3D printing, robotics, telemedicine increasing in NJ orthopedics

When you break an arm or a leg and get fitted for a cast or splint, the cotton-and-plaster combination invites a distinct set of headaches: You can't get it wet or it might turn to mush, or worse, pick up body odors you have to deal with for the duration of your injury.

Thanks to advancements in orthopedic technology, those days could be coming to an end, according to Dr. Alexander Vaccaro, a professor of neurosurgery and orthopedic surgery at Thomas Jefferson University in Philadelphia, and president of the Rothman Orthopaedic Institute, which has 15 locations in New Jersey.

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Vaccaro said the COVID-19 pandemic has accelerated the "exploitation" of technologies that make patient care easier.

Among those is the exploration of different biomaterials to make casts, and the burgeoning production of these devices using 3D printing.

A 3D-printed cast comprised of plastics and polymers can be easily snapped on and off, Vaccaro said.

"You print it out and it can be cleaned easily, it doesn't pick up a person's body odor, and it's a phenomenal way of moving forward," he said.

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Soon, a patient may not even need to be fitted for a cast in person. Vaccaro said a mobile app can take a picture of someone's affected extremity — with something like a quarter or other coin in the shot, for scale — and from that picture, a cast can be printed out that contours perfectly to the patient.

"You just take a picture, go online, have it delivered the next day, through (something) like an Amazon delivery service," Vaccaro said. "So, it sort of gets the hassle out of coming downtown, getting measured, not fitting appropriately."

One area in which 3D technology has been used for years is spinal surgery, and spinal surgeons are now also embracing robotics to guide their work.

The robot isn't autonomous, according to Vaccaro, but loads in data of previous mistakes that have been made in similar procedures, to prevent a doctor from committing future errors.

The result? The surgeon remains in control, but there's an extra layer of assurance of precision for the patient.

"When you begin to use a new technology, it takes a lot of time, because you have to learn the technology, (and) because you only use it when it's safe and it's reproducible," Vaccaro said. "But now we're using it every single week, and it's wonderful."

One advancement people should not be surprised to hear about is remote monitoring before and after certain procedures.

Fitbit and other companies pioneered the mass-market availability of devices that monitor a person's various health markers, and now doctors are taking that data and analyzing it.

And, just like a challenge against other Fitbit users, the doctor is able to compare a patient to others and present findings based on percentiles.

"You can get a printout on how you're doing, and it's a great outcome measure," Vaccaro said, noting that the technology can also be used to flag when someone is not progressing satisfactorily. "So you can see how you're doing, how you're doing compared to others your age, and how you're comparing to everyone who had that same type of operation."

All of these new ways of approaching patient care are contributing to an overall more efficient telemedicine experience amid the ongoing pandemic, greatly reducing the number of ailments that require an in-person consultation.

Vaccaro said doctors and patients alike seem to love that aspect in particular. Insurance companies and the government, he said, aren't so sure — but he also believes now that we have the technology, in the Garden State and elsewhere, it needs to be used and used often.