Recent advances in the field of medicine especially in minimal invasive interventions in cardiac and neurosciences and in orthopedic practice — trauma, spine or joint reconstruction, have brought in increasing usage of implants and prosthesis. These implants, etc., are medical devices that help in treating several conditions that hitherto were left for palliative treatment, providing options for minimal invasive interventions, reduced the hospitalisation and restoration of functionality in shorter time such that individual is rehabilitated faster. However, the ultimate success of usage of implants is just not insertion or fixation to the body organ where it is needed but restoration of anatomical integrity and restoration of functionality to normal or at least near normal.
The overall success of usage of implants, as mentioned above, is dependent upon intrinsic and extrinsic factors. The intrinsic factors being — type, quality and material of the implant and extrinsic factors are — proficiency and competency of the physician, professional exposure and training for using the specific implant (self development and inputs provided by the implant company) and overall experience in having used the implant following the protocol jointly developed with the implant providing company.
When it comes to choice of implant to be used, especially in trauma cases, physicians are sometimes faced with choosing between usage of metal plate with screws versus nail. Appropriate choice in such cases will affect the overall result. Adequate understanding of the biomechanical forces at play in such cases of fracture will determine the choice of type of the said implant and it is essential that such selection is based on scientific evaluation rather than past experience or personal preference of the physician.
Quality of implant is partly dependent upon the material used to make it but largely by the manufacturing processes. The implant company needs to remain in constant touch with the user physicians and obtain feedback to keep on improving upon the finished product. Improvement in quality can be brought about by companies which invest in research and development and are constantly looking at improving. Therefore, it becomes very important for physicians to be aware of such facts and choose implants from such companies rather than look for so called ‘cheaper option’. Incidentally, lots of physicians fall prey to this malaise for various reasons — larger implant companies do not penetrate beyond bigger cities to expose physicians about their products and latest developments happening in the arena.
Last of the intrinsic factors that plays a very important role in overall success of usage of implant is the material used to make it. It is to be appreciated that the implant is a basically a foreign body which interacts with the biochemical milieu of the body besides the anatomical fitment needs. Hence, the material used for making the implant has to be something that is able to adapt and allows the body organ to adapt to its own physical and chemical properties. Titanium seems to have dominated in this respect as it has been found that the body adjustment to the implant has been far easier.
The extrinsic factors, which are influenced by the physicians play key role in the success of usage of implants to restore the patient’s anatomical integrity and functionality. The overall proficiency and competency of the physician in implanting such chosen medical devices, which starts from choosing the appropriate implant is the essential component for successful culmination for patient’s benefit.
As the implants are constantly under improvement and techniques to use them get modified it is vital that the physicians invest time in professional development and formulate protocols for the procedures in collaboration with the implant company to ensure that the patients get the best. Implant companies could promote mentoring and proctoring of physicians in association with those physicians who have mastered the technique of using the implants such that the expertise is made available at all levels.
The writer, Praneet Kumar, is a New-Delhi-based consultant. He has more than 37 years of experience in managing and establishing hospitals and healthcare facilities, organisation development and conducting leadership workshops for health professionals
(This story was published in BW | Businessworld Issue Dated 12-01-2015)
