GLG News by Orthopedic Surgeons (US)

Giles ScuderiDirector, Orthopedic SurgeonINSALL SCOTT KELLY INSTITUTE

Joint Implants will always be needed

January 5, 2009

Analysis of:Medical devices not immune to recession worries | www.boston.com

This article highlights some of the concerns regarding the economy and utilization of surgical implants. While patients may defer total hip and knee surgery, they will ultimately undergo surgery for pain relief and restoration of function. The number of baby boomers with arthritis will increase the surgical volume. Insurance continues to cover the cost of surgery for the majority of patients.

Wayel KaakajiChief Executive Officer and Medical DirectorSpinal and Neurosurgical Institute

Sales of Infuse product will likely decline with closer scrutiny of off-label use

December 1, 2008

Analysis of:Medtronic Says Device for Spine Faces Probe | online.wsj.com

Medtronic might see a significant drop in its sales as a result of closer scrutiny of off-label use of its products.  Infuse has been a cash cow for Medtronic, and if sales drop, it will reflect deeply in the sales numbers.

Wayel KaakajiChief Executive Officer and Medical DirectorSpinal and Neurosurgical Institute

Accuray Cyberknife Sales About to Go Through The Roof

December 1, 2008

Analysis of:Experts Debate CyberKnife for Prostate Cancer | www.washingtonpost.com

Prostate cancer can be treated by Cyberknife, and the numbers of patients treated and the number of units sold by Accuray (ARAY:NASDAQ) will very likely increase dramatically over the next 5-10 years. 

Wayel KaakajiChief Executive Officer and Medical DirectorSpinal and Neurosurgical Institute

Mixed Blessings for Medtronic in Professional Spinal Surgery Organizations

October 10, 2008

Analysis of:Letter to CMS from a Coalition of Spine Care Professional Societies | www.spine.org

The data presented by multiple professional societies does not lend clinical support of many Medtronic products in the Medicare population.  The data does not support the use of disc arthroplasty in the Medicare population, and does not find any clinical advantage of kyphoplasty over vertebroplasty.  This may mean reduced sales of the Kyphon line of products as well as reduced sales of the Prestige implant, should CMS adopt some of these recommendations.

Wayel KaakajiChief Executive Officer and Medical DirectorSpinal and Neurosurgical Institute

New electrode may expand the capabilities of the Advance System from Neurometrix

October 9, 2008

Analysis of:NeuroMetrix Receives FDA 510(k) Clearance For UNIVERSAL(TM) Electrodes Used In The Performance Of Nerve Conduction Studies | www.medicalnewstoday.com

New electrode will increase the capabilities of the Advance device from Neurometrix, potentially leading to more sales of the disposable electrodes The increased capabilities may also increase the number of practicioners interested in the Advance system, generating more sales for the company

Wayel KaakajiChief Executive Officer and Medical DirectorSpinal and Neurosurgical Institute

Proton beam therapy has no proven advantage

September 25, 2008

Analysis of:Proton Radiotherapy: A Review | www.nytimes.com

The cost of proton beam installations is massive, and is not justified in light of available litterature regarding the superiority of this therapy. There are only a handful of tumors, such as chordoma, where the proton beam therapy is recommended over other types of radiation.  The higher compensation for this radiation is probably playing a part in the decision making for these new projects.

Giles ScuderiDirector, Orthopedic SurgeonINSALL SCOTT KELLY INSTITUTE

There is a need for a total joint registry in the United States

August 6, 2008

Analysis of:New York Times July 29, 2008 A call for warning system on artificial joints | www.nytimes.com

The AAOS has established the need for a total joint registry however there are financial and legal hurdles that must be overcome. The value of total joint registries have been realized in Europe and Australia with a significant reduction in the revision rate of implants. A joint registry can provide an early warning system on issues or problems related to a particular implant design or surgical technique. With the rising cost of healthcare, a registry in the United States can be a cost effective use of our limited healthcare resources. If the data can be delivered to the orthopedic community in a timely and understandable fashion, it should and will influence the surgeon's behavior and decision making such that patients and society are benefited.

Wayel KaakajiChief Executive Officer and Medical DirectorSpinal and Neurosurgical Institute

Overmedication, and underdiagnosis, are commonplace in the dementia patient

June 30, 2008

Analysis of:Doctors Say Medication Is Overused in Dementia | www.nytimes.com

Aricept, Namenda, Risperdal are grossly overused in the treatment of patients with suspected dementia Many patients with dementia have not received proper diagnosis, and do not receive proper treatment Better public and medical education will hopefully reverse this glaring deficit in our medical systems

Wayel KaakajiChief Executive Officer and Medical DirectorSpinal and Neurosurgical Institute

This acqusition, and others, represent a significant upgrade of Alphatec's portfolio

February 11, 2008

Analysis of:Alphatec Holdings, Inc. Acquires An Exclusive Worldwide License for Innovative Dynamic Anterior Cervical Plate Technology | www.healthpointcapital.com

Alphatec product line will expand and increase their market share The cervical plate from Progressive is much more promising than the Trestle plate developed by Alphatec, and should increase sales and improve the cervical implant portfolio

Wayel KaakajiChief Executive Officer and Medical DirectorSpinal and Neurosurgical Institute

Medtronic loses litigation to DePuy over polyaxial Vertex screws, what is the significance?

December 26, 2007

Analysis of:U.S. Federal Court Issues Permanent Injunction Against Medtronic's Vertex And Vertex Max Screws | www.medicalnewstoday.com

the use of Vertex polyaxial screws is only a minor part of the spinal implant protfolio at Medtronic (MDT:NYSE).  This should not affect the bottom line to any significant extent.

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