Pricing and Ordering Information

                                            Orthopedists' Adoption of New Technologies 
                                                           in Knee and Shoulder Surgery

• What fixation devices do orthopedic surgeons prefer the MOST for shoulder instability, 
  rotator cuff repair, and ACL reconstruction? 

• What are their graft preferences for ACL reconstruction?

• Which treatment approaches for shoulder instability, rotator cuff injuries, ACL injuries, and 
  isolated chondral defects are Increasing? Staying the same? Decreasing? And which treatment 
  approaches do orthopedic surgeons plan to use by 2003?

• How many procedures do orthopedists perform a MONTH for shoulder instability, meniscal injuries, 
  total knee replacements, rotator cuff injuries, ACL/PCL injuries, isolated chondral defects, and 
  abrasion chondroplasty?

Medtech Insight went to the 21^st Annual Meeting of the Arthroscopy Association of North America 
(AANA) to find out the answers to these and other provocative questions.  This Pr³ Physician Survey 
provides a comprehensive look at competing treatment modalities and has the need-to-know answers to 
questions on shoulder instability, rotator cuff injuries, ACL injuries, cartilage defects, and 
degenerative disease of the knee.

Research Methods
Over 130 orthopedic surgeons participated in the survey, which was a self-administered, written survey 
encompassing almost 120 variables conducted at the 21^st Annual Meeting of the Arthroscopy 
Association of North America (AANA).  See list of questions below.

SURVEY QUESTIONS
   (n=sample size)

