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The Clinical Application of Augmented Reality in Orthopaedics: Where Do We Stand?

  • The Use of Technology in Orthopaedic Surgery—Intraoperative and Post Operative Management (C Krueger and S Bini, Section Editors)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

The surgical community is constantly working to improve accuracy and reproducibility in patient care, with the goal to improve patient outcomes and efficiency. One area of growing interest with potential to meet these goals is in the use of augmented reality (AR) in surgery. There is still a paucity of published research on the clinical benefits of AR over traditional techniques, but this article aims to present an update on the current state of AR within orthopaedics over the past 5 years.

Recent Findings

AR systems are being developed and studied for use in all areas of orthopaedics. Most recently published research has focused on the areas of fracture care, adult reconstruction, orthopaedic oncology, spine, and resident education. These studies have shown some promising results, particularly in surgical accuracy, decreased surgical time, and less radiation exposure. However, the majority of recently published research is still in the pre-clinical setting, with very few studies using living patients.

Summary

AR supplementation in orthopaedic surgery has shown promising results in pre-clinical settings, with improvements in surgical accuracy and reproducibility, decreased operating times, and less radiation exposure. Most AR systems, however, are still not approved for clinical use. Further research is needed to validate the benefits of AR use in orthopaedic surgery before it is widely adopted into practice.

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References

  1. Azuma R, Baillot Y, Behringer R, Feiner S, Julier S, MacIntyre B. Recent advances in augmented reality. IEEE Comput Graph Appl. 2001;21(6):34–47.

    Article  Google Scholar 

  2. Nikou C, Digioiai A, Blackwell M, Jaramaz B, Kanade T, Digioia A. Augmented reality imaging technology for orthopaedic surgery. Oper Tech Orthop. 2000;10:82–6. https://doi.org/10.1016/S1048-6666(00)80047-6.

    Article  Google Scholar 

  3. Chytas D, Malahias MA, Nikolaou VS. Augmented reality in orthopedics: current state and future directions. Front Surg. 2019;6:38. https://doi.org/10.3389/fsurg.2019.00038.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Wang H, Wang F, Leong AP, Xu L, Chen X, Wang Q. Precision insertion of percutaneous sacroiliac screws using a novel augmented reality-based navigation system: a pilot study. Int Orthop. 2016;40(9):1941–7. https://doi.org/10.1007/s00264-015-3028-8.

    Article  PubMed  Google Scholar 

  5. Rohilla R, Singh R, Magu N, Devgan A, Siwach R, Sangwan S. Simultaneous use of cannulated reamer and Schanz screw for closed intramedullary femoral nailing. ISRN Surg. 2011;502408:1–8.

    Article  Google Scholar 

  6. Ma L, Zhao Z, Zhang B, Jiang W, Fu L, Zhang X, et al. Three-dimensional augmented reality surgical navigation with hybrid optical and electromagnetic tracking for distal intramedullary nail interlocking. Int J Med Robot. 2018;14(4):e1909. https://doi.org/10.1002/rcs.1909.

  7. Tu P, Gao Y, Lungu AJ, Li D, Wang H, Chen X. Augmented reality based navigation for distal interlocking of intramedullary nails utilizing Microsoft HoloLens 2. Comput Biol Med. 2021;133:104402. https://doi.org/10.1016/j.compbiomed.2021.104402.

  8. Kiarostami P, Dennler C, Roner S, Sutter R, Fürnstahl P, Farshad M, et al. Augmented reality-guided periacetabular osteotomy-proof of concept. J Orthop Surg Res. 2020 Nov 17;15(1):540. https://doi.org/10.1186/s13018-020-02066-x.

  9. Picard F, Deep K, Jenny JY. Current state of the art in total knee arthroplasty computer navigation. Knee Surg Sports Traumatol Arthrosc. 2016;24(11):3565–74. https://doi.org/10.1007/s00167-016-4337-1.

    Article  PubMed  Google Scholar 

  10. Logishetty K, Western L, Morgan R, Iranpour F, Cobb JP, Auvinet E. Can an augmented reality headset improve accuracy of acetabular cup orientation in simulated THA? A Randomized Trial. Clin Orthop Relat Res. 2019;477(5):1190–9. https://doi.org/10.1097/CORR.0000000000000542.

