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AHF Podcast

Anterior Hip Foundation

The AHF Podcast features thoughtful conversations about orthopedic surgery, outcomes, and clinical decision-making, with a particular focus on hip surgery and related innovation.

Produced by the Anterior Hip Foundation, the podcast brings together surgeons, researchers, and clinical leaders to examine how evidence, experience, and real-world practice intersect. Episodes explore what the data actually shows, where assumptions break down, and how clinicians navigate uncertainty in daily practice.

This podcast is intended for orthopedic surgeons, trainees, and medically literate clinicians who value nuanced discussion, critical thinking, and honest examination of what improves patient care.

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23 episodes
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Avg 40 min
English

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S3 · E30
Friday · 1 hr 13 min
JointMedica & the Hip Resurfacing Comeback
Send us Fan Mail Hip resurfacing was written off after the metal-on-metal era — but the patients kept coming back happy. Two surgeons who never stopped offering it explain what changed, and what a vitamin E polyethylene bearing does to the failure mode that ended it. For hip surgeons weighing whether resurfacing belongs in their toolkit, and for anyone interested in where orthopedic implant innovation actually comes from. Sharat Kusuma left clinical practice to lead JointMedica as CEO, developing the PolyMotion resurfacing device. Craig Della Valle, of Rush University Medical Center in Chicago, took Sharat on as a fellow nearly twenty years ago and is now an investigator in the device's IDE study. Both learned the operation in the Birmingham era — Craig with Derek McMinn, Sharat during six months in England with McMinn, Ronan Treacy and Andrew Manktelow. Neither of them skips the hard parts. Craig is candid about revising his own metal-on-metal failures, about resurfacing taking longer and paying the same as a total hip, and about how much of the case rests on results he cannot randomize. Sharat argues the real ceiling is instrumentation rather than the operation, and that implant companies — not surgeons — should carry the burden of making a difficult procedure easy. They disagree, usefully, about how familiar the PolyMotion cup will feel the first time a surgeon picks it up. A long stretch of the conversation is about the anterior approach specifically: whether resurfacing is harder or easier from the front, what the capsulotomy actually demands, and why centering the guide pin in the femoral neck is the step still waiting to be solved. If you do anterior approach hips and have wondered whether resurfacing is a reasonable extension of what you already do, start there. ⏱️ Chapters: 00:00 Why hip resurfacing is getting a second look 02:40 The problem a stemmed total hip still doesn't solve 05:29 Learning resurfacing in Birmingham and the first 20 cases 08:50 Dislocation, fracture and infection rates in resurfacing 13:55 The coming wave of periprosthetic fractures 19:20 Practicing through the metal-on-metal fallout 27:17 Is hip resurfacing niche? Sizing the candidate pool 33:22 Inside PolyMotion's vitamin E polyethylene bearing 40:50 Why cup stiffness affects acetabular bone response 45:02 Anterior approach resurfacing: synergy, not rivalry 55:36 Centering the guide pin and avoiding neck fracture 1:05:15 Telling a surgical fad from a real advance Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AHFPodcast #AnteriorHipFoundation #HipResurfacing #PolyMotion #JointMedica #AnteriorApproach #HipArthroplasty #MetalOnMetal #BHR #VitaminEPolyethylene #IDEStudy #SharatKusuma #CraigDellaValle
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S3 · E29
August 21 · 1 hr 14 min
Managing Instability in AA Hips (S+N Surgeon Roundtable)
Send us Fan Mail Dislocation after anterior approach total hip replacement still runs around 2% in the first two years — so what actually moves that number? Three hip surgeons work through instability prevention end to end, from the first clinic visit to the final construct. The anterior approach has pushed dislocation rates in the right direction, but it has not solved instability — and the belief that it has is where surgeons get caught. In this roundtable, Jeff Barry, Blair Ashley, and Chance Gray work through what the database and registry literature actually show, why anterior approach hips come out the front and the back rather than predictably out the back, and how much of that risk is genuinely modifiable. The conversation gets specific quickly. They disagree productively on whether instability risk can be optimized in the patient at all, or whether it is simply a surgeon's problem to engineer around. They cover cup targets in the setting of hip-spine mismatch, what a standing AP film really tells you, the intraoperative stability checks each of them refuses to skip, and how to escalate a construct — head size, lateralized liners, offset and length, dual mobility — without letting the most constrained option become the default. This one is for arthroplasty surgeons, fellows, and residents building their own instability algorithm, and for anyone who has looked at a well-positioned cup on a postoperative film and wondered what they missed. It closes with each surgeon's single piece of advice for avoiding that lesson the hard way. ⏱️ Chapters: 00:00 Introduction and what the data says about dislocation 03:47 Why instability prevention starts in the clinic 05:57 Cup position first when diagnosing an unstable hip 08:30 How anterior and posterior hips dislocate differently 12:34 Instability risk after revision anterior approach surgery 14:28 Counseling patients on dislocation risk and risk factors 19:14 Why instability is a surgeon problem, not a patient problem 22:55 Planning for hip-spine mismatch in anterior approach hips 27:32 Explaining the hip-spine relationship to patients 31:48 Where CT-based planning tools fit into instability risk 35:09 Dual mobility and high offset stems for high risk patients 40:22 Non-negotiable stability checks before you close 45:32 Intraoperative red flags and navigation beyond fluoroscopy 50:04 Escalating head size, lateralized liners, and offset 56:24 Are constrained liners obsolete in the dual mobility era 1:00:43 An end-to-end instability prevention algorithm 1:07:39 Parting advice on preventing dislocation Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. This episode was recorded in partnership with Smith+Nephew — Life Unlimited. Learn more at https://www.smith-nephew.com The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #HipInstability #HipDislocation #TotalHipArthroplasty #THA #AnteriorApproach #DualMobility #Spinopelvic #RevisionHipArthroplasty #ConstrainedLiner #JeffBarry #BlairAshley #ChanceGray
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S3 · E28
August 14 · 57 min
The 2026 Shark Tank Winners Rethinking Surgical Imaging
