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Elegance in Spine: Extracavitary Approaches
The delicate task of dealing with spinal problems is getting a bit less complex, says Dr. Francis Shen. Orthopedists can now remove a section of rib and approach the front of the vertebrae from the back in an oblique direction.

Endotec Beats FDA, Strikes Blow for Innovation
Endotec has struck a blow for every orthopedic surgeon who wants to develop a better device. See how the company’s founders took on the FDA and got a federal judge to charge the agency with “stymieing progress and technological advancement.” How did they do it? Read on.

From Obesity to Osteoarthritis, the Carpal Tunnel Connection
It’s certainly no surprise that Carpal Tunnel Syndrome (CTS) is an exceedingly common orthopedic malady. But, as PearlDiver’s data show, the linkage between obesity, osteoarthritis and other conditions to CTS is most surprising. Check it out.

Using DNA to Predict Scoliosis
Six million people (estimate from the National Scoliosis Foundation) have scoliosis in one form or another. The primary age for onset of idiopathic scoliosis is 10-15 years old. Finally, there is a test which can reliably predict scoliosis. Fewer X-rays. Lower cost. Better outcomes.

New Capital, New Science for Cartilage Repair
$36 million invested in the last couple of months. TiGenix has more than that in the bank to fund market penetration. Then a new paper last week finds molecular cause of OA. Cartilage repair momentum is building.

Should I Become a Physician-Employee?
Large healthcare institutions are increasingly purchasing orthopedic practices. What does this mean for patient referrals? How beneficial can it be for orthopedists? The upside is more stability, among other things…and one of the downsides is loss of freedom.

Outrageous Whistleblower Lawsuit Challenged
Spine surgeons sued by whistleblowers in Boston are fighting back. Their lawyer is outraged and says the claimants are just shopping an old and settled case to another judge. Is this the proverbial lipstick on a pig? Find out.

Medical Education Under the Microscope – Is It Up to Today’s Challenges?
Where is the line drawn between what medical schools, residencies, and professors should provide to students and what doctors-in-training should reach for themselves? Here are the results of interviews with three senior surgeons, who opine on things such as attitudes, how people learn, and the possible effects on the field.

The Underlying Meaning of Zimmer’s Purchase of Abbott Spine
From the price paid to the timing, this transaction held an underlying meaning for the entire spinal implant industry. Zimmer, the $4.2 billion (revenue) diversified orthopedic company is now #5 in spine. More to come?

Resurging Lumbar and Cervical Total Disc Replacement Markets! New PearlDiver Estimates
Rumors of the TDA market’s demise were premature. Increasingly positive long term patient data is at the core of a resurging lumbar and cervical TDR market. Senior analyst Matt Menze tackles the TDA market and interviews one of the fathers of TDR, Dr. Scott Blumenthal from the Texas Back Institute. Where is this market actually heading? We think to the $2 billion range by 2015. All details here.

Six Days in June – Biomet and Zimmer Battle for Distributors in Kentucky
Documents filed recently in a Kentucky lawsuit pull the curtain back on an epic battle between Biomet and Zimmer. For six fevered days in June 2007, Biomet CEO Jeff Binder and founder Dane Miller went into the trenches to save one of their own. For all the details, read on.

Multicenter Clinical Trials: Do They Get the Respect They Deserve?
They’re not fast or sexy, but they are critical…large trials, that is. With multiple sites and principal investigators who donate their time, large trials are more complex—and normally yield more actionable data—than smaller, quicker studies. But large trials don’t always get the respect they deserve. And, says at least one physician-researcher, this could affect the future of the field.

Patent Wars: Medtronic Attacks NuVasive
MSD’s lawsuit came amid a period of declining spinal implant market share – from a peak of 60% in late 1998 (just prior to being acquired by Medtronic) to, we estimate, 36% currently – and a growing sense that MSD’s reign as the king of spine was coming to a close. What’s really behind Medtronic’s attack on its former senior exec? Read on.

Call it the new lottery. Craig Patrick dropped a dime on his employer, Kyphon Inc., and today is splitting $15 million with Chuck Bates, another former Kyphon exec.

In his call to the authorities, Mr. Patrick questioned some of Kyphon’s sales practices. A “whistleblower” lawsuit ensued in federal court and Kyphon was accused of inflating the cost of spinal procedures in Buffalo, New York, and throughout the nation. Kyphon’s new owner, Medtronic, settled the case for $75 million.

A different whistleblower in a case against National Air Cargo received $3.3 million. Approximately 25% of all whistleblower cases result in payouts to the whistleblower.

This is a relatively new phenomenon, but it is increasingly causing more and more examples of employees “dropping the dime” on their employer. For all concerned—the company, the whistleblower, and the reimbursing agencies—these are highly expensive and potentially career ending activities.

These cases take three to four uncomfortable years. As Patrick related to a reporter in Buffalo earlier this year; “It’s a very stressful process, from beginning to end. While the lawsuit is pending, you’re not supposed to tell anyone about it. You’re wondering if your work friends will ever speak to you again, and some won’t.” Patrick now lives in Hudson, Wisconsin.

The case that resulted in the Kyphon whistleblower suit came from cases where Kyphon sales people persuaded doctors and hospitals to keep patients overnight in order to receive an additional $10,000 in Medicare payments—despite the fact that the procedure can be performed on an outpatient basis.

Kyphon and, subsequently, Medtronic officials did not admit to defrauding the government.

One in four. Those are the odds currently of winning the whistleblower lottery. More than 130 surgeons are being sued in a recently unsealed whistleblower lawsuit. The Department of Justice has announced that it is targeting surgeons who request payment for services that are suspiciously tied to purchases of products.

If any surgeon or company thinks these aren’t serious times, they are whistling past the graveyard.