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Procedure of the Month

This is the case of a 68 year-old male suffering from severe back pain for 3 months. Patient failed conservative treatment with high doses of analgesics. MRI was performed, as shown in Figure 1 below. This T2-weighted image clearly revealed evidence of acute fracture with bone marrow edema at the L1 level. Which choice do you think best describes the patient's treatment options (click on the x-ray below to take the multiple choice/guess test)?

Figure 1: Preoperative T2-weighted sagittal MRI showed evidence of bone marrow edema indicative of acute fracture at the L1 level (arrow).

Case review and x-rays courtesy of
Dr. Bassem A Georgy.
Interventional Radiologist Valley Radiology Consultants Assistant Clinical Professor University of California, San Diego

SPONSORED BY:


Procedure of the Month Sponsored by DePuy Spine, Inc.


 

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Orthopedics News

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Do Republicans Make Better Orthopedic Surgeons?
By Robin Young (posted May 13, 2008)
A recent Nature Neuroscience journal study of the decision making differences between liberals and conservatives appears to argue in favor of Republican surgeons! Which, frankly, explains a lot—to BOTH sides and, to stretch an analogy almost to its breaking point, it may also explain why McCain’s health care plan is different from Obama’s. Read OUR take here.

"Sound of Music" Turns to Greek Tragedy for Smith & Nephew
By Walter Eisner (posted May 13, 2008)
Smith & Nephew’s Swiss (mis)adventure with Plus Orthopaedics is turning into a Greek Tragedy. The company’s whole acquisition strategy is being called into question. Read how CEO Illingworth explained it to the brutal British press.

“Dear John Letter” for Hip Resurfacing?
By Scott Ellison (posted May 13, 2008)
“Dear John H. Resurfacing: I hope this little note finds you well. We certainly have had some great times and, gosh, I’ll never forget those wonderful moments when the FDA approved your PMA. We’ve just celebrated our second anniversary together and, well, I’m just not feeling the magic anymore….” Two years after FDA approval, how happy are orthopedists with hip resurfacing? Read our analysis here.

In the Beginning, There Was the End: Manuscripts 101
By Elizabeth Hofheinz (posted May 9, 2008)
Dr. Paul Manske, Professor of Orthopaedic Surgery at Washington University School of Medicine in St. Louis and Editor-in-Chief of The Journal of Hand Surgery, shares his thoughts and experience on the details of shepherding a manuscript through publication.

Did ConMed Get Re-Wired?
By
Robin Young (posted April 29, 2008)
Ever hear about the neurosurgeon who used an $80 Bosch power drill to do brain surgery? It really happened. Surgeons like their power tools. Increasingly they also like a particular line of sterilizeable power tools from ConMed’s Linvatec unit. Did ConMed get re-wired? We have the details here.

Rising CMS Orthopedic Payments for 2009
By Walter Eisner (posted April 29, 2008)
If you treat orthopedic problems in the elderly who have complications and comorbidities, you’re going to like CMS’s proposed payment system for 2009. Read about how to maximize your reimbursements.

Replace or Fuse? Can’t Decide?
By Dev Joshi (posted April 29, 2008)
An upcoming paper titled “Controversy of Total Ankle Arthroplasty” says the answer should increasingly be “replace.” Certainly as an outpatient procedure and with new technologies like Wright Medical’s new INBONE system, replacement/arthroplasty is on the rise. Using PearlDiver data we map out this very important market.

Implant Retrieval Labs 101
By Elizabeth Hofheinz (posted April 24, 2008)
The secret life of…implants? Dr. Joshua Jacobs, Professor and Chairman of Orthopaedic Surgery at Rush University Medical Center in Chicago, discusses the details of implant retrieval labs. Preclinical testing to predict implant performance, studying components when implants are removed, and the value of observing the pathogenesis of the failure at different time points in the process, are examined here.

"SpinalMotion conducts the first ever artificial lumbar disc-to-disc clinical trial in the U.S. But there's much more to its technology platform. Its Kineflex® technology is bringing new designs for a posterior disc, a shock absorption disc, and a laterally placed lumbar disc. Check out this company in motion."

Where Intuition Meets Intellect: Recruiting Surgeons
By Elizabeth Hofheinz (posted April 22, 2008)
Whether locating new talent via colleagues or advertisements, says Dr. Thomas Einhorn, Chairman of Orthopedic Surgery and Professor of Biomedical Engineering at Boston University, one must employ one’s instinct and intellect. Dr. Einhorn talks here of how to interview surgeons, how hiring is related to the payer mix, and red flags.

