Becker's ASC Review

55 ORTHOPEDICS The 'perfect' robotic application for orthopedic surgery By Alan Condon W isconsin orthopedic surgeon David Eggert, MD, began performing robotic-assisted joint replacements five years ago after the launch of Stryker's Mako system and has been impressed with the robot's application for complex cases, according to the Ripon Commonwealth Press. One such case was a hip replacement on a woman who previously had 40 screws placed in her pelvis after she fell and broke her acetabulum. She experienced a lot of pain and developed arthritis after her initial surgery, according to the report. The complex revision procedure, performed three years ago, was the "perfect application for the robot," according to Dr. Eggert, who practices at Orthopedic & Sports Institute of the Fox Valley in Appleton, Wis. Using the Mako robot, the surgeon created a scan of the patient that showed where the 40 screws were and how to ma- neuver the components to avoid them. "The issue with making contact with a screw is that it could potentially create an electrical charge, and that could cause loosening of the new joint," Dr. Eggert told the Press. "We could move the components a millimeter this way, 2 millimeters that way, so we avoided every screw." Dr. Eggert said the surgery would have been possible without the robot, but with so many screws and a small margin for error, the precision of the robot proved beneficial. "Can you do it [without the robot]? Sure. But let's say that you start hitting screws. What do you do? You compromise your plan because you've hit these screws, so it's going to be at increased risk of dislocation," he said. "It's been shown that dislocation rates are lower when using the robot." Orthopedic & Sports Institute of the Fox Valley was the firstsurgery center to offer Mako robotic-assisted surgery in North- east Wisconsin. The practice went from performing 150 surgeries a year with the robot in 2017 to nearly 1,500 per year, according to the Press. Dr. Eggert performs between 200 and 225 surgeries a year with the Mako robot. n 3 potential hot spots for spine care, practice growth By Carly Behm F lorida has been a prime target for practice expansion and growth in the last year. Donnie Romine, CEO of Jacksonville, Fla.-based Southeast Orthopedic Specialists, said he expects consolidation will continue in the state. "With the overall growth of Florida, coupled with the aging of the population, new market entrants are not unexpect- ed," Mr. Romine said. "I think the key to the success of any organization in this space will be their willingness to think differently, shed the ideas and models of the past and em- brace a willingness to bring all stakeholders to the table. We have seen in Florida that payers and health systems are focusing on those organizations with an integrated platform that can effectively drive outcomes and value in sustainable ways across markets, especially as greater patient choice and consumerism are playing a key role." Ernest Braxton, MD, of Vail (Colo.) Summit Orthopaedics and Neurosurgery, said he's seeing more people inter- ested in moving to Colorado, and with that comes practice growth opportunities. "We're steadily growing our practice at VSON, mostly in Colorado ski towns," he told Becker's. "What we're seeing is a great migration of folks from urban areas to our mountain communities. As a result, we are having some more pres- sure on our school system and increased housing prices. But there's also a demand for healthcare, from patients newly arrived from urban areas. We get a lot of folks from cities like Chicago, Los Angeles, Dallas, Houston, all buying properties and moving. People are either buying a second home, or permanently moving up here as our workforce becomes more remote. So we're trying to keep up with that population growth and offer high quality of care for these new people in our community." Outside the U.S., Tijuana, Mexico, is one city where Dr. Alfonso Garcia anticipates growth in spine care. "Endoscopic spine procedures are being done widely at ASCs, and Mexico is not an exception," Dr. Garcia said on the "Becker's Healthcare Spine and Orthopedic Podcast." "We are gifted to be at a very special location geographi- cally speaking, and we understand the language and are internationally recognized as a reference center for mini- mally invasive and endoscopic spine procedures. There's definitely a lot of work to do and to keep moving forward. I expect that very soon Tijuana will be a flagship represent- ing top-of-the-line hospitals and ASCs, becoming a very attractive destination for spine care." n

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