Mixed-Reality Surgical System Enhances Precision, Outcomes for Complex Hip Replacement

Using the world’s first planning and holographic surgical-guidance platform, surgeons at Orlando Health Jewett Orthopedic Institute have performed Central Florida’s first and currently only complex hip reconstructions. This mixed reality-based digital surgery technology provides surgeons with patient-specific, sequential three-dimensional (3D) information in and around the hip joint, helping them visualize accurate component placement and implant alignment in real time during total hip arthroplasty.

Surgeons wear calibrated mixed-reality display goggles to view the transmitted patient information while performing the procedure. “Operating with this technology is like having the superpower of X-ray vision,” says Cody Green, MD, an orthopedic surgeon with Orlando Health Jewett Orthopedic Institute who has trained extensively with the novel platform.

The next-generation technology utilizes a CT scan of the patient’s hip anatomy uploaded to the cloud where a 3D holographic model is designed and, if necessary, a custom implant created. The system then projects a holographic overlay onto the patient’s pelvis in the operating room to create an enhanced view of the procedure in real time. Matching the hologram over the bone in front of them, surgeons can precisely place the implant and drill holes with accurate screw directions.

“You actually see the 3D details of the patient’s bone structure, our instruments and the implants tracking in real time,” says Dr. Green, who specializes in total joint and direct anterior hip replacement, as well as reconstructive and robotic-assisted surgery. “The technology increases the precision in each individualized reconstruction, regardless of how challenging the complexity.”

The intuitive, intra-operative virtual guidance system supports the key steps of both primary and complex revision arthroplasty, including those requiring more patient-specific implants due to complications, infection or extensive bone loss.

“Orlando Health is one of only a few sites nationwide with surgeons trained to manage catastrophic hip revisions,” says Dr. Green. “We get referrals from all over Central Florida and beyond for the most-complicated cases because our surgeons stay at the forefront of innovation. Augmenting major, complex cases with 3D-imaging may be the future in surgical technology. For us, though, it’s always patient first and technology second.”

Orlando Health Jewett Orthopedic Institute has the Southeast’s first and only orthopedic-specific hospital, which was recognized as a Top Teaching Hospital by The Leapfrog Group in 2025. A team of 60-plus highly skilled orthopedic physicians provides innovative comprehensive care for over 250,000 patients annually, including the most challenging cases. Specialists perform more than 4,000 joint arthroplasty procedures each year with superior results.