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Procedure of the Month

This month's Procedure of the Month patient presented with chronic low back pain (3/10), with acute onset of right lower extremity pain (5/10). A physical exam showed weakness (4/5) of Rt. Extensor Halitus Longus, otherwise normal. X-ray images show Degenerative Disc Disease at L4/5. Provided below are two images of the patient’s lumbar spine.

Pre-op images - AP and Lateral View


Which choice do you think best describes the patient's treatment options (click on the x-rays above to take the multiple choice/guess test)?

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Procedure of the Month
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Extremities News

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What Do the Foot and Ankle Surgeons Have to Say?
By Dev Joshi (posted November 17, 2008)
New survey of 800 foot and ankle surgeons tells PearlDiver which companies are most innovative, most responsive and have the best training programs.  Interested? PearlDiver has the data.

Championship Golfer Helps Hand Surgeons
By Elizabeth Hofheinz (posted November 14, 2008)
Perfect swing, perfect generosity, winning stroke...The American Foundation for Surgery of the Hand is announcing that famed golfer Jim Furyk has just made a generous donation to their organization.

Hold the Knife: A+ for Non-Surgical Clubfoot Treatments
By Elizabeth Hofheinz (posted November 12, 2008)
The American Academy of Orthopaedic Surgeons (AAOS) is announcing that a new study published in the November 2008 issue of The Journal of Bone and Joint Surgery found that two non-surgical treatments most commonly used to correct clubfoot have similarly high levels of success.

Persistance Helps the Wrist: Good Results for BioMimetic Therapeutics on Bone Graft
By Elizabeth Hofheinz (posted November 5, 2008)
BioMimetic Therapeutics, Inc. has announced results from its pilot clinical study evaluating the safety and clinical utility of Augment Injectable Bone Graft (AIBG, formerly known as GEM OS2) for the treatment of closed distal radius (wrist) fractures.

A Handful of Clarity: AAOS Issues New Guidelines for Carpal Tunnel
By Elizabeth Hofheinz (posted November 5, 2008)
The American Academy of Orthopaedic Surgeons (AAOS) has approved and released an evidence-based clinical practice guideline on “The Treatment of Carpal Tunnel Syndrome.” A work group of physicians donated their time to develop the guideline, using current scientific and clinical information.

“Bump Off” the Bump: Alpha Orthotics Launches Bunion Aid™
By Elizabeth Hofheinz (posted October 31, 2008)
Getting the toe in line…Alpha Orthotics, a wholly owned subsidiary of the German Hallufix Corporation, has announced the U.S. launch of its hinged splint system Bunion Aid™. The Bunion Aid, a collaboration between orthopedists, orthopedic technicians, and scientists, helps relieve pain and corrects mild to moderate mal-positioning of the big toe while walking.

Website Makes Hand Easier to Handle
By Elizabeth Hofheinz (posted October 29, 2008)
Manipulate a mouse and physicians can visit a new site for the latest in hand surgery news. Sponsored by Auxilium Pharmaceuticals, Inc., HandSurgeryNews.com is an online portal dedicated to providing hand surgeons, orthopedists, and plastic surgeons with an array of features that support their practice and enhance patient care.

Triggering the Finger Disorder?
By Dev Joshi (posted October 27, 2008)
Fingers may have the smallest bone joints, but they can deliver the biggest pain. Case in point: Trigger Finger. Very painful. And it is marked by a snapping of the tendons. This is an extremely common orthopedic disorder and, according to the PearlDiver Patient Records Database, is most prevalent in certain patients. Which patients? Read on to get the full story.

Sonoma Orthopedic Products Gets FDA OK for Clavicle Device
By Elizabeth Hofheinz (posted October 27, 2008)
They’ve “collared” another clearance…Sonoma Orthopedic Products, Inc., a start-up based in Santa Rosa, California, has announced that they have received FDA clearance to market their fixation device for clavicle fractures, making this the second of Sonoma’s products to receive clearance.

