Making implants simpler

We’re not too far away from the day when your new customised hip joint will arrive in a briefcase.

There are round 10,000 hip replacements per year in New Zealand, but the long and costly design process of custom implants impedes their widespread adoption. In 2014, researchers at the Auckland Bioengineering Institute with skills in building statistical and computer models began tackling this problem.

“We used novel algorithms to analyse people’s bodies and then looked at how the shapes of bones differed between populations. From this, patient anatomy and optimised prosthesis designs could be calculated,” says Dr Ju Zhang, founder and chief architect of 2016 spinout Formus Labs.

“Our toolbox encompasses biomechanics, orthopaedics, finite-element modelling, medical image analysis, machine-learning, and 3-D web technologies. We incorporate this expertise into our platform as highly customisable design workflows suitable for a wide range of orthopaedic products.”

Today, Formus is working with local surgeons to trial their pioneering cloud-based, patient-specific orthopaedics programme that streamlines the pre-operative planning process. Their software is now being readied for commercial release with a major international orthopaedic company.

“Our goal is to make patient-matched orthopaedics more accessible by giving surgeons something very easy to use,” says Dr Zhang. “Once the scan is uploaded, our platform automatically creates 3D models of the patient anatomy and their matched implants. The design is fully customisable by both surgeon and engineer on any modern browser.”

The software also plays a key role before surgery, at what Dr Zhang calls the pre-hab phase. Currently, trays and trays of implants are dispatched for each operation, with about a handful put into the patient and the rest sent shipped back to the supplier. In this phase, the surgeon arrives in theatre with only some idea of the implant required. But, with the Formus software, the surgeon has already selected the most appropriate implant and can be sent one tray with a few options either side. Time in surgery is shorter and less anaesthesia is required. The software can also be used to help determine whether function has improved – in other words, the re-hab phase.

Dr Zhang says their current focus is better use of off-the-shelf implants. “Even though 95 percent of joint replacements use standard components, pre-operative planning is essential for personalisation around size, orientation and positioning in that same pre-hab phase.

“The goal is to help the surgeon and the patient through the whole journey – from pre-hab to re-hab.”

Over the next two to five years, Dr Zhang says they want to create a successful first product, focusing on hips and shoulders over the next year for the Australasian market. He’d then like to expand the user base with a view to launching in the US and start looking at other joints.

By Prue Scott