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We are using machine learning (AI), robotics, and 3D printing to improve joint replacement surgeries. We believe the synthesis of these three technologies will define the future of orthopedics.


Monogram is developing a novel approach to joint reconstruction.

Problem:

There are 1,658,200 total hip and knee replacements annually in the US. Over 14.5% of hips and 9.5% of knees fail. One-in-five patients are not satisfied with their knee replacement. Cemented implants are not ideal for younger active patients but remain widely used for knees (over 90%). Leading causes of revision include infection, mechanical loosening, implant failure, dislocation/instability, and fracture. Many of these complications are preventable with technology. Primary ankles, shoulders, and spine are also markets where problems persist that technology can solve.

Innovation advances in orthopedics remain slow and inefficient. Large companies dominate with almost indistinguishable implants. Robots are costly, slow, and redundant. Most implants, even those approved for robotic placement, are also insertable with manual instruments. The enormous inefficiency has built nearly insurmountable barriers to entry, where the top four implant companies account for 76% of the $18B primary hip and knee markets.

Solution:

We use algorithms to plan optimized surgeries pre-operatively. Using patient data, we fabricate implants designed to increase stability and reduce size. We can do this cost-efficiently (with 3D printing) and with high accuracy (with surgical robotics). We are starting with knee implants but expect to develop implants for all joints (hips, ankles, shoulders, and spine). In collaboration with the UCLA Biomechanics Laboratory and the University of Nebraska Medical Center, our patented hip implants were a factor of 7x more stable, and our novel knee showed 73% less micromotion in varus-valgus rotation. Monogram has demonstrated superior restoration of the native anatomy. We showed up to a 13mm improvement in hip center placement.