Worldwide Orthopedic End-User Markets & Technologies 2023-2030:Hip, Knee, Spine, Trauma, Shoulder, Extremities and Orthobiologics& Profile of 140 key players - 2nd edition
Orthopedic environment, drivers & limit
Orthopedic market by region & forecasts
Competitive landscape & players’ ranking & dispersion
Innovations & new technologies in orthopedics: Robotics, 3D printing, REACH & impact on Co-Cr, Orthobiologic cement &bone substitutes, single-use instruments, Ambulatory Surgery Center in the USA
Player profiles: 140
- 6 Majors: Zimmer Biomet, Depuy Synthes, Stryker, Smith & Nephew, Medtronic, Nuvasive & Globus
- 48 US Challengers: Enovis, Arthrex, Conmed, Exactech, etc.
- 55 European Challengers: Aesculap, Link, Medacta, Corin, Amplitude, etc.
- 31 Asian & Latin America Challengers: Microport, United, AK Medical, Teijin Nakashima, etc.
- 1. Orthopedic environment, drivers & limiters …
- Segmentation: Hip, knee, shoulder
- Segmentation: Spine, trauma & extremities
- Segmentation: Bone grafts & arthroplasty cement
- Summary of the orthopedic market: Market & trends, Competitive Landscape & Player strategies, Drivers & limiters, Key Success Factors for an orthopedic player
- Synopsis: Innovation & new products, Robotics & 3D printing, Impact of inflation, Covid & FX rate
- Opportunities: gaining market share through NPIs, level of Ebitda margin , long market visibility, solvency of payers, high barriers to entry & very active M&A
- Risks: regulatory burden, ASP almost frozen or declining, significant capex for instruments & CNC machines for orthopedic end-user market
- Orthopedics Macro environment: Political, Economic, Social / Culture, Technology, Environment, Legal & Regulatory
- Milestones in the orthopedic industry: major acquisitions, recalls, divestments, new-comers
- Product withdrawal cases over the past 20 years, 2000-2020
- Some product recall cases over the past 20 years, 2000-2020
- Market drivers: demographic & economic: Global population growth 1950-2050 and people over 65
- Market drivers: health expenses & obesity rates, USA, France & UK, 1980-2025
- Market drivers: innovation and new products are the differentiating factors on the orthopedic market: innovative, advanced and mature products
- Market drivers: innovative surgeons, follower surgeons and conservative surgeons
- Market limiters: regulatory & certification, referents European directive 93/42 & ISO 13485, details, impact on the market
- Market limiter: reimbursement, a worldwide pricing regulation detailed for the USA, Germany, UK, Sweden, Italy, Belgium, Switzerland and France – Date of
- launch, Classification system and targets
- MDR (Medical Device Regulation): impact in Europe for implants and for instruments
- MDR: New deadline for Class III products fixed in December 2027
- Market limiter: Hip ASP erosion 2012-2023 in developed countries, USA, Australia, Japan & Europe
- Market limiter: Knee ASP erosion 2012-2023 in developed countries, USA, Australia, Japan & Europe
- 2. Orthopedic & spine market by region & forecasts
- Forecast Price for hip & knee 2023-2030: USA, Australia, Japan, Europe
- Drivers & limiters for Orthopedic products: matrix summarizing (volume, price) x (driver, argument, past impact & future impact)
- Worldwide implants market in 2023 in value by region (US$Bn): knee, hip & spine - USA, Europe & ROW
- Worldwide implants market in 2023 in value by region (US$Bn): trauma, shoulder & extremities - USA, Europe & ROW
- Hip & Knee by region (US$Bn): USA, Europe, South Korea, Australia, Japan & ROW
- Hip & knee ratio for 10,000 inhabitants, USA, Europe, South Korea, Australia, Japan, China & ROW. Growth by area for hip & knee CAGR 2023-2030
- Spine procedures: fusion (trauma, deformation, degenerative), non-fusion (spine dynamic) & vertebroplasty-kyphoplasty
- Spine & trauma by region (US$Bn): USA, Europe, South Korea, Australia, Japan – Rest Of the World
- Extremities & Shoulder by region: USA, Europe, South Korea, Australia, Japan – Rest Of the World
- The life cycle of orthopedic products: growth forecasts by 2030 for hip, knee, spine trauma & extremities
- Worldwide orthopedic market 2000-2023 and forecasts 2024-2030 for hip, knee, spine, trauma, shoulder, extremities, orthobiologics and other
- 3. Competitive landscape & players’ ranking & dispersion
- Three types of Challengers compete with the Majors: Challengers type 1 (country leader) / Challengers type 2 (country player) / Challengers type 3 (local
- vendors)
- Hip, knee & shoulder challengers growth: : Corin revenues 2014-2023, Medacta revenues 2014-2023, Lima revenues 2014-2023 ,Wright revenues 2014-2019
- Spine challengers are grabbing market share from the Majors and emerging as top players: Globus revenues 2014-2023, Nuvasive revenues 2014-2022 , K2M
- revenues 2014-2018
- Challengers have continuously gained market share except in 2020 due to Covid impact: challengers market shares collapsed between 3% to 6% for hip, knee,
- spine, trauma & total ortho
- Challengers have continuously gained market share except in 2020 due to Covid impact: challengers market shares evolution from 2017 to 2023 for hip, knee,
- spine, trauma & total ortho
- Table of Contents of Orthopedic End-User Markets & Technologies 2023-2030 & Profile of 140 key players
- Published August 2024 – 2nd Edition
- Majors vs. Challengers: Majors saved their margins while Challengers got the growth, position of each players in terms of market shares and ortho & spine
- revenues growth from 2014 to 2023
- Majors saved their margins, position of each players in terms of market shares and ortho & spine revenues growth from 2014 to 2023 and EBITDA margin
- details for Zimmer Biomet and for Stryker
- Stryker growth for 2019-2023, Depuy Synthes, Zimmer Biomet and Smith & Nephew. The challengers growth.
