Theodore Blaine, MD, performed the first cases with Catalyst OrthoScience's stemmed system, which utilizes an anatomical ellipsoid head.
He recently connected with Becker's about the first use of the system and the impact the design may have on orthopedics and total joint replacement procedures.
Note: Responses were lightly edited for clarity and length.
Question: Can you take me through the design process of the system?
Dr. Theodore Blaine: I've been using this ellipsoid head for some time, and patients have been really happy with the results. If you can design a shoulder that looks like normal human anatomy, which in this case means having an ellipsoid head, then those results should be better, the patients should feel better and it should last for longer. Catalyst came out with this technology in 2016, and we have used it with great success since that time. The challenge has been that the old design, which was an anatomically shaped head, has not been convertible — so that's been the need. There are patients who have this more normal anatomical placement, and then they need to be converted to reverse replacement, and in order to do that you have to pull out the old prosthesis and put in a new one. With this newly designed prosthesis that has a stem that can be either reverse or an anatomic ball and socket replacement, you can go back and forth. The new innovation is that this anatomically shaped head can be put on a stem that can be changed from one to the other, which was previously not available in this type of design.
Q: What were some of the advantages of using a system like this with the ellipsoid head for these types of procedures?
TB: The first part of the answer is, "Why use an ellipsoid head?" We know it's more anatomic and shaped more like a normal human bone. If you can reproduce it exactly like the way it's shaped, it should be better. There have been more studies in laboratories, which have tested ellipsoid compared to spherical heads, and found that the motion is better in ellipsoid heads, so it should be better based on our biomechanical data. Lastly, we have seen great results with the ellipsoid head over the past seven years, so we know that it should be better.
Q: Do you think this technology and this system could be used in other procedures throughout the body?
TB: I think that what we're learning with all of the replacements that we're doing — the hip, the knee, whichever joint we are trying to address — we're finding that a more anatomically shaped prosthesis is better. A perfectly sized anatomic prosthesis should be better regardless of which joint, and we've kind of learned that from the knee. The knee processes have become more anatomically shaped over the years and more patient matched and specifically sized, and we found that those patients have done better. The design of this system sort of took that idea from the knee to the shoulder. If that can work well on the knee, it should also work well on the shoulder. The tradition is that you should make it a spherical head because that's the way it's been done since the 1950s, and nobody ever challenged that. Now from what we've learned from the knee and other joints, we should try to make it match in terms of the anatomy, which is what Catalyst has done and it seems to be working.
Q: How do you see this design impacting orthopedics in the future?
TB: I think what will happen when people see that the ellipsoid-shaped heads perform better than sphere heads, every company will ultimately design that same type of prosthesis. They may not be able to right now because of intellectual property issues, but at some point everybody will want to have an ellipsoid head. I think as things become more and more advanced, the replacements that we put in will perfectly match the exact anatomy — be the right size, the right shape and will fit perfectly. I think as we see more and more innovation coming in joint replacement surgery, we are going to be designing implants that exactly fit the patient's anatomy. Now there are newer techniques where we may even be able to use robotics during certain surgeries so that we can put our implants and our screws and everything else in exactly the correct position.