2023-2024 Challenges And Opportunities For Orthopedic Device Companies

Intro

Accuracy is key when it comes to orthopedic surgery. Even slight missteps, such as improperly placed implants or minor soft tissue damage, can require correction or prolong recovery, placing unwanted financial burdens on both patients and surgical centers. However, technological developments in fields such as artificial intelligence, robotics, and smart devices have revolutionized the orthopedic MedTech space, allowing people to overcome these hurdles. New devices that expedite the surgical planning process, improve the accuracy of surgery, and enable care providers to track recovery remotely have become increasingly commonplace, allowing a better orthopedic surgery experience for all to become a conceivable reality.

Surgical Planning

Minor flaws in the preoperative planning process can turn orthopedic surgery into more of an ordeal than it needs to be. If the chosen implant is incorrect or multiple possible implants are selected, the burden on clinicians to keep track of their implants and potentially perform corrective surgeries increases. Meanwhile, patients who fail to prepare for surgery adequately may face longer post-operative stays, and clinics may be ill-equipped to deal with rare complications or contingencies. However, medical software that aims to mitigate headaches on both sides is on the rise in the orthopedics industry, allowing for more efficient planning, better outcomes, and reduced financial burden on both parties.

Traditional methods for selecting implants can result in poor fits due to the finite number of shapes and sizes any commercial implant can have and the fact that 2D radiography grants a problematically limited view of the surgical area. 3D modeling software, which is becoming easier to access and more widely used in clinical practice, helps alleviate this. In fact, beyond providing a more extensive view of the patient’s bone structure, some 3D modeling software allows clinicians to design unique, customized implants and 3D print them, further diminishing the risk of an implant being ill-suited to a patient’s needs.¹ Of course, 3D modeling requires more computing power than 2D modeling, which can strain timelines and resources. To get around this, medical 3D modeling software is increasingly adopting AI to expedite the process of manufacturing implants based on radiographs, which can save enough time to make up for what was lost.²

Of course, preparing the implant itself is only half the battle; ensuring that patients are adequately prepared for their procedure is just as essential. All types of medical clinics have begun embracing software that connects patients to physicians, allowing for simplified communication and data transfer. In the realm of orthopedic surgery, this not only helps patients navigate the clinic, fill out forms, and obtain prescriptions, but it can also help physicians easily prescribe prehabilitation regimens. Adherence to prehabilitation, in which patients perform regular exercises before surgery to ensure a quicker recovery, can be difficult to enforce. Still, connecting to patients in their own homes and allowing them to exercise there makes it easy to minimize patients' time in post-operative hospital care.² Additionally, some academics have begun to explore the use of AI-based data analysis tools that use patient health records to determine the likelihood of complications, which may equip clinics to avoid prolonged hospital stays.³

Surgery

Developing appropriate implants and methodologies is one thing, but using them is another. Physicians are inevitably prone to error when performing sensitive, small-scale orthopedic operations remotely from across the OR, but introducing close-up cameras into the mix forces them to repeatedly look back and forth between the patient and a monitor, making for a trade-off that is not necessarily beneficial. These factors increase the likelihood of improper placement of implants or damage to the surrounding area, which only exacerbates the problem by requiring more procedures to correct the issue.⁴

This problem can be easily resolved using surgeon-controlled surgical robots, which have become more common in recent years. Because human limbs are more shaky and unpredictable than robotic limbs, robots are associated with lower rates of patient dissatisfaction due to the misplacement of implants. Using an augmented reality (AR)-based visualization system "gives orthopedic surgeons 'X-ray vision'"⁵ by layering patient radiographs over real-time footage of the actual surgery site. This technology allows surgeons to operate indirectly on patients with greater accuracy and less need to look away from the surgical site during an operation, resulting in “promising results” in 90.2% of cases in one study, compared to 56.1% without robots.² Meanwhile, smaller organizations like ambulatory care centers,  which have less space for storing large robots, can still benefit from using AR-based visualization systems, which are now accessible via mobile devices, and provide a massive step above the accuracy and simplicity of traditional surgical methods.²

Post-Surgical Monitoring

Traditional post-surgical monitoring, in which analog tools are used to assess physical aptitude and pain or side effects in a clinical setting, has a number of drawbacks. Regular back-and-forth travel and consistent self-reporting may be difficult for patients who are recovering from surgery. And physicians often fail to produce accurate measurements using analog tools, which tend to be overly expensive and labor-intensive.² Thankfully, we can alleviate these issues by adopting remote monitoring technology,  eliminating the need for such measuring tools while allowing patients to remain in the comfort of their homes.

