A novel visualization system of using augmented reality in knee replacement surgery: Enhanced bidirectional maximum correntropy algorithm

Abstract

Background and Aim Image registration and alignment are the main limitations of augmented reality (AR)‐based knee replacement surgery. This research aims to decrease the registration error, eliminate outcomes that are trapped in local minima to improve the alignment problems, handle the occlusion and maximize the overlapping parts. Methodology Markerless image registration method was used for AR‐based knee replacement surgery to guide and visualize the surgical operation. While weight least square algorithm was used to enhance stereo camera‐based tracking by filling border occlusion in right‐to‐left direction and non‐border occlusion from left‐to‐right direction. Results This study has improved video precision to 0.57–0.61 mm alignment error. Furthermore, with the use of bidirectional points, that is, forward and backward directional cloud point, the iteration on image registration was decreased. This has led to improve the processing time as well. The processing time of video frames was improved to 7.4–11.74 frames per second. Conclusions It seems clear that this proposed system has focused on overcoming the misalignment difficulty caused by the movement of patient and enhancing the AR visualization during knee replacement surgery. The proposed system was reliable and favourable which helps in eliminating alignment error by ascertaining the optimal rigid transformation between two cloud points and removing the outliers and non‐Gaussian noise. The proposed AR system helps in accurate visualization and navigation of anatomy of knee such as femur, tibia, cartilage, blood vessels and so forth.

Single-center experience with Knee+™ augmented reality navigation system in primary total knee arthroplasty

“…All measurements are calculated intraoperatively, thus, there is no demand for time and cost-consuming preoperative radiographic scans that expose the patients to radiation[ 19 , 20 ]. During surgery, not using extra pins as markers for restoration of the mechanical axis is linked with reduced risk of periprosthetic fractures during implantation, chiefly of the femoral component, and eliminated infection risk.…”

Integration of Square Fiducial Markers in Patient-Specific Instrumentation and Their Applicability in Knee Surgery

“…Iterative Closest Point (ICP) algorithms were introduced in the early 1990s to register 3D range data to CAD models of objects. Maharjan et al [ 13 ] proposed an ICP algorithm with bidirectional maximum correntropy. According to the authors, this algorithm helped improve registration and alignment, maximize the overlapping parts between two cloud points and eliminate the registration outcomes trapped in local minima.…”

“…According to the authors, this algorithm helped improve registration and alignment, maximize the overlapping parts between two cloud points and eliminate the registration outcomes trapped in local minima. Furthermore, it has also removed the non-Gaussian noise, impulse noise, and outliers and provided high registration accuracy, helping in accurate visualization and navigation of the knee anatomy [ 13 ]. Recently, Su et al [ 44 ] published a report on MR technology in preoperative planning and intraoperative navigation guidance for TKA.…”

“…Along with robotics, several authors are implementing augmented reality (AR) in different aspects of total knee arthroplasty (TKA) surgery [ 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. New platforms now use AR as a critical differentiator to enhance the surgeon’s experience during surgery.…”

A Symmetry-Based Superposition Method for Planning and Surgical Outcome Assessment

“…The ICP algorithm has been frequently used in medical imaging registration, registration among more than two sources of medical imaging in computer-assisted surgery [ 15 , 16 ], and augmented reality in medical imaging projection on patient for exposed visualization during operations [ 17 , 18 ]. It has also been applied to simulate fracture reduction surgery for bone alignment animation [ 5 , 6 , 19 ].…”