Orthopedic Surgery Trends for 2023

Since the onset of the COVID-19 pandemic, it seems like the healthcare industry has gone through countless iterations of itself to keep patients safe while ensuring care remains accessible and effective. Orthopedic surgery has not been immune to this transformation, thanks to accelerated technological advancements in everything from telemedicine to orthopedic devices.

As the orthopedic industry continues to rapidly evolve, surgeons must keep up with emerging trends so they can integrate them into their practices and make research-backed changes that optimize their practices and help them stand out from their competitors.

Ambulatory surgery centers (ASCs)

An ambulatory surgery center, or ASC, is an outpatient healthcare facility that provides same-day surgical care. Because they’re typically more efficient than hospital outpatient departments, ASCs have grown in popularity in recent years, with a 47% increase in the monthly average volume of claims at ASCs between 2020 and 2021. By the mid-2020s, 68% of orthopedic surgeries are predicted to take place in ASCs.

Orthopedic surgery in an ASC setting has many benefits for both patients and surgeons. Patients can avoid hospital-acquired infections when staying in an ASC during postoperative recovery. A study of over 1 million surgeries performed in ASCs found that ASCs have a “post-operative surgical site infection rate six times lower than hospital outpatient surgery departments.” Operating at an ASC also involves less bureaucracy, so orthopedic surgeons have more freedom to decide their own surgery schedules.

When orthopedic surgeons operate in specialized ASCs, they further hone their skills and perform more efficient, predictable surgeries. Think of an ASC that focuses on knee and hip replacement instead of offering a broader range of orthopedic procedures. With a smaller subset of procedures, you can invest in specialized training and equipment that will improve the efficiency and results of your operations.

Moving procedures from a hospital to an ASC won’t guarantee your success. If you’re considering partnering with an ASC or even starting your own, follow these best practices:

• Select patients carefully: Not every patient is fit for surgery in an ASC. Some patients need to be in the hospital due to age or comorbidities. Make sure to get medical clearance from a patient’s other specialists, like their cardiologist or pulmonologist, who might recommend an inpatient procedure instead for closer monitoring.
• Offer virtual care options: To further reduce patients’ length of stay, provide telehealth alternatives for common pre and postoperative services like patient education and physical therapy.
• Go beyond the minimum design requirements: Although ASCs are renowned for their “lean” operations, a cost-effective design doesn’t always save you money in the long run. For example, you’re required to have at least one recovery bay per operating room, so you might be tempted to stick to the bare minimum to cut costs. But if all the recovery rooms are occupied, you’ll end up having to delay surgical procedures, reducing your day-to-day revenue and frustrating patients.

Robotics in orthopedic surgery

Robots in the operating room sound like a futuristic scenario, but robotics-assisted surgery has existed for years — and it’s growing fast. By 2028, the global orthopedic robotics market is expected to be worth over $2 billion, almost tripling in value from 2022. Although robots still require supervision by an orthopedic surgeon, they can perform many tasks in the operating room, such as:

• Cutting and reshaping bone
• Positioning implants
• Guiding surgeons in positioning instruments
• Modeling joints in 3D

A robotic arm is much more precise than the human eye, enabling more accurate positioning to decrease soft tissue damage and deliver better stability and range of motion for the patient. The surgeon allows the robotic arm to control the bone cuts and remove just enough bone with an accuracy of 0.5 millimeters.

Gone are the days of taking X-ray after X-ray in the middle of a procedure to verify surgical accuracy. Instead, you can use surgical robots, which are much more precise, to determine the right placement for an orthopedic implant. When you accurately place an implant the first time, it’s less likely you’ll have to go back in later to reposition it.

Patients clearly recognize the benefits of robotics-assisted orthopedic surgery as well. A 2021 study found that 94% of patients were satisfied after robotic-assisted total knee replacement surgery, compared to 82% of patients who had undergone traditional total knee arthroplasty.

Robotics in orthopedic surgery has enormous potential, especially once robots can operate more independently, and we’re already seeing cutting-edge technology in the operating room today. The Mazor X Stealth from Medtronic is a robotic-assisted spinal surgical platform that uses robotic guidance system technology to improve orthopedic surgeons’ precision while operating. The robot sets up a trajectory based on the preoperative plan for the surgeon to follow when placing pedicle screws. This ensures that the screw goes in the right location at the correct angle and depth.

