It’s exciting as a small company to lead the effort to develop something that we know can be disruptive and great for clinical care: Dr. Sharat Kusuma of JointMedica
The Silicon Review
“Our core focus areas as a Class III medical device designer and manufacturer encompass a range of critical aspects aimed at revolutionizing joint reconstruction and improving patient outcomes.”
The rise and fall of hip resurfacing has been widely documented, with more than a dozen hip resurfacing systems on the market in the mid-2000s. At the time, analysts predicted the procedure could potentially grow to 15 percent of the hip replacement market. However, the narrative around the implant and the procedure was hijacked by the metal-on-metal total hip replacement controversy that rocked the orthopaedic industry.
To overcome the ‘taboo’ of metal-on-metal, JointMedica’s Polymotion® hip resurfacing system is a monoblock, Vitamin E-infused, all-polyethylene acetabular component with a highly porous titanium back surface. The design was implanted in 174 patients from 2015 to 2022 and has an over 95 percent survival rate.
JointMedica is a small and autonomous company that designs and manufactures high-classification devices for the orthopaedic industry. It partners with respected orthopaedic surgeons, experienced engineers, and a variety of cutting-edge suppliers and partners.
The company is headquartered in Worcestershire, UK.
The Silicon Review contacted Dr. Sharat Kusuma, who serves as the Chief Strategy Officer and Chief Medical Officer of Exactech, a partner company of JointMedica, and here is his response.
Please provide a summary of the events that led to the founding of JointMedica.
The journey leading to the founding of JointMedica was rooted in a shared vision to enhance the currently accepted hip and knee arthroplasty interventions. Formed in 2000, JointMedica’s history can be traced back to Midland Medical Technologies (MMT) and the creation of the Birmingham Hip Resurfacing (BHR), the most clinically successful Hip Resurfacing of its time. Our association with the BHR’s principal designing surgeons Prof Derek McMinn and Mr. Ronan Treacy, along with our design and manufacturing consistency has placed JointMedica in an advantageous position relative to the unique understanding of Hip Resurfacing design, surgical procedure, and long-term functional results.
As an orthopaedic surgeon, I was fortunate early in my training at Rush University with Dr. Craig Della Valle, to be part of some of the very first BHR procedures performed in North America, in 2007-2008. These early formative experiences instilled a deep passion for bone-conserving hip arthroplasty in my clinical practice. I have personally witnessed in my patients the benefit from the procedure.
Fast forward to 2023, I now serve as Chief Strategy Officer and Chief Medical Officer at Exactech, where I lead our organization’s partnership with JointMedica to commercialize the Polymotion® Hip Resurfacing implant. Exactech previously acquired a minority interest in JointMedica and announced that Polymotion® received FDA Breakthrough Device Designation. Over the next five years, we plan to bring the device to multiple global markets.
Exactech is a developer and producer of innovative implants, instrumentation, and smart technologies for joint replacement surgery.
Q. As a designer and manufacturer of high-classification devices for the orthopaedic industry, what are JointMedica’s key focus areas?
Our core focus areas as a Class III medical device designer and manufacturer encompass a range of critical aspects aimed at revolutionizing joint reconstruction and improving patient outcomes. A crucial focus area is ‘Restoring Anatomy and Function’, with the ultimate aim of allowing patients to return to an unrestricted lifestyle following hip arthroplasty, especially for the younger more active patients, unlike many other conventional total hip arthroplasty or traditional metal-metal hip resurfacing devices currently available on the market.
Q. What strategies does JointMedica implement to maximize patient satisfaction?
We believe that volumes of existing clinical data demonstrate that hip resurfacing devices generate superior patient satisfaction and function versus conventional total hip replacement devices. We believe that bone conservation and anatomy preservation are concepts that all patients understand and prefer. This alignment with patient preferences drives patient satisfaction. We also like to place a strong emphasis on ‘Surgeon Training and Support’ as a key strategy, insisting proper surgical technique is crucial for successful outcomes, and by offering education and training, allowing surgeons to optimize their skills and familiarity with the products, resulting in smoother procedures and improved patient outcomes. We also have maintained direct contact with patients who have an interest in our technology. Having been on the surgeon’s side, no other companies had that level of patient engagement.
Q. Can you introduce us to your services? What are their primary features?
Pioneered by Prof Derek McMinn and Mr Ronan Treacy, Polymotion® Hip Resurfacing (PHR®) is the next iteration of his previous design, The BIRMINGHAM HIP Resurfacing (BHR). Hip Resurfacing restores the natural shape of the joint meaning better stability, longevity, and higher levels of activity than a traditional hip replacement.
In Total Hip Replacement, the femoral head (ball joint of the hip) is chopped off and replaced by a long, stemmed device, where very little of the proximal femur is retained. The procedure is successful in elderly, inactive patients. However, in some cases, the replacement hip joints wear out quickly in younger, more active patients, leading to potential revision surgery being required.
With the PHR® procedure, your surgeon removes less bone from the two articulating surfaces of the hip. One way of describing it is PHR® is like the way a tooth is capped with a crown instead of entirely replaced, and the femoral head is shaped to accept a low-wear metal sphere. This sphere matches your anatomy, reducing the risk of dislocation by offering a broad range of movement and excellent stability. The acetabular socket (cup joint of the hip) is then fitted with a corresponding polyethylene component. What is interesting is that when my patients would see pictures of a hip resurfacing x-ray side-by-side with a THA, all would prefer hip resurfacing.
A comprehensive range of sizes is offered to address the needs of most patients, even those with acetabular deficiencies. Both components are designed to be permanently implanted, to achieve reconstructive and functional replacement of the hip joint. The PHR® System is intended to offer the traditional benefits of hip resurfacing over total hip arthroplasties, such as bone conservation and restoration of natural biomechanics, without a metal-on-metal articulating surface.
Q. No doubt JointMedica is charting new territories in this segment. Given how frequently circumstances change, what plans for transformation are you pursuing to remain relevant now and in the future?
Exactech and JointMedica are using early clinical data and rigorous lab testing as we seek regulatory approval around the world. In the U.S., the companies are working closely with the FDA via the Breakthrough Device Designation program and hope to bring the device to the market in the next two to three years. Surgeons have also leveraged Canada’s Special Access Program (SAP) to conduct surgeries there. There’s a lot of interest in markets that we already serve, and we are strategically looking at those markets to keep one step ahead of future demand.
As we look to the future, we will also invest in new technologies that will assist with the procedure. These technologies will only make a great operation better.
Q. Is there anything you would like to add before we wrap up?
It’s encouraging to have witnessed a resurgence in hip resurfacing at academic meetings in the last couple of years. Surgeons are now realizing that resurfacing is a good operation and a safe operation for the right patient. I believe more companies will follow in our footsteps. It’s exciting as a small company to lead the effort to develop something that we know can be disruptive and great for clinical care.
About | Dr. Sharat Kusuma
Dr. Sharat Kusuma studied medicine and business at Vanderbilt University and completed orthopedic surgery training at the University of Pennsylvania School of Medicine, Rush University Medical Center, and Queens Medical Centre in the United Kingdom. He left practice to take on a role at McKinsey and Company in the healthcare provider, payor, pharma, and MedTech space. He then moved to Apple Inc., where he led the development of digital health product lines and partnerships between Apple and various healthcare companies. Today he is the Chief Strategy Officer and Medical Officer at Exactech, a TPG portfolio company, and leading the partnership with JointMedica. Having worked in nearly all areas of the healthcare system (payors, providers, pharma, MedTech, and academia) throughout his career, Dr. Kusuma has developed a deep understanding of the technology solutions needed to advance the healthcare industry.