Computer-assisted total joint arthroplasty has become more popular in the 2 decades since its introduction.
There are a range of options now available, including robotics and hand-held navigation devices, to assist with surgical planning and provide intraoperative guidance.
Augmented reality-driven surgical guidance systems, such as the ARVIS (Augmented Reality Visualization and Information System) system (Enovis), which is a proprietary system used exclusively with Enovis EMPOWR hip and knee products, provide a new take on surgical guidance because these reduce the surgical guidance system to something that is worn and controlled by the surgeon that can seamlessly integrate into the surgical workflow.
The system has three components: an augmented reality (AR) headset that mounts to a surgical helmet and contains tracking cameras, headlight and AR display; a belt pack that powers the headset and runs the surgical guidance software; and one tray of reusable instruments that can be used for a total knee arthroplasty, unicondylar knee arthroplasty or total hip arthroplasty performed with the EMPOWR hip and knee implant systems. With the light, the headset weighs 260 grams. The only disposables with the system are two pins that are used to affix the reference trackers to the bone.
The headset contains lenses that project the AR display into the user’s field of view, as well as infrared cameras that pick up the trackers on the anatomy and instruments. The headset mounts to a surgical helmet or an AR headband, and normal personal protective equipment is worn over the helmet.
Once the headset is on and the device is powered on, an AR display will appear a few feet in front of the surgeon’s view. The cursor on this display follows the surgeon’s head movement. Basic voice commands allow the surgeon to move forward, start navigation, stop navigation and place the system in sleep mode.
The first screen is used to select which procedure is taking place (hip or knee). Then the options screen can be used to set the operative side and preferences, such as for workflow and target alignment.
Image Credit: Enovis