Is Orthofix prepping to “boot” its Spine Division ?
In the popular monthly Tiger Dashboard (found at the top of OrthoStreams for those lucky subscribers) I have predicted for […]
The “KOL Shortcut” is Dead in 2026
I remember the “Good Old Days.” In that era, the blueprint for an orthopedic startup was as predictable as a
The Generalist’s Creed: Orthopedics 2026
In the ortho offices of 2026, the most dangerous phrase a professional can utter is, “That’s not my department.” The
How to Move Up the Food Chain in Your Orthopedic Career
In our industry, “moving up” isn’t just about a loftier title or a bigger paycheck; it’s about increasing your professional
The Ortho IPO paradox: Will there be any oxygen left in the room for ortho in 2026 ?
The IPO window has opened up for orthopedics this year. Read more here – A detailed look at the positive
Why “Big Ortho” Still Matters (and Why We Need Them)
If you read my stuff, you know that I frequently argue that a Startup Ortho is the superior environment for
Join the discussion today with Hyperflex Medical on BoneChat – 3:00p EST.
No bone cuts. No fusion. Just correction. Traditional bunion surgery often requires aggressive bone trauma and weeks of recovery, but
Clinical Data Theatre in Orthopedics
In the sterile hallways of orthopedic conferences, “Level 1 Evidence” is treated like the holy grail. Sales reps carry tablets
Why Mid-Cap Orthopedics is Facing a Historic Valuation Crisis
The investment landscape for orthopedic innovation is shifting under our feet, and to get a clear view of the damage,
From “Wow” to “Flight”: The 5 Stages of an Orthopedic Life
I notice trends. After decades of startups, recruiting, podcasting, and pattern-matching across thousands of conversations in this industry, I’ve realized
What a 510(k) actually costs in 2026… because nobody tells you the real number until you’ve already spent half of it
Guest post by Lisa Voronkova, Founder & CEO of OVA Solutions and author of the “Hardware Bible.” Follow Lisa’s free
The Rise and Fall of the Bunion King: Making sense of the Treace Medical collapse
What happened? Many people have asked me this question over many quarters. It’s complicated, but I am going to do
The Tiger Dashboard – April 2026
Sharing the best monthly DASHBOARD in the ortho industry to the lucky OrthoStreams Subscribers ($1/day) – no-ads, no bias, just
An Ortho Startup’s insight into the VC Mindset
Most orthopedic founders view Venture Capital as a black box or, worse, a necessary evil. But if you want to
Big Ortho execs, it’s time to look in the mirror. You should be ashamed of yourselves.
Employees working at Big Orthos should be more financially literate and read the public disclosures each quarter. What we are
How to develop your new Orthopedic product idea.
This is a public service announcement for orthopedic entrepreneurs. The funding climate is frosty, but investors are still writing checks—they’ve
An inside look at a successful startup – Ellipse Technologies
The acquisition of Ellipse Technologies by NuVasive for $410 million—representing a staggering 10x sales multiple—remains a gold standard for orthopedic
The Orthopedic Monopoly: Why Being “The Only” Beats Being “The Best”
In our orthopedic industry, we often talk about innovation. But true success isn’t just about a slightly better screw; it’s
5 Historical Game Changers in Orthopedics
Let’s go back in history to look at five game-changing innovations in orthopedics and see how they originated. These five changed
Stryker Cyberattack: The Supply Chain Wake-Up Call Orthopedic Leaders Can’t Ignore
Six days after the Handala-linked wiper attack, the picture is no longer about the breach itself—it’s about what the breach
The Throughput Question.
Today, most of your customers aren’t buying titanium or polyethylene anymore—they’re buying time. If you think you’re still in the
Hospitals Started Treating Ortho Reps Like Outsiders back in 2015 (and it’s only gotten worse)
Look, I’ve been in this ortho game for decades, talking to startup people, reps, and surgeons. Things have changed…. but
Why “surgeon-directed” new product development doesn’t work in 2026
In the traditional orthopedic playbook, the path from “napkin sketch” to “FDA clearance” was a straight line through the surgeon.
Stryker Cyberattack Update: Outages Continue, Hospital Supply Risks Rise
The March 11 wiper attack linked to Handala remains active into its third day. Stryker has provided no firm timeline
Elephant stakes and how Big Ortho domesticates you.
