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Accuracy of Acetabular Component Positioning Using a Mixed Reality-Guided Navigation System During Total Hip

Alexander F Heimann1,2, William S Murphy3, Daniel C Sun4

  • 1Center for Computer Assisted and Reconstructive Surgery, New England Baptist Hospital, Boston, Massachusetts.

JB & JS Open Access
|March 24, 2025
PubMed
Summary

A novel mixed-reality (MR) system enhances total hip arthroplasty (THA) accuracy by using patient-specific CT scans for precise acetabular cup placement. This technology offers highly accurate results, comparable to other navigation systems.

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Area of Science:

  • Orthopedic Surgery
  • Medical Technology
  • Surgical Navigation

Background:

  • Patient-specific factors are crucial for optimal acetabular cup alignment in total hip arthroplasty (THA).
  • Existing surgical navigation systems aim to improve cup placement accuracy.
  • A new computed tomography (CT)-based planning and mixed-reality (MR) guidance system has been developed for patient-specific 3D planning and intraoperative guidance.

Purpose of the Study:

  • To evaluate the accuracy of a novel CT-based mixed-reality (MR) guidance system for acetabular cup positioning during total hip arthroplasty (THA).
  • To assess the intraoperative achievement of planned cup orientation using MR guidance.

Main Methods:

  • Retrospective observational study of 40 patients undergoing MR-guided THA.
  • Patient-specific CT-based planning defined target anteversion and inclination relative to the anterior pelvic plane.
  • Intraoperative holographic registration and guidance via a head-mounted display were used for acetabular component insertion.

Main Results:

  • The mean absolute target error for anteversion was 0.7° ± 1.1° (range, 0°-4°).
  • The mean absolute target error for inclination was 1.1° ± 1.2° (range, 0°-4°).
  • Achieved cup alignments were highly accurate and within the reported accuracy of other navigation systems.

Conclusions:

  • Acetabular component positioning using the MR guidance system in THA is highly accurate.
  • The MR system demonstrates accuracy comparable to or exceeding existing navigation technologies.