Background: The incorporation of biosensors into orthopedic implants, particularly tibial components in total knee arthroplasty (TKA), marks a new era in personalized joint replacement. These smart systems aim to provide real-time physiological and mechanical data, enabling dynamic postoperative monitoring and enhanced surgical precision. Objective: This narrative review synthesizes the current landscape of electrochemical biosensor-embedded tibial implants in TKA, exploring technical mechanisms, clinical applications, challenges, and future directions for translation into clinical practice. Methods: A comprehensive literature review was conducted across PubMed and Google Scholar. Articles were thematically categorized into technology design, integration strategies, preclinical and clinical evidence, regulatory frameworks, ethical considerations, and strategic recommendations. Findings were synthesized narratively and organized to support forward-looking system design. Results: Smart tibial implants have demonstrated feasibility in both bench and early clinical settings. Key advances include pressure-sensing intraoperative tools, inertial measurement units for remote gait tracking, and chemical biosensors for infection surveillance. However, the field remains limited by biological encapsulation, signal degradation, regulatory uncertainty, and data privacy challenges. Interdisciplinary design, standardized testing, translational funding, and ethical oversight are essential to scaling these innovations. Conclusions: Biosensor-enabled tibial components represent a promising convergence of orthopedics, electronics, and data science. By addressing the technological, biological, regulatory, and ethical gaps outlined herein, this field can transition from prototype to widespread clinical reality—offering new precision in arthroplasty care.

This case report from a Level 1 trauma center describes a novel surgical technique to remove a cannulated intramedullary nail, broken at the distal aspect, from the femur. We present a 40‐year‐old male who sustained a hardware failure, breaking his medullary nail at the distal aspect 7 weeks postoperatively while performing water aerobics. The broken implant was successfully extracted without complication, and a subsequent nail was exchanged. A benefit of this technique is avoiding a femoral osteotomy, which may prove useful for the unique and difficult case of distally broken nails.

Background: While Asian American individuals are well represented in medical schools in the United States, their advancement to senior positions within the field of orthopaedic surgery is disproportionately low. This underrepresentation not only limits diversity in leadership but also constrains the development of people-centred systems that reflect the needs of an increasingly diverse patient population. Objectives: This study systematically examines Asian American representation across the orthopaedic surgery professional pipeline, focusing on disparities between training-level representation and advancement into both faculty and leadership positions., and framing these gaps as a health equity concern. Methods: A comprehensive literature search for peer-reviewed original research articles was conducted via PubMed, EBSCO Open Research, Wiley Online Library, Google Scholar, and ScienceDirect. The potential articles were screened against prespecified eligibility criteria, and risk of bias was assessed using the Newcastle–Ottawa Scale (NOS). Data were then systematically extracted and analysed. Results: This analysis included 20 research articles investigating Asian American representation in orthopaedic surgery. The results demonstrated an underrepresentation of Asian Americans in orthopaedic leadership positions despite improvements in training programme representation with subspecialty clustering in adult reconstruction and spine. Asian American surgeons were less likely to occupy academic and leadership roles than their non-Asian American peers. Across studies, underrepresentation was consistently observed, with effect size estimates indicating a substantial disparity (e.g., pooled risk difference = 0.19; 95% CI [0.12, 0.28]) in those studies reporting comparative outcomes. Similarly, while Asian Americans in residency programmes increased, this growth did not translate proportionally to faculty advancement. In contrast, Asian women face compounded barriers, particularly in subspecialties like spine surgery. These inequities undermine workforce inclusivity and may reduce cultural and linguistic concordance with patients. Conclusions: Despite having strong representation in orthopaedic training programmes, Asian Americans are disproportionately absent from leadership positions. This poses a challenge to equity in surgical education and patient-centred care. To promote equity in leadership, focused mentorship, clear promotion processes, and institutional reform are necessary to address structural barriers to career advancement, this will reflect the diversity of both the workforce and populations served.