Augmented reality based navigation for distal interlocking of intramedullary nails utilizing Microsoft HoloLens 2

Area of Science:

• Orthopedic surgery
• Medical imaging
• Augmented reality

Background:

• Distal interlocking of intramedullary nails is a challenging surgical procedure.
• Current augmented reality (AR) solutions face limitations in hand-eye coordination, operation time, and resolution.

Purpose of the Study:

• To develop an advanced AR-based navigation system for distal interlocking of intramedullary nails.
• To overcome the limitations of existing navigation technologies.

Main Methods:

• Utilized Microsoft HoloLens 2, an optical see-through head-mounted display.
• Developed a customized registration cube for improved depth perception.
• Implemented in-situ visualization of the nail and drilling path with dynamic navigation.
• Integrated an intraoperative warning system for real-time deviation feedback.

Main Results:

• Preclinical phantom experiments demonstrated low reprojection errors (X: 1.55 ± 0.27 mm, Y: 1.71 ± 0.40 mm, Z: 2.84 ± 0.78 mm).
• End-to-end evaluation showed a distance error of 1.61 ± 0.44 mm and a 3D angle error of 1.46 ± 0.46°.
• Cadaver experiments confirmed the system's feasibility.

Conclusions:

• The developed AR navigation system shows potential advantages in accuracy and efficiency over traditional methods.
• The system has significant application prospects for improving distal interlocking procedures.