Several years ago, when Memphis Tomorrow hired Battelle Memorial Institute to study how the Bluff City could best compete nationally in the bioscience industry, the company returned with well-defined strategies: hone Memphis' bioscience vision, market the city as a biomedical center, and grow specific medical sectors. Chief among them were concentrating on orthopedics and the medical device business, as well as enhancing an already strong research presence in that field. What the business plan neglected to factor in was the world market's economic tumble.

 

While the economy's slow down has certainly impacted the city's plans, doctors in the field of orthopedics remain optimistic that the current slump is just a bump in the road for one of Memphis' strongest exports.

 

The news of orthopedics strength comes as no surprise. Since Willis Campbell opened Campbell's Clinic in 1909 and later penned his surgical guide, Campbell's Operative Orthopedics in 1931, which is now considered the gold standard, Memphis has long been on the national stage in orthopedic care. The growth of the medical device industry is also directly linked to Campbell's impact on the market. Both Smith + Nephew and Wright's Medical can trace their lineage back to the mother ship. With the addition of Medtronics and several smaller device manufacturers, Memphis is second only to Warsaw, Indiana, when it comes to the production of artificial joints.

 

With the boomers marching toward retirement, "the numbers of people needing orthopedic care will potentially double or triple," noted James Beaty, MD, Campbell's chief of staff and author of Campbell's four-volume guide, as well as a handful of other books on orthopedics. "Boomers want to remain active into their 60s, 70s, and 80s, they want to continue their hobbies and sports," he said, and that demand for superior products is pushing research and development projects, as scientists and doctors labor over ways to improve the lifespan of joint implants.

 

Yet the trickle down of the recession has been felt by the orthopedic industry. People without the means to pay for elective surgeries to replace worn out knees and hips are opting instead to play through the pain. This particularly holds true for those who have wound up unemployed and uninsured by COBRA. While roughly 500,000 knee replacements and 175,000 hip replacements were completed last year, those figures will likely be smaller this year, but the continuing trend over the next several decades is upward.

 

"We see a lot of total hips and knees with the aging population, whether it's wear and tear or a fall or something like that," said Jeff Brown, director of physical therapy at Campbell Clinic, Inc., in a recent story in the Memphis Business Journal. "The baby boomer generation is certainly going to be a factor for the growth of our business."

 

However, Terry Canale, MD, said he has seen activity in orthopedics in Memphis "mushroom," over the past decade, something he attributes, in part, to the translational research that is taking place here. Bench research being done by scientists at the University of Memphis, University of Tennessee Health Science Center, and St. Jude Children's Hospital, as well as independent research outlets like InMotion Orthopaedic Research Center (which was a founded in response to the Battelle study), leads to the development of implant devices which can then be tested in clinical trials before being brought to market. Having those three components in place gives the city a competitive edge.

 

Another edge Memphis has is strong logistics. The FedEx distribution hub means manufacturers can respond swiftly to customer shipping demands. "FedEx can send products faster from here than anywhere else. We have an eight hour delivery edge over anyone else in the country," said Canale.

 

But other issues have tempered growth, particularly in the area of research and development. The Department of Justice's investigation into doctor/industry relationships — they have been trying to ascertain whether and/or how doctors benefited financially from work done with manufacturers — has brought about a host of new regulations and compliance guidelines. Those findings mean manufacturers are being forced to proceed with caution as they renegotiate relationships with doctors and more clearly forecast the direction of their research. "It's thrown the industry into turmoil," states Dick Tarr, an orthopedic industry veteran and executive director of InMotion Orthopaedic Research Center. "Government has set development back three to five years because of undue investigations. Companies have spent lots of money for oversight committees to oversee compliance."

 

Since industry has trimmed back research budgets or opted to do work in-house, Tarr said groups like InMotion are forced to knock on more doors. Philanthropic giving is down, and the Arthritis Foundation and the Tennessee Orthopedic Research and Education Foundation, two groups that typically give away thousands of dollars in research grants annually, last year accepted no funding proposals. Since InMotion is still too new to qualify for federal grant money, the start-up is experiencing growing pains. But thanks to a Plough Foundation matching grant of $150,000, Tarr is optimistic that they'll be able to solicit new funds and grow their research endeavors. "It will eventually turn around because there's a real need for orthopedic care, because a high number of people are affected by trauma, osteoporosis, and back pain. Many people have these issues and there need to be solutions."