Surgical Technologies
Get ready for joint replacements, other implants that transmit data
January 31, 2025
TORONTO – Medical innovator Dr. Bill Hunter points out that a revolution in medical technology is occurring, including sleek, multi-armed surgical robots from Intuitive Surgical, Medtronic, Zimmer Biomet and others that are being steadily deployed by ORs around the world.
However, the follow-up procedure for most patients hasn’t changed in years – it’s an old-fashioned, analog process.
“We’re still using questionnaires to ask patients after their surgeries, ‘How are you feeling’,” said Dr. Hunter. “We’re doing things in the operating room down to the micrometer, but we’re following up afterwards with the equivalent of a sextant.”
Dr. Hunter was the keynote speaker at a medical innovation conference held at Sunnybrook Health Sciences Centre last October.
His company, Canary Medical, of Vancouver, is aiming to change the antiquated procedures used in surgical follow-ups and monitoring.
Canary produces smart implants that can be placed into surgical sites to automatically measure how the patient is recovering from surgery. Instead of the patient trying to tell the doctor about their recovery at encounters a few times a year, the implant transmits data to the care team each and every day.
One of the company’s latest inventions is the Canary canturio te, a short metal extension that’s inserted into Zimmer’s smart knee replacement.
This small knee extension contains a 3D-accelerometer, 3D gyroscope and pedometer, a memory board and transmitter. It also has a battery that’s designed to last 20 years. Altogether, the implant can gather data showing how a patient is faring after knee surgery, compared to other patients.
Data is gathered throughout the day and uploaded to the cloud at night.
It can tell doctors whether the patient is on the road to a good recovery or not. If the patient isn’t doing well, the data can help the clinician determine how recovery could be improved.
“A physiotherapist can get on a Zoom call with the patient and show him what to do,” said Dr. Hunter. “If you don’t, the patient may never fully recover and could end up back on the operating table.”
He noted that in orthopedic surgeries, the failure rate is still at 20 percent.
The Canary canturio te is designed to catch that 20 percent faster than before and to alert clinicians.
At the same time, the device could radically improve workflow and capacity in the healthcare system. He observed that an orthopedic practice in Atlanta, for example, performs about 1,000 joint replacements annually. They have their patients come in for follow-ups four times a year.
“That’s 4,000 encounters, but 80 percent of the patients will recover normally,” said Dr. Hunter. “Now, you can follow the patient digitally.”
He explained that surgeons could instead focus on the 800 patients who are having trouble, while continuing to monitor the others electronically. That eliminates 3,200 office visits – something that’s better for the patient experience, for clinicians and for payors.
“If you don’t positively affect workflow and workload, you won’t succeed,” said Dr. Hunter, offering advice to other medical technology entrepreneurs in the auditorium.
Canary’s canturio te is just one of a series of smart implants the company intends to introduce. They’re being designed for other orthopedic joints, and for other medical problems, such as heart failure.
On this front, Canary recently ran a small trial of a heart implant that measures the sounds of the mitral valve, comparing them to sounds from normal valves as a way of spotting problems.
The data is again transmitted and monitored remotely, alerting clinicians to the possibility of a problem.
Dr. Hunter discussed the exciting potential of bringing artificial intelligence into the equation. “When you’ve collected a billion data points, you can do predictive medicine,” he said.
For example, you can even predict strokes from the gait of a patient with an orthopedic implant. “The gait of these patients changes,” said Dr. Hunter. “Walking requires a normal neurological system, a normal respiratory system, and a normal musculoskeletal system.”
Regarding joint replacements, he said that algorithms can be developed to detect which patients are on the road to a good recovery and which ones are not. “With the ones who are not, you can treat them much more aggressively,” he said.
ChatGPT and other forms of advanced AI could even be used on the patient side to help at home. “A patient could ask, ‘Siri, how’s my knee replacement doing’,” to better understand his or her own health.
Dr. Hunter commented on the business case for automated monitoring of post-surgical patients. “If 80 percent of patients will recover well, do they really need four follow-ups a year?”, he asked.
Moreover, in the United States, 72 percent of post-surgical orthopedic patients receive homecare, but only 20 percent of them need it.
Implants such as the ones created by Canary could change the economics of the healthcare system, dramatically reducing the need for post-operative care and providing massive savings.