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Hip and Knee surgery During the COVID-19 Pandemic: What I noticed in this changing climate at AAHKS 2020

By Marietta Zissimatos

The 30th AAHKS Annual Meeting was unlike any other. Following current events, regulations, and trends AAHKS 2020 adopted a hybrid model allowing attendees and presenters to choose if they’d like to be present in Dallas, Texas, or attend virtually from all across the US. Force Therapeutics - being a virtual care platform - joined the meeting virtually and was glad to see our 10 Force Research Network (FRN) studies be presented amongst a hundred plus important works.

New opportunities to engage with a hybrid model:

I appreciated the ability to engage with the AAHKS mobile app and connect with attendees, but what I loved most about the hybrid model was the ability to view each session at my own speed and rate the quality of the presentation. I also enjoyed being able to see how many views each podium and poster received. This clued me in to the key challenges many attendees were facing and overall what information they were seeking.With COVID-19 inducing even more anxiety for patients than already experienced before surgery, the Force team was excited to see that the FRN podium presentation with Dr. Hanson and Dr. Fillingham on GAD-2 received 351 views and ultimately rounded out as one of the most viewed podiums. This study showcases that preoperative GAD is a risk factor for poor postoperative pain control following TJA, but it can be a modifiable risk factor when patients are appropriately treated.At the virtual symposium hosted by Dr. Daniel Berry, all attendees were able to take part in the live polling for practice norms in primary hip and knee arthroplasty where real-time results and commentary were displayed. Physical therapy was also included in the questions with 45% answering “YES” to have their patients work with a PT after THA as well as 98% recommending PT after TKA.

Patient selection OR optimization:

Patient selection has been widely used when referring to outpatient surgery and decreased length of stay. Providers are called to identify patients that are at high risk for complications, revisions, readmissions, and other adverse events which often lead to penalties imposed on healthcare facilities. Multiple presentations focused on which factors can be potential predictors of high risk such as BMI, allergies, and age. Additionally, patient selection was referred to as optimization. Knowing which patients are at higher risk and which risk factors are modifiable can guide providers to support patients in optimizing their health prior to TJA, and potentially improve their outcomes, decrease care costs as well as improve their overall health. As Force is constantly seeking to improve patient experience through evidence-based solutions we have previously used patient data and preoperative tools to investigate which patients are appropriate to receive surgery, how long their length of stay should be, and which post-op services are required. View the study on preoperative optimization.

AI and Machine Learning:

Engineering also had a place at AAHKS as artificial intelligence and machine learning topics contributed to the discussion for patient optimization. Dr. Brett Levine shared how AI can be utilized to predict risks and optimize patients without limiting their access to care. Machine learning may be a new concept for some orthopedic surgeons, but can be a valuable tool to predict complications and outcomes, and even be used to identify surgical implants. What was highlighted throughout the discussion was the need for high-quality data sets such as electronic medical records that can contribute to the development of AI solutions. What we know now is that through AI, targeted interventions can be developed to assist patients before and after their surgery. As such, Force has developed the Intelligent Care Plan as a prescriptive virtual care plan that dynamically engages and adapts to each unique patient to deliver highly personalized care at scale.AAHKS 2020 highlighted that multidisciplinary and innovative approaches are imperative in order to enhance patient care and deliver better outcomes. The Force Research Network continues to contribute to this mission by providing high-quality data to support care teams and patients.

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