Medical Device Daily National Editor

SAN FRANCISCO — One interesting sub-section of a media briefing on efforts by military orthopedists in Iraq and Afghanistan didn’t make it into a report from the conference last week (Medical Device Daily; March 7, 2008).

Panelist Steven Morgan, MD, of the University of Colorado’s Denver Health Medical Center, described the visiting orthopedic scholars program that has been put together by AAOS, the Orthopaedic Trauma Association and the U.S. Army.

From the military’s perspective, the program provides civilian orthopedic trauma experience in areas where more such help is greatly needed. The civilian surgeons who participate serve as a sort of consultant, offering what Morgan characterized as “a pair of fresh eyes” to review “war-related trauma care.”

From the civilian participant’s perspective, it’s an opportunity to gain experience in war-related trauma care, providing a broader background in what he termed “war-like injuries” that may occur in domestically.

The civilian participants, all of whom must have at least 10 years of experience in the practice of extremity trauma, work at Landsthul Regional Medical Center (Landsthul, Germany), located near Ramstein Air Base in Germany, where U.S. service personnel injured in Iraq and Afghanistan are transported following their initial treatment in those regions.

Among the lessons learned by the visiting surgeons, according to Morgan, is that, while there may be some similarities between civilian trauma and war injuries, on the whole, “war-related extremity wounds are different.”

He noted that the experience would help the participating surgeons be better-prepared to treat citizens targeted by an act of terrorism.

Boosting ranks of women in orthopedics

Another interesting briefing at the conference focused on the paucity of women among the ranks of orthopedic surgeons, with a caveat that change may be in the air.

Panelists noted that today, more than 90% of orthopedic surgeons are men, and that just 3% of board-certified orthopedic surgeons are female.

However, they also noted that women now comprise more than 50% of medical school classes in the U.S., so it’s a matter of convincing a larger number of them that orthopedics is the specialty for them.

Panel moderator Mary O’Connor, MD, department chair of orthopedic surgery at the Mayo Clinic (Jacksonville, Florida), said, “It is ... important to the public at large that more women become involved in the practice of orthopedics. If we work to increase diversity within the orthopedic workforce, it stands to reason we will probably have more awareness and sensitivity to gender and racial differences across the board.”

“On some level, young women are still given negative messages on surgical training, especially orthopedic training. We are here to tell them that ... as orthopedic surgeons they can really help patients improve their quality of life.”

Diversity, unity key issues for Rankin

E. Anthony (Tony) Rankin, MD, the new president of AAOS, is the academy’s first African-American president, so questions of diversity – and unity – in the orthopedic field are of considerable interest to him.

In an interview in AAOS Now, which is published daily during the conference, he said diversity is important because of its impact on providing the highest quality of patient care.

“In 2006, minorities comprised about one-third of our nation’s population, and that number continues to rise,” Rankin said, adding that “patients’ social and cultural traditions strongly influence their views of illness and doctors.”

He also emphasized unity, saying it is “a key to our continued existence ... we have orthopedic specialties, but we are all orthopedists first.”

Rankin, who is chief of orthopedic surgery at Providence Hospital and teaches at both Georgetown University and Howard University (all Washington), said his third specific goal as president beyond diversity and unity is advocacy – especially to tackle matters of medical liability reform and reimbursement, two top items from the AAOS Member Needs Assessment.

He said that while the organization has for the past several years had a “major effort” at the federal level, its strategy now is shifting to the state level, “where many advocacy proposals and issues initiate.”

Presentations bolster BioMimetics’ efforts

BioMimetic Therapeutics (Franklin, Tennessee) presented data highlighting its clinical and pre-clinical studies on products that combine recombinant protein therapeutics with tissue-specific scaffolds to stimulate tissue-healing and regeneration.

The company is developing recombinant protein/device combination products for the healing of musculoskeletal injuries and disease.

Two podium presentations at AAOS focused on the use of recombinant human platelet-derived growth factor-BB (rhPDGF-BB). Dr. Michael Ehrlich presented “rhPDGF-BB Increases New Bone Formation in a Rat Model of Distraction Osteogeneis” during a Pediatrics session. Dr. Christopher DiGiovanni presented “A Human Feasibility Trial Evaluating rhPDGF vs. Autologous Bone Graft during Foot and Ankle Fusion” during a Foot/Ankle session.

In addition, seven posters on various studies involving rhPDGF-BB I were presented at the Orthopedic Research Society meeting preceeding AAOS.

The company has received marketing approval from FDA for its first product, GEM 21S, as a grafting material for bone and periodontal regeneration. It also has clinical trials ongoing with product candidates GEM OS1 and GEM OS2 in multiple orthopedic bone-healing indications, including the treatment of foot and ankle fusions and the stimulation of healing of fractures of the arm.