Monogram is partnering to combine components of their existing implants already in the field with the 3D printed Monogram implants to release the next generation of orthopedic implants.
Let’s have a quick refresher of the problem Monogram is solving. In the "Comparative Epidemiology of Revision Arthroplasty", researchers evaluated over 2.8 million knee replacements and 1.3 million hip replacements over a five year period and found that the failure rate over the study term (as defined by revision, not patient satisfaction) was 9.2% for knees and 14.8% for hips. There are many causes of failure, and the causes vary considerably from joint to joint depending on the specific anatomical features of the joint, but what is certain is that the incidence of failure remains to high across the board. Monogram believes that technology can be used to improve outcomes and mitigate risks, especially for active young patients. While we have many opportunities to address current shortcomings, for example we see opportunities to improve knees, hips, ankles, shoulders and spine, Monogram believes the most attractive market to start with is knees.
The knee market is very large (almost $10BN) and growing and patients remain unsatisfied (1 in 5 patients is not satisfied with their knee replacement). By our analysis, over 90% of knee implants are cemented, which is not as suitable for active young patients. We also believe that component loosening, especially of the tibial component, is related to unoptimized designs. Finally, the complexity of the joint, especially as it relates to properly balancing the ligaments lends itself to surgical navigation and robotic execution. Monogram will start by focussing on knees.
Our Implant Solution:
An implant has three components that reconstruct the joint: a femur on top, a tibia on the bottom, and an insert that simulates cartilage in between. One of Monogram’s key innovations on the patented knee implant is a new type of tibia - rather than rely on a highly invasive central keel that removes a lot of bone (which is bad for revisions as you can see here: https://bit.ly/tibial_failure), Monogram has designed an implant that has no keel and relies entirely on peripheral fixation. Initial testing with UNMC indicates that the Monogram design could be more stable and less invasive than the current standard.