2018 AAOS Notes: Watch This Company: UOC

United Orthopedic Corporation—you may not know the name, but you may well have been using their products since 1993. And, based on their presentations at the 2018 American Academy of Orthopaedic Surgeons (AAOS) annual meeting, they have the chops to, eventually, be one of your standard suppliers.

More than 30 Chinese origin companies (Taiwan or mainland) had exhibitor booths at AAOS. The company with the biggest and, possibly, most enduring impact, it seemed to us, was Taipei-based United Orthopedic Corporation.

What impressed us the most was the way UOC’s management emphasized service to U.S. physicians—explaining bundled payments, for example, and offering a suite of logistics solutions that included a program which can reduce the number of instrument trays required for knee surgery from 6 to 1.5.

This, we think, demonstrates a nuanced understanding of the U.S. market that is unusual for a non-U.S.-based supplier.

Indeed, it is unusual for most U.S.-based suppliers. UOC, in our view, was one of the most customer-facing exhibitors at 2018 AAOS.

A Short History of the Company You Have Used, But Didn’t Know

In 1993, a Taiwan-based distributor decided to begin fabricating its own versions of large joint implants.

The company was, of course, United Orthopedic Corporation (UOC).

Over the ensuing 25 years, this boutique orthopedic manufacturer and distributor began supplying to Taiwanese surgeons and U.S.-based orthopedic companies with private-label implants, and methodically introducing their own branded implants and instruments to distributors and physicians in Taiwan, Japan and Korea.

Today, UOC supplies their own branded implants and instruments to physicians in 38 countries.

In 2004, UOC went public on the Taiwan stock exchange.

In 2017, UOC acquired A-Spine, a spinal implant company.

By 2018, UOC had 700 employees (100 of whom are engineers) and two manufacturing plants in Taiwan. The company is a fully integrated supplier of quality orthopedic implants.

“Even though we make metals and plastics, we’re really a service company.”

OTW spoke with the president of United Orthopedic Corporation USA, Calvin Lin, and, in describing the culture of his company said: “Even though we’re a metal and plastics fabrication company, we’re really a service company.”

What stood out for OTW at the 2018 AAOS, was the theme that UOC decided to emphasize at the conference—bundled payments and logistic innovation to cut costs without sacrificing quality.

At their 2018 AAOS booth, UOC hosted several presentations by U.S. based surgeons—most notably Mark Froimson, M.D., 27th president of the American Association of Hip and Knee Surgeons and one of the country’s leading experts on bundled payments as Principal at Riverside Health Advisors.

Dr. Froimson served as chief clinical officer and executive vice president of Trinity Health, the Michigan-based hospital system, from November 2014 through May 2017. During his tenure, he led the development and expansion of Trinity’s episode of care and bundled payment initiatives and ultimately positioned them as a model of industry best practice.

Prior to that, he spent 16 years with the Cleveland Clinic, serving in a variety of leadership roles, including vice chair of orthopedics and president and chief executive officer of Euclid Hospital, where he launched the clinic’s bundled payment program.

UOC’s lead booth speaker did not pitch a UOC implant, he delivered, instead, a four-point plan to help hospitals and clinics thrive in an era of bundled payments. He talked about:

1. Patient selection and engagement
2. Physician leadership and care co-ordination
3. Care optimization with protocol development and adherence
4. Clinical intelligence

It’s a new era in U.S. healthcare and UOC was dealing with it by giving U.S. physicians the person (Dr. Froimson) and the strategies for navigating this new environment.

The U2 Knee™ System

UOC received its first FDA approval in 2001—which was for a hip implant system. In 2006, the FDA cleared UOC’s U2 Knee™ System for the U.S. market.

This year UOC is deep into the clinical study for the U2 Knee™ System.

The clinical trial, titled “Prospective Post Approval Clinical Follow-Up Study of the Commercially Available U2 Knee™ System – ‘U-Propel Study’,” enrolled its first patient approximately one year ago.

This prospective, single arm, multi-center, post-market study is evaluating the short- and long-term clinical performance, and implant survivorship of the U2 Knee™ System in subjects receiving primary total knee arthroplasty (TKA).

“We were extremely confident with the execution and success of the first U2 Knee System replacement,” said David Cashen, M.D., principal study investigator and practicing orthopedic surgeon at Coastal Orthopedics in Bradenton, Florida. “One day after surgery our patient is ambulating independently, performing a straight leg raise and confident to return home with only mild discomfort. We look forward to monitoring her recovery through our research.”

The U-Propel study was designed to enroll up to 200 patients. Patients are participating in baseline, pre-discharge, 6-week, 3-, 6- and 12-month, as well as annual follow-up visits for up to 5 years. The study’s primary endpoint is implant survivorship. The secondary endpoints are Knee Society Score; radiographic success; subject satisfaction; KOOS, Jr.; EQ-5D and operative characteristics. The study will run for seven years.

“For more than two decades, our company has been engaged in helping orthopedic surgeons deliver high-quality care to their patients, providing them with innovative products designed to improve patient health and satisfaction,” said Calvin Lin, “The U-Propel study underscores our continued commitment to orthopedic care, building upon our foundation of research that demonstrates the value of our solutions.”

Outcomes from the U-Propel study will be analyzed and published in three phases—after all enrolled patients have completed their six-week follow-up; at the two-year follow-up mark; and at the conclusion of the study.

The U2 Knee System offers a 155-degree high-flexion design and unique bone preserving properties. The knee, according to UOC, is ideal for reducing or relieving pain and/or improving knee function in skeletally mature patients who suffer from: rheumatoid arthritis, osteoarthritis, primary and secondary traumatic arthritis, avascular necrosis of the femoral condyle, and other debilitating conditions.

The accompanying instrument set supports minimally invasive surgical techniques and offers predictable accuracy and precision during implant preparation and placement.

Includes: cementless porous CR and cemented CR & PS components, Ti forged baseplate, XPE tibial and patellar components.

Future

An old and true saying is that business is all about relationships.

Over the last few years, Biomet was absorbed into Zimmer, DePuy became part of Johnson & Johnson, then Synthes was bolted on to DePuy and, if rumors are to be believed (which would certainly be stretching things considering how often they’ve been wrong), Smith & Nephew will eventually be a victim of the orthopedics’ consolidation wave.

Consolidation, necessarily, takes a toll on distributor and physician relationships.

Through it all, since 1993 in fact, United Orthopedic Corporation has been a constant presence in the global joint reconstruction market—nurturing its physician and distributor relationships.

Last year, UOC reported 1.8 billion (New Taiwan Dollar-TWD) sales—which is approximately $65 million in U.S. dollars. The published analyst reports are forecasting that UOC sales will approach 3.0 billion (TWD) in two years (2020).

The next meeting for UOC in the United States will be the Current Concepts in Joint Replacement (CCJR) spring meeting, May 20-23, 2018 in Las Vegas, Nevada.

If you are thinking of attending, do and be sure to learn more about this company whose products you’ve probably been using for years.