Founded in 1989 Integra avoided the sad fates of its peers in tissue engineering (which went bankrupt) by adopting an acquisition strategy that took it into surgical product markets. Integra has enjoyed a compound annual revenue growth rate of 36% since it first embarked on its acquisition strategy in 1999. Its secret of success has been to consolidate fragmented niche markets into which it can create additional value by selling its internally-developed tissue-engineered products. Now, with six operating divisions covering four surgical specialties with a multiplicity of call points, it looks and acts like a large, diversified medical device company. But it's not-with $650 million in revenues, it's a mid-sized company. Can it now, as a mid-sized company with a complicated business, sustain its high level of growth through a combination of acquisitions and organic growth?

One of the hottest topics at the 2007 AAOS was the the trend toward resurfacing rather than completely replacing joints damaged by arthritis and other causes. There are a variety of metallic, synthetic and biologic methods used in hip, knee, shoulder and extremity joint resurfacing, many designed for younger patients who wish to remain active and avoid total joint replacement.