Five orthopedic surgeons connected with Becker's to discuss how surgeons 10 years from now will look back at how orthopedic procedures are performed today.
Ask Orthopedic Surgeons is a weekly series of questions posed to surgeons around the country about clinical, business and policy issues affecting orthopedic care. We invite all orthopedic surgeon and specialist responses.
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Note: Responses have been lightly edited for length and clarity.
Brett Auerbach, DO. Orthopedic Surgeon at Guthrie Medical Group (Sayre, Pa., and Big Flats, N.Y.): We will see the expansion of artificial intelligence, robotics, opioid sparing surgery and orthobiologics over the next 10 years. Some of the recent and emerging orthopedic procedures will be labeled as short term trends, while others will become mainstream and the standard of care. Emerging technology will continue to improve outcomes, quality and value for our patients.
Asheesh Bedi, MD. Director of Comprehensive Sports Medicine and Joint Preservation at NorthShore Orthopaedic & Spine Institute (Glenview, Lincolnshire and Skokie, Ill.): There is constant innovation and evolution in orthopedic surgery. We are fortunate to have new technologies that improve our ability to perform procedures with greater accuracy, efficiency, and in a minimally invasive manner. The synergy of this continued innovation with data-driven algorithms and artificial intelligence improves our decision-making at every phase of patient care, from diagnosis and surgery to recovery. This innovation will be the future. While the principles of restoring anatomy and function will remain timeless, I suspect in 10 years we will look back to our practices with some amazement at the absence of digital enabling tools of the future to guide evidence-based decision-making and clinical practice.
Thomas DeBerardino, MD. Sports Medicine Orthopaedic Surgeon at UT Health San Antonio: Orthopedic surgery is rapidly evolving in concert with technology advancements. In 10 years, the use of 3D-printed, single-use, patient-specific templates/implants used in orthopedic surgery will be limited to complex and difficult revision cases. The use of this advanced technology with routine cases will be shown to have no significant added value from patient, surgeon and payer perspectives.
Colin Haines, MD. Spine Surgeon at Virginia Spine Institute (Reston): Surgery seemingly advances day by day. The challenge for surgeons in keeping up with new innovations comes from two major challenges. First, there is a significant learning curve required to perform new procedures. There is no doubt the hurdle of teaching the metaphorical old dog a new trick. But a second and often more difficult leap comes not just from learning to do a new procedure but figuring out when the new procedure is most appropriate. For example, when joint arthroscopy was first invented, many well-meaning doctors didn't learn how to scope because it was new/hard and they didn't know if patients would do better. Now, one can argue that for most intra-articular conditions, arthroscopy is the standard of care. Since new physicians know it's better, they make the leap to learn arthroscopic surgical treatment.
Just like an arthroscopic meniscectomy is nearly universally viewed as the standard of care to treat an irreparable meniscal tear, I believe in 10 years both minimally invasive spine surgery, as well as motion preserving surgery, will be seen as the standard of care in spine surgery. We will look back at our [anterior cervical discectomy and fusions] and wish we had been doing more disc replacements. We will wish our open lumbar fusions were done with less invasive percutaneous incisions. In sum, we will realize more universally that minimizing muscle disruption and maintaining motion is better for patients.
Scott Sigman, MD. Founder and Chief Medical Officer of OrthoLazer Orthopedic Laser Centers (Chelmsford, Mass.): Ten years from now surgeons will look back at the two-dimensional screens used for arthroscopic visualization as antiquated relics. Surgery will be performed with three-dimensional visualization with augmented reality with a combination of artificial intelligence to guide anatomical landmarks and precise surgical placement of implants.