Tissue Repair Start-Ups Fill Orthopedics' Gaps
This article was originally published in Start Up
Technologies for total joint repair, the backbone of the orthopedics industry, have occupied most of the development resources of orthopedic companies, but there are gaps in the continuum of care when it comes to tendon and ligament repair. ACL reconstruction and rotator cuff repair thus are attractive niches for start-ups, worth anywhere from $500 million to $1 billion. Soft tissue repair expertise is outside the core skill-sets of big ortho, but those companies have been willing to partner and acquire smaller innovative players. Today, the opportunity is even more attractive; sports medicine--the realm of soft tissue repair--enjoys an economic resiliency not seen in total joint replacement. Ligament tears more closely resemble trauma applications, which must be treated as soon as possible.
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Imagine an implanted device that can be inserted through a small opening in the body but expands to a much larger size once inside. Morever, it's a permanent device that can adjust to changing conditions within the body following implantation. In other words, an active implant as opposed to a static implant. Such is the biocompatible, shape-memory polymer technology being developed by MedShape Solutions. The company is initially focused on sports medicine, with an emphasis in rotator cuff and shoulder repair and anterior cruciate ligament repair.
Sports medicine is the fastest growing specialty in orthopedics, attracting more than 25% of orthopedic residents seeking fellowships for the 2010 training year. Since many sports injuries occur in the young athlete, the way an injury is treated early on may be the determining factor in preventing progressive joint changes and the early onset of degenerative diseases such as osteoarthritis. The promise of new biomaterials and biologics for repairing or replacing supporting soft tissue structures will have a big impact on the orthopedics market for some time to come.
START-UP counts some 40 commercial development efforts in cartilage repair and regeneration. Some are implanting synthetic scaffolds, and some are offering cell-based therapies used with or without scaffolds. It's a crowded and confusing category. So many companies are chasing a market that is still somewhat undefined and doesn't seem large enough to support them all. What's clear, however, is that almost 15 years after the introduction of Carticel, the first cell-based implant for cartilage repari, there is still an unsatisified market of patients aged 20-60 with knee pain due to cartilage damage or degeneration.