Bryan Edwards, MD, senior vice president of Winston-Salem, N.C.-based Novant Health Orthopedics & Sports Medicine, and David Homesley, MD, chief of total joint replacement at Novant Health, discuss the big trends and opportunities for artificial intelligence and robotics in orthopedics today.
Question: What role does artificial intelligence play in orthopedic surgery quality and outcomes today?
Dr. Bryan Edwards: Artificial intelligence is being adopted more by the orthopedic surgery community; a promising trend that can help healthcare systems better deliver value-based care. As we move more toward this model of care, we not only need robust data collection systems, but tools that can interpret this data effectively. That's where AI steps in. Our CEO, Carl Armato, and CMO, Eric Eskioglu, MD, have a vision to become leaders in AI by adopting its use into our daily clinical work. To this end, we are partnering with multiple organizations such as Microsoft and Google in order to help make healthcare data actionable and then to build care and optimization pathways to modify or remove risk factors. This will, in turn, help us increase the safety and quality of care while helping to lower costs as well as physician burnout.
Q: What is the potential for AI in orthopedics?
BE: We are already using AI to identify the risk factors for poor outcomes after hip and knee replacement. We have established preoperative selection criteria based on body mass index, hemoglobin levels, diabetes control, nutrition and smoking status. If the patient does not meet the criteria, the total joint navigator routes the patient into our preoperative optimization clinic. In this clinic, we can work with the patient on weight loss, better blood sugar control and smoking cessation. Our readmission rates for total joint replacements are well below national averages, in part due to this program.
Q: How do other technologies like robotics improve orthopedic surgeries, including total joint replacements?
Dr. David Homesley: Robotics can improve the accuracy of the procedure and give the surgeon instantaneous feedback during the surgery with various measurements. When doing a knee replacement, we are trying to balance the flexion and extension gaps. This is based on tension across the medial and lateral collateral ligaments. Robotic surgery allows for measurements in actual numbers that the surgeon can use to help balance the knee.
Q: Do you see robotic technology becoming more ubiquitous for orthopedics in the future?
DH: There still needs to be long-term studies for comparing robotic surgery with our current methods, but the early data are promising. The early data shows more consistent alignment and bone cuts among all patients. Hopefully, this will allow for better balanced knees and even better durability of the implants.
Q: What should we expect from future iterations of robotic technology to continue improving outcomes for orthopedic patients?
DH: The preparation for the robotic surgery will continue to improve, from obtaining preoperative studies to intraoperative efficiency, so that the patient will continue to experience improved outcomes.
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