Hamid Rahmatullah Bin Abd Razak1,2, Jin Ye Yeo3
1Total Orthopaedic Care & Surgery, Singapore; 2Duke-NUS Medical School, Singapore; 3ATM Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. ATM Editorial Office, AME Publishing Company. Email: editor@atmjournal.org
This interview can be cited as: Bin Abd Razak HR, Yeo JY. Meeting the Editorial Board Member of ATM: Dr. Hamid Rahmatullah Bin Abd Razak. Ann Transl Med. 2024. https://atm.amegroups.org/post/view/meeting-the-editorial-board-member-of-atm-dr-hamid-rahmatullah-bin-abd-razak.
Expert introduction
Dr. Bin Abd Razak (Figure 1) completed his basic medical degree in 2009 at the National University of Singapore. He subsequently pursued residency training in Orthopaedic Surgery, completing his specialty training in 2018. He is a Fellow of the Royal Colleges of Surgeons of both Glasgow and Edinburgh and is currently in private practice. Dr. Bin Abd Razak is a fellowship-trained knee preservation surgeon who has published extensively in the field and has been invited as faculty at regional and international conferences.
Regarding his scientific activity, Dr. Bin Abd Razak has published more than 100 articles in peer-reviewed journals and has participated in numerous national, regional, and international congresses. He has authored key research articles in reputable journals, including the Journal of Bone and Joint Surgery (American Volume). Additionally, Dr. Bin Abd Razak serves as a reviewer for several musculoskeletal journals and is currently an Associate Editor for BMC Musculoskeletal Disorders.
Figure 1 Dr. Hamid Rahmatullah Bin Abd Razak
Interview
ATM: What drove you to pursue orthopaedic surgery? What aspects of orthopaedic surgery have kept you in the field until now?
Dr. Bin Abd Razak: It was somewhat by chance that I focused on orthopaedic surgery. I considered several other specialties during medical school, but I found myself most comfortable and confident during orthopaedic training. This was partly because I felt I could relate to the core knowledge and didn’t need to exert extra effort to excel. My interest was further piqued by my involvement in sports; experiencing sports injuries firsthand and going through orthopaedics deepened my interest in the field.
What has kept me in the field is the variety of needs and the numerous pathways an orthopaedic surgeon can pursue. The nature of the work aligns closely with engineering, a career I had considered before medicine. Orthopaedics involves problem-solving: you see a fracture and aim to fix it; you encounter a degenerated joint and decide whether to salvage, preserve, or replace it. This problem-solving aspect, akin to engineering, excites me. The potential for research, innovation, teaching, and integrating technology into orthopaedic surgery continually motivates me.
ATM: Could you provide an overview of recent publications in joint preservation surgery of the knee and hip? Are there any interesting articles or techniques that have stood out to you?
Dr. Bin Abd Razak: My recent focus has been on research, clinical training, and academic collaboration in knee preservation. There's been a noticeable increase in arthritis among younger individuals. While knee replacement is an excellent procedure for the right patient at the right time, preserving the natural knee remains crucial for younger patients. Recent literature has focused on outcomes and techniques for preserving the native knee, such as optimising alignment through osteotomies and exploring regenerative treatments to restore cartilage and ligaments. We are moving towards personalised medicine and surgery, enhancing both mechanics and biologics. Innovations in 3D printing for preoperative planning and bioprinting for tissue creation are also advancing joint preservation.
One article (1) that caught my attention was published in The Lancet, which studied over 70,000 patients who underwent knee replacement surgery. It found that those who had surgery before the age of 75 faced a threefold higher risk of needing revision surgery later in life. This finding was significant and influenced my decision to delve into knee preservation, leading me to pursue a fellowship in London and collaborate with experts in the field. I am now excited to push the boundaries of knee preservation in Singapore.
ATM: What are some recent advancements in biomechanical interventions for arthritis prevention? How have these advancements impacted your practice?
Dr. Bin Abd Razak: Rather than new advancements, there has been a resurgence in interest in biomechanical interventions for arthritis. This includes correcting alignment through osteotomies, a well-established method for treating knee malalignment. Although osteotomy itself is not new, there have been refinements in technique to make it safer and more reproducible, encouraging younger surgeons to learn this skill. We are also incorporating technologies like computer vision to enhance surgical processes. These refinements, gained from my fellowship and global interactions, have positively impacted my practice, boosting my confidence in addressing complex knee preservation issues and communicating effectively with patients about surgical outcomes.
