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.