First there was Athos, Porthos and Aramis. Then there was Crosby, Stills and Nash. And ten years ago another triad came together—Foster, Viscogliosi and Young. British, Italian and Guatemalan.
Three Guys in a Bar

It couldn’t last. Initially they’d come together under the HealthPoint Banner. But F, V&Y ultimately went their separate ways.
At infrequent and intermittent times over the decade the guys would take time from starting companies, acquiring companies or selling companies to touch base. Years passed between meetings.
Young got older, redder and balder. Viscogliosi got richer, smarter and more influential. Foster got happier, younger and, unfortunately, lamer (sports injury).
Then, in the midst of the celebration that was the 2014 AAOS annual meeting, the three ran into each other in a seedy hotel bar one block off Bourbon Street.
Young and Foster ordered diet cokes. Viscogliosi espresso. F, V&Y’s conversation took off as if the last ten years had never happened. The three old salts covered all that was new, broken or changing in the orthopedics industry. Could there be any other three individuals who knew as much or had spent so many years analyzing the trends, technologies, companies and people in this industry?
What, they wondered, could they have accomplished if they’d never split up?
Ten years on and old quarrels were gone in the haze of distant memories. Instead a sense of possibilities unrealized and ideas yet to be developed took hold.
What if….
Yes, JF is active at Healthpoint Capital. Yes, TV is managing partner at VB. Yes, RY runs OTW.
But…what if….
The minutes in that old bar turned into, well, one hour. But it seemed like more. Ideas bubbled up, plans took form and by mid-day the three amigos toasted each other and a bold, innovative and ultimately disruptive initiative.
They made an appointment to meet again in New York.
59th and Park. They knew the place.
JF paid the bill.
TV had a second espresso.
And RY wrote the story. To be continued…

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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