A Pilot Study on Preferences From Surgeon to Deal With an Innovative Personalized and Connected Knee Prosthesis. - Université de Bretagne Occidentale Access content directly
Conference Papers Year : 2022

A Pilot Study on Preferences From Surgeon to Deal With an Innovative Personalized and Connected Knee Prosthesis.


Introduction Knee arthroplasty (TKA) is one of the most predominant orthopedic intervention worldwide with respectively 720,000 in 2019 and more than 700,000 interventions in Europe (Eurostat) and USA (Sloan, 2018). This number is continuously increasing from several decades and is expected to exploded in the next years (+147% by 2030 in the USA [Sloan, 2018]]). This is the results of the population ageing, a strong demand from young (<65 years), often overweight, and more active people. Implanted for 20 years in active subjects, these prostheses are more frequently revised, leading to expensive and less effective procedures. To face this major public health problem, the project FollowKnee (www.followknee.com) is providing an innovative response by proposing a new care chain. With an efficient AI based software, surgeons automatically customize the design of the prosthesis that are then 3D printed. To allow a precise and optimal implantation, augmented reality tools, easy to use in the operating room, are developed. And to better drive patients’ care and rehabilitation, an integrated set of sensors will transmit data to monitor the mechanical behavior of the prosthesis and detect early infections. Patient recovery and optimized follow up will be eased. This personalized and connected prosthesis, bringing together several technologies, would represent a breakthrough and would lead to an adaptation and changes in practices for surgeons. We aimed to assess how surgeons’ preferences will affect acceptability to use this new prosthesis and associated technologies. Method We assessed surgeons’ preferences using a discrete choice experiment questionnaire (De Bekker-2012, Lancsar-2008, McFadden-1973) with 16 choice set scenarios with an status quo option. Surgeons were asked to select the one they would prefer. Based on literature review, experts’ consultation and pre-testing questionnaire, we characterize four attributes (table 1): customized prosthesis, integrated sensors, augmented reality tools and extra cost. A status quo option (ie “no change with my usual practice”) is include. Conditional logit model was used to estimate surgeons’ preferences. The questionnaire was distributed in France via the French national association of orthopaedic surgeons. Results The questionnaire was return by 56 surgeons, that were all males. 46.4% have 10 and less years of experience whereas 53.6% have more. 48.3% work in public hospital and 51.7% in a private structure. The random parameters are presented in table 2. Non-significant status quo’s coefficient indicates no influence of this alternative on surgeons’ preferences. All preference for FollowKnee’s technologies were important for surgeons and were in the expected direction. Overall, the conditional relative most important attribute on surgeons’ choice is “customized prosthesis” (0.62), followed by “Augmented Reality” (0.47), Extra Costs (0.41) and “Integrated sensors” (0.34). Conclusion This study demonstrate that surgeons want to used a customized prosthesis implemented by augmented reality for a measured extra cost. Although interesting, embedded sensors technology seems to be too early for them.
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hal-04560421 , version 1 (26-04-2024)


  • HAL Id : hal-04560421 , version 1


Mathieu Le Stum, Myriam Le Goff-Pronost, E. Stindel. A Pilot Study on Preferences From Surgeon to Deal With an Innovative Personalized and Connected Knee Prosthesis.. 33rd International Congress ISTA (International society for Technology in Arthroplasty), ISTA (International society for Technology in Arthroplasty), Aug 2022, Kaanapli, United States. ⟨hal-04560421⟩
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