Robotics in arthroscopic procedures, the role of post-op infections in patient recovery and the etiologies of pain are a few aspects of orthopedics that can sometimes be missed.
These three surgeons and orthopedic leaders recently connected with Becker’s to share what they think the industry is not paying enough attention to.
Note: Responses were lightly edited for clarity and length.
Question: What is something in orthopedics that you believe is currently being overlooked by the industry?
Michael Gross, MD. Orthopedic Director of Union Middlesex Orthopedics (Woodbridge, N.J.): One aspect of orthopedics that I believe is currently being overlooked by the industry is the integration of robotic guidance for arthroscopic procedures. Tremendous advancements have been made in robot assisted surgery for joint replacement, but I am unaware of any current robot assisted technology available for complex arthroscopic procedures of the shoulder and knee. At the very least, personalized guides for tunnel placement in ACL surgery and anchor placement for rotator cuff surgery would be interesting areas to explore.
In addition, the use of advanced technology and AI to develop plans for personalized patient care is another area to consider. With the rapid advancements in AI, machine learning and 3D printing, there is a tremendous opportunity to tailor treatments to individual patients more effectively. However, the industry seems to be lagging in fully embracing these innovations and incorporating them into standard practices.
Sean McMillan, DO. Chief of Orthopedics and Director of Orthopedic Sports Medicine of Virtua Willingboro (N.J.) Hospital: One of the larger gaps overlooked by the industry currently in orthopedic sports medicine is the role of indolent infections and postoperative inflammation in the spectrum of healing.
We spent an extensive amount of time creating new anchors and biologic solutions, however, the role of indolent infections is not very well understood, and in my opinion may lead to some critical failures and soft tissue repairs. A focus in the future on creating antibacterial implants and sutures may shift the paradigm of postoperative stiffness pain and failures.
Emeka Nwodim, MD. Orthopedic spine surgeon and managing partner of Centers for Advanced Orthopaedics, Bay Area Orthopaedics & Sports Medicine Division (Hanover, Md.): One topic that I believe is frequently overlooked in orthopedic surgery, particularly spine surgery, is the variety of etiologies of pain including central sensitization, the multimodal management of pain and also understanding non-structural pain. Oftentimes patients misunderstand these concepts and we surgeons are innately inclined to remedy pain by operating; however, this can lead to misunderstanding, frustration and poor outcomes, none of which are desired by patients or surgeons.
