13 Orthopedic Trends observed by Tiger
The Orthopedic Industry is changing faster then I can remember in my 30 years in the industry. Disruptive changes are coming from all fronts today – economics, demographics, and technology. The Orthopedic manufacturers that do not recognize these TRENDS will miss opportunities and get left behind. And the opportunistic companies will have to reinvent their businesses in order to take advantage of these TRENDS. I have observed 13 trends that I would like to share with you.
BRIC = Brazil, Russia, India, China. BRIC is the future for the Big 5 Orthos that have fully saturated the US and EU with mature sales and distribution organizations. With the Big 5 sales slowdown below 5%, they are investing heavily in BRIC for future growth. Case in point: Medtronic announced that they are growing to 2,000 employees in China. Smith + Nephew announced a reorganization to strategically focus on BRIC and is pumping more R&D money into BRIC products. More information here
2. FDA is shutting down US Innovation
Under this administration, the FDA has become unreasonable, unpredictable, and not driven by science. Orthopedic PMA devices are now on a drug timeline to clearance… and in the future, the 510(k) pathway will require clinical data. Startups with Class III devices under development are bailing out to Europe where the regulatory pathway is reasonable and predictable. Unfortunately, the end effect will result in stifled innovation for US patients. Most innovation has moved to Europe now. And this will contribute to the Medical Tourism trend. Read more… Does the US really innovation?, Sequestration, Health in jeopardy, EU is leading
3. Generic Implants
It’s coming… copies of legacy implants that cost a fraction of the latest and greatest implants from the big Orthos. The bonus is that these generic implants are able to piggy-back decades of proven clinical results. The challenge is that these generic implants come without any sales reps or OR service. There is no stopping this economic trend. At least 5 companies today are taking the charge to deliver these solutions to Hospitals.
4. Smart Implants
Sensors on implants and instruments are coming to Orthopedics. This is driven by a convergence of three areas – new technology capabilities in embedded sensing, a growing understanding of embedded chip capabilities by Orthopedic manufacturers, and incentives for manufactures (product differentiation) and healthcare providers (more cost effective care). Read Get Ready for Smart Implants for a deeper understanding.
Why use an artificial prosthesis… when you can transplant living tissue? Dr. Scott Levin is challenging the use of implants by transferring living tissue to solve orthopedic issues. The technique is called CTA – composite tissue allograft – but nicknamed Orthoplasty. U of Penn , HSS case study , Biologic Knee Replacement
6. Arthroscopic Hip Surgery
Arthroscopic repair of labrum tears can eliminate pain, restore function and ultimately delay the need for total hip replacement in the younger patient. Pivot Medical is a startup focused entirely on arthroscopic hip surgery. New study finds arthroscopic hip surgery may fully restore function in athletes (Rush University) http://www.usatoday.com/news/health/2009-07-19-goodhips_N.htm
7. Medical Tourism
This year, six million Americans will travel outside the United States for health care, and many travel for cheaper Orthopedic procedures. The scale is huge and the logistics are being worked out seamlessly. If you don’t believe it, just take a look at Planet Hospital as an example. Read Growing Trend for a deeper understanding of this trend.
8. Decreases in Length of Stay
Today, Orthopedic procedures average a 4.5 day hospital stay, but in ten years the average will fall to just 3.5 days. Joint replacement stays will be cut in half. Length of Stay is one of the few ways that hospitals can improve profitability.
9. Osseointegrated Prostheses for Lower Limbs
No more prosthetic socket problems! Dr Horst Aschoff and his team (Germany) have shown that people with the lower-limb implants move more naturally than those with traditional prostheses, have a more symmetrical gait, and use less energy to perform the same movement. His solution is the Osseointegrated Prosthesis.
10. Postponing Elective Procedures
This is a shortterm trend until the economy recovers. Economic conditions are forcing patients to reconsider surgery because of costs, potential missed work days, or lack of available family support once they get home.
11. More Demanding, More Informed Patients
Well-informed patients are pushing their Orthopedic Surgeon to consider specific treatments or implant systems. Surgeons report that all patients come in with Web research and pre-determined treatment opinions that the surgeon has to unwind.
12. Younger People Getting Joint Replacements
Years ago, suregons would never put a total joint in anyone under 60, then under 50, now its anyone. From 1996 to 2001, the number of total knee replacements for patients aged 38-56 years doubled from 23,000 to 48,000. Younger people are now getting Joint Replacements.
13. Heavier Patients
Unfortunately in the US, bariatric surgery has become a specialty and challenges the way an Orthopedic surgeon approaches a procedure and may even dictate unique implants designs.