Chief Technology Officer and Vice President of Global R&D - Joint Replacement, Stryker Corp
New Era in Medical Device Design | Robert Cohen | TEDxNJIT
Technology is contributing to healthcare innovation in amazing ways. This is a time like no other and patients will benefit with improved outcomes. Just think about the access today to computational power, the additive 3D printing manufacturing process, the potential of robotics, and digital science. So, much in the medical industry design space will evolve at a faster rate. One example showing the creative combination of all these technologies is in total joint replacement. Over a million people in the United States alone have a hip or knee replacement orthopedic procedure a year. A total kne...
About Robert Cohen
In a September 2021 TEDxNJIT talk, Robert Cohen discussed the convergence of robotics, 3D printing, computational power, and data science in medical device design, particularly for total joint replacement. He stated that these technologies "by themselves are nothing without people" and emphasized the role of creative individuals in unlocking their combined value. Cohen described a shift toward individualized medicine, noting that patients now have greater access to their own health data and expect more from surgeons, hospitals, and implant manufacturers. He said that innovation in orthopedic procedures, such as total knee replacement, has a direct link to clinical success and patient satisfaction. Cohen outlined how computational modeling allows engineers to design implants with complex geometries that can be produced via 3D printing. He explained that CT scans can create three-dimensional bone models, and that algorithm development can help determine optimal implant placement for each patient. He also mentioned the use of wearables to monitor postoperative mobility and the potential to analyze data from large patient populations to assess design performance. Cohen stated that robotics provides a level of accuracy and precision in the operating room that no other tool or human can achieve. He concluded that the combination of these technologies, driven by people in R&D organizations and startups, will continue to evolve and benefit patients.
Transcript (7 segments)
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Robert Cohen0:10
I've been in the med tech industry for over three decades, and I love it. Making health care better, improving outcomes, improving patients' lives. How, you may wonder? Through innovation. Today, we are in an amazing place. R&D designers have tools that only 10 years ago they could have dreamed about: robotics, 3D printing, computational power, data science. These technologies by themselves are nothing without people. Creative and inspired people that can unleash the value of each.
A human that will get an orthopedic total knee replacement. The human side of this makes a difference. That patient has expectations, and innovation has a direct link to that patient's clinical success. What is the patient thinking? Times have changed. The med tech industry has changed fast in the last few years. Patients have access to more data on themselves than ever before, and they expect more from their surgeon, from their hospital, and from their implant manufacturer. Think of a patient going through an orthopedic knee procedure to normal living activities.
Health care and innovation. Now let's think of the patient today and let's think of us in the world of technology. Well, before, a patient cared if they got a knee implant, is that kind of thing going to last their lifetime? Today, though, not the case. People have greater expectations. Someone expects to go to one-day surgery and be out of a hospital. Someone expects to go to physical therapy and get their knee flexing again. Someone expects not to be in pain. Someone expects to go back to work. They have an expectation that they never had before. The quality of life, the expectation is tremendous, and we as the med tech industry are rising to it. And we're rising to it because of all the technology we have today. The combination of technology and the combination of engineers, computer science people, data coordinators, data analytics, data engineering. It's exciting because today all of these things together give us more information to design. Manufacturing processes have increased dramatically. Now we can make shapes and configurations with 3D printing that we never could have made before with conventional manufacturing processes. Think about it: in the 80s and 90s, mills, laths, casting.
Untapped. And now, if we think about what is an improvement to clinical outcomes in the past, as an engineer in the past, the total knee procedure, someone's expectations from a company manufacturing or designers, someone like me, was that the person could get out of the chair, they could walk to the table and eat, they can get out of bed, maybe they could walk in a store, maybe they could have limited mobility, maybe they could play a golf game. Now, the expectation of a patient is they can get off a floor unaided, that they can go back to bike riding. Some people will want to walk and hike. Some people may have an occupation where they're unloading trucks. They want to do everything. And now we can look and treat patients as individuals. You have a certain knee geometry that's like no one else. Your ligaments and your muscles are configured for you like no one else. Your expectations may be very different. How you got to the form of arthritis, trauma, could be very different. What does that all mean? That difference tells us we will now move into the world of individualized medicine. We will now take that implant and not just design an implant that's right. We will help surgeons determine where the placement of that implant is.
We can design differently, and now that designed differently may be unique and have different aspirations and different pieces and parts and different configurations. That configuration now can be printed, so we can design differently. We can manufacture with 3D printing differently. And then the missing link is that individualized medicine: How do we know, with that specific patient, where the implant goes? And then how can we execute that plan with technology? So let's think of the total knee now. We designed an implant, now we manufactured one. It goes back to where does it fit in that person? Where is their joint line? What type of flexion do they need? We look at anatomic landmarks, thousands of points, with algorithm development and data engineering, and we could figure out for that unique person where the implant needs to go. Individualized medicine. Now let's technology further. Has technology help the surgeon? Okay, now we have a great implant, now we have a great plan, all data-driven. You have to execute the plan. And for it to work, it's one thing to see this plan on a computer; you have to take it out of the computer. You have to execute in the operating room with the surgeon. The way to do that is through robotics. There's never been a robot that entered an industry and left the industry.
Like no other tool and like no human can accomplish in an operating room. So now we can take that plan, individualized to the person, that goes into the robot, and that helps guide the bone preparation instruments, the saws, the burrs, the drills, the reamers, and you replicate that plan that you saw on a computer in ways we never could have envisioned before. So now we have the combination of computational power for design, 3D printing for unique features of design, and robotics for planning and executing the individualized medicine plan. And it's the gift that keeps on giving because now out of this we have more data on the patient. And we could pour it out: the final three-dimensional placement of the implant. And let's get feedback. Is that patient mobile? How often are they getting out of a chair? We never could have done this before. Now through the internet, we can get this. And we can now do more computer science and we could do algorithm development on population health. We can now take tens of thousands of patients, no, hundreds of thousands of patients, and look at all their data and benefit and understand: is our designs executing what we wanted to? Is the 3D printing aspect of this all, or can we do more? And with robotics, let's keep algorithm development and keep going through permutations and seeing, is that patient the best? How are they walking upstairs? How are they walking downstairs? How are they getting out of a car? Put wearables on them.
Using technology creatively, in this case computational modeling, 3D printing, robotics, and data science. By themselves, they are remarkable. But by themselves, they're nothing. It's people. It's students graduating college. It's small startup companies. It's large R&D organizations in large implant manufacturers. It's the people who creatively look at these tools. These tools are nothing without people. It is the combination to solve problems, in this case to solve clinical issues, to create remarkable things. And in the case of medtech, to evolve medtech in ways that truly benefit humans, truly benefit patients, truly benefit health care. It's exciting times now. And the journey that we are on, it will keep continuing and it'll keep evolving. And that's really great. It's great for technical people to have access to it. It's great for companies that are getting involved. It's great for physicians. And most important, it's great for the patients that benefit from this remarkable point in time that we are in health care. We will do great things.