Hot Topics to Expect at AAOS 2011

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This year’s installment of the American Academy of Orthopaedic Surgeons (AAOS) annual meeting takes place in sunny southern California—the San Diego Convention Center to be exact. On the minds of most of the attendees is not the weather (unless, perhaps you come from the snow belt in the United States).

Orthopedic device companies have faced greater demands for pricing concessions from hospitals struggling with declining patient admissions in a weak economy. The sector also is coping with stagnant demand for hip and knee replacement procedures due to a stubbornly high U.S. unemployment rate. But is any of that starting to change, and what does it mean for industry trends and hot topics to be addressed as this year’s biggest orthopedic event?

Rick Wise, senior analyst for Boston, Mass.-based investment firm Leerink Swann, reported that according to feedback from hip and knee surgeon sources, physicians at this year’s meeting primarily will focus on three key topics: the safety and effectiveness of metal-on-metal hip implants; whether custom knee solutions offer superior value; and various existing or emerging knee replacement techniques (for example, fixed vs. mobile bearing, partial vs. total, robotic vs. manual, cementless vs. cemented).

Wise said that according to a high-volume hip and knee surgeon that’s part of Leerink Swann’s research pool, in January, his hip and knee volumes have been particularly “robust,” citing pent up patient demand from deferred procedures and patients opting into Medicare plans early. The physician reported that his metal-on-metal product usage is declining steadily and is a trend that most likely will continue for most orthopedic surgeons. The surgeon highlighted his concerns, including metal ion debris and recent product recalls (e.g., DePuy’s ASR) as factors limiting his product use. He thinks his metal-on-metal product use will continue decreasing from approximately 25 to 30 percent, and sees industry product penetration settling in the 10 to 15 percent range.

As a result, companies with non-metal options are poised (if they haven’t already) to build some momentum as a result. Stryker Corp and ZimmerHoldings, for example, have gained market share at Johnson & Johnson’s (DePuy) and Biomet’s expense—and perhaps at the expense of other companies with metal-on-metal products, such as Smith & Nephew plc and Wright Medical.

Based on his research, Wise believes the orthopedic reconstruction pricing/volume environment may be, at least, stabilizing.