2005 AAOS: Louder, Yet Quieter than Ever Before
BY JOHN CHOPACK, MARCH 1, 2005
The 2005 American Academy of Orthopaedic Surgeon Annual Conference was unique to recent meetings. It was louder in terms of the amount of marketing, size of exhibits and mass advertising, yet it was quieter in terms of business development and, more specifically, mergers and acquisitions.
Each year the conference grows - in fact the 2005 AAOS was the largest conference Washington, D.C. has ever held and the conference will likely outgrow The Washington Convention Center shortly. The growth of the conference is a true testament to the strength of the orthopedic market. Two factors are driving the growth of the conference: 1) the growth in size of the exhibits and 2) the number of exhibitors.
The large orthopedic companies have reached an economic scale which allows for mass marketing and branding. This has allowed the largest manufacturers to create exhibits that take-on a Disneyland like feel. The Washington Convention Center's upper deck allowed a unique perspective - an aerial view which demonstrated how much of a spectacle the Conference has become. The largest orthopedic manufacturers, including Zimmer, Stryker, DePuy, Smith & Nephew, Biomet and Medtronic Sofamor Danek exhibits were a conference within a conference. Most had continuous surgeon presentations within their boxed off areas and Smith & Nephew even provided booth tours.
There were 461 exhibitors at the 2005 AAOS compared to 423 in 2004. More importantly, is the number of large pharmaceutical companies which have expanded their presence including Pfizer, Wyeth and Abbott Labs. We expect to see an increasing number of, and an expanding presence from, the pharmaceutical sector at the upcoming AAOS conferences.
Despite the over-whelming amount of mass marketing, branding and advertising, the 2005 AAOS was one of the quieter conferences in recent years. The largest acquisition that was announced was Stryker's $50 million purchase of eTrauma. This compares to Smith & Nephew's $100 million acquisition of Midland Medical Technologies last year and Synthes $350 million acquisition of Spine Solutions in 2003. While we heard rumblings of a potential Biomet deal as well as a potential transaction involving Hand Innovations, both turned out to be purely rumors.
Most business development announcements during the week involved Minimally Invasive Surgery. Zimmer announced that it was launching a new Minimally Invasive Solutions Anterolateral Hip Replacement Procedure and that the first Electromagnetic Navigation Knee Replacement procedure was performed at Methodist Hospital in Houston, TX. Wright Medical announced the release of a BrainLAB Surgical Navigation Software for the Advance Knee System, the launch of the Odyssey Tissue Preserving Minimal Invasive Knee Instrumentation and revealed the PATH Technique for Less Invasive Total Hip Arthroplasty. Other significant announcements including Medtronic Sofamor Danek's launch of its enhancements to its CD Legacy Poly-Axial Screw offering, Smith & Nephew's Periarticular Locked Plating System and Exactech's entry into spine graft market with first implantation of Optecure and introduction of OpteMx.
The clear topic of discussion at the 2005 AAOS continued to be minimal or less invasive surgery. While MIS procedures are offered by all of the largest orthopedic companies as well as several of the mid-sized organizations, there is still skepticism regarding the techniques and outcomes. Zimmer clearly is the dominant marketing force behind minimally invasive surgery. Other manufacturers including Biomet and Stryker are taking more cautious approaches. The latter expressed that there is a place for MIS procedures but that it is not an appropriate option in every surgical situation. There is an optimal patient and situation for the procedure. They also added that the procedure may not be for every surgeon, and that extensive surgeon training is required.
Adding fuel to the MIS fire was some lukewarm initial results related to different surgical minimally invasive procedures, especially the MIS Two Incision Hip procedure. We believe that this is a difficult technique but if done correctly may over optimal results. The mini or single incision MIS hip procedures are technically less demanding and may be more appropriate for the general orthopedic surgeon.
