Virtual Reality in Orthopaedics:

The Power of Medical Vision

Image Credit: CIO Techie 

Introduction

Virtual Reality (VR) is one of those sectors of the current medical realm, that once sounded like science fiction. As technology advances the transfer of knowledge from military operations to the medical field, the area of orthopaedic study is now beginning to embrace VR. The transition involved a lot of introspection, assessment of how VR worked in other surgical specialties, and the identification of how VR would be incorporated into the orthopaedic practice. With respect to current orthopaedic applications of VR, there are a series of applications in the training of future orthopaedic surgeons, as well as the implementation of VR in current therapies such as knee arthroscopy. 

THE FUTURE OF VR IN ORTHOPAEDICS

VR as a technology involves the utilization of special hardware and software, that are utilized with an imaging system to provide real time imaging data. A surgeon will be able to look at the data, and see the system that the data represents. With more information available to medical personnel, VR is proving itself as a decision making tool. With a vision of the patient’s internal condition, the ideal customised treatment path will be generated. 

Within the orthopaedic realm, the applications of VR have included [2]: 

*Tumor Resection

* Fracture Fixation

* Arthroscopy

*Component’s alignment in total joint arthroplasty

At the pre-clinical and clinical level, there is a wealth of possibilities that VR can optimize. As technology advances, with the advent of technologies such as medical robotics, the ability to improve surgical planning, simulation and actual procedure is increasing in precision. 

VR facilitates medical navigation, a medium via which orthopaedic surgeons are able to identify the fusion of their surgical instruments with the anatomical structures that they were going to be utilized on. This integration is known as the human-machine interface, and it is being optimized in order to improve the surgical procedure. Simulation is the key to successful procedure. If the surgeon is able to “see” the surgery ahead of time, there’ll be less uncertainty in the actual execution. The computer generated images are often displayed via video projection, a VR headset, or via display on a screen such as a tablet. 

Tools for VR In Orthopaedic Surgery

There are three primary components of effective VR in orthopaedic surgery. These include: 

  1. A position tracking system for object location and orientation. This system is often tracked to sensors that are placed on the patient or on surgical tools. 
  2. A display device 
  3. A system control software

VR systems are variable according to the specifications required. Both laboratory and clinical applications are seeing positive results. In pre-clinical studies, VR has proven that interventional procedure accuracy can be improved with the appropriate system inclusion. Improvement parameters include: 

*Operative Time Reduction 

* Radiolucent Drill Design

* Reduced Exposure to Radiation

*Reduced Operator Errors

*Improvement in accuracy of osteotomies for the treatment of total knee arthroplasty

CLINICAL APPLICATIONS OF VR 

In the clinical study, VR is also proving its effectiveness. In a procedure such as a C-arm procedure, the camera-augmented procedure compared to the traditional procedure proved to be quite effective. While the time of surgery remained identical, the number of diagnostic procedures such as X-rays, were reduced in half. With respect to the teaching of orthopaedic residents, the utilization of VR in technology is an effective method of knowledge transfer. Humans are by nature visual beings, and with a 3-D training medium, it is possible to have training on VR in a manner that is similar to patient analysis. Clinical applications of VR include: 

*Optimized total hip arthroplasty 

*Higher accuracy in spinal surgery. Improvement in the placement of thoracic and lumbrosacral pedicle screws

*Optimized percutaneous vertebroplasty

CONCLUSIONS

Life is always advancing, and so too is technology. With the implementation of VR, the improvement of accuracy in orthopaedic procedures is greatly improved. From the medical research conducted, the ability to reduce operational accuracy, and minimize radiation exposure are two of the predominant advantages to be gained. Technology will always have an associated cost curve. While the initial VR technologies will be accessible by the best of the medical facilities, with time and mass production, all facilities will one day have these amenities. Orthopaedic surgery will benefit from the utilization of VR. With the ability to receive real-time surgical information, the ability to accurately forecast the surgical procedure will be priceless. 

Reference Articles: 

PubMed: Virtual Reality in Orthopaedics: https://pubmed.ncbi.nlm.nih.gov/20559765/

Augmented Reality in Orthopaedics: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610425/

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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