The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report

Summary

A complex revision hip arthroplasty was performed using a custom-made implant and mixed reality technology. According to the authors' knowledge, this is the first report of such procedure described in the literature.

Abstract

The technology of 3D printing and visualization of anatomical structures is rapidly growing in various fields of medicine. A custom-made implant and mixed reality were used to perform complex revision hip arthroplasty in January 2019. The use of mixed reality allowed for a very good visualization of the structures and resulted in precise implant fixation. According to the authors' knowledge, this is the first described case report of the combined use of these two innovations. The diagnosis preceding the qualification for the procedure was the loosening of the left hip's acetabular component. Mixed reality headset and holograms prepared by engineers were used during the surgery. The operation was successful, and it was followed by early verticalization and patient rehabilitation. The team sees opportunities for technology development in joint arthroplasty, trauma, and orthopedic oncology.

Introduction

The technology of three-dimensional (3D) printing and visualization of complex structures is rapidly growing in various fields of medicine. These include cardiovascular surgery, otorhinolaryngology, maxillofacial surgery, and, above all, orthopedic surgery^1,2,3,4,5. Currently, this technology is used in orthopedic surgery not only in the direct implementation of 3D printed elements, but also in surgical training, preoperative planning, or intraoperative navigation^6,

Protocol

The protocol follows guidelines of the Human Research Ethics Committee of the Medical University of Warsaw. The patient gave informed consent to the procedure and acknowledged the fact that it will be recorded. The patient agreed to that prior to the procedure.

NOTE: The basic criterion for including the patient in the surgery project was the necessity to intervene because of the anatomical dysfunction, which made it impossible to use a standard implant. Mixed reality was aimed at better place.......

Discussion

Primary and revision hip arthroplasty may require personalization to ensure effectiveness of treatment. However, the use of custom implants requires longer preparation for surgery compared to standard procedures. Custom-made 3D printed implants are the solution that gives a chance to restore function in non-typical patients whose disease has caused significant bone destruction²⁹. Standard prostheses are insufficient due to advanced degenerative disease developing rapidly, bone defects caused by pr.......

Materials

Name	Company	Catalog Number	Comments
CarnaLifeHolo v. 1.5.2	MedApp S.A.
Custom-Made implant type Triflanged Acetabular Component	BIOMET	REF PM0001779
Head Constrained Modular Head + 9mm Neck for cone 12/14, Co-Cr-Mo, size 36mm	BIOMET	REF 14-107021
Polyethylene insert Freedom Ringloc-X Costrained Linear Ringloc-X 58mm for head 36mm / 10 *	BIOMET	REF 11-263658