Hyderabad, 8th September, 2019: Apollo Hospitals hosted a one-day 5th Arthroplasty Arthroscopy Summit, under the aegis of Telangana Orthopedic Surgeon's Association (TOSA) and Twin Cities Orthopedic Society (TCOS), on Sunday at Hyatt Place. Dr Mithin Aachi, Sr. Ortho & Joint Replacement Surgeon, Apollo Hospitals, Secunderabad & Dr N. Somashekar Reddy, Sr. Ortho & Joint Replacement Surgeon, Apollo Hospitals, Hyderabad briefed media about the latest techniques discussed at the summit like the Robotic & AI ML based techniques in joint replacement.
According to Dr Mithin Aachi, these techniques will mark a paradigm shift in knee & hip replacement surgeries in the near future. They bring about precision; lessen risk of failure as they ensure Dynamic Gap Balancing, which is error prone when done manually, enhance longevity of prosthesis, reduce blood loss, damage to blood vessels, soft tissue, cartilage etc., and thereby enable speedy recovery of the patient and them getting back to routine.
Robot arm assisted knee and hip replacement
Robot Arm assisted navigated knee replacement is the future of joint replacement surgery for the coming decade. Usually joint replacement involves cutting bones with prefixed jigs and human error can lead to wrong cuts or maligned cuts. This human error can happen even in the best of hands and experienced surgeons. Robot Arm stabilises, aligns the arm in prefixed cut direction and prevents any deviation from the correctly planned procedure. This ensures more accurate anatomical result due to lesser tissue insult which overall gives a better outcome in patient post operatively.
Usually for a Robot assisted surgery patient undergoes CT scan of the knee to correctly update the surgeon about the deformity and the thickness of bone cuts required and the implant sizes to be placed. This is enhanced planning which gives the surgeon idea of the type of bone cuts required and the size of implants which will correctly match that patient on an individual level. Once this is fed into the software a camera helps in understanding the position of knee by markers placed in its bone. Once the 3d position of the knee is determined by the Robot it helps in achieving the bone cuts to perfection by aligning the Robot Arm in the correct plane as the surgeon starts his bone cuts. No deviation from the correct plane is seen in this even though the knee might shift in position during surgery for which the Robot camera adjusts the alignment again in functionally accurate position. This is the ROBOT ARM ASSISTED PREPARATION which is 3 to 5 times more accurate than conventional knee replacement jig cuts. This is within virtual boundaries set by the Robot and also catastrophic injuries to the vessels and other soft tissues are also prevented by the Robot arm.
Once the bone cuts are made the Robot software also helps In soft tissue tensioning and balance determination also by correctly recording gaps in the joint. This DYNAMIC GAP BALANCING again is usually done based on surgeons experience and feel and not on measurements in conventional joint replacement. In Robot joint replacement this human dependence is negated and the gaps are perfectly balanced allowing better joint survival over long term.
A Robot doesn't do surgery by itself but it helps the surgeon plan, execute and achieve a better surgical result than he would have by human effort alone. Hence Robot surgery helps in FUNCTIONAL IMPLANT PLACEMENT based on individual patient dynamics and hence helps in less pain, more better outcomes and longer survival rates of joint replacement surgery.
Artificial intelligence in joint replacement
Good surgical outcome doesn't rely only on good surgery. Multiple variables about patient health, obesity, co morbid conditions, and other factors help in determining whether Minimal Clinically Important Difference (MCID) is achievable in patient populations.
Artificial Intelligence through MACHINE LEARNING Algorithms can accurately predict the outcomes of patients on the whole and will become an invaluable tool over the course of few years in selecting and categorizing patients for joint replacement and other surgeries.
Through Artificial Intelligence patients can be counselled about not only their need for surgery but also possible outcome percentages from the surgical procedure and thus these can improve doctor-patient communication and over all outcomes. These have long term positive implications not only on patient psyche but also in families with financial limitations.
According to Dr Mithin Aachi, overtime Artificial intelligence will determine which patient can reap the benefits from joint replacement surgery and who won't have good outcomes. Apollo Hospitals is a pioneer in Robotic Surgery and Artificial Intelligence Algorithms based care for patients, and will continue to strive to provide the best and the latest care including in joint replacement and orthopedics, adds Dr Mithin Aachi.
The Summit was attended by over 200 delegates from various parts of Telangana and Andhra Pradesh and the faculty comprised of leading practitioners. It helped seasoned and young orthopaedic surgeons to learn and fine-tune their skills on the newer techniques.