ArthroCut: Autonomous Policy Learning for Robotic Bone Resection in Knee Arthroplasty

Fuente: arXiv
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Main Authors: Lu, Xu, Zhang, Yiling, Cheng, Wenquan, Ma, Longfei, Chen, Fang, Liao, Hongen
Format: Preprint
Published: 2026
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author Lu, Xu
Zhang, Yiling
Cheng, Wenquan
Ma, Longfei
Chen, Fang
Liao, Hongen
author_facet Lu, Xu
Zhang, Yiling
Cheng, Wenquan
Ma, Longfei
Chen, Fang
Liao, Hongen
contents Despite rapid commercialization of surgical robots, their autonomy and real-time decision-making remain limited in practice. To address this gap, we propose ArthroCut, an autonomous policy learning framework that upgrades knee arthroplasty robots from assistive execution to context-aware action generation. ArthroCut fine-tunes a Qwen--VL backbone on a self-built, time-synchronized multimodal dataset from 21 complete cases (23,205 RGB--D pairs), integrating preoperative CT/MR, intraoperative NDI tracking of bones and end effector, RGB--D surgical video, robot state, and textual intent. The method operates on two complementary token families -- Preoperative Imaging Tokens (PIT) to encode patient-specific anatomy and planned resection planes, and Time-Aligned Surgical Tokens (TAST) to fuse real-time visual, geometric, and kinematic evidence -- and emits an interpretable action grammar under grammar/safety-constrained decoding. In bench-top experiments on a knee prosthesis across seven trials, ArthroCut achieves an average success rate of 86% over the six standard resections, significantly outperforming strong baselines trained under the same protocol. Ablations show that TAST is the principal driver of reliability while PIT provides essential anatomical grounding, and their combination yields the most stable multi-plane execution. These results indicate that aligning preoperative geometry with time-aligned intraoperative perception and translating that alignment into tokenized, constrained actions is an effective path toward robust, interpretable autonomy in orthopedic robotic surgery.
format Preprint
id arxiv_https___arxiv_org_abs_2603_03957
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle ArthroCut: Autonomous Policy Learning for Robotic Bone Resection in Knee Arthroplasty
Lu, Xu
Zhang, Yiling
Cheng, Wenquan
Ma, Longfei
Chen, Fang
Liao, Hongen
Robotics
Despite rapid commercialization of surgical robots, their autonomy and real-time decision-making remain limited in practice. To address this gap, we propose ArthroCut, an autonomous policy learning framework that upgrades knee arthroplasty robots from assistive execution to context-aware action generation. ArthroCut fine-tunes a Qwen--VL backbone on a self-built, time-synchronized multimodal dataset from 21 complete cases (23,205 RGB--D pairs), integrating preoperative CT/MR, intraoperative NDI tracking of bones and end effector, RGB--D surgical video, robot state, and textual intent. The method operates on two complementary token families -- Preoperative Imaging Tokens (PIT) to encode patient-specific anatomy and planned resection planes, and Time-Aligned Surgical Tokens (TAST) to fuse real-time visual, geometric, and kinematic evidence -- and emits an interpretable action grammar under grammar/safety-constrained decoding. In bench-top experiments on a knee prosthesis across seven trials, ArthroCut achieves an average success rate of 86% over the six standard resections, significantly outperforming strong baselines trained under the same protocol. Ablations show that TAST is the principal driver of reliability while PIT provides essential anatomical grounding, and their combination yields the most stable multi-plane execution. These results indicate that aligning preoperative geometry with time-aligned intraoperative perception and translating that alignment into tokenized, constrained actions is an effective path toward robust, interpretable autonomy in orthopedic robotic surgery.
title ArthroCut: Autonomous Policy Learning for Robotic Bone Resection in Knee Arthroplasty
topic Robotics
url https://arxiv.org/abs/2603.03957