ATM: Could you share your thoughts on the use of artificial intelligence (AI) for pre-operative planning of orthopaedic surgical procedures? How can AI contribute to pre-operative planning?
Dr. Bin Abd Razak: I recently published an article on the use of ChatGPT in pre-operative planning (2). While AI has potential in this area, we are still far from relying entirely on it. The effectiveness of AI depends heavily on the quality of the dataset used to train the algorithms. AI can assist in pre-operative planning for orthopaedic surgeries, but it is only as intelligent as the algorithms developed by humans. We need to create clean datasets to refine these algorithms. AI should augment rather than replace human input, improving efficiency and allowing surgeons to focus more on patient interaction and skill development. Currently, we use planning software that incorporates some AI, but there's much more potential as we refine the datasets.
ATM: Moving forward, what research directions do you think are needed to optimise the use of AI in orthopaedic surgical procedures?
Dr. Bin Abd Razak: One challenge in research is managing variability. We need to minimise and standardise reporting variations, especially in biologics research where bio-active substances are involved. Although it may sound contradictory, standardising how we report differences is crucial for AI to interpret data accurately. This area requires attention to enhance the usability of research outcomes, particularly for AI applications.
ATM: As the former lead of Sports & Joint Preserving Osteotomy Services and site chief for SingHealth Sports & Exercise Medicine Centre, are there aspects of sports medicine research that you believe have been overlooked or received insufficient attention?
Dr. Bin Abd Razak: As surgeons, we often focus on surgical outcomes, but there is a lack of emphasis on non-surgical and non-invasive interventions. For patients who choose non-surgical options like physiotherapy or acupuncture, we need better ways to monitor their outcomes. There is also a publication bias towards surgical results. More research and resources should be devoted to non-surgical management and rehabilitation protocols, which are critical but often based on anecdotal evidence rather than robust data. Personalized rehabilitation also needs more attention. We should strive for a comprehensive understanding of outcomes in joint preservation and exercise medicine.
ATM: As a recipient of numerous awards, what advice do you have for aspiring surgeons who wish to excel in orthopaedic surgery?
Dr. Bin Abd Razak: Awards should not be the primary motivation for excelling in orthopaedic surgery. The core goal is to improve patient outcomes. This can be achieved through research, refining clinical skills, and collaborating with industry, academics, and policymakers to enhance care accessibility. Everyone in the ecosystem, including surgeons, engineers, administrators, and patients, plays a role. My advice to aspiring surgeons is to keep the patient at the centre of everything they do—whether teaching, conducting research, or performing surgery. By maintaining this focus, they will be well-positioned to achieve excellence.
ATM: How has your experience been as a long-standing Editorial Board Member of ATM?
Dr. Bin Abd Razak: ATM has a broad readership and attracts global publications, offering diverse perspectives and writing styles. Reviewing these papers has been an enriching learning experience for me. ATM’s growth in readership and impact has been impressive, and I look forward to continuing this journey with the journal.
ATM: As an Editorial Board Member, what are your expectations for ATM?
Dr. Bin Abd Razak: One area to consider is equal opportunity across the globe. Highly developed regions often have ample research resources, whereas lesser-developed areas may lack support. If ATM can focus on philanthropic efforts in these under-resourced regions—such as building capacity for their medical schools or academic institutions, teaching them how to conduct quality research, and guiding them on publication and avoiding bias—it would be a significant contribution. Of course, we need to first ensure our own success before we can assist others.I would like to share an anecdote that illustrates the spirit of generosity. A man went to a market and stopped by a shop to buy a pen. He was surprised when the shop owner told him the pen was priced at $13, as he usually bought such pens for $3. Despite asking repeatedly why the pen was so expensive, the shop owner insisted on the $13 price. Frustrated, the man bought 30 pens for $90 from a neighbouring stall and returned to brag about it. The shop owner quietly responded, "I am satisfied with my business for today; I’ve sold all my pens, and this is the last one. My neighbour hasn't been selling well, and I priced my pens high hoping you would support him instead, since I’ve had my fill for today." This story highlights that, regardless of our position, we should help those in our community who might be struggling. In this spirit, I hope ATM can grow to a point where we can assist others in advancing to our level and support institutions in less developed countries on their journey as well.
Reference
- Bayliss LE, Culliford D, Monk AP, et al. The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study. The Lancet 2017;389:1424-30.
- Gengatharan D, Saggi SS, Bin Abd Razak HR. Pre-operative Planning of High Tibial Osteotomy With ChatGPT: Are We There Yet?. Cureus 2024;16:e54858.