Biomet Reports Strong Knee and Hip Sales for Third Quarter
By Walter Eisner (posted April 22, 2008)
Despite going private, Biomet keeps the curtain open to the public. Read about a great third quarter and what the company's CEO had to say about going public again to the locals in Warsaw.

The Rising Spinal Implant Market
By Matt Menze (posted April 22, 2008)
“A rising tide lifts all boats.” With more than 30 million physician visits each year for back-related symptoms leading to a million plus spine-related surgical procedures, spine care is a $7.1 billion business. The 800-pound gorilla in this market? It’s still instrumentation and interbody fusion devices. What’s driving spinal implant growth? We use PearlDiver’s massive databases to find the answer.

Stryker’s Double-Digit Revenue Machine
By Walter Eisner (posted April 22, 2008)
Stryker continues its roll of double-digit revenue growth for the 29th straight quarter. Company skipper Stephen MacMillan gives analysts and investors another lesson about thriving in a challenging economic time. Read about his take on the state of orthopedics.

Match Day…the Next Five Years
By Elizabeth Hofheinz (posted April 15, 2008)
On March 20, 2008, auditoriums around the country vibrated with excitement as medical students awaited their fate. Read the final article in our series on Match Day as experienced by two future orthopedists.

AAOS Awards Orthopedics This Week and Hofheinz the MORE Award – Again
By Walter Eisner (posted April 15, 2008)
For the second year in a row, the American Academy of Orthopaedic Surgeons (AAOS) has awarded its prestigious Media Orthopaedic Reporting Excellence (MORE) Award for journalistic excellence to Orthopedics This Week and senior writer Elizabeth Hofheinz.

Price Increases for Large Joint Implants
By Scott Ellison (posted April 15, 2008)
According to the patient records in PearlDiver’s database, the average charge for a total knee replacement increased more than 19% from 2004 through June 30, 2007. Hip replacement charges rose 15.7%. That’s an increase of just over $7,500 for a total knee replacement and $6,700 for a total hip in three and a half years. Is this a durable trend? Read on.

The Future of Innovation in Orthopedics Part I: MAKO Surgical
By Robin Young (posted April 15, 2008)
With the Office of Inspector General driving a wedge between surgeon and manufacturer, is the golden age of orthopedic innovation behind us? Could Charnley or Harrington pass muster these days with the OIG, IRB or CMS? This is the first of three articles exploring the future of innovation in orthopedics and we profile one company, MAKO Surgical, that epitomizes, we think, the right way to do it.

DePuy: Taking It to the Streets in ‘08
By Walter Eisner (posted April 15, 2008)
DePuy’s Group Chair Mike Mahoney met with analysts at the recent AAOS meeting to talk about growth strategies for the franchise. He brought along his chief orthopedic guy, David Floyd. See how the happy warrior and his team plan to take the battle for knees to the streets in 2008.

 

   

News Shorts
Complete Issue - PDF Past Issues

NuVasive Injects Itself With Stem Cells
The initial waiting game is over. NuVasive, Inc. has spent part of its big line of credit on stem cells. The company signed a definitive agreement on May 8 to acquire the Osteocel® biologics business from Osiris Therapeutics, Inc.

Scient'x Doubles 510(k) Clearance With DUO™ Dynamic Stabilization System
First there was one level...now there are two. Scient'x announced on May 6 that it had received FDA 510(k) clearance to market its new Isobar DUO™ Dynamic Stabilization System.

Alphatec Ponies Up $11 Million Settlement for ‘678 Patent
"Alphatec can now achieve some certainty." That's what Alphatec's President and CEO, Dirk Kuyper, told us at the SAS annual meeting in Miami Beach. He was referring to his company's announcement that its 2006 lawsuit with Biedermann and DePuy over the ‘678 pedicle screw patent is settled.

Abbott Spine’s Universal Clamp™ Now Available Stateside
The Universal Clamp™ spinal fixation system, developed by Abbott Spine, may now be enjoyed by Americans. The implant, which has been available in Europe for over a year, can be used to correct a wide variety of complex spinal pathologies including sagittal and coronal malalignment, as well as degenerative conditions of the thoracolumbar spine.

Facet Solutions, Inc. Completes Combination Facet Joint and Disc Replacement Study
It’s the motion in Miami…Facet Solutions, Inc. is announcing the successful completion of a scientific evaluation for a total joint reconstruction in the lumbar spine. The study evaluated the combination of Facet Solutions’ Anatomic Facet Replacement System (AFRS™) with a semi-constrained disc replacement device in a finite element model.

