The technologies that can change orthopedics


Artificial intelligence isn't the only technology taking orthopedics by storm.

Six orthopedic surgeons connected with Becker's to answer, "What technologies do you believe have the potential to change orthopedics?"

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.

Next question: What is the biggest threat to healthcare?

Please send responses to Riz Hatton at by 5 p.m. CST Thursday, March 21.

Note: These responses have been lightly edited for length and clarity.

Nitin Bhatia, MD. Orthopedic Surgeon at UCI Health (Orange, Calif.): Orthopedics is an incredibly exciting field not only because we get to help people, but also because our field is ever-changing. The incorporation of technology into orthopedics has been the backbone of orthopedic developments in the 21st century. As we look to the future, numerous technologies have the potential to change orthopedics. Regenerative medicine, for example, consists of varying areas of study all focused on repairing and restoring the body's normal function after deterioration due to injury or time. This field is still in its infancy, but there is incredible potential to not just correct, but stop, the pathologic process. Artificial intelligence is an exciting technology which has recently received many headlines due to rapid recent advancements. AI may eventually be incorporated into numerous aspects of orthopedic surgery, including the evaluation of imaging studies, making electronic medical records more efficient and accurate, identifying which patients have the best outcomes with surgery, and what surgeries are the most reliable. The ability to rapidly process large amounts of information makes AI a powerful tool, but it, as with all technologies, will only be as good as the physician behind the machine. 

Hafiz Kassam, MD. Shoulder and Elbow Surgeon at Hoag Orthopedic Institute (Irvine, Calif.): Robotics and enhanced reality are two technologies poised to revolutionize both orthopedic patient care and surgeon education. In surgery, robotic systems offer unprecedented precision and control, allowing for more accurate implant placement and enhanced outcomes. This technology also enables minimally invasive techniques, likely reducing patient trauma, post-operative pain, and recovery times. Enhanced reality, on the other hand, provides surgeons with immersive visualizations and real-time feedback during procedures. Surgeons can overlay digital information onto the patient's anatomy, facilitating better decision-making and improving accuracy.

These technologies also offer huge potential in how we train the next generation of orthopedic surgeons. Enhanced reality technologies can bring complex orthopedic concepts to life, allowing learners to visualize anatomical structures in 3D and understand surgical procedures in an interactive and controlled environment before operating on actual patients. Virtual reality simulations can also provide a platform for practicing surgical techniques and decision-making skills, enhancing proficiency and confidence among trainees. We can also use these technologies to bridge resource gaps and bring first class education to under-resourced areas, enhancing global access to high-quality orthopedic care that may not be historically available.

Earl Kilbride, MD. Orthopedic Surgeon at Austin (Texas) Orthopedic Institute: I sense big data will continue to change orthopedics. This combined with AI loaded into a specific algorithm gives specific answers to clinical questions. One of the implant companies currently inputs data into its algorithms, which then gives very unique answers in terms of patient outcomes. It predicts how well or how poorly a patient will do. This and similar technologies will continue to improve and, hopefully, ultimately improve patient outcomes. 

Philip Louie, MD. Spine Surgeon at Virginia Mason Franciscan Health (Tacoma, Wash.): The goal of these innovations is to improve the way we care for patients and, ultimately, drive meaningful change in how we practice. The industry has been making significant progress toward the development of many game-changing enabling technologies.

1. The "all-in-one" platform (ecosystem) — combining important features, including: pre-op planning tools, augmented reality, surgical robot/navigation, and collection of postoperative outcomes. Can these tools help guide us through the whole perioperative episode and provide us with crucial data on our planning and results?

2. Mixed reality platforms in which surgeons can interact with the digital environment. The ability to instantly review data/imaging and convey critical information to the entire operating room team on-demand will add another layer of safety and reproducibility in operations. These platforms can also be utilized to train staff and other medical providers.

3. 3D (depth-perception enabled) cameras that provide visualization of all procedures through small working corridors (at varying depths of placement) in which the surgeon is able to perform the entire surgery without the constant struggle of placing our bodies in ergonomically-compromised positions. Despite the evolution of surgical techniques, especially in the field of minimally invasive methods, orthopedic surgeons continue to remain at high risk for injury due to suboptimal standing/working conditions, often while trying to obtain optimal visualization through limited working corridors while executing repeated technical maneuvers through smaller soft-tissue windows.

John Shin, MD. Orthopedic Spinal Surgeon at RWJBarnabas Health Medical Group (Livingston, N.J.): One technology that's relatively novel in spine surgery, which I've discussed previously, is unilateral biportal endoscopic spine surgery. This novel approach offers adult patients suffering from degenerative spinal conditions an ultra-minimally invasive option, allowing for faster recovery, reduced blood loss, lower infection risk, and preservation of native soft tissues compared to traditional open spine surgery.

Anand Srinivasan, MD. Director of Anterior Hip Replacement Program at Endeavor Health Orthopaedic & Spine Institute (Gurnee, Glenview and Lincolnshire, Ill.): Two emerging technologies that have the potential to change orthopedics are ambient documentation in the outpatient setting and the use of augmented reality in the surgical setting. We are already seeing the use of devices in the operating room, and implant companies in joint replacement are creating augmented reality platforms to assist the surgeon during operative cases. Additionally, with labor costs increasing and inflation ever-present, ambient documentation that uses AI to synthesize a patient encounter may provide an alternative to a scribe or physician assistant for outpatient documentation. As such, a practice can then devote its valuable resources toward other clinical and functional tasks.

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