On (and Off) the Record

Dear OTW Reader: “70% of Stiff Shoulders Have Sugar Issue” says Dr. John Kelly….Shortage of Orthopedic Surgeons? New studies say YES…Are surgeons being punished for innovation –but rewarded for efficiency? … Mike Zafirovski, John Murphy Join DJO…and more.

70% of Stiff Shoulders Have Sugar Issue  

Dr. John Kelly, Associate Professor of Clinical Orthopaedic Surgery at the University of Pennsylvania, has been thinking about diabetes and healing lately. He tells OTW, “There is an emerging link between diabetes and shoulder stiffness and diabetes and arthritis. One study showed that of all patients coming in to a clinic with a stiff shoulder, a full 70% had a sugar issue. If a diabetic has a rotator cuff tear it definitely takes longer to heal. Interestingly, recent studies have found that poorly controlled diabetics have no higher risk of infection than those with tighter control; it’s almost like you must get the sugars normalized in order to see any real difference. You could call up the analogy that someone is either pregnant or not pregnant…either they have a sugar issue or they don’t. We are conducting a study on the role of inflammation, and are finding that diabetics seem to have more generalized inflammation and that’s why they take longer to heal. We are cutting rat rotator cuffs and then reattaching them to compare the healing response. The preliminary findings show a significant delay in healing…50-100% longer healing times in rats with diabetes.”

Matthew Murphy, Ph.D. Joins SpineSmith

The new Senior Scientist at SpineSmith is Matthew Murphy, Ph.D. Dr. Murphy will design and implement new strategies for the isolation and application of autologous stem cells for spine, orthopedics, and cardiovascular therapies. Formerly a senior researcher at Methodist Hospital Research Institute in Houston, Texas, Dr. Murphy focused on the combination of adult stem cells and biomaterials for regenerative medical applications in orthopedics, spine, pancreatic, and soft tissue repair. He earned a Ph.D. in Bioengineering from Rice University and a B.S. in Chemical Engineering from The University of Texas at Austin. Dr. Murphy also lent his talents to NASA where he designed new spacesuits for travel to the moon and Mars as part of the Constellation Program. He then joined the laboratory of Dr. Paul Simmons at UT Health Science Center at Houston where he investigated adult stem cells harvested from bone marrow, cortical bone, and adipose tissues.

Not Enough Orthopedic Surgeons 

An orthopedic surgeon with a significant amount of administrative experience tells OTW, “My biggest concern these days is manpower. Studies are showing that in 25 years we will not have trained enough surgeons to care for total joints, much less everything else. But when we try to develop a plan to train more surgeons, we find that the rules involved are so strict, and that it is so expensive that we can’t proceed. As usual in a democracy, it will have to be a crisis before things get addressed…All of a sudden—when it’s really too late—people will panic and say, ‘Oh no, we don’t have enough orthopedists.’ If you tell me today that I can train one orthopedic surgeon, it will be nine years before the first one ‘pops out.’ My plan would be to examine all orthopedic training programs and see which ones could add more training spots...and then fund them. Then, if we have enough spots based on our future needs, great. If not, we have to create new programs.”

Tom Boyd Joins Vertebral Technologies  

Going forward, Tom Boyd will be the one ensuring that thing are running smooth in sales at Vertebral Technologies, Inc. Boyd, who has more than 25 years of experience in the medical device industry, has been hired to oversee the sales and marketing teams. He has managed and advanced sales operations for firms ranging from mid-sized medical device companies to global, multi-billion dollar corporations. And importantly, Boyd has 19 years in senior management positions in the spine market. 

Reward Efficiency and Punish Innovation? 

A concerned spine surgeon tells OTW, “Those of us in spine and total joints are being punished for being innovative. We are really far along with instrumentation and approaches, and we are getting patients home quicker with a minimum of complications. The powers that be, however, are saying, ‘Listen, you’re working more efficiently and so we don’t need to pay you as much to do your procedures anymore.’ Talk about disincentivizing people! I mean, we are never reimbursed more for good outcomes! The result of this is that it is going to incentivize doctors to do simple procedures because they don’t want to put hospitals on the hook for lower reimbursements. If a doctor can do a surgery that carries lower infection rates, then why do the big surgeries? This ultimately means that all major surgeries will be done at tertiary centers. Why should surgeons continue to do cadaver training and evolve our skills—so we can best serve our patients—if we are going to get punished for it?”

Mike Zafirovski, John Murphy Join DJO  

DJO Global, Inc. has elected Mike S. Zafirovski as a member of the DJO Global Board and as non-executive Chairman of the Board. Zafirovski is a senior advisor to The Blackstone Group and also serves on the boards of directors of the Boeing Company and Apria Healthcare Services. He was previously Director, President and CEO of Nortel Networks Corporation from November 2005 to August 2009 and held several positions, including Director, President and Chief Operating Officer of Motorola, Inc. from June 2000 to May 2005. Prior to joining Motorola, Mr. Zafirovski spent nearly 25 years with General Electric Company, where he served in management positions, including President and Chief Executive Officer of five GE businesses in the consumer, industrial, and financial services arenas. John R. Murphy will now serve as a director of the company and as Chairman of the DJO Global Audit Committee. Murphy currently serves on the Board of Directors, the Governance Committee and as Chairman of the Audit Committee of O’Reilly Automotive, Inc. He was Senior Vice President and Chief Financial Officer of Smurfit-Stone Container Corporation from 2009 to 2010, and prior to that he served in various senior management roles, including Chief Financial Officer and Chief Operating Officer, ending as President and Chief Executive Officer of Accuride Corporation.

Surge of Excitement for Orthopedics in Developing Countires

Lew Zirkle, M.D. founder of the Surgical Implant Generation Network (SIGN), is pleased to see more of a focus on orthopedics in the developing world. He tells OTW, “We are seeing a real surge of excitement and knowledge from orthopedic surgeons in Africa and other developing countries. It used to be that there were only one or two orthopedic training programs on the entire African continent; now most countries have at least one training program. These programs are sending orthopedists to other places throughout Africa. For example, Kenya used to have one training program, whereas now they have three. In Ethiopia we were just keeping our heads above water, but things are better now that local surgeons there are developing protocols for treating fractures. The SIGN program is expanding, and we have a large number of requests for implants and education. We’ll now be starting programs in Zimbabwe, Sudan, and Somaliland. At the same time we are increasing the number of programs in Africa and Afghanistan. A common thread is urbanization. As people move to the cities they acquire vehicles, largely motorcycles. There are not more roads, however, and we are seeing a huge increase in motorcycle accidents. Anyone who wants to know more about our projects can visit www.signfracturecare.org.”

OrthoWilmington: Two Major North Carolina Groups Merge 

Atlantic Orthopedics and Wilmington Orthopaedic Group have joined forces to become OrthoWilmington. All together, the group’s resources include 20 board-certified or board-eligible orthopedic and spine specialists, 17 physician assistants and nurse practitioners, plus a team of therapists, technicians and support staff. There are five locations and six subspecialty care centers that focus clinical and diagnostic resources on specific areas. The practice also offers physical and occupational therapy in four locations, advanced imaging with an ACR-accredited MRI, and orthopedic urgent care through AccessOrtho, a walk-in medical clinic that enables patients to be diagnosed and treated immediately.