Technology Spotlight

How Augmented Reality Is Powering the Next Chapter of Orthopedic Surgery in ASCs

As ASCs evolve, the technologies supporting these centers must match the pace.

In April 2024, ARVIS was cleared for shoulder replacements, expanding its AR-guided surgical capabilities beyond hip and knee to improve precision and patient outcomes. Photo: Enovis.

It wasn’t long ago when the idea of performing total joint replacements outside of a hospital setting seemed far out on the horizon. Today, it’s becoming routine. As ambulatory surgery centers (ASCs) expand their capabilities, they’re transforming outpatient care by making complex procedures more accessible and cost-effective. 

The benefits are clear from the patient’s perspective: shorter stays, convenience, and more personalized care. For surgeons, ASCs offer more autonomy and efficiency. In health systems facing growing demand and shrinking capacity, ASCs provide much-needed flexibility. 

However, as ASCs expand their capabilities, they require tailored solutions to address their unique challenges—operating with leaner teams, smaller spaces, and tighter budgets. Any technology brought into this setting must do more with less and deliver surgical precision without slowing down workflows or overloading resources. This is where augmented reality (AR) has transformative potential. 

The Challenges of Scaling ASCs for More Complex Procedures 

As outpatient orthopedic procedures gain momentum, it’s important to note the significant challenges involved in moving complex procedures to the ASC. These centers must deliver the same excellent outcomes as hospitals with a smaller footprint. That’s why efficiency is essential. Every device, workflow, and decision must make the most of the limited space and staff available for each procedure, without compromising on procedure safety or predictability. 

The bar for what technology can deliver is rising as ASCs take on more complex procedures like total joint replacements. Meeting the dual demands for efficiency and quality requires a new approach to surgical technology.

Hospital-Based Surgical Support—Not Made for the ASC

Orthopedic surgeons in hospital settings have adopted robotics and surgical navigation systems to ensure patient safety and procedural precision. These technologies drive advanced and patient-specific alignment techniques, reduced variability, and improved patient outcomes, but most weren’t designed with ASCs in mind. 

Traditional systems typically have large footprints, require extensive setup time, and rely on specialized support staff. They’re capital-intensive and often need infrastructure that ASCs don’t have, while some require expensive disposable components that put a strain on ASC operating costs. Bringing legacy technologies into an ASC can disrupt, rather than enhance, the efficiency these environments are built around. 

The ARVIS proprietary eyepiece was designed specifically for orthopedic surgeons, combining stereo infrared tracking cameras with a 3D augmented reality display, all powered by a high-performance mobile processor. Photo: Enovis.

Enovis recognized this challenge early. Rather than try to retrofit systems designed for hospitals into ASCs, the company took advantage of new technologies to develop a solution that could provide the same precision as traditional navigation systems in a fraction of the size and cost. The result was ARVIS—an augmented reality surgical guidance system developed with input from orthopedic surgeons that offers real-time guidance to improve accuracy during joint replacement procedures. 

Compact Tech Solves the Scalability Problem

As orthopedic procedures continue expanding into outpatient settings, the need for compact, intelligent, and cost-effective surgical technologies will only increase. With ARVIS, the goal is to deliver the same technology capabilities seen in the hospital but in a form factor and workflow designed specifically for ASCs. It’s the only AR technology specifically designed for hip, knee, and shoulder replacement surgeries, where accurate placement and alignment of implant components are critical to long-term success. 

ARVIS provides data-rich surgical guidance for implant alignment and positioning through a compact, wearable, heads-up display, allowing surgeons to maintain an unobstructed view of the surgical field. The user interface is designed so the surgeon operates the system hands-free, keeping the surgeon in control and eliminating the need for an unscrubbed operator. Key components such as the tracking arrays are reusable, minimizing per procedure costs as compared to traditional systems. Thanks to advances in chip design, display technology, and spatial sensors, ARVIS miniaturizes the traditional bulky console, external tracking cameras, monitors, and floor-based towers into a wearable device weighing less than 8 ounces. 

ARVIS delivers the high-tech precision surgeons need without the expansive infrastructure, complexity, and costs that only hospitals can support, streamlining the surgical workflow while delivering high-performance guidance when it matters most.

The Future of AR in the ASC

As ASCs evolve, the technologies supporting these centers must match the pace. Moving forward, the industry can expect to see compact solutions like ARVIS integrated with artificial intelligence (AI) solutions to take surgical support to the next level. Combining AR with AI-backed technologies has the potential to enhance preoperative planning, improve intraoperative decision-making, and enable more personalized, data-informed care. 

Even as technology advances, the core requirements—precision without compromise, delivered in a form that fits the real-world constraints of the ASC—remain the same. Enovis is designing for a smarter, scalable, and more intuitive future for orthopedic surgeons, without sacrificing the quality care that patients deserve.


Marc Mackey leads strategy, marketing, R&D, and commercialization of the Enovis portfolio of artificial intelligence, augmented reality, and robotics surgical technologies. He has more than 25 years of experience in surgical enabling technologies in neurosurgery, ENT, spine, and orthopedics, with a focus on surgical navigation, robotics, medical imaging AI, augmented reality, and the healthcare cloud. Prior to joining Enovis, Mackey was executive vice president at Surgalign, where he led R&D and marketing for augmented reality and imaging AI technologies, and was in charge of strategy and commercialization for robotics and digital surgery as vice president of Global Marketing at Smith+Nephew. Earlier in his career, Mackey had diverse and international roles at Brainlab, including as general manager of the Orthopedic Joint Reconstruction business unit. Mackey earned his bachelor of science degree in aeronautical and astronautical engineering from Purdue University, and a master of science degree in bioengineering from University of California, San Diego.

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