By: 1 November 2007

NHS Private Centres To Take Over Orthopaedic Procedures
A controversial start to the year, with the NHS announcing that Primary care trusts in Cumbria and Lancashire were to carry out an eight-week consultation with Clinical Assessment Treatment and Support centres to carry out diagnostics and minor treatment to cut waiting lists.

The centres are run by private firms, but would be paid by the NHS, leading to complaints from the BMA that it may fragment the NHS. Mike Farrar, chief executive of NHS North West, said: “The centres are not a replacement for hospital services, rather they will let the hospitals concentrate more on what they do best – treating those who need immediate care. But Dr Jonathan Fielden, chairman of the BMA's consultants committee, said: “These proposals could represent a significant threat to local NHS hospitals. When work goes to the private sector, they lose income.

Biomet Announce Merger – And It's Not Smith & Nephew
After months of speculation, troubled Biomet finally announced details of a merger with a private equity consortium worth $10.9bn. The merger was announced just a week after rumours that Smith & Nephew would table an $11bn bid for the company.

Daniel P. Hann, Interim President and CEO of Biomet, said, “As an independent, private company with the strong backing of private equity partners who recognise our potential for growth and support our dedication to providing our patients the best in innovative, high quality medical products, we will be in an even stronger position to deliver on our commitment to them and their doctors, as well as our team members and the communities in which we operate.”

Alcohol May Protect Against Arthritis
If you're a mouse. A study by Gothenburg University gave mice injections of collagen to induce rheumatoid arthritis (RA), then either untreated water or water with 10% pure alcohol. RA was found to develop significantly slower in the mice given alcohol, and had less severe symptoms once the disease did start to progress.

It's thought the alcohol may boost production of testosterone, which restricts the release of cytokines that cause inflammation. But Professor Andrzej Tarkowski, who led the research, said: “We can't translate these results to find out the therapeutic dose in humans. Professor Alan Silman, medical director at the Arthritis Research Campaign said: “It is possible that in this mouse model, alcohol may have had some effect in relation to arthritis. However it is doubtful whether this would have much influence in the human situation.”

The Great Debate - Early Intervention in the Hip and Knee was held in the IMAX Theatre at the heart of the Science Museum in South Kensington, London. The meeting, which was sponsored and organised by Finsbury Orthopaedics, was designed to encourage an atmosphere that would allow the 33-strong faculty to explore the technologies that enable them to manage the early symptoms of osteo-arthritis in the hip and knee and proved very popular – enough for a second to be announced for 2008.

Men Just As Likely As Women To Suffer Second Fracture
For years, women have been warned of the high risk of refractures, but it seems that men are the ones at the highest risk, according to a study. “After a first fracture, the risk of a subsequent fracture in women is doubled, but for men, it is increased three- to four-fold, so that the absolute risk of a subsequent fracture is the same for women and men,” said the study's author, Jacqueline Center, a senior research officer at the Garvan Institute of Medical Research in Sydney, Australia.

Women's refracture risk after one fracture similar to a woman 10 years older who had never experienced fracture, the researchers say. For men, the refracture rate was similar to a man 20 years older. So a 60 year-old man who fractures a bone has the same risk of another fracture as an 80 year-old, according to the study.


Researchers Warn Of Osteoporosis Risk For Men
Another bad news story for men – physicians were warned by a Canadian researcher that they cannot continue to overlook osteoporosis problems in men. Dr. Aliya Khan said her paper, which supplements clinical practice guidelines for the diagnosis and management of osteoporosis, was intended to make physicians aware of the fact that they can no longer overlook diagnosing osteoporosis in their male patients. “The problem is that when men sustain fractures they are more likely to die or suffer a disability.”

Arthroscopy is 'Failing Rotator Cuff Disease'
A U.S. surgeon claimed that using arthroscopy to treat rotator cuff disease is failing in a lot of operations. Jon Warner, director of The Harvard Shoulder Service in Massachusetts spoke of the “elephant in the room that no one wants to talk about.” at the AAOS meeting, that was held in in San Diego. “A large portion of my practice is fixing failed surgeries.”

