Augmented Reality System Advances Joint Arthroplasty

A new head-mounted augmented reality (AR) intra-operative system guides joint arthroplasty and hip replacement surgery.

The Surgical Planning Associates (SPA; Boston, MA, USA) HipInsight AR is a surgical guidance platform that combines cloud-based preoperative planning and real-time interoperative guidance, enabling surgeons to be more precise during the most critical aspects of the procedure. The HipInsight system also provides a seamless and intuitive solution, as it is contained entirely within the Microsoft (Redmond, WA, USA) HoloLens 2. The AR system is designed to integrate with the company’s HipExpert planning software and instrumentation.

HipExpert provides a detailed, CT-based, 3D surgical plan that includes component positioning and sizing, leg length, offset, pelvic tilt, and tuning parameters for the alignment instrument. The surgical plans are posted to cloud-based servers and are available for download and surgeon review prior to the operation. An innovative alignment instrument enables surgeons to position the acetabular component in accordance with the plan’s preoperative targets for anteversion and inclination. System software currently supports more than 20 implant systems from leading manufacturers.

“Traditional navigation systems, robotics and interoperative imaging provide information on flat screens outside the surgeon's view of the patient, leaving the process disjointed and awkward,” said orthopedic surgeon Stephen B. Murphy, MD, founder of SPA. “The HipInsight system enables surgeons to stay focused on the patient, projecting holograms on AR glasses that effectively give them 'x-ray vision,' so that surgeons can see what they need to see, when they need to see it, right inside the patient's body.”

A hip replacement implant is a ball-and-socket mechanism, designed to simulate a human hip joint and mimic its movement. Typical components include a stem that inserts into the femur, a ball that replaces the head of the thigh bone, and a shell that lines the hip socket. Assessment of individual patient pelvic tilt and digital measurement of leg length and offset changes are imperative to achieve more consistent leg length restoration.

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Surgical Planning Associates
Microsoft