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Innovative Technologies in Orthopedic Surgery

Autumn Years reports on innovative technologies in orthopedic surgery featuring HSS spine surgeons James E. Dowdell III, MD,  Gbolabo Sokunbi, MD, and Frank P. Cammisa Jr., MD,  hip and knee surgeons Jonathan M. Vigdorchik, MD, Peter K. Sculco, MD, knee surgeon Fred David Cushner, MD.

In the field of medicine, technological advances lead to new and better treatments, more personalized care, increased efficiency and improvements in safety. Such innovations have been a boon to orthopedic surgery, as engineers, scientists and inventors design systems to improve accuracy and safety in the operating room. As technologies evolve and studies demonstrate the benefits, increasing numbers of orthopedic surgeons are using robotics, computer navigation, augmented reality and smart sensors to improve patient care.

According to Dr. Dowdell, in spine surgery, surgical robots, advanced imaging technology and computer-assisted navigation provide enhanced precision, accuracy and predictability. “The system enables the surgeon to make very small incisions that preserve muscles and other structures surrounding the spine, so patients generally experience less pain after surgery, a shorter hospital stay and a quicker return to activities compared to traditional open surgery.” 

The technologies are especially useful for more challenging cases—patients whose anatomy differs from the norm— according to Dr. Sokunbi. He advised anyone considering spine surgery to carefully check the physician’s credentials and choose a hospital in which a high number of spine surgeries are performed. He noted that a good rapport with the treating physician, good communication and trust are also essential.

Dr. Vigdorchik performed the first knee replacement using augmented reality (AR) in the US in 2020, stating “It’s like a car that has the speedometer projected on the windshield, so you don’t have to look down when you’re driving.” Taking the car analogy one step further, he compared the AR knee replacement platform to GPS. “Everyone knows how to drive home, but you use GPS technology to find the best and most efficient route to take. Dr. Vigdorchik added that the augmented reality platform allows for an ultraprecise surgery.

HSS spine surgeons have also begun to use augmented reality technology. The spine system consists of a headset and the elements of a traditional computer navigation system. During surgery, it accurately determines the position of surgical instruments in real time and superimposes them on the patient’s CT scan. “The technology allows us to visualize the patient’s 3D spinal anatomy during surgery to accurately guide instruments and place surgical implants, such as pedicle screws, while looking directly at the patient rather than at a separate computer screen,” explained Dr. Cammisa “Improved control and visualization of the patient’s anatomy and critical structures can lead to a more precise, efficient surgery and can enhance safety.”

An innovation in the growing field of remote patient monitoring, it was the first implantable device approved to collect data on an individual’s progress after a knee replacement. Although the technology does not preclude office visits altogether, it enables the doctor to actively monitor a patient’s recovery with real-world, objective data to supplement his or her care. and recovery. Remote monitoring can be especially useful during the early post-operative period, said Dr. Sculco, who performed the first procedure at HSS. “In the first several weeks following knee replacement, hard work is required from the patient. The earlier you identify a patient who may not be progressing as well as you would like, the sooner you can intervene,” he explained.

Read the full article at autumnyearsmag.com.