Personalization in Orthopedic Implants

In many areas of healthcare, personalized medicine is becoming increasingly more ubiquitous. From gene therapies developed from an individual’s DNA to made-to-fit orthopedic replacements, personalized care is transforming the healthcare industry. Jeff Bishop from Zimmer Personalized Joint Replacement Technologies gave the Mines community an interesting insight as to how more advanced fabrication techniques, improved medical scanning technologies, and big data are converging to provide more effective joint replacements. With a more accurate understanding of the anatomical structure of the knee, tibia, and other joints, orthopedic companies can provide patients with increased mobility and higher durability of their replaced joints after orthopedic surgery.

With a soon to be retiring baby boomer population and an osteoporosis and joint replacement industry already worth over $51 billion, orthopedic companies such as Zimmer have spent a great deal of resources in research and development to leverage their improved products over the competition’s in regards to surgeon’s preference for joint replacement surgeries. This has given rise to increasingly greater personalization of implants. Large studies have shown very significant differences in shape and size of knee joints due to gender and, to a lesser degree, ethnicity differences. Tibia length composition varies significantly as well due to height discrepancies in those surveyed.

Bishop’s personal stance on the research is that size variances in the joint implants play a much larger role in the personal fit than any deviation in the actual shape of the implant. Shape incongruities from person to person could actually play a more important factor in the mobility of joint replacements than they are suggesting from the research. Even after acknowledging that the statistical anatomical data supports the theory that size does indeed dominate morphological variability between patients and that an implant can be correctly fitted to the patient, individual surgeons are not consistent in their implementation of the implants.

Years after knee replacement, overhang of the implant often becomes a main problem which leads to instability, dislocation, lysis/loosening, or implant fractures. For total knee replacements, a surgeon must make sure there is less than 1 mm of overhang of the implant. However, If the implant is placed too deeply within the body tissue, there can be rotational constraints, which creates a tough line for surgeons wanting to give their patients higher mobility in the short term while at the same time preventing failures in the future.

With three of the largest players in the industry located in Warsaw, Indiana, orthopedic companies are no strangers to their competition. The orthopedic capital of the world, much like Silicon Valley for technology companies, creates an intense environment of competition. In many ways the evolution of joint replacement technologies has been a collaborative effort to improve the field. There has been an abundance of feedback between surgeons, university researchers, and engineering teams with the ultimate goal of creating faster, cheaper, and better implants for an aging population.