As the global population ages, the volume of orthopedic-related complaints is skyrocketing, spurring the demand for technologies that can help people maintain active lifestyles. At the same time, there us a substantial amount of resistance towards products such as conventional artificial joints, thank in part to high failure rate of metal-on-metal hip implants. Here, we take a look at five technologies helping to usher in the future of orthopedics, an example of which is the intelligent orthopedic implant from OrthoSensor shown above.

For more on the topic of advances in orthopedics, also see a recent article titled “Emerging Technologies for Fighting Orthopedic-Implant Infections.”

Smart Implants

In the future, orthopedic implants could monitor how well implants fare in the body, measuring how well bone attaches to them while also detecting problems such as inflammation and infection. Nanotech sensors could be embedded into the implants along with reservoirs of anti-inflammatory agents and antibiotics that are deployed only when and where they are needed. A sensor-equipped titanium implant, for instance, could determine how sensitive a patient is to the implant and then respond to the body’s immune cell response. Alternately, simple sensors that measure variables such as force and pressure can be integrated into orthopedic implants with little or no modification.

Orthopedic implants, such as the device shown here from OrthoSensor (Sunrise, FL), also can offer real-time information regarding implant placement and other performance metrics. The company’s Verasense devices uses embedded sensors and microelectronics to provide real-time kinetic data related to the function of the knee. The chief technical officer of that company, will speak on smart orthopedic technology at the upcoming Orthotec conference in Warsaw, IN.

Arthroscope Technology

Arthroscopy, which means “looking within the joint” in Greek, uses fiber optics located at the end of an arthroscope to see the inside of a joint via a small incision, dramatically improving orthopedic surgeons’ ability to diagnose joint problems. “It revolutionized our ability to peer within and accurately treat intra-articular pathology,” explains HowardLuks, MD, a board-certified orthopedic surgeon over Twitter.

The popularity of the arthroscopy and other minimally invasive procedures such as laparoscopy “fundamentally changed the operative relationship between the physician and the patient,” explains Sanovas CEO Larry Gerrans, who formally served as an executive at Stryker Corp., Smith & Nephew Corp. and DePuy Orthopedics. And the field continues to grow as advances in camera technology enables arthroscopy to be used for a growing number of orthopedic applications.

Robotic Surgical and Computer-Assisted Technology

Although there has been a certain amount of backlash against surgical robotics recently, the technology is here to stay. In the field of orthopedics, computer navigation technology has enabled significant gains in the accuracy of implant alignment in total knee arthroplasty and, more recently, total hip arthroplasty. Advances in artificial intelligence, motors, materials, and the precision of medical imaging are additional factors that bode well for the future of surgical robotics’ future.

Already, systems like the Rio from MAKO (which won the Gold Medical Design Excellence Award in 2010) are analogous to GPS: they leave the user in control while offering guidance to them. The most obvious advantage of the technology is its ability to improve surgical precision and thus patient outcomes. As robotics technology improves and its costs comes down, the number of orthopedic applications it targets is poised to increase.

Biologics

While progress continues to be made in the field of artificial joints, replacing a joint continues to be a major surgical procedure and artificial joints do not perform as well as the native versions do. This point has been accentuated in recent years with the controversy around products such as metal-on-metal implants, which FDA deemed early this year to have “unique risks.” Other artificial joints also have inherent risks and, over time, wear out and, occasionally, break or become dislocated, necessitating revision surgery. Still, demand for artificial joints is growing and emerging markets such as China have seen significant growth in joint replacement procedures in recent years.

Orthopedic surgeon and chairman of the Stone Research Foundation Kevin Stone, MD is an advocate of a biologic approach to treating joint problems. “In the midst of the modern buzz around the promises of a bionic body, shouldn’t we stop and ask if there is a better more natural way,” he said in a TED talk. Stone points to the promise of biologics in orthopedics, which is a market growing faster than conventional artificial joints. Biologics could potentially be used to treat joint problems and arthritis with better outcomes than conventional alternatives. Stone will be speaking on the subject in the upcoming keynote at the Orthotec conference in Warsaw, Indiana.

3-D Printing

Sure, 3-D printing may be getting more than its fair share of press coverage lately. But we’ve only scratched the surface in terms of its potential medical-related applications. In the field of orthopedics, 3-D printing technology has enabled the production of surgical guides for preoperative planning and custom bone implants. In addition, researchers have used the technology to produce cartilage.

The skull implant shown here from Oxford Performance Materials was recently cleared by FDA. “We see no part of the orthopedic industry being untouched by this,” said Scott DeFelice, president of the company after the regulatory milestone.

A recent report from Luxresearch titled “Building the Future: Assessing 3D Printing’s Opportunities and Challenges” is also bullish on the prospects of 3-D printing for orthopedics. “Within medical applications, we see the greatest opportunity in orthopedic implants,” said Anthony Vicari, the lead author of the document.