Where Are the Flying Cars, Hoverboards, and Smart Implants?

Speculation about the future can often result in unrealistic expectations, regardless of the source from which the speculation originates. For example, just look at the second “Back to the Future” movie. Fans of the film gawked at the prospect of flying cars and hoverboards (ignoring the fact that fax machines were still apparently a vibrant and useful communication tool in the film’s future perspective). Come 2015—the timeline for the film’s future predictions—and there were neither flying cars nor hoverboards to be found. Unrealistic expectations in too short of a timeframe, for certain. But it’s much easier to arrive at that realization once the fixed prediction date has been reached.

In the orthopedic space, one might view the prospects of smart implants as a similar prediction that was perhaps made with unrealistic expectations. Surely, with an analysis of other related tech trends such as low power capabilities, the miniaturization of electronics, the explosion of the Internet of Things (IoT) and connectivity, and the growing interest in data for all aspects of healthcare, the foundation is certainly present. However, the goal remains elusive for the most part.

Depending on who you ask, smart implants are most often described in one of two ways—either a 3D-printed, patient-specific product designed from imaging scans, or a sensor-enabled orthopedic device that offers feedback on the implant’s performance. The latter definition is the one to which I am referring.

Development of these types of implants has been mentioned for at least 10 to 15 years, but some may have conceptualized them even before that. Further, given the connected environment in which we live today with the significant growth of IoT, one might wonder what the issue is. How have we not seen these devices on the market?

Perhaps the technology has been a casualty of “incremental innovation.” Perhaps it has suffered from a lack of reimbursement potential. Or perhaps the clinical benefit of providing the sensor-enabled technology simply isn’t as beneficial as has been speculated. Regardless of the reason, it’s fairly safe to say the promise of smart implants has fallen short.

That said, there are still initiatives taking place (those within the public view anyway; who knows what projects are in the works behind the closed doors of OEMs’ R&D labs).

Ian Hipschman, an engineering management student at Stevens Institute of Technology is one such creator of smart implant technology. He, along with fellow classmates Theodore D’Amico, John Mottole, Hashem Selim, and Izabela Serowik, took on a project involving the development of a system that would detect the trends that occur when a patient’s implant is going in the direction of requiring knee revision surgery. The OrthoInsight system provides an indication that there’s an issue so preventative maintenance can be conducted to avoid the need for a full second surgery. The system is a first-of-its-kind solution that provides real-time information about the internal conditions of the prosthetic joint. As a result of the team’s effort, it was selected from among 60 undergraduate, graduate, and Ph.D. research posters to take first place in the 2018 Johnson & Johnson Engineering Showcase.

Elsewhere, Renishaw, a global company focused on measurement, motion control, healthcare, spectroscopy, and manufacturing, partnered with Western University in Ontario, Canada, on a collaborative project involving smart implants. One area under review is using sensors on orthopedic implants to detect increased temperature—a possible sign of infection. Earlier detection of this issue would result in quicker treatment, avoiding potential complications and greater expense. The collaboration is also examining the opportunity to employ sensors to detect the strain on bone reinforcement implants used in the treatment of fractures. Less strain could be an indication of the progression of the healing of a fractured bone. Further, the partnership is also exploring the use of accelerometers to monitor the movement of patients in complying with their prescribed physiotherapy and rest regimen.

These are merely two examples of the ongoing research being conducted in the smart implant realm. Perhaps the only issue is a lack of patience or unrealistic expectations based on discussions very early in the technology’s development timeline. Just as it’s very likely we will one day see flying cars—and perhaps even hoverboards—smart implants will arrive into the mainstream. We may simply need to demonstrate a bit more patience. Until then, I can at least reserve my excitement for the further development of the other, aforementioned type of smart implant—those that are personalized for each patient.