The Journal of Bone and Joint Surgery (American). 2007;89:1641-1649.
doi:10.2106/JBJS.F.01185
© 2007 The Journal of Bone and Joint Surgery, Inc.
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Symposium

The Introduction of Biologics in Orthopaedics: Issues of Cost, Commercialism, and Ethics*

William T. Obremskey, MD, MPH1, James S. Marotta, PhD2, Michael J. Yaszemski, MD, PhD3, Larry R. Churchill, PhD4, Scott D. Boden, MD5 and Douglas R. Dirschl, MD6

1 Vanderbilt Orthopedic Trauma, Medical Center East–South Tower, Suite 4200, Nashville, TN 37232-8774. E-mail address: william.obremskey@vanderbilt.edu
2 Medtronic, 1800 Pyramid Place, Memphis, TN 38132
3 Mayo Clinic, 200 First Street S.W., Rochester, MN 55905
4 Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, 319 Oxford House, Nashville, TN 37232-4350
5 59 Executive Park South, Suite 3000, Atlanta, GA 30329
6 Department of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7055

The first 150 words of the full text of this article appear below.


   Introduction
 
Orthopaedic surgery has a rich history of introducing new procedures and new technology into the profession for clinical practice. Orthopaedic surgeons have become much more innovative and successful in treating a variety of musculoskeletal diseases and injuries with improved implants and biologics. This article focuses on the ethics of the introduction of new technology, with bone morphogenetic proteins (BMP) and platelet concentrations used as primary examples.

With the introduction of any new product or new procedure, ethical concerns are raised. They include questions about (1) the responsibility of surgeons to their patients and to medical progress, (2) the responsibility of the product manufacturer, and (3) the responsibility of a payer to the physician or medical institution.

Orthopaedic practice has introduced into clinical use an abundance of new procedures and implants that were considered advances in technology. Some have proven to be beneficial, but others have been deleterious. Some examples of . . . [Full Text of this Article]


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