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Sean McMillan, D.O., understands the power that data can have on an orthopedic surgeon’s decision to use certain products.
He and a team of surgeons and researchers just completed a study that found the use of needle arthroscopes for visualization during a partial meniscectomy led to a nearly fivefold reduction in fluid versus procedures that use traditional arthroscopes. Dr. McMillan serves as Chief of Orthopedics and Director of Orthopedic Sports Medicine at Virtua-Our Lady of Lourdes Hospital and Virtua Willingboro Hospital in New Jersey, and the data has been helpful as they navigate supply chain constraints spurred by the closing of a Baxter facility affected by flooding from Hurricane Helene.
“The hurricane decimated one of the biggest plants that manufactures arthroscopic fluid,” Dr. McMillan said. “We’ve been on a stringent protocol with the hospital asking us to be judicious with the amount of fluid we use. Our study is timely and shows a way that we can maximize our supplies to benefit our hospitals and surgery centers. Because we’re not wasting extra fluid, we can perform more surgeries and help more people.”
Dr. McMillan’s randomized study of 68 patients showed that 479 ml of fluid were used in patients during a needle arthroscopic procedure compared to 2,569 ml during a traditional arthroscopic surgery. The study was accepted by Surgical Technology International and is expected to be published in the coming month.
The study’s original purpose was to examine quadricep strength after a partial meniscectomy was performed with Arthrex’s NanoNeedle arthroscopy system. Quadricep muscles often weaken after cartilage is torn in the knee joint.
“We pump fluid into the knee joint when we perform an arthroscopy, and it creates effusion or swelling inside the joint,” Dr. McMillan said. “The body’s receptors pick up on that extra fluid and shut down the muscle even more. We found that patients experience three times less loss of strength in their quadricep when we use a needle scope compared to a traditional scope because we’re using less fluid.”
Dr. McMillan has used needle scopes for about ten years and said they offer less post-op pain and loss of strength, which allows patients to quickly return to function and quality of life. He also uses needle scopes in the office in place of an MRI to diagnose a patient’s pathology. It’s a more cost-effective approach to treating patients and leads to a faster turnaround time if surgery is needed.
Those are the patients’ priorities— not supply chain issues, Dr. McMillan said.
Supply constraints are also often not at the top of surgeons’ minds until they’re impacted, he added. However, he experienced product disruptions as an effect of COVID, a war in the Middle East and now the hurricane.
In the current case, Baxter’s North Carolina facility was damaged by flooding from Hurricane Helene in September. According to the American Hospital Association, Baxter manufactures about 60%, or 1.5 million bags per day, of the nation’s supply of intravenous fluids and peritoneal dialysis solutions.
As of mid-October, Baxter began shipping products to the U.S. from its international facilities and said it’s working to meet 90% to 100% of its customers’ needs by the end of the year. The shortage is expected to impact multiple orthopedic specialties.
Events in recent years show it’s inevitable that over time every surgeon will face a resource shortage, Dr. McMillan said, noting it’s important to make surgery more efficient. He added that while natural disasters are outliers, strong products and services weigh into the hospital system’s decision on whether to buy products from a company.
“We ask ourselves: What do we want? What is best for our patients? How can we get it?” Dr. McMillan said. “If a company has recurring supply chain issues, we steer away from them. We can’t reschedule surgeries or deviate much from our practice. Unfortunately, these issues happen in orthopedics.”
Another growing trend Dr. McMillan has seen is that educated patients come to his office with a request for a specific product to repair rotator cuff, ACL and meniscus tears. He noted that the use of biology and biologics to regenerate and preserve tissue rather than replace it is the future of sports medicine, and patients crave it.
“The biology factor is huge for patients,” he said. “They want better, quicker, more natural. Patients have never been more informed consumers. They’ve done their research and will ask questions that are poignant and inquisitive.”
Surgeons must stay up to date on the latest technologies and be good stewards of patient care and hospital resources, he added. “Our job as surgeons is to be educated on new products and offer patients what we think is best for their case, even if it’s not always what they want to hear,” he said, “and then ultimately execute the plan.”
Sean McMillan, D.O., understands the power that data can have on an orthopedic surgeon’s decision to use certain products.
He and a team of surgeons and researchers just completed a study that found the use of needle arthroscopes for visualization during a partial meniscectomy led to a nearly fivefold reduction in fluid versus procedures that...
