Augmented reality in robotic assisted orthopaedic surgery: A pilot study.

Background: The research and development of augmented-reality (AR) technologies in surgical applications has seen an evolution of the traditional user-interfaces (UI) utilised by clinicians when conducting robot-assisted orthopaedic surgeries. The typical UI for such systems relies on surgeons managing 3D medical imaging data in the 2D space of a touchscreen monitor, located away from the operating site. Conversely, AR can provide a composite view overlaying the real surgical scene with co-located virtual holographic representations of medical data, leading to a more immersive and intuitive operator experience.

Materials And Methods: This work explores the integration of AR within an orthopaedic setting by capturing and replicating the UI of an existing surgical robot within an AR head-mounted display worn by the clinician. The resulting mixed-reality workflow enabled users to simultaneously view the operating-site and real-time holographic operating informatics when carrying out a robot-assisted patellofemoral-arthroplasty (PFA). Ten surgeons were recruited to test the impact of the AR system on procedure completion time and operating surface roughness.

Results And Discussion: The integration of AR did not appear to require subjects to significantly alter their surgical techniques, which was demonstrated by non-significant changes to the study's clinical metrics, with a statistically insignificant mean increase in operating time (+0.778 s, p = 0.488) and a statistically insignificant change in mean surface roughness (p = 0.274). Additionally, a post-operative survey indicated a positive consensus on the usability of the AR system without incurring noticeable physical distress such as eyestrain or fatigue.

Conclusions: Overall, these study results demonstrated a successful integration of AR technologies within the framework of an existing robot-assisted surgical platform with no significant negative effects in two quantitative metrics of surgical performance, and a positive outcome relating to user-centric and ergonomic evaluation criteria.