Description
This transcript features a presentation by Michael Dunbar, who expresses gratitude to the COA and the team for their resilience during difficult times. Dunbar humorously remarks about not being in Halifax with its good weather and discusses his conflicts with Stryker due to his work on kinematic alignment in knee arthroplasty.
He introduces philosophical reflections by referencing Pascal, emphasizing the concept of an 'asymptote to utopia,' drawing parallels to innovation in arthroplasty through different phases of device evolution. He argues that the focus has shifted from the implants themselves to the placement of these implants, particularly in relation to kinematic alignment.
Dunbar mentions the increasing literature on kinematic alignment, highlighting the distinction between its implications and the existing concepts of mechanical alignment. He shares anecdotes and philosophical insights, criticizing how orthopedic literature can be used selectively, leading to debates without resolution.
He also addresses challenges such as measuring differences in outcomes due to the high effect size of total joint arthroplasty, making subtle distinctions harder to identify for patients. Through various studies and meta-analyses, Dunbar argues there's growing evidence supporting kinematic alignment as potentially superior without increasing complications, while addressing misconceptions and the importance of individual patient anatomy.
His discussion of various studies underscores that while the technical aspects of alignment are crucial, they must also consider the soft tissue impact, proposing a blended 'functional alignment' approach. Dunbar concludes by suggesting an approaching epistemological rupture in orthopedic practice towards kinematic alignment, emphasizing the robustness of current evidence and the transformative role of emerging technologies.