Validation Study on Iatrogenic Nerve Damage Reduction Using Augmented Reality on Elbow Phantom

Area of Science:

• Orthopedic surgery
• Medical imaging technology
• Surgical navigation systems

Background:

• Intraoperative imaging guidance is crucial for accurate orthopedic procedures.
• Classical C-arm fluoroscopy is a standard but has limitations in precision and radiation exposure.
• Augmented reality (AR) offers a potential advancement in visualizing surgical targets.

Purpose of the Study:

• To compare augmented reality (AR) surgical navigation with classical C-arm intraoperative guidance.
• To evaluate the efficacy of head-mounted displays (HMDs) in improving surgical accuracy for K-wire placement.
• To assess the impact of AR on key surgical parameters like time, accuracy, and radiation exposure.

Main Methods:

• Development of an AR system, X-ray simulation, and an anatomically accurate elbow phantom.
• Testing K-wire placement in three distinct bone locations within the phantom.
• Comparative analysis using X-ray guidance alone versus AR with HMD, measuring time, angle, X-ray usage, and proximity to anatomical structures.

Main Results:

• AR navigation reduced K-wire placement time by -53.8 seconds compared to standard procedures.
• Angular error was decreased by 47% with AR, and X-ray images required were reduced by 80%.
• AR demonstrated an 81% decrease in distance variability from critical anatomical structures.

Conclusions:

• Augmented reality navigation significantly enhances surgical accuracy and efficiency in K-wire placement.
• AR systems, particularly with head-mounted displays, offer a superior alternative to traditional C-arm navigation.
• The study highlights AR's potential to reduce operative time, improve precision, and minimize radiation exposure in orthopedic surgery.