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This episode is brought to you by Heron Therapeutics. Please see full Prescribing Information, including Boxed Warning or visit www.ZYNRELEF.com.

Dror Paley, MD, FRCSC, is the founder (2009) and director of the Paley Institute in West Palm Beach, Florida. Prior to that he was the founder (2001) and director of the Rubin Institute for Advanced Orthopedics, and the director of the International Center for Limb Lengthening (ICLL) at Sinai Hospital of Baltimore from 2001-2009. He was the Chief of Pediatric Orthopedics at the University of Maryland in Baltimore 1987-2001. He is internationally recognized for his expertise in limb lengthening and reconstruction.

Topics include:

-We hear why he went into orthopedics and then chose the niche path for limb lengthening. Dr. Paley trained under the guidance of Professor Ilizarov of Russia (Ilizarov method) and Professor Debastiani of Italy (Orthofix method). In 1986, he introduced the Ilizarov method to the United States and Canada. Since that time, he has performed more than 20,000 limb lengthening and reconstruction-related procedures. Patients come to his Institute from more than 100 countries.

-Dr. Paley reviews how limb lengthening works and breaks down this complex topic for anyone to understand, including the different types of limb lengthening to include the use of external fixators, often called cages, and remote controlled internal limb lengthening.

Find out more about Dr. Dror Paley here.

Also, find out more about Zynrelef here:

ZYNRELEF utilizes a novel synergistic mechanism of action that combines bupivacaine with a low dose of meloxicam to overcome the challenges of the inflammatory process at the surgical site. ZYNRELEF is the first and only extended-release dual-acting local anesthetic™ (DALA™) and delivers 72 hours of postoperative pain relief via a single needle-free application. It has been clinically proven to better manage pain than standard of care bupivacaine HCl solution over 72 hours and to significantly reduce opioid utilization following surgery.

-ZYNRELEF was initially approved by the FDA in May 2021 and in December 2021, the FDA approved an expansion of ZYNRELEF’s indication.

-Limitations of Use: Safety and efficacy have not been established in highly vascular surgeries, such as intrathoracic, large multilevel spinal, and head and neck procedures.

WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS

See full prescribing information for complete boxed warning.

• Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use

• ZYNRELEF is contraindicated in the setting of coronary artery bypass graft (CABG) surgery

• NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events

ZYNRELEF is contraindicated for:

• Patients with a known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to any local anesthetic agent of the amide-type, NSAIDs, or to any of the other components of ZYNRELEF OR history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Severe, sometimes fatal, anaphylactic reactions to NSAIDs have been reported in such patients

• Patients undergoing obstetrical paracervical block anesthesia OR coronary artery bypass graft (CABG) surgery

WARNINGS AND PRECAUTIONS include –