Is Total Knee Arthroplasty Surgical Performance Enhanced Using Augmented Reality? A Single-Center Study on 76 Consecutive Patients

Background: Augmented reality (AR) is a powerful multipurpose tool. With a dedicated visor, AR allows the visualization of a series of information and/or images superimposed on the user's field of vision. For this reason, it was recently introduced as a surgical assistant tool. This single-center study aimed to evaluate the intraoperative outcomes of total knee arthroplasties performed with AR assistance in terms of time required and the difference between preplanned and achieved implant positioning (in terms of tibial cut varus and slope angles). Methods: A total of 76 consecutive patients was selected. Preplanning was performed according to the AR protocol, and the target varus and slope angles were defined to instruct the device, which subsequently guided the tibial cuts intraoperatively. Surgeries were performed starting from the tibial cut, and the time required to perform the calibration, registration, and fixation of the resection block was recorded. The varus and slope angles achieved were recorded to compare with the preplanned ones to determine the means and SDs of the differences. Results: The mean usage time of the AR tool was 5 +/- 1 minutes. Results showed a mean difference of 0.59 +/- 0.55 degrees for varus angles and 0.70 +/- 0.75 degrees for the slope. For varus angles, the differences were <1 degrees for 96% of the cases. Concerning the slope, 89% of the cases were <1 degrees. Conclusion: The results showed excellent accuracy of the surgical cuts and a limited increase in surgery duration. Therefore, these outcomes highlighted the potential of this new technology as a valid option for surgical assistance. (c) 2023 Elsevier Inc. All rights reserved.