Taiwan Tech team uses mixed reality to boost hip surgery precision

The “AccuHip” real-time visualized navigation system for total hip arthroplasty enables surgeons to accurately identify lesions, critical blood vessels, and nerves during surgery through real-time imaging guidance, making the safe zone visible.

A research team from National Taiwan University of Science and Technology (Taiwan Tech) has developed a mixed reality (MR) navigation system to improve the accuracy of hip replacement surgery, according to a university statement.

Led by Professor Yi-Zeng Hsieh of the Department of Electrical Engineering, the team integrated MR technology with a head-mounted device that overlays a patient’s 3D bone images directly onto a surgeon’s field of view. The system helps guide the positioning and angle of artificial hip implants in real time.

Hsieh said the project was driven by clinical needs. Traditional hip replacement procedures rely heavily on surgeons’ experience, while existing high-precision navigation systems or robotic solutions are often costly. The MR-based approach aims to provide a more intuitive and cost-effective surgical aid.

Using MR, surgeons can access critical information without frequently turning to external monitors, enabling more seamless hand-eye coordination during operations. The system displays key parameters such as inclination and anteversion angles, helping reduce surgical errors and lowering reliance on additional imaging, which in turn may reduce radiation exposure.

The team faced several technical challenges, including maintaining accurate image alignment in dynamic operating room environments and converting medical imaging data into real-time computational models. Doctoral student and team leader Cheng-Hao Zou said the system is currently tested using synthetic bone models (sawbones) and validated through simulated surgical procedures. Optical measurement platforms are used to analyze positioning errors and ensure clinical-level accuracy.

To better align the system with real-world conditions, team members also observed live surgeries. Zou said the experience helped engineers better understand clinical constraints and refine system design, despite the initial psychological pressure of witnessing operations up close.

The project involved a multidisciplinary effort. Graduate student Che-Yang Lin translated surgical procedures and anatomical definitions from medical literature into mathematical models and algorithms. Doctoral student Chia-Hsuan Wu handled experimental design and accuracy validation, while Chun Chen focused on system testing and optimization.

The system is tested in laboratory simulations using human skeletal models (sawbones) and validated in accordance with actual surgical workflows to ensure its accuracy meets clinical requirements.

The research was conducted in collaboration with orthopedic surgeon Dr. Shu-Hao Chang from Fu Jen Catholic University Hospital, who provided clinical insights. Hsieh emphasized that demand-driven collaboration is key in biomedical engineering, noting that such cross-disciplinary work requires sustained communication but offers valuable learning experiences for students.

The team won first place in the Information Application category at the 2025 National Collegiate IT Service Innovation Competition and also received the 21st National Innovation Award, a major recognition in Taiwan’s biomedical and health technology sector.

Professor Yi-Zeng Hsieh (left) collaborated with orthopedic surgeon Dr. Shu-Hao Chang (center) from Fu Jen Catholic University Hospital on the “MR-assisted navigation system for total hip replacement surgery,” which received the 21st National Innovation Award, a major benchmark honor in Taiwan’s biomedical and health technology sector. Professor Ying-Jung Yeh (right), Vice President for Office of International Affairs at National Taiwan University of Science and Technology, also participated in the project.

Looking ahead, Hsieh said the team aims to secure funding to further refine the system, pursue certification from Taiwan’s Food and Drug Administration, and advance toward clinical applications. Potential future uses include surgical training and education to enhance overall surgical quality and expand smart healthcare applications.