This is a politically neutral blog.
Having said that, I found this article in the July 15, 2025 New York Times interesting: Administration Will Limit Medicare Spending: Medicare plans to slash payments for expensive and untested skin bandages that have cost the federal government billions of dollars. According to the article, spending on "skin substitutes" has increased fortyfold in the past five years, surpassing $10 billion in 2024. "That sharp increase is one of the largest examples of Medicare waste in the program’s history, according to data analysts and industry experts." "Medicare, the government insurance plan for seniors, spent more last year on the bandages than on ambulance rides or anesthesia, despite limited evidence that they work. The bandages are made from dried bits of placenta and are used on wounds that won’t heal."
Is this "biologic" in any way analogous to the biologics (bioactive grafts, bone marrow aspirate concentrate, stem cells, platelet rich plasma (PRP), etc) used by some for rotator cuff disease? These modalities are costly and the indications for their use and their effectiveness are still under evaluation. Does this action suggest that the government may soon be asking for documentation of effectiveness and value for these biologics in orthopaedics? Of interest, one study quoted the incremental cost of graft augmentation at about $3,500 per procedure, on top of the ~$12,500 baseline surgery cost.
We'll follow with interest.
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Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link).
How to x-ray the shoulder (see this link).
The ream and run procedure (see this link).
The total shoulder arthroplasty (see this link).
The cuff tear arthropathy arthroplasty (see this link).
The reverse total shoulder arthroplasty (see this link).
The smooth and move procedure for irreparable rotator cuff tears (see this link)
Shoulder rehabilitation exercises (see this link).
