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AAOS Now

Published 11/1/2010
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Annie Hayashi

New horizons in orthopaedic research

ORS to present cutting-edge tools for clinicians and researchers

Imagine a hip implant with a microscopic sensor that can detect the beginnings of a periprosthetic infection. Or a computer program that enables you to enter patient-specific data and estimate how much range of motion that patient might have after a shoulder replacement.

Believe it or not, such scenarios might not be too far away. These possibilities are among those that will be considered during the New Horizons Workshops at the annual meeting of the Orthopaedic Research Society (ORS), Jan. 13–15, 2011, in Long Beach, Calif.

Implantable sensor technology
According to Eric Ledet, PhD, organizer of the “Implantable sensor technology: From research to clinical practice” workshop, clinician scientists and orthopaedic surgeons should find the session very relevant.

“The technology is truly translational at this point,” he said. “Implantable sensors aren’t just research tools anymore. They can positively affect clinical practice without complicating it.”

Implantable sensors have been used in orthopaedic research for decades and have evolved to extremely small, wireless, passive devices that don’t require batteries.

“At this point, the sensors require very little—if any—modification to implant,” Dr. Ledet said. “Implantable sensors present opportunities in trauma, spine, and total joint treatments. For example, an infection detector can be placed on an implant to detect local infections.”

Implantable sensors could also improve diagnosis techniques, provide surgeons with better information before procedures, result in improved outcomes, and lower costs.

“The sensors could provide a surgeon with a lot more information with little extra effort,” he noted. “For example, is a spine going on to fusion versus pseudarthrosis? Is a fracture healing? Is a total hip implant starting to loosen?”

As the technology improves, the sensors are declining in price. “If you look at a risk/benefit ratio, the risk is extremely low and the benefit is potentially very high,” he said.

The 90-minute workshop on Friday, Jan. 14, will also feature Darryl D. D’Lima, MD, PhD, sharing his experiences using an instrumented knee prosthesis; Peter Westerhoff, Dipl.-Ing, discussing the use of implantable sensors in the shoulder; and Mark Allen, PhD, addressing the latest developments in micro- and nanotechnology.

Computer simulation in orthopaedics
The practical relevance of biomechanical modeling is the focus of the other New Horizons Workshop—“Leveraging probabilistic methods in orthopaedic biomechanics,” organized by Anthony J. Petrella, PhD, and Peter J. Laz, PhD—scheduled for Thursday, Jan. 13.

“The probabilistic approach allows one to account for normal variation in patient and surgical variables so that computer simulation can provide practical insight to inform the clinical decision making process,” explained Dr. Petrella.

According to Dr. Laz, probabilistic methods are used in the aerospace and automotive industries where engineers must ensure new designs can handle uncertain wind loads or road conditions.

“But orthopaedics introduces the added challenge of patient-to-patient variability. The probabilistic approach to biomechanical modeling incorporates that variability in tissue properties, loading, and anatomy, enabling more realistic predictions,” Dr. Laz explained.

“This approach enables the evaluation of joint mechanics and muscle or joint loading for a specific population. These tools consider patient-to-patient and component alignment variables and begin to isolate some of those effects that can lead to the development of more robust implant designs,” he continued. “A better understanding of these variables and their impact on performance can influence surgical decision-making on issues such as the use of computer-assisted versus manual surgery and the placement of implants.”

The workshop organizers will seek to provide a “middle ground” for both the clinician and the technical researcher. They will discuss the basic theory behind probabilistic simulation methods, describe how the technology is being used in the biomechanics field, and pre-sent a broad range of case studies.

In addition, workshop participants will have an opportunity to try some of the software products that are currently available for performing probabilistic simulation.

For more information on the ORS 2011 annual meeting, visit www.ors.org

Annie Hayashi is a contributing writer for the Orthopaedic Research Society. She can be reached at achayashi@gmail.com