Disc arthroplasty: lessons learned from total joint arthroplasty.
BACKGROUND
With the rapid emergence of new disc arthroplasty designs and ongoing clinical trials, there is great anticipation among clinicians. Inevitably there will be challenges associated with adoption of this new technology. Potential lessons learned from the extensive experience with extremity arthroplasty may predict some of the perils and pitfalls associated with motion-preserving devices in spinal applications.


OBJECTIVE
To review the extremity total joint literature for lessons that may be transferable to disc arthroplasty and anticipate predictable problems that will occur.


METHODS
A literature review and conjectural analysis of key lessons learned from the experience of extremity total joint arthroplasty and anterior lumbar interbody fusion devices with subsequent application of these lessons to disc arthroplasty in the lumbar spine.


METHODS
Limited data are available on disc arthroplasty.


RESULTS
Particular areas of controversy and uncertainty exist. The ongoing US Food and Drug Administration Investigational Device Exemption clinical trials may provide additional insight into these questions.


CONCLUSIONS
Complications will occur. These will be approach related, device related and patient-selection related. Studying the experience of extremity joint arthroplasty may accelerate the learning curve for lumbar disc arthroplasty.
Santos
Edward G
EG
Department of Orthopaedic Surgery, University of Minnesota and the Twin Cities Spine Center, 2450 Riverside Avenue South R 200, Minneapolis, MN 55454, USA.
Polly
David W
DW
Mehbod
Amir A
AA
Saleh
Khaled J
KJ
D019643:Arthroplasty, Replacement; D002986:Clinical Trials as Topic; D018795:Device Approval; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D007595:Joint Prosthesis; D007596:Joints / Q000601:surgery; D018579:Patient Selection; D011183:Postoperative Complications; D012086:Reoperation; D014481:United States