Augmented Reality Comes Into Focus for Orthopedic Surgery

Augmented reality (AR), also known as mixed reality (MR), is a way for humans and computers to interact. AR technology overlays real-time, 3D-rendered computer graphics into the real world through a handheld device or head-mounted display. 

In orthopedic surgery, AR technology overlays 3D patient anatomy and real-time navigation data onto the surgeon’s field of view via a smart headset. The technology has the potential to improve precision in joint replacements, spine alignment, and fracture fixation while removing the need for external screens and intra-operative X-rays.

So far this year, three medical device companies have celebrated milestones for their AR technology for orthopedic and spine surgery. Let’s explore.

VB Spine

In February, the spinoff of Stryker’s spine business purchased exclusive rights to Augmedics’ xvision Spine System. xvision is the first FDA-cleared AR navigation platform in spine surgery.

The system lets surgeons visualize patient anatomy as though they have “X-ray vision” to precisely navigate instruments and implants during surgeries.

The system combines the benefits of navigation with the ease and utility of open surgery—visualization while looking directly at the patient, accuracy and precision, workflow efficiency, and radiation reduction. With nearly 13,000 patients treated with xvision, the transaction brought together two complementary portfolios focused on redefining spine care.

“We have long admired the xvision technology and potential of the platform,” VB Spine Co-CEO Marc Viscogliosi said. “We believe with our implant integration and scale, we have the ability to harness the true potential of AR navigation. Combined with the SpineHawk platform, this will expand our existing spine solutions and supports our long-term roadmap to redefine spine care with differentiated technologies.”

From product launches to M&A and manufacturing trends, the ODT Now delivers the orthopedic device news you need weekly. Subscribe here!

Pixee Medical

The company’s Knee+ NexSight AR-based tool for total knee arthroplasty earned CE mark clearance in March. The technology projects a virtual screen directly into the surgeon’s field of view and incorporates voice command.

The AR platform functions as an optical heads-up display, overlaying critical navigational information, including bone alignment, implant positioning, and surgical landmarks, directly into the surgeon’s visual field without requiring him or her to look away from the operative site.

Knee+ NexSight is lighter and more compact than the previous generation and the system needs no robot, dedicated console, or single-use disposables. Knee+ NexSight is compatible with most primary knee implants and supports personalized alignment, including kinematic alignment. Its software is designed for connectivity, allowing integration with third-party digital solutions and remote software updates.

Two months later, Knee+ NexSight was used in its first U.S. procedure by Michigan large joint specialist Safa S. Kassab, M.D. 

“Augmented reality in the operating room is not a distant concept—it is here, and it is transforming the outcomes we can achieve for our patients,” Dr. Kassab said. “The Knee+ NexSight glasses allow me to keep my eyes on the patient while receiving precise, real-time navigational data in my line of sight. It represents a new standard for how knee replacement surgery can be performed, and I am proud that our patients in Michigan are the first in the country to benefit from this technology.”

Medacta

In April, surgeons performed the first U.S. glenoid deformity and revision shoulder arthroplasty using the company’s NextAR shoulder AR platform. The Glenoid Reconstruction System (GRS), introduced in 2024, provides AR guidance during k-wire insertion, angled reaming, implant positioning, and screw preparation.

“The release of MyShoulder Planner allows me to move from CT scanning to planning and NextAR execution within a short time frame, typically around 15 minutes. The ability to plan cases intraoperatively and execute the plan with a high degree of precision brings significant value to my practice,” shared designer Wesley Cox, M.D., of the University of Arkansas for Medical Sciences in Arkansas.

Three months later, the company added total hip arthroplasty to NextAR’s library. The platform integrates real-time, patient-specific data into the surgical workflow to support personalized adjustments. NextAR Hip supports CT-based and CT-free workflows across anterior and posterior approaches, with initial clinical cases completed in Australia and the U.S.

NextAR Hip provides real-time guidance for bone preparation, cup positioning, screw placement, and implant alignment. The platform supports CT-based and CT-free workflows and may reduce reliance on intraoperative fluoroscopy, lowering radiation exposure, procedural time, and costs.