From Obesity to Osteoarthritis, the Carpal Tunnel Connection
By Dev Joshi (posted September 23, 2008)
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.

New Endoscopic Cubital Tunnel Release System From Integra
By Robin Young (posted September 22, 2008)
Integra LifeSciences introduced last week its new EndoRelease™ Endoscopic Cubital Tunnel Release System at the 63rd annual American Society for Surgery of the Hand Meeting (ASSH) in Chicago.

With a Flick of the Wrist, Wright Medical Acquires RAYHACK® System
By Elizabeth Hofheinz (posted September 10, 2008)
Building a better wrist…Wright Medical Group, Inc. has announced the acquisition of the RAYHACK® System for complex wrist reconstruction.

A Leg Up for Extremities: Articles Says Orthopedic Surgeons Vital to Recovery of Stroke Patients
By Elizabeth Hofheinz (posted September 2, 2008)
Don’t forget to call the orthopod. The American Academy of Orthopaedic Surgeons (AAOS) is announcing the publication of a review article in the August 2008 issue of the Journal of the American Academy of Orthopaedic Surgeons indicating that orthopedists plays a significant role in stroke recovery.

Plantar Fascia: The Annual 3 Million Patient Market
By
Dev Joshi (posted August 19, 2008)
“Plantar Fascial Fibromatosis (ICD-9-D-728.71) is right up there in frequency with pain in the shoulder joint, degeneration of lumbar intervertebral discs, pain in the lower leg joint, and carpal tunnel syndrome. As usual, PearlDiver has this market mapped out.

24/7 Quality Control: Low Plasticity Burnishing Supported by FDA Data
By Elizabeth Hofheinz (posted August 1, 2008)
There’s data…and then there’s MAUDE. Cincinnati-based Lambda Technologies is reporting that recent data gathered from the FDA’s Manufacturer and User Facility Device Experience Database (MAUDE) on “adverse events” to orthopedic implants, reveals that Low Plasticity Burnishing (LPB) eliminates the occurrence of fretting fatigue failures in modular hip implants.

The Pain of Fashion! 4 Million Patients Every Year and Growing
By
Dev Joshi (posted July 23, 2008)
Eighty-eight percent of all women wear shoes that are too small. Fifty-five percent developed bunions. Despite costs that can reach as high as $20,000 per procedure, four million patients every year seek surgical relief. Want to know the footprint of this market? Read on.

   

News Shorts
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Pioneer Raises $15 Million for NuBac IDE Study
Pioneer Surgical is getting a helping hand from the State of Michigan. The Upper Peninsula device company has raised $15 million in new investments to pay for an FDA pivotal study for its NuBac nucleus replacement device.

FDA Holiday Present for ReGen Biologics
Merry Christmas, Happy Hanukah and Happy New Year ReGen Biologics shareholders. We’ll also throw in a Happy Kwanzaa and Solstice for good measure. ReGen needs all the friends it can get.

Synovial Celebration: MabThera Inhibits Joint Destruction in RA
Hope flowing from the lab…MabThera. Roche is announcing today that MabThera (rituximab) has been shown to significantly inhibit structural damage to joints in patients with early rheumatoid arthritis (RA) who have not been treated with methotrexate (MTX), the current standard of care for RA treatment.

Canadians Receive $1.3 Million for Engineering
Taking a bite out of arthritis, osteoporosis, etc…Dr. Douglas Hamilton, a dental researcher with the University of Western Ontario, has received substantial funding from The Canadian Foundation for Innovation (CFI) to engineer stronger bone and cartilage tissue to treat patients with traumatic injuries or bone disease.

Congressional Healthcare Reform: Irresistible Forces and Immovable Objects
Those who believe that Congress will move quickly and dramatically during the first days of the Obama Administration on comprehensive national healthcare reform got a cold shower on December 19.

Study: Pycnogenol® Reduces Marker in OA
Another reason to make a pilgrimage to France…Horphag Research Ltd. is announcing that the third osteoarthritis (OA) study this year is showing that Pycnogenol® lowers the inflammatory marker C-reactive protein (CRP).

