4 stories this morning, for surgeons and the people who support them.
- Spine Journal: in 18,914 matched single-level P/TLIFs, rhBMP-2 added $4,543 and 14% to the index encounter with no significant difference in readmission, revision or two-year costs — Chen AR, ... Hsu WK, Patel AA, Divi SN (Northwestern). 'Costs and outcomes of rhBMP-2 usage in single level posterior or transforaminal lumbar interbody fusion (TLIF) in a propensity score matched national, retrospective cohort.' Spine J, online ahead of print September 12, 2026, doi:10.1016/j.spinee.2026.09.007; covered by Orthopedics This Week September 23, 2026 ('The $4,543 Question', https://orthopedicsthisweek.com/2026/09/the-4-543-question-does-rhbmp-2-earn-its-place-in-single-level-fusion). Premier Healthcare database 2016-2022; 9,457 rhBMP-2 patients matched 1:1 with 9,457 without. Index encounter costs 14% higher with rhBMP-2, driven by the product ($4,543.51). 90-day spine readmission 1.25% vs 1.39%; 2-year revision fusion 2.7% vs 3.2%; 2-year revision decompression 0.29% vs 0.53% (p=0.008) — none significant after Bonferroni correction (p<0.0036, 14 hypotheses). 2-year post-discharge costs not different (p=0.558), possibly because revision fusions cost more in the rhBMP-2 group. Authors: broad use may not be necessary outside select high-risk populations; claims data, no radiographic or patient-reported outcomes. Authors report no conflicts. Medtronic's INFUSE is the rhBMP-2 product marketed in the US. Not previously covered. Context: Medtronic announced September 2, 2026 that INFUSE gained Medicare NTAP eligibility for TLIF effective October 1, 2026, after FDA approval for the TLIF indication earlier in 2026 (covered September 3: https://orthospinenews.com/2026/09/02/infuse-bone-graft-for-tlif-receives-eligibility-for-medicare-new-technology-add-on-payment-advancing-reimbursement-support-for-hospitals-and-spine-surgeons/). The study's 2016-2022 cases therefore predate the TLIF approval. Source
- Precision Neuroscience closes an oversubscribed $250M Series D for its Layer 7 surface brain-computer interface — Company release, New York, September 24, 2026 (https://www.financialcontent.com/article/gnwcq-2026-9-24-precision-neuroscience-closes-oversubscribed-250m-series-d-led-by-pershing-square-inc-the-ackman-oxman-institute-and-a-leading-life-sciences-investment-fund), plus MedTech Dive, September 25. $250M Series D co-led by Pershing Square, the Ackman Oxman Institute and an undisclosed life sciences fund; $430M raised since 2021 founding. Layer 7 Cortical Interface: 1,024 electrodes on a thin flexible film on the brain surface, implanted via a 'micro-slit' technique; FDA clearance for up to 30-day use in 2025 (MedTech Dive). Company reports more than 100 patient procedures across 18 institutions (including Penn, UChicago Medicine, Mount Sinai, WVU Rockefeller Neuroscience Institute) and a partnership to integrate with Medtronic's neurosurgical platform. Funds go to the clinical program, further FDA review and commercial infrastructure. MedTech Dive notes Science Corporation raised $230M and Merge Labs $252M. Paradromics' Connexus speech result was covered September 16; this is a different company. Source
- UPMC's CLEAR rapid exchange protocol for recalcitrant PJI: 10% failure versus 60% for historical repeat two-stage controls (EBJIS-MSIS 2026) — Healio, September 25, 2026, reporting Urish K, et al., 'Cyclical local exchange with antibiotic revision (CLEAR) protocol has decreased 1-year failure vs. repeat two-stage exchange arthroplasty for recalcitrant PJI,' presented at the joint EBJIS-MSIS Conference, September 17-19, 2026, Porto. Ken Urish, UPMC Magee Bone and Joint Center. Intra-articular cyclic irrigation with 80 mg tobramycin once daily for 7 days then hourly 125 mg vancomycin. Primary outcome infection control without suppressive antibiotics. Failure 10% rapid exchange vs 60% historical two-stage controls; controls also had more reoperation for any reason. Rapid group had more prior surgeries (two-stage, DAIR) and more multidrug-resistant organisms. Patient counts not reported in the coverage; historical-control abstract, not an RCT. Urish discloses research support, advisory board and equity in Osteal Therapeutics. Context: Osteal's VT-X7 (vancomycin/tobramycin irrigation, 7-day rapid exchange) met its six-month endpoint vs two-stage in the randomized APEX trials (>150 patients) in 2024 and holds FDA Breakthrough Therapy designation (Dec 2023): https://www.biospace.com/osteal-therapeutics-presents-positive-six-month-results-from-the-apex-clinical-trial-program-at-the-34th-annual-musculoskeletal-infection-society-meeting Source
- ICSES 2026 meta-analysis: PRP no better than placebo for lateral epicondylitis across six RCTs and 355 patients — Healio, September 25, 2026, reporting Santos RSS, et al., Paper ES02.08, International Congress on Shoulder and Elbow Surgery, September 22-25, 2026, Vancouver. Ramon Sampaio Souza Santos, Federal University of São Paulo. Systematic review/meta-analysis of six placebo-controlled RCTs, 355 patients. No significant difference vs placebo in pain or function at 4 weeks, 8-12 weeks or 24-26 weeks; complications similar. Limitations: poor reporting of PRP formulation, volume, technique, follow-up, quality of life. Authors suggest possible value in athletes or recalcitrant cases. The ACR 2026 OA guideline (strong against PRP in knee/hip OA) was covered September 15; this is a different indication and a new dataset. Source
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