SMART IMPLANTS IN HEALTHCARE: RESHAPING HEALTHCARE SERVICES DELIVERY THROUGH SENSORS

Advances in emerging technologies present unprecedented opportunities to transform healthcare service delivery globally to deal with health uncertainties posed by infectious and non-communicable diseases (NCDs). Technologies like artificial intelligence (AI), machine learning, blockchain technology, nanotechnology, sensors, Internet of Things, Internet of Medical Things, cloud computing, 5G/6G technology, cognitive computing, cognitive robots, and virtual reality continue evolving and revolutionizing healthcare service delivery to improve the continuum of care.

These technologies have been taken advantage of in various healthcare systems to improve disease diagnosis, surveillance and prevention, health monitoring, real-time collection of health data, treatment reminders, emotional state of patients, compliance and adherence, and maintenance of social distancing.

ZIMMER BIOMET AND CANARY MEDICAL ARE INTRODUCING THE FIRST KNEE IMPLANT WITH AN INTEGRATED SENSOR

The move towards smart techno-driven health service delivery has accelerated the demand for innovations and alternative strategies to incorporate emerging technologies especially sensors in the development of smart implants and smart devices. Smart implants enhance health monitoring for early disease detection, tracking and diagnosis of physiological conditions, prognostication and prevention.

The amazing contribution of smart implants has been predominantly observed in managing chronic illnesses and conditions like cardiovascular diseases, cancer, cognitive impairment, and most importantly in orthopedics. Such diseases cause a significant burden on patients and healthcare systems and reduce the quality of life.

Smart implants integrated with sensors however can help reduce the burden of diseases by providing personalized virtual care. Javaid et al. and Haleem et al., in their papers, implied that biosensors and nano-sensors present great capabilities like disease detection, contrast imaging, retinal prostheses, heart diagnosis, medical mycology, and health monitoring. These sensors can be utilized to develop smart implants that could be used in several spectra of healthcare to improve healthcare services.

ZIMMER’S KNEE IMPLANT

The emergence of COVID-19 has increased the enthusiasm for remote patient monitoring devices. Smart devices, including smart bands, smartwatches, smartphones, smart clothes, wireless smart glucometers, and wireless blood pressure monitors, have been used during the pandemic for virtual health monitoring. Another significant advancement is the first knee implant with an integrated sensor, developed by Zimmer Biomet along with Canary Medical, Inc., a company that produces sensors for medical devices.

This smart knee, called Persona IQ, is one of the growing number of devices sending data to physicians to help them monitor their patients. It can measure a patient’s range of motion, stride length, step count, and walking distance from within the human body. Persona IQ incorporates sensors and processors to send data about how the joint works from inside the patient’s body.

SMART IMPLANTS: CHALLENGES

Data Problems

Although this is a great innovation, one of the challenges is how to use the generated data to help patients. Having data is not enough; It is important to be able to make diagnoses, and tell patients what they need to do differently from the data.

The sensors aim to detect problems with implants and help patients to adjust their gait, or provide data to predict patient outcomes.

Time Factors

Another challenge is time. With the influx of information from several devices, medtech companies are still sorting out how to make the data useful for doctors. Physicians also haven’t had time to look at the raw data now flooding in from these devices. The data are still not user-friendly, requiring the doctor to have a dedicated analyst reviewing the data on a third-party website.

Doctors, most times, have only about 10 minutes to meet with a patient, review their records and come up with a care plan. This spares no time to analyze reams of raw data.

Physicians 

This field is still in its early stages, there is still very little experience with it. Also, the sensor’s size means that surgeons have to remove more bone when implanting a smart knee. Therefore, persuading physicians to use the Persona IQ device over traditional knee implants is challenging. However, somebody has to put these devices in people for us to learn what they can do and how exactly they will do it.

Matthew Hepinstall, an associate professor of orthopaedic surgery at New York University’s Grossman School of Medicine, and co-director of its Center for Computer Navigation and Robotics said in a speech

“I’m waiting for the wearable sensors to give enough data and for us to have enough experience with wearable sensors to understand how to act on that data before implanting something in one of my patients,”

The Difference Between Smart Knee and Wearable Devices

Zimmer’s competitors are creating systems that use wearable sensors to track patient recovery and hinting at their own plans for sensor-embedded implants.

The data collected by smart implants are similar to those tracked by wearable devices that are connected to smartwatches. One major difference is the cost and compliance. The data from smart implants also give details on a patient’s stride, gait, and speed which could help develop recovery curves to predict how patients will adapt to their implants.

Through these data, physicians could learn how to reduce pain after a replacement and how best to position the replacement joint. Data coming from within the patient’s body could also help scientists design better knees.

The Revolution

Zimmer aims to augment its products with its own robotics and technology. During knee implantation surgery, Zimmer’s surgical robots collect data while surgeons use HoloLens smart glasses to guide themselves through instrument assembly. The smart knee is connected to an iPhone application known as “Mymobility”, which pulls in kinematic data from the implant and a patient’s Apple Watch to track exercise after surgery.

Zimmer could use data from the Mymobility app to power a feature called WalkAI, intended to predict which patients may have a slower gait 90 days after knee or hip surgery. However, the company will need FDA approval to use the data to make care recommendations.

SMART IMPLANTS: CONCLUSION

Although the technology is in its early stages, sensors that will allow patients and physicians to monitor their health and improve outcomes are essential to the medical device industry. It will take a few more years before there’s enough data to show the sensors can improve health, however, the potential opportunities are so significant that they seem likely to be increasingly adopted and use in the medical industry.