This is Carly Beam with Becker Spine and
Orthopedics podcast. And joining me today is doctor
Bradley Lamb, director of Foot and Ankle Deformity
Center and Fellowship at the Paley Institute.
Doctor Lamb, thank you so much for joining
us today.
Thank you for having me. And so before
we dive into our questions, I'd love if
you could just introduce yourself, share more about
your work and background.
I am doctor Bradley Lam. I am a
foot and ankle
surgeon
in West Palm Beach. I am the chief
of foot and ankle surgery at the Saint
Mary's Medical Center in Palm Beach Children's Hospital.
I'm also the director of the Foot and
Ankle Deformity Center and Fellowship at the Paleo
Orthopedic and Spine Institute.
I've been practicing for over twenty five years
and have had
numerous fellowships in club feet,
orthopedic trauma, which is called AO trauma,
limb deformity correction and limb lengthening.
And
I am specifically interested in,
deformity correction when it comes to the foot
and ankle and have had,
vast experience
with,
very complex cases that require unique solutions.
Yeah. And you're kind of hooking off of
that. You recently performed the world's first,
MedCAD three d printed
patient specific cut guide procedure for an ankle
realignment, and it was a very complex case.
And I was wondering if you could share
more about that and what you learned from
it. What are the wins? What will you
build on for future cases, etcetera?
Yeah. So MedCAD offers something,
I think, disruptive
to orthopedics,
meaning
it offers
my
unique patients or unique deformity,
or my patients who have unique deformities,
a solution which is very
patient specific.
This is kind of revolutionary
in orthopedics where it's not deformity
specific,
where it's five degrees of
rotated or angled,
bone,
but it's very patient specific where it's not
only five degrees, but it's got the lumps
and bumps and contour of their specific,
deformity.
And so
what MedCAD
provides
and what I was able to provide provide
my patient
was,
the first ever in the world patient specific,
MedCAD,
medical procedure. So
that includes,
patient specific,
procedure
where we use cut guides to make sure
we cut and realign the bones correctly.
We use specific,
reduction
devices that are,
made for that patient's,
specific,
correction of their malaligned bone or ankle in
this case.
Also, patient specific plates,
to fit the contour of that bone,
and screw sizes that fit the length of
the bone and the exact contour
and can,
be planned so that
it's in the anatomic right position or correct
position so that doesn't give them trouble down
the road and also creates the,
correction and healing that we need.
And this is all based off of a
three d CAT scan that,
we use to plan this whole procedure.
So the beauty is the patient can see
the plan, I can see the plan, I
can adjust it,
what I need to adjust it to make
sure that it is
gonna work exactly how I plan it to
work. And in the OR, it's kind of
becomes just cookie cutter in a sense where,
this is all,
following the steps of this patient specific plan.
So
it's an awesome,
way to,
correct these deformities where we were in the
past just free handing and,
also kinda guessing, hey. Is this five degrees
or is this
six degrees of a change? And every millimeter
matters, every degree matters, and this provided my
patient a,
superb accurate outcome, which again is gonna,
create a great functional outcome in the end
is what we're looking for for these patients.
I can imagine. And can you talk more
about just the actual process of getting these
guys from the image to the product and
then to to OR? How does it fit
into the whole
workflow within this patient episode?
Yeah. So the workflow,
with MedCAD is,
is simple.
Basically,
with these complex deformities,
patients usually get CAT scans,
preoperatively,
before the procedure anyway.
So with this CAT scan that's three-dimensional,
we can therefore
then plan the correction,
whether it's a joint fusion,
whether it's a realignment osteotomy,
whether it's a
combination of some
bony work and soft tissue work.
We can basically preplan this out,
with the engineers at MedCAD.
Of course, they have great knowledge and plan
most of the case out and share with
me their results, and then we,
work together to fine tune it to the
patient's specific needs. And then, also,
you can design specific implants, whether it's a
screw, a plate, a pin, as,
a rod. That way, it goes exactly where
you want it for the correction that you
want. And, you know, preoperatively, I can talk
to the patients and show them exactly the
plan,
correction
through these beautiful printouts or on the computer,
and this gives patients confidence in me. It
gives me confidence that I know we can
get this accurately,
corrected.
And then in surgery,
it it makes it real easy that, I
can kind of follow the steps one by
one.
Got it.
And, you know, how do you see this
type of technology, you know, both MedCAD and
just patient specific technology, North Peaks overall,
converging with other big things like robotics,
outpatient care, value based care?
Yeah. So I think this fits nicely into
the,
ever changing,
advancing
technology
that,
surgeons are provided to help their patients. So,
this would, you know, lessen,
implant,
you know, misuse
or lessen the,
chances of,
negative outcomes because having a a better plan
leads to a better result. So,
I think it fits nicely into all this,
it is patient specific and I know patients
demand
the best of the best
health care in The States, and so this
MedCAD,
patient specific
treatment option
is right on that same track.
And
what what's your what are your predictions for
this technology in the next five years? What
do you think, you know, MedCAD two point
o, for instance, would look like?
Yeah. So I think, at the moment, I'm
using these,
specialty,
cut guides,
reduction guides, and implants,
for for complex cases. But I think it's
something that is going to
be,
demanded of even the more simplistic,
everyday,
cases that we do. So that way patients
can
have,
you know, the the best possible outcome and
the best possible,
implants,
and position
of their, you know, foot and ankle,
and,
again, that I feel can lead to the
best,
possible functional outcome.
Got it. And, you know, last question for
you, doctor Lam, is what are three top
health care trends that you're following today?
Yeah. So I think
the ever changing
medical field or ever evolving
medical field is,
you know, hard to keep up with because
there are so many new
advancing technologies.
But I think this,
patient specific,
repair of deformities and malalignments,
is definitely in that
spectrum of
disruptive technology where it's gonna change what we
do, where we can make it specific
each surgery for each patient.
I think also
technology where there's,
you know, all calcium implants which become incorporated
into the body is kind of the next,
the next frontier.
Having,
you know,
surgeries that heal quicker than, say, the average
where we have,
medical technology to help in advance,
healing of the surgeries that we do. I
know we do
more minimally invasive surgeries, which is, along that
same line, but also having technology that will
advance, repair of our our surgeries or,
injury repair so that patients can get back
to their feet, back to their activities,
their sports, and work as as fast as
possible.
Thank you. And a quick follow-up. I'm curious
to just kind of pick your brain on
biologics in orthopedics. I'm wondering what your predictions
are just in the short and long term
in that area.
These days, biologics
play a huge role in our surgical
procedures,
to try to advance the healing, whether it's,
you know, stem cells, whether it's, bone grafting,
whether it's,
PRP,
peptides, you name it. There are many forms
of
advanced healing
techniques that are,
promising to be regenerative, and I think that's
going to be,
now and also in the future, a huge
part of
orthopedics and,
helping the patients get back to their feet
and,
do their activities quicker.
Alright. Well, doctor Lam, thank you so much
for your time hopping on the podcast. It's
been a great conversation, and I look forward
to connecting the future.
Yep. Thank you very much for your time
too. Have a great day.