Development of an augmented reality-guided computer-assisted orthopaedic surgery system

N. L. Smith, V. Stankovic, P. Riches

Research output: Contribution to journalMeeting abstract

Abstract

A number of advantages of unicondylar arthroplasty (UKA) over total knee arthroplasty in patients presenting osteoarthritis in only a single compartment have been identified in the literature. However, accurate implant positioning and alignment targets, which have been shown to significantly affect outcomes, are routinely missed by conventional techniques. Computer Assisted Orthopaedic Surgery (CAOS) has demonstrated its ability to improve implant accuracy, reducing outliers. Despite this, existing commercial systems have seen extremely limited adoption. Survey indicates the bulk, cost, and complexity of existing systems as inhibitive characteristics. We present a concept system based upon small scale head mounted tracking and augmented reality guidance intended to mitigate these factors.

A visible-spectrum stereoscopic system, able to track multiple fiducial markers to 6DoF via photogrammetry and perform semi-active speed constrained resection, was combined with a head mounted display, to provide a video-see-through augmented reality system. The accuracy of this system was investigated by probing 180 points upon a 110×110×50 mm known geometry and performing controlled resection upon a 60×60×15 mm bone phantom guided by an overlaid augmented resection guide that updated in real-time.

The system produced an RMS probing accuracy and precision of 0.55±0.04 and 0.10±0.01 mm, respectively. Controlled resection resulted in an absolute resection error of 0.34±0.04 mm with a general trend of over-resection of 0.10±0.07 mm.

The system was able to achieve the sub-millimetre accuracy considered necessary to successfully position unicondylar knee implants. Several refinements of the system, such as pose filtering, are expected to increase the functional volume over which this accuracy is obtained. The presented system improves upon several objections to existing commercial CAOS UKA systems, and shows great potential both within surgery itself and its training. Furthermore, it is suggested the system could be readily extended to additional orthopaedic procedures requiring accurate and intuitive guidance.

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Computer-Assisted Surgery
Orthopedics
Photogrammetry
Head
Fiducial Markers
Orthopedic Procedures
Knee Replacement Arthroplasties
Osteoarthritis
Arthroplasty
Knee
Costs and Cost Analysis
Bone and Bones
Surveys and Questionnaires

Keywords

  • CAOS
  • knee
  • augmented Reality
  • computer assisted orthopaedic surgery
  • unicondylar arthroplasty
  • visible-spectrum stereoscopic system

Cite this

@article{9fb42f9c64514553b13f8f20769e1744,
title = "Development of an augmented reality-guided computer-assisted orthopaedic surgery system",
abstract = "A number of advantages of unicondylar arthroplasty (UKA) over total knee arthroplasty in patients presenting osteoarthritis in only a single compartment have been identified in the literature. However, accurate implant positioning and alignment targets, which have been shown to significantly affect outcomes, are routinely missed by conventional techniques. Computer Assisted Orthopaedic Surgery (CAOS) has demonstrated its ability to improve implant accuracy, reducing outliers. Despite this, existing commercial systems have seen extremely limited adoption. Survey indicates the bulk, cost, and complexity of existing systems as inhibitive characteristics. We present a concept system based upon small scale head mounted tracking and augmented reality guidance intended to mitigate these factors.A visible-spectrum stereoscopic system, able to track multiple fiducial markers to 6DoF via photogrammetry and perform semi-active speed constrained resection, was combined with a head mounted display, to provide a video-see-through augmented reality system. The accuracy of this system was investigated by probing 180 points upon a 110×110×50 mm known geometry and performing controlled resection upon a 60×60×15 mm bone phantom guided by an overlaid augmented resection guide that updated in real-time.The system produced an RMS probing accuracy and precision of 0.55±0.04 and 0.10±0.01 mm, respectively. Controlled resection resulted in an absolute resection error of 0.34±0.04 mm with a general trend of over-resection of 0.10±0.07 mm.The system was able to achieve the sub-millimetre accuracy considered necessary to successfully position unicondylar knee implants. Several refinements of the system, such as pose filtering, are expected to increase the functional volume over which this accuracy is obtained. The presented system improves upon several objections to existing commercial CAOS UKA systems, and shows great potential both within surgery itself and its training. Furthermore, it is suggested the system could be readily extended to additional orthopaedic procedures requiring accurate and intuitive guidance.",
keywords = "CAOS, knee, augmented Reality, computer assisted orthopaedic surgery, unicondylar arthroplasty, visible-spectrum stereoscopic system",
author = "Smith, {N. L.} and V. Stankovic and P. Riches",
year = "2016",
month = "10",
day = "27",
language = "English",
volume = "98-B",
pages = "18",
journal = "Bone & Joint Journal : Orthopaedic Proceedings Supplement",
issn = "1358-992X",
number = "SUPP 16",

}

Development of an augmented reality-guided computer-assisted orthopaedic surgery system. / Smith, N. L.; Stankovic, V.; Riches, P.

