Incremental change is how innovation in the orthopedics world is often described.
In fact in an interview at the annual meeting of American Academy of Orthopaedic Surgeons, Howard Luks, a sports medicine surgeon and healthcare social media expert, rolled his eyes when asked about what exciting technologies he has seen recently.
"There hasn't been tremendous advances as far as I'm concerned - and I have 15 years of [experience] - in terms of the overall advances [in orthopedics.]," he said in an interview in New Orleans, Wednesday, where the meeting is being held. "The technology has certainly made what I do easier to do and perhaps perform a little more reliably but I was fixing rotator cuffs arthroscopically when all I had available to me was a spinal needle and a suture that I could feed through, so you adapt the technology as it evolves. However, I haven't said, "Oh my God. This is amazing.'"
The problem in Luks' opinion is that manufacturers have historically found it safer to build a better version of the wheel instead of reinventing the wheel altogether.
Now, however, he senses things are changing.
"We are understanding the biological implications of what we are doing both to the human body and in response to the procedures that we want to accomplish," he said. "So why are rotator cuffs failing, why are joint replacements failing and in many of those instances, there's going to be a biological solution. So that's when I am going to say 'Oh my god.'"
In talking with smaller biologics companies, Luks believes many of them are looking to put biological surfaces on metals.
"There's a lot of work being done in cartilage restoration and biomaterials," he said. "That's going to be exciting."
Just as Luks can easily define what excites him as an orthopedic surgeon, he declares what will elicit a yawn.
I am not looking for another joint replacement. I am not looking for another suture anchor. We have suture anchors that hold rotator cuff tissues or tendon tissue, ligament tissue very well. How do we get the ligament to heal faster, the tendon to heal faster before the suture fails or pulls out or rips through?
The suture anchor does not have to lift up a car. The rotator cuff is failing because the rotator cuff is poor quality. Let's focus on the biology.
The analogy I always use with my patients is that trying to fix your rotator cuff is trying to sow your favorite pair of jeans that now has a hole on the front. The tissue is not normal, the fabric is now not normal and we have to change the fabric, not the thread.