Stable Technology

8/26/12  The expression “stable technology” is the innovation of the near future in orthopedic surgery.  This expression is little known by orthopedic surgeons.  At a recent orthopedic meeting following a presentation on the state of the art on total joints, I asked two experts in total joint replacement the following two questions.  The first was “What are the new innovations in total joint surgery”.  The answer was “making modifications to the new technology” to overcome the problems.  It is clear the new technology is a problem evidenced by the  multiple TV advertisements to “call the number on the screen” if you had such and such total joint from J&J DePuy or Stryker.  The problems with ceramic joints and metal on metal are only a few of the problems with new technology.  I then asked them if they were familiar with “stable technology”?  Neither were familiar, but one asked to have lunch with me so he could be advised.

The truth is that over the last several years there has been a convergence of the design of total joints so that many look alike.  This is another aspect of “stable technology”  The reports in the literature have shown there are many long term reports on older total joints having certain common denominatiors (look alikes) that are better than latest greatest technology from the major players.  These joint consitute stable technology.  Stable technology is one that has been around for a while.

It is true that the majors, like Zimmer, J&J and Stryker have strong branding that brings a high price for the total joint; i.e. 5-10 thousand dollars to the hospital.  The truth is they have also a high cost to maintain the “branding” by advertisement and high cost of distribution.  The truth is that their total joints are not better in design or material than other less expensive joints and perhaps in some cases they are worse.

The second tier manufacturers make 12% of the total joints sold by the major brands.  In fact, most of these companies make joints for all five majors, running side by side in the production line.  The facilities equal or exceed the major brands factories.

A total joint made by a second tier company for a major brand has cost of $300.  They sell to the major for $600.  The major brands sell it for $5000-10,00.

The truth is that the stable technology total joint will sell retail to the hospital for $1500.  Do the math.  Soon others will make this calculation.

These are the arguments for stable technology.

Established design; tried and true

Same materials and quality

Same manufacturer as what Major Brands sell now (12%)

Eliminate cost of distribution:

Lowered or eliminated  advertising expense for latest and greatest

Much less cost; i.e. $1500 vs $5000-10,000.

No compromise in patient care

May be mandated by Federal government the main purchaser of total joints via Medicare.

A major hospital chain is presently has literally bought into the concept.  Do the math.