Augmented reality navigation systems vs. conventional techniques in acetabular cup positioning: a systematic review...

Area of Science:

• Orthopedic Surgery
• Medical Technology
• Surgical Navigation

Background:

• Accurate acetabular cup placement is crucial for successful total hip arthroplasty (THA).
• Conventional methods for acetabular cup positioning can be subject to variability.
• Augmented reality (AR) offers potential for enhanced surgical precision.

Purpose of the Study:

• To systematically review and meta-analyze the effectiveness of AR techniques for acetabular cup positioning in THA.
• To compare AR-assisted positioning with conventional methods regarding accuracy and safety outcomes.

Main Methods:

• Systematic search of Cochrane, MEDLINE, and EMBASE databases until December 12, 2024.
• Inclusion of prospective and retrospective studies comparing AR to conventional acetabular cup positioning.
• Assessment of anteversion, inclination, blood loss, operation time, and complications; bias assessment using RoB 2 and ROBINS-I tools.

Main Results:

• Meta-analysis of 8 studies (346 hips with AR, 395 conventional) showed significantly more precise anteversion and inclination angles with AR.
• No significant differences were found in blood loss, operation time, or postoperative complications between groups.
• Substantial heterogeneity was noted for angle measurements; risk of bias was high in retrospective studies.

Conclusions:

• AR systems demonstrate a strong potential for improving acetabular cup positioning accuracy in THA.
• AR-assisted positioning maintains a favorable safety profile compared to conventional techniques.
• Limitations include study heterogeneity and varied angle assessment methods.