Exponential Technologies and Orthopedics: Why a Collaborative Approach is Needed

Orthopedists aim to bring relief for those experiencing pain in their joints and ligaments. And with new technologies developing every day, it’s no surprise that it is getting easier for orthopedists and orthopedic surgeons to recommend practical and personalized solutions.

As these technologies continue to evolve, we as practitioners and surgeons need to be able to properly recommend to our patients the right treatments, modalities, and surgical options.

Therefore, while exponential technologies (ET) are developing, a level of input is needed by those in the field to make this right.

Current Technologies Available in the Orthopedic Discipline

Many of the current surgical technologies that orthopedic surgeons use today were once considered to be exponential technology(opens in a new tab). Things like ACL reconstruction surgery to joint replacement, surgeries which are now very common, were developed with the help of robotic engineering and computer technology.

Here are some of the current technologies that orthopedists use daily, which were once considered exponential technologies:

Computer-assisted Technology

Much of the work that orthopedic surgeons do today requires the use of computer technology to assist surgeries. These technologies provide additional comfort to the patient during and after the procedure, but they also secure more long-term success for the patient’s recovery and functionality. Additionally, computer-assisted technologies improve the surgery process by speeding things up and providing more accurate measurements.

Several common computer-assisted technologies in orthopedics use 3D and image mapping to see what’s going on inside the body.

Volumetric imaging (VI), for example, is extremely common even outside of orthopedics. As a physician or surgeon, you interact with VI through CT scans and magnetic resonance imaging (MRI). The VI displays a 3D visual representation of an image as opposed to a planar image, so we can view a joint on three axes and view internal contours in greater detail.

Fluoroscopic techniques are used regularly in replacement surgeries as physicians are able to inject a joint with fluid and view the joint structure and movement more clearly through an X-ray image on a monitor. Without the use of fluoroscopic imaging, we would be opening up our patients more often, subjecting them to higher health risks, and providing recommendations that may not be altogether accurate.

The Kinematic Assessment Tool, or KAT, is also another form of computer-assistant technology that provides an assessment based on 3D positional data, capturing the subject through a motion capture system.

Why Collaboration is Needed When Developing Exponential Technologies for Orthopedics

While seemingly commonplace now, the technologies listed above used to be like something straight out of a science fiction novel. But now we see these types of tools used in diagnostics, joint replacement surgery, spinal surgeries, and fracture repairs.

Of course, this list is missing so many computer-assisted orthopedic surgery (CAOS)(opens in a new tab) that we have come to rely on as orthopedic surgeons.

From arthroscopy(opens in a new tab) to absorptiometry, as well as ultrasonography, we use computer-assisted technologies to improve our patient’s well-being every day. And we continue to improve upon these technologies(opens in a new tab) through clinical practice and testing, research, and patience reassessment.

What I find most interesting about the growth of the ETs in orthopedic surgery is the range in which our evolution is possible. It was only a few decades ago that we could only see a 2D plane inside the body.

As surgeons we are on the front line, so what we do in our surgeries dictates our research and the direction of the field. Collaboration not only with those who are more heavily invested in surgery rather than research, and vice versa, makes intuitive sense as we become able to explore the technological capabilities in a beta testing environment.

Not only is collaboration needed within our field, but it is also imperative that we explore the realm of possibilities from outside of orthopedic research and sports medicine technologies.

Disciplines like engineering show us that the future of robotics can very well assist in actual surgeries now. Robotics were approved and tested for use as semi-autonomous robot-surgeons as early as 1985 when the first robotic surgeon was used by Kwoh et al(opens in a new tab).

ROBODOC was another project based out of Sacramento, California that was a U.S. Food and Drug Administration (FDA) approved robotic for the use of performing surgery on humans.

Areas for Exponential Technological Growth in Orthopedics

As we begin to consider what is possible for technology and surgery in orthopedics, I realize that what is first needed is an assessment of the possible future growth potentials.

Scholars Zheng and Nolte (2015) suggest that a new wave of mobile imaging systems(opens in a new tab) is coming soon, and they encourage a focus on alternative tracking technologies that would rectify some of the drawbacks that limit the current optical tracking and magnetic devices. These improvements would make these technologies less invasive and improve upon their use beyond kinematic control during surgery.

Other scholars (Zhang et al., 2007) foresee that virtual reality (VR)(opens in a new tab) could be useful as a promising pedagogical tool for surgical training, operative planning, surgery rehearsal and telesurgery, which would also take advantage of the usefulness of the robot-assisted orthopedic surgery system (HIT-RAOS).

Robot-assisted and hybrid CAOS are a definite possibility in the future and they could improve upon the accuracy and speed of orthopedic surgeons.

Exponential Technologies and Orthopedics

With exponential technologies rapidly advancing, and the eagerness of orthopedics to bring in new imaging technologies and assistive tech, we should expect to see dramatic growth in surgical assistance, robotic assistant, and in pedagogical technologies.

A collaborative approach is required when developing these ETs as, without our input, the technologies stand to be intrusive or inaccurate. Past ETs, that have now become commonplace, could only have succeeded with input based on the knowledge and training of orthopedists applied alongside the engineering insights and innovations that made their creation possible in the first place.

Resources:

Adili, A. (2004, June). Robot-assisted orthopedic surgery. In Seminars in laparoscopic surgery (Vol. 11, No. 2, pp. 89-98). Sage CA: Thousand Oaks, CA: Sage Publications. Retrieved Aug 7, 2020, from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.959.7271&rep=rep1&type=pdf(opens in a new tab)

Lanfranco, A. R., Castellanos, A. E., Desai, J. P., & Meyers, W. C. (2004). Robotic surgery: a current perspective. Annals of surgery, 239(1), 14. Retrieved Aug 11, 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1356187/(opens in a new tab)

Langlotz, F., & Nolte, L. P. (2004). Technical approaches to computer-assisted orthopedic surgery. European Journal of Trauma, 30(1), 1-11. Retrieved Aug 7, 2020, from https://boris.unibe.ch/117916/1/068_2004_Article_1374.pdf(opens in a new tab)

Zhang, F., Du, Z., Sun, L., & Jia, Z. (2007, December). A new novel virtual simulation system for robot-assisted orthopedic surgery. In 2007 IEEE International Conference on Robotics and Biomimetics (ROBIO) (pp. 366-370). IEEE. Retrieved Aug 7, 2020, from https://ieeexplore.ieee.org/abstract/document/4522189(opens in a new tab)

Zheng, G., & Nolte, L. P. (2015). Computer-assisted orthopedic surgery: current state and future perspective. Frontiers in surgery, 2, 66. Retrieved Aug 7, 2020, from https://www.frontiersin.org/articles/10.3389/fsurg.2015.00066/full(opens in a new tab)