Analysis examines rate of in-hospital blood clots following hip, knee replacement

A recently published review found that approximately 1 in every 200 patients undergoing hip replacement will develop a venous thromboembolism before hospital discharge when current venous thromboembolism preventive medications are used.

The findings were recently published in the Journal of the American Medical Association and also revealed that 1 in every 100 patients undergoing knee replacement will develop a venous thromboembolism (VTE).

“These estimates are of value to individuals and organizations seeking to evaluate institutional VTE event rates against contemporary benchmarks,” Jean-Marie Januel, RN, MPH, and colleagues wrote in their review. “Our above-mentioned rate estimates provide these contemporary benchmarks.”

Low Cost Orthopedic Implants: 5 Things to Know About Buying at Wholesale Price

Until recently, the cost of orthopedic and spine devices weren't inhibitory for providers, even though 700 percent mark-ups on these devices were the norm. Surgeons were able to select their preferred implants and payor reimbursement would cover the cost. However, with a recession at hand and incentives for lowering the cost of care, more surgeons are looking for high quality implants at the lowest cost; that's where small orthopedic and spine device companies like The Orthopaedic Implant Company come in, which offers implants to providers at their retail price.

"We founded the company about a year ago to meet the needs of surgeons who were frustrated with the high cost of orthopedic implants and our healthcare system's inability to pay for [them]," says Itai Nemovicher, president and co-founder of The Orthopaedic Implant Company. "If we tried to do this five years ago, it probably wouldn't have worked out, but now as physicians and hospitals are forced to align their interests, part of which is cost containment, there is a lot more care on the surgeon's side to use cost-effective implants."

Modular acetabular cup system provides versatility and positive results

The Pinnacle® Hip System (DePuy Orthopaedics, Inc.) was the first cementless acetabular cup to feature a design allowing varying combinations of acetabular liners. Though other designs have since mimicked this approach, Pinnacle has been established as a class leader and an extremely reliable clinical device. Within my clinical practice over the past 10 years, I have implanted more than 3,000 of these acetabular cups, and I continue to use it for all total hip arthroplasty (THA) patients, both primary and revision.

The variable liner cup system allows surgeons to use Pinnacle on almost every patient that requires a THA. In older patients, for example, a polyethylene liner may be the most appropriate bearing choice. In high-demand patients, a hard-on-hard bearing (ceramic-on-ceramic, ceramic-on-metal, metal-on-metal [MoM]) may be the best choice. The variable liner cup also allows for simplified reoperations in the event a revision is required. In fact, there is no need to replace the entire cup when a liner can easily be switched out to accommodate other designs—lipped, lateralized or face-changing liners—in cases of instability. The Pinnacle Hip System uses Variable Interface Prosthesis taper technology to allow for multiple liner options. Additionally, Pinnacle enables me to refine a single surgical technique with which I am very familiar, and one that has provided consistently positive results for my patients. This has the potential to minimize any variability in outcomes that could be introduced by adopting different implant systems, which I would use less frequently, for different patients.

Best of Both Worlds: Stanmore’s Patient-Specific Implant Meets Robotics

In 2012, UK-based Stanmore Implants is preparing to take on part of the world (the UK, Europe, and the United States) with a patient-specific knee system that integrates robotics. Although there are technologies that address patient-specific implant creation, the twist on the Savile Row system is that it integrates such an implant with robotics. “Everything from the planning phase through to the implant manufacture and surgical execution is personalized to the patient,” says Graeme Brookes, managing director of computer-assisted surgery and integrated technologies at Stanmore Implants. As a result, accuracy and reproducibility is introduced into the surgical procedure. The implant is a unicondylar knee replacement, which means it preserves more tissue than a total knee replacement.

Hip Implant Bearing Report Shows Little Difference Among Bearing Combinations

As metal-on-metal hip implants continue to be scrutinized, here's the latest from Jim Dickinson in MD+DI's Washington Wrap-Up:

"A review of clinical trials, observational studies, and registries produced limited evidence on comparative effectiveness of various hip implant bearing combinations, according to an open source British Medical Journal report by researchers from CDRH and universities in the United States and Australia. “Results do not indicate any advantage to metal-on-metal or ceramic-on-ceramic implants compared with traditional metal-on-polyethylene or ceramic-on-polyethylene bearings,” the study concludes....They say they systematically reviewed the evidence as part of that project to determine the short- and long-term outcomes reported by patients undergoing hip replacement and the rates of revision after using implants with various bearings."

Recovery of Orthopaedics Companies Remains Slow

In a daily letter from Canaccord Genuity, analysts reiterated a statement made last summer about the end of the glory days in orthopaedics. That is not to say that things won’t get better, but don’t expect to see improvements until the economy as a whole recovers.

Three Manufacturers Who Look Good:

• China Kangui Holdings. The China-based orthopaedics company continues to grow through its strong product pipeline.
• NuVasive. The acquisition of Impulse Medical could help strengthen NuVasive’s business strategy.
• OrthoFix. The company already surpassed analyst revenue expectations for Q4 2011.

Two Takeaways from the Canaccord Analysts:

KFx Medical Corporation Awarded New Medical Devices Patent

KFx Medical Corporation today announced that it was granted a new patent from the United States Patent and Trademark Office: U.S. Patent No. 8,100,942 broadly covering knotless double row rotator cuff repair. The new patent bolsters KFx Medical’s patent portfolio and highlights KFx Medical’s innovation in the orthopaedic and medical devices industry.

In 2011, an anonymous party filed a request that the Patent Office re-examine KFx’s first and seminal patent (U.S. Pat. No. 7,585,311) which also broadly covers knotless double row rotator cuff repair. The Patent Office rejected all arguments made by the anonymous party and completely upheld the KFx patent.

Medtronic, Inc. Announces 510 Clearance For Aquamantys SBS 5.0 Sheathed Bipolar Sealer For Spine Surgery

Medtronic, Inc. announced that it has received 510 clearance from the Food and Drug Administration (FDA) for the Aquamantys SBS 5.0 Sheathed Bipolar Sealer, a new addition to the spine portfolio of the Company’s Advanced Energy business. The SBS 5.0 Sheathed Bipolar Sealer gives spine surgeons the ability to optimize speed and continuity in surgical cases by providing hemostatic sealing capabilities for both incised soft tissue (e.g., cut muscle) and epidural veins with a single device. Like other devices in the Aquamantys line, the SBS 5.0 uses Transcollation technology, a combination of radiofrequency energy and saline that has been shown to reduce blood loss and improve visualization when used during spine procedures. Reductions in blood loss during surgery have been linked to reduced blood transfusion rates and decreased surgical time. 

38 Orthopedic & Spine Device Company Executive Moves in 2011

Former president of medication delivery company Baxter Healthcare Peter Arduini was named CEO of orthopedic device company Integra LifeSciences. He replaced Stuart Essig, who became chairman of the company's board.

Wright Medical Group's chief technology officer Frank Bono is no longer with the company.

Interventional Spine named Stephen T. Colaiezzi senior vice president. He previously worked with Stryker, Medtronic and Aesculap.

Leslie H. Cross, former CEO of DJO Global, was elected to the Alphatec Spine board of directors as the non-executive chairman of the board. While with DJO Global, Mr. Cross helped the company's revenues grow from $30 million-$966 million.

Ascendx Spine recently appointed Maria Pilar Debelius-Kinsey as the company's new sales and marketing manager in Europe. She has served in management and sales positions at Medtronic and SpineVision.

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