Exploration of Digital Health Technologies

Table 1. Patient demographics and results.

Variable	Value
Patients	72 (July 2021–November 2025)
Sex	Male (44); Female (28)
Age	Average: 50 (14–91)
Diagnosis	Soft tissue sarcoma 23 (31.9%) Benign bone tumors 20 (27.8%) Bone sarcoma 19 (26.4%) Revision prostheses after previous reconstructive surgery 7 (9.7%)
Locations of the pathology	Lower limb 37 (51.4%) Pelvis 15 (20.8%) Foot and ankle 6 (8.3%) Upper limb 5 (6.9%) Chest wall 4 (5.6%) Others 5 (6.9%)
Neoadjuvant treatment before surgery	Bone sarcoma (19): Chemotherapy 7 (36.8%) None 12 (63.2%)
Neoadjuvant treatment before surgery	Soft tissue sarcoma (23): Radiotherapy 14 (60.9%) Chemoradiation 4 (17.4%) None 5 (21.7%)
Assistive tools required for the surgeries	Navigation: 4 of 19 (21.1%) in bone sarcoma 1 of 7 (14.3%) in revision surgery
Assistive tools required for the surgeries	PSG: 7 of 19 (36.8%) in bone sarcoma 1 of 7 (14.3%) in revision surgery Navigation + PSG: 1 of 19 (5.3%) in bone sarcoma
Bone reconstruction	Benign bone tumors (20): Cement 9 (45%) None 8 (40%) Bioactive cement 1 (5%) Vascularized fibular graft 1 (5%) Modular tumor prosthesis 1 (5%)
Bone reconstruction	Bone sarcoma (19): None 7 (36.8%) Custom tumor prosthesis 5 (26.3%) Modular tumor prosthesis 3 (15.8%) Cement 2 (10.5%) Iliac bone graft 2 (10.5%)
Image datasets used for Mixed Reality (MR)	CT + MRI: 32 (44.4%) CT: 25 (34.7%) PET-CT + MRI: 11 (15.3%) CTA + MRI: 3 (4.2%) PET-CT: 1 (1.4%)
MR platform	Version 1 (July 2021–November 2024)	Version 2 (December 2024–November 2025)
No of patients	36	36
Time to generate cinematic rendered models	N/A	Average of 61 minutes (49–156)
Engineer’s intervention during MR case preparation	N/A	4 (11.1%)
Success in MR preoperative assessment	All succeeded: 3 cases required rebooting of the MR headsets during the initial study period
Resection margin	Bone and soft tissue sarcoma (42)
	R0 margin: 27 (64.3%) R1 margin at soft tissue: 10 (23.8%) R1 margin at bone: 5 (11.9%) R2 margin: 0
	Bone sarcoma (19)	Soft tissue sarcoma (23)
	R0: 12 (63.2%) R1 at soft tissue 4 (21.1%) R1 at bone 3 (15.8%) R2: 0	R0: 15 (65.2%) R1 at soft tissue 6 (26.1%) R1 at bone 2 (8.7%) R2 :0

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Three patients (4.2%) had other diagnoses that included metastatic groin lymph nodes, a L3 retroperitoneal nerve tumor, and a broken intramedullary nail in a femoral bone metastasis.

Supplementary materials

The supplementary Movie S1 for this article is available at: https://www.explorationpub.com/uploads/Article/file/101199_sup_1.mp4.

The supplementary Movie S2 for this article is available at: https://www.explorationpub.com/uploads/Article/file/101199_sup_2.mp4.

The supplementary Movie S3 for this article is available at: https://www.explorationpub.com/uploads/Article/file/101199_sup_3.mp4.

Declarations

Acknowledgments

We thank the biomedical implant engineers of the C-Fit 3D Team, Implantcast GmbH, Buxtehude, Germany, for designing and manufacturing the 3D-printed, Patient-Specific Guides and Implants for five patients in this study; Mr. Hon-Wai Leung, IT engineer, HOIT&HI/NTECITD, Prince of Wales Hospital, Hong Kong, China, for establishing and maintaining the hospital IT infrastructure to deploy MR technology for patient service.

Author contributions

KCW: Conceptualization, Data curation, supervision, validation, Investigation, Visualization, Methodology, Writing—original draft, Writing—review & editing. COYW: Formal analysis, Investigation, Methodology, Writing—review & editing. LKYS: Software, Visualization, Methodology, Writing—review & editing. AHYL: Software, Visualization, Methodology, Writing—review & editing. All authors read and approved the submitted version.

Conflicts of interest

The author (LKYS) is an employee of Syngular Technology Limited and provided technical knowledge and support for the manuscript preparation. The other authors (KCW, COYW, AHYL) declare no conflicts of interest.

Ethical approval

The study was approved by the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (the Joint CUHK-NTEC CREC) (CRER No: NTEC-2026-260) of the author (KCW)’s hospital.

Consent to participate

Informed consent was obtained from all study participants.

Consent to publication

Not applicable.

Availability of data and materials

The datasets that support the findings of this study are available from the corresponding author upon reasonable request.

Funding

Not applicable.

Copyright

Publisher’s note

Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.

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