Department of ElectronicsInformation and BioengineeringPolitecnico di Milano 20133 Milan Italy.
Istituto Auxologico Italiano IRCCS 20149 Milan Italy.
IEEE J Transl Eng Health Med. 2023 Nov 21;12:279-290. doi: 10.1109/JTEHM.2023.3335608. eCollection 2024.
Recent advancements in augmented reality led to planning and navigation systems for orthopedic surgery. However little is known about mixed reality (MR) in orthopedics. Furthermore, artificial intelligence (AI) has the potential to boost the capabilities of MR by enabling automation and personalization. The purpose of this work is to assess Holoknee prototype, based on AI and MR for multimodal data visualization and surgical planning in knee osteotomy, developed to run on the HoloLens 2 headset.
Two preclinical test sessions were performed with 11 participants (eight surgeons, two residents, and one medical student) executing three times six tasks, corresponding to a number of holographic data interactions and preoperative planning steps. At the end of each session, participants answered a questionnaire on user perception and usability.
During the second trial, the participants were faster in all tasks than in the first one, while in the third one, the time of execution decreased only for two tasks ("Patient selection" and "Scrolling through radiograph") with respect to the second attempt, but without statistically significant difference (respectively [Formula: see text] = 0.14 and [Formula: see text] = 0.13, [Formula: see text]). All subjects strongly agreed that MR can be used effectively for surgical training, whereas 10 (90.9%) strongly agreed that it can be used effectively for preoperative planning. Six (54.5%) agreed and two of them (18.2%) strongly agreed that it can be used effectively for intraoperative guidance.
DISCUSSION/CONCLUSION: In this work, we presented Holoknee, the first holistic application of AI and MR for surgical planning for knee osteotomy. It reported promising results on its potential translation to surgical training, preoperative planning, and surgical guidance. Clinical and Translational Impact Statement - Holoknee can be helpful to support surgeons in the preoperative planning of knee osteotomy. It has the potential to impact positively the training of the future generation of residents and aid surgeons in the intraoperative stage.
增强现实技术的最新进展催生了骨科手术的规划和导航系统。但目前对骨科领域的混合现实（MR）技术知之甚少。此外，人工智能（AI）有可能通过实现自动化和个性化来增强 MR 的功能。本研究旨在评估基于 AI 和 MR 的 Holoknee 原型，用于膝关节截骨术的多模态数据可视化和手术规划，该原型运行于 HoloLens 2 耳机上。
11 名参与者（8 名外科医生、2 名住院医师和 1 名医学生）进行了两次临床前测试，完成了 6 项任务，共 3 次。每次试验对应于一定数量的全息数据交互和术前规划步骤。每次试验结束时，参与者都会回答一份关于用户感知和可用性的问卷。
第二次试验中，所有任务的完成时间均快于第一次试验，而在第三次试验中，仅“患者选择”和“浏览 X 光片”这两项任务的执行时间减少，且无统计学差异（分别[Formula: see text] = 0.14 和 [Formula: see text] = 0.13，[Formula: see text]）。所有参与者都强烈同意 MR 可有效用于手术培训，而 10 人（90.9%）强烈同意其可有效用于术前规划。6 人（54.5%）同意且其中 2 人（18.2%）强烈同意其可有效用于术中指导。
讨论/结论：本研究首次展示了 AI 和 MR 技术在膝关节截骨术手术规划中的整体应用Holoknee。它有望在手术培训、术前规划和手术指导方面得到转化应用。临床和转化影响陈述 - Holoknee 有助于支持膝关节截骨术的术前规划。它有可能对未来一代住院医师的培训产生积极影响，并为外科医生提供术中辅助。
