Spire Murrayfield Hospital Wirral, a private hospital at Thingwall on the Wirral in North West England, says Consultant Hip and Knee Surgeon Mr Alan Highcock has performed the UK's first revision total knee replacement guided by Pixee Medical's Knee+ augmented reality system. The hospital announced the case on 17 February 2026; the theatre photographs published with it are dated 10 February 2026. A revision replacement re-does a failed earlier implant and is among the most technically demanding orthopaedic procedures, because the anatomy has been altered and previous components are still in place.
Knee+ is imageless: it needs no preoperative CT or MRI scan and builds no patient-specific bone model. QR-coded marker arrays are pinned to the femur, the tibia and the surgical instruments, and the camera on the surgeon's smart glasses tracks them while computer-vision software calculates their 3D coordinates in real time. Anatomical landmarks are acquired with a pointer to derive the patient's mechanical axis, and the femoral and tibial cutting guides are then navigated against it. The surgeon reads live alignment values in the glasses rather than turning to a separate navigation tower; a theatre monitor mirrors the same view, showing varus and flexion angles over the glasses' camera feed of the surgical field, with on-screen controls to step through the workflow. Pixee positions the system against computer-assisted and robotic platforms as compact and surgeon-controlled, adding no extra imaging, bulky capital equipment or invasive reference points.
The revision case was a UK first but not the start of the deployment. Mr Highcock has been using Pixee AR guidance at the hospital since 2023, and in November 2025 Spire Murrayfield Wirral marked its 50th augmented reality total knee replacement alongside its 100th Evolution medial-pivot knee alignment procedure. The hospital describes him as the only surgeon in the region offering medial-pivot AR-assisted knee replacement. MicroPort Orthopedics, whose Evolution implant system the hospital uses, distributed the Pixee headset in the UK.
