Ten orthopedic surgeons discuss the technology trends most intriguing for 2019 and beyond.
James T. Caillouette, MD. Hoag Memorial Hospital and Hoag Orthopedic Institute (Irvine, Calif.): I believe that we are on the cusp of developing regional pain management drugs and technologies that will dramatically alter the surgical experience. If we are able to create a sensory block that lasts four to six weeks, it will have vast implications for surgery that would significantly benefit the patients and lower the overall cost of care.
Robert LaPrade, MD. Orthopedic Surgeon (Colorado): I am most excited about technology that will allow us to perform surgeries more efficiently and anatomically. These technologies will ultimately lead to better patient outcomes and more reproducible results among all surgeons. Currently, one of the big dilemmas in my field of complex knee surgery is that many of the procedures that we perform require experience to be able to accomplish the surgeries efficiently, anatomically and successfully. Thus, the development of virtual reality programs to allow aspiring and practicing surgeons to ‘practice’ complex surgeries should enable surgeons to significantly cut down on their learning curves and lead to more efficient and successful surgeries. In addition, the encroachment of the field of robotics into the field of sports medicine may also allow for these surgeries to be more reproducible and successful.
Keith Berend, MD. Joint Implant Surgeons (New Albany, Ohio): I’m excited about the Zimmer Biomet MyMobility Apple Watch platform. Not only is the technology exciting, but the data being collected on more than 10,000 arthroplasty patients will provide predictive analytics that will try to change outcomes.
Shane Nho, MD. Midwest Orthopaedics at Rush (Chicago): There are interesting technologies that incorporate intraoperative image guidance for hip arthroscopy. Stryker sports medicine is introducing a tablet that can be used during surgery to measure the size and location of hip femoroacetabular impingement deformities. In addition, the software is able to assess in real time when the surgical correction has been completed. For surgeons performing hip arthroscopy, the technology will provide the intraoperative guidance that has been missing. I believe that this will allow us to be more accurate as well as more efficient in the operating room.
Adam Yanke, MD. Midwest Orthopaedics at Rush (Chicago): While many surgical treatments are improving, I am currently the most excited about biological augmentation of non-operative and surgical treatments. The technologies that we are employing most frequently are platelet rich plasma, amniotic product injections and bone marrow aspirate injections. These can be applied for non-operative treatment of arthritis and tendonitis or during surgery to improve outcomes of rotator cuff repairs, anterior cruciate ligament reconstruction and meniscus tears.
David Fisher, MD. OrthoIndy (Indianapolis): The technology I am most excited about in the future is in the orthobiologics arena where there may be some breakthroughs in new treatments for musculoskeletal conditions.
Platforms that more efficiently allow surgeons to follow and treat their patients are also exciting.
James Weisstein, MD. Colorado Center of Orthopaedic Excellence (Colorado Springs):Interoperability. In today’s world it’s a necessity for systems to communicate with one another. I know vendors and other membership organizations are working diligently on this, and I also know it’s not as easy to enable this as we’d like to think.
Edward Wang, MD. Stony Brook (N.Y.) Medicine: Ultrasound imaging and office-based arthroscopy, stem-cell treatments for rotator cuff healing and enzymatic treatment of frozen shoulder with collagenase enzyme.
Tom Stanley, MD. OrthoIllinois (Algonquin, Ill.): Stem cells for spinal fusion. The outcomes are more consistent without the complications associated with other biologics.
Scott D. Gillogly, MD. ASPETAR Orthopaedic and Sports Medicine Hospital (Doha, Qatar):Undoubtedly, artificial intelligence is the pervading technology that is only limited by imagination. Sometimes as orthopedic surgeons we only see the cool technology in front of us that greatly enhances surgical challenges such as robotics, 3D image guided hardware placement or slick meniscus repair systems. However, we are so busy we can temporarily miss the extensive data science scope of AI in the ‘softer’ areas of healthcare such as big data mining, integrated treatment protocols and outcomes databases as well as machine learning guided imaging reading, consultation second opinions and complication risk stratification.
These same compelling features of AI driven enhancements extend to administrative areas, population medicine, revenue cycle and supply chain optimization and so on. We are clearly at the tip of the iceberg with AI and so if we are to make an impact to enhance the value of the patient experience and outcomes, this is the future.
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