How Technology Will Affect the Design and Use of Implants
Interview with an orthopaedic surgeon
According to an OECD[1] report published in 2017, hip and knee replacement surgery has become a common procedure in many countries. Their number is also increasing, especially in Canada where joint replacements have increased by about 17% over the past 5 years[2]. The quality of the implants, both in terms of the materials used and in manufacturing, is a major factor in the success of these replacement surgeries. It also partly determines the longevity of the implant.
Surgeons and manufacturers have been working together for decades to develop ever more efficient implants. What is the future of orthopedic implants? How can manufacturers help develop tomorrow’s implants? How can robotics contribute to the evolution of orthopaedic surgeries? Dr. Michael Weber, an orthopaedic spine surgeon at the Montreal General Hospital, explains the link between medicine and manufacturers, and offers a perspective on the possible evolution of orthopaedic implants.
Surgeons and Manufacturers: A Long-Standing Collaboration
Dr. Weber tells us that “Surgeons do not assess the quality of an implant on the day of the procedure. The surface finish of the implants has been validated by manufacturers according to high quality criteria. Only an abnormality visible to the surgeon eye can induce rejection of the implant, which remains an exception.” This information tells us how much trust is needed between surgeons and manufacturers.
The quality of the surface finish of the implants has a major impact in the success of joint replacements. Over the years, manufacturers have adopted technologies, such as robotics, to ensure the highest quality of manufactured implants and contribute to the success of joint replacement surgeries.
Collaboration between manufacturers and surgeons is also required from the early stages of implant development. Dr. Weber states, “It’s a process of close cooperation, that advances technology.” Manufacturers make their engineering and research resources available to conceptualize implants and perform laboratory tests. Surgeons link up with patients to test implants in clinical trials.
The Evolution of Joint Replacements
“The demand for orthopaedics is growing, in part because of the aging population and the level of activity that patients want to maintain. Until a magic pill is found against aging, the need for orthopaedic surgeries will become increasingly important.”
Dr. Weber also tells us that orthopaedic needs are not limited to hip and knee joints. “The technologies developed for knee and hip implants in other anatomical regions, ankle, hand, wrist, spine, are opportunities for the development of orthopaedic discipline.” Knee and hip implants have become orthopaedic standards, and manufacturers have the potential to capitalize on these technologies to design and improve other types of implants.
Customization and Robotics
The customization of implants according to the patient’s anatomy is also a trend in the orthopaedic field. According to Dr. Weber, “personalization techniques are currently used for more specialized procedures, on patients with irregular anatomy or a tumor. Medical imaging, such as CT scans, assesses the needs of the implant. The surgeon then works with manufacturers to obtain a custom implant using 3D printing.”
Dr. Weber adds that this trend towards customization can go even further: “From the operating room, the surgeon could identify the joint problems, 3D print the missing components, sterilize them and immediately introduce them into the patient.” However, these techniques would bring new challenges related to the raw finish of implants designed with 3D printing. The need for surface finishing and visual inspection to finalize and validate implant compliance would therefore be major. Dr. Weber concludes by saying, “That’s why I believe that a company like AV&R will play a key role in the development of these implants.” Surface finishing and visual inspection specialists will be able to work hand-in-hand with manufacturers and surgeons to deliver customizable robotic systems that meet high levels of quality.
Orthopaedic implant manufacturing technologies, such as 3D printing and robotics, will be key elements in the evolution of the orthopaedic field. Thanks to the sequencing software of robotic systems, which allows the rapid design and execution of surface finishing processes, surgeons will be more autonomous in the customization of implants, for the benefit of patients.
We thank Dr. Michael Weber for his time and insight into orthopaedic implants and their evolution.
