What’s on the Horizon?
Joint replacements have come a long way from the first unsuccessful attempts of the 1800s, but there’s still lots of room for improvement.
Here’s what some of the people working in the field think we might see in the future. Click on each name to learn their prediction.
Charles Sorbie, MB, ChB, FRCS(E), FRCS(C)
Professor of Surgery, Queen's University & Assoc. Staff, Kingston General Hospital
"In the future, we can expect joint replacement implants to have similar mechanical properties to human bone. That is, the same ability to bend, just a little, when loaded."
"Implants will have similar surface geometry to the original joints, be available in 'gender specific' forms, and have closely matched dimensions."
"Implants will be made permanently antibacterial to eliminate the possibility of infection in the vicinity of the implant."
"Joint replacements that will have almost no wear or no harmful wear particles will be possible in young patients Young patients can look forward to bearing surfaces that will last a lifetime."
"Computer navigation systems will become simplified, affordable, and in common use. Surgical access to joints will use minimal tissue disturbance and make implant placement precise enough to restore normal joint kinematics."
Professor Emeritus, Mechanical Engineering, Queen’s University
"For the future we can expect hybrid bio materials that incorporate living tissue embedded in bio-compatible scaffolding for bone grafting and re-surfacing of our joints. This would enable in situ micro surgery that preserves the unique articular shape of our own joints."
"Intermediate future solutions might involve plastics with a structure similar to cartilage that would provide shock absorption in implants, similar to our natural joints, which would extend life expectancy under regular ambulatory heavy loading."
Tassos Anastassiades, MD, Ph.D, FRCP
Head of Rheumatology, Queen’s University & Kingston General Hospital
"A focus on the repair of tissues is on the cutting edge of recent advances in biology and bioengineering. Here are some of the advances:A large number of biological factors driving the growth and the repair of cartilage and bone have been recently discovered and cloned.There is the beginning of the development of ‘nutriceuticals' which would specifically stimulate the growth and repair of damaged cartilage and bone.There is a lot of work on better ways to deliver only to the joint some of these biologicals and matrices and to follow the effect with non-invasive, sensitive computerized technology."
Carolyn Small, Ph.D, P.Eng
Professor, Department of Mechanical Engineering and Department of Surgery, Queen’s University
"I think the future of joint replacement lies in developing new materials to better emulate bone, cartilage, and ligament, both mechanically and biologically."
"Eventually, we will learn how to grow replacement bones and joints, either in the lab for conventional implantation, or in the body at the site of the damaged joint."
"In fifty years, people will tour the museum and say, "They actually used to put hunks of metal inside your knee? How crude!"
David Pichora, MD, FRCSC
Chair of the Division of Orthopedic Surgery at Queen’s University
"Total joint replacement has a bright future through technical advancements such as new computer assisted surgical techniques."
"The provincial total joint registry and other outcome studies will help us evaluate specific implants and surgical techniques to find out which provide the best long term successes."
Professor, Departments of Computing & Information Science, Mechanical Engineering, Surgery, Queen’s University
"The use of computer assisted surgery will allow for more accurate and timely surgical processes which will translate into improved health services to the public."
"We will be able to build computer models that will give us an increased ability to predict how well a particular surgical operation will benefit a specific patient."