Mixed reality-based support for total hip arthroplasty assessment

The evaluation of hip implantation success remains one of the most relevant problems in orthopaedics. There are several factors that can cause its failure, e.g.: aseptic loosening and dislocations of the prosthetic joint due to implant impingement. Following a total hip arthroplasty, it is fundamental that the orthopaedist can evaluate which may be the possible risk factors that would lead to dislocation, or in the worst cases, to implant failure. A procedure has been carried out with the aim of evaluating the Range of Movement (ROM) of the implanted prosthesis, to predict whether the inserted implant is correctly positioned or will be prone to dislocation or material wear due to the malposition of its components. Leveraging on a previous patented methodology that consists in the 3D reconstruction and movement simulation of the hip joint, this work aims to provide a more effective visualization of the simulation results through Mixed Reality (MR). The use of MR for the representation of hip kinematics and implant position can provide the orthopaedic surgeon with a deeper understanding of the orientation and position of implanted components, as well as the consequences of such placements while looking directly at the patient. To this end, an anchoring system based on a body-tracking recognition library was developed, so that both completely automatic and human-assisted options are available without additional markers or sensors. An Augmented Reality (AR) prototype has been developed in Unity 3D and used on HoloLens 2, integrating the implemented human-assisted anchoring system option.