Jonathan Vigdorchik, a surgeon at the Hospital for Special Surgery in New York City, last month used augmented reality (AR) to perform knee replacement surgery on two patients, marking the first time the technology has been used in the United States for the surgery, John McCormick reports for the Wall Street Journal.

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How it works

According to McCormick, AR works by superimposing digital content, including instructions or 3-D imaging, on a user's view of the world via mobile devices and headsets. For the surgeries Vigdorchik performed, he relied on Medacta International's NextAR augmented-reality platform, which received FDA approval for total knee replacements in July 2020, and a pair of AR glasses developed by Vuzix Corp.

Leading up to the procedure, Vigdorchik performed computer tomography knee scans on the two patients—both suffering severe arthritis in their knee joints—and loaded them into the NextAR platform. The platform developed 3D models of the patients' knees, which Vigdorchik could then use for preoperative planning, such as where best to place the implant.

Then, as each procedure started, Vigdorchik put on the glasses that enabled him to not only see the patients, but also view a digital display of the patient's leg with a 3D model superimposed showing a diagram of each planned cut. If a surgeon makes a correct cut, the line on the model turn green, and if a cut is incorrect, the line turns red.

Vigdorchik said the glasses allowed him to make more accurate cuts during the surgery. "At many points during the operation, it's actually providing me information, making sure that my cuts are degree for degree, millimeter for millimeter, accurate," he said, ensuring an optimal fit for the implant. And the better-fitting a knee replacement is, the more improved odds the surgery has for long-term success, Vigdorchik said.

In addition, the glasses received data from two quarter-sized sensors placed on the patients—one above their knee joints and one below it—to provide Vigdorchik with "a precise measurement of their spatial position in 3-D," which enabled him to ensure that the patients' ligaments were balanced as he put the new joints through a range of motions during the procedure.  

Since the surgery, Vigdorchik said he has examined both patients and said they're doing well. He added that he believes AR will improve procedures and lead to quicker recoveries and knee implants that function better.

Separately, Tuong Huy Nguyen, a senior principal analyst at the research and advisory firm Gartner, said the AR market will continue growing as more people use it.

"AR is the next generation in computing experiences," he said. "This is how we'll interact with the world" (McCormick, Wall Street Journal, 1/21).