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Surgeons Seek Muscle-Sparing Techniques in Arthroscopy/Soft Tissue Repair Market

Active Implants is also focused on developing alternative treatments for the meniscus. The company’s NUsurface® meniscus implant, the first “artificial meniscus” designed to replace one that is damaged or deteriorating, is currently in its investigational stage in two clinical trials, SUN and VENUS, in the U.S.

The NUsurface is designed to be used in patients who had a partial meniscectomy, and now have persistent knee pain, but aren’t ready for total or partial knee replacement, says Adam Klyce, Vice President of Marketing & Communications, U.S. at Active Implants.

“There’s a giant pool of patients who had surgery that didn’t yield the result they wanted, and they don’t want the next surgery that’s available because [joint replacement is] too big,” Klyce says. “This aims to fill that treatment gap. It fits in between the injections/non-operative care and joint replacement.”

Klyce says that meniscectomy as a standalone procedure is under attack scientifically and economically.

“Having an artificial meniscus available in the market in a year or two will help to fill that gap. The gap is getting bigger, because the evidence and support for the current index procedure is going down,” he says.” If you have a meniscus tear and go to your doctor, and he says, ‘I would have done a meniscectomy on the knee but now, for reimbursement reasons and medical necessity, that’s going to be harder to do.’ ”

Rotator cuff repairs can pose challenges for surgeons as well, as the procedures are associated with high revision rates, Schaffner says.

“[Rotator cuff repair] is a great procedure, but we still acknowledge there are way too many revisions and cases that aren’t successful,” he says. “Everyone acknowledges that there’s room for improvement. There’s an appetite for technologies and techniques that can help with that.”

Smith & Nephew emphasized its shoulder repair portfolio, which includes a suture passer, anchor and suture tape for rotator cuff procedures, at the 2016 AAOS Annual Meeting.

“It’s a host of products that can stand on their own individually, but the way we’re positioning them is as a solution that gives surgeons options to address various anatomical challenges or pathologies,” Schaffner says. “They can tailor those different tools and combine them as a solution for rotator cuff repair.”

Offering a broad product portfolio may serve companies well, says Brian Cole, M.D., a sports medicine and cartilage restoration orthopaedic surgeon at Midwest Orthopaedics at Rush University Medical Center in Chicago, Illinois.

“Given the nature of hospital systems, broad product platforms are a potentially dominant strategy amongst device companies versus narrow technology platforms,” Cole says. “Those [product platforms] that cross boundaries—not just the device, but things that enable you to use the device—and having technology that surrounds a core device platform, with capital equipment and so forth, can make a big difference. It’s difficult to differentiate certain devices based on their own merits, but when you’re taking the context of a family of products from a device company, the decisions are made a little differently, by the clinical doctors and decision makers in how that device gets in the hands of a surgeon.”

Part of that product platform could be orthobiologics, such as stem cells, which are an emerging a potential treatment option as surgeons seek to augment the body’s natural healing process. However, there is mixed feedback on the use of orthobiologics in the segment.

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