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    TECH SHOWCASE: Augmented Reality in Hip and Knee Arthroplasty

    Editor’s Note: A session at ICJR’s 13th Annual Winter Hip & Knee Course was billed as a Technology Showcase, featuring 8 presentations on aspects of technology and techniques intended to help surgeons improve outcomes of hip and knee arthroplasty. We are highlighting those presentations on ICJR.net this week.

    First things first: Augmented reality is not the same as virtual reality.

    Virtual reality replaces the real world; augmented reality overlays information on the real world. In the case of joint replacement, that means providing additional data to help the surgeon fine-tune the procedure.

    And now just might be the right time for this emerging technology to enter the OR.

    When you consider how joint replacement surgery has changed in the past 18 months, you can understand why augmented reality may be desirable.

    In 2020, the COVID-19 pandemic pushed many elective procedures – including total hip arthroplasty (THA) and total knee arthroplasty (TKA) – into the outpatient environment, either at the hospital or at ambulatory surgery centers, to preserve inpatient beds for COVID patients. Even with the dramatic drop in the number of COVID inpatients in 2021, the volume of total joint arthroplasty procedures being performed as outpatient surgery is increasing – and is not likely to abate, in part due to new Medicare regulations and in part due to patient and surgeon preference.

    R. Michael Meneghini, MD, told attendees at ICJR’s 13th Annual Winter Hip & Knee Course that in his practice, about 20% of TKA patients and more than 25% of THA patients were discharged the same day as surgery before the pandemic. In 2020, those numbers rose to about 50% of TKA patients and 50% of THA patients, with mean patient age increasing by about 5 years for TKAs and about 8 years for THAs. The percentages will be even higher in 2021, he said.

    At the same time, technology that helps surgeons improve accuracy and reproducibility of total joint arthroplasty procedures is becoming increasingly ubiquitous in hospital ORs and ambulatory surgery centers across the country. But, Dr. Meneghini said, any new technology implemented in ambulatory surgery centers in particular must be compatible with the unique needs of that setting – meaning that the technology must not:

    • Compromise efficiency
    • Increase costs
    • Increase space consumption
    • Increase resource consumption

    And that’s where augmented reality could really shine.

    Dr. Meneghini and his team are exploring the use of augmented reality in their ambulatory surgery center, and they have a favorable view so far. Augmented reality offers the benefits of computer-assisted surgery and robotics without taking up the space of those technologies, and the cost is minimal, Dr. Meneghini said. It’s also efficient in that it allows the surgeon to keep their eyes on the surgical field during the procedure. There’s no looking back and forth between the screen and the patient.

    Will this be the technology of the future for surgeons performing total joint arthroplasty? Click the image above to find out more about augmented reality and joint replacement surgery from Dr. Meneghini.

    Faculty Bio

    R. Michael Meneghini, MD, is a Professor of Clinical Orthopaedic Surgery at Indiana University School of Medicine, Fishers, Indiana. He is also Director of the IU Hip & Knee Center.

    Disclosures: Dr. Meneghini has disclosed that he receives royalties from and is a paid consultant for DJO and OsteoRemedies; that he has stock or stock options in Emovi; that he is a paid consultant for 3M+KCI, Kinamed, and Surgical Care Affiliates; and that he had ownership shares in the IU Health Saxony ambulatory surgery center.