Advances in Surgical Technology: Injectable Bone Substitute

Today I'm attending an educational workshop about a novel technique to treat bone cysts in the foot and ankle. This is only one application of this substance, as it can be used in any bone that has a qualifying cyst or injury.

Before I dive in, I want to make it clear that I do not work for, or get paid by this company (or any other medical device company, that way I can be objective in my writing). They did arrange for my travel and lodging to come to this educational workshop, but I have no conflict of interest to disclose. 

These types of workshops are very common in the surgical world, and it's not uncommon for your surgeon to attend one or two per year (in addition to some sort of continuing medical education conference, which is typically mandatory to maintain your physician's license). Some are more beneficial than others and I personally don't always choose to use a product that has been presented to me because I don't always believe the product is effective (using a bad product is bad for your patients and your reputation), or I believe it is too expensive or impractical to use.

The product is called the Subchondroplasty, produced by Zimmer Biomet. They are one of many companies that have some sort of flowable bone substitute material (any sales rep for any of these companies will tell you a well-manicured pitch for why their product is superior, but the truth is the differences between the multiple products are probably very small in most situations). These products are used to fill bone cysts that develop. 

This type of product has been out for several years now and there are stacks of data now to show they are generally safe and effective. The biggest risks of this procedure generally are associated with putting too much of it into the area you're treating. 

The best part about these types of procedures is that the material incorporates nicely into the bone and in most cases it eventually becomes replaced by bone over several months, leaving virtually no trace behind. 

Using the system is easy because it has a trochar--a fancy word for a straw--that is designed to be used both as a drill to get to the area in question and the actual delivery system for the implant material. After you squeeze a carefully measured amount of the implant into your repair area, they typically harden and add to the support of the area. 

These procedures have a lot of different applications in the foot and ankle. These have been used to fill cysts in every bone in the foot (even toes, I learned today), to treat stress fractures, and they've even been used with antibiotics mixed in to treat bone infections (this is a newer application that time will tell whether it is crazy, brilliant, or a little bit of both).

I wasn't allowed to take pictures today, but I'll take some the next time I get a device rep for one of these companies coming through.