Medical Innovation

The human being is innovative by nature and Medicine does not escape this essential characteristic of our species. Innovation is the way to adapt quickly to changes in our environment and our needs. The ways of innovating respond to the opportunities offered by the capacity for observation and rational judgement so characteristic of humans, but they can also be the result of chance, improvisation and, most of the time, trial and error. Scientific and technological development as a virtuous circle provide platforms for generating new knowledge. Scientific research through the scientific method has been consolidated as the best way to advance in the knowledge of the diverse sciences and related disciplines that integrate human knowledge and its interpretation of the world that surrounds us.

The placement of a prosthesis with the aim of replacing a damaged joint is one of the procedures that achieves the best clinical results in terms of safety and quality of life perceived by patients. They are some of the operations most frequently performed in orthopedic surgery and ensure good lasting results.

In spite of this, every now and then new implants appear on the market with supposed technical improvements aimed at achieving better results than with the prostheses used up to that moment. In order to demonstrate their usefulness, these novelties must pass through the test of time in order to demonstrate their efficacy.

A recent article published in the British Medical Journal in September 2014 reviews the data from clinical studies that explore the effectiveness and safety of the supposed improvements of five of the innovations that have appeared in recent years in the world of joint prostheses: three in hip prostheses (ceramic-ceramic friction pair, modular femoral collars and monobloc uncemented gibbets) and two in knee prostheses (high-flex prostheses and gender-specific prostheses). That is to say, those improvements in the designs of the prostheses that have been commercialized and that were going to revolutionize the world of the prostheses.

The result of reviewing all the work published to date is devastating: none of the five innovations has been shown to improve the function or clinical results of the intervened patients. The authors conclude that there should be stricter regulation or supervision of scientific societies to prevent patients from future alleged innovations presented without proven data that demonstrate clinical improvement with confidence.