Latest / Becker’s Healthcare Podcast / Dr. Bradley Lamm, DPM, Director of the Foot and Ankle Deformity Center and Director of the Foot and Ankle Deformity Correction Fellowship at the Paley Institute

Transcript

Dr. Bradley Lamm, DPM, Director of the Foot and Ankle Deformity Center and Director of the Foot and Ankle Deformity Correction Fellowship at the Paley Institute · Becker’s Healthcare Podcast

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