Orthopedic Innovations Expand the Possibilities of Movement
This is the second in a series of blog posts celebrating the 150th anniversary of HSS. Throughout the year you’ll hear about the evolution of the HSS clinical service, research division and the hospital overall. We hope you’ll enjoy this look back as we continue to lead musculoskeletal medicine into the future.
Innovation has always been at the heart of the HSS mission. When surgeon-in-chief Dr. Philip D. Wilson, Sr., established the research division in 1955, he harnessed the spirit of innovation that has always been integral to the HSS culture and created a new infrastructure for scientists and physicians to work together to advance the medicine of movement. Our inventions have real-world impact because their goal is improved patient care. Here we highlight some HSS orthopedic inventions that have changed the way the world moves.
Spinal fusion implementation
A team of spine surgeons and biomechanical engineers including Dr. Federico Girardi, Dr. Andrew Sama and Joseph Lipman, developed a comprehensive spinal fusion system that entered the market in 2007. The system incorporates some 50 pieces, including color-coded screws (above), various rod configurations with slightly different curvatures to match the particular location in the spine and measuring tools to ensure precision in complex spinal fusion surgery.
Improving hip replacement accuracy
To improve accuracy of hip implant cup placement into the pelvic bone during hip replacement surgery, surgeon Dr. Chitranjan Ranawat and engineer Joseph Lipman are developing a method of using CT scan and x-ray images taken prior to surgery. Guided by these patient-specific images, engineers can use computer-aided modeling to plan and orient the cup position before surgery precisely for each individual patient.
Ex-fix for elbow mobility
Upper extremities surgeon Dr. Robert Hotchkiss and a team of biomechanical engineers have invented an external-fixator (ex-fix) device that will greatly improve recovery for people with elbow injuries. Casts or hinged-based frames typically hold the elbow in one position, causing stiffness once the cast is removed. The ex-fix is adjusted as the elbow heals, allowing patients to conduct appropriate rehabilitation exercises, encouraging full range of motion once the injury heals. Because of its proposed simplicity of installation, the ex-fix will be ideal for trauma sites.
New kind of wrist
Dr. Scott Wolfe, chief emeritus of the Hand and Upper Extremity Service, invented a new wrist implant and partial implant that, for the first time, mimic how the wrist really works. Until now, experts believed the wrist moved the hand in two planes: up and down, and side-to-side. Researchers demonstrated that many of the wrist’s important functions actually combined a movement between these planes: the so called “dart-thrower’s motion.” The new implants were born out of this discovery.
Dr. Royal Whitman invented this contoured arch as cure for flat feet in 1907. Dr. Whitman believed that static support was needed to fix the anatomy of the feet. Whitman Plates are still used today.
First modern knee implant
In 1969 surgeons Dr. John Insall, Dr. Chitranjan Ranawat and Dr. Allen Inglis and engineer Dr. Peter Walker began to design and develop the modern total knee implant, called the total condylar knee, which was first used in patients in 1974. The total condylar was the first knee implant to recreate the way a real knee works, allowing patients to move naturally and without pain. HSS surgeons have performed more than 55,000 knee replacement surgeries, more than any other hospital.
These innovations and more are featured in the Spring 2013 issue of Discovery to Recovery, a quarterly publication of HSS clinical and research highlights.