Augmented Reality Based Navigation for Computer Assisted Hip Resurfacing: A Proof of Concept Study

• Published in: Annals of biomedical engineering 2018-10, Vol.46 (10), p.1595-1605
• Main Authors: Liu, He, Auvinet, Edouard, Giles, Joshua, Rodriguez y Baena, Ferdinando
• Format: Article
• Language: English
• Subjects: Accuracy; Augmented reality; Biochemistry; Biological and Medical Physics; Biomedical and Life Sciences; Biomedical Engineering and Bioengineering; Biomedicine; Biophysics; Bone surgery; Classical Mechanics; Drilling; Femur; Femur Head - pathology; Femur Head - surgery; Hip; Humans; Implantation; Information processing; Medical Robotics; Navigation systems; Orthopedic Procedures - instrumentation; Orthopedic Procedures - methods; Outliers (statistics); Proof of Concept Study; Resurfacing; Robotic surgery; Robotic Surgical Procedures - instrumentation; Robotic Surgical Procedures - methods; Surfacing; Surgery; Workflow
• ISSN: 0090-6964; 1573-9686
• DOI: 10.1007/s10439-018-2055-1

Implantation accuracy has a great impact on the outcomes of hip resurfacing such as recovery of hip function. Computer assisted orthopedic surgery has demonstrated clear advantages for the patients, with improved placement accuracy and fewer outliers, but the intrusiveness, cost, and added complexity have limited its widespread adoption. To provide seamless computer assistance with improved immersion and a more natural surgical workflow, we propose an augmented-reality (AR) based navigation system for hip resurfacing. The operative femur is registered by processing depth information from the surgical site with a commercial depth camera. By coupling depth data with robotic assistance, obstacles that may obstruct the femur can be tracked and avoided automatically to reduce the chance of disruption to the surgical workflow. Using the registration result and the pre-operative plan, intra-operative surgical guidance is provided through a commercial AR headset so that the user can perform the operation without additional physical guides. To assess the accuracy of the navigation system, experiments of guide hole drilling were performed on femur phantoms. The position and orientation of the drilled holes were compared with the pre-operative plan, and the mean errors were found to be approximately 2 mm and 2°, results which are in line with commercial computer assisted orthopedic systems today.