Biomet Gains Hinge on Old Standby

Popularity Contest

So far, at least, MIS has yet to achieve the popularity that some -- like Zimmer -- tend to celebrate.

Robert Bourne, chairman of the Canadian joint registry, says that fewer than 10% of hip and knee replacements currently involve the new technique. He also says that nobody really knows, yet, whether MIS implants will perform as well or last as long as traditional devices.

"That will be very important data," he says. But right now, "there's a lot of hype in the marketplace without a lot of substance."

As it stands now, however, the U.S. has limited access to scientific data on joint implants in general. Despite recommendations to start a joint registry here -- and a feasibility study launched years ago by the American Association of Orthopedic Surgeons -- the U.S. remains without one.

Bourne hopes to see that change. He says that joint registries have helped other countries already. Since establishing the first joint registry in 1979, he says, Sweden has seen its rate of "revision" surgeries on senior citizens -- needed when original implants fail -- drop to just 6%. In contrast, he says, the revision rate on U.S. Medicare patients remains three times that. That rate is also higher than the revision rates in other countries, like Australia and Canada, that have registries of their own.

"Just about every first-world country except the U.S. has one," Bourne says. "I think it would be a great thing" if the U.S. followed suit.

But Miller of Biomet stops well short of endorsing a joint registry that would document actual surgical outcomes.

"Unfortunately, the results of a registry could be misinterpreted if people are not careful," Miller says. "I think we need to be careful that a registry doesn't become a shopping list for plaintiffs' attorneys."

Cipolletti, for one, sees other motives.

"There are very big dollar reasons for large companies to try to prevent it," he says. "They have a real vested interest in keeping the status quo the way it is."