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The Orthopaedic Forum   |    
SymposiumThe 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; 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 Journal of Bone & Joint Surgery.  2007; 89:1641-1649  doi:10.2106/JBJS.F.01185
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Extract

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.
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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