Mixed Reality Enhances Hip Replacement Surgery
Sarasota Memorial Hospital has become the first medical centre to adopt an FDA-cleared mixed reality navigation platform for total hip replacement procedures. Under the leadership of orthopaedic surgeon Dr Edward Stolarski, the institution integrates the HipInsight 2.0 system with head-mounted HoloLens devices, enabling surgeons to overlay three-dimensional hologrammes of patient anatomy onto the operative field. This novel approach optimises implant positioning, reduces intra-operative guesswork, and anticipates complications such as post-surgical dislocations.
The HipInsight 2.0 platform received FDA clearance in 2024 and represents the latest evolution in intra-operative guidance for joint arthroplasty. By importing pre-operative CT data, the system generates a bespoke surgical plan that details implant size, pelvic tilt, leg-length discrepancy, and offset modifications. During the operation, surgeons view this planning data in real time through Microsoft’s HoloLens mixed reality headset, which projects holograms directly over the patient’s hip. Unlike conventional systems that display crucial metrics on external monitors, this configuration keeps essential information within the surgeon’s direct line of sight, streamlining workflow.
Dr Stolarski has applied this technology in more than 100 hip replacement operations, reporting marked improvements in precision, particularly in cases complicated by advanced arthritis or congenital dysplasia. He highlights that HipInsight integrates both spinal alignment and pelvic orientation into its planning algorithms, permitting pre-operative identification of potential risk factors. Surgeons gain an “x-ray vision” capability, allowing them to assess sequential, three-dimensional data around the joint without diverting attention from the patient.
The pre-operative phase involves a CT scan, which is processed to create a detailed three-dimensional model of the pelvis. This model informs decisions on implant component sizes, anticipated changes in leg length and optimal acetabular cup orientation. By tailoring each surgical plan to the individual’s unique anatomy, the system aims to deliver consistent, reproducible outcomes and reduce the likelihood of revision surgery.
Intra-operatively, the HoloLens headset aligns the hologram with the patient’s anatomy, guiding bone resections and implant positioning. Traditional guidance relies on visual estimations or mechanical jigs, but mixed reality overlays allow the surgeon to visualise implant depth, angulation and alignment in real time. This can be particularly beneficial in minimally invasive anterior-approach procedures, where limited exposure increases the challenge of accurate component placement.
Most patients undergo the surgery under spinal anaesthesia combined with a regional nerve block, which aids post-operative pain management and facilitates earlier mobilisation. Dr Stolarski’s technique employs a minimally invasive anterior approach, accessing the hip via the front of the thigh to preserve major muscle groups. As a result, many patients are able to bear weight and ambulate on the same day as their operation, with some discharged home within 24 hours.
Sarasota Memorial Health Care System, celebrating its centenary in 2025, is the largest community-owned healthcare provider in Sarasota County. Its regional network includes two full-service acute hospitals in Sarasota and Venice, freestanding emergency facilities in North Port and Lakewood Ranch, a rehabilitation hospital, a behavioural health unit, a skilled nursing centre and a comprehensive array of outpatient and urgent care clinics. More than 2,500 physicians and advanced practitioners support nearly two million patient visits annually across the system.
The integration of mixed reality into orthopaedic surgery underscores Sarasota Memorial’s commitment to adopting cutting-edge technologies that enhance patient safety and clinical outcomes. As the hospital commemorates 100 years of service, it continues to invite community members to participate in centennial events and stay informed via its dedicated online portal throughout 2025.
