As the recent recall of one-piece hip sockets illustrates, new technology is not necessarily better technology. At a recent meeting of the American Association of Hip and Knee Surgeons in Dallas, Texas, November 5-7, 2010, a discussion regarding introduction of new technology into the orthopedic market place was quite lively. Recent events such as the introduction of bicompartmental knee arthroplasty have been evaluated in short-term followup and found to have an unacceptably high failure rate. Custom cutting guides and use of computer assisted technology has likewise been introduced with very little objective clinical data to support the increased cost. Many of the implants we have used with 10 to 15-year track records continue to function quite well, and while it is critical for the evolution of joint replacement to continue to evaluate new technology, it is generally felt this should be done in a more controlled fashion with well controlled clinical studies at few centers to determine the efficacy, safety, and advantage of many of these new technologies.
Going forward, particularly in light of health care reform, objective measures of quality will be required.