Send us Fan Mail What if the C-arm you already own could show you the entire pelvis — in real time, with less radiation? The winners of the 2026 AHF Shark Tank believe it can, and they built the system to prove it. Dr. Dean Cole, an orthopedic trauma surgeon with roughly 40 patents and designs licensed across the industry, and Scott Banks, PhD, who has spent nearly four decades quantifying how joints actually move under fluoroscopy across more than 200 published papers, join Joe Schwab to tell the story of Orthopedic Driven Imaging (ODI) — the company born from a 2022 cold call — and SODI, their FDA-cleared imaging platform that retrofits the GE OEC C-arms already sitting in an estimated 22,000 operating rooms. The conversation traces both founders' paths: Dean's trauma training under Jeff Mast and a lifetime of problem-solving inherited from a space-program father; Scott's route from pre-med engineer to Mako-era implant design and a career asking how knees and hips really move. Together they explain why surgical planning and postoperative confirmation have advanced dramatically while the middle of the operation stayed fuzzy — and what a full-field-of-view detector changes for anterior approach hip replacement: pelvis alignment from a video camera in the collimator, fewer scout shots, less radiation, and femoral offset you can actually measure. They also get practical about adoption: what they'd say to the surgeon who trusts their current imaging, why anterior hip and spine come first while the joint-kinematics vision matures, and what they're looking for from early-adopter surgeons (orthodriven.com). ⏱️ Chapters: 00:00 Introduction: the AHF Shark Tank winners 01:35 Pitching surgeons live at AHF 2026 04:33 Dean Cole: trauma, Jeff Mast, and 40 patents 07:12 Scott Banks: an engineer's toolbox for medicine 09:02 What we still can't see about joint motion 11:31 The 2022 phone call that started ODI 15:33 A founding team built by serendipity 18:13 Two decades of C-arms, nav, and robotics 21:30 What robotics does well — and the ill-defined target 26:56 Full field of view, less radiation, same workflow 30:55 Retrofitting the C-arm you already own 34:16 What early ODI cases taught Dean 36:11 Why anterior hip (and spine) come first 38:29 To the surgeon who trusts their current setup 40:09 Hip replacement five years from now 41:16 What ODI wants from early adopters 44:08 Taking risks late in a career 49:50 Advice for surgeon-innovators in training 53:06 What they hope patients never have to know Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com Guest company: https://orthodriven.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #TotalHipArthroplasty #THA #AnteriorApproach #HipReplacement #Fluoroscopy #SurgicalImaging #OrthopedicInnovation #SharkTank #DeanCole #ScottBanks #ODI #OrthopedicSurgery
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S3 · E27
August 7 · 55 min
Operation FUBAR: Eight Challenging Hips with Nick Mast
Send us Fan Mail What do you do when the foot slips out of the traction boot mid-case — and a manageable periprosthetic fracture becomes a femur in pieces? Dr. Nick Mast has an answer, because it happened to him. Nick Mast, a hip and pelvis surgeon in private practice in San Francisco, trained under Joel Matta at the Hip and Pelvis Institute in 2007–2008 and completed hip preservation training in Europe. He's also a second-generation surgeon — son of fracture-surgery pioneer Jeff Mast — and his practice runs heavy on the cases other surgeons send away: complex trauma, revisions, non-unions, and malunions. For this Operation FUBAR episode, he brings a career's worth of them. The case series spans a 35-year-old malunited both-column acetabular fracture with protrusio (in a yoga instructor), the reverse femoral-head grafting technique he learned from Frédéric Laude in Paris, bilateral Crowe IV high hip dislocations, converting a failed PAO in a Perthes hip, post-traumatic arthritis with intrapelvic hardware, geriatric acetabular fractures treated with fix-and-replace, simultaneous bilateral Perthes replacements — and the recent one: an osteoporotic periprosthetic fracture revision where the foot came out of the boot and the leg fell, comminuting the diaphysis mid-case. The most valuable part may be what happens around the surgery: how Mast keeps a room calm by lowering his voice instead of raising it, the pack-the-wound pause he learned from his father, the mid-case calls to trusted colleagues that produced the solution, how he reads bone quality on a plain radiograph (the "third-third-third" rule), and why his practice has shifted toward French-paradox cementing. For anterior approach surgeons, fellows, and residents, this is a masterclass in complex hips — and in composure. ⏱️ Chapters: 00:00 What Operation FUBAR is 01:01 Introducing Dr. Nick Mast 03:06 A both-column fracture, 35 years later 06:05 Restoring the hip center in protrusio 08:46 The reverse femoral-head grafting technique 13:27 Reduce, reuse, recycle: step by step 17:29 Bilateral Crowe IV: who needs a subtroch? 19:34 Low, small, and medial — the dysplasia mantra 21:09 An SROM for ninety degrees of anteversion 24:05 Converting a failed PAO in a Perthes hip 27:05 Intrapelvic hardware from the front 29:08 Geriatric acetabular fracture: fix and replace 33:37 Bilateral Perthes, done simultaneously 35:21 The hardest call: length in unilateral Perthes 37:33 A periprosthetic fracture goes FUBAR 40:56 The foot comes out of the boot 43:59 Staying calm when the case falls apart 46:34 Pack the wound, phone a friend 48:55 Reading bad bone; the case for cement 51:39 Advice to a younger Nick Mast Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #OperationFUBAR #TotalHipArthroplasty #THA #AnteriorApproach #HipReplacement #AcetabularFracture #PeriprostheticFracture #Dysplasia #CroweIV #Perthes #NickMast #OrthopedicSurgery
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S3 · E26
July 31 · 57 min
Complex primary THA with AA (S+N Surgeon Roundtable)
Send us Fan Mail What do you do the moment a calcar crack appears? Where does the cup go when the spine won't move? And which complex primary belongs in an ASC — and which one absolutely doesn't? This episode launches a six-part surgeon roundtable series recorded in partnership with Smith+Nephew — peer-to-peer conversations aimed at one thing: practical, reproducible techniques you can take back to your operating room. First up, the complex primary total hip: severe dysplasia, post-traumatic anatomy, obesity, osteoporosis, and Dorr A femurs — the hips where the margin for error shrinks and the plan gets tested. Three guests join Joe Schwab: Dr. Jessica Hooper, who leads an outpatient joint program and knows what complex work can be done safely in an ASC; Dr. Stephen Duncan, who operates from hip preservation through revision and sees exactly which traps in a primary set up the revision that follows; and Dr. Chad Watts, a high-volume hip surgeon focused on making every step repeatable. The conversation gets concrete fast: structured planning two weeks out (CT for version, long-leg standing films — "hope is not a plan"), go/no-go criteria for the anterior approach, the low-small-medial cup strategy in dysplasia versus the oversized-cup trap, locking-screw cups in deficient bone, why triple-taper stems changed the fracture picture, automated impaction, the full decision framework for an intraoperative calcar crack, controlled medialization under fluoro (and