The Changing World Around Orthopedic Implants

Those who have been in this industry for more than a few years realize implant technology has not changed all that much. Sure, there are new product releases offering innovative benefits not previously available. Further, emerging manufacturing technologies and advancements achieve new capabilities in terms of the equipment and machines fabricating the implants using better, more efficient methods (Get more on this topic in this month’s cover article, Technology Revision, on page 34). Overall, however, the form, function, and appearance of many orthopedic implants has remained relatively unchanged for quite some time.

In stark contrast to this, the products and technologies surrounding the implants are rapidly transforming. In some cases, the digital revolution is taking hold, with smart technologies being incorporated into rehabilitation devices. Elsewhere, surgeons are benefitting from the incorporation of robotic-based guidance systems. Further still, imaging technologies are improving and emitting less radiation, virtual and augmented reality systems are being used for training as well as during surgical procedures, and biologics have become a significant part of the orthopedic sector. While advances in implants remain relatively static, the dynamic changes in their supporting technologies are quite exciting.

To see many of these revolutionary solutions on display, one needs travel only as far as the location of the next American Academy of Orthopedic Surgeons (AAOS) annual meeting (which will next be in Orlando, Fla., in March 2020). I attended this year’s event in Las Vegas and was pleased to see just how quickly certain “supporting” areas of the orthopedic industry were developing and embracing many of the aforementioned advanced technologies.

Reflexion Health was one of my first visits during this year’s event. The firm offers a virtual solution called VERA for at-home and onsite physical therapy, combining 3D motion capture technology with a game-like interface. VERA tracks a patient’s physical therapy routine, capturing information about range of motion and overall progress. This data is also shared with the patient’s physician, enhancing communication (and honesty) between the two parties. The system has been the subject of studies by both Duke and Yale that presented favorable assessments. In particular, one aspect of great interest to a variety of stakeholders is that the use of the system resulted in greater patient compliance. It also provides cost savings, which makes it quite beneficial in an industry moving to a value-based healthcare system and seeing greater incorporation of bundled payments.

CyMedica Orthopedics displayed another interesting solution in the rehabilitation space. The company’s e-vive system was developed to help patients better deal with their knee osteoarthritis (OA). The idea behind the technology is to help improve the quadriceps; thigh muscle weakness is often associated with OA. Restoring strength in the quadricep can help a patient delay the need for surgery and enable them to return to more normal activities. The e-vive device employs neuromuscular electrical stimulation (NMES) of several muscles for the purpose of rehabilitation and strengthening. According to the company, the NMES stimulus is designed to mimic the same type of signal the brain sends to the muscle when exercising.

At another show booth, I met with Myoscience. This company has developed a pain management solution that utilizes non-opioid nerve block technology to offer knee pain relief. The iovera° system provides a handheld alternative to physicians for the delivery of cryoanalgesia (the reversible destruction of the signal carrying parts of a nerve). The unit enables precise, controlled doses of the cold temperature to the specific nerve with no damage to the surrounding tissue. Given the efforts being put forth to find alternatives to opioids, this technology could certainly be welcomed by those who suffer from knee pain.

Although not offering a specific technology themselves, my meeting with the organization Mend Medical was still intriguing. They are investing in various companies as they seek to “heal healthcare.” While that’s a rather vague mission, it seemed to me to be an earnest, worthwhile effort. More specifically, as it reads on the firm’s website, Mend Medical is “working to positively impact the culture of healthcare—eliminating waste, changing corrupt incentives, and improving access to care.” While the company currently showcases three partners on its website, none of them are in the orthopedic space. That could change, however, by the next AAOS meeting.

So while the main focus of the orthopedic industry—the implant technologies—are still slow to go through changes and modernization, it is quite exciting to see what’s happening in the changing world around those implants.  

Sean Fenske, Editor-in-Chief
[email protected]