Surgeons at Houston Methodist Hospital use HipInsight virtual reality technology during a hip replacement surgery.
Orthopedics & Sports Medicine

WATCH: Houston Methodist Embraces Virtual Hip Replacement Technology for High-Risk Patients

On Medicine

Advanced imaging and simulation before surgery can support safer hip replacement procedures and more predictable recovery for patients with elevated surgical risk.

Aug. 2, 2024
Eden McCleskey

Article Highlights

  • Preoperative CT-based 3D modeling allows precise templating and intraoperative guidance for acetabular component placement, supporting more individualized surgical execution compared to conventional approaches.
  • Hip dislocation remains a persistent postoperative risk, and AR-assisted planning and placement are positioned as a strategy to optimize component positioning and potentially reduce instability rates.
  • The ability to model anatomic variation (e.g., dysplasia, post-traumatic changes) enhances decision-making in patients with altered biomechanics or prior surgery — populations traditionally associated with higher complication risk.
  • Use of AR guidance can decrease reliance on fluoroscopy or intraoperative X-rays, which may lower radiation exposure and streamline workflow in the operating room.
  • While AR has been historically used in orthopedic education, this application demonstrates its emerging role in real-time surgical decision support, signaling a shift toward broader clinical adoption with potential system-level benefits.

At Houston Methodist Hospital, orthopedic surgeons are pioneering the use of the HipInsight System, a cutting-edge mixed reality guidance technology designed to enhance hip replacement surgeries.

The HipInsight System leverages the Microsoft HoloLens head-mounted device to project 3D holograms of a patient's anatomy, implants and surgical instruments in real-time. This innovation provides surgeons with "x-ray vision," allowing for precise visualization and placement of acetabular components during surgery. By combining cloud-based preoperative planning with virtual intraoperative guidance, the system marks a significant advancement in orthopedic surgery.

"The HipInsight system allows us to template our surgery based on patients' 3D models," said Dr. Kevin Park, medical director of Orthopedic Surgery at Houston Methodist Hospital and head of the Total Joint Replacement Steering Committee. "We get a preoperative CT scan and use that model to plan and execute the precise placement of the acetabular component."

This system proves particularly beneficial in addressing complex cases, such as hip dysplasia and post-traumatic arthritis. The ability to visualize and plan for bony abnormalities preoperatively enhances surgical accuracy and patient outcomes. Furthermore, it reduces the need for fluoroscopy or other intraoperative x-ray uses, minimizing radiation exposure.

Dr. Park performed his first HipInsight-assisted surgery on February 23, 2023. The patient, suffering from debilitating hip arthritis and a history of spine surgery, faced a high risk of dislocation after hip replacement. Utilizing the HipInsight technology, Dr. Park meticulously planned the surgery, significantly improving the patient's prospects for a successful recovery.

“As an orthopedic surgeon, I strive to improve my patients' outcomes while adopting innovative technologies. Orthopedic surgery has evolved significantly since the 1960s, and we are constantly seeking ways to enhance patient care.”

Dr. Kevin Park
Medical Director of Orthopedic Surgery at Houston Methodist Hospital

Houston Methodist Hospital's investment in the HipInsight System underscores its commitment to integrating advanced technologies in clinical practice. The adoption of augmented reality systems like HipInsight holds promising potential for both patients and medical professionals, paving the way for improved surgical outcomes and enhanced training opportunities.

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Aug. 2, 2024
Eden McCleskey
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Transcript

00:00–00:30
I've always been interested in newer technologies. As orthopedic surgeons, newer innovations and emerging technologies are very interesting. We're not just set in our old ways of how we have been doing hip replacement surgery since the 1960s. We're constantly trying to improve outcomes for our patients. Hip dislocation after hip replacement is a complication, and that is something our surgeons are trying to constantly improve our techniques to minimize. My name is Kevin Park. I'm an orthopedic surgeon at Houston Methodist Hospital.


00:30–01:00
I'm the medical director for the orthopedic department. I'm also the head of Total Joint Replacement Steering Committee. I specialize in hip and knee replacements, including direct anterior hip replacement. Using an augmented reality system like this allows us to template our surgery based on a patient’s 3D model. We get a preoperative CT scan, and based on that model, we are able to plan and execute a precise acetabular component.


01:00–01:30
This allows us to plan for any type of bony abnormalities that the patient may have, such as hip dysplasia, post-traumatic arthritis and so on. And we can use these projections that are created from the headset to help us place this acetabular component into the hip socket. This is the first of its kind to be used to assist surgeons to do augmented reality assisted hip replacement surgery. Using this technology reduces our need for fluoroscopy or any X-ray uses in the room.


01:30–02:00
My first HipInsight surgery was done February 23rd, 2023. The patient came to me with debilitating hip arthritis. She has failed non-operative management, including physical therapy, injections and medications and the patient was recommended to undergo hip replacement surgery. We discussed the risks and benefits of the surgical procedure. The patient previously had spine surgery due to low back disc issues and she has some difficulty bending forward and backwards. So I thought she would be at high risk for dislocation after hip replacement surgery.


02:00–02:30
So we got a preoperative CT scan which allowed us to template and plan for using the technology. As an orthopedic surgeon, I want to improve my patients’ outcome while adapting newer, innovative technology. We have quite a bit of augmented reality technologies out there for orthopedics. A lot of that has been used for training purposes. However, using it in an actual clinical situation really excited me.


02:30–03:00
Using augmented reality system like this will potentially benefit our patients as well as our clinical staff in the future.