Biologic Bummer for Stryker in Beantown
Stryker's stock stopped trading for 16 minutes before resuming on Friday, May 2. The reason was because Stryker was about to announce that its Biotech division, in the Boston suburb of Hopkinton, had received a warning letter from the U.S. Food and Drug Administration (FDA) related to quality systems and compliance issues.

MAKO’s Robot Zaps 1st Quarter Expectations
MAKO Surgical Corp. reported 2008 first quarter revenues of $500,000. Analysts had expected revenues of only $300,000. The company markets its Tactile Guidance System™ (TGS™), an advanced robotic-arm solution, and its implants for minimally invasive orthopedic knee procedures, known as MAKOplasty®.

Shake Up at Medtronic Sofamor Danek
We were frankly surprised as were many people both inside and outside the company to hear of Pete Wehrly’s sudden departure from Medtronic Sofamor Danek day before yesterday. Mr. Wehrly, 49, was the President of Medtronic Sofamor Danek and the abruptness of his departure followed by Medtronic’s extreme caution in commenting adds additional mystery to the circumstances of Pete’s leaving.

DePuy Puts 3 Million Sq. Ft. to Work in China
DePuy products have gone into production in Suzhou, China. Tradingmarkets.com reported on April 25 that Johnson & Johnson Medical (DePuy-Suzhou) Ltd. has started operations at its first Chinese facility to produce medical equipment in the Suzhou Industrial Park in eastern China.

Smith & Nephew Endoscopy Launches FOOTPRINT PK Suture
Just try to follow in their footsteps! Smith & Nephew's Endoscopy Division has announced the launch of the FOOTPRINT PK Suture Anchor, a system used to attach rotator cuff tissue to bone in the shoulder.

Put on Your Futuristic Headgear: Immersion Medical and GMV Sign Agreement for Reality Arthroscopy Simulation System
So much for skiddishness about minimally invasive surgery…Immersion Corporation, a touch feedback technology firm, and GMV, an engineering firm, have announced that Immersion Medical, a wholly owned subsidiary of Immersion, and GMV have signed an agreement whereby Immersion Medical will market and sell GMV's insightArthroVR® virtual reality arthroscopy surgical simulator in most countries around the world.

Zimmer Revenues On Target for First Quarter. Disappoints Investors
Zimmer reported first quarter 2008 revenues (constant currency) on April 24. Total Revenues: up 6.2% to $1.06 billion. The company also announced a $1.25 billion stock repurchasing program and reaffirmed earlier guidance for the year of 6%–7% revenue growth (in constant currency).

Physician Disciplinary Actions Decline 22% Since 2004
With the current hyper-vigilant focus on surgeon and industry relationships, it begs the question: Are disciplinary actions against physicians increasing or decreasing?

Frost & Sullivan Shines Light on Raymedica
Feelin’ hot, hot, hot! Frost & Sullivan has named Raymedica, LLC, as winner of the 2008 Frost & Sullivan Hot Investment Opportunity Award.

NuVasive Revenues Break Expectations, Lukianov Waives HIPAA
The NuVasive Chairman and CEO waived all his HIPAA rights during a first quarter 2008 conference call with analysts on April 22 when asked about his own back surgery. He said he's doing very well after his two-level XLIF® procedure, thank you very much.

Good News for Lower Extremities: Archus Completes First Human Implant of TFAS-C™ System
They’ve come to a conclusion: Some patients can be done with fusion. The reconstructive implant aficionados at Archus Orthopedics, Inc. have announced the successful completion of the first human implant of their TFAS-C™ system, the newest addition to the company's product line for treating spinal stenosis.

DePuy Launches Spine System for Small-Stature Patients
DePuy Spine has launched a titanium and stainless steel hook, rod and screw system designed to treat complex spinal deformities in small-stature patients.

People in the News

Judith Huber Joins ConforMIS as CFO

Jack Maertens Joins Theken Family of Companies as VP of Marketing

Mike McCarthy Joins Board at Facet Solutions

Shake Up at Medtronic Sofamor Danek

Patrick O’Donnell Joins Medical Capital Advisors

Upcoming Conferences

SpineWeek
May 26 - 31, 2008 – Geneva, Switzerland

CMSA's 18th Annual Conference & Expo
June 17 - 20, 2008 – Orlando, Florida

 

   

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