VOLUME 8, ISSUE 17 | MAY 22, 2012 week in review The 23 Top Foot & Ankle Surgeons in the U.S. ♦ 4Who better to pick the top foot and ankle surgeons than their own col- leagues? OTW has asked leading foot and ankle specialists to select the best of their peers. Here is what we heard. New Policy Would Cut Some Spine Surgery 8Funding ♦ The Blues of Illinois say there is a lack of evidence to justify spinal fusion for DDD and other indi- cations. Spine’s best minds fire back in this OTW exclusive story by accusing the insurer of shoddy literature work and using unscientific guidelines. Read it here. Orthopedics in the breaking news Amazon Basin ♦ Or- 13thopedists just want to fix “Fear and Medical Tour- things. Dr. Peter Cole decided to make ism” in Vegas a semi-annual trip to the jungle to fix 21.......................................... some especially needy patients. He and OrthoSensor Builds Cash Stash his team could write a text book in pa- ............................................................ thology with what they see in a week. Feds Give “All Clear Signal” on Infuse Dr. Cole’s labor of love and faith is sim- Investigation ply wonderful and uplifting. We hope ............................................................ it inspires you too. Nevada Doc Builds Own Hospital, Rehab Unit Vince v. Hungerford ............................................................ on Correcting Extra- Predict Arthritis Before Symptoms 17Articular Deformity ♦ Arrive! Extra-articular deformity? Go intra- ............................................................ articular for the correction, says Kelly Arthritis: Manipulate Cilia, Reduce Vince. David Hungerford: There are Inflammation? many kinds and sources of deformity: ............................................................ congenital, metabolic, etc. And what is CBS Featured Sealant for Low Back Pain the magnitude of the deformity, and the ............................................................ location from the knee, etc.? For all news that is ortho, read on. 1-888-749-2153 | www.ryortho.com 2 VOLUME 8, ISSUE 17 | MAY 22, 2012 Orthopedic Power Rankings Robin Young’s Entirely Subjective Ordering of Public Orthopedic Companies THIS WEEK: How fast the wind turns. Last week it was at our back as several companies pleasantly surprised with sales (NuVasive beats estimates, Biomet and SNN stand out) or earnings (Globus had huge earnings numbers). This week the wind is blowing hard from across the Atlantic. Bank runs in Greece. Spain and Italy teetering. And the threat of new global credit contraction. LAST TTM OP 30-DAY RANK COMPANY COMMENT WEEK MARGIN PRICE CHANGE If ever there was a time to appreciate headquarters in 1 1 Orthofix 16.23% 4.89% the Netherlands Antilles, this may be it. NUVA so completely beat expectations that the glow 2 3 NuVasive 6.63 15.98 has yet to wear off. Time for another look at spine! Symmetry Up 20% in the last month. SMA is being run by a 3 6 5.29 20.41 Medical comparatively young, strategic management team. It had to happen eventually—ARTC is finally bottoming 4 NR ArthroCare (0.67) (1.04) out. Also is the 2nd lowest PE to Growth in Ortho. Can’t fight the tape. CNMD deserves better valuation 5 2 Conmed 10.09 (7.99) than this but will require more strong quarters. Integra Recent run up in IART’s price just triggered a profit 6 4 13.34 2.30 LifeSciences taking sell-off. 2nd lowest overall valuation in ortho. In a stormy world, JNJ looks like an investor’s version Johnson & 7 5 24.93 0.14 of the London Fog Trench coat. Time-tested wind and Johnson rain protection. Nearly un-noticed is the fact that 4 analysts have 8 7 Zimmer 24.95 (8.45) raised their estimates in the past 30 days. As we see in ZMH, the market is just not enamored 9 8 Stryker 23.68 (9.38) right now with big ortho—regardless of demographic argument. In advance of this week’s release, most analysts are 10 9 Medtronic 28.24 (2.79) forecasting declining sales but higher margins for the quarter. 