AI, data & financing: How joint replacements using robots will improve in 10 years


From easier affordability to more advanced technology, joint replacements involving surgical robots will improve dramatically over the next decade, these four surgeons predict.

Ask Orthopedic Surgeons is a weekly series of questions posed to orthopedic surgeons around the country about clinical, business and policy issues affecting orthopedic care. We invite all orthopedic surgeon and specialist responses.

Next week's question: What will orthopedic surgery look like 10 years from now?

Please send responses to Carly Behm at by 5 p.m. CDT Tuesday, Sept. 7.

Note: Responses were edited for style.

Question: How will joint replacement surgical robots improve in the next 10 years?

Jonathan Dattilo, MD. Coastal Orthopedics (Brandenton, Fla.): One aspect of robotic technology that I would like to see evolve, which is particularly relevant in the ASC setting, is the financial viability. Assuming the robot can be obtained by promotional means or alternative financial model, the disposable costs per case can still present significant barriers. At several hundred dollars per case which is not generally reimbursable by insurance carriers, my hope would be that these companies allow for an amended robotic CPT code as this becomes more mainstream to allow physicians to utilize this technology where they feel appropriate. Alternatively, the center can choose to absorb that loss or pass the cost onto the patient. The former situation could be quite costly, potentially on the order of hundreds of thousands of dollars per year depending on the center’s arthroplasty volume. The latter situation creates a somewhat distasteful financial choice for the patient and degrades the physician-patient relationship, as one can imagine a patient who may not be able to afford an additional co-pay now perceive that they will receive an inferior surgical outcome. Hopefully in the coming years we can reconcile these barriers with our continuous efforts to provide the best patient care possible as more patients choose to pursue outpatient joint replacement.

Jeffrey Hodrick, MD. Southern Joint Replacement Institute (Nashville, Tenn.): I believe surgical robots in joint replacement will continue to improve in the next 10 years as we better understand the target and are able to use the data collected during the surgery to refine the technique.

Robotics will allow surgeons to further standardize the procedure by eliminating or minimizing two large variables in the room: the human hands holding the saw blade or reamer and providing reliable data to surgeons data to optimize decision-making. As our experience evolves, the technology, techniques, and hopefully the outcomes, will continue to get better.
Harnessing the power of the data collected and marrying it with post operative outcomes will be challenging, but if accomplished, will provide an opportunity to improve an already successful procedure.

John Woodward Jr., MD. OrthoONE at Swedish Medical Center (Englewood, Colo.): I believe that with artificial intelligence robots will continue to improve in regards to the accuracy and precision of bone cuts. They will also become more user- friendly and cost- effective.

Jason Snibbe, MD. Snibbe Orthopedics (Los Angeles): I think robotic surgery will improve with automation. We will be able to cut less muscle and tissue and still provide accurate operations. The design of the implants will change because we will prepare bone in different ways with unique instruments.

I think artificial intelligence will provide information about the outcomes of every decision we make during surgery. We will have instant information about how we change alignment and how it will affect the patient in movement and function.

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