Simulation of a Total Knee Arthroplasty System Based on Extended Reality

Total arthroplasty is one of the most common knee surgeries and, due to the ageing of the population, the number of procedures performed each year is expected to increase. With almost a quarter of patients dissatisfied, systems for computer assistance in orthopaedic surgery have been on the rise, appearing to have better outcomes than conventional techniques by reproducing a planned alignment with a similar learning curve. The search for inexpensive solutions to improve these prototypes is extremely relevant since most systems in the market involve expensive robots. The development of a simulation for an extended reality system, specifically spatial augmented reality, with a projector and a depth camera to project the desired total knee arthroplasty bone cuts onto a simulated knee joint has been proposed. It was created with Gazebo and communicates with the Robotic Operating System (ROS) framework so that it can easily be transposed to the real world. An evaluation of the simulator was performed regarding the projection’s accuracy. The performance of the simulator was fitting for surgery, with the highest mean position error between the desired bone cut and the simulated bone cut of 1.11 ± 0.86 mm (minimum = 0.00 mm, maximum = 2.60 mm) for the tibia cut. These values could be further improved with the implementation of a feature-matching algorithm and a dynamic projection.