1-888-749-2153 | www.ryortho.com 3 VOLUME 8, ISSUE 17 | MAY 22, 2012 Robin Young’s Orthopedic Universe TOP PERFORMERS LAST 30 DAYS WORST PERFORMERS LAST 30 DAYS COMPANY SYMBOL PRICE MKT CAP 30-DAY CHG COMPANY SYMBOL PRICE MKT CAP 30-DAY CHG 1 Kensey Nash KNSY $38.39 $334 34.80% 1 MAKO Surgical MAKO $22.17 $944 -46.31% 2 Symmetry Medical SMA $8.32 $305 20.41% 2 Bacterin Intl Holdings BONE $1.59 $67 -28.70% 3 NuVasive NUVA $18.73 $809 15.98% 3 TiGenix TIG.BR $0.60 $55 -23.97% 4 Wright Medical WMGI $19.71 $775 6.08% 4 Alphatec Holdings ATEC $1.65 $148 -23.61% 5 Orthofix OFIX $39.03 $731 4.89% 5 Tornier N.V. TRNX $20.68 $818 -12.93% 6 Exactech EXAC $16.52 $218 3.96% 6 TranS1 TSON $2.94 $80 -12.82% 7 Integra LifeSciences IART $32.96 $890 2.30% 7 CryoLife CRY $4.69 $129 -9.98% 8 RTI Biologics Inc RTIX $3.56 $199 0.56% 8 Stryker SYK $50.26 $19,146 -9.38% 9 Johnson & Johnson JNJ $63.35 $173,983 0.14% 9 Zimmer Holdings ZMH $58.86 $10,367 -8.45% 10 ArthroCare ARTC $24.80 $686 -1.04% 10 Conmed CNMD $26.96 $763 -7.99% LOWEST PRICE / EARNINGS RATIO (TTM) HIGHEST PRICE / EARNINGS RATIO (TTM) COMPANY SYMBOL PRICE MKT CAP P/E COMPANY SYMBOL PRICE MKT CAP P/E 1 Medtronic MDT $36.96 $38,460 11.51 1 Wright Medical WMGI $19.71 $775 50.54 2 Zimmer Holdings ZMH $58.86 $10,367 11.94 2 NuVasive NUVA $18.73 $809 43.56 3 Johnson & Johnson JNJ $63.35 $173,983 12.62 3 Symmetry Medical SMA $8.32 $305 33.28 4 Stryker SYK $50.26 $19,146 13.19 4 Kensey Nash KNSY $38.39 $334 26.85 5 Orthofix OFIX $39.03 $731 13.99 5 Exactech EXAC $16.52 $218 23.27 LOWEST P/E TO GROWTH RATIO (EARNINGS ESTIMATES) HIGHEST P/E TO GROWTH RATIO (EARNINGS ESTIMATES) COMPANY SYMBOL PRICE MKT CAP PEG COMPANY SYMBOL PRICE MKT CAP PEG 1 Orthofix OFIX $39.03 $731 0.81 1 Wright Medical WMGI $19.71 $775 6.00 2 ArthroCare ARTC $24.80 $686 0.98 2 NuVasive NUVA $18.73 $809 4.50 3 Stryker SYK $50.26 $19,146 1.22 3 CryoLife CRY $4.69 $129 4.19 4 Zimmer Holdings ZMH $58.86 $10,367 1.28 4 Symmetry Medical SMA $8.32 $305 2.77 5 Integra LifeSciences IART $32.96 $890 1.34 5 Johnson & Johnson JNJ $63.35 $173,983 2.15 LOWEST PRICE TO SALES RATIO (TTM) HIGHEST PRICE TO SALES RATIO (TTM) COMPANY SYMBOL PRICE MKT CAP PSR COMPANY SYMBOL PRICE MKT CAP PSR 1 Alphatec Holdings ATEC $1.65 $148 0.75 1 TiGenix TIG.BR $0.60 $55 47.58 2 Symmetry Medical SMA $8.32 $305 0.85 2 MAKO Surgical MAKO $22.17 $944 11.17 3 Conmed CNMD $26.96 $763 1.05 3 Synthes SYST.VX $165.78 $19,691 4.96 4 Exactech EXAC $16.52 $218 1.06 4 Kensey Nash KNSY $38.39 $334 4.66 5 CryoLife CRY $4.69 $129 1.08 5 TranS1 TSON $2.94 $80 4.18 PSR: Aggregate current market capitalization divided by aggregate sales and the calculation excluded the companies for which sales figures are not available. Advertise with Orthopedics This Week Click Here for more details or email [email protected] Tom Bishow: 410.356.2455 (office) or 410.608.1697 (cell) 1-888-749-2153 | www.ryortho.com 4 VOLUME 8, ISSUE 17 | MAY 22, 2012 The 23 Top Foot & Ankle Surgeons in the U.S. By OTW Staff ho do other orthopedists want In alphabetical order, here are the top (AOFAS). He is also a founding mem- treating their feet? We asked! 23 foot and ankle surgeons in America. ber of the Foot & Ankle Institute at LeadersW in the foot and ankle realm OrthoCarolina. “He is the ‘go to guy’ let us know their thoughts on the top Ned Amendola, M.D. is professor and for professional athletes with foot and orthopedic surgeons in their subspe- director of the University of Iowa (UI) ankle problems. And he is just a very cialty. Sports Medicine Center. Dr. Amen- nice guy.” dola was named recipient of the Kim Here is that list. We don’t have “the mar- and John Callaghan Endowed Chair Donald E. Baxter, M.D. is an orthope- ket” on lists…this isn’t the be-all and in Sports Medicine by the UI in June dic surgeon with Athletic Orthopedics end-all list—but it is a list of who are 2009. “He is a superb team physician & Knee Center in Houston, Texas. He arguably the finest foot and ankle physi- with a good perspective on the field. He is also a past president of AOFAS. “He has a very practical way of managing cians, teachers, investigators or admin- has made significant contributions to the injured athlete.” foot and ankle, and in particular, he is istrators in the country. This informa- known for innovations in understand- tion was obtained via a telephone survey Robert B. Anderson, M.D. is an ortho- ing problems related to runners.” of thought leaders in the field. The infor- pedic surgeon with OrthoCarolina, and mation in quotes is what we heard about is a past president of the American James W. Brodsky, M.D. is an ortho- these surgeons. Orthopaedic Foot & Ankle Society pedic surgeon with Orthopedic Associ- Source: Wikimedia Commons and Pavlov by Repin 1-888-749-2153 | www.ryortho.com 5 VOLUME 8, ISSUE 17 | MAY 22, 2012 ates of Dallas, and is clinical professor rienced, and is known for his work with books, and helped develop the STAR of orthopaedic surgery at the University elite athletes.” ankle.