In: Orthopaedic Proceedings, Vol. 98-B, No. SUPP 16, 27.10.2016, p. 18.

Research output: Contribution to journalMeeting abstract

TY - JOUR

T1 - Development of an augmented reality-guided computer-assisted orthopaedic surgery system

AU - Smith, N. L.

AU - Stankovic, V.

AU - Riches, P.

PY - 2016/10/27

Y1 - 2016/10/27

N2 - A number of advantages of unicondylar arthroplasty (UKA) over total knee arthroplasty in patients presenting osteoarthritis in only a single compartment have been identified in the literature. However, accurate implant positioning and alignment targets, which have been shown to significantly affect outcomes, are routinely missed by conventional techniques. Computer Assisted Orthopaedic Surgery (CAOS) has demonstrated its ability to improve implant accuracy, reducing outliers. Despite this, existing commercial systems have seen extremely limited adoption. Survey indicates the bulk, cost, and complexity of existing systems as inhibitive characteristics. We present a concept system based upon small scale head mounted tracking and augmented reality guidance intended to mitigate these factors.A visible-spectrum stereoscopic system, able to track multiple fiducial markers to 6DoF via photogrammetry and perform semi-active speed constrained resection, was combined with a head mounted display, to provide a video-see-through augmented reality system. The accuracy of this system was investigated by probing 180 points upon a 110×110×50 mm known geometry and performing controlled resection upon a 60×60×15 mm bone phantom guided by an overlaid augmented resection guide that updated in real-time.The system produced an RMS probing accuracy and precision of 0.55±0.04 and 0.10±0.01 mm, respectively. Controlled resection resulted in an absolute resection error of 0.34±0.04 mm with a general trend of over-resection of 0.10±0.07 mm.The system was able to achieve the sub-millimetre accuracy considered necessary to successfully position unicondylar knee implants. Several refinements of the system, such as pose filtering, are expected to increase the functional volume over which this accuracy is obtained. The presented system improves upon several objections to existing commercial CAOS UKA systems, and shows great potential both within surgery itself and its training. Furthermore, it is suggested the system could be readily extended to additional orthopaedic procedures requiring accurate and intuitive guidance.

AB - A number of advantages of unicondylar arthroplasty (UKA) over total knee arthroplasty in patients presenting osteoarthritis in only a single compartment have been identified in the literature. However, accurate implant positioning and alignment targets, which have been shown to significantly affect outcomes, are routinely missed by conventional techniques. Computer Assisted Orthopaedic Surgery (CAOS) has demonstrated its ability to improve implant accuracy, reducing outliers. Despite this, existing commercial systems have seen extremely limited adoption. Survey indicates the bulk, cost, and complexity of existing systems as inhibitive characteristics. We present a concept system based upon small scale head mounted tracking and augmented reality guidance intended to mitigate these factors.A visible-spectrum stereoscopic system, able to track multiple fiducial markers to 6DoF via photogrammetry and perform semi-active speed constrained resection, was combined with a head mounted display, to provide a video-see-through augmented reality system. The accuracy of this system was investigated by probing 180 points upon a 110×110×50 mm known geometry and performing controlled resection upon a 60×60×15 mm bone phantom guided by an overlaid augmented resection guide that updated in real-time.The system produced an RMS probing accuracy and precision of 0.55±0.04 and 0.10±0.01 mm, respectively. Controlled resection resulted in an absolute resection error of 0.34±0.04 mm with a general trend of over-resection of 0.10±0.07 mm.The system was able to achieve the sub-millimetre accuracy considered necessary to successfully position unicondylar knee implants. Several refinements of the system, such as pose filtering, are expected to increase the functional volume over which this accuracy is obtained. The presented system improves upon several objections to existing commercial CAOS UKA systems, and shows great potential both within surgery itself and its training. Furthermore, it is suggested the system could be readily extended to additional orthopaedic procedures requiring accurate and intuitive guidance.

KW - CAOS

KW - knee

KW - augmented Reality

KW - computer assisted orthopaedic surgery

KW - unicondylar arthroplasty

KW - visible-spectrum stereoscopic system

UR - http://www.bjjprocs.boneandjoint.org.uk/content/98-B/SUPP_16/18

UR - http://www.borsoc.org.uk/meetings.html

UR - http://www.bjjprocs.boneandjoint.org.uk/

M3 - Meeting abstract

VL - 98-B

SP - 18

JO - Bone & Joint Journal : Orthopaedic Proceedings Supplement

T2 - Bone & Joint Journal : Orthopaedic Proceedings Supplement

JF - Bone & Joint Journal : Orthopaedic Proceedings Supplement

SN - 1358-992X

IS - SUPP 16

ER -