ArticleArchives of orthopaedic and trauma surgery2025
Intraoperative evaluation of bone resection accuracy in total knee arthroplasty using an augmented reality-based navigation system.
Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Intraoperative Analysis of Collateral Ligament Elongation Patterns by Coronal Plane Alignment of the Knee Classification Using Augmented Reality Navigation in Japanese Osteoarthritic Knees.Arthroplasty today · 2026Article
- Clinical technique for augmented reality-guided tibial resection in kinematic alignment total knee arthroplasty: Real-time ligament elongation enables personalised soft tissue balance.Journal of experimental orthopaedics · 2026Article
- Reframing Fixation Strategy in Total Knee Arthroplasty With Tibial Bone Density as a Central Criterion.JB & JS open accessReview
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12 authors.
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Abstract
introductionComputer-assisted surgery (CAS) in total knee arthroplasty (TKA) has seen growing adoption, with over 30% of primary TKA procedures in Japan using CAS as of 2021. Augmented reality (AR) navigation has emerged as a novel alternative, providing real-time visualization and high-precision guidance during surgery. However, standardized protocols, long-term outcomes, and quantitative accuracy data remain limited. This study aimed to evaluate the intraoperative bone resection accuracy achieved with an AR-based navigation system during TKA.
methodsWe retrospectively analyzed 100 knees that underwent primary TKA using the NextAR navigation system (Medacta International SA, Switzerland). Bone resection accuracy was assessed by comparing intraoperative cut angles and thicknesses to preoperative plans. Evaluated parameters included femoral coronal, sagittal, and rotational angles; distal and posterior resection thicknesses (medial/lateral); tibial coronal, posterior slope, and rotational angles; tibial resection thicknesses (medial/lateral); and implant size concordance.
resultsMean absolute differences from preoperative plans were as follows: femoral coronal angle 0.46° ± 0.48°, sagittal angle 0.72° ± 0.61°, and rotational angle 0.30° ± 0.33°; distal cut thickness 0.56 ± 0.46 mm (medial) and 0.54 ± 0.49 mm (lateral); posterior condyle cut thickness 0.23 ± 0.35 mm (medial) and 0.35 ± 0.44 mm (lateral). Tibial parameters showed coronal error of 0.64° ± 0.56°, posterior slope 0.66° ± 0.55°, and rotation 0.25° ± 0.60°; resection thickness 0.73 ± 0.69 mm (medial) and 0.79 ± 0.75 mm (lateral). Implant size matched 100% with preoperative planning.
conclusionThe AR-based navigation system enabled precise three-dimensional intraoperative assessment and execution of bone resections in TKA. All angular and thickness errors remained within 1° and 1 mm, respectively, confirming high reproducibility and precision across multiple planes.
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