Ever since the invention of the arthroscope and its wider use in the 1980s, surgical orthopedics has been dominated by musculoskeletal care. The reason that surgeons suddenly had a way to perform their craft through a smaller incision, and they could “see” what was wrong as they “fixed it”. Seeing and fixing is a powerful concept, so the idea caught on like wildfire.
The idea that structure equals function is a powerful one. We all believe that the little spot we see on an MRI is surely the cause of our pain, but research has shown that this is often not the case. In fact, it’s clear that we’re often operating on phantoms, as just as many patients without pain have the same MRI abnormalities. In addition, another problem facing surgical orthopedics is that it can be like a bull in the proverbial china shop. Much damage can be done just getting to tissues, despite the fact that arthroscopic procedures are called “minimally invasive.” As an example, most patients don’t know that routine arthroscopic hip surgery involves putting so much traction on the hip that one of the main nerves of the leg loses its ability to conduct signals during the surgery and must be monitored to prevent nerve damage.
Interventional orthopedics means using precise imaging-guided procedures to place things that can heal tissues in specific areas of need. To figure out what interventional orthopedics (IO) is, it’s first helpful to look at what it’s not:
Our goal for IO is to compete head-to-head with surgical orthopedics because when a disruptive technology competes with an established one, everybody benefits. In many areas, we believe IO will win out because it’s less invasive and will be able to offer better outcomes with less recovery time. In some areas, surgery will remain the standard.
In the future, expect the sophistication of IO to grow to unimaginable levels.
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