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Technical Approach for Infrared Tracking for Soft Tissue Navigation with a Holographic Head-Mounted Display and Preclinical Validation
Published on: September 2, 2025
A preliminary validation study showing comparable accuracy between Computed Tomography based and imageless portable
Yuichi Miura1, Hideki Ueyama2, Ryo Sugama1
1Department of Orthopedic Surgery, Osaka Metropolitan University, Osaka, Japan.
International Orthopaedics
|June 22, 2026
Summary
A new CT-based navigation system for total hip arthroplasty (THA) shows accuracy comparable to imageless systems. This study compared both systems in THA, finding similar cup placement accuracy for inclination and anteversion.
Area of Science:
- Orthopedic Surgery
- Medical Imaging
- Surgical Navigation
Background:
- Accurate acetabular cup placement is critical for successful total hip arthroplasty (THA).
- Portable navigation systems aid surgeons in achieving precise implant positioning.
- Evaluating novel navigation technologies is essential for improving surgical outcomes.
Purpose of the Study:
- To compare the acetabular cup placement accuracy of a new Computed Tomography (CT)-based portable navigation system against an imageless portable navigation system.
- To assess the performance of both systems in primary THA performed in the lateral decubitus position.
- To investigate differences in cup inclination and anteversion errors between the two navigation modalities.
Main Methods:
- A retrospective cross-sectional study involving 36 patients undergoing primary THA using a direct lateral approach.
- Concurrent use of both imageless and CT-based portable navigation systems within the same surgical procedures.
- Postoperative cup alignment evaluated via 3D CT, with primary outcomes being absolute errors in inclination and anteversion.
Main Results:
- No statistically significant differences were found in the mean absolute error for cup inclination (2.2° vs. 2.3°, p=0.93) or anteversion (2.3° vs. 2.6°, p=0.41) between the CT-based and imageless systems.
- Outlier rates for cup placement did not differ significantly between the two navigation systems.
- A registration success rate of 92% was achieved, with three technical failures reported.
Conclusions:
- The CT-based portable navigation system demonstrated comparable acetabular cup placement accuracy to the imageless system in THA.
- While the CT-based system may offer additional intraoperative spatial information, its definitive impact on clinical outcomes requires further long-term study.
- This preliminary study suggests the CT-based system is a viable alternative for navigation in THA.
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