Immersive virtual reality in orthopaedics—a narrative review

Combalia, Andrés; Sánchez-Vives, María V.; Donegan, Tony

doi:10.1007/s00264-023-05911-w

Cited by 10 publications

(7 citation statements)

References 68 publications

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“…AR shows promise in improving pre-surgical and peri-surgical education and training for patients and surgeons. It can also alleviate stress associated with immobilization and reduce movement-induced pain without relying on anxiolytics or analgesics ( 51 , 52 ).…”

Section: Discussionmentioning

confidence: 99%

The application of extended reality technology-assisted intraoperative navigation in orthopedic surgery

Bian,

Lin,

et al. 2024

Front. Surg.

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Extended reality (XR) technology refers to any situation where real-world objects are enhanced with computer technology, including virtual reality, augmented reality, and mixed reality. Augmented reality and mixed reality technologies have been widely applied in orthopedic clinical practice, including in teaching, preoperative planning, intraoperative navigation, and surgical outcome evaluation. The primary goal of this narrative review is to summarize the effectiveness and superiority of XR-technology-assisted intraoperative navigation in the fields of trauma, joint, spine, and bone tumor surgery, as well as to discuss the current shortcomings in intraoperative navigation applications. We reviewed titles of more than 200 studies obtained from PubMed with the following search terms: extended reality, mixed reality, augmented reality, virtual reality, intraoperative navigation, and orthopedic surgery; of those 200 studies, 69 related papers were selected for abstract review. Finally, the full text of 55 studies was analyzed and reviewed. They were classified into four groups—trauma, joint, spine, and bone tumor surgery—according to their content. Most of studies that we reviewed showed that XR-technology-assisted intraoperative navigation can effectively improve the accuracy of implant placement, such as that of screws and prostheses, reduce postoperative complications caused by inaccurate implantation, facilitate the achievement of tumor-free surgical margins, shorten the surgical duration, reduce radiation exposure for patients and surgeons, minimize further damage caused by the need for visual exposure during surgery, and provide richer and more efficient intraoperative communication, thereby facilitating academic exchange, medical assistance, and the implementation of remote healthcare.

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Section: Discussionmentioning

confidence: 99%

The application of extended reality technology-assisted intraoperative navigation in orthopedic surgery

Bian,

Lin,

et al. 2024

Front. Surg.

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“…In the realm of augmented reality and virtual reality, these technologies are increasingly integrated into preoperative planning. Surgeons are provided with immersive experiences for visualizing fracture patterns and practicing procedures, ultimately aiding in enhancing surgical precision [ 53 ]. Nanotechnology is leveraged in creating coatings for implants, specifically in the domain of implant coatings.…”

Section: Reviewmentioning

confidence: 99%

A Comprehensive Review of Proximal Humerus Fractures: From Epidemiology to Treatment Strategies

Goyal,

Ambade,

Singh

et al. 2024

Cureus

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This comprehensive review delves into the intricate landscape of proximal humerus fractures (PHFs), exploring their epidemiology, historical evolution, contemporary classification systems, treatment strategies, and outcome measures. PHFs present a complex orthopedic challenge, necessitating a nuanced understanding of their multifaceted dimensions. Despite their clinical significance, PHFs remain relatively understudied in population-based epidemiology. This review critically examines existing literature to uncover the incidence, prevalence, and demographic patterns associated with these fractures. A foundational understanding of the epidemiological landscape is crucial for effective preventive strategies and optimized fracture management. Tracing back to historical records, the review explores the evolution of diagnostic and therapeutic approaches for PHFs. From ancient treatment modalities documented on the Edwin Smith papyrus to contemporary X-ray-based classifications such as Neer and AO/OTA, a historical context is provided to understand the journey of managing these fractures. Navigating through a spectrum of treatment strategies, the review contrasts nonoperative approaches with various surgical interventions. The challenges and outcomes associated with conservative management are juxtaposed against methods like open reduction internal fixation and tension band osteosynthesis. Evidence synthesis guides clinicians in making informed decisions based on patient characteristics and fracture complexities. Central to assessing PHF management are patient-reported outcome measures. The review explores the significance of instruments such as the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and the Constant-Murley score in evaluating treatment success. The shift toward subjective measures is discussed, considering their correlation with patient experiences and the concept of minimal clinically important difference. The impact of demographic factors, including age and gender, on PHFs is scrutinized. The association between these fractures and osteoporosis is highlighted, emphasizing the crucial role of bone health in fracture prevention and management. Through this comprehensive exploration, the review provides a robust foundation for understanding, evaluating, and advancing the management strategies for PHFs. The synthesis of historical perspectives, contemporary classifications, and treatment modalities serves as a valuable resource for the orthopedic community, fostering improved clinical decision-making and patient outcomes.

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“…This navigation system offers real-time visual feedback during surgery, enabling precise alignment of the surgeon’s instruments with the preoperative plan. This alignment is achieved by integrating a line-of-sight camera and trackers attached to the surgical instruments and the scapula [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Metaverse, virtual reality and augmented reality in total shoulder arthroplasty: a systematic review

Longo,

Lalli,

Gobbato

et al. 2024

BMC Musculoskelet Disord

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Purpose This systematic review aims to provide an overview of the current knowledge on the role of the metaverse, augmented reality, and virtual reality in reverse shoulder arthroplasty. Methods A systematic review was performed using the PRISMA guidelines. A comprehensive review of the applications of the metaverse, augmented reality, and virtual reality in in-vivo intraoperative navigation, in the training of orthopedic residents, and in the latest innovations proposed in ex-vivo studies was conducted. Results A total of 22 articles were included in the review. Data on navigated shoulder arthroplasty was extracted from 14 articles: seven hundred ninety-three patients treated with intraoperative navigated rTSA or aTSA were included. Also, three randomized control trials (RCTs) reported outcomes on a total of fifty-three orthopedics surgical residents and doctors receiving VR-based training for rTSA, which were also included in the review. Three studies reporting the latest VR and AR-based rTSA applications and two proof of concept studies were also included in the review. Conclusions The metaverse, augmented reality, and virtual reality present immense potential for the future of orthopedic surgery. As these technologies advance, it is crucial to conduct additional research, foster development, and seamlessly integrate them into surgical education to fully harness their capabilities and transform the field. This evolution promises enhanced accuracy, expanded training opportunities, and improved surgical planning capabilities.

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Immersive virtual reality in orthopaedics—a narrative review

Cited by 10 publications

References 68 publications

The application of extended reality technology-assisted intraoperative navigation in orthopedic surgery

The application of extended reality technology-assisted intraoperative navigation in orthopedic surgery

A Comprehensive Review of Proximal Humerus Fractures: From Epidemiology to Treatment Strategies

Metaverse, virtual reality and augmented reality in total shoulder arthroplasty: a systematic review

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