Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 29:30:101565.
doi: 10.1016/j.artd.2024.101565. eCollection 2024 Dec.

Accuracy of a New Augmented Reality Assisted Technique for Total Knee Arthroplasty: An In Vivo Study

Jasper Lambrechts  1 , Pieter Vansintjan  2   3 , Cynthia Lapierre  2   3 , Farah Sinnaeve  2   3 , Wouter Van Lysebettens  2   3 , Philippe Van Overschelde  2   3
Affiliations

Accuracy of a New Augmented Reality Assisted Technique for Total Knee Arthroplasty: An In Vivo Study

Jasper Lambrechts et al. Arthroplast Today. .

Abstract

Background: Total knee arthroplasty (TKA) remains the standard of care for treating end-stage osteoarthritis of the knee. Approximately 15%-20% of the patients are dissatisfied following surgery. To improve accuracy and outcomes of TKA, various assistive technologies have been introduced. For this study, an augmented reality (AR) system was explored and tested.

Methods: The Knee + system (Pixee Medical, Besancon, France) was used to guide TKA. It uses a combination of quick response-code labeled instruments and AR glasses to guide tibial and femoral cuts. The primary research goal was to evaluate its accuracy by direct comparing the planned angular values for lateral distal femoral angle, medial proximal tibial angle, hip-knee-ankle axis, and tibial slope to the intraoperative obtained values and the measured angles on postoperative full leg radiographs. The secondary research goal was to assess its feasibility.

Results: This retrospective study evaluated 124 patients, with a follow-up of at least 1 year. The average absolute difference between planned and measured postop values were 1.39° for lateral distal femoral angle, 1.03° for medial proximal tibial angle, 2.16° for tibial slope, and 1.51° for hip-knee-ankle axis. Within the follow-up period, 8 complications were observed. The average surgical time was 83 minutes.

Conclusions: This study has demonstrated a high accuracy, comparable to robotic-assisted total knee arthroplasty, of the Knee + AR system. It has shown to be a safe, cheap and time-efficient assistive technology for patients undergoing medial pivot TKA.

Keywords: Accuracy; Augmented reality; Medial pivot; TKA.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Knee + intraoperative workflow.
Figure 2
Figure 2
Deviation from HKA target. Visual representation of the deviation from target HKA (preoperative planned vs postoperative measured angles).
Figure 3
Figure 3
Visualization of skin-to-skin time of the augmented reality total knee arthroplasty cases for every surgeon.
Figure 4
Figure 4
Cumulative summation analysis of the initial augmented reality total knee arthroplasty cases of 2 surgeons. Inflexion points can be seen at 28 and 10 cases for surgeons 1 and 2, respectively. CUSUM, cumulative summation.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Batailler C., Parratte S. Assistive technologies in knee arthroplasty: fashion or evolution? Rate of publications and national registries prove the Scott Parabola wrong. Arch Orthop Trauma Surg. 2021;141:2027–2034. - PubMed
    1. Gao J., Dong S., Li J.J., Xing D., Lin J. New technology-based assistive techniques in total knee arthroplasty: a Bayesian network meta-analysis and systematic review. Int J Med Robot. 2020;27 doi: 10.1002/rcs.2189. - DOI - PubMed
    1. Ollivier M., Parratte S., Lino L., Flecher X., Pesenti S., Argenson J.N. No benefit of computer-assisted TKA: 10-year results of a prospective randomized study. Clin Orthop Relat Res. 2018;476:126–134. - PMC - PubMed
    1. Hinloopen J.H., Puijk R., Nolte P.A., Schoones J.W., de Ridder R., Pijls B.G. The efficacy and safety of patient-specific instrumentation in primary total knee replacement: a systematic review and meta-analysis. Expert Rev Med Devices. 2023;20:245–252. doi: 10.1080/17434440.2023.2177152. - DOI - PubMed
    1. Dorling I.M., Geenen L., Heymans M.J.L.F., Most J., Boonen B., Schotanus M.G.M. Cost-effectiveness of patient specific vs conventional instrumentation for total knee arthroplasty: a systematic review and meta-analysis. World J Orthop. 2023;14:458–470. - PMC - PubMed

LinkOut - more resources