4 stories this morning, for surgeons and the people who support them.
- Carlsmed appoints former ZimVie CFO Richard Heppenstall as chief financial officer and reaffirms 2026 revenue guidance of $74 to $78 million ahead of the October 1 aprevo payment policy — Carlsmed release, September 28, 2026: Richard Heppenstall named CFO effective immediately, replacing Leo Greenstein (CFO since 2023, leaving 'to pursue other professional interests'). Heppenstall was EVP, CFO and Treasurer of ZimVie (Sept 2021 to Oct 2025), CFO of Breg (2019 to 2021) and SVP Finance and Treasury at Orthofix (2015 to 2019). Company reaffirmed full-year 2026 revenue guidance of $74 to $78 million, 50% growth over 2025 at the midpoint, and cited the new CMS reimbursement for aprevo lumbar fusion effective October 1. Second source: MedTech Dive, September 29 (https://www.medtechdive.com/news/carlsmed-names-new-cfo/831587/), notes ZimVie's $730 million sale to ArchiMed and quotes BTIG expecting 'little to zero change' in strategy. Source
- VB Spine receives FDA Breakthrough Device Designation for ScolimiR-3D, a six-microRNA blood test to predict adolescent idiopathic scoliosis progression — Business Wire release, September 29, 2026: ScolimiR-3D measures six circulating microRNAs to assess risk of progression to a severe curve in AIS; 100% sensitivity and 100% specificity in validation testing in 116 AIS patients (Khatami et al., Sci Rep 2025;15:5305). Developed by Dr. Alain Moreau's Viscogliosi Laboratory at CHU Sainte-Justine / Universite de Montreal; VB Spine is owned and led by the Viscogliosi brothers. Intended to align conservative treatment such as bracing with risk; more data at SRS 2026, Sydney, October 6 to 10, nominated for the Hibbs Award; no launch timeline given. Second sources: ORTHOWORLD (https://www.orthoworld.com/breakthrough-device-designation-for-vb-spine-scoliosis-test/) and OrthoSpineNews (https://orthospinenews.com/2026/09/29/vb-spine-announces-fda-breakthrough-device-designation-for-new-blood-test-designed-to-identify-patients-at-risk-for-scoliosis-progression/). Context: the earlier DNA-based ScoliScore failed independent validation in 126 patients (JBJS 2015, doi 10.2106/JBJS.O.00217). Source
- Anesthesiology: in 258,624 Ontario hip and knee arthroplasties, a new extended-release opioid prescription at discharge was associated with more persistent opioid use, readmissions and ED visits — Tierney, Malone, McGinn, Talarico, McIsaac (University of Ottawa, The Ottawa Hospital, ICES). Anesthesiology, online September 29, 2026, doi 10.1097/ALN.0000000000006400. Population-based comparative effectiveness study of elective primary THA/TKA, 2013 to 2022, propensity overlap weighting. 31,224 of 258,624 (12.1%) filled a new ERO prescription within seven days of discharge. Persistent postoperative opioid use 6.0% vs 5.2%, aOR 1.08 (1.01 to 1.15); 90-day readmission aOR 1.09 (1.02 to 1.17); 90-day ED visits aOR 1.16 (1.12 to 1.21); 365-day health system costs lower (ratio of means 0.87) and days alive at home marginally higher (1.002). Observational; authors call for a cautious approach to postoperative ERO prescribing. No competing interests declared. Source
- OTA 2026 randomized trial: local aqueous tobramycin added to IV antibiotics did not reduce infection in 569 open extremity fractures — Presented by Arun Aneja, MD, PhD (Mass General Brigham) at the Orthopaedic Trauma Association Annual Meeting, Nashville, September 23 to 26, 2026; reported by Healio September 29. Prospective RCT at three trauma centers: 40 mL local aqueous tobramycin plus IV antibiotics (n=285) vs IV antibiotics alone (n=284) in open extremity fractures requiring fixation. Infection about 6% in both groups; trial powered for 6% vs 12%. Gustilo-Anderson I 19.5%, II 45.3%, IIIA 32%, IIIB 1.8%, IIIC 1.4%. Meeting presentation; exact rates, CIs and follow-up not reported in coverage; single write-up, attributed as presented. Context: TOBRA (JAMA, April 2026, 39 centers, >1,500 periarticular tibial fractures) found deep SSI 7.4% with tobramycin plus vancomycin powder vs 6.6% with vancomycin alone (https://www.medschool.umaryland.edu/news/2026/large-us-trial-finds-no-added-benefit-from-combination-antibiotic-to-prevent-infections-after-surgery-for-complex-leg-fractures.html). Source
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