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Augmented Reality-Guided Individualized Total Knee Arthroplasty: Initial Clinical Implementation and Results
H Gene Dossett1, Michael Stickels, Rini Desai
1From the Department of Orthopaedic Surgery, Phoenix VA Healthcare Center, Phoenix, AZ (Dr. Dossett and Ms. Shanahan); the University of Arizona College of Medicine-Phoenix, Phoenix, AZ (Dr. Stickels and Dr. Desai); the Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ (Dr. Kozak); and the Department of Orthopedic Surgery, Mayo Clinic, Phoenix, AZ (Dr. Tummala).
Augmented reality (AR)-guided total knee arthroplasty (TKA) precisely executes individualized alignment plans. This innovative approach shows excellent accuracy and favorable early patient outcomes, with no complications at six months.
Area of Science:
- Orthopedic Surgery
- Medical Technology
- Biomedical Engineering
Background:
- Total knee arthroplasty (TKA) is shifting from mechanical to individualized alignment for better patient outcomes.
- Manual instrumentation challenges precise execution of patient-specific alignment in TKA.
- Augmented reality (AR) offers real-time intraoperative visualization to improve TKA accuracy.
Purpose of the Study:
- To evaluate the accuracy and early clinical outcomes of AR-guided individualized TKA.
- To assess the precision of the Pixee Knee + AR system in executing patient-specific alignment plans.
- To determine the safety and efficacy of AR-assisted TKA within defined alignment parameters.
Main Methods:
- Retrospective analysis of 50 patients undergoing primary TKA with the Pixee Knee + AR system.
- Individualized alignment strategies were employed with patient-specific planning.
- Radiographic accuracy assessed via CT scans; patient-reported outcomes collected at 6-month follow-up.
Main Results:
- High alignment accuracy: 96% of coronal measurements within 3° of planned values.
- Component-specific accuracy within 1°: Tibial (72%), Femoral (62%), HKA (46%).
- Significant improvements in patient-reported outcomes (mASE and KOOS Jr.) with no early complications.
Conclusions:
- AR-guided individualized TKA achieves high accuracy in executing patient-specific alignment.
- Favorable early clinical outcomes and a good safety profile were observed at 6 months.
- AR technology presents a promising alternative for precise TKA alignment, warranting further investigation.
