New York City, New York-based Castleford Capital and Lake Forest, California-based US Orthopedic Alliance (USOA) have announced a partnership and the formation of USOA Strategic Capital.
New Strategic Capital Firm Launched in Orthopedics

USOA provides orthopedic management services. Castleford is a private equity firm. Together, the companies have formed USOA Strategic Capital. USOA Strategic Capital will “support USOA’s growth and pursue partnerships with leading orthopedic providers.”
Castleford Managing Director Jeffrey Marlough said, “Combining the extensive industry expertise of USOA with the financial resources of Castleford into USOA Strategic Capital creates a compelling platform for orthopedic practitioners considering an investment to expand their practice, upgrade a surgery center, or merge with other practices.”
Marlough continued, “We couldn’t be more excited to work with Rick [Sales], John [Kang] and the USOA team in building an exceptional orthopedic services and investment platform.”
USOA’s mission is to “build the leading network of independent orthopedic practices empowered with all the resources necessary to succeed in this dynamic healthcare marketplace.” Currently, USOA provides services to more than 100 orthopedic surgeons, 12 ambulatory surgery centers, and one specialty hospital. USOA’s services include “revenue cycle management, contracting, risk management, and value-based care services including infrastructure, technology, and data analytics.”
USOA CEO Rick Salas commented, “USOA has rapidly grown by providing orthopedic practices with specialty specific services to manage and grow their practice while enhancing the patient experience.”
Salas continued, “Our network has been asking about USOA’s ability to invest in their future. USOA Strategic Capital is an ideal fit for our network to support and fund their growth.”
Castleford invests in middle market healthcare services and pharmaceutical services companies. Castleford’s previous investments include ZirMed, MED3000, and Cornerstone.
USOA Chief Strategy Officer John Kang stated, “Castleford is the perfect partner with an experienced investment team. Together we are committed to supporting physicians to build industry leading practices.”

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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