Digital Twin Augmented Reality for Image-Guided Trochleoplasty

Trochlear dysplasia, a condition in which the groove at the end of the femur (trochlea) is misshapen, causes the kneecap (patella) to have difficulty staying aligned during movement. This often leads to patellar instability and repeated dislocation. In cases where dislocations are recurrent, surgical intervention is indicated. Trochleoplasty is a surgical procedure to reshape the trochlea. Medial patellofemoral ligament reconstruction is often needed to fix or replace the ligament tissues around the patella. Currently, preoperative imaging, such as X-ray, magnetic resonance imaging (MRI), and computed tomography (CT), are used to examine tissue structures. However, static preoperative images cannot visualize joint movements or tissue deformation. During surgery, there is no three-dimensional (3D) image guidance. As a result, the procedures often depend on the skills of individual surgeons. In this study, we explored digital twin augmented reality (AR) for the potential application in image-guided trochleoplasty with the aim of improving surgical planning and precision guidance. By overlaying 3D models onto the surgical field with an AR headset, the technique aims to improve the shape correction of trochlea and match it with the patella during trochleoplasty, ultimately improving surgical precision and treatment outcomes.