You know that old circus trick with the elephant? They chain a baby elephant to a massive iron stake—big enough
Business Model > Product
Over time, the graveyard of failed orthopedic companies that has become more crowded. People don’t like to talk about the
Why is SI-BONE worth 6X Treace with the same revenue?
An ortho friend asked me this interesting financial question and there is a simple answer. This is a classic case
What Happened at AAOS 2026? Ecosystems, Ozempic, and Arnold.
The vibe in New Orleans this week? Mostly high-decibel noise, but if you filter out the jazz and the marketing
Are startups for me? Take the test and answer 8 simple yes/no questions.
The orthopedic startup ecosystem thrives on a rare breed of talent—individuals who thrive amid uncertainty, embrace relentless pace, and turn
Globus and Arthrex are eating the US ortho market.
Following up to the original article – Globus continues to eat orthopedics with fantastic financial numbers including 25% revenue growth
Your quick startup guide for New Orleans
While Big Ortho occupies the central anchors, the real pulse of the industry is often found in the startup alleys
The Tiger Dashboard – Mar 2026
Sharing the best monthly DASHBOARD in the ortho industry to the lucky OrthoStreams Subscribers ($1/day) – no-ads, no bias, just
Orthopedics Odd Couple: A Global Giant Meets a Specialized Startup That Can’t Break Even
This announced partnership confuses me – Smith+Nephew signs distribution agreement with SI-BONE. I am still trying to wrap my head
Why your “eureka” product idea will fail and iteration is your real superpower
After years of pattern recognition of the great ortho winners, I’ve realized that there are two distinct paths to the
Sticky Business: The High-Stakes Race to Perfect Bone Adhesion
For decades, we’ve been trying to find a way to make things stick in the body. But let’s be honest:
Vendor Credentialing is Broken. It’s Time to Fix this Orthopedic “Cash Grab.”
Recently, I saw Omar Khateeb over at The State of MedTech echoing many of the same frustrations we have discussed
Seagulls, Groupthink, and Contrarian Wins in Orthopedics
Why This Article is Worth Reading This article explores the pitfalls of herd mentality in the orthopedic industry through a
$15,000 of inventory savings versus 15° degrees of extra hip stability.
Why Read? Let me be crystal clear. The purpose of this article is to “right a clinical wrong”.We must: 1/
Why you need a Nemesis
The Power of Rivalry in Driving Innovation The most impactful innovations in orthopedics often emerge not from isolation, but from
Which one are you on LinkedIn? 14 choices.
I have been sharing content on LinkedIn since 2007 when I decided to become a super-connector in ortho. Since then
The Top 8 Orthopedic companies by revenue as of Feb 2026
I am a small company guy, but cannot ignore the Big Orthos as part of my job, so sharing an
A few thoughts on non-competes in Orthopedics
Disclaimer: I am not an attorney. This is not legal advice. These are just observations Ortho talent moves faster than
JPM 2026: Why “Boring” is the New Breakthrough in Orthopedics
JPM 2026: From “Recovery” to “Execution” The “growth at all costs” era is officially dead. The vibe at the 44th
PSA – Get free tax money for your ortho startup. This is real.
Immediate R&D Tax Breaks are Back A major change in tax law (the “One Big Beautiful Bill Act”) is a
The Tiger Dashboard – Feb 2026
Sharing the best monthly DASHBOARD in the ortho industry to the lucky Subscribers – no-ads, no bias, just my thoughts
New startup to watch that has developed faster, safer, smarter fracture reductions.
Faster, Safer, Smarter Reductions We all know that getting a perfect fracture reduction is the most critical—and often the most
Why Ortho CEOs Don’t Need to Know It All
If you’ve been following my journey in the orthopedic industry— from startup hustles to big medtech deals — you’ll know
A Spine Journal just documented what we all know – Spine surgery is being devalued.
It’s documented now. Over the past two decades, spine surgeons have faced systematic devaluation of their work, leading to financial
How Iteration Drives Orthopedics Innovation
“I’ve realized that the key to being successful is not how good your ideas are, it’s how good you are
“Your nearest exit may be behind you”
A small dose of greed can be a good thing for orthopedic company leaders… but excessive greed can be problematic.