Are We Finally Ready for Total Joint Replacement of the Spine? An Extension of Charnley’s Vision

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Figure 1
The facade of Wrightington Hospital appears today very much the same as it did in the time of Sir John Charnley.
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Figure 2
Historical timeline for the development of the total joint replacement implant. Commencing in 2004 (A), initial concept (B), removal of superior screw (C), removal of tail and optimizing and finalizing the materials (D and E).
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Figure 3
The MOTUS device (3Spine, Chattanooga, TN, USA).
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Figure 4
Intraoperative fluoroscopic image confirming final implant placement showing the rectangular device resting on posterior superior S1 with the L5 to S1 segment in lordosis. The wedge-shaped pedicle vertebral body osteotomy of S1 allows the device to rest in the disc space while maintaining segmental lordosis.