Researchers investigate orthopaedic medical devices

December 31, 2014

Topic: total joint replacement

There are registries around the world that are used to help track medical devices’ performance, noting if one stopped working or is acting up.

There are registries around the world that are used to help track medical devices' performance, noting if one stopped working or is acting up. Researchers from various universities recently examined these registries to find out how effective they actually are. The findings were published in the Journal of Bone and Joint Surgery.

There are many different types of medical devices on the market today, including ones relevant to orthopaedic medicine. The researchers mainly wanted to focus on the effects related to hip and knee implants. Devices are placed in these areas when a patient needs a total joint replacement. Though the prevalence of these devices is significant, their tracking may not be, national and international medical agencies noted.

Getting to know total hip and knee replacements
Hip and knee replacements are two of the more common surgeries performed in orthopaedics. The American Association of Orthopaedic Surgeons noted that total hip replacement surgery is one of the most successful surgeries available, with approximately 285,000 surgeries performed each year in the United States. About 600,000 knee surgeries are performed each year. In both knee and hip surgery, the bone is replaced with prosthetic pieces, mainly made out of metal. There are two different types of knee replacements: fixed-bearing prosthesis and mobile-bearing prosthesis. Fixed-bearing prostheses are more common among patients.

Different types of arthritis, such as osteoarthritis, are the common causes behind the condition. Additional weight and activity can wear down a joint replacement implant more quickly. This wearing down can cause the implant to loosen, which can cause patients to be in a significant amount of pain. It may also require additional surgery. Investigating these implants' performances may help determine better ways to treat patients and develop better devices.

"In orthopedics, large registries or networks of registries capture device information on a very detailed level and can become particularly important for active surveillance and post-market evaluation," lead researcher and Weill Cornell Medical College professor Art Sedrakyan said.

Researchers from Weill Cornell Medical College and other educational institutions investigated data using seven national and international registries. They wanted to learn specifically about the performances of hip and knee devices, but also make conclusions about other types of devices as well.

All of the registries studied are a part of the International Consortium of Orthopedic Registries, an organization that attempts to strengthen the connection between relevant medical research and current medical devices. Normally, the Food and Drug Administration is responsible for tracking these products and determining their performance levels on the market. The research was funded by the ICOR. 

Positive findings
The study authors noted that their research may help distinguish the types of medical devices on the market and make it easier for orthopaedic surgeons to understand. They also stated that their findings may lead to a more educated public and help develop better, less costly safety devices. With this research, orthopaedic surgeons may be able to help patients choose the best implant for their condition.

The registries examined were in Australia, Italy, Spain, Sweden, Norway and the United States.

Many electronic health records and claims systems cannot track medical device data like registries can. However, when examining patient data, there are some privacy issues. So, the researchers decided to look at data in groups of patients, instead of sharing data from one person at a time.

The FDA is hopeful for the future of medical devices. The organization hopes to create a national medical registry for devices and will decide how current registries could be improved upon. The researchers noted that the data can help them discover the best possible implants for patients and allow patients' minds to rest assured knowing they have the best device for their lifestyle and condition.

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