this scan powers an AI-driven preoperative interface, which uses predictive algorithms to help the surgeon plan the procedure from every angle. An automated fabrication system then 3D-prints the implant, shaping it to slip seamlessly into the patient's joint.

A surgical robot arm serves as the second component of Monogram's system. Guided from a real-time virtual navigation panel, the robot follows the surgeon's instructions, yet requires no direct manual guidance—effectively eliminating human error from the surgery itself. The arm begins by making a small incision, then uses a milling drill to clear out a precisely sculpted cavity in the bone. The implant is fitted snugly into the cavity with minimal or no cement, which Monogram boasts is up to 270 percent more stable than a generic equivalent.

Taken together, Monogram's hardware and software represent long-awaited innovations for the orthopedic sector. Given traditional implants' rate of failure, it's not hard to see why. Adoption of Monogram's technology could greatly reduce instances of loosening and dislocation, resulting in far fewer repeat surgeries and significantly improved patient outcomes.

Robots and 3D Printing Are Both on Track for Rapid Expansion

As low-wear plastics make knee implants more practical for people under 65, young and active patients are expected to account for more than half of all knee replacement procedures by 2030—creating a total market of at least $12.5 billion.

Companies who make it to market first in this sector gain a sizable advantage over their competitors. For example, today's leading orthopedic robot outsells its second-place rival 12 to one, with an 87 percent market share. Kamran Shamaei, Monogram's vice president of engineering, helped develop that robot—and right now Monogram is the only company selling an active-milling robot arm that installs custom-printed implants.

In short, Monogram has a first-to-market advantage in a sector that's about to get even more competitive. It is entering this market using a multipronged approach designed to mitigate risk while bringing about as much traction as possible from its existing capital.

Over the next few months, Monogram plans to generate immediate-term revenue by licensing its overall knee-implant system to medical distributor networks. It will then leverage those networks to sell patient-specific 3D-printed implants, initially for use in traditional manual surgeries. Finally, it will introduce its surgical robot, completing the rollout of its entire integrated solution.

Monogram has already raised $16.7 million from more than 6,700 investors, and made it through three successful financing rounds. Now, with two distributor contracts signed and more in the works, Monogram is offering individual investors the chance to purchase shares normally restricted to venture-capital firms and banking institutions. It has already sold $7.3 million of those shares, exceeding yet another funding target.

It's clear that the future of medicine is personalized. Individually tailored implants and robotic surgeries will be the norm by the end of this decade. By then, Monogram may well be the leader in this rapidly changing space—enabling surgeons to deliver the consistent outcomes their patients deserve.


The contents of this article should not be regarded as a substitute for professional medical advice, diagnosis or treatment. Always consult a physician before trying any treatments or purchasing products to help manage your condition.

The contents of this article also does not constitute any financial or investment advice. It's important to perform your own research and consider seeking advice from an independent financial professional before making any banking or investment decisions.