Time is of the essence — particularly for baby boomers and younger patients who want to return to active lifestyles quickly. Orthopaedic programs can set themselves apart from other in-network options based on time to next available appointment. Digital solutions can help programs navigate shifting sites of care and shave time off procedures and planning without compromising results, leading to greater (and more predictable) program capacity.

For example, Dr. Cody Wyles, an orthopaedic surgeon at Mayo Clinic, has found in a study that AI-enabled imaging can document a hip cup’s position more quickly and accurately than a human can.⁴ His team’s AI application processed 15,000 patients’ data in eight hours — a time savings of two to three months over manual processing. This kind of time savings allows clinicians to see more patients and improve timely access.

In a meta-analysis, patients who had robotic-assisted total knee arthroplasty (TKA) had a 14% shorter length of stay than patients receiving conventional TKA, leading to faster bed turnover and expanded capacity.⁵

Before and during procedures, surgeons can employ digital solutions to enhance patient outcomes. Imaging techniques and real-time navigation systems can optimize surgical planning and execution, leading to better physician precision and accuracy. For instance, digital fluoroscopic navigation improves accuracy in direct anterior approach total hip arthroplasty (THA) over unaided standard fluoroscopy: 66% (versus 40%) of patients who underwent THA with digital fluoroscopic navigation had less than three millimeters of leg length discrepancy.⁶ Similarly, the use of robotic-assisted surgical tools can improve procedural outcomes: one study found a lower incidence of patellar tilt (a significant contributing factor for revision TKA) in a robotic-assisted TKA cohort compared to in manual TKA.⁷

While technology can’t compensate for experience or technique, tools like digital fluoroscopy and robotic-assisted technologies that can help surgeons improve their accuracy. This in turn can reduce the risk of complications, boost patient satisfaction, enhance procedural accuracy, and help practices differentiate themselves.

By increasing accuracy, digital surgery can reduce the need for future surgeries and minimize rates of revision surgeries and readmission, which is appealing to patients, payers, and referring providers. For example, patients who used digital fluoroscopy had 30% and 36% lower 90- and 365-day, hip-related readmission rates, respectively, than patients who underwent manual THA.⁸

Digital tools may also help reduce patient pain and improve patient satisfaction compared to non-digital surgery. Of course, not all studies have demonstrated consistent outcomes. However, one study found that two weeks postoperatively, patients undergoing robotic-assisted TKA had a lower average visual analogue scale (VAS) pain score at rest and with activity than the manual instrumentation group.⁹ Another study shows lower morphine use by patients who underwent robotic-assisted TKA compared to patients who underwent manual TKA.¹⁰ And a third study demonstrates that patients in the robotic-assisted TKA had a better average satisfaction score of 7.1, compared to a score of 6.6 for patients in the manual TKA group.¹¹

Digital innovation spotlight: VELYS^TM Enabling Tech

Johnson & Johnson’s VELYS^TM Enabling Technology is a portfolio of technologies that support orthopaedic surgery techniques through real-time data and clinical insights. VELYS^TM Robotic-Assisted Solution and VELYS^TM Hip Navigation are two platforms, and they have been proven to show the value of digital surgery outlined above.^{12, 13}

For example, VELYS^TM Robotic-Assisted Solution, which has shown that it can be adopted efficiently with a short learning curve, has demonstrated to improve downstream outcomes.^{14, 15, 16} In one study, it reduced knee-related hospital revisits by 45% and knee-related readmissions by 53% compared to patients receiving manual TKA.¹⁷ It also improved VAS pain scores, knee function, and patient-reported outcomes post-surgery compared to patients receiving surgical navigation.¹⁸

VELYS^TM Hip Navigation can also help distinguish an orthopaedic program by enhancing predictability and efficiency, thus facilitating patient access. One study showed that VELYS^TM Hip Navigation reduced operating room time by an average of 33% compared to procedures using fluoroscopy and conventional overlay technique.¹⁹ It also has been shown to improve mean overall cup positioning success by 19% compared to manual THA, thus helping to improve a program’s procedural outcomes.²⁰

Considerations for orthopaedic leaders

Digital surgery is one of many offerings that can help an orthopaedic program stand out by improving access, procedural results, and downstream outcomes for patients. While we expect digital surgery volumes to continue growing, digital enabling technologies may not be the right answer for all orthopaedic programs. Here are some considerations to weigh for any new technology investment:

• Does this investment support my top program goals?
• Can I make a business case to justify the investment? Am I accounting for direct revenue as well as indirect returns (such as growth or savings enabled by expanded capacity, easier physician recruitment, and leverage in health plan negotiations)?
• What is the learning curve associated with adopting this new software? What support will the vendor provide with training and licensing requirements? Do I anticipate physician hesitation or lack of trust in the new technology?
• How will this new tool impact my current physical space, staffing, and scheduling protocols?
• Does this tool meet my organization’s cybersecurity and interoperability requirements?
• What health equity impacts could this investment have? What patient populations were included in the tool’s design and testing?

To help capture growth and compete for market share, orthopaedic leaders can consider making investments in digital surgery to help differentiate their program. Platforms such as VELYS^TM Robotic-Assisted Solution and VELYS^TM Hip Navigation can improve access to joint replacements, procedural results, and downstream outcomes. Thus, they can help orthopaedic programs better appeal to patients, health plans, and providers.

DePuy Synthes is the orthopaedics company of Johnson & Johnson. With one of the most comprehensive orthopaedics portfolios in the world, we help heal and restore movement for millions of patients. Our products span various specialties, including joint reconstruction, trauma, craniomaxillofacial, spinal surgery, and sports medicine. 

Building on our proud legacy of industry firsts, we are honoring our commitments to quality and innovation while creating a future where it's easier than ever before to keep people moving.

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This report is sponsored by DePuy Synthes, an Advisory Board member organization. Representatives of DePuy Synthes helped select the topics and issues addressed. Advisory Board experts wrote the report, maintained final editorial approval, and conducted the underlying research independently and objectively. Advisory Board does not endorse any company, organization, product or brand mentioned herein.

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