Orthopaedics “Diverse teams perform better and think


forward better,” he asserted. He is also passionate about addressing bias within the orthopaedics sector in general and the DePuy Synthes R&D facility based in Leeds is currently looking at ways to help female surgeons overcome some of the challenges with using faced within the specialty. The British Orthopaedic Association (BOA) points out that, historically, orthopaedic surgery has been one of the least diverse specialties in medicine. Despite trauma and orthopaedics being the second largest surgical specialty, it has had the lowest proportion of female surgeons across all grades.1 changing.2


However, this is now DePuy Synthes UK recently supported


a ‘Women in Orthopaedics’ session at the 2023 BOA Congress, which sought to explore some of the key issues. “We had 70 female surgeons and the energy


in the room was incredible. The stories that they told me about the challenges that they had to overcome to be orthopaedic surgeons was really humbling. “Their stories really made me think about what we need to do to address this in orthopaedics. I learned that 50% of orthopaedic medical students in the UK, today, are female. 20 years ago, it was around 5%. There has been a sea change. It makes sense from a gender diversity perspective, as well as economic sense, that we reflect the demographic of our customer as a business and focus on what our customers need,” Gavin commented. In particular, there are some key challenges


around the ergonomics of orthopaedic tools, which doesn’t always consider the needs of female orthopaedic surgeons. The BOA points out that the optimal size and grip strength for tool design in men and women are different. However, the single size tools available are designed using ‘standard’ (male) ergonomics which results in repetitive strain injuries, and discomfort for many people with smaller hand sizes.3 The BOA further highlights that the need for


a more diverse range of tools will continue to rise. DePuy Synthes UK is therefore continuing


to invest in R&D to deliver instrumentation and solutions with this changing demographic in mind.9 “There is a real opportunity for innovation


and development in this space. For example, I know the R&D teams are designing a reamer handle that is shorter for ease of handling by people with a smaller build. A lot of products were designed years ago when this thinking wasn’t there, so everything going forward should strive to be more inclusive, while addressing the challenges associated with those iterative designs,” Gavin asserted.


Innovation MedTech companies must also build systems that help surgeons meet the physical demands of their vocation. Standing in the operating theatre for hours takes a huge physical and mental toll on physicians, and implant manufacturers must account for this workload and its physical challenges when designing and developing products. With this in mind, DePuy Synthes UK has launched a solution for robotic- assisted Total Knee Arthroplasty (TKA). Not only does the system help relieve the physical and mental toll of performing orthopaedic surgery, but it also improves patient outcomes and is associated with reduced resource utilisation compared to manual TKA. “The technology behind the VELYS Robotic


Assisted Solution provides precision and accuracy, allowing surgeons to personalise TKA to a patient’s individual needs,” comments Gavin. “Feedback from surgeons so far is that it is very simple to use and operate, allowing greater efficiency compared to some other operating systems; it has a smaller footprint; it is easier to move around; and it is easier to decontaminate.” He explained that the VELYS robotic assisted solution is designed to facilitate procedural efficiency, predictability, and standardisation. It features a clear user interface, streamlined


58 www.clinicalservicesjournal.com I February 2024


clinical application, adaptable workflow, and a fast registration process which helps improve procedural efficiency. This is achieved with limited disruption in the operating room, as the robot does not require a product specialist or technician and there is no need for costly pre- operative CT imaging. “VRAS has been designed and created with


simplicity at its core. It assesses the landmarks on the knee, so you don’t have to base your decisions on a CT scan. In addition, the elimination of CT scans from the pre-operative workflow can save time for patients and episode of care costs. There has been a huge amount of interest in the technology,” Gavin commented. The table-mounted, imageless solution


features a streamlined design that integrates into surgeons’ current workflow. The system gives surgeons the control they are used to and allows them to retain their preferred technique without the increased risk of damage to the soft tissue envelope. The system uses ‘Natural Control’ Technology, a proprietary technology that maintains the saw cut plane to help execute precise, reproducible surgeon-controlled cuts without the need for a cutting block. “We always provide vigorous training on our


technology, and there is a cascade of surgeons training on VELYS, scheduled throughout 2024, initially in the US, and then Europe and the UK. We have a full curriculum to support the whole theatre team on the implementation of the robots – from nurses to consultants,” Gavin reported.


The importance of PROMs He added that the VRAS works exclusively with the ATTUNE Knee System, which has been shown to improve patient-reported outcome measures (PROMs) by working in harmony with the patient’s anatomy to deliver both stability and motion. Together, these technologies aim to define a high standard for patient performance


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