Hoag's joint replacement chief on the future of orthopedic robots

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Irvine, Calif.-based Hoag Orthopedic Institute has grown its robotic arsenal in 2022, installing its fourth system in August.

Nader Nassif, MD, HOI's division chief of joint replacement, told Becker's about his outlook for robots in orthopedics.

Note: Responses were edited for clarity.

Question: What considerations do you weigh when deciding to try new surgical technology?

Dr. Nader Nassif: I think the biggest considerations when deciding on any new technology is value. We need to consider how this is going to make a real impact in the outcome of a patient's procedure versus the cost, including capital purchase, additional operating room time, disposables. There are some really "cool" technologies out there right now that are just fancy gadgets and provide no improvement in patient care. Those technologies cost the healthcare system. 

Q: What aspects of orthopedic robots need more development?

NN: Robots continue to improve in the way they are being implemented both in the tools used as well as the software. Improved efficiency of the tools as well as improved robotic intelligence will be important in the next generation of robotically assisted tools. 

Q: How do you think orthopedic robots will change in the next five years?

NN: In the next five years, I believe that the data currently being gathered by robots will be able to be fed back into the systems for improved decision support to the surgeons.

Q: What advice do you have for students and early-career surgeons who want to use robots without becoming over reliant on the tech?

NN: Robots do not make surgeons better, but robots can help good surgeons execute plans they have otherwise been unable to do with traditional analogue instruments. For early-career surgeons it is paramount that they learn to operate without the assistance of technology first to hone their skill, perfect basic principles. In real life, surgeons may not necessarily have a robot for every case. What if the robot is not functioning? Surgeons cannot be entirely reliant on technology. 

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