Safer Surgery Through Higher Precision

By John Palmer

Surgical precision has advanced by leaps and bounds in recent years, especially when it comes to orthoscopic procedures. Through the use of artificial intelligence (AI) technology and smaller cameras that allow surgeons to align their tools more accurately, intricate surgeries such as knee and shoulder operations that once involved invasive cutting and long recovery time now are routine.

OrthoGrid, a Salt Lake City–based medical technology provider known for orthopedic platforms, has developed what is being called the only patented intraoperative alignment and distortion correction solution on the market. Essentially, the system uses AI and specialized visualization technology as a “radar” to help the surgeon line up incisions and make surgeries less invasive, speeding up recovery times and improving efficiency.

PSQH discussed the technology with Edouard Saget, co-founder and co-CEO of OrthoGrid, as well as Christopher L. Peters, MD, the George S. Eccles Endowed Chair for the Department of Orthopedics at the University of Utah School of Medicine, as well as an adjunct professor in the University of Utah Department of Bioengineering. The University of Utah is using the OrthoGrid technology to help teach orthopedic surgeons.

PSQH: How does the new intelligence-guided system work?

Saget: OrthoGrid Systems offers the only patented intraoperative alignment and distortion correction solution on the market to fully address these challenges without interrupting the clinical workflow or a heavy technical footprint for integration. By applying AI for real-time decision support, including uniquely accounting for a little-known phenomenon called fluoroscopy image distortion, OrthoGrid’s solutions contribute to improved surgical outcomes, operational efficiency, and ultimately a higher standard of patient care. The level of precision afforded by our platform also improves device precision and adoption, enabling devices to meet their fullest potential.

Peters: We have used the OrthoGrid system predominantly in a surgical procedure called periacetabular osteotomy (PAO). PAO is used to treat predominantly young female patients who suffer from underlying acetabular dysplasia or shallow hip sockets. The PAO operation is a technically complex operation that involves cutting through bone surrounding the hip socket and then reorienting the hip socket into a more normal position. The operation relies on the use of intraoperative fluoroscopy to execute the bone cuts around the existing hip socket and to verify final placement of the repositioned hip socket. Traditionally, surgeons have essentially used their eyeball to estimate whether the newly positioned hip socket is in an appropriate position. The beauty of the OrthoGrid system is that for the first time we can make quantitative measurements of the amount of the correction of the hip socket while we are doing surgery without an interruption to our normal workflow. The addition of the distortion correction feature of the OrthoGrid system ensures that we are making as accurate a measurement as can possibly be made.

PSQH: What benefits will the new system provide compared to older surgical techniques?

Saget: OrthoGrid Systems uses a universal patented software platform that works with all manufacturer devices across multiple procedures to assist with implant, instrument, and anatomic alignment that use fluoroscopic imaging. It is the only patented intraoperative alignment technology on the market to correct the phenomenon of image distortion in orthopedic surgery, attributed to external electromagnetic interference and the mapping of the planar image on a curved input phosphor, affecting image integrity and causing potential risks of malalignment. With the use of this software, surgeons are able to improve surgical accuracy and efficiency.

PSQH: How does the system make surgical procedures safer for patients?

Saget: By equipping orthopedic surgeons with the latest technology in surgical precision, OrthoGrid’s system contributes to the reduction in hospital readmissions [and] the reduction in leg-length discrepancy, and contributes to decreased hospital readmissions. OrthoGrid’s software leads to the improvement of patient outcomes for a variety of procedures, including total hip replacement and total joint arthroplasty. OrthoGrid’s software technology is used directly in the OR via surgeons’ existing imaging tools, providing accuracy in a field where it’s extremely important and could impact leg-length discrepancies and overall mobility for patients.

PSQH: This system will be used in a teaching setting. How will it make learning procedures easier and safer for the budding surgeon?

Saget: The University of Utah Health is Mountain West’s only academic healthcare system, combining excellence in patient care, the latest in medical research, and teaching to provide leading-edge medicine in a caring and personal setting. The system provides care for Utah [residents] and residents of five surrounding states in a referral area encompassing more than 10% of the continental U.S. With this software in place in a teaching setting, residents and established surgeons alike are able to improve their accuracy and efficiency in surgery, leading to better patient outcomes.

PSQH: Can you give an idea of early results of the new system, if it’s already being used in surgical procedures?

Saget: Within our partnership with the University of Utah Health, the accuracy of placement for new hip joints has gone to nearly 100%, whereas before using OrthoGrid, it was between 75% to 85%.

Peters: As a full-time orthopedic surgeon practicing in the area of adult reconstruction, I see a large number of patients who are suffering from osteoarthritis of the hip and knee, and a smaller subset of patients who are generally younger and suffer from a sequela of structural hip disease. We ultimately treat patients with hip or knee joint replacement surgical procedures, and in some of the younger patients with structural hip disease, we use novel surgical techniques to preserve their joints for as long as possible before joint replacement is needed.

PSQH: What do you think will be some bureaucratic barriers to getting hospitals to use this technology?

Peters: I work in a very traditional healthcare system. Additionally, academic medical environments are challenging to work in because most have a substantial existing bureaucracy that often defends the status quo and is slow to adapt to change. Nevertheless, some academic environments, such as the one I work in, are doing their best to break out of this mold.

PSQH: In your opinion, how has OrthoGrid benefited the patient in terms of safer surgeries? How have surgeons benefited—especially those who are still learning?

Peters: Historically, there is strong evidence that precise correction of the newly positioned hip socket is the best predictor of long-term success and survivorship with the PAO operation. Thus, I think the OrthoGrid system offers the most exciting new additions to hip preservation surgery that we have seen in the last decade or so.

Moreover, with the distortion-corrected image and the intraoperative quantifiable position of the new hip socket, surgeons who are new to the PAO operation may be able to substantially shorten their learning curve. In terms of making surgery safer for patient care, I think this technology can improve long-term survivorship of the native hip socket and reduce surgical outliers.

John Palmer is a freelance writer who has covered healthcare safety for numerous publications. Palmer can be reached at johnpalmer@palmereditorial.com.