Stimulating the Natural Healing Process

Kevin R. Stone, M.D., helped usher in the Age of Anabolics.
 
The San Francisco, Calif.-based orthopedic surgeon invented the world’s first orthopedic tissue regeneration template in 1986, giving hope to countless numbers of patients with torn knee cartilage. Debuting in 2000, Stone’s collagen meniscus implant (CMI) induces the body’s self- healing prowess to repair torn or missing segments of the knee’s main shock absorber. The implant is comprised of highly purified collagen, which acts as a trellis for new meniscus tissue growth.
 
Since gaining market admittance, Stone’s invention has helped repair more than 4,000 injured knees worldwide. Perhaps more importantly, though, it laid the groundwork for the cultivation of biological treatments for orthopedic injuries, a sector that was valued at $5 billion in 2015 and is expected to swell to $10.2 billion in 2025, according to Million Insights data. Driving this growth over the next seven years will be the planet’s aging population, technological advancements, changing (more active) lifestyles, and a steady increase in musculoskeletal-related conditions like arthritis and osteoporosis.
 
There will likely be no shortage of technologies available in 2025, as the orthobiologics field is already brimming with companies jockeying for market share. ODT’s January/February feature story “Biological Building Blocks” examines the trends and challenges shaping the orthobiologics market as well as some of the latest technologies available to patients. Art Wotiz, president and CEO of NovaBone Products LLC, was among the experts interviewed for the feature; his full input is provided in the following Q&A.
 
Michael Barbella: Please discuss the current trends in orthobiologics. What forces are driving these trends? Have they changed in recent years?
Art Wotiz: Orthobiologics has been growing as many practitioners see the need to augment hardware to ensure the ultimate success of the procedure. With the aging baby boomers, the number of spine fusions has increased. The popularity of dental implants has also been a positive factor. As with any growing market, the number of competitors has increased. Orthobiologics has been evolving towards products that stimulate bone growth. Another consideration has also been to make the product offerings as easy to use as possible. These changes have affected the regulatory environment as well, as hospital philosophies on numbers of vendors adding challenges for orthobiologics suppliers.
 
Barbella: What opportunities does this sector present to companies that operate in this space?
Wotiz: Opportunities for this sector include improved delivery systems, broadened indications, and emerging global markets.
 
Barbella: What challenges/concerns are facing the orthobiologics industry? How can the industry and companies in this sector overcome these challenges?
Wotiz: The biggest challenges are price pressure from hospital systems, hospitals’ desire to reduce the number of vendors, and increasing regulatory hurdles (particularly in OUS markets). These hurdles can be managed, but they represent a significant challenge for smaller companies that may not have critical mass.
 
Barbella: Why is it so difficult/challenging to mimic the body’s natural biological healing process for bone?
Wotiz: NovaBone products stimulate the body’s natural healing process rather than change it. Therefore, there are no issues with mimicking the body’s natural healing process for bone.
 
Barbella: What factors are currently driving innovation in orthobiologics?
Wotiz: Cost is a concern in every market. Achieving safe, reliable performance at the lowest possible cost is a big driver.
 
Barbella: What interesting, new technologies are in the works?
Wotiz: At NovaBone, we offer the broadest family of synthetic bioactive bone grafts of any company in the world. We have a complete user-friendly line of grafts that are ready to use as supplied, and we also have a family of products that use collagen as a carrier for those surgeons who want to add bone marrow aspirate to the graft. We continue to tailor products to satisfy surgeon suggestions.