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  • India’s first AI-enhanced HoloLens surgery performed with patient specific instrumentation at Medica – a new era in knee surgery

    Published on April 10, 2024

     Kolkata:  Medica Superspecialty Hospital, the largest hospital chain in Eastern India has achieved yet another significant milestone in the field of orthopedic surgery with the successful completion of India’s first transmission of AI-powered HoloLens surgery combined with patient-specific instrumentation. This procedure was performed on a severely arthritic 50-year-old woman by Dr. Vikash Kapoor, Vice Chairman, Group Director, Joint Replacement and Arthroscopic Surgeon, Medica Institute of Orthopedic Sciences, Medica Superspecialty Hospital, marking a paradigm shift in precision surgery techniques. The surgery was conducted by a skilled team led by Dr. Vikash Kapoor and Dr. Manish Shah, from Gujarat using the Made in India Medial Pivot Knee implant manufactured by Biorad. This ground-breaking utilization of cutting-edge technologies, which included live relaying the surgery to a sizable audience of 400 orthopaedic and joint replacement surgeons at the Forum of the Indian Society of Hip and Knee Surgeons, marking it as a major accomplishment that demonstrated India’s creative advancements in artificial intelligence applications for knee replacement surgery. This groundbreaking event was not only a first for Medica and Kolkata but also a recorded first for India, showcasing the country’s advancements in medical technology.

    Namita (Name Changed), 50-years-old, a resident of Kolkata, suffered from severe arthritis affecting all three parts of her knee joint, resulting in significant deformity with inward growth. This condition severely restricted her mobility, causing intense pain and rendering her unable to walk for more than 10 minutes or perform daily activities. Despite her young age, the only viable solution was knee replacement surgery, a procedure typically avoided in younger patients. Recognizing the critical role of implant type and knee alignment in ensuring the longevity and effectiveness of the replacement, advanced technologies such as robotics, navigation, and patient-specific instrumentation were employed.

    While discussing the case, Dr. Vikash Kapoor shared, “The longevity of a knee replacement not only depends on the type of implant, but it also depends on the alignment of the knee and the motion of the knee. This technique’s incredible precision makes it achievable to precisely align the knee joint, which is one of its key advantages. The HoloLens technology, is a composite mix of reality, artificial intelligence, and internet. Basically, it recreates the image of the bone in the air, which is mapped, and we see it with a special type of 3D virtual image, which is projected in the air by HoloLens. This level of precision is on par with that achieved by robotic assisted surgeries. Notably, this technology allows for seamless integration with implants made by other manufacturers, giving surgeons an unparalleled degree of flexibility and choice. Furthermore, the use of HoloLens technology adds a cross-checking system driven by AI, guaranteeing constant precision during the surgical procedure. This advanced device raises the bar for orthopaedic procedures by greatly improving safety and dependability.”

    Utilizing cutting-edge technology, the patient’s 3D deformity mapping was meticulously analyzed through a CT scan, enabling the creation of customized instrumentation tailored to the individual’s unique anatomy. Unlike conventional methods, this innovative approach minimizes the need for drilling femoral holes, thereby reducing disruption, and mitigating the risk of chest and cardiac issues. Implant selection and alignment were significantly improved by patient-specific instrumentation, which integrated CT imaging with accurate sizing estimates before the surgery. This unique strategy reduced risks and increased accuracy, yielding better results. Furthermore, the incorporation of HoloLens technology allowed surgeons to view holographic representations of bone structures in real time, which made it easier to precisely insert and align components during surgery.

    The integration of internet-based technology and virtual reality in knee replacement surgery has revolutionized the medical field. This combination allows for a comprehensive view of the patient’s bone structure, which is then superimposed on the actual patient for precision. It serves as a cross-checking tool to ensure perfect alignment during the procedure. The result is an optimal sizing of the patient’s implant and alignment, which significantly improves the long-term outcome of the knee replacement. This method is particularly beneficial for young patients, but it is also applicable to older patients.

    The use of this technology yields results comparable to robotic surgery, with the added advantage of being able to use implants from any company. In contrast, robotic surgery restricts surgeons to using implants compatible with the specific robot. This innovative approach, a part of artificial intelligence application in knee replacement surgery, was first implemented at Medica Superspecialty Hospital.

    Mr. Ayanabh Debgupta, Jt. Managing Director, Medica Group of Hospitals, shared, “At Medica, we are very happy to have successfully performed the first HoloLens operation in India using AI technology in conjunction with patient-specific equipment. AI is gradually becoming intergral part of our treatment process to ensure the efficacy and accuracy, allowing surgeons to perform operations with never-before-seen levels of safety and precision. This accomplishment not only demonstrates Medica’s competence but also highlights the international level of clinical work that are now being dome at Eastern India.”

    Under the guidance of Vice Chairman and Group Director of Orthopedics, Dr. Vikash Kapoor, the hospital previously introduced Eastern India’s first non-haptic robotic technology for total knee replacement, further solidifying its commitment to delivering excellence in patient care.

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