Dr Andreas Ottersbach, a highly specialized orthopedic surgeon, is the Chief Physician and Head of the Orthopedic Clinic at the Upper Valais Hospital Center in Brig. He began implementing digitalisation in the operating theater at an early stage, thereby making the hospital center’s orthopedic department a pioneer in this field. This enabled him to implement and establish optimized surgical standards characterized by high precision and process consistency. With his idea to develop an innovative leg positioning unit – the RotexTable® – Dr Ottersbach transformed orthopedic surgical procedures worldwide. In Switzerland, he is regarded as a pioneer of the Rapid Recovery™ fast-track concept in orthopedics, which accelerates recovery processes and standardizes and continuously improves all procedures relating to joint replacement.
Leading Medicine Guide: Dr Ottersbach, your enthusiasm for new things must be innate. It was sport that first fascinated you. Your interest in technical and digital developments in medicine came later, didn’t it?
Dr Andreas Ottersbach: Yes, in my younger years I was a surfing instructor and, in 1986, in my early twenties, I took part in the World Surfing Championships in Italy. For five years, while studying medicine in Münster, I was the owner and manager of the Diemelsee Surf and Sailing School in the Sauerland; I was born in Bochum. I also dabbled a little in church music and can call myself an assistant cantor.
Since I joined the Upper Valais Hospital Center in Brig in 2005, where I have been head of orthopedics since 2008, digitalisation in orthopedics – particularly in the surgical field – has been a source of fascination for me. Computers have also brought about lasting changes to our daily medical practice. Modern IT is now an indispensable part of the operating theater, and I use it with enthusiasm. It enables a whole new level of precision, reliability and accuracy. Our work is meticulously recorded, which means our successes are measurable. You can see this in detail in the Swiss Implant Register (SIRIS).
Leading Medicine Guide: The success of your work in orthopedics at Spital Oberwallis – what does SIRIS say about this?
Dr Andreas Ottersbach: Compared to the rest of Switzerland, Spital Oberwallis achieves above-average results in both knee replacement and hip replacement surgery. We perform significantly fewer revisions – that is, repeat replacement surgeries – than the Swiss average. This means we have significantly fewer complications to report from our implant surgeries. Furthermore, SIRIS has attested to our continuous improvement in outcomes.
Leading Medicine Guide: Could you explain to us in a bit more detail why this is the case? These good figures don’t appear overnight; there’s a lot of work behind them. Could you elaborate on that?
Dr Andreas Ottersbach: In 2005, I introduced navigation technology in knee arthroplasty in Brig, a technique I had been using consistently since 1999. Compared to the hip, the knee is a more complex joint, which presents us surgeons with major technical challenges. The implanted joint must fit perfectly within the leg’s axis and allow for good mobility. With computer-assisted navigation technology, we work using infrared beams, transmitters and cameras. This allows the bone cuts to be monitored very precisely and, ideally, modified during the operation. The fitting of the implant, as well as the mobility and tension of the ligaments, can be carried out, checked and digitally recorded with the utmost precision. The advantages are clear, and the figures prove it: patients experience fewer ‘complaints’ overall, which is why our revision rates are below the Swiss average.
Leading Medicine Guide: In 2018, you pioneered the introduction of digitalisation in the operating theater; what does this mean for medical laypeople?
Dr Andreas Ottersbach: A digital process manager supports us during operations. Even the smallest surgical steps are defined and standardized here. The next step is announced on a screen or via voice, and the surgeon or a member of the team confirms it. This simultaneously generates a meticulous surgical record that we can review regularly. If improvements are needed or new medical findings emerge, the program can be revised and optimized. We broke new ground in Switzerland with intraoperative digitalisation, and other clinics have followed our example.
Leading Medicine Guide: It is not only in this way that you have demonstrated strategic foresight in orthopedics; a special operating table designed according to your basic principles is also being used worldwide in hip arthroplasty and for arthroscopic hip surgery.
Dr Andreas Ottersbach: Yes, that is the RotexTable®, a special unit for positioning the leg. It allows the surgeon to move and fine-tune the patient’s leg themselves without relying on assistance from the positioning team. Thanks to its special design features, the surgeon can clearly feel and control tissue tension, which increases patient safety. One function of the ergonomic positioning aid – namely lowering the leg – is operated electrically by the surgeon and is a unique selling point. The patient’s foot is positioned in a particularly ergonomic manner within the RotexShoe®. The concept behind this unique positioning aid is also based on my fundamental ideas. I have published extensively on this subject, and we regularly train surgeons from all over the world in the entire technique, which I have termed ‘Process-optimized minimally invasive total hip replacement’.
Leading Medicine Guide: You are regarded as a staunch advocate of the “Rapid Recovery” concept. Can you explain to us what this involves?
Dr Andreas Ottersbach: Rapid Recovery essentially means “fast healing” and is a holistic concept. In principle, it means getting patients back on their feet as quickly as possible after joint surgery. This means that the majority of our patients are taking their first steps just six hours after the procedure. By the very next day, many are able to climb stairs, and after a short time we can discharge them back home or to a rehabilitation center. The concept works because we have consistently focused on which treatment methods are truly effective and have moved away from traditional techniques that simply did not deliver the results we desired. In interdisciplinary working groups, we have also developed standardized treatment pathways here, optimized pain management and freed patients from unnecessary tubes and catheters. Here too, the results are clearly measurable and the success of our work is visible. Patients are delighted to regain their mobility so quickly, and this supports the entire healing process, including from a mental health perspective.
Dr Ottersbach, thank you very much for these interesting insights into the innovative developments surrounding joint replacements, their use and replacement!
Anyone wishing to contact Dr Andreas Ottersbach can do so very easily via his profile page in the Leading Medicine Guide.
