Taking robotics to the next level of precision orthopedics: Q&A with HOPCo's Dr. Marc Jacofsky


Marc Jacofsky, PhD, chief scientific officer of HOPCo, which manages The CORE Institute, plays an integral role in the organization's efforts to advance musculoskeletal research and treatment.

He is also a founding member of MORE Foundation, the charitable organization associated with Phoenix-based The CORE Institute. Here he describes how robotics will play an important role in orthopedics going forward and what MORE Foundation is doing to contribute.

Question: What is the mission and focus of MORE Foundation?

Dr. Marc Jacofsky: The mission of MORE Foundation is to Keep Life in Motion through innovative research, community education and charitable assistance programs in the field of musculoskeletal health. MORE Foundation conducts over a dozen clinical trials per year and houses two state of the art laboratories dedicated to biomechanics and human movement analysis. As an accredited CME provider, MORE Foundation is continually helping to define the standard of care through its nationally recognized educational events which draw prominent faculty and attendees from across the country. Our charitable assistance programs ensure access to musculoskeletal care for military veterans and children with upper limb differences.

Q: How do you see robotics and technology evolving in orthopedics today?

MJ: Robotics have introduced a new level of precision to orthopedic surgery. From surgical planning using advanced imaging techniques to the ability to execute the surgical plan without deviation, robots and associated software allow the surgeon to be incredibly precise. We are now at a point where the ability of the surgeon-robot team to execute a surgical plan has exceeded our ability to generate evidence-based patient-specific surgical plans that will optimize the biomechanics and outcomes of individual patients. The robots are capable of performing critical surgical steps with high precision, but what should we be programming the robot to do? The future of robotics will rely on improved patient centered programming strategies and a lot more research is needed in this area.

Q: What research are you most excited about?

MJ: I am most excited about the robotic simulation research platforms. While robots clearly have an established role in patient care, they also have a lot to offer in answering unknown questions that remain around optimizing the programming of surgical robots. We have built both upper and lower extremity robotic simulators that can test new paradigms and provide new insights into surgical planning. Our simulators can tension the tendons in a cadaver limb and see how the limb moves in response to this 'muscle input.' By doing this with multiple muscles simultaneously we can recreate human-like motion in a robotic simulation, much the way a puppeteer controls a marionette – only we accomplish this under precise computer control systems that we have developed in-house. Having our Human Motion Lab right next door allows us to quickly validate our simulations with patients and volunteers.

Q: What impact do you hope to make on the field of orthopedics in the future?

MJ: MORE Foundation looks forward to advancing the ability for surgeons to provide patient specific care through optimized biomechanical algorithms which result from our research. This will allow the orthopedic community to take full advantage of the precision offered by the robotic tools at their disposal. Of course, as we discover we feel it is our duty to educate, to disseminate new found knowledge and advance the standard of musculoskeletal care across the global orthopedic community.

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