02

Technology has come up in a big way in the healthcare sector. Dr. Vikash Kapoor, MS (Orthopaedics), Fellow Sports Medicine (Singapore) - Group Director, Joint Replacement  and Vice Chairman, Medica Superspeciality Hospital, spoke to BE’s Ellora De regarding the technological revolution in the field of orthopaedics.

Q. What are the challenges as well as opportunities before you as an orthopaedic surgeon?

A. As an orthopaedic surgeon, the challenges and opportunities are mixed because every challenge can become an opportunity. In the past, the number of surgeries used to be less and process of treatment was a bit conservative. It had a lot of complications. So, it used to take months and years for people to heal. Orthopaedic patients were unable to go back to their jobs for months and years.

But with the evolution of technology that includes state-of-the-art instrumentation, computer navigation and robotics, the recovery period has come down substantially. The cost of treatment in terms of currency has increased but patients can go back to their livelihood options sooner. With the intervention of modern technology, we have been successful in reducing the loss of man hours. Here the challenge has turned into an opportunity. From that perspective, the actual cost has decreased.

Q. Robotics in orthopaedics has been introduced in many countries. Where does India stand in this context?

A. India is where the world is. Most of the latest technology is available in India. If you look at 97% of the total work which is being done in our field, I think India is at par with the best in the world or probably better.

Now about the remaining 3% - the countries which have developed such robotics, spend a good percentage of their GDP in research and development, which India is not doing at this moment. Robotics will come very soon to our shores but for that we need to focus on research and development.  Robotics is still at a very nascent stage in orthopaedics. There is special robotics technology for knee surgeries and for hip surgeries but it has not developed beyond that. We are in the process of acquiring that technology for Medica but it can only be used for knee replacements. The software has not yet been worked out for ligament constructions. The usage of robotics will increase the accuracy of surgeries by 2-3%.

Q. How are orthobiologic technologies being implemented in orthopaedics?

A. At this point, orthobiologic technology is more exciting than robotics in orthopaedics. Orthobiologic technology is about developing tissues which you can put back in the fracture site and ensure a more natural healing process. That is where the excitement is – culturing stem cells, creating a new artificial bone and artificial joint. It is basically creating something that is very close to God’s creation and using it for healing processes instead of using metals and plastics.

Q. Is orthobiologic technologies being used in Medica?

A. Yes, we do everything in Medica. We do stem cell implantation in the hips. We take the bone marrow of the patient and send it to the lab that cultures the stem cell out of that bone marrow. There are two such labs in the country. The cultured stem cells come back to us after a month and we implant them back into the hips.

Q. How is nanotechnology being used in the field of orthopaedics?

A. Nanotechnology in healthcare refers to a process to deliver targeted medication with the help of nano-molecules. The molecules carrying medicines go to the targeted specific sites. So the dosage of medicine becomes less and there is a resultant reduction in side effects. The drug delivery system becomes better with nanotechnology. But in orthopaedics, we are not yet using nanotechnology in India.

Q. How is Medica promoting quality of life for senior citizens by using technology?

A. In orthopaedics, the biggest technological intervention has happened in the joint replacement surgeries. The whole team in Medica has an experience of more than 10000 joint surgeries and in these surgeries we have less than .01% cases of infection. With a joint replacement, an aged patient gets a better and longer life. A joint replacement enriches and increases an aged patient’s life. We do around 500 surgeries per year.