Remembering vague directions and watching for street signs is one way to get to a destination. But, when Dr. Eric Black wants to get somewhere, he pulls out his cellphone and launches Google Maps.
Black, an Atlantic Health System shoulder and elbow specialist, looks at emerging medical technology just the same way. There are professionals who want to do surgeries the old-fashioned way. He’s not one of them.
There’s a cultural divide at the heart of medicine. In the niche of shoulder surgery, that’s something Black is seeing play out in the tentativeness around high-tech “mixed reality” technology, which, he believes, holds revolutionary potential in his field.
He’s already involved in its early deployment at Atlantic’s Morristown Medical Center, which is one of the few health centers anywhere utilizing Stryker’s Blueprint Mixed Reality platform. This technology, which was only conceptualized as recently as four years ago, allows surgeons to plan out operations through a holographic headset.
Few have used this type of technology with shoulder replacement surgeries before, Black said. So, that means there are some hangups. There’s the predictable regulatory aspects involved in ensuring the technology is leading to accurate and reproducible results. And then, there’s the reluctance Black believes you’ll find with any breakthrough technology in medicine.
“I like technology,” he said. “I can grapple with new technology, play around and get comfortable quickly. I’m an early adopter. But there’s an old guard of surgeons saying: ‘Well, I can do it the way I’ve been doing it for 20 years, and that’s working just fine. Why change it?’”
Black believes the answer lies in the findings of recently published studies.
“When you take a new surgeon or a resident, pair them with this technology and put them up head-to-head against a veteran, senior surgeon, the technology wins every time,” he said. “I think we all sort of know this in our hearts. We’d love to think AI isn’t going to be a reality. It already is. It might have its downfalls, but collective reasoning and computers have the ability to make us better, faster and more accurate.”
Black is a specialist in complex shoulder replacement surgeries. No two shoulders, particularly those that need replacing, are the same. Patients can have unexpected deformities in their shoulder anatomy that alter how surgeries and implants should be carried out.
That can all be visualized with mixed reality tools, which can display 3D renderings of a patient’s anatomy. The headsets also allow surgeons to always have easy access to patient history, X-rays and CT scans before and during operations. In the future, Black expects to do even more with mixed reality and robotic devices to navigate surgeries as they’re happening.
The bottom line is this: Is it actually making surgeons such as Black better at what they do?
In his view, there’s no question it is. And he’s seeing results indicative of that.
“When I first started practicing, (shoulder replacements) would be often looked at as a salvage operation,” he said. “You’d be pretty good. But you might not be playing pickleball anytime soon. Now, people are swimming, playing golf, tennis — things people never thought they’d do after a shoulder replacement.”
As for the data to back it up … he might not have that for decades, potentially.
“We’ve gotten so good (at orthopedic implant procedures) that the failure rates are low in the first five to 10 years,” Black said. “When this is going to start making its true mark is the longevity of shoulder replacements done now, which we believe will be 20-plus years.”
Barring unforeseen circumstances, they expect favorable, reproducible results for patients anytime they’re pairing surgical expertise with this new technology, he added.
Patients have come to expect it themselves. They’re growing more comfortable with high-tech additions to surgical operations, Black said.
“They know we’re not just going in on any random person, throwing in a shoulder replacement and then leaving,” he said. “They know we’ve thought about the surgery, sat and looked at images and planned it all out before doing it. So, the patient buy-in is incredible. They also feel like they’re part of the experience. I’ll sit with them a lot of the time and plan it out with them on a computer. They appreciate that, and feel like we’re doing something special for them.”
As it stands, Morristown Medical Center is still one of the only places where you can find this technology being put to use.
Providing for cost considerations with these devices, Black anticipates that there will need to be more of a culture shift in the “old guard” surgery teams before that changes.
“For me, it’s a fun and also unique opportunity that I’ve been able to procure (this innovation), which, I’d imagine, most hospitals would be envious of,” he said. “We’re really spearheading some of the industry side of this technology.”