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. 2020 Feb 15;21(1):103.
doi: 10.1186/s12891-020-3110-2.

Applicability of augmented reality in orthopedic surgery - A systematic review

Lukas Jud  1 , Javad Fotouhi  2 , Octavian Andronic  3 , Alexander Aichmair  3 , Greg Osgood  4 , Nassir Navab  2   5 , Mazda Farshad  3
Affiliations

Applicability of augmented reality in orthopedic surgery - A systematic review

Lukas Jud et al. BMC Musculoskelet Disord. .

Abstract

Background: Computer-assisted solutions are changing surgical practice continuously. One of the most disruptive technologies among the computer-integrated surgical techniques is Augmented Reality (AR). While Augmented Reality is increasingly used in several medical specialties, its potential benefit in orthopedic surgery is not yet clear. The purpose of this article is to provide a systematic review of the current state of knowledge and the applicability of AR in orthopedic surgery.

Methods: A systematic review of the current literature was performed to find the state of knowledge and applicability of AR in Orthopedic surgery. A systematic search of the following three databases was performed: "PubMed", "Cochrane Library" and "Web of Science". The systematic review followed the Preferred Reporting Items on Systematic Reviews and Meta-analysis (PRISMA) guidelines and it has been published and registered in the international prospective register of systematic reviews (PROSPERO).

Results: 31 studies and reports are included and classified into the following categories: Instrument / Implant Placement, Osteotomies, Tumor Surgery, Trauma, and Surgical Training and Education. Quality assessment could be performed in 18 studies. Among the clinical studies, there were six case series with an average score of 90% and one case report, which scored 81% according to the Joanna Briggs Institute Critical Appraisal Checklist (JBI CAC). The 11 cadaveric studies scored 81% according to the QUACS scale (Quality Appraisal for Cadaveric Studies).

Conclusion: This manuscript provides 1) a summary of the current state of knowledge and research of Augmented Reality in orthopedic surgery presented in the literature, and 2) a discussion by the authors presenting the key remarks required for seamless integration of Augmented Reality in the future surgical practice.

Trial registration: PROSPERO registration number: CRD42019128569.

Keywords: Augmented reality; Image overlay; Orthopaedic surgery; Trauma surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the systematic research in “PubMed” and “Cochrane Libraray”
Fig. 2
Fig. 2
Reprinted by permission from AANS: Journal of Neurosurgery Spine, A novel 3D guidance system using augmented reality for percutaneous vertebroplasty: technical note, Yuichiro Abe, Shigenobu Sato, Koji Kato et al., Copyright 2013. a) HMD with camera. b) A raw image is captured by the camera. c) Actual view of the surgeon. The software creates an augmented view and indicates the ideal insertion point and needle trajectory
Fig. 3
Fig. 3
Reprinted by permission from Springer Nature: Springer, International Journal of Computer Assisted Radiology and Surgery, MR image overlay guidance: system evaluation for preclinical use, Paweena U-Thainual, Jan Fritz, Choladawan Moonjaita et al., Copyright 2012. a) Visualized is the MR-IOS. b) The surgeon looks through the semi-transparent mirror that is augmented with the correct insertion path
Fig. 4
Fig. 4
Visualized are the perfect circles for distal locking
Fig. 5
Fig. 5
The surgeon sees multiple virtual perspectives of the surgical site and moves the impactor until it completely overlaps with the virtual planning
See this image and copyright information in PMC

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