Mr. Albers, the AO Foundation is well-known among surgeons. How would you explain what the AO stands for to non-surgeons?

Claas Albers: The AO is indeed an extraordinary organization. When it was founded in the late 1950s, modern trauma surgery as we know it today did not yet exist. Broken bones were often immobilized for many weeks—with all the associated consequences: long periods of bed rest, stiff joints, poorer healing prospects, and a significantly higher risk of permanent disability. 

The founders of the AO—a small group of Swiss surgeons—radically questioned this approach. They developed four basic principles that are still valid today: realign fractures as anatomically as possible, stabilize them, protect the surrounding tissue, and mobilize patients early on.  

However, it was not only the medical approach that was decisive, but also the consistency with which the AO founders documented and passed on their knowledge. They collected surgical data, compared results, and trained colleagues around the world. This was revolutionary at the time—and has had a lasting impact on traumatology. 

What is the role of the AO today? 

Claas Albers: Our mission remains unchanged: we want to make surgeons around the world better. To this end, we conduct research, help develop implants and instruments, carry out clinical studies, and train tens of thousands of doctors in over 160 countries every year. 

It is important to us that this training is scientifically sound, independent, and globally accessible. Good care should not depend on whether someone works in a university hospital or a remote hospital. When we spread knowledge worldwide, patients benefit everywhere. 

Where do you currently see the biggest developments in surgery?

Claas Albers: Implants are continuing to evolve, but the biggest lever now clearly lies in data. We have a much better understanding of how patients feel after surgery—not just on x-rays, but in real life. 

Today, for example, we can see how far someone can walk ten days after surgery, how confident their movements are, how pain develops, and when patients can resume their daily activities. When this data is structured and compared with thousands of similar cases, patterns emerge: Which treatment is particularly effective? Which factors accelerate recovery? And where do risks arise earlier than expected? 

Such correlations were hardly visible in the past. Today, they help to tailor treatments more individually and make decisions more reliable—a real advantage for patients. 

Mr. Ehrke, how does Brainlab contribute to making such data useful?

Nils Ehrke: Our contribution consists of digitally connecting the entire treatment pathway. In the past, imaging, planning, surgery, and follow-up care were often separate processes. Today, we can bring these steps together on one platform—and that is precisely what makes data truly useful.  

When you can see what was planned, how precisely it was implemented, and how patients are doing afterward, you get a more complete picture. And this overall picture helps teams make better decisions and manage treatments in a more targeted manner. 

The data generated today along this treatment pathway comes from a wide variety of technologies and systems. Does this heterogeneity also pose a challenge in everyday clinical practice?

Nils Ehrke: Yes, absolutely. In many hospitals today, imaging, planning, navigation, and documentation operate on completely separate technological siloes. Each system works well on its own, but they often do not communicate with each other. For teams, this means that data must be transferred, compared, or re-entered manually—and in doing so, time is lost, and sometimes information as well. 

Our approach is therefore to bring these technologies together on an open platform. When imaging, planning, surgery, and follow-up care are linked, a continuous workflow is created. Then the relevant data is available where it is needed—without interruptions and without detours. This optimizes surgical procedures, relieves the burden on teams, and ultimately makes decisions more reliable. 

Could you give a concrete example of what that looks like?

Claas Albers: Consider, for example, the subject of robotics in surgery. A robot alone does not automatically make an operation better. It needs precise imaging, clear planning, reliable navigation, and clearly defined steps in the procedure. If these technologies run separately from each other, their potential cannot be fully exploited. 

However, when they are integrated—in other words, when the robot knows exactly what has been planned, what the anatomy looks like, and how it needs to orient itself in the space—the result is a truly reproducible and safe process. Robotics clearly demonstrates how crucial the interaction between systems is: such technologies only reveal their value in a functioning workflow. 

Since you mention the example: What role will robotics play in the future?

Claas Albers: Robotics does not make surgery better per se, but it does make it more reliable. It reduces physical strain on the surgeon and increases precision.

Nils Ehrke: As Claas said, robotics is powerful when the workflow is right. A robotic arm alone does not improve anything. But when imaging, planning, and navigation work in harmony, robotics brings structure, calm, and precision to complex procedures—thereby increasing both the quality of treatment and safety in the operating room. 

