Other Articles

In the Beginning, There Was the End: Manuscripts 101
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?
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
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?
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
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.

Where Intuition Meets Intellect: Recruiting Surgeons
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
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
“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
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
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
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
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
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
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.

The Evolving Reimbursement Landscape for Spine Procedures
CMS, AMA, 510(k)…Oi. Cindy Vandenbosch, President of Strategic Reimbursement Consulting talks here about procedure codes, coverage, and the high bar for evidence-based medicine.

Geriatric Orthopedic Surgery – It’s the future, baby!
The number of patients over 65 years of age is increasing 10 times faster than those under 65. Is your practice ready? The average geriatric patient has 1.8x the complications of the non-geriatric patient. Medicare is now paying a small bounty to those surgeons willing to track comorbidities. Read how one orthopedist has made geriatric orthopedics her primary focus.

Chan's Sentence, Industry's Lessons
Dr. Patrick Chan didn't have to go to jail or pay huge fines, but his role as witness for federal prosecutors and the continuing civil lawsuits may affect orthopedic companies for years. Will it change industry and surgeon relationships? Who is still on the hot seat? Read our take here."

How to Start a World-Class Orthopedic Department
Building an orthopedic department means ensuring that you have and can keep the best physicians, can maintain a financially viable entity, and that you know how to collaborate with others. Dr. Richard Gelberman, Chair of Orthopaedics at Washington University School of Medicine in St. Louis, shares his thoughts on this process.

An Exquisite Sense of Exploration
“If I have seen a little further it is by standing on the shoulders of Giants." – Sir Isaac Newton. Sir John Charnley had 300 hip surgery failures—consecutively. The polio epidemic struck down a generation of this country’s children and one future president. It became the heart and soul of modern orthopedics. We pay homage this week to that exquisite sense of exploration and the giants upon whose shoulders we all stand. You must read this.

Molecular vision! New York University and Tel Aviv University researchers have developed a non-invasive imaging method that can be used to diagnose and monitor a number of diseases, including osteoarthritis and intervertebral disc degeneration (in their early stages). The work is detailed in the latest issue of the journal Proceedings of the National Academy of Sciences (PNAS, February 12, 2008).

The international research team examined glycosaminogycans (GAGs), molecules that serve as the building blocks of cartilage and are involved in numerous functions in the human body. As noted by the researchers, GAG mapping in a living organism is helpful in the diagnosis and monitoring of a number of diseases, as well as in determining the efficacy of drug therapies. Finding limitations in the existing MRI-based techniques for GAG monitoring (they cannot directly map GAG concentrations or they require the administration of contrast agents), the researchers used a more direct measurement of GAGs. They employed the exchangeable protons of GAG to directly measure GAG concentration in vivo.

The NYU/TAU team, working from the premise that GAG molecules have proton groups that are not tethered tightly, investigated whether proton exchange in GAGs could allow concentrations of the molecule to be measured by the MRI. By separating out the GAG protons from those of water, they can be used as a sort of inherent contrast agent. Testing the idea in tissue samples, the researchers found that the available GAG protons did in fact serve as an effective type of contrast enhancement, allowing the researchers to readily monitor GAGs through a clinical MRI scanner. It became clear that this technique can be readily implemented in a clinical setting.

It is hoped that this chemical exchange saturation method could not only provide a non-invasive way to diagnose osteoarthritis in its very early stages, but could also help to indicate early interventions for degenerative disc disease.