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Updated: May 26, 2026
Augmented Reality Navigation-Guided Core Decompression for Osteonecrosis of Femoral Head
Published on: April 12, 2022
Mixed-Reality Guidance for Total Knee Arthroplasty Is Associated With More Accurate Femoral Resection but Longer
Michael A Hewitt1, Catelyn A Woelfle1, Anthony H Zou1
1Department of Orthopedic Surgery, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA.
Background:
Mixed-reality guidance for total knee arthroplasty (MR-TKA) offers a novel approach that may enhance intraoperative planning and surgical site tracking compared to established techniques, such as accelerometer-based guidance (AB-TKA). This study investigates operative time, resection accuracy, and short-term clinical outcomes of MR-TKA compared with AB-TKA.
Methods:
MR-TKA procedures were performed at a single institution and retrospectively matched 1:1 with an AB-TKA cohort based on age (±5 years), sex, and body mass index (±5 kg/m2). Postoperative femoral and tibial resection angles were radiographically measured and compared with intraoperative plans. Operative times, complications, and postoperative range of motion were also recorded.
Results:
A total of 94 cases were included (47 MR-TKA, 47 AB-TKA). There was no difference in age (74 ± 7.6 years; range, 53.0-88.7), body mass index (28.7 ± 4.6; range, 19.0-42.0), or sex (74.5% women, 25.5% men) between groups. Mean operative time was longer for MR-TKA compared to AB-TKA (109 ± 21 vs 90 ± 13 minutes, P < .001). Postoperative deviation from the planned femoral resection angle was lower for MR-TKA compared to AB-TKA (1.20° ± 1.21° vs 1.87° ± 1.48°, P = .021), but there was no difference in tibial resection angle (1.06° ± 0.77° vs 1.39° ± 1.08°, P = .093). There was no difference in 3-month postoperative knee flexion, knee extension, or complication rate between groups.
Conclusions:
Mixed-reality guidance was associated with improved femoral resection accuracy but may require longer operative time compared to accelerometer-based guidance. Both techniques demonstrate comparable short-term range of motion and complication rates.
