How Augmented Reality Is Delivering Robotic-Level Precision in Orthopedic Surgery: A Conversation with Charlotte Jacquet of Pixee Medical
11 May 2026 | Interaction | By Editor Robotics Business NEWS <editor@rbnpress.com>
Charlotte Jacquet, Manager Marketing & Clinical Affairs at Pixee Medical, discusses the FDA 510(k) clearance of Knee+ NexSight, the future of AR-guided orthopedic surgery, and how wearable augmented reality platforms are reshaping precision, accessibility, and efficiency in operating rooms worldwide.
In this exclusive interview with Robotics Business News, Charlotte Jacquet, Manager Marketing & Clinical Affairs at Pixee Medical, explains how the company’s latest augmented reality platform, Knee+ NexSight, is transforming orthopedic surgery with wearable AR guidance, streamlined workflows, and robotic-level precision—without the complexity and cost of traditional robotic systems.
With the FDA 510(k) clearance of Knee+ NexSight, what key innovations differentiate this next-generation AR platform from earlier versions of your technology?
The latest generation of Knee+ NexSight introduces several key innovations that significantly enhance both user experience and performance. The platform features a newly designed headset that is more compact and lightweight, integrating bifocal vision, a virtual display, and voice control to improve surgeon comfort and ergonomics. The workflow has also been streamlined, enabling faster acquisition of anatomical landmarks and reducing overall device usage time.
Importantly, the system maintains a high level of clinical accuracy comparable to robotic technologies, while avoiding their complexity and associated costs. Finally, the solution remains compatible with all primary knee implants, requires no consumables, and delivers a reliable, reproducible performance with strong economic efficiency
The system is designed to deliver “robotic-level accuracy” without traditional robotic systems—how does augmented reality achieve this level of precision while remaining more compact and user-friendly?
Augmented reality achieves this level of precision by overlaying real-time, data-driven guidance directly into the surgeon’s field of view. The system relies on accurate tracking of instruments, combined with robust proprietary registration algorithms, to continuously align digital information with the patient’s actual anatomy.
This allows the surgeon to visualize key parameters—such as alignment and resection levels—in real time, while maintaining full control of each step of the procedure. Because the guidance is delivered through a lightweight headset rather than a large robotic platform, the system remains compact and easy to integrate into the operating room.
In this way, augmented reality enhances the surgeon’s precision and consistency without adding complexity, offering a more flexible and user-friendly alternative to traditional robotic systems. Recent clinical studies, including those by Lambrechts et al. [1] and Highcock et al. [2], have shown that this approach can achieve an accuracy comparable to robotic-assisted surgery.
References:
(1) Lambrechts J, Vansintjan P, Lapierre C, Sinnaeve F, Van Lysebettens W, Van Overschelde. Accuracy of a New Augmented Reality Assisted Technique for Total Knee Arthroplasty: An In Vivo Study. Arthroplast Today. 2024.
(2) Panchal S, Barker B, Highcock AJ. Improved alignment and reduced peri-operative blood loss with augmented reality-guided total knee arthroplasty: a single-centre comparative study. J Robot Surg. 2026 Feb 24;20(1):285. doi: 10.1007/s11701-026-03245-4.
Knee+ NexSight is tailored for ambulatory surgical centers (ASCs)—what specific workflow, cost, and efficiency challenges in outpatient settings does this solution address?
Knee+ NexSight has been specifically designed to meet the constraints of ambulatory surgical centers, where efficiency and cost control are critical. These environments require streamlined workflows with minimal setup time, no dependency on bulky infrastructure and no need for pre-operative imaging. The system addresses these challenges by simplifying the surgical workflow, enabling faster anatomical landmark acquisition, and adding only minimal operative time compared to traditional instrumentation, while eliminating the need for consumables. In addition, the lightweight and portable nature of the solution removes the logistical burden associated with capital-intensive robotic systems, making high-precision technology more accessible in outpatient settings. Its compact and mobile design also allows surgical teams to move quickly from one operating room to another, optimizing OR utilization and workflow efficiency throughout the day.
