Other Articles

Biologics for Spine: Where We Are Now
Dr. Jeffrey Wang, Chief of the UCLA Spine Service and Director of the UCLA Spine Surgery Fellowship, discusses the exciting happenings in spine biologics, including growth factors, the use of different genes, and injecting stem cells into the disc. And then there are the challenges, namely the disc environment and the funding environment.

Physician Medicare Payments: Grandma vs. Docs
The fight over Medicare physician payments in Congress has been reduced to a fight over limited public dollars between Grandma and her physician. Is this a prelude to how public health care policy will be decided in the future? Read about the tussle here.

Spine Niche! Opportunity in the Spinal Deformity Market
Given the myriad of start-up companies pursuing the same patients, product differentiation and solutions for specific target markets could be the key in the future. Using the PearlDiver Patient Records Database we estimate procedure volumes for posterior fusion as a treatment for scoliosis—followed by the results of a study identifying complications associated with instrumented posterior thoracic fusion in treating scoliosis.

AAOS Political Action Committee
Active players in the orthopedic field know the importance of the AAOS Political Action Committee (PAC). On the cusp of hot topics affecting physicians and patients, the AAOS PAC works diligently to provide data to members of Congress and improve the present and future of orthopedics.

Who ARE These Guys?
Every 60 seconds or so a surgeon tears the cover off an Integra LifeSciences package. Quietly, this company has become the seventh largest medical implant manufacturer serving orthopedic surgeons in the world. Where to now? Would you believe $1 billion in two years? How about $2 billion by 2015?

Redemption in a Mechanism of Failure: The TOPS™ Story
Impliant’s TOPS™ System had a “squeaker” in its clinical study. After a voluntary suspension of the study by the company and finding the mechanism of failure, the FDA has approved a resumption of the study. What insider lessons were learned? Class starts here.

Who is Numero Uno in the PearlDiver Database!! Are You Surprised?
The answer may surprise you. Is it sore backs, aching hips, sore knees, fingers? PearlDiver details 3.8 million spine related complaints—complete with demographic information and charging information. But that’s not #1. PearlDiver also lists 3.5 million large joint complaints. Sorry, still not #1. What could the most common orthopedic complaint possibly be? To get the surprising answer…read on.

What the Knees Need: Baby Boomers and Their Options
Knee patients often show up at the doctor’s office with recurrent mechanical symptoms. It is up to the orthopedist, says Dr. Giles R. Scuderi, Director and orthopedic surgeon with the Insall, Scott & Kelly Institute in Manhattan, to thoroughly assess the patient and then determine if nonoperative treatment will do, or if the person needs a unicompartmental or total knee procedure.

Physician: Report Thyself
The government says its healthcare anti-fraud efforts are working and it wants to encourage physicians to self-report possible fraud. How well did the government do in 2007 and what about those deferred-prosecution deals with undisclosed evidence? Read about it here.

Revising the Statistics
The word that orthopedic patients least want to hear is “revision.” Who, in the universe of large joint patients, do we expect to see on the receiving end of this news? If you guessed “the elderly” you would have been wrong. The reality of who is hearing “revision” may come as a surprise. Read what we found when probing PearlDiver’s database.

Where Is Ben Now? Trends in Venture Capital
What is being funded by VCs and why? First of all, spine is having to share the spotlight, says Gary Stevenson, Managing Partner at MB Venture Partners, LLC. Here Stevenson outlines what constitutes an attractive investment…he also highlights issues that are affecting the distribution of VC funding.

The Hounds of Wall Street
Conventional wisdom on Wall Street is that ArthroCare is in a bare-knuckle fight to the finish with short sellers. Which leaves us with the dominating question: If ArthroCare is essentially a “lame duck” growth stock, then why are sales, earnings, and the stock price contradicting the short seller’s dire predictions and even outperforming consensus analyst forecasts? We have the answer.

