Copy to clipboard 
In 2015, Daniel Fick, FRACS; MB BS (Hons), Riaz Khan, Ph.D., FRACS, and Brett Robertson, Ph.D., recognized the emerging applicability of advanced cutting technology, artificial intelligence and robotics in joint reconstruction.
As a direct response, the trio leveraged their clinical, surgical, academic and orthopaedic expertise to create the Australian Institute of Robotic Orthopaedics (AIRO).
AIRO’s research pursuit is the development of its proprietary Intelligent Robot-assisted Subtractive Laser Ablation System (IRASLAS™), which will unite lasers, robot-assisted motion, computational modeling, artificial intelligence, digital sensing and real-time responses. The focus is on improving the speed, accuracy and precision of bone cutting to reduce damage to bone and surrounding tissues. AIRO has completed two prototyping phases and is incorporating custom controller software to synchronize all of the subsystems, as well as collection and storage of data.
AIRO’s three Directors hold adjunct faculty positions at both Curtin University of Technology (Perth, Australia) and University of North Texas. Professors Fick and Khan work in partnership at a network of Australian outpatient facilities. Robertson, an Associate Professor, has over a decade of experience in both executive health management and research.
To gain a greater understanding of AIRO’s objectives and predictions for the orthopaedic robotic market, we posed several questions to Robertson, AIRO’s Managing Director.
How do you see robotic technologies changing orthopaedics, and these technologies evolving over the next five years?
Robertson: We are already seeing a growing acceptance of the use of robotics during surgery, due to the potential for greater precision and accuracy. We feel they will become commonplace and will soon be universally accepted as standard orthopaedic surgical tools. Ultimately, we expect to see fully autonomous intelligent systems that are centrally and concurrently controlled by a surgeon-engineer operator.
We foresee seamless integration between planning, execution, implant positioning and mechanical alignment. Advanced cutting technology will replace mechanical tools and there will be a move towards intelligent and semi-autonomous systems.
What developments in the orthopaedic industry excite you most? Which are of most concern to you?
Robertson: We are increasingly seeing surgeons embrace new technologies for improved surgical outcomes to support a patient’s quality of life. However, integration and applicability in “real world” surgical environments is an essential consideration.
Outside of advanced cutting technology, intelligent systems and big data analytics, we are excited by the work being done in the regenerative medicine space by innovative companies, such as Orthocell. We are also excited about the burgeoning development in additive manufacturing and see clear synergies with our IRASLAS technology.
We consider one of the long-term commercial risks for the industry to be upstream disruption, with new techniques rapidly displacing established practices.
Going back to AIRO; how are you engaging device companies?
Robertson: We are working to ensure that IRASLAS has full functionality and applicability in surgical settings, and complements and enhances existing surgical technologies and devices.
At this stage, we are not able to speak in detail about our engagement with device companies, but we can say that our technology has been purposely designed to seamlessly integrate and enhance the current orthopaedic robotic surgical systems.
As a comprehensive treatment platform, IRASLAS is attractive to both surgeons and their patients. Our technology offers a step change advance in accuracy and precision, offering unprecedented levels of bone and soft tissue sparing. This enables a considerable value-add for a patient’s lifetime of care and the procedures they may require, including chondral regenerative procedures, partial resurfacing, total joint replacement and revision.
With whom does AIRO partner and collaborate?
Robertson: At the core of our research is a multidisciplinary approach matching innovation and scientific excellence with industry know-how. From its inception, AIRO’s founders have driven a strategic local and global collaboration strategy, aimed at harnessing Australian expertise and augmenting it with knowledge from the very brightest international leaders. We collaborate with experts in materials science, artificial intelligence, optics and photonics, who are not only leaders in their fields but also have proven success in commercializing their research.
Our knowledge partnerships reach internationally and include leading researchers and practitioners from The University of North Texas, Institute für Lasertechnologien in der Medizin und Meßtechnik, the University of Jenna, Curtin University and The University of Western Australia.
What is AIRO’s most significant challenge, and how are you overcoming it?
Robertson: Our most significant challenge is similar to that commonly faced by all startup companies – not scaling prematurely and keeping the burn rate low while de-risking the project sufficiently to attract the right industry partner. We are also working with our international research partners to support the technical components of our undertaking.
We are working hard on our development while continuing to pursue strategic relationships. To support the interest and engagement we have already seen, we are establishing links with potential industry partners that have the capacity, desire and demonstrated commitment to be the dominant player in the industry.
Brett Robertson graduated from the University of Western Australia with a Ph.D. in perioperative orthopaedic rehabilitation. In 2007, he founded Physical Solutions, an Australian physiotherapy company, before becoming CEO of one of Australia’s leading medical research organizations, the Ear Science Institute of Australia (ESIA). In this role, Robertson managed development and establishment of ESIA research facilities and surgical simulation and training facilities. He has over 10 peer-reviewed journal articles and has attended leadership workshops at the Harvard Business School on scholarship from the Harvard Club of Australia. Robertson is currently studying at the Stanford Graduate School of Business.
