What are the remaining “Unmet Clinical Needs” in Orthopedics?

I am publicly compiling a list of “Unmet Clinical Needs” in Orthopedics. No agenda. Just trying to help move orthopedics forward. This list is open source and for everyone. Here is the permalink – https://orthostreams.com/2021/03/unmet/

The List
(in no particular order)

#1 – Non-permanent implants for trauma and extremities. (Ossio is working on this).

#2 – Joint replacements that never need revisions. Bearings that never wear out. Bio-integrates forever with bone. (there are ~300,000 joint revisions performed in the US each year).

#3 – An ankle replacement that actually works.

#4 – The 4-part proximal humeral fracture in fragility patients. (toughest trauma problem. Patients are never happy. Surgeons are never happy with results.)

#5 – Meniscus repair that lasts. (Active Implants is working on a total meniscus replacement).

#6 – Cartilage repair that lasts forever.

#7 – Extend the life of a growth plate (physis) in a child.

#8 – Early detection and reversal of osteoporosis. (OsteoApp is doing the first part of this).

#9 – Closing large annular defects following lumbar discectomy to prevent re-herniation while enabling surgeons to preserve the disc (Intrinsic Therapeutics has brought a solution).

#10 – Modularity in ALIF cage design to allow for uncoupled height and lordosis as well as coronal correction. (Axis Spine is bringing this solution to the US market).

#11 – Slowing OA disease progression. (Early research with the prolonged mechanical separation of the bones at the joint for treatment of end-stage osteoarthritis, eg: delaying joint replacement surgery.)

#12 – Rotator cuff tears, especially full repair of massive tears.

#13 – Lower the 25% death rate within one year of elderly hip fractures.

#14 – Prediction of infection following a TJR.

#15 – Osteonecrosis/AVN, both etiology and a biologic treatment

#16 Interpositional implants to buy early OA patients decades of time before the TJR. (Notes: Unispacer was a good start, but pulled in 2011. NuSurface not approved in the US).

#17 – Natural repair for tendon and ligaments. (Biorez is working on this).

#18 – Nucleus replacement. (Orthoson is working on this).

#19 – Right-sized implant solutions for kids (Orthopediatrics and WishBone are working on this).

#20 – Wireless cameras for arthroscopy (Lazurite is working on this)

#21 – Prevent hip fractures from falls in the elderly (Tango is working on this)

#22 – Software for robotic total knee replacement that allows kinematic/restricted kinematic alignment, linked to patient outcomes and machine learning. (submitted by Dr. H. Gene Dossett @ Mayo-Phoenix)

#23 – Early monitoring of aseptic/septic loosening, and fracture healing around implants. [OrthoDX is working on sensor without batteries for precise measurement of micro-motion between hardware and host bone.]

#24 – ACL repair without the need for harvesting (harm to patella tendon or hamstring) or allografts (quality issues). Miach Orthopedics is working on this.

#25 – Fragility Fractures in the Pelvis (FFP) – only 10,000 FFP US patients are treated annually out of the 100,000. [ CurvaFix has developed an implant that follows a patient’s unique shape and stabilizes fragility fractures of the pelvis.

#26 – Printing cartilage in the patients cells for unlimited grafts and no morbidity – [CellBricks is working on this].

#27 – ????????

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