Introduction: The medical profession has a very close interaction with the medical devices industry to develop cutting edge medical technology and improve existing products. There is no doubt that innovation and creativity are essential to the development and evolution of therapeutic and medical devices. This often occurs outside the laboratories of the medical device companies. The industry support of research, audits, device registries and user groups where results are reported and enhancements of products and new products developed, is important.

Commentary: The Medical Technology Association of Australia (MTAA) Code of Practice facilitates ethical interactions with the profession and with others within the medical technology industry. There is a Code Complaints panel and the Code Monitoring Committee. The Code Complaints panel will hear complaints about company activities against the Code. The Code Monitoring Committee has a proactive role in examining company behaviour against the Code and is not dependent upon a complaint being received. The AMA supports the MTAA’s efforts to strengthen the Code of Practice and its compliance activities. This is industry self-regulation at work.

Orthopaedic surgeons have a responsibility to ensure that their participation in collaborative efforts with medical device companies is consistent with their duties towards their patients and towards society at large. Transparency is the key. We must always disclose financial or other arrangements to peers, patients and Ethics Committees. This will improve confidence in the self-governing role of the medical profession. Our relationship with a medical device company should have the primary objective of the advancement of the health of patients.

Codes of Conduct for the profession are helpful in guiding expectations and are becoming more prescriptive.

Conclusion: The close and essential collaboration between the medical profession and medical device industries will always come under scrutiny. The close working relationship with the MTAA helps to ensure our collaboration with these industries is ethically robust. What matters most is that our patients get the medicines and the devices that are right for them and deliver high quality patient outcomes. We must ensure our position is unambiguous in that process.

The results of surgery in 59 patients with Scheuermann's kyphosis are reported at an average follow-up of 56 months. These show that in skeletally immature patients, in whom the iliac apophysis has not yet fused to the body of the ilium, posterior fusion alone is adequate and is followed by little loss of correction. For skeletally mature patients combined anterior and posterior surgery is recommended. In all cases a period of pre-operative treatment is important. It is stressed that the indications for surgery are limited.