Implant selection requires some flexibility in orthopedics

As we try to standardize implant selection and force surgeons into a round hole, it will be harder and harder to select implants based on our clinical judgment. There are no other monolithic implants on the market that allow me to “straddle” this old ACL screw and avoid having to remove it. This is a Monolithic uncemented implant w arguably the most potential for the longest survivorship. If this implant is not “on contract” then I would have to argue and argue and email and email until i get the implant approved to use. Part of the trade off as health care transitions from the old model where I could use anything and everything whenever I want at whatever price. Patient is approx 8 y out from this tka and was approx 50yo at the time of surgery.

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American Innovation and Opportunity!

Ziptek’s ZipE® is a resorbable locking suture button-a knotless tissue repair system, and works like a Zip-Tie. The company is entering its 2nd year of commercialization.

Many people may be unaware that the southwest coast of Florida is becoming a hub for medical device companies, especially orthopedic devices.

Arthrex, located in Naples Florida, with nearly 1200 employees, over a billion per year in revenue, 9700 different types of devices, and whose devices are being implanted in more than 50 countries worldwide- started from a very small one device implant moving to Florida in 1995. With respect to soft tissue repair for orthopedic indications Arthrex is the top player globally.

Other very respected companies include Catalyst Orthopedics in Naples, Conmed in Largo, Parcus in Sarasota and Exactech in Gainesville, not to mention numerous Orthobiologic companies.

Ziptek LLC, a Sarasota based (and born) Medical device company founded by William F Bennett MD, a practicing orthopedic surgeon since 1995 in Sarasota, with privileges at SMH and Lakewood Ranch was incorporated in 2012. Dr Bennett came up with the idea in 1995 when operating at Doctors Hospital when he was trying to develop a technique that could address a certain pathology in the shoulder- arthroscopically- that to date was unaddressed.

From his efforts the “Bennett”” biceps subluxation classification was developed- see Radiopedia. He then went on to try to develop a device that could address this pathology, ultimately developing a device which could be used for all tissue repair and went away after time.

Starting with the commercialization process in 2010, Dr Bennett with Ziptek and his biomedical engineers received FDA clearance from the FDA in March of 2017. He and the company received over 24 IFUs- Indications for use.

Ziptek makes the ZipE®, which is a resorbable locking suture button that works like a Zip-Tie. All devices in this domain for orthopedics soft tissue repair use permanent suture and the suture fixation is permanent, meaning it never releases. This approach for tissue repair, typically ends up with scar repair and disorganized collagen.

The ZipE® which is knotless, no need for surgeon to tie knots, releases its hold on the tissue after 3 months, thus the first device to allow for the transfer of forces to the tissue allowing for true tissue remodeling allowing for the repair tissue to approach native tendon or ligament.

The Future is Now

At ProcedureCard, we don’t wait for the future, we build it. 

We have created paperless surgical preference cards. It’s a really big deal.

Here’s our story:

It started like every other day in surgery. The ritual of prepping, draping and the timeout. Today was different. We started our day using ProcedureCard.  The music station was set to Classic Rock. The nice steady beep of heart rate monitor. 

The surgical technologist deftly handed the 15 blade to me. The nurse was charting. She never had to leave the operating room. Her focus was the patient. She looked up and instinctively changed the empty IV bag. I incised the transverse carpal ligament and then started to close. Humming to my favorite band, dressings on, even the cradle boot was ready to elevate the operative extremity. 

This is how smoothly every case should go. And it can with ProcedureCard. From carpal tunnel to revision arthroplasty surgery, we’ve got you covered.

At ProcedureCard, we have built a cloud-based surgical preference card management system. Access it on any device 24/7. Cards can be easily updated and shared with the team.

Finally, reliable and accurate surgical preference cards for every case.

Have a better day in surgery with our easy to use and affordable software. Save time, save money and improve your bottom line…patient care.

Accessible. Accurate. Simple.  – Schedule a demo now –

L.R. Williamson, MD

Orthopaedic Surgeon

Consumers want Mobile Health

It’s a bold statement to say that the future of orthopedics lies in mobile health.

But the data shows an irrevocable link between technology and the future state of medical practice in the United States. That’s not just because our culture is obsessed with the digital universe, it’s because your patients will soon be demanding the convenience of telemedicine and mobile health applications.