    Article  PubMed  Google Scholar 

  11. Ogawa H, Kurosaka K, Sato A, Hirasawa N, Matsubara M, Tsukada S. Does an augmented reality-based portable navigation system improve the accuracy of acetabular component orientation during THA? A randomized controlled trial. Clin Orthop Relat Res. 2020;478(5):935–43. https://doi.org/10.1097/CORR.0000000000001083.

    Article  PubMed  Google Scholar 

  12. Tsukada S, Ogawa H, Nishino M, Kurosaka K, Hirasawa N. Augmented reality-based navigation system applied to tibial bone resection in total knee arthroplasty. J Exp Orthop. 2019;6(1):44. https://doi.org/10.1186/s40634-019-0212-6.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Cho HS, Park YK, Gupta S, Yoon C, Han I, Kim HS, et al. Augmented reality in bone tumour resection: an experimental study. Bone Joint Res. 2017;6(3):137–43. https://doi.org/10.1302/2046-3758.63.BJR-2016-0289.R1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Cho HS, Park MS, Gupta S, Han I, Kim HS, Choi H, et al. Can augmented reality be helpful in pelvic bone cancer surgery? An in vitro study. Clin Orthop Relat Res. 2018;476(9):1719–25. https://doi.org/10.1007/s11999.0000000000000233.

  15. Molina CA, Theodore N, Ahmed AK, Westbroek EM, Mirovsky Y, Harel R, et al. Augmented reality-assisted pedicle screw insertion: a cadaveric proof-of-concept study. J Neurosurg Spine. 2019;29:1–8. https://doi.org/10.3171/2018.12.SPINE181142.

  16. Siemionow KB, Katchko KM, Lewicki P, Luciano CJ. Augmented reality and artificial intelligence-assisted surgical navigation: technique and cadaveric feasibility study. J Craniovertebr Junction Spine. 2020;11(2):81–5. https://doi.org/10.4103/jcvjs.JCVJS_48_20.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Elmi-Terander A, Burström G, Nachabe R, Skulason H, Pedersen K, Fagerlund M, et al. Pedicle screw placement using augmented reality surgical navigation with intraoperative 3D imaging: a first in-human prospective cohort study. Spine (Phila Pa 1976). 2019;44(7):517–25. https://doi.org/10.1097/BRS.0000000000002876.

  18. Vadalà G, De Salvatore S, Ambrosio L, Russo F, Papalia R, Denaro V. Robotic spine surgery and augmented reality systems: a state of the art. Neurospine. 2020;17(1):88–100. https://doi.org/10.14245/ns.2040060.030.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Ha J, Parekh P, Gamble D, Masters J, Jun P, Hester T, et al. Opportunities and challenges of using augmented reality and heads-up display in orthopaedic surgery: a narrative review. J Clin Orthop Trauma. 2021;18:209–15. https://doi.org/10.1016/j.jcot.2021.04.031.

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Authors and Affiliations

  1. WFBMC Department of Orthopaedic Surgery, Watlington 4th Floor, 1 Medical Center Blvd, Winston-Salem, NC, 27157, USA

    J. Hunter Matthews

  2. WFBMC Department of Orthopaedic Surgery, 329 NC-801 N, Bermuda Run, NC, 27006, USA

    John S. Shields

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  1. J. Hunter Matthews
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Correspondence to J. Hunter Matthews.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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J. Hunter Matthews owns stock in Johnson & Johnson.

John S. Shields declares no conflict of interest.

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This article is part of the Topical Collection on The Use of Technology in Orthopaedic Surgery—Intraoperative and Post Operative Management

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Matthews, J.H., Shields, J.S. The Clinical Application of Augmented Reality in Orthopaedics: Where Do We Stand?. Curr Rev Musculoskelet Med 14, 316–319 (2021). https://doi.org/10.1007/s12178-021-09713-8

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  • DOI: https://doi.org/10.1007/s12178-021-09713-8

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