Orthopedic implant designs embody, occupy and define the inner human space. They are the visible and tangible outcome of a reach for fluency in both metal and tissue. The folks who create these forms (which, when the light hits them a certain way, are gorgeous) are the gear heads in the back room. They are the dirty finger nailed, rough-handed, absentminded, shirt-tail-out artists of our industry.
And boy do they make some beautiful parts.
The implant you are looking at is one part of Wright Medical Technology, Inc.’s new INFINITY ankle replacement system. When we first saw it, we were struck by its fluidity and grace. And we were reminded that, like all human endeavors, orthopedic implants have the potential to rise to high art and design.
Art, in our orthopedic world, comes from an intersection of the natural world and fabricated world. It is where tissues meet metal and plastics.
The challenge for engineers is to mix the grammar of nature with the syntax of metallurgy and polymer.
Philology of Nature and Design
In the natural world, textures, colors, forms, sounds and rhythms are everywhere. It is no exaggeration to say that nature is both the raw material and the finished work of all art and design, whether great or small, visible or implanted, literal or abstract.
The heartbeat, for example, is the foundation of all rhythm.
Kingfisher beaks were the inspiration for the nose of Japan’s bullet trains. Traveling at more than 200 miles per hour, these trains would build up massive air resistance when entering Japan’s many tunnels. Upon exiting, they’d create a sonic boom from compressed air.
Japan’s engineers found the design solution in nature—specifically from a bird called the Kingfisher. A Kingfisher’s beak is perfectly shaped for stealthily diving into water, with very little splash. It’s how they catch fish. Japan’s engineers used the Kingfisher beak design to give their bullet trains the now iconic tapered nose. Even the recessed train headlights are modeled on the nostrils of the Kingfisher.
“Surrounded by Genius”
As one Japanese design engineer was quoted as saying, “We are surrounded by genius.”
Of course, the bullet train’s nose design has come to symbolize high speed rail travel around the world. These trains look fast even standing still.
Another example is the massive wind turbine blades which were inspired by the shape of whales’ fins.
At one level, the implants made by the guys in the back room have to talk in the philology (science of language) of bio-mimicry. And because they are speaking the language of nature, bio-engineers may occasionally find themselves moving into the realm of art and design.
But at another level, bio-design requires that engineers make metals and plastics fluid-like so that they facilitate the flow of biologic movement. Movement has two basic features—the flowing movement itself and the physical structures which facilitate that flow.
To occupy and work in a biologic system, engineers and the implants they design, have to contend with a landscape filled with resistance—like friction. So, to occupy space in a biologic system, they need to facilitate flow as part of movement. Hence the need for smaller profiles, more fluid shapes, and even the ability to articulate themselves.
Designing by, for and With Nature
In her wonderful book, Design by Nature, Maggie Macnab identified the following key concepts to designing by, for and with nature:
- Aesthetics are both relevant and necessary to effective design
- Intuition is essential to creativity
- Synchronicity opens possibilities that may not otherwise exist
- Simplicity is reduction; emptiness is expansion
Making a linguistic shift to implants-as-art brings new meaning, new forms and certainly new contexts with which to discuss these marvelous creations.
Consider the importance of a circle as the foundation for all biologic complexity. The blastocyst is two intersecting circles. As the cells continue to divide they form redundant circles upon circles, which become layers upon layers of circles in ever more complex scale and dimension until, finally, a fully formed, eating, pooping and babbling human emerges.
Wright’s Infinity Ankle System
The designs of Wright’s new INFINITY ankle system triggered the above riff on design, art, bio-mimicry and Kingfishers. Here is what INFINITY looks like in its entirety.
Wright Medical launched its INFINITY Total Ankle Replacement (TAR) system on June 16. It’s a low profile total ankle implant which integrates with Wright’s PROPHECY Pre-Operative navigation alignment guides. It also features a distinctive talar resurfacing option for those docs who want to preserve the talar bone. It also comes with a tibia design that is compatible with Wright’s existing INBONE II system.
The key features of the implant, aside from its sleek look, is that it allows physicians to treat end-stage ankle arthritis patients with a bone conserving total ankle system that is fully integrated with the navigation system.
Robert Anderson, M.D., a foot and ankle surgeon at OrthoCarolina in Charlotte, North Carolina, said in Wright’s press release: “In addition to the many patient-centered attributes of the INFINITY total ankle, my experience has been that procedure times with the INFINITY ankle with PROPHECY can be on par with fusion procedure times. I believe the result of these significant improvements in total ankle design and technique can be a win-win for end-stage ankle arthritis patients and physicians.”
And, of course, it’s also aesthetically appealing.
