By Lauren Johnson
Surgical Institute of Alabama became the first facility in the state to obtain Zimmer Biomet’s new OrthoGrid equipment, and Scott Appell, MD completed a Total Hip Arthroplasty with the equipment in July.
After using OrthoGrid for over 15 surgeries to date, Appell has seen the benefits in the operating room.
“It makes it simpler and faster. It’s better for our patients, and it’s more efficient. This technology allows us to put the hips in the exact position,” he said.
The OrthoGrid system uses AI to provide data and calculations in real time, giving surgeons the ability to put the cup and stem in the right position. This technology only needs to take a single x-ray in the operating room, which reduces the patient’s exposure to radiation and saves the surgeon time.
“I had been using another system where you had to take four to six different x-rays in the operating room, and there was a lag in between taking the x-rays and the computer looking through the information,” Appell said. “A lot of it depended on the position of the x-rays, and you had to be finicky about that. OrthoGrid is one shot and it’s done.”
A representative for Zimmer Biomet said: “OrthoGrid takes a 2D image, and through AI and with proprietary software, it reconstructs these 2D images taken via C-arm in the OR. Then it constructs a 3D image that guides the surgeon to put the components exactly where they need to be.”
One of the biggest complications surgeons have seen with hip replacement surgery is the instability of the joint. In the past, patients were at risk of dislocating their hips until all the tissue healed and matured.
“It all has to do with how the hip joint was put in,” Appell said. “You have to put the socket and the ball in exactly the right geometry and position. The technologies that we have now allow us to do that, do it accurately and do that in real time, so we have stable hips. It makes it a much better procedure than it was 15 or 20 years ago.”
Total hip replacement surgery was popularized in the 1960s by an orthopedic surgeon named John Charnley. His technique was widely accepted because of the successful patient outcomes.
“Everyone was learning how to do it like Dr. Charnley, and that was using a posterior approach, which means you have to go through the gluteus muscles,” Appell said. “With this approach, it took patients a little while before they could walk and recover, which was an obvious shortcoming to this procedure.”
When Appell first started performing hip replacement surgery, patients stayed in the hospital for two weeks. After he finished his residency in 1992, he continued to see new improvements that refined the surgery. Over time, surgeons began adopting the anterior approach, which allows them to make smaller incisions and avoid the need to cut any muscles which allows for quicker rehabilitation time.
Today, the surgery is completely an outpatient procedure. With the help of robotics and now AI technology like OrthoGrid, the surgery only takes 30 minutes and patients go home afterwards.
The most common cause for malpractice against hip surgeons has been leg length discrepancies, where surgeons decided to put the hip in a little longer for stability. Now, with the anterior approach and with the help of technology, like OrthoGrid, surgeons can be confident that patients’ legs are the same length, and the hips will be stable.
“Part of Surgical Institute of Alabama’s mission is to be leading in all the things that will improve patient outcomes – everything related to making sure our patients are getting the absolute best care,” Appell said. “We’re focused on providing the best experience, and that means a phenomenal outcome. This is just one more thing that allows us to advance that.”
Using OrthoGrid means more accuracy, less radiation, lower cost and less trauma during surgery.
“It’s exciting, as somebody who’s been doing this for 20-plus years, to see the evolution of how much we had to go through to get the data we’re now getting in seconds,” said the Zimmer Biomet representative. “We’ve gone from patients staying multiple days in the hospital to artificial intelligence robotics and people going home the same day.”
