Meet you at the joint
Further meandering leads to a real sculptor's double booth near the back of the hall, where a constant stream of doctors admire and gently stroke Ron Wicks's striking bronzes. The former stockbroker, who calls himself Ronadro professionally (www.ronadro.com), has been depicting doctors plying their profession--gowned for surgery, wielding a scalpel--for more than 20 years. A 9-inch-tall physician with folded hands costs $975. A much larger, amazingly detailed snapshot in bronze of detached hands performing shoulder surgery with arthroscopic instruments is $5,450. There are dozens of them, all in limited editions. Some surgeons, Wicks says proudly, have purchased each bronze as it appears. He never gets tired of creating a new one.
Additional art-loving orthopedists are a few booths away. A crowd is snapping up fun $35 ties from eBone (www.eboneties.com) that bear depictions of bones, MRI images, instruments, and other themes appropriate to the specialty. The exhibitors are an orthopedist from Kenosha, Wis., who came up with the idea, and his wife. (An ophthalmologist in New York handles manufacturing.)
This random walk is fun, but a guide would be useful. Frank Pettrone, this year's exhibits committee chairman and a partner in a 31-physician orthopedic practice across the Potomac River in the Virginia suburbs, agrees to play Virgil.
Pettrone heads for the Aesculap booth and one of the hot products of the year, a computerized navigation system. That turns out to mean a way for orthopedists to line up the upper and lower leg bones prior to knee replacement surgery and replicate exactly the same configuration afterward. Misalignment, explains a representative, is the main reason replacement knees fail, and the $150,000 system can improve alignment by 2 to 3 degrees over the conventional approach. On the way to the next booth, Pettrone is asked whether such a system is worth the price. "It will be," he says--once the data show reduced knee failures because of the system. Meaning his practice isn't ready to spring for one.
Less is more. "Unicompartmental" knee replacements are also hot. At the DePuy Orthopaedics booth, Pettrone manipulates a model of the knee and points to its three sections, or compartments. All three don't always need replacing, he explains. In a unicompartmental replacement, only one is done--generally the medial compartment at the inside of the leg, which carries about 60 percent of the weight. The procedure permits a smaller incision because fewer of the ligaments that tie the knee together need to be cut. Recovery is faster, with less post-op pain. Is there a disadvantage? Not with the procedure itself, but it is still new enough that many orthopedists haven't done a large number. The observer is grateful his knees are sound.
Varieties of replacement hip joints are in abundant display. For elderly patients, a joint that lasts 10 or 15 years probably is fine, and the ball that goes into the artificial hip socket is made of plastic. Then there are balls made from metal or an advanced ceramic. Apparently both last just short of forever. After repeated prodding, one representative allows that metal balls shed metallic ions, tiny atomic scraps of chromium and cobalt. There is a question about whether the shed ions might make the bone react in some way that could lead to failure or might even promote cancer. But there have been no long-term investigations. Ceramic balls can--very rarely--fracture, "and when that happens, it's a real mess," says Pettrone. But few surgeons have had this happen. So, asks the observer, why choose one over the other? It sounds like a religious issue. Pettrone and the representative regard each other. Then the surgeon grins. "That's exactly what it is," he says.
A scattering of physicians, identifiable by their badge color, stand just outside the cavernous center puffing on cigarettes. There are only a few smokers--not nearly as many as at the American Heart Association meeting. Go figure.
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