Paradigm Spine is building a pipeline of dynamic stabilization devices based on two core technology platforms: coflex interspinous spacers for stenosis and Orthobiom implants for adolescent idiopathic scoliosis. The three-year-old company is rolling out products at a rapid pace: it will have five devices on ex-US markets by the middle of this year.

The founders of Small Bone Innovations believes the device industry is entering the decade of small bones and joints, and has embarked on a consolidation strategy to prepare for dramatic innovation and change in what today is a fragmented marketplace.

Clinical trials strategies, particularly in the medical device industry, can confer an important competitive advantage to a company-or present a stumbling block that costs time, money, and markets. This is particularly true in orthopedics, where development lead times stretch into years. In hip, knee, and spine surgery, companies with new technologies can enjoy first-mover advantages that let them dominate markets for five, even ten years, but market delays can undercut such advantages. That's why Viscogliosi Brothers LLC, a venture capital firm/merchant bank focused exclusively on the musculoskeletal industries, recently formed Musculoskeletal Clinical Regulatory Advisors LLC (MCRA), a firm that aims to help orthopedics start-ups develop and execute clinical research strategies.

Orthonics has developed a way, using nanotechnology fabrication techniques, of creating a microarchitecture on the surface of a hydrogel or polymer such that its physical shape induces bone and cartilage precursor cells to differentiate into cells that produce bone and cartilage. Its first product will be a device for the repair of a damaged annulus of the spine.