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Focuses on a simple question: should Zimmer develop a gender-specific artificial knee? The decision is complicated because while the idea seems to make sense, there is little clinical evidence that a gender-specific knee produces superior patient outcomes, and orthopedic surgeons are likely to be skeptical of the innovation.

To teach new product strategy and growth strategy, and introduce students to the medical device industry.

After knee replacement surgery, rehabilitation is needed to recover to normal levels of mobility. A continuous passive motion (CPM) machine is usually introduced at this stage to aid rehabilitation. However, the redundant structure and complex mechanism of the existing machine has resulted in irregular use. The purpose of this paper is to redesign the current machine.

The mechanical and electrical systems of the current machine were studied alongside interviews with stakeholders. Problems with the existing machine were identified. Related information was gathered in both the engineering and medical aspects. The redesign concept of the equipment was specified following engineering analyses to develop the final model. Finite element analysis was performed to ensure the appropriate size and dimension of the equipment. The prototype of the redesigned CPM was manufactured in-house. Product testing was conducted with 40 volunteers including experienced therapists, nurses, university students and working-age people.

Compared to the previous machine, the newly designed model was improved in both functioning and manufacturing costs. The redesigned machine is more durable and consists of a less complex structure.

The redesigned machine introduces some new features and removes unnecessary functions. As a result, the model costs less and hence, is considered beneficial to the general public. More utilization is expected which could eventually reduce the therapists’ workload at the hospital. This research provides well-defined processes of the product development starting from the users’ requirement analysis to the prototype testing stage.

Executives at biotechnology firm Genzyme are debating funding a clinical trial for a new version of a medical device called Synvisc. The trial is expensive and the odds of success are not high, but the upside is substantial. The case presents a common business question: invest or not? The case forces students to think about customer insights, wrestle with a number of complex issues, and evaluate the financials of the decision.

The case is ideal for teaching financial analysis and decision making. It can also be used to teach marketing, new product strategy, and healthcare industry management.

A “hands‐on” robotic system for total knee replacement (TKR) surgery is presented. Computed tomography (CT) based software is used to accurately plan the procedure pre‐operatively. Intra‐operatively, the surgeon guides a small, special‐purpose robot, called Acrobot^®, which is mounted on a gross positioning device. The Acrobot uses active constraint control, which constrains the motion to a pre‐defined region, and thus allows the surgeon to safely cut the knee bones to fit a TKR prosthesis with high precision. A non‐invasive anatomical registration method is used. The system has undergone early clinical trials with very promising outcomes.

This paper report the effectiveness of a nursing quality assurance program over three years, which demonstrates improvement in the incidence and severity of post‐operative clean wound infections and the associated extended length of hospital stay and cost. General surgery categories included cardiovascular, orthopaedic, neurosurgery, kidney, abdominal, mammary and other. Cardiovascular categories included coronary artery bypass graft (CABG), heart transplant, and atrial valve replacement. Hip replacement and total knee replacement procedures were included in the orthopaedic category. Additional length of stay and concomitant hospital costs were calculated. Results show that early reporting of observations and implementation of appropriate treatment will decrease the incidence, severity and associated costs of post‐operative clean wound infections.

The purpose of this paper is to examine the application of low-end, low-fidelity (gaming/consumer-level) haptic devices for medical-based, surgical skills development (surgical bone-based drilling in particular) with serious games and virtual simulations as an affordable training solution with the potential of complementing current and traditional training methods.

The authors present the adaptation of two low-end haptic devices (Novint Falcon and Geomagic 3D Touch) to simulate a surgical drill drilling through bone for a serious game developed for total knee arthroplasty training. The implementation was possible through the analysis of the bone drilling mechanics. The authors provide a quantitative comparison of both haptic devices with respect to forces, movements, and development.

Although further testing is required, the initial results demonstrate that the low-end, consumer-level haptic devices can be incorporated into virtual environments/serious games to allow for the simulation of surgical drilling. The authors also believe that the results will generalize and allow these devices to be used to simulate a variety of technical-based medical procedures.

In contrast to previous work where the focus is placed on cost-prohibitive haptic devices, this approach considers affordable consumer-level solutions that can be easily incorporated into a variety of serious games and virtual simulations. This holds promise that haptic-based virtual simulation and serious games become more widespread, ultimately ensuring that medical trainees are better prepared before exposure to live patients.

The value of pre‐admission assessment clinics prior to elective surgery has been previously reported. However, no assessment of their value to orthopaedics in particular has been made. This preliminary study shows that such clinics can bring about a significant saving in theatre time and hence improved efficiency. Most cancellations at the clinic resulted from change in orthopaedic requirement and not from anaesthetic contraindications.

The aim of this paper is to call for an increased focus on the ethics of direct-to-consumer (DTC) prescription drug advertising. This is important, not only to improve DTC prescription drug advertising, but also to inform DTC advertising of future medical advances.

This conceptual paper discusses two examples of medical advances – personal genetic testing services and surgically implanted medical devices – to explain how investigating the research of DTC prescription drug advertising can set the stage for more ethical advertising of future medical advances.

Specific issues related to health literacy, at-risk populations impacted by health disparities, and medicalization of issues common to aging relate to the DTC advertising of prescription drugs and other medical advances. Creative approaches to investigating these issues in the context of prescription drug advertising can enrich the debate about drug advertising, but also prepare researchers, policymakers, and consumers for future advertising of new medical developments.

The value of this paper is its call for increased focus on the ethics of DTC prescription drug advertising, to improve the current marketing environment but also lay the foundation for other healthcare marketing in the future.

This chapter analyzes the tourism industry from national and regional perspectives, in order to understand the past and current trends in Costa Rica’s positioning and branding attributes and strategies for tourism development. The intent here is not to provide an exhaustive comprehensive literature review of academic research on country branding; and so it is by all means a case study as it describes the evolution of the tourism industry in Costa Rica – including the transformative stages the country went through since the 1980s – as planned tourism national management programs evolved toward reaching the target of creating a nature-based tourism brand. The medical industry and then medical tourism industries are analyzed in a global basis and the US market is examined in detail because of its potential to develop a new complementary niche for Costa Rica’s tourism industry. The chapter intends to asses Costa Rica’s potential to become a country brand in medical tourism, leveraged on its natural tourism destination branding status quo.

Perhaps the best place to start is to tell you something about our business. Smith & Nephew is a British firm, founded in 1856 by a pharmacist named T.J. Smith. Mr. Smith was an entrepreneur with one significant product—cod liver oil, which he imported from Norway.