Abstract
.SignificanceOrthopedic surgery currently comprises over 1.5 million cases annually in the United States alone and is growing rapidly with aging populations. Emerging optical sensing techniques promise fewer side effects with new, more effective approaches aimed at improving patient outcomes following orthopedic surgery.AimThe aim of this perspective paper is to outline potential applications where fiberoptic-based approaches can complement ongoing development of minimally invasive surgical procedures for use in orthopedic applications.ApproachSeveral procedures involving orthopedic and spinal surgery, along with the clinical challenge associated with each, are considered. The current and potential applications of optical sensing within these procedures are discussed and future opportunities, challenges, and competing technologies are presented for each surgical application.ResultsStrong research efforts involving sensor miniaturization and integration of optics into existing surgical devices, including K-wires and cranial perforators, provided the impetus for this perspective analysis. These advances have made it possible to envision a next-generation set of devices that can be rigorously evaluated in controlled clinical trials to become routine tools for orthopedic surgery.ConclusionsIntegration of optical devices into surgical drills and burrs to discern bone/tissue interfaces could be used to reduce complication rates across a spectrum of orthopedic surgery procedures or to aid less-experienced surgeons in complex techniques, such as laminoplasty or osteotomy. These developments present both opportunities and challenges for the biomedical optics community.
Highlights
IntroductionOrthopedic surgery represents one of the most common surgical procedures.[1]
In most developed countries, orthopedic surgery represents one of the most common surgical procedures.[1]
The objective here is to explore the potential roles of optical sensing in specific orthopedic and spinal surgery applications, to reduce complications by increasing surgical precision and to enable extension of the surgical field with greater control and improved safety
Summary
Orthopedic surgery represents one of the most common surgical procedures.[1]. Many surgical procedures have been developed successfully to treat common degenerative conditions, including total knee or hip replacement and spinal fusion, which are the most common hospital discharge procedures in the United States with about 1.5 million cases per year. Other procedures, such as partial and total shoulder replacement, partial hip replacement, kyphoplasty/ vertebroplasty, and lumbar decompression, are regularly performed by orthopedic surgeons as well as other specialists (neurosurgeons and interventional radiologists). There has been more recent adoption in total hip arthroplasty, with renewed interest in anterior hip approaches.[5,6,7] Other hip arthroplasty techniques have included bone resurfacing, which has been controversial with several large registries highlighting concerns over premature wear and metallosis.[8,9]
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