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. 2021 Mar;16(3):407-414.
doi: 10.1007/s11548-020-02302-z. Epub 2021 Feb 8.

Mixed reality as a novel tool for diagnostic and surgical navigation in orthopaedics

Andrea Teatini  1   2 , Rahul P Kumar  3 , Ole Jakob Elle  3   4 , Ola Wiig  5
Affiliations

Mixed reality as a novel tool for diagnostic and surgical navigation in orthopaedics

Andrea Teatini et al. Int J Comput Assist Radiol Surg. 2021 Mar.

Abstract

Purpose: This study presents a novel surgical navigation tool developed in mixed reality environment for orthopaedic surgery. Joint and skeletal deformities affect all age groups and greatly reduce the range of motion of the joints. These deformities are notoriously difficult to diagnose and to correct through surgery.

Method: We have developed a surgical tool which integrates surgical instrument tracking and augmented reality through a head mounted display. This allows the surgeon to visualise bones with the illusion of possessing "X-ray" vision. The studies presented below aim to assess the accuracy of the surgical navigation tool in tracking a location at the tip of the surgical instrument in holographic space.

Results: Results show that the average accuracy provided by the navigation tool is around 8 mm, and qualitative assessment by the orthopaedic surgeons provided positive feedback in terms of the capabilities for diagnostic use.

Conclusions: More improvements are necessary for the navigation tool to be accurate enough for surgical applications, however, this new tool has the potential to improve diagnostic accuracy and allow for safer and more precise surgeries, as well as provide for better learning conditions for orthopaedic surgeons in training.

Keywords: Augmented reality; Holographic visualisation; Image-guided diagnosis; Image-guided treatment; Mixed reality; Orthopaedic surgery; Orthopaedics; Surgical navigation.

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Conflict of interest statement

All authors are co-inventors of technology licensed by the company HoloCare AS and hold shares indirectly through Inven2 AS.

Figures

Fig. 1
Fig. 1
Experiment with the Patient phantom, seen with the HoloLens as augmented reality while the surgeon manipulates the limb. The grey line is the edge of the Polaris measurement volume (frustrum) visualised in HoloLens. This snapshot from the HoloLens video is taken from the left eye view, hence, does not fully reproduce the accuracy of the system (which, rendered in 3D view, is much more accurate as described in “Patient phantom” section)
Fig. 2
Fig. 2
Evaluation experiment through the Validation phantom. The left image shows the 3D printed frame on the HoloLens and how the quantitative experiments were performed. The images on the right show, in the upper, the holographic tip at a distance from NDI’s pointer, and in the lower, the position of the Polaris in HoloLens Camera coordinates
Fig. 3
Fig. 3
Boxplot of experimental results for the Validation Phantom. Each user is represented by a letter from A to E. Each boxplot represents the errors (with mean, median and standard deviation) across the 28 titanium positions in the Validation phantom for each of the two trials
Fig. 4
Fig. 4
Boxplot of experimental results for the Patient Phantom. Each user is represented by a letter from A to C. Each boxplot represents the errors (with mean, median and standard deviation) across the 23 metallic washer positions in the Patient phantom for each of the two trials
See this image and copyright information in PMC

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