Plan in 2-D, execute in 3-D: an augmented reality solution for cup placement in total hip arthroplasty

  title={Plan in 2-D, execute in 3-D: an augmented reality solution for cup placement in total hip arthroplasty},
  author={Javad Fotouhi and Clayton P. Alexander and M. Unberath and Giacomo Taylor and Sing Chun Lee and Bernhard Fuerst and Alex Johnson and Greg M. Osgood and Russell H. Taylor and Harpal S. Khanuja and Mehran Armand and Nassir Navab},
  journal={Journal of Medical Imaging},
Abstract. Reproducibly achieving proper implant alignment is a critical step in total hip arthroplasty procedures that has been shown to substantially affect patient outcome. In current practice, correct alignment of the acetabular cup is verified in C-arm x-ray images that are acquired in an anterior–posterior (AP) view. Favorable surgical outcome is, therefore, heavily dependent on the surgeon’s experience in understanding the 3-D orientation of a hemispheric implant from 2-D AP projection… 
Technical note: an augmented reality system for total hip arthroplasty
An easy to use intra-operative component planning system based on two C-arm X-ray images that is combined with 3D augmented reality (AR) visualization that simplifies impactor and cup placement according to the planning by providing a real-time RGBD data overlay is proposed.
Feasibility of image-based augmented reality guidance of total shoulder arthroplasty using microsoft HoloLens 1
The design and feasibility analysis of a marker-less image-based registration pipeline using the Microsoft HoloLens 1 and its built-in sensors to guide glenoid drilling during TSA is presented.
A calibration-free workflow for image-based mixed reality navigation of total shoulder arthroplasty
A calibration-free mixed reality navigation workflow for glenoid pin placement in TSA that contributes to solving some open challenges and introduces a slide-on marker calibrated by design to overcome perceptual difficulties that arise when trying to align real to virtual objects.
Technical note: on-the-fly augmented reality for orthopaedic surgery using a multi-modal fiducial
An on-the-fly surgical support system that provides guidance using augmented reality and can be used in quasi-unprepared operating rooms and the accuracy of the system is found to be comparable to the traditional image-guided technique while substantially reducing the number of acquired X-Ray images as well as procedure time.
Accuracy and Reliability of Software Navigation for Acetabular Component Placement in THA: An In Vitro Validation Study
This data validates the proposed methodology to calculate 3D anteversion and inclination angles based on 2D fluoroscopic images to within five degrees and can be utilized to improve acetabular component placing intraoperatively and to check component placement postoperatively.
Assessing the Value of a Novel Augmented Reality Application for Presurgical Planning in Adolescent Elbow Fractures
Preoperative planning using AR-based models can increase surgeon confidence in preoperative planning, hardware selection, and confidence in hardware fit, and estimated potential intraoperative time savings.
Towards clinical translation of augmented orthopedic surgery: from pre-op CT to intra-op x-ray via RGBD sensing
The proposed solution enables the surgeon to visualize pre-operative data overlaid with information from the surgical site for any C-arm pose, and negates issues of line-of-sight and long setup times, which are present in commercially available systems.
On-the-fly augmented reality for orthopedic surgery using a multimodal fiducial
An on-the-fly surgical support system that provides guidance using augmented reality and can be used in quasiunprepared operating rooms and design a feasibility study on a semianthropomorphic phantom is presented.
Co-localized augmented human and X-ray observers in collaborative surgical ecosystem
A collaborative augmented reality (AR) surgical ecosystem to jointly co-localize the C-arm X-ray and surgeon viewer and presents a thorough evaluation of the hand-eye calibration procedure.


A hybrid CT-free navigation system for total hip arthroplasty.
The proposed CT-free hybrid system promises to increase the accuracy and reliability of THA surgery and a pilot clinical evaluation showed that THA could benefit from this newly developed CT-less image-guided surgical navigation system.
Preclinical usability study of multiple augmented reality concepts for K-wire placement
The 3D visualization of patient, tool, and DRR shows clear advantages over the conventional X-ray imaging and provides intuitive feedback to place the medical tools correctly and efficiently.
Haptically guided robotic technology in total hip arthroplasty: A cadaveric investigation
  • D. Nawabi, M. Conditt, D. Padgett
  • Medicine
    Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine
  • 2013
Robotic-assistance is more accurate than manual implantation in achieving optimal cup orientation and has the ability to eliminate human error from THA and should be considered in light of THA failures due to component malposition.
2D/3D Registration for Measurement of Implant Alignment After Total Hip Replacement
A tool to accurately measure 3D implant orientation from postoperative antero-posterior radiographs by registering to preoperative CT scans is developed, which demonstrates a wide range of inter-subject variability.
Statistically Deformable 2D/3D Registration for Accurate Determination of Post-operative Cup Orientation from Single Standard X-ray Radiograph
A statistically deformable 2D/3D registration approach is developed and validated for accurate determination of post-operative cup orientation and results evaluated on cadaveric and clinical datasets indicate the validity of the approach.
Comparison of Robotic-assisted and Conventional Acetabular Cup Placement in THA: A Matched-pair Controlled Study
Use of the robot allowed for improvement in placement of the cup in both safe zones, an important parameter that plays a significant role in long-term success of THA, but whether the radiographic improvements will translate into clinical benefits for patients—such as reductions in component impingement, acetabular wear, and prosthetic dislocations, or in terms of improved longevity—remains unproven.
Intraoperative Simulation and Planning Using a Combined Acetabular and Femoral (CAF) Navigation System for Total Hip Replacement
The aim of this work is to provide intraoperative assistance to the surgeon in selecting the optimal component combination as well as in planning additional osteotomy to remove unwanted bone impingements and widen the safe ROM.
Imageless navigation for insertion of the acetabular component in total hip arthroplasty: is it as accurate as CT-based navigation?
Both CT-based and imageless navigation showed a significant reduction in variation of the position of the acetabular component compared with conventional freehand arthroplasty (p < 0.001).