Sean McMillan, D.O., understands the power that data can have on an orthopedic surgeon’s decision to use certain products.
He and a team of surgeons and researchers just completed a study that found the use of needle arthroscopes for visualization during a partial meniscectomy led to a nearly fivefold reduction in fluid versus procedures that use traditional arthroscopes. Dr. McMillan serves as Chief of Orthopedics and Director of Orthopedic Sports Medicine at Virtua-Our Lady of Lourdes Hospital and Virtua Willingboro Hospital in New Jersey, and the data has been helpful as they navigate supply chain constraints spurred by the closing of a Baxter facility affected by flooding from Hurricane Helene.
“The hurricane decimated one of the biggest plants that manufactures arthroscopic fluid,” Dr. McMillan said. “We’ve been on a stringent protocol with the hospital asking us to be judicious with the amount of fluid we use. Our study is timely and shows a way that we can maximize our supplies to benefit our hospitals and surgery centers. Because we’re not wasting extra fluid, we can perform more surgeries and help more people.”
Dr. McMillan’s randomized study of 68 patients showed that 479 ml of fluid were used in patients during a needle arthroscopic procedure compared to 2,569 ml during a traditional arthroscopic surgery. The study was accepted by Surgical Technology International and is expected to be published in the coming month.
The study’s original purpose was to examine quadricep strength after a partial meniscectomy was performed with Arthrex’s NanoNeedle arthroscopy system. Quadricep muscles often weaken after cartilage is torn in the knee joint.
“We pump fluid into the knee joint when we perform an arthroscopy, and it creates effusion or swelling inside the joint,” Dr. McMillan said. “The body’s receptors pick up on that extra fluid and shut down the muscle even more. We found that patients experience three times less loss of strength in their quadricep when we use a needle scope compared to a traditional scope because we’re using less fluid.”
Dr. McMillan has used needle scopes for about ten years and said they offer less post-op pain and loss of strength, which allows patients to quickly return to function and quality of life. He also uses needle scopes in the office in place of an MRI to diagnose a patient’s pathology. It’s a more cost-effective approach to treating patients and leads to a faster turnaround time if surgery is needed.
Those are the patients’ priorities— not supply chain issues, Dr. McMillan said.
Supply constraints are also often not at the top of surgeons’ minds until they’re impacted, he added. However, he experienced product disruptions as an effect of COVID, a war in the Middle East and now the hurricane.
In the current case, Baxter’s North Carolina facility was damaged by flooding from Hurricane Helene in September. According to the American Hospital Association, Baxter manufactures about 60%, or 1.5 million bags per day, of the nation’s supply of intravenous fluids and peritoneal dialysis solutions.
As of mid-October, Baxter began shipping products to the U.S. from its international facilities and said it’s working to meet 90% to 100% of its customers’ needs by the end of the year. The shortage is expected to impact multiple orthopedic specialties.
Events in recent years show it’s inevitable that over time every surgeon will face a resource shortage, Dr. McMillan said, noting it’s important to make surgery more efficient. He added that while natural disasters are outliers, strong products and services weigh into the hospital system’s decision on whether to buy products from a company.
“We ask ourselves: What do we want? What is best for our patients? How can we get it?” Dr. McMillan said. “If a company has recurring supply chain issues, we steer away from them. We can’t reschedule surgeries or deviate much from our practice. Unfortunately, these issues happen in orthopedics.”
Another growing trend Dr. McMillan has seen is that educated patients come to his office with a request for a specific product to repair rotator cuff, ACL and meniscus tears. He noted that the use of biology and biologics to regenerate and preserve tissue rather than replace it is the future of sports medicine, and patients crave it.
“The biology factor is huge for patients,” he said. “They want better, quicker, more natural. Patients have never been more informed consumers. They’ve done their research and will ask questions that are poignant and inquisitive.”
Surgeons must stay up to date on the latest technologies and be good stewards of patient care and hospital resources, he added. “Our job as surgeons is to be educated on new products and offer patients what we think is best for their case, even if it’s not always what they want to hear,” he said, “and then ultimately execute the plan.”
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Carolyn LaWell is ORTHOWORLD's Chief Content Officer. She joined ORTHOWORLD in 2012 to oversee its editorial and industry education. She previously served in editor roles at B2B magazines and newspapers.
