Orthopaedic Innovation

The health care industry is experiencing a rapid development of new technology, and the rate of innovation itself is accelerating. Analogous to Moore's Law in the world of semiconductors, we are seeing an explosion of new technologies being built upon the back of enabling technologies. Everything from robotics, three-dimensional (3D) printing, advanced imaging, and genetic processing techniques are impacting the way in which we care for patients. New technologies are both exciting, and, at times, concerning. We have experienced failures in initially promising technologies, such as carbon reinforced polyethylene, as well as transformational successes as was seen in the development of the magnetic resonance imaging scanner, bone ingrowth technologies, and antibiotics.

Four exciting areas of new technology development in the orthopaedic arena include 3D printing, infection diagnostics, robotic surgery, and cartilage restoration. In this special section, we provide one article to stimulate thoughts about each of these subjects.

First, you will find an article written by David Henessey et al titled “Complex Pelvic Reconstruction Using Patient-Specific Instrumentation and a 3D-Printed Custom Implant Following Tumor Resection.” In this manuscript, the authors explained the value that combining 3D imaging with 3D custom-printed technology can bring to patients undergoing these complex resection–reconstruction procedures. However, readers likely will find other applications for such technologies that are keenly relevant to them.

The second manuscript by Parvizi et al reviews the latest updates in the diagnosis of periprosthetic arthroplasty infection. This devastating mode of failure continues to pose a serious financial burden on the health care system, but more importantly poses a major, life-altering, complication for patients. With the prevalence predicted to rise, and with less than concrete diagnostic criteria, this review is timely, helpful, and thought-provoking.

“Robotics in Total Hip Arthroplasty – A Current Review” by Allen et al discusses the history of robotics, as well as the current and expected future state of robotics in hip arthroplasty. As the number and types of devices marketers are branding as “robots” increases, and as the body of literature grows, this article attempts to organize the concepts of surgical robotics in orthopaedics into categories that are easy to understand.

Finally, “Hip Cartilage Restoration: Available Evidence and Current Trends” by Tyler Collins reviews the often-controversial techniques used in cartilage pathology, with a focus on the clinical aspects of this care. Many treatment options for cartilage restoration, including nonoperative treatment, debridement, microfracture, acetabuloplasty, cartilage fixation, cartilage scaffolds, autologous chondrocyte implantation, and osteochondral grafting, are discussed. Collins tries to clearly delineate science from dogma, in a way that allows the readers to decide what they believe makes the most sense.

Innovation has always been a hallmark of advancement in medicine. I hope that these articles spark both innovative ideas, as well as healthy skepticism, about the subjects discussed. The future looks bright for our orthopaedic patients with each passing day… and innovation in new technology is at least one part of the reason why.