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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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Medical Education Under the Microscope – Is It Up to Today’s Challenges?
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Six Days in June – Biomet and Zimmer Battle for Distributors in Kentucky
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Stryker Responds to FDA Warnings—Recalls County Cork Hip Products
By Walter Eisner
February 1, 2008

They say the squeaky wheel gets the grease. At Stryker the squeaky hip got the President and CEO’s undivided attention.

On January 22, the same day that Stryker said it was voluntarily recalling its hip surgery products (Trident PSL and Hemispherical Acetabular Cups) manufactured in its County Cork, Ireland, facility because they did not meet internal specifications, the normally publicity averse company also felt compelled to issue a statement regarding recent media attention regarding a November 2007 warning letter from the FDA.

The company wrote:

"While Stryker does not normally comment on discussions with the FDA, the company believes it is obligated to provide additional information to healthcare professionals, providers and patients in light of several media reports that draw erroneous conclusions surrounding the Warning Letter.

Most importantly, the company does not believe there is any clinical evidence to indicate that the products mentioned in the Warning Letter present a safety issue to patients. Numerous published independent reports validate the long-term clinical performance of these products.

The company takes these matters very seriously and has been cooperating fully with the FDA to address questions related to the FDA's observations of Stryker's internal process specifications. As part of a comprehensive review of internal processes following the FDA's observations, the company conducted an investigation into a deviation from its internal specifications and processes for the Trident PSL and Hemispherical Acetabular Cups manufactured in its Cork, Ireland, facility.

As a result of the deviation from internal specifications, the company is initiating a voluntary recall of Trident PSL and Hemispherical Acetabular Cups manufactured in its Cork facility. Medical expert opinion of current and historical data concludes that there are no safety issues for patients who received these products. In fact, independent clinical evidence confirms that the performance of these cups compares very favorably with other high-performing acetabular devices.

The company anticipates some short-term supply disruption as a result of this action and is focused on eliminating these disruptions as expeditiously as possible. In that regard, the manufacturing process for these cups in Cork has now been validated, product shipments have resumed and the company has increased production at both the Mahwah and Cork facilities."

Stryker President and CEO, Stephen MacMillan, told analysts during a quarterly conference call on January 23 that he has personally become engaged in fixing the quality problems by instituting new quality and compliance programs, and he was tying senior executive bonuses to resolution of the matter.

 

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