Total joint replacement surgery, also known as total joint arthroplasty, has come a long way over the years. It used to mean long recovery times, large scars and limited mobility. However, advancements in medical technologies and techniques have transformed the process, making it safer, less invasive and more effective.
While some of these innovations are still being tested, they could soon change how joint replacements are performed. We spoke with Kirk Kindsfater, MD, an orthopedic surgeon with The Joint Replacement Center of Northern Colorado at Banner Health, to learn more about innovations shaping the future of joint replacement procedures.
1. Better implant materials
In the past, you often had to wait until your 60s or older for total joint replacement surgeries. That’s because early implants did not last more than 10 to 15 years making it hard to justify the procedure at a younger age. These implants were prone to wear and tear and could cause inflammation and bone loss around the joint.
“In the 90s, we’d see a lot of patients with loosened components or osteolysis because the joint implants were wearing down and particulates were being absorbed into the body,” Dr. Kindsfater said.
“Because of advancements in joint replacement materials, implants can now last longer, 20 to 25 years or more,” he said. “They are stronger and more compatible with the body. This is great news for younger, active patients.”
Some of the advancements include:
- Cross-linked polyethylene (XPE or XLPE): In the past, traditional polyethylene (a type of plastic) used in joint replacement would break down over time. XPE is designed to be more durable, helping to extend the life of devices.
- Ceramics: In the past, ceramic materials used in implants were brittle, which meant they could fracture under stress. Advancements in ceramic technology have led to the development of resilient ceramic materials. Ceramic-on-ceramic joints create less friction and wear compared to metal-on-plastic types.
- Uncemented non-adhesive porous backing: This new design lets bone grow into the implant, creating a stronger bond. This feature helps keep the implant stable and reduces the chance of loosening over time.
- Titanium alloys: Titanium alloys are more biocompatible than other metals, such as cobalt-based alloys. “Titanium alloys are more friendly to the body, which can enhance the ability of the bone to bond to the prosthesis. They are also less likely to cause the bone to atrophy because their stiffness is more like bone than the stiffer cobalt-based alloys,” Dr. Kindsfater said.
2. Robotic-assisted surgery aids in more precise outcomes
Beyond implants, technological advancements in robotics and guided surgery are changing how joint replacements are performed. One of the most promising advancements in robotic joint surgery is imaging and planning software. These advanced robotic systems enable surgeons to visualize the optimal placement of the implant before making any incisions, which means better outcomes for patients.
“Robots can help you make bone cuts with a higher degree of accuracy but also visualize the best location for implants,” Dr. Kindsfater said. “This precision and accuracy help balance the soft tissues around the joint, improving stability and reducing the risk of complications like joint stiffness or instability post-surgery.”
While most hip and knee replacements are still done without robotic assistance, the popularity of these technologies is on the rise.
3. 3D printing for a perfect fit
3D printing is transforming orthopedic surgery. The precision of 3D printing enables the creation of complex implants that were previously difficult to manufacture using traditional methods.
“3D printing allows us to create surface textures on implants that were previously not possible,” Dr. Kindsfater said. “These new surface textures are designed to be compatible with bone, improving the integration between implant and bone.”
The use of imaging technology allows surgeons to create computer-simulated models of joints. They can experiment with various implants until finding the ideal fit.
4. The rise of smart implants
Imagine an implant that can monitor your joint after surgery. Smart implants equipped with sensors are on the horizon and they could revolutionize postoperative care.
“These smart implants can track a patient’s activity levels, detect temperature changes and even measure the forces acting on the joint,” Dr. Kindsfater said. “While it’s still in an experimental phase, it holds immense potential.”
For example, a tibial implant could include an accelerometer to monitor gait and activity levels, providing valuable data to the patient and their health care provider. If a patient experiences temperature changes, this could signal an infection before symptoms become apparent.
5. Advanced surface coatings
Though the risk of infection after a knee and hip replacement is low – usually less than 1% - it can have serious consequences for patients. An infection can lead to longer recovery times, more surgeries and even implant replacement. Because of this, preventing infections is one of the top priorities for surgeons and researchers.
"Antibacterial surface coatings are being developed to reduce the risk of infection,” Dr. Kindsfater said. “These coatings containing antimicrobial agents are designed to prevent bacteria from attaching to the surface of the implant.”
Hydroxyapatite, a mineral that closely resembles the natural structure of bone, is often used in surface coatings. It can be sprayed on top of the implant, where it dries and hardens like bone. “Because hydroxyapatite looks and behaves like bone, it encourages the body to bond more naturally with the implant,” Dr. Kindsfater said. “This helps the surrounding bone integrate with the implant more quickly and securely, improving long-term stability and speeding up recovery.”
Takeaway
The future of joint replacement surgery is bright, with innovative implant technologies set to transform the field. From 3D printing and smart implants to advanced materials and surface coatings, these developments promise to improve patient outcomes and enhance the overall joint replacement experience.
“The focus remains on creating implants that not only last longer but also adapt to each patient's unique needs,” Dr. Kindsfater said. “With continued research and development, we can expect even more groundbreaking advancements in the coming years.”
For more information about joint replacement options, speak to your health care provider or a Banner Health specialist.