In the context of orthopedic surgery, there are two basic categories of remote monitoring technology: mobile applications and wearables. The former allows patients to easily self-report their recovery progress using only their mobile devices. Range of motion, for example, can be measured by placing one’s device on the recovering joint and using a digital inclinometer to measure the angle. This simple procedure results in greater accuracy and reduces a previously onerous clinic visit to an easy at-home exercise. Secure instant messaging apps designed to help patients and physicians communicate also ease the reporting burden on post-surgery patients. After all, responding to a text is much easier than meeting someone face-to-face or even drafting an email. In fact, one study found that an SMS-based pain-reporting system saw a 96% response rate _ 1.5 times higher than a similar email-based reporting system.²

Wearables, meanwhile, can eliminate the need for patients to self-report by automatically transmitting a wealth of physiological data directly to care providers – one study estimates that prolonged use by a single patient could result in the transfer of “several million discrete data points”.³ This makes it easier for physicians to analyze patient data while also making it easier for patients to adhere to their treatment plans, as evidenced by a literature review which found that adherence rates are typically around 90% when patients use wearables to track recovery, compared to about 70% when they do not.² Of course, usage of this technology requires clinics to find a data management system capable of dealing with these high volumes of data securely and effectively. Recent advancements in AI may be able to address this, as studies of AI-based information management systems have found that they can classify and retrieve information with an average of 95% accuracy.³

Conclusion

While the effectiveness of orthopedic surgery is often complicated by human fallibility and limited technology, new technological developments allow orthopedic surgeons to circumvent these issues and bring newfound accuracy and efficiency to their practice. Existing procedures like analyzing radiographs and performing operations can be expedited by modern medical technology, allowing clinics to preserve resources and enhance the effectiveness of treatment. Meanwhile, new solutions such as 3D printed, custom-made implants and predictive AI give orthopedic surgery clinics even more room to grow. While many of these technologies are still relatively nascent, they are all supported by a large body of studies with overwhelmingly positive outcomes, and it is clear that embracing modernization in orthopedics benefits patients, clinics, and manufacturers alike.

Orthopedic manufacturers need not leap into modernized surgery alone. From empowering your sales force to sell orthopedic equipment to providing sales reporting and analytics or managing the vast amount of data collected by the latest devices, Axtria is dedicated to helping MedTechs succeed. Axtria’s leadership in omnichannel, commercial operations, and data management, along with our industry-leading cloud-based applications, will set up your organization to succeed in a competitive, ever-evolving industry.

References

1. O’Rourke M. Shaping surgical innovation and the future of orthopaedics. Yale School of Medicine. March 10, 2021. [Accessed August 10, 2023]. https://medicine.yale.edu/news-article/shaping-surgical-innovation-and-the-future-of-orthopaedics/
2. Shah NV, Gold R, Dar Q-A, Diebo BG, Paulino CB, Naziri Q. Smart technology and orthopaedic surgery: current concepts regarding the impact of smartphones and wearable technology on our patients and practice. Current Reviews in Musculoskeletal Medicine. November 3, 2021;14(6):378–91. doi:10.1007/s12178-021-09723-6
3. Kurmis AP, Ianunzio JR. Artificial intelligence in orthopedic surgery: evolution, current state and future directions. Arthroplasty. March 2, 2022;4(1). doi:10.1186/s42836-022-00112-z
4. NYU Langone Hospitals. Robotic orthopedic surgery. [Accessed August 10, 2023]. https://nyulangone.org/care-services/orthopedic-surgery/adult-reconstructive-surgery/robotic-orthopedic-surgery
5. Shanahan D. The top 3 orthopedic technologies to transform your practice. exer.ai. October 18, 2022. [Accessed August 10, 2023]. https://www.exer.ai/posts/top-orthopedic-technologies