Head-to-Head Comparison of Magic Leap 2 and HoloLens 2 Using Patient-Specific Phantoms in Orthopedic Oncology: A Feasibility Study

Augmented reality (AR) represents an emerging technology that is increasingly being integrated into surgical navigation across various medical disciplines, including orthopedic surgery. This preclinical study investigated the application of AR in orthopedic oncology and performed a comparative assessment of two head-mounted displays (HMDs): Microsoft HoloLens 2 and Magic Leap 2. The study evaluated the feasibility of AR-assisted tracing of planned osteotomies for bone tumor resections in orthopedic surgery. The objective was to evaluate the visualization capabilities, spatial guidance performance, and user interaction provided by the two AR platforms under controlled preclinical conditions. Accuracy of AR-guided tracing of planned osteotomies was quantified using custom cutting guides incorporating grooves of 1 mm, 2 mm, and 3 mm to measure deviations from the planned osteotomy lines. Both AR HMDs were tested under identical experimental conditions, and their performance and accuracy were comparatively analyzed. Magic Leap 2 demonstrated a trend toward greater accuracy in AR-guided tracing of osteotomies, achieving 82%, 95%, and 100% accuracy within 1 mm, 2 mm, and 3 mm thresholds of the planned osteotomy lines, respectively. In comparison, the HoloLens 2 achieved 65%, 85%, and 95% accuracy within the same respective thresholds. Ergonomic assessment also suggested favorable user comfort and handling characteristics for Magic Leap 2. Further studies involving larger cohorts and comparisons with established navigation techniques are required to confirm the potential advantages of HMD-based AR guidance for bone tumor resections and other orthopedic procedures.