Solutions to an age-old problem

In the growing market to keep ageing baby-boomers mobile, one British company is flourishing in the face of international competition

The recent bid battle between Zimmer of the United States and Smith & Nephew of Britain for control of Centerpulse, the Swiss group that is Europe's biggest maker of medical devices, is indicative of the growing importance of a once-obscure corner of the medical market. The ageing of the baby boomers and their determination to stay active has created huge demand for artificial knee and hip joints and similar devices.

But, while large international companies such as Zimmer - which won control of Centerpulse this week - are seeking to increase their share of this sector, an important role is being played by a small British company operating from an anonymous trading estate in leafy Surrey.

The Leatherhead-based Finsbury Orthopaedics is finding such a ready market for its products that it expects its sales to increase by about half in the current financial year, to about £12m.

This growth is partly a result of the company's expansion into new premises across the road from its base for the past eight years. The doubling of the floor space has enabled it to increase production.

However, other factors are also involved. For a start, the company has developed some particularly successful devices. In addition, rather than remaining content to be what founder Mike Tuke calls "just back-room boys," he and his colleagues have started to sell and market devices under the company's own name instead of merely producing them for other manufacturers in return for a royalty or a fee.

Whatever the reasons for the expansion, this success is all a far cry from the company's origins 25 years ago, when - named after the London square where its solictors were based and with capital of just £1,000 - it was started in the attics of Tuke and his fellow founders, Professor Alan Swanson and surgeon Michael Freeman.

An early example of a university spin-out, a concept that has recently become highly popular but was then little known, the idea for Finsbury came after the three men met at Imperial College, London, where Tuke worked as a research assistant in the then newly-formed biomechanics unit.

Freeman and Swanson were behind the opening of this unit and had pioneered the development of modern unconstrained knee replacements. It was through them that Tuke started to take an interest in joint replacement. Over the years he was involved in developing ankle replacements and invented the Tuke Saw, an instrument specially designed to cut bone without disturbing the tissue around it.

Though Finsbury has become known for metal joints that look more like pieces of fine sculpture than medical implants, Tuke attributes much of its success to this knowledge of how the joints fit within the body and also to the understanding he and his colleagues have of surgeons and how they work.

"Part of our design work is to work very hard at getting a user-friendly process to the surgeons, who are often not as adept as a hands-on carpenter might be," says Tuke. "You have to provide an average man with a set of instruments that allow him to get a respectably good result all the time."

Though proud of the achievements of himself and his 100-strong workforce, Tuke is like many innovators and entrepreneurs in never being satisfied. The devices - made of an alloy of cobalt and chromium - are constantly being tweaked for improvements, while new opportunities are also examined. For example, the company, which already holds more than 20 patents and has more than 40 development projects under way, is looking beyond traditional hip and knee replacements and moving on to fingers, shoulders and elbows.

No longer confined to working with Imperial College scientists, Finsbury has associations with a variety of surgeons and various universities in Britain and elsewhere. It is working with a team in Bologna, Italy and Oxford on a replacement ankle.

The company is not solely involved in producing replacement limbs for amputees, but Tuke insists that this narrow market has tremendous potential for extended growth in the years ahead. In the UK alone, it is reckoned that a market that began only a few decades ago with surgeons inserting devices made in garden sheds now sees about 50,000 joints being replaced each year, with all but a fifth of operations carried out on the NHS.

Moreover, other markets are opening up as the company starts to sell its products overseas. One way in which the market might expand is as a result of growing sophistication among patients to the extent that they are starting to choose which devices are used in their joint replacement operations - another reason for Finsbury's decision to come out of the shadows and start marketing itself.

"We used to think of the surgeon as our customer. Increasingly, we're seeing the patient as the end consumer and the patient might have the right to know what's going into them," explains Tuke.

Indeed, he says that one of the most satisfying aspects of his job is seeing patients smile once pain they've endured for years has been taken away.

Tuke's sense of doing "something worthwhile" means that he works long hours, including spending most Saturdays at the office. He has the freedom to make his own decisions about such matters as strategy and investment in development, which currently takes up about a fifth of profits.

"I enjoy doing it," he says, when asked why he does not spend more time messing about in his boat on the river or driving the exclusive cars to which his membership of a local club gives him access.

Tuke is also aware that - for all the progress made in alleviating the pain of arthritis sufferers and others - there is much to be done. "There are still some big secrets to unlock to make these things really work. There's still a lot of work to be done in catching up with what nature provided," he says.