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Related Concept Videos

Computed Tomography01:10

Computed Tomography

Tomography refers to imaging by sections. Computed tomography (CT) is a non-invasive imaging technique that uses computers to analyze several cross-sectional X-rays to reveal minute details about structures in the body.
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...

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Updated: Jun 19, 2026

The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report
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How Much Does a Computed Tomography-Based Mixed-Reality Navigation System Change Freehand Acetabular Component

Justin Leal1, Alexander F Heimann2, Eric S Dilbone1

  • 1Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.

Arthroplasty Today
|April 1, 2025
PubMed
Summary
This summary is machine-generated.

A computed tomography-based mixed-reality (MR) navigation system helped surgeons correct acetabular component orientation in total hip arthroplasty. This navigation tool was needed in about half of cases to achieve planned operative anteversion and inclination targets.

Keywords:
AnteversionAugmented-reality (AR)InclinationMixed-reality (MR)Total hip arthroplasty (THA)

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Area of Science:

  • Orthopedic Surgery
  • Medical Technology
  • Surgical Navigation

Background:

  • Total hip arthroplasty (THA) aims for precise acetabular component placement.
  • Freehand positioning can lead to deviations from planned acetabular orientation.
  • Mixed-reality (MR) navigation systems offer potential improvements in surgical accuracy.

Purpose of the Study:

  • To evaluate the impact of a computed tomography-based MR navigation system on acetabular component orientation during THA.
  • To compare the accuracy of MR-guided positioning versus freehand positioning.
  • To quantify the adjustments needed to achieve planned operative anteversion (OA) and inclination (OI).

Main Methods:

  • A retrospective review of 79 patients undergoing THA using an MR navigation system.
  • Surgeons initially placed acetabular cups freehand, recording the orientation.
  • The difference between freehand and planned orientation determined the navigation system's impact and required adjustments.

Main Results:

  • Preoperative planned OA averaged 30.1°, while freehand OA averaged 30.2° (P = .885), with a mean adjustment of 6.8° needed in 54.4% of cases.
  • Preoperative planned OI averaged 40.8°, while freehand OI averaged 37.8° (P < .001), with a mean adjustment of 5.7° needed in 43.0% of cases.
  • The MR navigation system facilitated corrections of at least 5° in OA and OI in approximately half of the patients.

Conclusions:

  • Freehand acetabular component positioning is variable in achieving patient-specific orientation targets.
  • The evaluated MR navigation system assisted surgeons in correcting acetabular component orientation.
  • The system proved beneficial in achieving planned operative anteversion and inclination in a significant portion of THA procedures.