the case for sharp reamers), where each surgeon falls on the spinopelvic spectrum, when dual mobility earns its place, and what changes between ASC and hospital workflows — including how to teach plan B and plan C so, as Dr. Duncan puts it, "plan C should not be chaos." ⏱️ Chapters: 00:00 A new roundtable series 02:06 Keeping high-risk primaries safe in an ASC 02:59 The step Chad Watts never skips 04:08 The traps that set up tomorrow's revision 05:05 What dysplasia and post-trauma change in the plan 07:39 When not to go anterior 09:00 Non-negotiables: templating, version, limb length 10:25 "Hope is not a plan": CT and long-leg films 11:41 Restoring the hip center without over-lengthening 15:09 A preservation mindset in dysplasia 16:51 Dorr A femurs: exposure and broaching principles 18:17 Where fractures happen — and how to prevent them 19:57 Intraoperative cues to slow down 23:00 Stem design, triple tapers, and automated impaction 28:18 Calcar crack: the decision framework 34:33 Keeping the room calm and controlled 35:39 Avoiding over-reaming in compromised bone 37:21 Hitting narrow cup targets under fluoro 40:13 How much does spinopelvic mobility matter? 44:01 Where dual mobility earns its place 46:24 Reproducible workflows: ASC vs. hospital 50:23 "Plan C should not be chaos" 51:48 Closing advice: mindset shifts and patient selection Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This episode was recorded in partnership with Smith+Nephew — Life Unlimited. Learn more at https://www.smith-nephew.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #TotalHipArthroplasty #THA #AnteriorApproach #HipReplacement #Dysplasia #CalcarFracture #DorrA #DualMobility #SpinopelvicMobility #OutpatientSurgery #SmithNephew #OrthopedicSurgery Smith+Nephew We design and manufacture technology that takes the limits off living. Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.
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S3 · E25
July 24 · 25 min
From Idea to Market: Ep 12 - From Here, It's Yours
Send us Fan Mail In the finale of From Idea to Market, the surgeons, engineers, founders, attorneys, and investors who lived every stage of medical device innovation look back and answer one question: what do they wish they had known from the start? Across this series, one pattern kept surfacing: innovation doesn't begin with a business plan. It begins with a clinical problem someone can't let go — a resident watching a procedure that felt inadequate and carrying that feeling for twenty-five years, or a physician-turned-founder who couldn't stop thinking about a patient who lacked what she needed. In this closing episode, Robert Cohen reflects on four decades in med tech and the permission to say "I don't know." Alexander Sah describes the emotional rollercoaster of introducing new technology — and knowing when to abandon an idea. Charlie DeCook and Simon Mifsud explain why the idea itself is never the advantage. Charles Lawrie distills the whole journey into a playbook: start with a problem you live, build with people who know what you don't, think big but execute small. Leo Whiteside talks about protecting intellectual property, standing alone on panels, and why the work is "a very joyful thing to do." Emily Ast and Marie-Isabelle Batthyány close with the tests that matter: the right team, the family at the dinner table, and a real need — not an imagined one. If there's a problem in your practice that keeps coming back to you, this episode is the series' parting argument for taking it seriously. From here, it's yours. ⏱️ Chapters: 00:00 Introduction: what the series taught us about innovators 02:54 The problem you can't let go: where innovation begins 07:13 What innovation demands: vulnerability and listening 09:42 The emotional rollercoaster of device development 11:29 Why the idea is not the advantage: iteration and teams 13:55 Charles Lawrie's playbook: start with a problem you live 16:52 Leo Whiteside on opposition, IP, and the joy of the work 19:04 Legal, financial, and family support for innovators 20:33 Real needs, not imagined ones: the test of every device 22:03 From here, it's yours: a challenge to the next innovator Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #MedTech #MedicalDevices #HealthcareInnovation #OrthopedicSurgery #SurgeonEntrepreneur #DeviceDevelopment #MedicalInnovation #FromIdeaToMarket #StartupAdvice #HipReplacement
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S3 · E24
July 17 · 28 min
From Idea to Market: Ep 11 - Built to Last or Built to Sell?
Send us Fan Mail Is your med tech company built to last, or built to sell? Voices from inside Stryker, XRSynergies, FIOS Health, and physician contract law explain why exit strategy is a design choice founders make on day one — whether they realize it or not. In 2024, med tech M&A reached a record $474 billion in global transaction value. For most successful device startups, the path to broad patient reach runs through acquisition — and that reality shapes how experienced founders structure their companies from the moment of incorporation. Corporate form, consulting agreements, equity design, and quality systems all encode an implied destination long before an acquirer ever calls. Robert Cohen (VP of Innovation & Technology, Stryker Orthopedics) describes how acquisition conversations actually unfold — why the clinical case comes before any discussion of cost of goods or time to market, and how incorporating as a C corporation from day one made his second company's acquisition by Mako Surgical dramatically easier. Marie-Isabelle Batthyány (founder & CEO, XRSynergies) explains building a company that is "easy to take over," from phantom share programs to diligence-ready quality management. Attorney Emily Ast unpacks the shift from long royalty streams toward milestone-based deal structures, and Charles Lawrie (co-founder, FIOS Health) makes the case for clinical validation as the founder's contribution, with commercial scaling left to the acquirer. Whether you're a surgeon with a device idea, a founder weighing an LLC against a C corporation, or a clinician curious how acquisitions preserve or lose the clinical knowledge behind a product, this episode maps the decisions that determine what your company becomes. ⏱️ Chapters: 00:00 Introduction: exit as a design choice, not a finish line 03:00 Meet the founders, acquirers, and attorneys 05:06 Early structural choices that define what a company becomes 06:04 What a med tech acquirer is actually buying 08:12 How acquisition conversations start: the clinical case first 10:24 Structuring a startup to be acquisition-ready 12:57 Path dependency: early decisions that get expensive to reverse 14:17 Why a C corporation from day one speeds diligence 16:31 Royalties vs milestone payments in med tech deals 19:34 Why acquisitions underperform: knowledge transfer and retention 24:18 Building to sell: clinical validation vs commercial scale Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #MedTech #MedicalDevices #MedTechAcquisitions #ExitStrategy #MedicalDeviceStartup #OrthopedicSurgery #HealthcareInnovation #DeviceDevelopment #FromIdeaToMarket #Stryker
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S3 · E23
July 3 · 43 min
