- The longer the surgery, the greater the risk of post-surgical complications for patients.
- Since most THAs and TKAs are elective procedures, better pre-operative planning can help improve patient outcomes.
Surgical Time Affects Post-Surgical Complications
According to a study by the University of Chicago, patients who undergo THA or TKA surgery longer than 87 minutes are at a higher risk of wound complications. Longer surgical times also increase the risk of sepsis. And a review of over 200,000 TKAs performed in the United States showed that the operative time was strongly related to patient Length of Stay (LOS). LOS is a significant factor affecting patient outcomes. And though rare after total joint surgery in the United States, longer surgical times are associated with sepsis - a severe complication that can elevate a patient’s mortality rate.
Effective Pre-operative Planning Can Help Lower Operative Times
Pre-operative planning is one of the most crucial steps for surgery. For elective surgeries like most total joint replacements, better pre-operative planning can help shorten operative times and patient LOS.
In Orthopedics, there are new advancements in technology designed to help orthopedic surgeons plan their cases more accurately, improve intra-operative precision, and contain overall costs. However, some of these technologies may add time to the pre-operative planning process, which adds an administrative burden on surgeons and the healthcare system.
Here is how critical steps in pre-operative planning can be streamlined and bring greater value to the surgical process and, ultimately, patient care:
1. Patient Pre-Surgery Evaluation
The first step for orthopedic surgery begins with reviewing a patient’s medical history, test results, and medical imaging scans to make sure they are eligible for the surgery. This process involves many moving parts and is a collaborative process between surgical teams, labs, imaging departments, and more.
Often, surgeons make important notes to help them plan for their cases better. Additionally, once a patient is approved for surgery, surgical teams must share relevant information with medical device companies to identify the right implant for the patient.
A single collaborative platform for pre-operative planning can help surgeons and medical device companies reduce redundancies and the risk of errors. In addition, surgeons can effortlessly share their thoughts and preferences with their surgical teams, anesthesiologists, other relevant OR and hospital staff, and medical device companies.
2. Templating and Implant Selection
The templating process of sizing and identifying the right implant for a patient has changed significantly with advancements in medical imaging and digital templating, patient-specific instrumentation, and 3D-printed implants.
Patient-specific instrumentation and 3D-printed implants help surgeons:
- find the best-fit implants for each patient.
- Improve accuracy in bone cuts and implant placement in surgery – all factors that enhance patient outcomes.
- Gain efficiencies in the OR by minimizing the number of implant and instrument kits needed for each case.
- Significantly reduce overall costs related to instrument and implant kitting, sterilization, and logistics.
However, while these technologies bring greater intra-operative efficiency and accuracy, they can add inefficiencies to the pre-operative planning process when:
- Medical device companies need more time on their end per case to manually digitize and recreate a patient’s anatomical structure, size implants, and design instruments.
- There are more back-and-forth discussions between surgical teams and medical device companies regarding implant and surgical guide design iterations before final approval.
Introducing Artificial Intelligence (AI) at this stage can help streamline the entire pre-operative process.
With AI, surgeons and hospitals can reap the benefits of patient-matched and 3D-printed solutions and eliminate inefficiencies in the pre-operative process. For example, AI can generate accurate 3D anatomic models from 2D images of each patient’s anatomies at a fraction of the time a human can and minimize the risk of manual error.
Learn more about how Artificial Intelligence is the disruption orthopaedics needs today:
3. Optimize Intra-Operative Procedures
Enabling technologies like computer-assisted and robot-assisted surgeries, and Augmented Reality (AR) are starting to play a more prominent role in elective orthopedic procedures.
They bring many advantages to the surgical process like:
- providing surgeons better visualization of the surgical space to help improve surgical precision
- permitting surgeons to collect valuable intra-operative data during each case for post-operative analysis. This information can help surgeons and surgical teams improve their surgical outcomes, streamline their end-to-end surgical flow, and eliminate logistical bottlenecks.
But these new enabling technologies can add time to the overall surgery because surgical teams have to input a patient’s pre-operative plans for each case manually. Surgical teams must also navigate a learning curve for robotics or new navigation technology before achieving higher efficiency in the OR.
An intelligent platform that links the entire surgical process, pre-op to post-op, can help keep patients safe by:
- Transferring pre-operative plans to intra-operative enabling technologies smoothly
- Allow surgeons and their surgical teams greater visibility in surgery, in particular for minimally invasive procedures. With more visibility, the surgeon can perform surgery with higher precision in a shorter amount of time.
- The rest of the surgical team also gets to view the operating surgeon’s field of view in surgery. By watching a surgeon as they perform surgery, the OR team can improve their efficiency. For example, they can assemble and prepare required instrumentation and implants a few steps ahead of time.
4. Post-Operative Analytics to Improve Preoperative Planning
All steps in a patient’s surgical journey need to be optimized for an enhanced patient-centric approach and greater patient satisfaction.
AI algorithms can analyze pre-operative patient selection, intra-operative data, and post-operative results and “learn” how to make the process better. As more surgical and patient data is analyzed, AI can help further automate the patient selection and templating processes and help surgeons be more accurate, faster.
With greater accuracy and efficiency, surgeons, hospitals, and ASCs can better cater to the rising patient demand for more total joint replacement surgeries.
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