Robotics in Orthopaedics: Exploring Future Possibilities for South Africa

Area of Science:

• Medical Technology and Innovation
• Healthcare Systems Analysis
• Surgical Robotics

Background:

• Robotic-assisted orthopaedic surgery offers enhanced precision and outcomes, established in high-income countries.
• Adoption in resource-limited settings like South Africa faces significant logistical, financial, and ethical hurdles.
• Disparities between public and private healthcare sectors complicate technology prioritization.

Discussion:

• Widespread robotic surgery adoption requires specialized training, robust IT infrastructure, and high patient volumes, often lacking in public hospitals.
• Ethical considerations (justice, beneficence, non-maleficence, autonomy) must guide technology integration to avoid exacerbating inequities.
• Alternatives like image-guided navigation and AI-supported planning offer more scalable solutions for resource-constrained environments.

Key Insights:

• A phased, context-sensitive strategy is proposed: centralize robotic capabilities in high-volume centers and invest in simulation-based training.
• Simulation training using virtual and augmented reality (AR) can create a cost-effective, scalable, and locally trained workforce.
• Upgrading hospital IT systems, ensuring interoperability, and establishing data governance are crucial for effective robotic system integration.

Outlook:

• Robotic orthopaedic surgery is aspirational but achievable in South Africa with strategic planning and investment in human capital.
• A modular approach focusing on planning tools and digital navigation systems can serve as a viable entry point for surgical digitization.
• Aligning technological innovation with national priorities and public good is essential for advancing surgical care equitably.