RECENT DEVELOPMENTS IN ORTHOPEDICS HAVE OCCURRED AT both ends of the product spectrum. Quality upgrades in imaging technology let surgeons peer inside minute incisions, while the nuts and bolts of the specialty have evolved with improved suture anchoring products. Whether buying big or small, keep the following purchasing tips in mind.

Suture anchors are very useful for a variety of orthopedic procedures, notably shoulder capsule and rotator cuff repairs. While surgeon preference usually determines which anchors to stock, make sure the product has adequate pullout resistance and the suture material is flexible and easy to tie.

With an overall increase in minimally invasive techniques, quality OR imaging is an essential extension of the surgeon's eyes, providing visual access to surgical sites that are a few millimeters wide. Intra-operative imaging is essential for many outpatient surgical procedures, including ACL reconstruction, closed reduction of fractures and percutaneous pinning of fractures. The best system combines a high quality image with ease of use by the surgeon or his assistant. Your surgeon should be able to easily manipulate the imaging arm to obtain the image he desires; the arm should also be lightweight and moved easily around a hand table or standard OR platform.

Experts say imaging upgrades are necessary every two or three years. The good news: Manufacturers are sensitive to the pressure to improve or add components and are designing products to accommodate upgrades. Still, consider whether the device will work with the equipment you have or the equipment you will purchase down the road. Some devices will only work with one manufacturer's equipment. Look for open-architecture software that can be used with more than one endoscope, say experts. Above all, stay current with the technology's developments and trends.

Power tools are always helpful in orthopedic cases and surgeons have varying preferences on the weight, balance and control settings of today's power instruments. Check out the positioning of the controls - are they close together and manipulated easily? Also make sure the tool has variable speed control that can be controlled with minor adjustments.

More Products to Improve Your Ortho Specialty

• Arthrex. The 5.5mm Bio-Corkscrew FT suture anchors come preloaded with #2 FiberWire which, along with 3.5mm PushLock knotless anchors, are the keys to the Suture-Bridge Double Row Rotator Cuff Repair, a quick maneuver that minimizes knot tying but maximizes the tendon's contact with the bone. The anchors list for $285 each. For more information, visit www.arthrex.com or call (800) 933-7001.
• Arthrotek. The InnerVue Diagnostic Scope System can supplement or even eliminate the need for MRIs by placing an active and immediate diagnostic test on site and in a physician's hands. Using a disposable scope 1.2mm in diameter, the size of an 18-gauge needle, the system is primarily promoted for use in the knee and shoulder, although the company reports that it's investigating wrist, elbow, ankle and other small joint uses. List price for the InnerVue system is about $30,000. For more information, visit arthrotek.com or call (800) 348-9500.
• Arthrocare Corp. Arthrocare Corp. released a rotator cuff repair procedure with its LabraFix System. The system simplifies a complex procedure, says the company, with its SpeedStitch Suturing Device for fast, single-step suture placement and its Mini-Magnum Implants for knotless suture fixation. Contact the Arthrocare for more information: www.arthrocare.com or (800) 797-6520.
• Biodex Medical. The EW Surgical C-arm Table 846 is an affordably priced float-top table that allows for quick and comfortable patient positioning, says the company. It features a large radiolucent area and motorized actuation of height. Price is $18,900. For more information, visit www.biodex.com or call (800) 224-6339.
• ConMed Linvatec. The company introduced two power tool sets, the Hall MPower and the Hall Micropower. The MPower, a comprehensive large and small bone procedure tool system, offers enough torque for larger cases as well as the speed required for the smaller ones, says the company. The MPower system includes drill and saw attachments and a battery charger and lists for $26,000. The Hall Micropower, on the other hand, is designed for small bone, plastic and reconstructive procedures. Its electrically powered pencil grip handpiece is lightweight and runs quietly with minimal vibration, says the company, and is fully encapsulated against fluid and moisture. List price is $18,000 for the handpiece, console, cord and footswitch. Contact the company for more information: www.conmed.com or (315) 797-8375.

• Inion. The OTPS Hand System, a set of biodegradable plates, screws and pins, is an alternative to titanium fixation. Made from a composite of three polymers, the material is strong yet thermally contourable, doesn't interfere with imaging and biodegrades beginning 18 to 36 weeks post-op, says the company. The polyaxial screws can be adjusted up to 10 degrees in the plates. Visit www.inion.com or call 866-INION-US for additional product info.
• InteliFuse. StimuLink shape-memory alloy mini implants do the job of plates, screws and other fixation hardware more efficiently, says the company. Somewhat resembling wire staples in shape, the implants align, fix and fuse bones in the hand, wrist, ankle and foot, applying continuous compression. The implants and the amount of compression can be adjusted toward a predetermined geometry with a thermoactivation electrode that warms the implants in seconds, says the company. A company official estimated StimuLink's cost at 30 percent to 50 percent less than plate-and-screw systems. To obtain additional product info, visit www.intelifuse.com or call (504) 527-6928.
• MedArtis. The company's Aptus Hand and Aptus Radius 2.5 fixation systems feature smooth, rounded, low profile titanium plates for long-term implantation, says the company. The double-threaded locking screws can be inserted at up to 15 degrees in any direction. They feature rounded heads for minimal projection, even at an angle, and blunt tips to avoid soft tissue irritation at their exit points. While pricing per set was unavailable, a representative estimated the cost for a radius case's plates and screws at $1,000 to $1,500. More information can be obtained at www.medartis.com.
• Smith and Nephew Endoscopy. A surgery center could spend $70,000 for a specially articulating fracture table in order to perform hip arthroscopy, says a representative from Smith & Nephew, or it could consider the company's hip distractor at about $14,000. The device, which attaches to an OR's existing table, adjusts and locks to provide patient positioning angles for hip arthroscopy. Visit www.smith-nephew.com or call (800) 387-5263 for more information.
• Stryker Endoscopy. Stryker's Champion Shoulder Instrumentation System includes three new tools for suture passage without disposable accessories, says the company. The StabiliHook, designed for suture passing in the glenoid labrum, employs a rotating, twist-in, twist-out motion for instability repair. The Cuff Hook, for rotator cuff procedures, also pierces tissue with rotation of its sharp distal tip. The StitchBlade Suture Cutter's transverse loading technique allows the distal tip to be used as a knot pusher and suture strands to be cut without removing the tool from the joint.Visit www.stryker.com/orthopaedics or call (201) 831-5000 for more information.