Matthew Miller’s New Gig
Twenty-five year industry veteran, Matthew Miller, is now driving business at Jupiter, Florida-based Atlas Spine, Inc. Miller has had the unique experience of working with some of the greats in the business of orthopedics and he very deliberately is bringing those experiences to a young, emerging growth spine company.
Miller told OTW, “Working for Steve Gorlin for 12 years best prepared me for my role with Atlas Spine. I learned so many things from him. Surrounding your company with talented individuals [is important]; “bet on the jockey, not the horse,” probably is the best lesson and the most difficult to achieve. Gorlin’s 7 Golden Rules are business rules by which I live. Being a co-founder of MiMedx is perhaps my proudest achievement and the experience that had the greatest impact on me professionally.”
“Second to the benefits of spending time in Steve Gorlin’s orbit was working with Lew Bennett, one of the founders of Howmedica and Sofamor Danek. Every day Lew stressed business is about fundamentals, sound and conservative financial responsibility, leadership and training. He said always focus on helping others achieve their goals, for when you do that, you make a friend for life (team members/managers, customers/surgeons, distributors, sales reps, stakeholders, etc….).”
“Atlas Spine is a tremendous opportunity and I’m grateful to be working with this team. The company is at a tipping point where the talents, creativity and experience of everyone at Atlas are really going to shine over the following year. The company’s expanding and lordosis-correcting interbody devices are exceptional and differentiated from any competitor in the market.”
“The company’s Director of Product Development Brett Zarda, is one of the company’s diamonds. Not only is he an exceptionally talented engineer but his business and strategic sense is second to none. ‘Z’ as we call him, will be an exceptional CEO in the spine industry. He spends his days assuaging development issues, managing device testing, designing an ever expanding product line, and consulting for several well-known spine companies that outsource to Atlas their instrumentation and implant design. Then, while he’s doing all that, he can change gears and be called in to present the company to investors, discuss the pros and cons of a potential partnership and provide leadership on a range of strategic business issues.”
“The company’s Co-Founder and Chief Technology Officer Matt Baynham comes from a family of over-achievers. His two brothers are spine surgeons (one adult and the other pediatric), and Matt has invented all of Atlas’s technology—over 50 patents in the company’s intellectual property portfolio. The expanding, lordosis-correcting, sagittal balancing, nesting-segmental plating, and other products that reside in our IP [intellectual property] estate all belong to Matt’s creativity, design and engineering talent.
“Our CEO, Douglass Watson, ex-Navy and retired Captain of a destroyer, has completed the company’s reorganization. When he took over, the company faced a lot of challenges. Over 18 to 24 months, Doug has set the course, worked with payables and has the company’s balance sheet shipshape (of course). In fact, Doug’s done such an outstanding job that the company has a positive EBITDA and it will grow this year by over 25%. Of course, having the discipline and leadership of a retired Navy Captain is a huge benefit to the team.”
“Every team member at Atlas has equity in the company and performs at an exceptionally high level. From our Office Manager Lorna Thorne without whose work the company would come to a grinding halt, to our machinists, Chris Cordova and Greg Cornelius who manufacture our products (Atlas owns its machines and our manufacturing is on site). Everyone associated with Atlas is of the highest ethical and professional standard. The team is tremendous.”
“Over the next 12 months we will be focused on launching products, growth, and gaining measureable market share. We just received 510(k) Clearance on Ortus Expandable Posterior Lumbar Interbody System and are in launch mode now. We’ll have another 510(k) at the FDA before the end of the year, and then it’s off to the races. Competitors are going to be hearing about Atlas from key opinion leading surgeons as we aggressively leverage and expand our distribution. As Steve Gorlin said, ‘If you have a piece of junk—you can’t give it away for free; if you have a piece of gold, someone will take it away from you.’ Atlas is mining gold right now and the next 12 months are going to be fun!”
Treating the Ischemic Orthopedic Patient
Treating orthopedic patients who also have ischemic heart disease co-morbidities requires extra care and a new study from Hospital for Special Surgery (HSS) tackles this important issue.