Daschle Will Lead Health Care Reform for Obama
Former Senate Majority Leader Tom Daschle of South Dakota will be the country's new health care czar. He’ll be health care czar who has written that “doctors and patients might resent any encroachment on their ability to choose certain treatments, even if they are expensive or ineffective compared to the alternatives.”

Medtronic’s Excellent China Spine Adventure
Medtronic's toe in China just got a little wetter. The company announced on December 18th that it had completed its equity investment in China's Weigao Group Medical Polymer Company Limited.

Baring the Medical Soul: Disclosure Summit
The first annual summit on disclosure, transparency and aggregate spend for drug, device and biotech companies will be held March 5 and 6, 2009 at the Renaissance Washington D.C. Hotel…and now they are announcing the keynote faculty, agenda and Disclosure Training Program.

Centinel Spine Continues Transformation
Centinel Spine, the descendant of Raymedica, continues to morph into its new form. On December 16, Centinel Spine announced that the company was on track to see increased revenue by early 2009 due to having secured exclusive distribution rights to market STALIF TT™ (Stand Alone Lumbar Interbody Fusion) products for the entire globe.

Orthofix Defends Itself and Dumps Debt
As Orthofix fights off a hedge fund threatening to board its corporate ship, the company announced that it was going to dump some ballast by paying off some debt early.

New AAOS Guideline for Knee OA
Before you cut…AAOS is announcing the release of an evidence-based clinical practice guideline on “Treatment of Osteoarthritis of the Knee,” a protocol that was explicitly developed to include only treatments which are less invasive than knee replacement surgery.

Nose to Bones: Tentative FDA Nod for Osteoporosis Spray
MDRNA, Inc., a company focused on products based on RNA interference (RNAi), has announced that the FDA has granted tentative approval of its Abbreviated New Drug Application (ANDA) for generic calcitonin-salmon nasal spray for the treatment of osteoporosis.

Cool Discovery: New Genetic Info on Low BMD
Icelandic researchers from deCODE genetics, along with colleagues from Australia and Denmark are reporting the discovery of common single-letter variations (SNPs) in the human genome linked to low bone mineral density (BMD).

MA Plans Bring $1.3 Billion Extra Profits to Insurers
Congress stuck another fork into the Medicare Advantage (MA) program on December 11. House Ways and Means Health Subcommittee Chair, Congressman Pete Stark of California, had requested an analysis from the Government Accountability Office (GAO) about the MA plans' profits for 2006.

Gang of Four Named To Challenge Orthofix Directors
We recently reported that hedge fund Ramius LLC was threatening to call a special meeting of Orthofix shareholders. At the meeting, if called, they would vote to throw four of ten current Orthofix board members overboard and replace them with Ramius' own slate of candidates.

Direct Hit: BioMimetic Achieves Enrollment Target
BioMimetic Therapeutics, Inc. has announced that the company has completed the enrollment of 396 patients in its North American pivotal clinical study for its lead orthopedic product candidate Augment™ Bone Graft. The study is designed to assess the safety and efficacy of Augment for the treatment of hindfoot and ankle fusions as compared to autograft.

U.S. Army Aiming for ‘Disruptive Technologies’
Who knew there was a U.S. Army Science Conference?  In the shadow of Disneyworld no less. But, sure enough, it does exist and this past week a number of cool, futuristic, and potentially “disruptive” medical technologies were on display at the U.S. Army Science Conference in Orlando, Florida.

People in the News

Dr. Andrew Lynn Garners Entrepreneurial Award

Dr. Richard D. Scott Joins ConforMIS Board

Pete Wehrly Lands at Medingo

Upcoming Conferences

5th Annual Emerging Technologies Spine Education Summit
February 4 - 7, 2009 – Steamboat Springs, Colorado

4th Annual Stem Cell Summit
February 17, 2009 – New York

   

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