TrackX is a universal instrument tracking software that uses one to two low-dose scouting X-rays to provide virtual live fluoroscopy to track surgical instruments in real time. By using this tool instead of traditional X-rays, orthopedic surgeons can reduce radiation exposure for patients and the operating room team by over 91%.

Artificial intelligence and machine learning

Artificial intelligence (AI) can rapidly process huge amounts of data in real time and make accurate decisions. Combined with machine learning, where computers use data to constantly learn, adapt, and improve, artificial intelligence can supercharge your data infrastructure and help you deliver better patient care.

Take surgical outcomes as an example. When you can more accurately predict the outcome of a procedure, you can adjust your patient’s postoperative care plan accordingly. A 2019 study used supervised machine learning models to predict the outcomes of total shoulder arthroplasty procedures. Compared to the standard model, the machine learning algorithm could better predict outcomes like adverse events (71% vs. 63%) and surgical site infection (65% vs. 58%).

Delegating tasks like data collection to AI-enabled tools gives you room to focus on work that requires your medical expertise, like diagnosis, treatment, and patient education. We can expect to see a lot more patient data in the coming years. A recent study estimates that by 2025, over 25% of the U.S. population will use remote patient monitoring (RPM) tools. The success of remote patient monitoring has revealed the potential of other remote approaches to orthopedic care, like remote therapeutic monitoring.

While remote patient monitoring exclusively measures physiological data, like oxygen and glucose levels, remote therapeutic monitoring (RTM) collects non-physiological data, like therapy adherence and pain levels, to provide even more insight into the patient experience. Because most of this data is self-reported by patients, incorporating remote therapeutic monitoring into your practice encourages patients to invest in their own health. Higher engagement helps patients adhere to their treatment plans and ultimately improve their outcomes.

One of the simplest ways to experiment with artificial intelligence at your practice is through remote therapeutic monitoring. Consider using an AI-enabled remote therapeutic monitoring tool like Exer Health. Exer Health is a mobile app that uses artificial intelligence and a smartphone camera to precisely measure patient performance data, like range of motion. You can set up daily or weekly prompts for patients to report other RTM data, like their pain levels, and receive personalized reports of their progress. By closely monitoring patients between appointments, you can more quickly determine if their recovery is going as expected and intervene if necessary.

3D printing

3D printing has enormous potential in orthopedic surgery: research shows that using 3D printing reduces operative time and estimated blood loss. Also known as additive manufacturing, 3D printing uses a digital file to create a physical object by fusing material together, usually layer by layer. Unlike traditional manufacturing methods, you don’t need a mold or a block of material to create something, which allows you to quickly make minor adjustments.

3D printing has changed how the industry approaches orthopedic implant design. The traditional process of designing implants can take a long time, even just to make a small change. However, 3D printing speeds up production by enabling rapid prototyping so a designer can quickly check it for accuracy and then make a new version until they reach the perfect one. Patient-specific implants have also become more affordable. As personalized implants become more accessible, we should expect to see better patient outcomes beyond unique cases like traumas or deformities.

One of the most accessible applications of 3D printing in orthopedics is to incorporate it into the preoperative planning process. 3D-printed models provide highly accurate, life-size representations of the anatomy so you can explore the area and identify potential obstacles during surgery. This provides a particular advantage in complex cases like total joint replacements or fractures. In most instances, orthopedic surgeons have to rely on X-ray and CT images and technical guides from a manufacturer when choosing an implant for a patient. Modeling these images in 3D gives surgeons more data with which to inform their final decisions.

A 2019 study compared the use of X-ray and CT images with life-size 3D-printed models when selecting anatomically contoured plates for distal tibia fracture surgery. When using the 3D-printed models, surgeons could physically test out each plate by trying it against the fracture so they could check the fit and visualize the locking screw trajectories after the plate was inserted. After using the 3D-printed models to assess a complex fracture, 55% of surgeons chose a different plate than the one they selected when only using radiological images.

Stay at the forefront of trends in orthopedics

Like any medical field today, it seems like orthopedics is advancing at breakneck speed. Although the trends in the field are far from temporary, not every emerging technology is worth investing in.

Consider how you might apply a trend in your practice today. Identify a few concrete benefits — like improving patient satisfaction, reducing operative times, or lowering costs for patients — that are currently achievable. If you aren’t convinced that these advantages will outweigh the costs, then it’s better to hold off than to jump on a trend too soon and not see much return on your investment.