Skip to main content

Mixed Reality-Based Simulator for Training on Imageless Navigation Skills in Total Hip Replacement Procedures

Part of the Lecture Notes in Computer Science book series (LNISA,volume 11462)


Imageless navigation systems (INS) in orthopaedics have been used to improve the outcomes of several orthopaedic procedures such as total hip replacement [1, 2]. However, the increased surgical times and the associate learning curve discourage surgeons from using navigation systems in their theatres [2]. This paper presents a Mixed Reality (MR) simulator that helps surgeons acquire the infrared based navigation skills before performing it in reality. A group of 7 hip surgeons tried the application, expressing their satisfaction with all the features and confirmed that the simulator represents a cheaper and faster option to train surgeons in the use of INS than the current learning methods.


  • Imageless navigation
  • Holographic
  • Augmented reality
  • Mixed reality
  • Machine vision
  • Surgical training

This is a preview of subscription content, access via your institution.

Buying options

USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
USD   59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions


  1. 1.

    Plane that divides the body into front and back sections.

  2. 2.

    Plane that divides the body into left and right sections.


  1. Snijders, T., Gaalen, S., Gast, A.: Precision and accuracy of imageless navigation versus freehand implantation of total hip arthroplasty: a systematic review and meta-analysis. Int. J. Med. Robot. Comput. Assist. Surg. 13, e1843 (2017)

    CrossRef  Google Scholar 

  2. Thorey, F., Klages, P., Lerch, M., Flörkemeier, T., Windhagen, H., von Lewinski, G.: Cup positioning in primary total hip arthroplasty using an imageless navigation device: is there a learning curve? Orthopedics 32, 14–17 (2009)

    CrossRef  Google Scholar 

  3. National Joint Registry: NJR StatsOnline.

  4. Chang, J.-D., Kim, I.-S., Bhardwaj, A.M., Badami, R.N.: The evolution of computer-assisted total hip arthroplasty and relevant applications. Hip Pelvis 29, 1–14 (2017)

    CrossRef  Google Scholar 

  5. Schnurr, C., Michael, J.W.P., Eysel, P., König, D.P.: Imageless navigation of hip resurfacing arthroplasty increases the implant accuracy. Int. Orthop. 33, 365–372 (2009)

    CrossRef  Google Scholar 

  6. Paprosky, W.G., Muir, J.M.: Intellijoint HIP: a 3D mini-optical navigation tool for improving intraoperative accuracy during total hip arthroplasty. Med. Devices (Auckland, NZ) 9, 401 (2016)

    Google Scholar 

  7. Silvennoinen, M., Helfenstein, S., Ruoranen, M., Saariluoma, P.: Learning basic surgical skills through simulator training. Instr. Sci. 40, 769–783 (2012)

    CrossRef  Google Scholar 

  8. CAE Healthcare: VimedixAR.

  9. Fundamental VR: Multiperson Medical Training.

  10. Microsoft-OpenSource: MixedRealityToolkit-Unity.

  11. Vuforia, P.: Vuforia Developer Library.

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Mara Catalina Aguilera-Canon .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

Aguilera-Canon, M.C., Wainwright, T., Yang, X., Nait-Charif, H. (2019). Mixed Reality-Based Simulator for Training on Imageless Navigation Skills in Total Hip Replacement Procedures. In: El Rhalibi, A., Pan, Z., Jin, H., Ding, D., Navarro-Newball, A., Wang, Y. (eds) E-Learning and Games. Edutainment 2018. Lecture Notes in Computer Science(), vol 11462. Springer, Cham.

Download citation

  • DOI:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-23711-0

  • Online ISBN: 978-3-030-23712-7

  • eBook Packages: Computer ScienceComputer Science (R0)