Where do you see untapped potential?

Claas Albers: One particularly exciting field is sensor technology. You can think of it this way: Implants of the future could provide feedback—for example, how stable a fracture is healing, how much stress is already possible, or whether inflammation is developing. Such real-time feedback would help us tailor therapy to the individual: mobilize earlier, rest more specifically, or intervene more quickly if something changes. This could speed up recovery and avoid complications—a real benefit for patients. 

Nils Ehrke: And the prerequisite is clear: genuine integration. Many clinics today have numerous systems operating side by side—but they are not linked in a meaningful way. That is why we are focusing on an open platform that works independently of implant manufacturers. Only when technologies from imaging, planning, navigation, robotics, and results documentation are fully integrated we truly exploit their entire potential—worldwide. 

The AO helps us enormously in this regard. It contributes perspectives from surgical training and from very different healthcare systems. This teaches us which solutions not only work technically, but also in everyday life, all over the world. This combination of technology development and practical experience is a great advantage. 

What else is needed to truly exploit this potential?

Claas Albers: First of all: time—because data only reveals useful patterns once a very large number of cases have been collected and evaluated. That takes time and cannot be rushed.  

And secondly: training. The more individualized our treatment, the more information we need to make our decisions. So it's more demanding than it used to be. That's why we need new forms of learning—such as simulations, mixed reality visualization, or digital guidelines directly at the operating table. They help us access the best possible knowledge at the decisive moment.  

For these approaches to have a global impact, they must not only be technically mature, but also scalable—in other words, designed to work in very different structures. This is precisely why the collaboration with Brainlab is so valuable.  

Nils Ehrke: And we have to be realistic: not every clinic can start with the same range of technology right away. Our goal is therefore to develop solutions that work everywhere—whether in a large center or a smaller hospital. In addition to all the technology, training remains one of the decisive factors for successful treatment—in Munich as well as in Marrakesh or Sāo Paolo. 

You already mentioned the collaboration between AO and Brainlab—what does that look like in concrete terms?

Claas Albers: Very close. We have been using Brainlab technologies in our courses and training programs for years because they help us convey complex procedures in a way that is easy to understand and follow. Together, we are developing new learning formats—such as interactive planning exercises and simulations—that not only teach surgeons theory but also allow them to practice making real decisions. We also analyze typical operating room procedures together and ask ourselves: Where is information lost? Where does it become confusing for teams? And how can we design workflows that function worldwide? 

It is important to us that these tools can be used not only in highly specialized centers, but also in smaller clinics. This is exactly where the collaboration works particularly well. We are working toward the same goal: a safe, transparent, and easily comprehensible way of working—regardless of the implant, the manufacturer, or the country. And we are working together to not only teach this knowledge in courses, but also to put it directly into practice. 

Nils Ehrke: The AO is an extremely important partner for Brainlab in two respects. Firstly, as an independent organization, it has very close ties to surgeons—through courses, networks, and a wide variety of healthcare systems. This gives us a very clear picture of where uncertainties arise, or information is lacking in everyday practice. 

Second, the AO is a platform that gives us early feedback on new developments: How easy is a software interface to use? Where does a registration process get stuck? Which training formats are really helpful? This feedback flows directly into new applications. Our goal is to design technologies that are easy to use in the operating room, reduce the workload for teams, and can be implemented in a wide variety of clinics. Ultimately, patients benefit when good processes work reliably everywhere. 

In the end, it is often the many small improvements in the many details of a treatment process that add up to significantly better treatment for patients. And our partnership with the AO helps us to achieve these significantly better treatments, not only in a few top hospitals, but in all kinds of environments worldwide.  

How do patients actually benefit from all these developments?

Claas Albers: Patients benefit in very concrete ways: they have fewer complications, recover more quickly, and return to their everyday lives faster. 

Nils Ehrke: And operations become more reliable. When procedures are planned according to clear, standardized steps and supported by digital tools, the results are less dependent on chance. This makes treatments more reproducible and safer. For patients, this means fewer complications and a quicker return to their everyday lives.