Tuesday 19 September
4.45pm – 5.15pm
Sir Walter Mercer Lecture
5.25pm – 5.55pm
Robert Jones Lecture Professor Andrew Carr
Robert Jones Lecture Professor Andrew Carr
BOA Session
INNOVATION, REGULATION AND EVALUATION IN ORTHOPAEDIC SURGERY
The global burden of musculoskeletal disease is a major cause of years lived with pain and loss of mobility. There is an urgent need globally to improve the quality, cost and access to orthopaedic treatments.
Innovation is the introduction of a new method into a particular area of clinical practice or health care system, it can include changes to systems of care. Generally two types of innovation are recognised; disruptive innovation that dramatically changes existing care pathways or creates a new pathway; incremental and sustaining innovation aim to maintain or gradually improve an existing treatment. The latter type tends to make relatively little difference to clinical outcomes but often results increasing costs.
Recent innovations in orthopaedics include new imaging, novel implants, new outcome assessments, new systems of care such as hybrid care, virtual reality training and digital systems or information technology. Many of these innovations have been accelerated globally by the Covid-19 pandemic. Alignment of clinicians with research intensive universities and industry is often helpful to enable the multidisciplinary environment required for rapid and effective translation and evaluation of innovations.
Innovation also has the potential to adversely influence patient care and therefore requires some form of regulation and scrutiny. Recent safety issues involving surgical implants has resulted in changes to the regulatory environment for surgical procedures, both in Europe and North America.
The orthopaedic surgery community has long realised the need for improved methods of assessment of outcome of surgical procedures. This has included the design and widespread use of patient reported outcome measures, the use of national registries of joint replacements and adherence to guidelines of best practice. Establishing a robust evidence base from surgical trials particularly randomised trials have been slower to gain support but high quality evidence is now becoming more widespread.
Disruptive innovation involving new surgical techniques and technologies or new systems of care is crucial and, if accompanied by appropriate regulation and effective assessment of outcomes, will improve care for the increasing numbers of patients requiring orthopaedic care globally.
Speakers
Professor Andrew Carr
