Good surgical technique and accurate acetabular and femoral component positioning continues to be a challenge even for the experienced orthopaedic surgeon, suboptimal implantation of the components are likely to reduce the longevity and function. Computer-assisted Navigation systems has been shown to improve accuracy in placing acetabular and femoral component in hip arthroplasty. The application take advantage of Augmented reality and merges with computer assisted orthopaedic surgery (CAOS) techniques and principles in effort to help an orthopaedic surgeon in every surgical schedule without the need of expensive equipment.
App assist the surgeon:
-during manipulating the reamer or inserter in real time, angles anteversion and inclination change dynamically, obtaining positional information and direction with accuracy in real time in augmented reality intraoperatively over iPhones or iPad’s screen. The surgeon can be directed by App readings and place the cup to optimal, and biomechanically sound position according to redefined the safe zone which take into account patient-specific pelvic tilt.
-to automatically calculate intraoperatively pre and postoperative discrepancies in femoral offset and Leg Length. Pelvic tilt, femoral anteversion, native acetabulum and cup anteversion, inclination are also calculated.
-resenting the native hip axis of patients acetabulum in surgeons sight in AR is vital in orientation during handling the reamer or cup insertion device in case surgeon wants to reproduce the native patient hip axis during surgery without strictly taking in to account numerical values of measured anteversion and inclination values.
-adjust intra-operatively in augmented reality the exact resection level of the femoral neck.A colourful cylinder appears from the centre of femoral head to the trochanter minor ). distance is depicted numerically in mm as LL (leg length) over the screen. The alternate colour is helpful and act as a ruler in augmented reality, each colour represent certain distance in mm.
-A yellow plane appears between anterior notch and posterior acetabular notch which outlines the direction of transverse ligament. Cup placement should be parallel to the transverse acetabular ligament for optimal orientation of acetabular prosthesis anteversion. Seeing in AR the desired yellow plane over transverse acetabular ligament app offer an other way to assist surgeon during surgery.
The surgeon can be directed by augmenting his vision in AR reality by taking into account in real time intra operatively calculations and simultaneously adjusting operative technique without being mislead by simply eye perception. The combination of Augmented reality environment and real surgery with planes and rulers appearing in operative field intra operatively, aiding the ability of surgeon to perform accurate implant placement brings a new dimension in operational surgery.
Disclaimer.
Regarding its plausibility apps offers no diagnosis or treatment. Explicitly is announced that the apps are not for diagnosis. Clinical judgment and experience are required to properly use the software. Apps alone do not replace an M.D. or specialist. All information received from the Apps output must be reviewed before any attempted treatment. The software is not for primary image interpretation. Any influence to the operators in making decisions remains user own responsibility and experience. Apps does not dispense medical advice. Patient should seek a doctor’s advice in addition using these apps and or before making any medical decisions for themself. Never substitute or replace doctors advice or change treatment modalities based on any measured outcome. Apps indicated for assisting healthcare professionals for scientific reasons and research reason. Clinical judgment and experience are required to properly use apps and further research and validation is pending in coming future.