Table 1.
Clinical studies about augmented reality in orthopedics.
| References | Field | AR system | Main outcomes |
|---|---|---|---|
| Von der Heide et al. (39) | Several procedures performed with fluoroscopy (plate, nail and screw osteosynthesis, implant removal) | Camera-augmented C-arm | The X-ray shots were diminished to approximately a half with the use of AR. The time of surgery remained similar to that of traditional C-arms |
| Ponce et al. (40) | Shoulder arthroscopy | VIP | AR technology was a useful teaching tool for orthopedic residents, it was safe and was characterized by comparable operative times to conventional methods |
| Ponce et al. (41) | Total shoulder arthroplasty | VIP combined with wearable computing device | Satisfactory postoperative range of motion and pain reduction in a patient who underwent total shoulder arthroplasty |
| Ogawa et al. (42) | Total hip arthroplasty | AR-HIP | AR was significantly more accurate than the goniometer regarding the intraoperative measurement of the angles of acetabular cup fixation |
| Shen et al. (43) | Pelvic and acetabular fractures | A virtual fracture reduction system and an AR-aided templating system, comprising a personal computer and a video camera | AR-based reconstruction plate may lead to reduction of the operative time, surgical invasiveness and complexity |
| Elmi-Terander et al. (44) | Spine surgery | AR surgical navigation system, based on video input from four cameras mounted into the frame of a C-arm detector | AR-based surgical navigation could offer acceptable time of navigation and high accuracy of placement of pedicle screws |
| Wu et al. (2014) | Spine surgery | ARCASS | The AR-based system was characterized by feasibility, accuracy, reduced operative time and radiation dose to patients |
| Abe et al. (45) | Spine surgery | VIPAR | The AR-based system offered a remarkable help to surgeons to find the ideal needle trajectory and insertion point when performing percutaneous vertebroplasty |
| Kosterhon et al. (46) | Spine surgery | A system which preoperatively creates virtual resection planes and volumes for spinal osteotomies and exports three-dimensional operative plans to a navigation system controlling intraoperative visualization via a surgical microscope's head-up display | Increased accuracy and safety in a patient who underwent surgery for congenital hemivertebra of the thoracolumbar spine |
AR, augmented reality; VIP, Virtual Interactive Presence (merges in real time two video streams that capture separate and remote fields into a common task field, thus permitting real-time interaction between remote surgeons in that field); AR-HIP, a system which enables the surgeon to view an acetabular cup image superimposed on the real surgical field through the display of a smartphone, which shows anteversion angles and inclination of the acetabular cup; ARCASS, Augmented Reality Computer Assisted Spine Surgery (projects a preoperative three-dimensional model of the patient onto the intraoperative scene, using a camera and a projector); VIPAR, virtual protractor with augmented reality (comprises a head-mount display with a tracking camera and a marker sheet to visualize a needle trajectory in three-dimensional space during percutaneous vertebroplasty).