Page 2 - Orthofeed 2022_issue1_June

Augmented Reality in Orthopaedics 01

multiple oblique or curved osteotomy planes Conclusion
Recent Advances
are challenging to perform without support AR has already been absorbed in many other
Augmented Reality in Orthopaedics through surgical navigation. fields of human endeavour and industry. It is

Endorsed by: Dr. Bharat Mody, Joint Replacement & Arthroscopy Surgeon, Vadodara being tested and used in the field of surgery,
Arthroplasty - Exact implantation of the including orthopaedics, and has the potential of
Introduction prosthetic components with respect to the revolutionising the accuracy and ease of
patient’s anatomy is a main contributor to
Vast number of instances in orthopaedic surgery involves application, placement and fixation of hard successful outcomes, functional recovery, and executing the surgical act.
artificial objects such as cups, femoral stems, knee components, plates, and other objects on to longevity in hip and knee arthroplasty.
bones. This puts a demand on the surgeon to place them accurately in the right orientation to ensure

the best results. Ogawa et al. performed 56 THAs in 54 patients References
superimposing cup orientation through a
Would it not be a dream come true if the surgeon had a “guardian angel” image beckoning him on the smartphone into the surgical filed (group 1) 1. Casari FA, Navab N, Hruby LA, et al. Augmented Reality
right path of placing these components! and using a goniometer (group 2) for in Orthopedic Surgery Is Emerging from Proof of Concept

navigating placement and orientation of the Towards Clinical Studies: a Literature Review Explaining
Augmented reality (AR) has the potential of making this “dream come true” in orthopaedic surgery. acetabular cup component. 3 months after the Technology and Current State of the Art. Curr Rev

implantation, navigation was significantly more Musculoskelet Med. 2021;14:192–203.
In simple terms, AR will offer the operating surgeon to have the image of an implant sitting on the bone accurate in terms of radiographic anteversion

in exactly the position which would be ideal. The surgeon now has the simple job of putting the real compared to the goniometer method. 2
component on to this image ensuring that the placement is exactly as per the pre-operative plan. 1 2. Ogawa H, Hasegawa S, Tsukada S, Matsubara M. A
pilot study of augmented reality technology applied to the
Trauma - Accurate anatomic reduction of acetabular cup placement during total hip arthroplasty. J
Basic principles of AR 1 orientation and movement in 3D space. fracture fragments and reduced radiation Arthroplast. 2018;33(6):1833-7.
exposure and operating time.

1. Data Preparation for Visualization of 3. Visualization
Radiologic Imaging and Navigation Within the field of human-computer interaction, Orthopaedic Oncology - High surgical
A CT scan of the pathologic bones is acquired in augmented reality can be understood as a class accuracy and exact execution in maintaining
high resolution with a slice thickness of 1 mm or of displays. The fusion between artificial the safety margin required for sufficient
smaller. The data is then imported in a information and real-world images is performed tumour resection without excessive removal of

commercial image processing software. The by either optical or video see-through techniques. functional tissue. These are crucial for patient
anatomical region of interest is segmented from There are three main approaches to survival and optimal functional outcome.
the soft tissue and a 3D triangular surface model implementing those displays: head-mounted

is generated. The 3D model is then imported into displays (HMD), monitors, and projectors.
a surgical planning software.
Clinical Applications of AR in
2. Registration and Tracking Orthopaedics 1
Registration is the process in which the

visualized computer generated object is Spine Surgery - Majority of AR applications in
superimposed and oriented in the correct spine surgery address the surgical navigation
position. After registration, tracking enables the of pedicle screw instrumentation.

visualized object to stay in the right position
when moving and to adapt to the user position as Osteotomies - Precise surgical execution of
well as to detect instruments and their complex corrective osteotomies consisting of