The study
Our latest research has been published in JSES International. The study examined the use of mixed reality (MR) holographic overlay for glenoid guidewire placement in shoulder arthroplasty, compared against freehand technique and against established navigation systems.
Why guidewire placement matters
In a shoulder replacement, the position of the glenoid component is set by a guidewire placed into the socket. If that wire goes in at the wrong angle, the component follows it, and a component sitting in the wrong orientation changes how the joint is loaded for as long as it remains in place. Getting the wire right is therefore one of the more consequential steps of the operation, and it has traditionally been done by eye, guided by anatomical landmarks.
What was found
The published study reports that mixed reality improved the accuracy of guidewire inclination compared with freehand technique, reducing malposition rates from 67% to 40%. Individual results vary, and the figures above are those reported in the study.
Mixed reality did not, however, outperform conventional navigation for overall accuracy. The paper suggests that combining the two technologies could be useful in future workflows, rather than one replacing the other.
Reporting the negative finding alongside the positive one is the point of a comparative study of this kind. The result is that mixed reality is better than freehand but not better than existing navigation, which is more informative than a straightforward endorsement would be.
Co-authors
Kristine Italia, Marine Launay, Luke Gilliland, Angus Lane, James Nielsen, Kathir Azhagan Stalin, Nicholas Green, Jashint Maharaj, Sarah Whitehouse, Kenneth Cutbush and Ashish Gupta.
Read it
The paper is available via this link: read the study. The aim of work of this kind is to close the gap between what is planned before surgery and what is achieved in theatre.
Related information
See our anatomic total shoulder replacement and reverse total shoulder replacement pages, and our posts on robotic assistance and augmented glenoid components.