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).
#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].