“I am increasingly concerned that the demand, from patients, for arthroscopic surgery is driving this trend. Not all cases are suited for this type of surgery. There is an epidemic of rotator cuff problems with 'baby boomers.' They want arthroscopic surgery on an outpatient basis so they can get back to work the next day. As surgeons, we want to meet our patients' requests. It's a challenging situation.”

The NHS are paying too much for drugs, an Office of Fair Trading (OFT) report said. The OFT said that the Department of Health (DoH), which buys £7bn of drugs a year, was not getting the best prices from companies and recommended an overhaul of the Pharmaceutical Price Regulation Scheme (PPRS).

The two-year study identified several drugs where prices were up to ten times more costly than other drugs offering similar benefits. Value-based pricing would give companies stronger incentives to invest in drugs for medical conditions where there is greatest need.

But the director-general of the Association of British Pharmaceutical Industry, Dr Richard Barker, said the UK paid less per head for medicine than most major European countries and warned that drug firms need to feel valued in the UK “to keep research and development here.”


Stem Cell Research 'Being Held Back' – Study
Scientific, ethical, social and financial hurdles were besetting the commercialisation of stem cells, according to a study. “Embryonic stem cell research has been mired in controversy with opposition from several ethical and social quarters besides which the science surrounding embryonic stem cells is itself in a very nascent stage,” said analysts Frost & Sullivan.

“In addition, owing to the high cost of development, these therapies are expected to be very expensive, and procuring reimbursement could be an uphill task.”

Smith & Nephew Become Fourth Largest Orthopaedic Player Through Plus Acquisition
With the potential Biomet deal coming to nothing, Smith & Nephew wasted no time in establishing itself as a top four orthopaedic player as it snapped up Plus Orthopedics for $889m and increased its reconstruction market share to 12%. The acquisition of Plus meant that the UK Company's market share jumped by an all-important 3%, leapfrogging Biomet, and further decreasing any possibility of a takeover itself. The deal also doubled Smith & Nephew's share of the European orthopaedic market.


Three New Diabetes Genes Found
Scientists found several new genes that appear to increase the risk for developing type 2 diabetes, increasing the amount suspected to 10.
Dr. Kari Stefansson, CEO of deCODE Genetics, conducted a survey in Iceland comparing the frequencies of several hundred thousand common genetic variants in healthy people against those who have the disease. They found the CDKAL1 gene was associated with type 2 diabetes. “It affects the secretion of insulin,” Stefansson said.

Those with two copies of the risk variant faced a 50% increased risk of developing the disease when compared with people with only a single copy of the gene variant. About 25% of the population has this variant.

People with two copies of the gene variant produce about 20% less insulin in response to rising blood sugar than those with only one copy or non-carriers. This suggests that the variant increases the risk for type 2 diabetes by reducing insulin production.

Stryker Recognised in Company List
The Sunday Times named Stryker as the 44th 'Best Mid-Size Company To Work For' in the UK for 2007. It is the first year that the medical device company has entered the listing and has found itself ranked in the top 100.

Director of Human Resources at Stryker, Louis Efron said: “Stryker is about its people and that is why we are so proud of this listing. The company prides itself on a high service ethic, innovation and accountability – all elements which are embraced by every individual and the reason why we are leaders in the healthcare industry. Stryker's strength lies in its recognition of the value of its people.”

Precise CAOS To Improve Hip Replacement Surgery
A state-of-the-art measuring techniques, similar to those used in aerospace, may be used to improve success rates for hip replacement surgery. The prototype hip replacement 'phantom' provides a precisely measured coordinate system and magnetic ball and socket joint to calibrate and to measure the clinically relevant performance of CAOS tracking instruments used in delicate operations to install artificial hip joints. The National Institute of Standards and Technology submited its CAOS phantom to surgeons for review with clinical trials expected in the future.


Internet Surgery Becomes Reality
You'll never have to leave your desk – Robotic surgery can now be driven by surgeons across the Internet.

A team of scientists showed that the surgeon and robot can be linked via a 4,000 mile Internet connection, or by satellite, raising the possibility of a surgeon's expertise being made available to patients lying in surgical theatres thousands of miles away.

The surgical trials showed that the delays were much greater when they used the satellite link than using the Internet, but after a short period of practice, the surgeon got used to this and there were no measurable differences in the quality of the surgery using the two forms of communication.