Robot-assisted surgery is a game changer, not only for orthopedic device companies but the contract manufacturers serving them. For major supplier Tecomet, it means forging relationships earlier, sometimes tighter instrument tolerances — and much more.It makes sense that Tecomet officials would see the rise of robot-assisted surgery in the ortho space as a big deal.
The Wilmington, Mass.–based company touts itself as the largest supplier to the OEM orthopedic marketplace in the world, with about 17 locations and more than 3,000 employees globally.
Tecomet counts all of the major companies in the space as its customers, including Stryker, DePuy Synthes, Zimmer Biomet and Smith & Nephew. Tecomet makes surgical implants, instruments, delivery systems, cases and trays, and much more.
The company’s work has shifted in recent years toward supporting new robot-assisted surgery systems, including Stryker’s best-selling Mako robots. Barry Parker, Tecomet’s SVP of design and development/innovation, recently discussed the changing landscape with Medical Design & Outsourcing:
MDO: We’re seeing robot-assisted surgery becoming more common in knee, hip and spine surgery. How does that affect a contract manufacturer in the ortho space such as Tecomet?
Parker: We haven’t seen this as a particularly disruptive technology compared with what we provide in traditional manual instrumentation, but it’s more of a manufacturing adjacency, because we provide both services to the OEM customers. This is still a capability that is in our wheelhouse. Some of the specific process capabilities that are required are a little different than we use to support the traditional orthopedic instrumentation, and because of that, we’ve structured and invested a little bit around that difference as we set up for this.
MDO: Tell me more. What is the difference?
Parker: We followed the robotic surgery market for a number of years prior to it making its way into ortho. We’ve been supplying companies in the surgical robotics space for probably seven or eight years. The biggest difference really comes in terms of dimensional schemes and tolerancing. Anytime you have a multilevel assembly, you have to design to eliminate tolerance overlaps to make it work. Since this is a very precise type of a surgical procedure, all of your tolerance goes away.
These are a lot more demanding tolerance schemes. That’s predominantly what we see. Also, some of the end effectors, the jaws, if you will, and so forth, are a lot smaller scale in terms of manufacturing, so it’s more precision machining than just machining.
For instance, if we’re talking a standard orthopedic instrument, what would be considered a tight tolerance is plus or minus two-thousandths [of an inch], for instance. On a robotic instrument, that might be two ten-thousandths [of an inch], so it’s sometimes a scale of magnitude different from what traditional instruments are. What that causes you to do from a manufacturing process standpoint is rather than milling a feature, you would probably grind that feature. You’re still creating the same geometry, but you’re using a different manufacturing process to create that geometry.
Not all components have extremely tight tolerances. It really just depends on the role the component plays within the robot. We also are involved in producing a fair amount of product located further upstream within the robot, beyond just the functioning instrument end. We produce things like housings and pivots that the robot arms work from.
MDO: When did you notice robotics moving into the orthopedic space?
Parker: We noticed that entry around four to five years ago, probably first with the Mako launch [by Stryker]. I think as technology has evolved through the orthopedic market, our challenge has been gaining early-stage project involvement to better leverage how we can add the most value. A lot of the technology has come to our OEMs through acquisition. and as a result, there was not a lot of opportunity to collaborate on design, which we always like to have the chance to do, so that the components can be produced most cost-effectively. But it’s understandable why it’s gone the way it went.
MDO: Have you had to bring on new expertise and capabilities to better serve the shift toward robotics? If so, tell us more.
Parker: We have been fortunate as Tecomet had made some key acquisitions over the last five to six years which helped to support this robotic market opportunity. A few of our facilities were already supplying into the computer-assisted, endoscopic and arthroscopic instrument markets, which do translate well into a robotic surgical instrumentation manufacturing capability, and we have since invested further in advanced manufacturing technology such as precision grinding to better serve our customers in this market space. We also actually created a new structure and strategy, commercially segmenting out what we term as “Advanced Surgical,” which includes robotics.
MDO: Overall, how do Tecomet officials view the rise of robotics in orthopedic surgery? What’s real and what’s hype from your standpoint?
Parker: We view the rise of robotics in orthopedics as a very real event. It’s hard to dispute that the robotic approach delivers a higher level of precision versus a manual approach when doing arthroplasties. But you do have to take into consideration the expertise of the surgeon performing the manual approach as to whether it really provides a significant advantage. There is obviously a lot of industry discussion going on around the actual degree of improved clinical outcomes, because I’m sure, as you talk to people, it’s too new to really see whether it’s going to improve outcomes over time, and it’s a pretty high cost of capital equipment for the hospital or surgical center. …
But there’s definitely an advantage and we certainly see it as real. It also seems to be fully supported by financial markets. They’re behind it. Our customers are responding.
From a Tecomet perspective, we’ve both structured and invested in being well-positioned to grow in the business around this whole robotic orthopedic surgery approach and try to be in the best position to support all of our OEM customers participating in the market. We don’t think it’s hype, and we definitely see that it’s got legs. It definitely provides some salient advantages, so we’re structured to capitalize on it.