Citing “seismic shifts” in the healthcare environment and a need to reorganize, Michael Orsinger, head of Johnson & Johnson’s orthopedics business announced the elimination of approximately 400 jobs in the DePuy Synthes unit. Orsinger made the remarks in an internal video message to employees on July 2, 2014.
DePuy Synthes Reorganizes – Cuts 400 Jobs

A J&J spokeswoman said the majority of employee roles are not expected to change or will change minimally and that more than 80 new positions have also been created as the reorganization gets under way. The company employs around 23, 000 workers. Severance benefits and career counseling will be offered to the laid off employees.
The orthopedics maker hopes the shifts will help it adjust to the “fundamentally changing” healthcare market and global economy, according to a statement.
“DePuy Synthes companies is transforming our operating model to enhance our ability to offer broader portfolio solutions to hospitals, provide superior product innovation and expert service to surgeons, reinforce our organizational capabilities and align our cost structure to our evolving environment, ” company spokeswoman Lorie Gawreluk told MassDevice.com.
No further information was reported on the reorganization efforts. Orsinger has not made it a secret that integration issues resulting from J&J’s acquisition of Synthes for $21.3 billion two years ago resulted in disruption of spine sales. The merger also started a scramble for scale among device makers to compete for the business of increasingly sophisticated hospital purchasers. Zimmer Holdings, Inc. followed suit by announcing plans to acquire hometown rival Biomet, Inc. and Stryker Corp. acknowledged kicking the tires of Smith and Nephew.

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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