Robert LaPrade, MD, is an orthopedic surgeon based in Colorado.

He has experience as the sports medicine committee chair for the International Society for Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine. Here, Dr. LaPrade discusses the biggest challenges for orthopedics over the next year and what he is most excited about for the future.

Question: What are the top challenges orthopedic surgeons face heading into 2019?

Dr. Robert LaPrade: I am sure that many of us have to provide counter-discussions with patients about their perceived and desired treatments from information read online from ‘Dr. Google.’ Misinformation provided online is one of the big challenges we face because this often leads to taking time away from patient care and ultimately slows one down in clinic. One of these big challenges many of us face is from patients who feel that ‘stem cells’ will heal any injury that they have, including complete ligament or complex meniscus tears, and restore worn articular carriage surfaces. Providing accurate and correct information about the fallacies of most of these claims in the lay press is a necessary part of our profession to protect patients from being taken advantage of by false claims, but it also can be tiring when several patients each clinic day bring up this topic and I fear that this issue will continue to eat away at our efficiencies in clinic in the future.

Another important challenge we have is to ensure that the peer-review process is followed for the validation of new technologies and procedures. It is our responsibility to ensure that we perform new procedures that advance patient care and improve outcomes and to not necessarily fall prey to trialing new procedures in patients without validation of their success. Having the biggest advertisement or a stick-on flyer to the front of a high-level journal does not ensure that the new technology has either been validated or leads to improved outcomes in patents.

Q: What technology are you most excited about in the future?

RL: I am most excited about technology that will allow us to perform surgeries more efficiently and anatomically. These technologies will ultimately lead to better patient outcomes and more reproducible results among all surgeons. Currently, one of the big dilemmas in my field of complex knee surgery is that many of the procedures that we perform require experience to be able to accomplish the surgeries efficiently, anatomically and successfully. Thus, the development of virtual reality programs to allow aspiring and practicing surgeons to ‘practice’ complex surgeries should enable surgeons to significantly cut down on their learning curves and lead to more efficient and successful surgeries. In addition, the encroachment of the field of robotics into the field of sports medicine may also allow for these surgeries to be more reproducible and successful.

Q: What is your best opportunity for growth?

RL: I believe that the best opportunity for growth in orthopedics is in the area of biologics and their proper use. While we desperately need more basic science research to determine the when, how and at what doses for the usage of biologics products, the use of biologics to augment or advance the healing process could potentially be the greatest advancement in orthopedic sports medicine since the arthroscope. However, before we can use biologics to their full potential, we need to counter the unproven hype around their usage and determine when they are best utilized with high level basic science and Level I clinical studies.

Full Article: Orthobiologics: Key challenges & opportunities from Dr. Robert LaPrade

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