More than 600 orthopedic device manufacturers were on hand at the American Academy of Orthopaedic Surgeons 2016 Annual Meeting in Orlando, where 15,000 orthopedic surgeons, health care professionals, and researchers participated to customize a unique educational experience and share perspectives. Discussions relating to athletic hip and knee injuries, minimally invasive spine surgeries, and biologics were ongoing throughout the conference. The poster exhibit area included over 900 papers and 575 posters that demonstrated the latest scientific and clinical studies and over 245 instructional courses presented by world-renowned faculty. Strolling through interesting podium presentations opened my eyes to the overall direction of the orthopedic industry.
The dynamic between large companies—which have created “one-stop shops” where facilities can purchase a large variety of orthopedic devices from a single vendor at a discount—and smaller manufacturers with specialized products, was illustrated on the conference floor. The impact of Zimmer’s acquisition of Biomet, which closed in June of 2015, was proven at the show with its exhibit being the largest: a two-floor exhibit booth combining conference rooms and demonstration labs, a 6-section automated LED wall that moved together and broke apart to suit different content, as well as its Z-logo with bright blue lighting. Zimmer’s reconstructive implants and trauma and osteosynthesis fixation devices combined with Biomet’s broad sports medicine/soft tissue fixation products represented the newly combined Zimmer Biomet entity and captured synergies between these two firms.
Another eye-catching exhibit was Wright Medical’s; the merger of Wright Medical Group and Tornier was completed in October 2015, combining three of the fastest-growing areas of orthopedics—upper and lower extremities, as well as biologics. With the new capability to cross-sell specialized technologies among existing product lines and business units, the newly merged company announced the launch of new innovative products, all of which obtained a favorable reception among surgeons and health care professionals.
Computer-assisted and robotic surgical systems, including 3D technology, were two hot themes of product launches, especially in joint reconstruction and spinal fusion treatments. Players in the exhibit hall—Stryker, Smith & Nephew, Exactech, and Materialise—demonstrated how the increased predictability caused by their technologies can improve patient outcomes. The 3D printing technology, in particular, has been penetrating the health care field at an astonishing rate. For instance, Materialise, a provider of additive manufacturing software solutions and sophisticated 3D printing services in a wide variety of industries, showcased a full suite of integrated software and solutions, with which hospitals can create detailed pre-operative plans from digital x-ray images, treat complex cases with 3D-printed anatomical models, and create patient-specific guides and implants, and most importantly, integrate virtual planning and 3D printing into their surgical workflow; this suite will enable surgeons to 3D print accurate medical models in hospitals.
Nonetheless, there is still a long way to go to obtain reliable clinical and economic evidence for these aforementioned innovations to sway mainstream adoption of surgeons and hospitals. At the conference, orthopedic surgeons voiced their opinions that they are facing the challenges of the rapidly changing health care environment, which include increasing capital costs, declining reimbursement rates, and increasing data reporting requirements, such as specific rules for extended conservative care. The bottom line is that hospitals, especially ASCs, are losing money on operative procedures due primarily to the poor reimbursement for patients receiving some of these latest technologies. Additionally, orthopedic surgeons were concerned with limited implant designs and their high costs using the computer-assisted or 3D approach because there are various anatomies and types of patients. As a result, orthopedic surgeons, particularly those who practice in the US, will be reluctant to adopt those new devices unless they receive sufficient positive clinical data supporting their cost-effectiveness and efficiency.
As financial reimbursement and providing quality in orthopedic care are becoming more closely related than ever, surgeons, health care professionals, and manufacturers at the AAOS 2016 meeting strived to prepare for a value-based environment while providing a fascinating glimpse into a medical field where innovation is ongoing and the improvement of patients’ lives is front and center.
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