Orthopaedics
The faulty funding model in orthopaedics
Dr. Eduardo Gonzalez-Hernandez argues that a skewed vision of value, where short-term cost-cutting has replaced analysis of overall medical costs is damaging the healthcare system, making it impossible for surgeons to operate to the best of their abilities because they are lacking basic tools.
The global orthopaedics market is expected to see significant growth during the period of 2023- 2027, with a CAGR of 3,1%.1
In the United Kingdom,
the orthopaedics devices market is estimated to reach a market volume of US$2.03bn by 2028 (approximately £1.61bn), with a CAGR of 3,93%.2 Despite these bullish figures, healthcare
provisioning for orthopaedic surgery is still largely based on a short-term cost-cutting approach, often neglecting investment in critical tools. As a result, surgeons, facing resource constraints and lacking adequate tools, typically resort to designing solutions on-the-fly during procedures, with the risk of compromising the quality of care and patient safety.
Challenges to the orthopaedics sector in the UK NHS performance data shows that waiting times for surgeries in the United Kingdom continue to present significant challenges.3 survey, covering one quarter of all UK surgeons,
A
found that 56% believe that access to operation theatres is a major challenge.4
The NHS has also
had to face walkouts by NHS doctors fighting over better pay, and a report by the Royal College of Surgeons England found that more than 3,000 surgeons had contemplated quitting the NHS, with two-thirds blaming burn out and work-related stress.5 Re-evaluating the prevailing value model in healthcare is therefore imperative to support all stakeholders effectively. Prioritising investments in essential surgical tools ensures that surgeries are carried out seamlessly and more rapidly, thus making it possible to treat more patients and clear the backlog. Furthermore, it need not cost the earth: while
advanced technologies like AI and robotics hold promise for the future, immediate benefits can be realised by improving access to simple yet effective orthopaedic tools. This is especially evident if we take for example the complex anatomical features of an area in the hand
known as “no man’s land” for which surgery could be simplified with the appropriate tools.
“No man’s land”: hand injuries and their consequences Zone II, or “no man’s land” is a segment of anatomy in the hand from the mid-palm where the flexor tendons of each finger glide back and forth inside a tight tunnel structure called the flexor tendon sheath, or pulley, system. In essence, a tendon is like a rope, woven of individual collagen fibres. As long as the tendon is inside the flexor tendon sheath and under some tension, the tendon is healthy. When a lacerated tendon retracts outside the pulley system (flexor tendon sheath), the tendon swells and frays, so that it may be very difficult to place it back into its sheath. Simultaneously, the empty flexor tendon sheath begins to contract, until the sheath becomes practically obliterated. In addition to lacerations, certain sports activities can cause flexor tendon injuries. These injuries often occur in football, wrestling, and rugby or rock climbing. Certain health conditions, such as rheumatoid arthritis, weaken the flexor tendons and make them more likely to tear. Oddly enough, this can happen without warning or injury – a person may simply notice that his or her finger no longer bends but cannot recall how it could have happened. Because tendons tear in different ways –
such as straight across, at an angle, or pulled right off the bone – there are many different methods for surgeons to repair them. All the methods of repair, however, involve suturing the tendon back together. Surgery is usually performed on an outpatient basis and patients are often encouraged to begin movement immediately. The procedure can, however, be extremely
frustrating especially in the “no man’s land” area and there is risk of soft tissue trauma. In addition to this, tendon injuries usually cannot
October 2025 I
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