The Era of “Tell Me Right Now” Dawns at FDA
The FDA wants the next phase of post-market oversight to change from self reporting to proactive surveillance. How? Through the Sentinel Initiative. Read what it means to device manufacturers here.

The Day After Tomorrow: Complication Rates and Instrumentation Trends in Posterior Lumbar Fusion
Could PearlDiver be the Nostradamus of spinal instrumentation? This most commonly performed surgery on the lumbar region of the spine increases fusion rates and improves spinal stability—but what about complications? Using PearlDiver’s database we find the answers. Are you ready for some quatrains about what happens next?

You Try It. No You Try It First: New Technology Adoption
What are the forces working for and against new technology adoption? Youth versus age, risk taking versus conservatism, and the economic realities of the day, says Dr. Rick Guyer, President of the Texas Back Institute.

Cheaper, Thinner, Faster, Stronger
In this, the second of our series of three articles on innovation, we tackle the question: How do you measure medical technology innovation? While difficult, measuring innovation is NOT impossible. Why? Well to start, and in the immortal words of Supreme Court Justice Potter Stewart, “We know it when we see it.”

SAS Crosses the Rubicon in Miami Beach
The SAS 8th Annual Global Symposium in Miami Beach may have crossed the Rubicon. How? Read about the Society’s opportunities for growth and collaboration as its new President lays out a vision for the future.

Some of the practitioners of the 4th Estate - the press - were worried that with the retirement of Zimmer's Ray Elliot, we would lose a sense of joy, humor, and entertainment as we slogged through quarterly conference calls with stock analysts and company executives. An hour-long recitation of numbers from balance sheets, sales statistics and currency impacts by an accountant may be the stuff of joy for some, but they are not always the insightful observations of a leader of an enterprise or industry.

Well, we were worried for nothing.

Stryker leader Steve MacMillan, the new "elder" among major orthopedic CEOs, is staking his place as someone who will bring personality, insight, and entertainment in communications with analysts, reporters, and observers of the 21st-century orthopedics industry.

Just last quarter we picked on Mr. MacMillan for his appearance on a national business cable program wielding a new blade for cutting bone. We called him "Mac the Blade." But we were premature.

During last week's 2007 second-quarter conference call, with analysts announcing Stryker's 15th quarter in a row of double-digit growth, a 16% increase in net sales, 8% growth in hips, 15% growth in knees, 20% growth in trauma, and a sizzling 26% growth in spine, MacMillan also talked about highlights of the quarter and the outlook for the remainder of 2007.

One of the quarterly highlights was the acquisition of technology which includes a "level of consciousness" monitor.

Given the hot numbers, the level of consciousness at Stryker must be at an all-time high and allowed MacMillan to present the results in a Zen-like fashion. “Steve the Zen Meister”?

Thankfully MacMillan's presentation wasn't overshadowed by the sycophant fawning of some analysts over the great numbers. If I never hear another analyst say, "Gee, great quarter guys, can you give us a little more color or granularity ..." it will be too soon. We respect and admire analysts who can dig through the numbers and spot trends that can inform investors and company strategies for future investments. But we couldn't imagine Helen Thomas, the venerable former UPI White House correspondent beginning a press conference with, "Gee, Mr. President, great budget negotiating with Congress."

MacMillan wasn't shy about pointing to some areas where Stryker fell short. He cited the FDA's warning about their production facility in Ireland and pledged to do better. He was clearly happy about spine, noting that four years ago, Stryker was nothing in spine.

Looking ahead, the Zen Meister said the company was looking forward to a seventh straight year of double-digit sales growth. Business has been good and the company has accumulated $1.8 billion in cash. MacMillan said that the company was biding its time and could afford to be patient as they look for a new division to add to the company portfolio. That kind of cash can buy a lot of patience.

There will probably be some pain later in the year for Stryker and others when the U.S. Attorney in New Jersey announces the conclusion of his two-year investigation into physician consulting contracts with device manufacturers. But at the moment the mantra in Kalamazoo is: “Ohhhhmmmmmm.”