Hospitals organised ‘Arthroplasty Arthroscopy Summit’ focuses on techniques
which are simpler with better results
September, 2019: Apollo Hospitals hosted a one-day 5th
Arthroplasty Arthroscopy Summit, under the aegis of Telangana Orthopaedic
Surgeon’s Association (TOSA) and Twin Cities Orthopaedic 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,
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, less complications etc., and thereby enable speedy
recovery of the patient and they getting back to routine. Despite the greatest
experience a surgeon has performing surgeries, there is always an element of
human error, Robot greatly reduces that error.
Dr Somashekar Reddy said, the
conference discussed the latest techniques in joint replacement treatments and
explored what would be best for Indian patients. Robot Arm assisted navigated
knee replacement and Artificial Intelligence, definitely will dominate in
future for patient care, there will be an exponential increase in their usage
in the years to come.
ROBOT ARM ASSISTED KNEE AND HIP
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.
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
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.
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.
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
ARTIFICIAL INTELLIGENCE IN JOINT
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.
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 categorising patients for joint
replacement and other surgeries.
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.
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, that way can provide patient specific care.
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 orthopaedics, 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.
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