Augmented Reality-Assisted Glenoid Pin Placement in Total Shoulder Arthroplasty

Overview

This study evaluates an integrated augmented reality (AR) solution using inside-out tracking with infrared markers for guiding glenoid pin placement in total shoulder arthroplasty (TSA). Phantom trials demonstrated precise registration and tracking performance, suggesting AR-HMDs can enhance surgical accuracy without ancillary hardware.

Background

Total shoulder arthroplasty is increasingly performed to address mechanical and degenerative shoulder disorders, with proper prosthetic component placement critical to long-term success. Glenoid pin placement guides implant positioning but is challenging due to anatomical variability and limited margins. Conventional methods use surgical guides and computer-aided navigation, while augmented reality offers intuitive visualization by overlaying planning data onto the surgical field. However, AR adoption has been limited by tracking and cost issues. Inside-out tracking using integrated AR-HMD sensors and infrared markers may overcome these barriers.

Data Highlights

Key Findings

• AR-HMDs with inside-out tracking using standard surgical infrared retroreflective markers can achieve sub-millimeter pose estimation accuracy.
• Phantom trials demonstrated precise registration and tracking of the scapula and glenoid trajectory using a rigid tracker with IR markers.
• Previous studies showed mean pin placement deviations around 1.5–3.5 mm and angular errors of approximately 1.5°–3.8° using AR-assisted navigation.
• Inside-out tracking avoids the need for external tracking hardware, potentially reducing costs and complexity.
• Use of integrated IR sensors only, without depth or multiple sensor streams, can still provide accurate tracking suitable for surgical navigation.

Clinical Implications

Integrating inside-out AR tracking with infrared markers into TSA procedures can improve the accuracy of glenoid pin placement, potentially reducing complications such as implant loosening and revision surgeries. This approach may streamline surgical workflows by eliminating external tracking hardware and providing intuitive visualization of preoperative plans directly in the surgeon’s field of view.

Conclusion

The presented AR-assisted solution demonstrates promising accuracy and feasibility for guiding glenoid pin placement in TSA using commercially available hardware and inside-out tracking. This technology may enhance surgical precision and outcomes while maintaining cost-effectiveness.

References

1. Kriechling et al. -- AR-assisted Glenoid Pin Placement Accuracy
2. Gu et al. -- Markerless Photogrammetric Drift Correction in AR Navigation
3. Gregory et al. -- Early Proof of Concept AR-assisted TSA