Operation FUBAR: One-in-Six-Million Bone
Send us Fan Mail What do you do when the greater trochanter shears off during a routine hip replacement — and the bone is too soft to hold a screw? Dr. Jeff Barry of UCSF walks through two intraoperative disasters in the same patient, and how he salvaged both. Jeff Barry, who directs the Hip and Knee Arthroplasty Fellowship at UCSF and co-directs the Arthroplasty for the Modern Surgeon course, joins Joe Schwab for an Operation FUBAR case review most surgeons will recognize with a wince: a frail 75-year-old retired nurse with a rapidly collapsing hip, leukemia, low platelets, and osteoporosis so severe her DEXA T-score came back at -5.1 — statistically about one in six million. On the first side, the trochanter shears off during a femoral exposure Barry has performed thousands of times. On the second side a year later — after a missed femoral neck fracture — a gently tapped multi-hole cup punches straight through the medial wall. Barry talks through the decision-making in both moments: when less is more, how locking-screw revision cups can function as an internal cage, and why the "trap side" of a case is often the one you weren't worried about. The conversation goes beyond technique into how surgeons process intraoperative complications — stepping back from the wound to game-plan, communicating with anesthesia before cementing in a pulmonary patient, protecting the next case on the schedule, and the value of a "confessional" text thread with trusted colleagues. For arthroplasty surgeons, fellows, and residents, this is an honest look at what severely osteoporotic bone can do to even a well-planned primary. ⏱️ Chapters: 00:00 Introduction and guest background 01:31 Frail elderly patient with a rapidly collapsing hip 03:37 Planning a cemented hip in severe osteoporosis 06:21 Greater trochanter shears off during femoral exposure 08:00 How surgeons react when a case goes wrong 13:27 What a T-score of -5.1 means for hip surgery 14:42 Missed femoral neck fracture in the opposite hip 16:44 Acetabular cup punches through the medial wall 19:21 Salvaging a failed cup with locking screws 24:45 Managing pelvic discontinuity as the rescue surgeon 28:46 Knowing when to call for help in the OR 33:33 Teaching trainees through intraoperative complications 40:12 Debriefing and the surgeon confessional after complications Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #TotalHipArthroplasty #THA #AnteriorApproach #HipReplacement #Osteoporosis #RevisionHipSurgery #FemoralNeckFracture #PeriprostheticFracture #CementedStem #PelvicDiscontinuity #JeffBarry #OrthopedicSurgery
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S3 · E22
June 26 · 21 min
Mapping How the World Really Does Hip Replacement
Send us Fan Mail How does hip replacement practice really differ from one country to the next? Researcher Irrum Afzal joins the AHF Podcast to discuss the Global Arthroplasty Practice Survey (GAPS) — the first effort to map how surgeons worldwide actually perform total hip replacement. Despite roughly seventy years of modern hip replacement, there's still no global consensus on the fundamentals — surgical approach, fixation, bearing surface, or the perioperative pathway. National joint registries capture some of this, but their coverage and data quality vary widely, and many countries have no registry at all. The result is that we know surprisingly little about how the operation is actually performed around the world. Irrum Afzal, a researcher at Imperial College London and a digital health transformation specialist, is working to close that gap. Co-led with Professor Richard Field, GAPS asks surgeons of every volume and career stage to describe their real preoperative, intraoperative, and postoperative practice. It takes under ten minutes, covers the full patient journey, and is built to feed a long-term dataset that machine learning can eventually turn into research priorities and a working global consensus. Along the way, Irrum explains how her study on the accuracy of National Joint Registry revision data shaped her thinking about data quality, why anterior approach adoption ranges from around 1% in the UK to 56% in the US, and what surgeon-reported practice data can add to what registries already collect. If you perform hip replacement, your answers help build the first real worldwide picture of the field — and the survey is open through 30 June. Take the Survey Here: https://tinyurl.com/GAPSHIPS Visit the Working Group: https://www.globalarthroplastypractice.com/ ⏱️ Chapters: 00:00 Introduction and guest background 01:40 How a public health researcher moved into orthopaedics 02:48 Why hip revision registry data is often inaccurate 04:46 What the Global Arthroplasty Practice Survey measures 07:14 Why hip replacement practice still varies worldwide 08:42 Who runs GAPS and how to join the working group 10:08 Why surgeons should take the survey and what they gain 13:18 Using AI to turn survey responses into research priorities 14:01 How many responses GAPS needs and the June 30th deadline 16:50 What success looks like and sharing data with registries 19:05 Presenting GAPS results at the European Anterior Hip Meeting Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #HipReplacement #TotalHipArthroplasty #THA #AnteriorApproach #JointRegistry #NationalJointRegistry #OrthopaedicResearch #GAPS #IrrumAfzal #HipRevision #ArthroplastyData
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S3 · E21
May 22 · 32 min
From Idea to Market: Ep 10 - What Breaks at Scale
Send us Fan Mail What real-world use reveals about a medical device that no clinical trial ever could — and why the most dangerous moment in med tech innovation often comes after success, not before. A conversation about the fatigue failures, reimbursement gaps, and feedback breakdowns that surface only at scale. For ten episodes, the From Idea to Market series has followed medical innovation through every threshold an idea must survive — the first clinical insight, the years of iteration, the funding rounds, the regulatory climb, the investor's decision room. Episode 10 asks what happens after all of that succeeds. When a product is working, when demand is building, when expectations have risen, what new vulnerabilities does that very success create? Joe Schwab is joined by four voices who have lived this stage from different positions. Jared Foran is an orthopaedic surgeon in Denver and co-founder and chief scientific officer of Forcast Orthopedics. Doug Fairbanks is the president, CEO, and board member at VISIE Inc. Charlie DeCook is the president of Total Joint Specialists, a 17-surgeon group in Atlanta. Robert Cohen is the vice president of innovation and technology for Stryker's orthopaedic group, with four decades of watching the commercial environment for med tech innovation shift around him. The episode works through three questions: what does real-world use reveal that no development program ever can, which structural and commercial weaknesses surface only at scale, and how do teams build the organizational discipline to act on what the market tells them. The conversation moves from product iteration after launch, to the second valley of death between regulatory clearance and reimbursement, to