Orthopedics This Week

Same day total knee arthroplasty is the siren song of large joint reconstruction. Michael Berend has performed over 2,000 knee arthroplasties with 98% of these folks going home the same day and recommends it strongly. Michael Dunbar points out that these are select patients in a tightly controlled environment. Hard to duplicate especially with heavier, more diabetic and older patients. Read this very interesting debate here.

Unicompartmental Knee or Total Knee? What’s not to like about preserving natural kinematics, lower infection rate and good post op range of motion? But can the patient live with higher revision rates? Dr. Thienpont argues for Uni while Dr. Ranawat takes the counter position. Great and timely debate this week.

OK, it’s a distal femoral peri-prosthetic fracture. Do you reach for the locking plates, the screws or the intramedullary nails? Or do you opt for a mega prosthesis? This week’s Orthopaedic Crossfire® debate tackles this excellent subject with ENDO-Klinik’s Gehrke choosing the big implant and Orlando Health’s Haidukewych going ORIF. Who wins? You judge.

Legendary private investment firm Stephens Group, LLC has made the leap into spine. Earlier this year another major private equity firm, Kohlberg & Company also put their considerable resources behind a small spine company. Stephens is investing in CoreLink, a relatively unknown St. Louis based manufacturer. What’s going on?

The Big Five private insurance carriers—you know who they are—want to consolidate into the Big Three. The U.S. Department of Justice has sued to block them. The American Medical Association agrees and says that if the DOJ fails, private health insurance in America will be forever changed. For the worse. Hard to disagree.

DePuy Synthes’ new U.S. President Juan-José Gonzalez sat down with OTW recently and painted a picture of an invigorated DePuy Synthes. It’s a vision that wraps the implant in a blanket of services and digitized intelligence. Where’s DePuy Synthes heading? Into a most interesting future. Check it out.

DePuy Synthes has scale, but can it also navigate a changing and ever more challenging orthopedic environment? New leadership and a series of innovative moves paint a picture of a more nimble and aggressive DePuy Synthes. Here is Part 1 of our series: Inside DePuy Synthes’s Strategic Playbook.

Invibio was the first provider of PEEK to obtain an FDA Master File. The product was a game changer. According to the FTC, the company then tried to create a monopoly by locking up customers with exclusivity contracts. When competitors tried to enter, they were blocked. The FTC filed a lawsuit. The company agreed to a Consent Decreed. Will the monopoly end?

Two former California politicians have pleaded guilty to bribery charges and joined nine others who have pleaded guilty in the massive Worker’s Comp criminal billing scheme that cost insurers over $600 million. The scorecard keeps growing.  More to come?

Open reduction internal fixation or total hip arthroplasty for younger (50-60 years old) patients with displaced femoral neck fractures?  This week’s debate pits George Haidukewych against Edwin Su. Who wins?  You do…with an outstanding debate.

Here are the Best Sports Medicine Technologies for 2016. Sports medicine is the hot new arena in orthopedics and these innovative products show why. This year’s panel of judges included Drs. James Andrews, Brian Cole, John Dorris, David Petron and Tom Vangsness.

The federal government and a giant healthcare system are preparing to square off over the issue of “Steering and Tiering.” The government says Carolinas Healthcare System, due to its dominant market share, is keeping prices high and competitors down. The big guns are out on this one.

When you want to know who the best is, you seek out the best. So we sought out leading spine surgeons and asked them to select their peers who stand out. Here is that list...

When Zimmer Biomet announced that it intended to buy LDR for $1 billion, investors immediately turned their attention to NuVasive, Globus and other fast growing, independent spine companies. Is Zimmer’s bid a sign that spine may start consolidating? Wall Street thinks so. But Wall Street would. What’s the real story?

The world’s largest spinal implant company, Medtronic Spine, is adding robotics to its product line. That brings the number of major orthopedic suppliers with computer-assisted surgery and robotics to three. Are surgeons ready? Are other orthopedic product suppliers scratching their heads? Here are the details.

PODs (physician-owned distributors) are spreading. The U.S. Senate and the device industry continue to try to kill them off. The latest attack from the U.S. Senate found an unexpected ally—leaders of the POD movement. Read about the latest battle in this ongoing war.

GUEST EDITORIAL: Value-based purchasing is changing everything surgeons, administrators and orthopedic product suppliers are doing. But how fast and how powerfully are these changes coming? Ted Kucklick, President of Cannuflow, answers these questions in his excellent guest editorial.

Is the use of ceramic-on-ceramic in young patients the new standard of care? Yes, says Lee.  In fact c-on-c has better wear, is more reliable and provides more options. Not so fast says Schmalzried. Survivorship and function are no better, there is a squeaking and fracture risk. Who wins this debate? You be the judge.

Legendary private equity firm, Kohlberg, is investing in spine and Amendia is the vehicle. Kohlberg’s MO is to buy a platform company, invest in management then bolt on acquisitions. On average, Kohlberg puts between $50-300 million to work. This could be interesting.

A landmark study out of Michigan tracked the effects of health plan prior authorizations on low-back pain patient care. Do such requirements reduce spine surgeries or lower costs? The data clearly shows they do not. It also explains why. Every health plan, hospital and spine surgeon should read this study.