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Video of AR use in Total Hip Arthroplasty

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Video of AR use in Total Hip Arthroplasty

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American Academy of Orthopaedic Surgery (2023, April 11). Augmented reality for primary total hip arthroplasty.

https://www.aaos.org/videos/video-detail-page/26791__Videos

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American Academy of Orthopaedic Surgeons

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AAOS OVT - Augmented Reality for Primary Total Hip Arthroplasty

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Adolph V. Lombardi, Jr., MD, FACS demonstrates a primary total hip arthroplasty with augmented reality on a 52-year-old male. The preoperative plan from HipInsight provides leg length and offset change as well as native and planned femoral anteversion.

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Augmented reality (AR) is used in orthopedic surgery to improve visualization of fractures, joints, and tissues, enhancing preoperative planning and aiding precision during surgery. It can also assist with physician documentation and patient monitoring postoperatively. However, challenges include a lack of training opportunities, increased cost, and dependence on technology. There are concerns in the orthopedic community about the reliance on robots and potential loss of surgical hands-on skills when AR cannot compensate for unplanned events or anatomical deviations.

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As an orthopedic Operating Room Nurse I have extensive experience with robotic surgery and AR use in orthopedics. The technology is improving and the systems seem to flow better now than they did just a few short years ago. However, I have witnessed some surgeons who struggle with traditional non-robotic surgery. Sometimes the AR system can be cumbersome or technology simply is not performing correctly with set up targeting, sensors, or registering. This can lead to frustrations and increased time in the OR. However, most of the time in my experience the use of AR benefits the patient and the surgical team. The view, accuracy, and precision in unlike any human can generate. Plus, it looks really cool and it is fun! We called one surgeon JARVIS, a nod to Ironman and the AI/AR system he used because the helmet worn in surgery looks similar.

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1. Preoperative Planning: AR assists in creating personalized surgical plans by analyzing imaging data and identifying optimal approaches for individual patients.

2. Robotic Surgery: AR-powered robotic systems enhance precision during procedures, such as joint replacements, by providing real-time feedback and support to surgeons.

3. Automated Documentation: Robotic surgery and AR can streamline physician dictation and documentation, allowing surgeons to focus more on patient care.

4. Patient Monitoring: Some robotic and AR systems can monitor patients post-surgery with implants, using data to detect early signs of complications or to assess recovery progress.

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1. High Initial Costs: Implementing AR technology can be expensive, including costs for software, hardware, and training, which may be a barrier for some institutions. Some popular robotic AR systems start at $1 million dollars.

2. Dependence on Technology: Reliance on automated systems may reduce surgeons' hands-on skills and critical thinking in complex situations.

3. Regulatory Issues: The evolving regulatory landscape for AR in healthcare can create uncertainty and hinder the adoption of new technologies.

4. Training Requirements: Surgeons and medical staff need additional training to effectively use AR tools, which can be a logistical challenge.

5. Health Disparity: Access to robotic and AR surgery is more common in wealthy countries and to patients with health insurance coverage or financial ability to pay.

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Gallup (2024). CliftonStrengths. Retrieved September 12, 2024, from https://www.gallup.com/cliftonstrengths/en/252137/home.aspx

Lisacek-Kiosoglous, A. B., Powling, A. S., Fontalis, A., Gabr, A., Mazomenos, E., & Haddad, F. S. (2023). Artificial intelligence in orthopaedic surgery. Bone & joint research, 12(7), 447–454. https://doi.org/10.1302/2046-3758.127.BJR-2023-0111.R1

Lombardi, A. V., Jr (2023, April 11). Augmented reality for primary total hip arthroplasty. Retrieved September 12, 2024, from https://www.aaos.org/videos/video-detail-page/26791__Videos

Tafat, W., Budka, M., McDonald, D., & Wainwright, T. W. (2024). Artificial intelligence in orthopaedic surgery: A comprehensive review of current innovations and future directions. Computational and Structural Biotechnology Reports, 1, 100006. 10.1016/j.csbr.2024.100006

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