the feedback loops inside an organization that determine whether real-world signals reach the people who can act on them. For surgeon-founders, for engineers in med tech, and for anyone trying to understand why so many clinically promising ideas stall after they reach the market, this episode is about what scale actually demands. ⏱️ Chapters: 00:00 What happens to medical devices after they reach the market 02:53 Surgeons and industry leaders who scaled med tech innovations 04:35 The fatigue failure principle applied to medical devices 06:05 What real-world use reveals that clinical trials never can 09:15 Why most med tech products require a major pivot post-launch 11:33 How to sustain commercial momentum after launch 14:32 The second valley of death between clearance and reimbursement 16:13 Inside the new FDA-CMS RAPID coverage pathway 17:36 How reimbursement uncertainty kills good clinical ideas 22:35 Building feedback loops before scale exposes the gaps 25:39 Why launch is the start of development, not the end 30:55 Preview: built to last or built to sell Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #anteriorhipfoundation #AHFPodcast #MedTech #MedTechInnovation #FromIdeaToMarket #PostMarketSurveillance #MedicalDevices #Reimbursement #FDA #ValleyOfDeath #Stryker #OrthopedicSurgery
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S3 · E20
May 19 · 23 min
FITM Extended Interview: Alexander Sah
Send us Fan Mail Alex Sah on what it actually takes for a practicing surgeon to develop new orthopaedic tools — from first idea to OR adoption. An honest conversation about mentors, mistakes, AI, and knowing when to walk away from a collaboration. Most surgeons spot problems in the OR daily and quietly adapt to the limits of existing tools. Alex Sah, a high-volume hip and knee surgeon in Silicon Valley and Chief Medical Officer at Think Surgical, has chosen instead to engage directly with industry — first as an evaluator, then as an advisor, and eventually as a design partner. In this conversation with Joe Schwab, he walks through how that progression actually works in practice, and why he thinks every surgeon with a good idea owes it to themselves to start the process now rather than later. The discussion gets practical fast. Alex breaks down how to vet an idea with a mentor and a patent search, why timing and portfolio fit can make or break a great concept, how to set milestones that let you walk away gracefully from a stalled collaboration, and why the technologies that succeed are usually the ones that speak for themselves the first time a surgeon uses them. He also shares a small habit with big implications — keeping his OR team blinded when testing new products to neutralize the placebo effect that quietly distorts informal evaluations. The conversation closes on AI's inevitable arrival in orthopaedics, the surgeon's role in shaping it before it gets shaped for us, and the AHF Shark Tank as a live laboratory for the From Idea to Market journey. If you've been sitting on an idea, or wondering whether to take that next call from a device rep with a prototype, this episode is a realistic map of the road ahead. ⏱️ Chapters: 00:00 Introduction and Silicon Valley innovation roots 01:02 Why surgeons should solve problems instead of adapting 03:25 Surgeon roles in product development 04:24 First steps for surgeons with no industry connections 05:41 Turning a clinical idea into a development concept 06:46 Setting milestones and knowing when to walk away 08:01 Lessons from working with Think Surgical 10:50 Evaluating new surgical technology objectively 12:14 Essential advice for first-time surgeon innovators 15:47 Why surgeons must help shape AI in orthopaedics 17:40 Inside the AHF Shark Tank for surgical innovation Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #AlexanderSah #SurgeonInnovator #MedicalDeviceDevelopment #ThinkSurgical #Ospitek #OrthopaedicInnovation #JointReplacement #HipAndKneeSurgery #AIinSurgery #FromIdeaToMarket #MedTech #SurgicalRobotics
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S3 · E19
May 15 · 33 min
From Idea to Market: Ep 9 - Inside the Decision Room
Send us Fan Mail What med tech investors and strategic acquirers actually evaluate when a founder walks into the room — and what separates the pitches that earn capital from those that don't. A conversation drawn from people who've sat on both sides of the table. For nine episodes, the From Idea to Market series has followed innovation from the founder's perspective — the problem noticed in a clinic, the iteration through years of prototypes, the regulatory climb, the manufacturing scale-up. Episode nine flips the lens. For the first time, the conversation moves into the room where decisions about that founder get made: by investors, by strategic acquirers, by the people whose capital and reputation come along with a yes. Joe Schwab is joined by voices who've lived this evaluation from every side. Charles Lawrie is a co-founder and chief medical officer at FIOS Health and the current president of the Anterior Hip Foundation. Charlie DeCook is the president of Total Joint Specialists and has watched dozens of Shark Tank pitches at AHF annual meetings. Alex Sah is past AHF president, chief medical officer at Think! Surgical, and chief innovation officer at Ospitek. Robert Cohen, vice president of innovation and technology for Stryker's orthopaedic group, has spent four decades evaluating med tech ideas from inside startups and from inside one of the largest companies in the field. The episode unpacks three questions: what truly drives the decisions made behind closed doors, how clinical value and financial logic and strategic interest actually intersect in real time, and which kinds of narrative survive due diligence — and which collapse the moment scrutiny begins. For surgeon-founders preparing to pitch, for clinicians thinking about their first innovation, and for anyone curious about how med tech capital actually gets allocated, this episode lays out what the decision room is really testing. ⏱️ Chapters: 00:00 Why this episode flips perspective from founder to investor 02:42 Surgeons and industry leaders inside the med tech decision room 04:46 What investors actually look for in a med tech pitch 08:23 How to structure a 15-minute med tech pitch 13:30 Where clinical value, profit, and strategy intersect 15:30 Why a great med tech idea can fail to scale 18:36 Why founders should pitch with a CEO at their side 22:02 How honest narrative wins under due diligence scrutiny 26:40 Stick to your competency: advice from a Stryker VP 29:12 What the decision room is really testing 31:43 Preview: when scaling success threatens to break the company Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #MedTech #MedTechInnovation #FromIdeaToMarket #MedicalDevices #MedTechInvesting #OrthopedicSurgery #StartupPitch #VentureCapital #Stryker #SharkTank
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S3 · E18
May 12 · 31 min
FITM Extended Interview: Charles Lawrie (FIOS Health)
