OSET 2024: The All-in-One Ortho Industry Meeting
Event Recap and Key Takeaways
By Masha Dumanis, Senior VP
This year the Orthopaedic Summit for Evolving Techniques (OSET) welcomed its most diverse set of faculty and attendees and hosted sessions across 14 different subspecialties and groups in addition to its inaugural Investor Day hosted by Healthpoint Capital and its Business of Medicine course. Over 6 days at the incomparable Fontainebleau Hotel, Las Vegas, attendees got to participate in nonstop morning to night learning and unprecedented networking opportunities. What was abundantly clear is that there was a definitive desire among physicians to cross-pollinate with their peers and counterparts across specialties.
This year’s joint Spino-Pelvic course and joint Trauma-Shoulder sessions were very well received. OSET also broke down barriers as it welcomed both podiatric surgeons and foot and ankle orthopedists to its Foot and Ankle sessions. What makes this meeting truly unique for those who have not attended is its intentionality in bringing together industry with clinicians to further innovation in the industry.
Attendees also got to hear moving keynotes – stories of triumph, of overcoming hardships, and of celebrating the spirit of healthcare from Trina Spear, founder of FIGS scrubs, tennis legend Andre Agassi, and hockey and football heroes, Mike Eruzione and Joe Theismann.
For those who didn’t get to attend, I will share a few themes and findings:
- The realities of operating in an ASC (ambulatory surgical center) – which the majority of clinicians are doing at least on a part-time basis – means doing things differently and it also means needing something different from your vendors
- JnJ MedTech sponsored a panel with some of its surgeons that echoed this exact point – the importance of “finding the right partner” who can provide not just implants, but complete solutions, and understands the needs of your ASC
- Clinicians touted the use of the right technologies – for instance automation for scheduling, notes dictation, and maybe even coding automation
- Others advocated for simple solutions like reducing instruments, consolidating to fewer (or yes, in some cases, one) vendor(s) and various sterilization solutions – outsourcing or pods/cubes to avoid wrapping (see Turbett Surgical and SteriCUBE)
- One of the powerful points made was that lots of the work that used to be done post-op is now done pre-op: patient education and communication is critical – several surgeons touted their use of Zimmer’s mymobility platform to enable this
- Post-op pain management and elimination of opioids continued to be a hot topic, especially with the imminent arrival of the hard fought “NOPAIN” act which will provide separate reimbursement to qualifying treatments
- In addition to Pacira and Heron, Gate Science presented on its novel RELAY technology (nerve block port and PNS device) and digital pain management with the GateKeeper app, while newcomer Synaptrix presented about its novel pre-op neuromod administration Novabloc that is slated to provide 20+ days of post op pain relief
- There is an avalanche of revision surgeries coming in the next decade whose growth will far outpace the growth rate in primary joints
- Solutions that address complex revisions while lowering complications and costs and improving outcomes will be highly valued, including instruments that help remove stubborn implants while being bone sparing, technologies to help rapidly diagnose and treat periprosthetic joint infections, and technologies to reduce infections (for instance, the new antibacterial coating from Onkos Surgical)
- A discussion topic: Will revisions move outpatient and to ASC too? Likely yes, but a lot is necessary on the enabling side first.
- On the sports medicine side, biologic augmentation has very much become a household term and there seems to be consensus that soft tissue-to-bone fixation and healing is made better by one of the now many available options (synthetics, collagen, hyaluronic acid, etc)
- The indications for biologic augmentation, anecdotally, seem to be spreading beyond rotator cuff – hip/labral repair, foot and ankle/achilles repair – what fixations are not yet optimized?
- Other regenerative topics included ACL repair and cartilage restoration with the MACI arthro launch, and S+N CartiHeal promotion
- While Trauma doesn’t get a lot of airtime, several notable topics came up. Fragility fractures are associated with significant morbidity and mortality, and so is the standard of care – conservative treatment – for many patients, leading to death within a year.
- There are new options for treatment which can get patients back to mobility and reduce pain rapidly – specifically, CurvaFix for fixation of the pelvic ring.
- Additionally, surgeons discussed adjunctive treatments of IlluminOss to aid in fixation.
- Across ortho – and particularly in trauma and sports medicine – compartment syndrome is a devastating complication that is both hard to catch and very invasive to treat the later it is caught.
- Newcomer MY01 is bringing awareness to compartment syndrome with their minimally invasive continuous pressure monitoring technology that can reduce staff time and be limb saving – it definitely garnered a lot of interest.
- The “war on technology” – whether its robotics, custom guides, or even custom implants, navigation, AR, or smart implants was ON throughout OSET – not just at this eponymous evening session, but throughout the whole conference.
- As many surgeons as there were at the conference, there were equally as many opinions about the role of robotics and which robot is appropriate.
- In attempting to answer whether robotics should be used in orthopedics broadly, but spine, and the ASC specifically, Dr Roland Kent turned to general robotics experts asking where robots make sense. The answer: “Robots shine in completing human tasks that require accuracy, redundancy, and reproducibility”
- Arguably, we are heading in the right direction, but it’s refinement and data that may help improve the performance.
- The reality is that technology continues to be more of a menu of options, rather than a need for some “death match” in which there is a conclusive winner. Surgeons not only pick what they each prefer, they often switch between technologies depending on case, setting, and patient needs.
- AI was perhaps subtly or overtly a topic throughout the conference. We now have machine learning built into so many of the tools that clinicians are using and its power grows exponentially. While some scoff at AI’s potential in healthcare, I believe that we are just at the precipice of seeing its power.
- Dr Isador Lieberman opened his session on the use of predictive analytics in spine with a critical point – “the decision is more important than the incision.” Today, robots are only as effective as the plan inputted by the surgeon. Similarly, cuts by a guide, or the fit of a custom implant will only be as good as the plan from the surgeon and engineer. Over the last several years this pre-operative planning demanded a completely new skill set of surgeons.
- Today, aided by technology, and not just their own clinical experience, but machine learning capabilities, its facetious to say our plans are getting incrementally better. Driven by AI – our understanding of biomechanics and ability to plan cases are getting exponentially better.
- AI is likely to be the tool that finally makes robotics in MSK a value-add, rather than an expensive toy that adds time.
- AI will help streamline efficiency – everything from patient scheduling optimization, risk scoring and predictive analytics, and AE and readmission prevention, to improvements in treatments, and better understanding of the body’s inter-relatedness
- While it seems ironic to close with the basics, there was more discussion this year on how optimizing patients’ baseline health through exercise, nutrition optimization (check out Xcelerated Recovery and Mend), and chronic disease management will have outsize impacts on outcomes in MSK
- What is not as simple is that this requires coordination across sub-specialties and care-coordination tools – to steal the words of Dr Benjamin Schwartz, – what we really need is an “MSK Medical Home”
- Some mechanisms that could help patients don’t exist yet – the notable clinician Dr Bob Sallis said “I can’t refer my patients to an exercise professional. Insurance pays for surgery but not personal trainers.” He went on to talk about how Kaiser has used physical activity as a “vital sign” for 15 years in its EMR and the impact on population health management
- The availability of GLP-1s has helped surgeons offer actionable next steps to patients who otherwise would not have qualified for surgery
This is barely scratching the surface of all that was happening across 5-6 conference halls and the exhibit hall for six straight days (if you happen to invent something that allows me to be in multiple places at once – please call me first 😉).
To learn more about our insights on MSK, the growth in enabling tech, shifts in site of service, and more, reach out to Masha Dumanis, Senior VP and co-lead of the MedTech Practice at masha.dumanis@kxadvisors.com