Accuracy of Acetabular Component Positioning Using a Mixed Reality-Guided Navigation System During Total Hip Arthroplasty

• DOI: 10.2106/jbjs.oa.24.00144
• Publication Date: 2025-03-22T23:37:10Z
• Authors: Alexander F. Heimann; William S. Murphy; Daniel C. Sun; Stephen B. Murphy
• Keywords: Surgical Planning; Fiducial marker

Background: Surgeons increasingly recognize the importance of patient-specific considerations in determining ideal cup alignments. In addition, various surgical navigation systems have been reported to improve placement accuracy during total hip arthroplasty (THA). Recently, a novel computed tomography (CT)–based planning and mixed-reality (MR) guidance system was developed enable 3-dimensional position further intraoperative achievement planned orientation. Methods: This is retrospective, observational study 40 patients (40 hips) who underwent MR-guided THA. Patient-specific CT-based with definition target operative anteversion inclination acetabular relation anterior pelvic plane performed. 3D holograms impactor selected were created exported. Intraoperatively, automatic holographic registration performed using smart tool–based linked-paired-point matching method. content displayed on head-mounted display, component inserted by spatial hologram position. Postoperatively, biplane simultaneous imaging for measurement achieved alignment validated Results: Mean angles 28.4° ± 1.6° (95% confidence interval [CI], 27.9°-28.8°) 39.9° 0.3° CI, 39.8°-40.0°), respectively. The mean absolute error between preoperative 0.7° 1.1° 0.3°-1.0°; range, 0°-4°). 1.2° 0.7°-1.4°; Conclusion: Acetabular positioning mixed reality THA highly accurate well within other systems. Level Evidence: III . See Instructions Authors complete description levels evidence.