When developing a product to meet the customer’s needs many aspects of the healthcare delivery process come into play. The cost of healthcare is an increasingly important customer concern for patients, hospitals and the insurance companies. Maintenance of a healthy lifestyle is key to reducing healthcare costs but failing that improving patient outcomes after a medical intervention is critical from a cost point of view. The Orthopedic Department at Wake Forest in concert with OR-Live created an excellent marketing video which provides a very good overview on the subject of total knee replacement. In addition, it includes an interlaced slide show demonstrating the impact on overall cost among other topics. The presentation argues convincingly that improving alignment of the artificial knee components will improve the overall healthcare costs for this procedure by reducing the need to redo the surgery.
From a biomedical engineering point of view there are a number of observations. Most prominently is the impact on accuracy of the optically based computer assisted alignment of the surgeon’s cuts. Its impressive to watch the surgeon use the technology to guide and refine his incisions. It isn’t hard to imagine that an in depth knowledge of motion capture, general imaging and medical imaging were key to developing the positioning technology demonstrated in the video. Anyone familiar with the typical surgical environment will note the head gear of the surgical team in this video. It completes the isolation the surgeon’s and nurse’s body from the open wound in a manner that is not typically seen for most surgeries. Bone surgery has been notorious in the past for post surgical infection. As a result orthopedic surgical suites typically attempt to maintain a higher degree of sterile field integrity as a result. Although apparently low tech compared to the computer assisted surgery a closer analysis of what it takes make this system work would reveal a fairly complex set of electronic and mechanical engineering challenges. Another engineering point of interest is the technology used to cut through the bone. The vibrating ( ultrasonic ) blade makes the cuts very quickly and efficiently. It is easy to imagine that engineering studies with a sensitivity to potential cell damage caused by friction heating needed to be made to establish the safe amplitude and rate of vibration. Surgeon feedback would also have been critical. Theoretically a biomedical engineer with enough mechanical engineering education to design and industry experience would have been the perfect choice to design or develop the vibrating blade system. The biomedical background would be valuable in particular when creating the test protocols, and in pre-clinicals and clinicals.