Description – Apple Vision Pro Hip Arthroplasty Navigation App
Good surgical technique and accurate acetabular and femoral component positioning remain a challenge even for experienced orthopaedic surgeons. Suboptimal implantation of these components can compromise implant longevity, stability, and function. While traditional computer-assisted navigation systems improve accuracy, they require costly equipment and specialized infrastructure.
This application harnesses the power of Apple Vision Pro to merge Augmented Reality (AR) with Computer-Assisted Orthopaedic Surgery (CAOS) principles, delivering an intraoperative navigation tool that is accessible, intuitive, and highly accurate. By using the Vision Pro’s advanced spatial computing capabilities and recognition of reference markers placed on surgical tools, the app enables precise, real-time guidance without the overhead of large commercial navigation systems.
Workflow & Registration
At the beginning of the procedure, the surgeon manually registers anatomical points of interest (e.g., anterior superior iliac spines, pubic symphysis, acetabular rim, femoral head center, trochanter landmarks). These references create a reliable patient-specific coordinate system. Once registration is complete, the AR overlays, measurements, and tool-tracking functions become active and guide the surgeon throughout the operation.
Key Features
Real-time reaming and cup insertion guidance
The app dynamically calculates and displays anteversion and inclination angles during manipulation of the acetabular reamer or cup inserter. Positional data and orientation feedback are projected directly into the surgeon’s field of view in AR, allowing optimal, biomechanically sound cup placement. Safe zones can be patient-specific, taking into account pelvic tilt.
Automatic intraoperative calculations
The app continuously measures leg length, femoral offset, pelvic tilt, femoral anteversion, and acetabular cup orientation (anteversion/inclination). Pre- and postoperative discrepancies are highlighted to assist in achieving target biomechanical parameters.
Error reduction in sequential reaming
Off-center reaming is a frequent error source with manual techniques. The app provides objective guidance toward chosen anteversion and inclination angles, reducing deviation and improving press-fit accuracy. A radar-style interface and directional indicators ensure cup alignment regardless of intraoperative pelvic movement.
Augmented osteotomy guidance
A colored AR cylinder appears from the femoral head center to the lesser trochanter, acting as a digital ruler. Each color band corresponds to a specific distance in millimeters, assisting the surgeon in accurately determining femoral neck resection level and leg length.
Native hip axis and ligament visualization
The app can overlay the patient’s native acetabular axis in AR, assisting surgeons who wish to reproduce natural hip anatomy. A yellow AR plane is projected between the anterior and posterior acetabular notches, outlining the transverse ligament. Aligning the cup parallel to this plane provides another intuitive method for correct anteversion.
3D reference planes in AR
Transparent sagittal (blue), coronal (red), and transverse (green) planes are displayed over the pelvis, along with the anterior pelvic plane. These reference planes orient the surgeon intraoperatively and enhance accuracy in minimally invasive approaches where visual exposure is limited.
Final validation and adjustment
The app calculates leg length, offset, and anteversion changes pre- and post-implantation. Based on this real-time feedback, the surgeon may adapt femoral stem choice, orientation, or implant positioning before final fixation.
Advantages
Brings a new dimension to intraoperative navigation by merging live AR visualization with surgical workflow.
Requires only manual registration of key anatomical landmarks, making it flexible and adaptable across different surgical setups.
Offers a cost-effective and portable alternative to traditional navigation systems.
Integrates live depth, angle, and distance measurements directly into the operative field, particularly valuable in minimally invasive settings where visual landmarks are restricted.
Enables the entire surgical team to view 3D anatomical models and navigation overlays as if they existed in reality—via Apple Vision Pro’s immersive display environment.
By combining manual anatomical point registration, tool marker recognition, and real-time AR overlays, this Apple Vision Pro app empowers orthopaedic surgeons to achieve precise implant placement with confidence, consistency, and efficiency.