How orthopedic technologies, outpatient care will push the specialty forward

Technologies focused on efficiencies will play a major role in the future of orthopedics, Matthew Harb, MD, said.

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Dr. Harb, of The Centers for Advanced Orthopaedics in Washington, D.C., spoke with Becker’s about the innovations pushing orthopedics forward and how he uses social media to strengthen patient relationships.

Note: This conversation was lightly edited for clarity.

Question: What innovations have intrigued you in orthopedics?

Dr. Matthew Harb: The biggest things have been innovations to improve efficiencies. There’s been a very large transition to the outpatient surgical center, and I probably do about 80% of my joint replacements at ASCs. There are also innovations in patient education, such as digital formats or patient-specific handouts. Additionally, the use of short-acting anesthetic agents like lidocaine has improved efficiency, allowing patients to get up and walk within 30 to 45 minutes after surgery. We’re using techniques to perform more minimally invasive surgeries so there’s not as much soft tissue disruption, which leads to quicker recoveries. There have also been innovations in technology, including robotics, various computer software, and overlays. They use some form of artificial intelligence to assist with component positioning, alignment, and limb length measurements. These are all in the newer realm of innovation that will likely become more widely adopted in the future. 

Q: How are you using AI in your practice? Will there be any nonnegotiable uses for orthopedic surgeons and AI?

MH: Things in medicine always move very slow. The reason for that is for anything that’s new, we have to make sure that patient safety is of the utmost importance. The ways that I would see AI most quickly being implemented would be on the documentation side of things in order to more quickly and efficiently document patients, notes, medications, history, physical examinations and help to generate tailored treatment plans. In orthopedics a lot of our treatment plans across different conditions are very similar, but with slight modifications or adjustments. That would be an early adoption, even prior to the big AI craze. 

Computer software as far as templating and determining positioning of implants and leg lengths was already starting to be implemented. That’s something we’ve been using for a while that falls under the realm of AI as it is a computer software that helps you to achieve a good outcome. But AI will mostly be used as a tool to assist surgeons and physicians in improving patient care.

From an outside perspective, I see patients who have used AI tools in their daily lives to better understand their diagnosis and arrive with some idea of their musculoskeletal issue, which is actually helpful in formulating a treatment plan

Q: Total joints have really led the charge in the outpatient setting for orthopedics. Will we ever see a day where practically all TJRs are done same-day?

MH: I think that will be the case. There are some patients who no matter how good we are at the operation will have to be monitored in a hospital setting. That includes very sick patients or patients who need very large revision surgeries where there may be risks for blood transfusion or needing some type of cardiac monitoring. 

I would say the procedure itself at this point for the general primary joint replacement has become very safe. I can’t recall the last time I had to give a patient a blood transfusion following a joint replacement because we use certain medications to minimize blood loss Surgical technique is very noninvasive, and that all led to the push to the ambulatory surgery center. The other advantage is it’s a much lower cost on the health system. The cost of doing a joint at an ASC is almost four to five times less expensive than doing it in a hospital setting. Insurers have noticed that, and they’ve also begun to cover these procedures more in these types of facilities. 

Q: You’re a prominent figure on social media with more than 52,000 Instagram followers and more than 508,000 TikTok followers. How has your social media work supported your day-to-day duties?

MH: The platforms I have had the most success with are YouTube, TikTok and Instagram A lot of that has to do with the algorithms and how they get your content to your specific audience that you’re looking for. 

My main goal with social media was to provide another outlet for patient education. There haven’t been many studies on this, but I feel that patients who come in who have some form of education about their condition, whether that’s through social media, or through doing their own research through Google are already geared for having a better outcome as you treat them through these conditions. 

I think it will continue to be an excellent avenue for dispersing patient information, and I think that can really be utilized to improve the overall healthcare landscape. And for some patients who have watched one of my videos ahead of time, it helps to create a more interpersonal relationship. When they come into the office, they may feel like they already know me if they’ve watched one of my videos. It’s hard to say which platform will be the best. There’s a lot of push between most of the companies, and how that landscape will exist. But for me, personally, those have been my main avenues, because I feel I can most strongly reach my desired audience.

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