A future with no MVC patients? Impact of autonomous vehicles on orthopaedic trauma may be slow and steady

INTRODUCTION: Orthopaedic trauma results in significant patient morbidity. Autonomous vehicle (AV) companies have invested over $100 billion in product development. Successful AVs are projected to reduce motor vehicle collision (MVC)-related injuries by 94%. The purpose of this study was to estimate the timing and magnitude of AV impact on orthopaedic trauma volume. METHODS: ICD 9 codes consistent with acetabulum (OTA 62), pelvis (OTA 61), hip (OTA 31), femur (OTA 32–33), tibia (OTA 41–43), ankle (OTA 44), and calcaneus (OTA 82) fractures and the proportion of cases caused by MVC were taken from the National Trauma Databank (NTDB) 2009–2016. Regression was performed on estimates of market penetration for autonomous vehicles taken from the literature. RESULTS: For NTDB years 2009 to 2016, 300,233 of 987,610 fractures of interest were the result of MVC (30.4%). However, the percentage of MVC mechanism of injury ranged from 9% to 53% depending on fracture type. Regression of estimates of AV market penetration predicted an increase of 2.2% market share per year. In the next 15 years we project 22% market penetration resulting in a 6% reduction in orthopaedic lower extremity trauma volume. CONCLUSION: Adoption of AVs will result in a projected 8% reduction in MVC-related orthopaedic trauma-related injuries over a 15-year period. Although this represents a significant reduction in morbidity, the advent of AVs will not eliminate the need for robust orthopaedic trauma programs. The gradual rate of injury reduction will allow hospitals to adapt and reallocate resources accordingly.