Development and Pre-Clinical Analysis of Spatiotemporal-Aware Augmented Reality in Orthopedic Interventions

Abstract

Suboptimal interaction with patient data and challenges in mastering 3D anatomy based on ill-posed 2D interventional images are essential concerns in image-guided therapies. Augmented reality (AR) has been introduced in the operating rooms in the last decade; however, in image-guided interventions, it has often only been considered as a visualization device improving traditional workflows. As a consequence, the technology is gaining minimum maturity that it requires to redefine new procedures, user interfaces, and interactions. The main contribution of this paper is to reveal how exemplary workflows are redefined by taking full advantageof head-mounted displays when entirely co-registered with the imaging system at all times. The awareness of the system from the geometric and physical characteristics of X-ray imaging allows the exploration of different human-machine interfaces. Our system achieved an error of 4.76 ± 2.91 mm for placing K-wire in a fracture management procedure, and yielded errors of 1.57 ± 1.16° and 1.46 ± 1.00° in the abduction and anteversion angles, respectively, for total hip arthroplasty (THA). We compared the results with the outcomes from baseline standard operative and non-immersive AR procedures, which had yielded errors of [4.61mm, 4.76°, 4.77°] and [5.13 mm, 1.78°, 1.43°], respectively, for wire placement, and abduction and anteversion during THA. We hope that our holistic approach towards improving the interface of surgery not only augments the surgeon’s capabilities but also augments the surgical team’s experience in carrying out an effective intervention with reduced complications and provide novel approaches of documenting procedures for training purposes.

HAPPY: Hip Arthroscopy Portal Placement Using Augmented Reality

“…For each acquired X-ray, the frustum was augmented in space and the X-ray image was visualized in the frustum, allowing for a comparison of various C-arm poses. The proposed AR solution showed clear benefits of reducing the operating time and radiation dose while maintaining similar accuracy [10] for the K-wire insertion and the placement of the acetabular cup. In our system, we leveraged a similar frustum augmentation strategy.…”

Optimal allocation strategy of orthopedic clinical nursing services based on artificial intelligence

“…According to the analysis of the current situation of clinical nursing services in orthopedics, it can be divided into four categories, including basic hospitals, emergency expert type, ward nursing and rehabilitation guidance, and comprehensive treatment centers [12]. Among them, ward nursing and rehabilitation guidance are the most important and critical links.…”

Medical Augmented Reality: Definition, Principle Components, Domain Modeling, and Design-Development-Validation Process

“…Later, the introduction of an RGB-D camera attached to the X-ray detector enabled acquiring a 3D representation of the surgical scene [ 52 , 53 ]. A recent advancement of CAMC adopted HMDs [ 54 , 55 ] both for visualization of the surgical site for the surgeon, as well as for tracking the C-arm.…”

“… Evaluation in CAMC Applications: The system was first evaluated on phantoms [ 51 , 61 ], then on human cadaver and ex-vivo animal anatomy [ 62 , 63 ] and finally through a set of patient studies [ 64 , 65 , 66 ]. Quantitative data such as radiation dose, planning and execution time, K-wire insertion accuracy, and other surgical tasks have been evaluated over the years with different types of the CAMC [ 55 , 63 , 67 , 68 ]. We also have performed qualitative evaluations of the system usability and user depth perception to help better understand and improve the visualization of CAMC.…”