The study, “The Incidence of Perioperative Cardiac Events after Orthopedic Surgery: A Single Institutional Experience of Cases Performed over One Year,” appears in the October 2017 edition of HSS Journal.
Michael Urban, M.D., Ph.D. anesthesiologist at Hospital for Special Surgery in New York and co-author on the study, told OTW, “A significant percentage of patients who require arthroplasty or spine surgery have multiple medical co-morbidities, including ischemic heart disease.”
“We were interested in assessing the incidence of postoperative ischemia and cardiac complications in our orthopedic population. We utilized a recently installed hospital electronic ordering system to identify every patient who had troponins ordered (a marker for myocardial ischemia).”
The authors wrote, “Preoperative cardiac risk factors and postoperative cardiac complications were identified in patients undergoing a total hip arthroplasty (THA), total knee arthroplasty (TKA), and posterior spinal fusion (PSF). A postoperative myocardial infarction was defined by a cTnI > 0.1 ng/mL, ECG changes, new echocardiographic regional wall motion abnormalities, and evaluation by a cardiologist.”
Dr. Urban told OTW, “The incidence of myocardial ischemia in our at-risk patients was higher than I expected (8.7%), but the incidence of myocardial infarctions and serious cardiac complications was low (<2%). More patients than we expect are at risk for cardiac complications, but I think with the perioperative care provided at HSS most of these ischemic episodes do not progress to serious complications.”
“Patients at risk for postoperative myocardial ischemia require postoperative care designed to reduce cardiac events (hemodynamic control, adequate pain management, administration of ASA [aspirin], statin, beta blockers). In the near future when more of our patients are ambulatory, it will require screening for those patient who would benefit from postoperative hospital monitoring.”
“Future research will be directed toward determining if a preoperative BNP measurement can be used as a marker for patients at risk for postoperative cardiac events.”
Exercise for Hip OA: Get the Dose Right
When it comes to hip osteoarthritis (OA) how much exercise is appropriate?
This is the question posed by researchers in Oslo, Norway in their study, “The importance of dose in land-based supervised exercise for people with hip osteoarthritis. A systematic review and meta-analysis,” was published in the October 2017 edition of Osteoarthritis and Cartilage.
Tuva Moseng, P.T., M.Sc. with the National Advisory Unit for Rehabilitation in Rheumatology at the Diakonhjemmet Hospital in Oslo, Norway, told OTW, “Exercise is recommended as a core treatment modality in hip OA, and should according to the guidelines be offered to all OA patients.”
“High quality evidence has shown that exercise (both cardiorespiratory and resistance) is effective in relieving OA symptoms such as pain and improving physical function. Although we do not yet know what is the optimal exercise dose for this patient group. This is a major concern to all clinicians which prescribe exercise programs to their OA patients daily.”
“The systematic review and use of meta-analysis is the best method of synthesizing existing knowledge within a field. What was especially interesting with the meta-analysis conducted for this study was that we distinguished studies with interventions delivered in accordance with international exercise dose recommendations (originally made for healthy adults) from those that did not adhere to these recommendations.”
“Although 12 randomized controlled trials have been conducted to examine the effect of exercise on hip OA symptoms, no one has yet looked at the explicit exercise dose used in these exercise interventions and evaluated effect according to the different dose prescriptions.”
“The most important finding was that the studies with exercise programs with exercise doses prescribed according to the dose recommendations from American College of Sports Medicine observed significantly larger improvements in pain compared to the studies that did not follow these dose recommendations. For physical function we also observed larger effects for the studies with exercise programs with high adherence to the recommendations, but the results were not statistically significant between the groups.”
“From this work we can say that people with hip OA can safely exercise according to guidelines developed for healthy adults, and that they might experience less pain and possibly improved physical function compared to if they exercise on a lower dose.”
“Orthopedic surgeons should make sure all patients referred to hip replacement surgery have tried a period of supervised exercise therapy, prior to having their surgery. This will make sure the right patients are prioritized for surgery.”