Send us Fan Mail Charles Lawrie, MD — president of the Anterior Hip Foundation and a high-volume anterior approach hip and robotic knee surgeon in Miami — walks us through how a frustration in his own clinic became FIOS Health, an AI-powered patient communication platform now used in orthopaedic practices across the United States. This is an extended From Idea to Market conversation about the often lonely process of turning a clinical observation into a commercialized med-tech product, and what surgeons should know before they try. Most surgeons see the same pattern every week: a flood of routine post-op questions about swelling, walking, showering, and driving that consumes clinic staff and amplifies patient anxiety. Lawrie's argument is that the bottleneck isn't surgical expertise — it's access to timely, trusted information, and that scaling that information is a fundamentally different problem than scaling clinical capacity. We get into why he chose an AI-first product layered on familiar SMS and WhatsApp instead of yet another app, how he found a complementary co-founder in engineer and serial entrepreneur Andrew McDaid, what he had to unlearn to translate clinical expertise into product-market fit, and where FIOS Health is heading next — from answering patient questions to acting as an intelligence layer for the entire clinic. If you're a surgeon thinking about innovation, this is a candid look at what it actually involves: starting with a problem you live every day, resisting the urge to build alone, defining a minimum viable product, and sitting with the daily self-doubt that comes with taking an idea to market. https://fioshealth.com/ ⏱️ Chapters: 00:00 Introducing Charles Lawrie and FIOS Health 01:14 Why patients struggle with information access after surgery 03:26 Solving staff scarcity and patient anxiety at the same time 05:43 Why AI plus SMS beats yet another patient app 08:53 Turning a clinical observation into a startup 13:07 The mahogany desk vision for patient care 18:21 Finding product market fit in a busy clinic 22:41 How FIOS becomes a surgeon's digital twin 26:50 Advice for surgeons who want to build a company 29:43 The intelligence layer for the entire clinic Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #FIOSHealth #CharlesLawrie #FromIdeaToMarket #MedTechStartup #OrthopaedicInnovation #AIinHealthcare #PatientEngagement #HipArthroplasty #SurgeonEntrepreneur #DigitalHealth #ClinicalWorkflow
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S3 · E17
May 8 · 38 min
From Idea to Market: Ep 8 - Built to Run
Send us Fan Mail What does it actually take to move a medical device from a working prototype to a product that can be built reliably at volume? In this episode of From Idea to Market, surgeons, founders, and attorneys describe the discipline that separates an approved device from a scalable company. Most medical device teams underestimate what happens after a prototype works. Manufacturing at scale is a different problem from manufacturing at all, and the assumption that the hard work is done once the device is validated tends to be the most expensive miscalculation in med tech. This episode unpacks the transition from a hand-tuned engineering project to a controlled, reproducible production system, and why the process itself, not the device, becomes the real product. Jared Foran of Forcast Orthopedics, Leo Whiteside, Marie-Isabelle Batthyány of XRSynergies, Charles Lawrie of FIOS Health, Charlie DeCook of Total Joint Specialists, attorney Emily Ast, and Simon Mifsud of Garland Surgical share what they have learned from inside this transition. The conversation covers ISO 13485, design for manufacturability, supplier qualification, the economics of hardware versus software, supply chain design as part of the device itself, the kinds of problems that only surface at volume, and the contract clauses that quietly determine whether a successful product remains a fair deal once it scales globally. If you build, fund, regulate, or use medical devices, this episode is for you. It is the part of innovation that gets the least attention and decides the most outcomes — the daily, unglamorous work of building systems reliable enough that the product performs the same way every time, no matter who is in the room. ⏱️ Chapters: 00:00 Why scaling production breaks medical devices 02:57 Meet the founders, surgeons, and attorneys 05:30 What design freeze means in medical devices 06:46 Why the process becomes the product, not the device 09:32 Bringing manufacturing partners in before design freeze 12:18 The three-times rule of medical device development 15:59 Quality, cost, and scalability at production scale 18:02 Why hardware med tech is harder than software 20:18 Designing surgical kits for real-world supply chains 25:22 Problems that only emerge at production volume 28:11 Why founders should titrate the speed of scale 30:45 IP clauses and royalty timing for global products 34:58 What scale really proves about a medical device company Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #FromIdeaToMarket #MedTech #MedicalDeviceDevelopment #ISO13485 #DesignForManufacturability #DFM #QualityManagementSystem #MedTechScaling #OrthopedicInnovation #SurgicalInnovation #MedicalDeviceManufacturing #MedTechFounders
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S3 · E16
May 1 · 35 min
FITM Extended Interview: Emily Ast
Send us Fan Mail There is no such thing as an off-the-record innovation discussion. Even a casual conversation over drinks can create a factual record of idea sharing that impacts patent ownership, joint development leverage, and your negotiating position for years. Emily Ast, a contract attorney whose practice is 75 percent orthopedics, explains exactly what surgeon innovators need to know before they say a word to anyone — including friends and family. Ast breaks down the two main contract types innovators encounter: general consulting agreements and intellectual property development agreements. She identifies the single clause she sees surgeons consistently underestimate — the product or project scope definition — and shows how a description that is even slightly too broad can transfer far more IP than intended while limiting what the innovator can do with other companies. She walks through how work orders and statements of work can keep scope appropriately narrow, why royalty streams need to account for different regulatory timelines across global markets, and how to structure IP compensation so it qualifies for capital gains treatment rather than ordinary income. The conversation also covers what a healthy, well-balanced IP partnership actually looks like, why companies may be shifting away from long royalty streams toward milestone payments and flat-rate structures, and the single most common mistake Ast sees innovators make: getting excited and signing a two-year agreement covering all of hip and knee arthroplasty when they were only asked to do one product lab. For any surgeon sitting on an idea, this is the legal foundation you need before your first meeting. https://www.astcontracts.com/ ⏱️ Chapters: 00:00 Meet Emily Ast — contract attorney for surgeon innovators 01:06 Role of a contract attorney in early-stage innovation 01:55 The biggest mindset shift: no off-the-record discussions 02:45 Why you need an NDA before talking to anyone 04:40 Risks of sharing ideas without protection 07:15 The most underestimated clause: product scope definition 09:23 General consulting agreements and hidden IP transfer 11:00 How work orders keep scope appropriately narrow 13:58 Key negotiation points for your first consulting agreement 15:25 IP development agreements: royalties, equity, and structure 17:36 Tax benefits of properly structured IP compensation 18:45 What happens when your IP appears in a product variation 21:40 Regional royalty timing across global markets 24:03 What a healthy IP partnership looks like 27:17 The most common mistake innovators make with industry 28:16 Foundational preparation before meeting with a company 29:52 One piece of advice: protect your napkin idea 31:42 How the surgeon-industry relationship is evolving 34:16 What "from idea to market" means: get your team in place Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #SurgeonInnovator #IntellectualProperty #MedicalDeviceContracts #PhysicianEntrepreneur #NDA #RoyaltyAgreement #OrthopedicInnovation #EmilyAst #IPProtection #ConsultingAgreement #MedTechLaw #FromIdeaToMarket
