Thursday, August 29, 2019

Forward Steps in the World of Orthopaedics - A Look at Emerging Trends


August 27, 2019 | By Dr. Sandra Mitic
New technologies are transforming the world of medicine, including the field of orthopaedics and trauma. The years to come promise even greater advances, given developments in materials science, computer-simulation and robotics.
The positive effects of such developments on the body’s locomotor system and other parts have big implications for the duration of a patient’s recovery, as well as for associated disabilities, bringing earlier and better functionality, and reduced morbidity.
Aside from the benefits for the disability and workers’ compensation industries, the life insurance sector will also feel the impact of these developments - so it’s worth gaining an understanding of some of the most important emerging and future trends in orthopaedics before they fully enter the mainstream.
In spinal surgery, for example, recent studies on patient outcomes have shown that total disk replacement with artificial ones can lead to adjacent segment disease.
A new, alternative approach employs the implantation of tissue-engineered intervertebral discs made of canine disk material seeded into collagen and alginate hydrogels. These implanted tissue-engineered intervertebral disks demonstrated significantly higher retention of their position, structure, disc height and physiological hydration in in vivo studies.
Osteoarthritis of the knee, where cartilage wears away, is a common complaint. The condition causes stiffness and discomfort that worsen over time. For people in daily pain, treatment options to slow the progression of osteoarthritis are very limited. But now an implantable shock absorber has been released that could delay, or even avoid, the need for total knee replacement. Implanted for the first time in the U.S., it is designed to lower the pressure applied to knee joints, thus allowing the patient to remain active without being in pain. Made from advanced biomaterials, it attaches to the sides of the femur and tibia bones and doesn’t alter the joint itself.
Meanwhile, monitoring devices are also being refined to make knee implants last longer. A group of scientists in the U.S. has developed a knee implant sensor that is self-powered by friction.
Three-dimensional printing has many uses, including orthopaedic device manufacture. Modern 3D printers can produce patient-specific implants and prosthetics that are fully customized to the individual. Producing implants in this way brings greater flexibility, accuracy and reduced risks, making recovery faster and better for the patient.
Virtual reality is now commonly used in orthopaedic surgery training. and in pre-operative planning software. The idea of learning to operate on a virtual patient is not new, but virtual technology has only recently become advanced enough for simulators to be practical. Simulation is also used for planning procedures.
Surgeons are being assisted by robots, improving accuracy beyond human limits. Robot systems provide planning, workflow, procedural execution and confirmation capabilities for accurate placement of instruments and tools, for example, during spinal surgeries. The system allows computerized surgical planning, 3D assessment of spine anatomy, robotic guidance and live navigation feedback throughout the surgical procedure. Cameras, guidance markers and a robotic arm continually monitor the location of surgical instruments in relation to the spine and position them precisely as planned.
But what are the implications of these emerging technologies for Life, Disability or Workers’ Compensation insurance? Well, the outlook is certainly very positive as the physical mobility of people who have suffered diseases of the musculoskeletal system or have been injured in accidents will continue to improve.
It means that periods of occupational disability will become shorter for those who are able to return to work, at least in countries with health systems that have access to modern technologies. With effective aids to overcome physical limitations, an individual’s work performance could be restored to greater levels than previously imagined.
Clearly, it makes good business sense to start thinking now about how underwriting guidelines can take account of the benefits promised by the continuing technological revolution.

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