Unlike conventional robotic surgery platforms, your solution is wearable and integrates directly into the surgeon’s field of view—how does this impact adoption and training for orthopedic surgeons?
Unlike conventional robotic systems, Knee+ NexSight is fully wearable and integrates directly into the surgeon’s field of view, which significantly reduces the barrier to adoption. There is no need to learn complex robotic interfaces or adapt to constrained workflows. Instead, surgeons operate within a familiar surgical environment, augmented by real-time visual guidance. This shortens the learning curve and facilitates faster onboarding.
In addition, more than 10,000 procedures have already been performed worldwide using previous generations of the technology, providing surgeons with strong clinical familiarity and confidence in the platform. With this new version being even more intuitive, simplified, and user-friendly, adoption is expected to further accelerate across a broader range of surgical centers and users.
The platform builds on a track record of thousands of procedures worldwide—what clinical insights or feedback most influenced the development of this new AR platform?
The development of Knee+ NexSight has been strongly shaped by extensive clinical experience gathered over thousands of procedures worldwide, as well as continuous usability testing conducted in close collaboration with surgeons throughout the development process. From the earliest stages, the platform was designed with direct surgeon feedback to ensure that it truly meets the realities and constraints of the operating room.
Key feedback consistently emphasized the need for a solution that is simple, efficient, and intuitive to use, without adding unnecessary steps or time during surgery. Surgeons also highlighted the importance of maintaining a workflow that is safe, minimally invasive for patients, and easy to integrate into everyday practice.
These insights directly influenced the shift toward a lightweight AR-based platform that prioritizes usability, reproducibility, and intraoperative efficiency while maintaining high clinical precision.
How does eliminating bulky equipment and disposables affect both the cost structure and environmental footprint of orthopedic surgery?
Removing bulky robotic equipment and single-use consumables has a direct impact on both cost structure and sustainability. From an economic perspective, it reduces capital expenditure, maintenance costs, and per-procedure disposable expenses. This makes advanced surgical guidance more scalable, particularly in high-volume or outpatient environments. From an environmental standpoint, it significantly reduces medical waste and the overall carbon footprint of surgical procedures, aligning with increasing pressure on healthcare systems to adopt more sustainable practices.
As AR-based navigation competes with traditional robotic-assisted surgery, how do you see the balance between cost, accessibility, and clinical outcomes shaping future adoption?
The balance between cost, accessibility, and clinical outcomes will be a key driver of future adoption. While robotic systems have demonstrated clinical value, their high cost and infrastructure requirements limit widespread use. AR-based navigation offers a compelling alternative by delivering robotic-level accuracy in a more accessible and cost-efficient format. This positions AR as a democratizing technology, potentially broadening access to high-precision orthopedic surgery across a larger number of hospitals and surgical centers without compromising clinical performance.
Looking ahead, do you envision augmented reality platforms like Knee+ NexSight expanding beyond knee arthroplasty into other surgical specialties or becoming a standard of care in operating rooms?
Looking ahead, we clearly envision augmented reality expanding far beyond knee arthroplasty. We already have a similar AR solution for shoulder surgery that has obtained CE marking, and we are currently continuing its development with the same philosophy applied to Knee+ NexSight: improving the user experience, simplifying workflows as much as possible, and making the technology increasingly intuitive and efficient for surgeons.
In parallel, future developments are already being explored for additional applications such as hip surgery and other orthopedic procedures where precision and real-time guidance are essential.
We believe augmented reality represents a new era in computer-assisted surgery. What we are seeing today is only the beginning. As the technology continues to mature, AR platforms have the potential to become a standard layer of intelligent guidance integrated naturally into operating rooms, helping surgeons achieve greater precision, efficiency, and consistency without adding unnecessary complexity.