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S3 · E15
April 28 · 48 min
FITM Extended Interview: XRS Medical (Marie-Isabelle Batthyány)
Send us Fan Mail A patient had already signed every document — but no one had told her she would lose her stomach. That moment early in her anesthesia training convinced Marie-Isabelle Batthyány that informed consent was fundamentally broken. Years later, she built XRS Medical, a VR platform that replaces paper consent forms with immersive, avatar-delivered patient education and tracks attention in real time using a patented eye-tracking algorithm. Batthyány walks through exactly what happens from the moment a patient puts on the headset to the moment an attention evaluation report is generated for the surgeon's file. The numbers back it up: 84 percent recall accuracy and 87.5 percent patient satisfaction versus paper forms that almost nobody reads. The platform creates photorealistic digital twins of the operating surgeon, delivers the explanation in the patient's native language, and produces a legal record that the information was delivered and attended to. With over 4,000 patient uses across Austria, Switzerland, Poland, and France, XRS Medical has moved well past proof of concept. The business story is equally sharp. Batthyány designed the company for acquisition from day one — lean team, phantom shares program, three distinct revenue streams across healthcare providers, pharma, and medical device manufacturers. A surprise pivot into clinical trial consent with Boehringer Ingelheim turned out to be one of the strongest product-market fit moments of the journey. For clinician-founders navigating the European fundraising landscape with a disruptive technology, her playbook on investor fit, due diligence readiness, and the "three threes" rule is essential listening. https://www.xrs-medical.com/ ⏱️ Chapters: 00:00 Meet Marie-Isabelle Batthyány — anesthesiologist turned founder 03:00 The patient who didn't know she would lose her stomach 06:04 From clinical frustration to founding XRS Medical 07:23 Why paper forms and traditional videos fail patients 09:28 How the VR informed consent workflow actually works 14:40 The eye tracking algorithm and US patent 19:40 Early prototypes — from real VR film to digital avatars 26:04 Designing a company for acquisition from day one 28:24 Ideal acquirers: pharma, hospital groups, and three revenue streams 34:41 Advantages of being a physician-led European startup 37:04 How the core team came together 39:41 What medical school never taught about business 46:02 Where XRS Medical is heading: US, Japan, AI avatars 48:08 Advice for future clinician-founders 49:05 What "from idea to market" means: blood, sweat, tears Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #XRSMedical #InformedConsent #VirtualReality #PatientEducation #EyeTracking #MedTechStartup #DigitalHealth #ClinicalTrialConsent #MarieIsabelleBatthyany #ClinicianFounder #MedicalLegalRisk #VRinHealthcare
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S3 · E14
April 24 · 35 min
FITM Extended Interview: Simon Mifsud (Garland Surgical, Ltd.)
Send us Fan Mail Garland Surgical's flagship product, the TriActiv Hip (formerly known as the MaltaHip), replaces the ball-and-socket geometry that has defined hip arthroplasty for 120 years with a cylindrical bearing system inspired by the biomechanics of the ankle joint. Simon Mifsud, CEO of Garland Surgical, explains how this design virtually eliminates dislocation risk and reduced wear by 75 percent in accelerated testing. Mifsud walks through how the cylindrical design achieves its stability advantage — larger contact area, linear reciprocating motion that avoids cross-shear of the polymer — and why surgeons at AAOS and ACUS told him stability matters far more to them right now than durability. He describes the four patient populations this technology targets, from chronic dislocators and post-spinal-fusion patients to the roughly half of the global population whose daily activities involve squatting and cross-legged sitting. The TriActiv Hip stays in place through all of it while offering range of motion that constrained liners cannot match. https://www.garlandsurgical.health/ The business story is just as instructive. Garland Surgical is a University of Malta spinout navigating a pre-revenue funding landscape where deep-tech hardware competes against AI and digital health for investor attention. Mifsud shares how a hybrid of equity and non-dilutive grant funding — including a 1.4 million euro Malta Enterprise award — has kept the company moving, and how a successful FDA Q-sub cleared the biggest objection investors had. For innovators building physical devices in a software-obsessed market, this is a roadmap worth studying. ⏱️ Chapters: 00:00 Introducing Simon Mifsud and the TriActiv Hip 00:49 Why ankle biomechanics inspired a new hip design 02:54 Four underserved patient populations 06:19 How cylindrical bearings reduce wear debris 08:18 What "a hip for life" really means 09:41 Proof of concept: cadaver surgery and the garland pose 11:03 Cross-compatibility with existing femoral stems 13:11 Licensing model versus becoming an OEM 15:04 FDA 510(k) pathway and regulatory strategy 16:01 UK launch, ODEP, and training early adopters 17:26 Funding a hardware startup in a software-first market 20:23 How investor feedback shaped the regulatory approach 23:15 What surgeons at AAOS and ACUS actually wanted 26:46 Managing relationships with academic co-inventors 29:26 Where the TriActiv Hip fits in five years 33:27 What "from idea to market" means to Garland Surgical Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #TriActivHip #GarlandSurgical #HipReplacement #TotalHipArthroplasty #THA #HipDislocation #CylindricalBearing #MedicalDeviceStartup #SimonMifsud #HipForLife #510k #OrthopedicInnovation
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S3 · E13
April 17 · 40 min
From Idea to Market: Ep 7 - Beyond Clearance
