BACKGROUND Computer-assisted solutions are changing surgical practice continuously. One of the most disruptive technologies among the computer-integrated surgical techniques is Augmented Reality (AR). While Augmented Reality is increasingly used in several medical specialties, its potential benefit in orthopedic surgery is not yet clear. The purpose of this article is to provide a systematic review of the current state of knowledge and the applicability of AR in orthopedic surgery. METHODS A systematic review of the current literature was performed to find the state of knowledge and applicability of AR in Orthopedic surgery. A systematic search of the following three databases was performed: "PubMed", "Cochrane Library" and "Web of Science". The systematic review followed the Preferred Reporting Items on Systematic Reviews and Meta-analysis (PRISMA) guidelines and it has been published and registered in the international prospective register of systematic reviews (PROSPERO). RESULTS 31 studies and reports are included and classified into the following categories: Instrument / Implant Placement, Osteotomies, Tumor Surgery, Trauma, and Surgical Training and Education. Quality assessment could be performed in 18 studies. Among the clinical studies, there were six case series with an average score of 90% and one case report, which scored 81% according to the Joanna Briggs Institute Critical Appraisal Checklist (JBI CAC). The 11 cadaveric studies scored 81% according to the QUACS scale (Quality Appraisal for Cadaveric Studies). CONCLUSION This manuscript provides 1) a summary of the current state of knowledge and research of Augmented Reality in orthopedic surgery presented in the literature, and 2) a discussion by the authors presenting the key remarks required for seamless integration of Augmented Reality in the future surgical practice. TRIAL REGISTRATION PROSPERO registration number: CRD42019128569.

中文翻译：

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增强现实在骨科手术中的适用性——系统评价。

背景技术计算机辅助解决方案正在不断改变外科手术实践。计算机集成手术技术中最具颠覆性的技术之一是增强现实（AR）。虽然增强现实越来越多地应用于多个医学专业，但其在骨科手术中的潜在益处尚不清楚。本文的目的是对 AR 在骨科手术中的知识现状和适用性进行系统回顾。方法 对当前文献进行系统回顾，以了解 AR 在骨科手术中的知识状况和适用性。对以下三个数据库进行了系统检索：“PubMed”、“Cochrane Library”和“Web of Science”。该系统评价遵循系统评价和荟萃分析首选报告项目（PRISMA）指南，并已在国际前瞻性系统评价登记册（PROSPERO）中发表和注册。结果 纳入 31 项研究和报告，并分为以下类别：器械/种植体植入、截骨术、肿瘤手术、创伤以及手术培训和教育。可以在 18 项研究中进行质量评估。在临床研究中，有 6 个病例系列的平均得分为 90%，还有 1 个病例报告，根据乔安娜·布里格斯研究所关键评估清单 (JBI CAC) 的得分为 81%。根据 QUACS 量表（尸体研究质量评估），这 11 项尸体研究得分为 81%。结论本手稿提供了 1) 文献中介绍的骨科手术中增强现实知识和研究现状的总结，以及 2) 作者的讨论，提出了未来外科手术中无缝集成增强现实所需的关键评论实践。试用注册 PROSPERO 注册号：CRD42019128569。