“Health is of paramount importance, but many people do not make eating well and exercising a priority until their health deteriorates. You must live in a balanced state so that you can be at your optimal level in all aspects of your life. Below is a list of motivating health quotes to help you live a healthy balanced life.”
-Anonymous
The orthopaedic world is changing with every passing, month, year and decade. Over the past few months, we’ve actually taken the time to highlight a few innovations that are shaping the way your orthopaedic surgeon will provide you with the appropriate health treatment for your condition. The internet of things, an evolution of the globe’s smart interconnected devices, has highlighted that we are in a position where our implants are also now smart. At this point, in time, we can take the time to imagine how this will be of benefit either to ourselves, or even to people that we love.
Smart implants are implantable devices that are designed to be integrated into an implant. Under the right conditions they remain dormant, gather data and monitor patient health. If anything changes within the patient, they will then detect the change and alert the relevant officials of what will be needed in order for the appropriate treatments to be facilitated. These changes can help improve the implant design in the future and also help with the post operative care. Health officials do anticipate that these systems will enable more longevity of the implant, and facilitate a health care system that will save money for the patients.
While applications of the smart implants have found their way to areas such as the knee, for knee arthroplasty the possibilities still remain endless. The parameters that these devices will measure include: pressure, force, strain, displacement, proximity and temperature. With time, it is anticipated that the smart implant will become part of daily clinical practice.
APPLICATIONS OF SMART IMPLANTS
As with all technologies, there is always an introductory curve. The industry anticipates that this wave will take place in major waves.
These four waves are [2]:
Wave #1 – Smart Tools in the OR: feedback or data given to surgeon real-time.
Wave #2 – Smart Diagnostics on Demand: accessed by Doctor or nurse at follow-up visits.
Wave #3 – Smart Diagnostics by Exception: sent by the implant to Doctor or nurse when an alert is triggered.
Wave #4 – Treatment by Exception: drug delivered by implant when an alert is triggered.
As of the time of writing, we are currently in phase one of this transition phase.
With all technologies, orthopaedic implant development does take a considerable amount of research and development, just to ensure that the implants are serving their purpose and also are very robust in the human biological system. Knowing what is happening inside the body is always important for health monitoring.
TECHNOLOGICAL ADVANCEMENT IN SENSOR DEVELOPMENT
When it comes to sensor development smart implants are actually designed to detect:
- Poor bone ingrowth
- Infection
- Subsidence or dislocation once an implant is in place
Nanotechnology is facilitating these functions, as well as working towards incorporating new functionalities that the current sensors can’t yet address. These additional features include detection of the vibration of the prosthetics environment. Joints are mechanical structures, and it is always a good idea to ensure that they are as robust as possible. This parameter will give the surgeon an insight into the joint, so that they can know if any adjustments to the internal tension are to be made. Research is also being done to develop biomaterials that are resistant to infection.
Current research has indicated that the devices themselves have smart interactive elements that recognize malignant organisms in close proximity to the implant. These elements will then release an antibiotic to the area and facilitate the healing process. With a system that is very pH aware, the mechanism is able to adapt to the changes and keep the implant and its surroundings very healthy.
Developments are currently ongoing, and there is much to look forward to. With cost being the current deterrent, with time, once these hurdles are overcome, access to the smart devices will be readily available to everyone. The health care system also has to adapt to developing the ideal compensation plan for the procedure once it is installed in the patient.
With time, we will expand on these smart implants. These are the future that we are looking for in orthopaedics. With access to data, information can be generated, and with the information better health decisions can be made.
References:
- Smart Implants: https://www.healio.com/orthopedics/business-of-orthopedics/news/print/orthopedics-today/%7B27cc9f09-766a-4e1b-bb00-9277dd8edf5d%7D/smart-implants-to-provide-biofeedback-measure-joint-loads-detect-infection
- Dovepress: https://www.dovepress.com/smart-implants-in-orthopedic-surgery-improving-patient-outcomes-a-revi-peer-reviewed-article-IEH
- OrthoStreams: https://orthostreams.com/disruptive-trend-in-orthopedics-the-smart-implant-revolution/