Send us Fan Mail Your device just got FDA clearance. So why isn't anyone using it? In this episode of From Idea to Market, Joe Schwab and a panel of surgeons, engineers, and MedTech leaders explore why regulatory approval is only the beginning — and what it actually takes to earn a place in the operating room. Clearance tells you a device is safe and effective. It doesn't tell you whether a busy surgeon will change their workflow, whether a procurement committee will approve it, or whether a hospital can absorb it into daily practice. This episode unpacks the gap between permission and performance — the space where most MedTech innovations either earn trust or stall out. Drawing on Everett Rogers' Diffusion of Innovations theory and recent research on early adoption decision-making in surgery, the conversation examines why clinical evidence alone isn't enough. Guests describe how simplicity, immediate benefit, team dynamics, and peer influence determine whether a technology sticks — and why the intention-behavior gap in surgical practice is wider than most companies expect. The panel also explores how success is redefined after clearance, moving from trial endpoints to real-world outcomes including patient satisfaction, complication rates, workflow efficiency, and health economics. In the PJI space alone, annual hospital costs are projected to reach $1.85 billion by 2030, giving technologies that move the needle enormous clinical and economic significance. ⏱️ Chapters: 00:00 Introduction and series overview 02:34 Meet the panel 05:47 Why clearance is only the beginning 07:42 Diffusion of innovations in surgery 11:07 Investing in data vs inventory after clearance 16:11 The intention-behavior gap in adoption 18:14 Deliberate rollout and early adopter strategy 20:55 Simplicity as the key to surgical adoption 23:18 Market forces behind technology uptake 26:19 Redefining success outside controlled settings 29:24 PJI economics and the case for innovation 33:19 When innovation becomes the standard of care 36:52 Three lessons from life after clearance Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #MedTechAdoption #RegulatoryStrategy #FDAClearance #DiffusionOfInnovations #SurgicalInnovation #TotalHipArthroplasty #PJI #PeriprostheticJointInfection #RealWorldEvidence #OrthopedicSurgery #FromIdeaToMarket #MedicalDeviceAdoption
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S3 · E12
April 14 · 29 min
FITM Extended Interview: Charlie DeCook
Send us Fan Mail Charlie DeCook has exited seven medical device companies while performing 1,500 joint replacements a year — all packed into three clinical days per week. In this extended interview, he breaks down exactly how he evaluates new technologies and why he now filters every opportunity through an AI and robotics lens. DeCook traces his entrepreneurial arc from his first venture in surgical impaction — a product that eventually sold to Johnson & Johnson and became Kincise — through to his current focus on software-driven solutions. He explains why the "jobs to be done" framework from Clayton Christensen's Innovator's Dilemma is the foundation of every product he touches, and why surgeons who skip the financial model are setting themselves up for years of pain. Along the way, he offers a candid look at how large device companies operate, including the "slow no" that strings inventor-surgeons along for months without a real commitment. The conversation also covers the AHF Shark Tank program and what separates pitches that land from those that get eaten alive. Whether you are a surgeon sitting in the OR frustrated with an inefficiency, or a founder trying to get traction with the big three, DeCook's hard-won playbook is worth hearing in full. ⏱️ Chapters: 00:00 Meet Charlie DeCook — surgeon, serial entrepreneur 02:11 First venture: surgical impaction to Johnson & Johnson 03:29 Filtering ideas with easier, faster, better 05:22 Patient outcomes vs commercial reality in med-tech 07:43 Why cost concerns work themselves out over time 09:02 Strategic shift from hardware to AI and robotics 10:41 Finding innovation through jobs to be done in the OR 12:43 Lessons from ventures that required major pivots 14:49 Protecting IP from large device companies 17:27 Why public companies can't think past the quarter 19:02 Evaluating products beyond your own efficiency lens 21:40 What makes a winning AHF Shark Tank pitch 24:29 Common mistakes surgeon-entrepreneurs make pitching 27:17 Innovation areas the Shark Tank needs more of 29:25 Top advice for surgeons with a great OR idea 31:45 What innovation in orthopedics really means Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #SurgeonEntrepreneur #MedicalDeviceStartup #OrthopedicInnovation #TotalJointArthroplasty #SurgicalImpaction #AIinOrthopedics #RoboticSurgery #JobsToBeDone #AHFSharkTank #CharlieDeCook #MedTechEntrepreneur #THA
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S3 · E11
April 10 · 26 min
From Idea to Market: Ep 6 - The Valley Between Idea and Approval
Send us Fan Mail What actually happens between building a medical device and getting it approved? In this episode of From Idea to Market, we walk through the regulatory valley that separates a working prototype from a cleared product — and why so many promising innovations stall right here. This is the stage where progress stops being about what you can build and starts being about what you can prove. Joe Schwab breaks down the FDA's device classification system, the critical difference between 510(k) and PMA pathways, and why the gap between regulatory clearance and reimbursement has become one of the defining challenges in modern med tech. You'll hear from founders and industry veterans — including Jared Foran, Peter Noymer, Doug Fairbanks, Marie-Isabelle Batthyány, Robert Cohen, and Simon Mifsud — who share hard-won lessons about navigating this process with limited capital and no margin for error. Whether you're a surgeon with a device idea, an engineer entering the med tech space, or an investor trying to understand what makes regulatory risk so difficult to price, this episode maps the valley in concrete terms — and explains why the teams that survive it tend to build better products because of it. ⏱️ Chapters: 00:00 Introduction to the regulatory valley 02:21 Meet the founders and industry veterans 04:36 Why promising devices stall before FDA review 05:23 FDA device classification for hip arthroplasty 09:10 Designing to regulatory standards from day one 10:26 FDA clearance without reimbursement 14:07 How design controls sharpen device claims 16:32 FDA designations that accelerate development 19:56 Costs and risks founders underestimate 23:31 Three lessons from the regulatory valley Listen to the AHF Podcast on your preferred platform: Buzzsprout: https://ahfpodcast.buzzsprout.com Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487 Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc LinkedIn: https://www.linkedin.com/showcase/ahf-podcast YouTube: https://www.youtube.com/@anteriorhipfoundation Homepage: https://anteriorhipfoundation.com This podcast is intended for educational and informational purposes only. The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion. #AnteriorHipFoundation #AHFPodcast #FDAApproval #MedicalDeviceRegulation #510k #PMA #TotalHipArthroplasty #MedTechInnovation #DeviceClassification #DesignControls #Reimbursement #OrthopedicSurgery #ValleyOfDeath #FromIdeaToMarket
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