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Orchid Blog

Trends in the Orthopedic Industry: An Overview of the AAOS 2019 Annual Meeting

Posted: Monday, April 15, 2019

For those of us in the orthopedic world, the American Academy of Orthopedic Surgeons (AAOS) annual meeting is one of the most important conferences of the year. This conference is significant not only because it is the largest gathering of the orthopedic industry, but also because of its ability to capture and educate on state of the art product innovation and patient care. I attended this year’s conference as a product development engineer with Orchid Design to learn about the latest in orthopedic innovation and healthcare trends, and to help identify new potential customers. Ultimately, I found the conference to be enlightening on both an academic and industry level, and I have a newfound appreciation for our industry and how Orchid continues to turn orthopedic innovation into reality.

This year’s 2019 AAOS conference, otherwise affectionately known as “Academy”, was held in Las Vegas and set amid the grandeur of the Venetian Hotel. This iconic venue certainly made for a unique Academy experience. Normally, or at least in my limited experience of previous Academies, the venue seems to be dominated entirely by the conference and all its attendees. Indeed, I was one of nearly 30,000 total registered attendees this year and that is more than enough to dominate most venues. However, we’re talking about Vegas here, and the expansiveness of the Venetian with its interconnected canalways and piazzas were clamoring with tourists and spring breakers, reminding me that I was not on an orthopedic retreat from the rest of the world. Admittedly, it was sometimes difficult to discuss the future of spinal fusion with colleagues over lunch when you are competing with serenading gondoliers.

Nevertheless, navigating through the impressive waterways followed by the bustling of the casino floor invoked a natural sense of excitement and vigor as I headed towards the conference halls. As I was leaving the casino floor behind and the continuous bells and dings of slot machines began slowly to be replaced by the humdrum of 30,000 people, I wondered to myself, “What technology is the orthopedic industry betting on today to be the game changer in healthcare?” The answer came to me as I stepped into the exhibitor hall and approached the booth for THINK Surgical, a robotics company.

Robotics seem to have captured the hearts and minds of the people at Academy and, as an engineer, I cannot argue with the fact that robots are pretty cool, nor can I help from imagining a robot shouting, “Danger, Dr. Will Robinson!” when the surgeon tries to do something they shouldn’t. Companies like THINK Surgical, Mako (Stryker), Blue Belt (Smith & Nephew), and Mazor Robotics (Medtronic) have developed robots to assist with partial and total knee replacements, hip replacements, and pedicle screw placement. The underlying design intent for each of these robotic systems is to improve the accuracy of orthopedic surgery. This is accomplished by either giving full control to a robot to make surgical bone cuts, or providing robotic guidance while the surgeon commands the cutting tool. It is no secret that surgeon error combined with the limited accuracy of standard instrumentation can present a challenge when trying to obtain perfect alignment. In fact, most studies looking at the accuracy of standard instruments for total knees report between 70% and 80% for hitting the target alignment window of +/- 3 degrees between the femur and tibia mechanical axes. With the pressure to reduce readmission rates in hospitals, reduce the overall cost of an episode of care, and simply to improve patient outcomes and satisfaction, finding a way to increase accuracy and reduce surgeon error is paramount. And let’s face it, no patient wants to feel like they are rolling the dice on surgery.

Academy was also stirring with talk about the growing migration of orthopedic procedures away from large hospitals towards ambulatory surgery centers (ASC’s). For much of the history of modern healthcare, hospitals have been almost exclusively the setting for orthopedic surgery. Often, hospitals are characterized by scheduling difficulties, OR and central sterilization inefficiencies, and budget driven decisions that can limit surgeon access to technology. This has changed with the advent of ASC’s which aim to remove some of the inefficiencies of large hospitals and provide surgeons with more autonomy in their patient care. Reports looking at overall health care costs have shown that hip and knee procedures cost 30% to 40% less at an ASC than at a hospital. On top of this, patients are usually back home for recovery within 24 hours of admission to an ASC, barring any medical emergency. Even with greater freedom to choose new technology at ASC’s, paying for a million dollar robot may be difficult without the purse of a large hospital. Additionally, more limited OR floor space in ASC’s may be a significant challenge for these large robots. As ASC’s continue to grow in popularity, robotics companies will have to address these cost and space issues or miss out on a projected 50% of surgeries by 2026.

Having caught a glimpse of the frontier which lies ahead of the orthopedic industry, the next question we might ask is, “How can medical device manufacturers grow with the industry?” While there is no simple answer, we can speculate a few new trends in the products we manufacture. As the demand for robotics increases, we might expect to see an increase in cutting and guiding instruments meant to interface with robotic technology. We might also expect to see a growing need from the market for single use instrumentation and sterile packaging. Some of these single use instruments might be intended for use with robots but they could also be a growing trend with ASC’s looking to maximize the efficiency of their sterile processing. As manufacturers, we should be aware of these trends and innovative solutions for the market as we head into the future of orthopedics.

     By Brogan McGuire, Product Development Engineer, Orchid Design