Consumers Want Mobile Health Convenience

Telehealth is a promising opportunity to increase member engagement because a greater number of individuals are open to the use of telehealth services. Telehealth and remote care provide an exceptional customer experience opportunity for payers. Consumers want telehealth as a convenient way to receive checkups, preventive care, and non-critical services without the need for travel and wait times. HealthPayer IntelligenceMay 16, 2018

A study cited by mHealth Intelligence suggests that patients are willing, the technology is ready, but clinical providers and insurance payers have lagged behind the data that shows patients are ready for the convenience found in mobile health applications. Of the 400 consumers surveyed, 77% said they would be more likely to pick a doctor that offered telemedicine applications over one that hadn’t yet adopted the technology. The data showed the reasons behind the interest in mobile health virtual visits included:

  • Patients want the option of skipping a time-consuming trip to the doctor for a simple recheck or non-urgent visit.

  • Short wait times and the convenience of receiving a virtual house call are very attractive to patients.

When combined with the data showing that telehealth reduces costs in the medical practice, it seems clear that there are new options in the healthcare field that may improve the bottom line.

Keeping the Customer Satisfied -- Mobile Health in the Orthopedic Practice

“This direct link between patient satisfaction and revenue will likely become stronger because the U.S. Department of Health and Human Services has set a goal of linking 90% of Medicare payments to quality or value by 2018.”Beckers Hospital CFO Report

While many orthopedic providers continue to express their concern that patients will not be willing to evolve from traditional visits, the most recent research does not hold up this assumption. A 2017 Advisory Board study of patient attitudes toward the virtual visits shows that 77% would be willing to at least try the model.

The Accenture study highlighted what patients say are the primary benefits of telehealth:

  • Faster diagnosis and treatment.

  • Reduced costs.

  • Providing and receiving high-quality care.

  • More flexibility in scheduling.

  • A time savings for physicians and doctors.

A 2018 article in The New England Journal of Medicine suggests that the current model of traditional in-patient visits will eventually be flipped to the visit of last-resort over mobile health or telehealth options. The authors suggest:

Face-to-face interactions will certainly always have a central role in health care, and many patients prefer to see their physician in person. But a system focused on high-quality nonvisit care would work better for many others — and quite possibly for physicians as well.

Some of the systems leading the way are Kaiser Permanente, with 52% of their 100 million + patient encounters each year conducted as virtual visits. But a large health system has the budget to establish telehealth applications while retraining clinical providers and their patients on best practices for using the service. How can a small medical practice find the time and energy to reinvent itself under a mobile health framework?

The answer may lie in the individual practice seeking innovative ways to obtain a competitive advantage. An article by a solo-orthopedist in the American Academy of Orthopaedic Surgeons AAOS Now recounted his experience in using telehealth applications to treat post-operative patients. His decision to use the technology was tied to improved patient experience, lower overheads, and higher quality of care.

Is it time for your practice to discuss the opportunities to offer mobile health as an option for your patients? OrthoLive has developed a cloud-based affordable telehealth model designed specifically for the orthopedic practitioner. Contact us to find out more.


You need surgery

“You need surgery” may be the scariest thing we tell our patients.  In 2014, 14 million Americans were diagnosed with knee arthritis. Roughly 7 million of these patients were eligible for a knee replacement, yet only 700,000 had a knee replacement.  Why do only 10% of eligible patients have a knee replacement?  Patients are paralyzed by the fear of having surgery, of making a mistake, of selecting the wrong surgeon, hospital or implant.  When a patient can’t find someone they trust to convince them that a knee replacement is their best option, they do nothing, which explains the prevalence of mediocre knee injections for arthritis.  

An orthopedic surgeon’s reputation is their most important asset.  It is what makes patients and PCPs ask for your services by name.  A good reputation means patients sign up for surgery the first time their surgeon says, “you need surgery”.  A bad reputation means you leave town and start over somewhere else.  Your reputation is determined by what PCPs say about you behind your back to their patients. It is what patients say about you to their friends.  It is a compilation of your bedside manner, personality, decision making, communication, surgical skills, and outcomes. Your reputation is what makes patients comfortable with having you as their surgeon.

Why do orthopedic surgeons not take ownership of their reputation?  Why do we rely on chance encounters between a potential patient and one of your past patients?  Many of your past patients are so appreciative of your services that they are willing to tell their friends about you if someone would just ask them.

Enter Reviews from Friends.  We are a free service on orthopedic surgeons’, hospitals’, and implant companies’ websites that allows potential patients to anonymously chat with all of your past patients.  We protect everyone’s privacy by never revealing anyone’s name.  Everything from our list of patients to the chat messages are anonymous which allows us to tell connect people with their friends using Facebook, Google contacts, and home addresses.  We take the fear out of having surgery by connecting potential patients with your past patient that is best suited to offer trusted advice.

Give your patients what they need to feel comfortable with the surgery.  Let them talk with your past patients.