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Simple Systems and Minimally Invasive Techniques Drive Hand and Wrist Market

Posted in Research to Reality | Feb 2015 | Comments (0)

Tags: Editor's Choicehand surgeonsorthopaedic industry trendsarthroscopic surgeryarthroplasty

Minimally invasive techniques are becoming increasingly popular across the hand and wrist market, in response to surgeons’ requests to advance patient outcomes through tissue sparing approaches. Furthermore, employing minimally invasive techniques can also drive efficiencies by reducing OR time.

The increased use of minimally invasive techniques for hand and wrist surgery was a topic of discussion at this year’s American Association for Hand Surgery Annual Meeting in January 2015.

Alejandro-Badia WEB“A subset of us hand surgeons are doing a lot of arthroscopy in the small joints, in the knuckles, in the metacarpophalangeal joints, at the base of the thumb, the basal joint, and obviously the wrist,” says Alejandro Badia, M.D., Owner and Chief Medical Officer of OrthoNOW, an orthopaedic urgent care center, and founder of Badia Hand to Shoulder Center. “There’s more focus from some of these (device) companies on getting us better technologies and instrumentation to do that. One of the things that is going to be needed in the future is small joint arthroscopes, specifically for this. If we can fix a fracture with a couple of little incisions or stab wounds rather than flaying open all the soft tissue over that metacarpal or the phalanx, your fingers are going to be able to extend and flex much easier and faster, vs. an invasive surgery. There are a lot of things that have been done in that area over the last ten years.”

ORTHOPRENEUR® spoke to representatives from three device companies to delve further into this trend and others in the market.

Participants included:
Oliver Burckhardt, President and CEO, Flower Orthopedics
Amit Sinha, President & CEO, GenOssis
Kevin O’Brien, Market Development Manager, Conventus Orthopaedics

ORTHOPRENEUR: What trends do you see in the hand and wrist market?

Oliver BurckhardtOliver Burckhardt: There seems to be a bit of lull in technological innovation when it comes to the hand and wrist implant market. The actual implants in the market these days are quite similar; for example, most distal radius implants are anatomic and low profile, with an adaptive watershed design and beveled edges. Variable angle locking is no longer a competitive strength; it is an industry standard. In order to stand out among the competition, you need much more than just a great implant; you need to bring concrete and quantifiable value into the OR. Thinking outside of the implant is key. Disposable solutions, single-use instruments and “less is more” concepts are new in the market, but are garnering lot of attention. Standardization and a focus on OR efficiency is the next step in orthopaedics.

Amit Sinha: Cost control from the hospitals and regulations to ensure traceability of implants [are key].

Kevin OBrien
Kevin O’Brien:
 In the past decade, innovation for distal radius surgery has largely revolved around modifications to volar plate technologies (i.e., variable angle screws, anatomic specific plates, hardware profile, etc.). However, with the introduction of new disruptive technologies,  clinical outcomes with volar plates are now being challenged as alternative tissue sparing techniques further evolve and demonstrate measurable clinical improvements. 

: What are surgeons asking for? What recent products have you launched or are you working on in response to surgeon requests?

Burckhardt: Surgeons are looking for more simplicity, more versatility and increased cost savings in their ORs. They want their cases to be faster, simpler and more efficient without compromising patient outcomes. At Flower Orthopedics, our goal is to facilitate these surgical efficiencies and reduce overall case expenditures. Flower’s Ready-for-SurgeryTM concept, the FlowerCubeTM, is tailored for specific surgical indications, housing all of the requisite implants and standardized instruments, sterile packaged and disposable. The concept allows you to go from one case to another without having to preprocess or reprocess any of the components. This can amount to significant cost savings in the OR.

Earlier this year, Flower released the Anatomic Distal Radius FlowerCubeTM to complement our upper extremity product portfolio. Complete with an anatomic plating set and multi-use disposable instruments, it was designed to address some of the most complex distal radius fracture patterns. Like the rest of the FlowerCubes, we expect the Anatomic Distal Radius FlowerCube to cut surgery times, and overall OR costs.

Sinha: Surgeons are continuing to look for instrumentation that is simple, however an improvement over current devices. GenOssis has developed a compression device that is simple to use and can compress extremely small fragments. Its simplicity allows it to be used for fixation in the hand, foot and ankle as well as in long bones as a standalone device or as supplemental fixation.

O’Brien: Patients are always demanding procedures that best achieve superior clinical outcomes and less complications, while achieving this through less invasive techniques and approaches; therefore, surgeons are receptive to new technologies that offer these outcome improvements. To meet that need, Conventus Ortho has designed a completely novel implant technology for distal radius repair. By avoiding a traditional volar incision and dissection, our implant allows patients to avoid the recovery process associated with healing of the flexor compartment. Clinically, this has shown that patients are having much less pain and have remarkable finger and wrist motion immediately post op.

ORTHOPRENEUR: What challenges have you faced in meeting the needs of your surgeon customers?

Burckhardt: As more and more surgeons embrace the FlowerCube concept, Flower must continue to stay true to its mission of driving surgical efficiencies. Often times this will mean choosing standardization over customization. While we continue to work closely with our design surgeons on updating our current portfolio, and adding new plating sets at a fast pace, we need to carefully review requests for new projects to ensure that we will not steer away from our core competencies.

Sinha: Getting through the approval process of hospitals, especially for a new product, can be time consuming.

O’Brien: Physicians’ natural comfort with their current techniques.

ORTHOPRENEUR: Is there anything else that you would like to share with the surgeon audience?

Burckhardt: As I mentioned earlier, thinking outside of the implant is key. Savings in healthcare cannot alone come from discounted implants. We need to look at the potential savings in the OR, where time is very expensive. Disposable, sterile bone fixation products can significantly cut down scheduling costs, device related case delays and cancellations and eliminate sterilization pre-processing and post-processing costs completely. With that said, one should not only concentrate on cost savings, but also factor in the considerable time savings in surgical prep, case duration and turnover time.

O’Brien: While volar plates and fragment specific fixation deserve much credit for improving clinical outcomes, treatment modalities continue to evolve with tissue sparing techniques. Clinical outcomes of this technology further support the reason for change.

Hannah Corcoran is an Editorial & Media Assistant at ORTHOWORLD. 

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