Demographics 1.  In which region of the country do you practice?                              N=128 2.  How many years have you been practicing orthopedics?                   N=130 3.  What is your age?                                                                     N=130   What percent of your practice is… 4.    Arthroscopy?                                                                 N=129 5.    Total joint surgery?                                                        N=128 6.    Trauma?                                                                       N=129 7.    General orthopedics?                                                       N=129   How many surgical procedures do you perform per MONTH for… 8.    Shoulder instability?                                                       N=123 9.    Meniscal injuries?                                                           N=125 10.  Total knee replacements?                                                N=117 11.  Rotator cuff injuries?                                                       N=125 12.  ACL/PCL injuries                                                             N=121 13.  Isolated chondral defects?                                               N=106 14.  Abrasion chondroplasty?                                                  N=103   Shoulder Instability Rank the following treatment approaches for recurrent shoulder instability in order of your use: 15.  Non-surgical treatments                                                  N=109 16.  Capsular repair with absorbable tacks                                N=113 17.  Capsular repair with non-absorbable tacks                          N=101 18.  Capsular repair with absorbable suture anchors                   N=111 19.  Capsular repair with non-absorbable suture anchors             N=116 20.  Capsular repair with sutures through bony tunnels               N=102 21.  Capsular tightening with electrothermal energy                   N=109 22.  Bone block repair                                                           N=101   Please indicate your planned use of the following treatment approaches for recurrent shoulder instability (Use now, Will use by 2003, No plans to use): 23.  Non-surgical treatments                                                 N=114 24.  Capsular repair with absorbable tacks                               N=111 25.  Capsular repair with non-absorbable tacks                         N=107 26.  Capsular repair with absorbable suture anchors                   N=118 27.  Capsular repair with non-absorbable suture anchors            N=117 28.  Capsular repair with sutures through bony tunnels               N=110 29.  Capsular tightening with electrothermal energy                   N=109 30.  Bone block repair                                                          N=106   31.  Which of the treatment approaches for shoulder instability             N=145 Mentions         do you think will see the MOST growth over the next         2 to 3 years? (Open-ended question)   32.  Which of the treatment approaches for shoulder instability             N=136 Mentions       do you think will see the LEAST growth over the next         2 to 3 years? (Open-ended question)   33.  Which fixation device do you personally use the MOST                  N=117 Mentions         for shoulder instability? (List manufacturer/product name)         (Open-ended question)   Rotator Cuff Injuries Rank the following treatment approaches for rotator cuff repair in order of your use: (1=Most used, 2= 2nd Most used, 3=3rd Most used, 4=4th Most used, 5=5th Most used, 0=don’t use at all). 34.  Non-surgical treatments (sling/immobilization, PT)                 N=101 35.  Mini-open repair with absorbable suture anchors                   N=102 36.  Mini-open with non-absorbable suture anchors                     N=109 37.  Mini-open repair with absorbable tacks                               N=90 38.  Standard open with absorbable suture anchors                    N=98 39.  Standard open with non-absorbable suture anchors              N=98 40.  Standard open repair with absorbable tacks                        N=89 41.  Standard open repair with sutures through bony tunnels       N=104 42.  Arthroscopic repair with absorbable suture anchors              N=98 43.  Arthroscopic repair with non-absorbable suture anchors        N=101 44.  Arthroscopic repair with absorbable tacks                           N=91   Please indicate your planned use of the following treatment approaches for rotator cuff injuries (Use now, Will use by 2003, No plans to use): 45.  Non-surgical treatments (sling/immobilization, PT)                 N=115 46.  Mini-open repair with absorbable suture anchors                   N=117 47.  Mini-open with non-absorbable suture anchors                     N=118 48.  Mini-open repair with absorbable tacks                               N=107 49.  Standard open with absorbable suture anchors                    N=105 50.  Standard open with non-absorbable suture anchors              N=106 51.  Standard open repair with absorbable tacks                        N=103 52.  Standard open repair with sutures through bony tunnels       N=108 53.  Arthroscopic repair with absorbable suture anchors              N=116 54.  Arthroscopic repair with non-absorbable suture anchors        N=115 55.  Arthroscopic repair with absorbable tacks                           N=109   56.  Which of the treatment approaches for rotator cuff repair               N=128 Mentions         do you think will see the MOST growth over the next          2 to 3 years? (Open-ended question)   57.  When in need of a material to patch a large rotator                   N=103 Mentions        cuff tear, what do you use?   58.  Which fixation device do you personally use the MOST                N=122 Mentions         for rotator cuff repair?  (List manufacturer/product name)         (Open-ended question)   Please rate the importance of the following factors as obstacles in performing arthroscopic rotator cuff repair (1=No obstacle, 2=Minor obstacle, 3=Moderate obstacle, 4=Major obstacle): 59.  Current fixation techniques too difficult                              N=121 60.  Current techniques for securing or tying sutures too difficult  N=124 61.  Possible migration of tacks                                               N=110 62.  Pullout strength of suture anchors worrisome                      N=118 63.  Takes too long                                                              N=122 64.  Published results of outcomes do not justify technique          N=120   ACL Injuries 65.  What percent of your ACL reconstructions are performed                N=121   arthroscopically?   What percent of your arthroscopic ACL reconstructions are performed using the following techniques: (Total must = 100%) 66.  Bone-tendon-bone patellar tendon graft                             N=124 67.  Quadriceps graft                                                            N=113 68.  Hamstring grafts                                                            N=120 69.  Allograft with bony attachment                                        N=119 70.  Allograft tendon only                                                      N=113   Rank the following hamstring fixation devices in order of your preference: (Titanium interference screws, Acufex Endobutton, Femoral cross pins, Bioabsorbable interference screws, Allograft interference screws) 71.  Most preferred                                                                N=83 72.  2nd Most preferred                                                           N=71 73.  3rd Most preferred                                                           N=47 74.  4th Most preferred                                                           N=39 75.  5th Most preferred                                                           N=39   76.  What is the manufacturer and product name of your MOST              N=80 Mentions        preferred hamstring fixation device? (Open-ended question)   Rank the following patellar tendon fixation devices in order of your preference: (Titanium interference screws, Bioabsorbable screws, Allograft interference screws) 77.  Most preferred                                                               N=114 78.  2nd Most preferred                                                          N=87 79.  3rd Most preferred                                                          N=75   80.  What is the manufacturer and product name of your MOST              N=94 Mentions        preferred patellar tendon fixation device?         (Open-ended question)   Please indicate your planned use of the following for ACL reconstruction: (Use now, Will use by 2003, No plans to use) 81.  Bone tendon bone patellar tendon graft                              N=121 82.  Quadriceps graft                                                             N=108 83.  Hamstring grafts                                                             N=117 84.  Allograft with bony attachment                                         N=116 85.  Allograft tendon only                                                       N=107   Please rank the following variables in order of importance in affecting your graft preferences for ACL reconstruction: (1=Most important, 2=2nd Most important, 3=3rd Most important, 4=4th Most important, 5=5th Most important). 86.  Quality of fixation devices                                                N=119 87.  Results of published comparison studies                              N=114 88.  Concern about viral disease transmission and allografts          N=117 89.  Biomechanical strength of the graft                                   N=119 90.  Postoperative patient morbidity                                         N=118   Cartilage Defects How many of the following procedures do you perform a year? 91.  Allograft osteochondral implantation?                                  N=122 92.  Autologous chondrocyte implantation?                                N=120 93.  Mosaicplasty?                                                                N=124   Please rank the following treatment approaches for isolated chondral defects in order of your use: (1=Most used, 2=2nd Most used, 3=3rd Most used, 4=4th Most used, 5=5th Most used, 0=Don’t use at all) 94.  Arthroscopy and debridement                                           N=120 95.  Autogenous osteocartilagenous transfer (Mosaicplasty)         N=102 96.  Autologous chondrocyte implantation                                 N=89 97.  Microfracture technique                                                  N=110 98.  Abrasion chondroplasty                                                   N=109 99.  Allograft osteochondral implantation                                  N=93   Do you think your use of the following treatment approaches for isolated chondral defects are increasing, staying the same or decreasing? 100.  Arthroscopy and debridement                                          N=123 101.  Autogenous osteocartilagenous transfer (Mosaicplasty)       N=101 102.  Autologous chondrocyte implantation                                N=82 103.  Microfracture technique                                                 N=110 104.  Abrasion chondroplasty                                                  N=104 105.  Allograft osteochondral implantation                                 N=76   Please rate the importance of the following factors in affecting your choice of treatment for isolated chondral defects (5=Very important and 1= Not important at all): 106.  Ability to perform procedure arthroscopically instead of open N=125 107.  Results of published comparison studies                             N=124 108.  Adequate healing of cartilage graft                                   N=122 109.  Concern about viral disease transmission and allografts        N=123   Degenerative Disease of the Knee Please indicate your planned use of the following treatment approaches for degenerative disease of the knee: (Use now, Will use by 2003, No plans to use) 110.  Total knee replacement                                                 N=123 111.  Minimally-invasive unicompartmental knee replacement        N=119 112.  Viscosupplementation (Hyaluronic acid therapy)                 N=121 113.  High tibial osteotomy                                                    N=119 114.  Autologous chondrocyte implantation                               N=117 115.  Allograft osteochondral replacement                                 N=113 116.  “Off-the-shelf” ligament replacements                              N=113                   (allograft or synthetic) 117.  Meniscal replacement (allograft or synthetic)                     N=118 © 2002, Medtech Insight, LLC

Ordering Information

Physician Survey #	# of Questions	Format	Price
PS401, Orthopedists' Adoption of New Technologies in Knee and Shoulder Surgery	117	PowerPoint/ CD-ROM	$4,950

To purchase the results of this survey or for further inquiries, please contact 
pr3@medtechinsight.com or call our sales office at (949) 219-0150 or toll 
free in the U.S. at (888) 290-2225.

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