- The hip implant market is highly concentrated, with the 4 majors accounting for 68% of the market: ranking & dispersion in 2023: Top 4 / Top 5-10 / Other
- The knee implant market is highly concentrated, with the 4 majors accounting for 73% of the market: ranking & dispersion in 2023: Top 4 / Top 5-10 / Other
- The spine implant market is highly concentrated, with the 4 majors accounting for 69% of the market: ranking & dispersion in 2023: Top 4 / Top 5-10 / Other
- The Trauma implant market is highly concentrated, with the 4 majors accounting for 62% of the market: ranking & dispersion in 2023: Top 4 / Top 5-10 /
- Other
- The shoulder implant market is highly concentrated, with the 4 majors accounting for 70% of the market: ranking & dispersion in 2023: Top 4 / Top 5-10 /
- Other
- The extremities implant market is moderately concentrated, the 4 leaders accounting for only 42% of the market: ranking & dispersion in 2023: Top 4 / Top 5-
- 10 / Other
- The Orthobiologics market is moderately concentrated, the 4 leaders accounting for only 32% of the market: ranking & dispersion in 2023: Top 4 / Top 5-10 /
- Other
- Market by products: Hip market in details with 49 players* / Knee market in details with 38 players / Spine market in details with 46 players / Trauma market in details with 42 players / Shoulder market in details with 21 players / Extremities market in details with 43 players / Orthobiologics market in details with 41 players
- 4. Innovations & new technologies in orthopedics
- History of disruptive innovations: ceramics, hip dual mobility cup, short stem, anterior approach surgery, 3D printing for hips, cementless products, robotics,
- specific ceramic parts for the knee, reversed for shoulder, disk, 3D printing cages for spine
- Innovation and new products are the differentiating factors on the orthopedic market
- Innovation level comparison between Smith & Nephew and Alphatec Spine
- Orthopedic robotics
- Orthopedic robotic market: MAKO from Stryker, ROSA from Zimmer Biomet, Navio of Smith & Nephew, Mazor from Medtronic and Velys from Depuy robotic
- systems
- Navigation Vs robotic assisted surgery comparison: tools description, features, end-user price, easy to use, pro&cons
- Stryker with Mako’s acquisition boosted the orthopedic robotic market and have a huge impact on instruments market
- Orthopedic robotics surgeries: Stryker open the mass market, Smith & Nephew, Zimmer Biomet, Depuy and many others have followed
- New generations of Mako for shoulder and spine surgery planned for the coming years & Stryker Mako installed base machines 2017-2023 for hip & knee
- Robotic-assisted surgeries: the USA is by far the leading country for robotics usage. Knee surgery is the first target: number of surgeries conducted in US
- 2015-2027 for Stryker, Smith & Nephew, Zimmer Biomet, Depuy, Think Surgical & other companies
- 3D Printing
- 3D Printing in Orthopedics: Zimmer opened up this market with Trabecular Tantalum then Lima & Adler, Italian-based companies, started mass market sales
- Story of Zimmer and Trabecular Tantalum 1997-2025
- Zimmer Trabecular metal product portfolio: Patellar knee implant, femoral et tibial cone augments, acetabular revision system, acetabular cup, reversed
- shoulder system, shoulder glenoid part, knee tibial plate, primary hip stem
- Metal 3D Printing: technologies and major players, EOS, Arcam, SLM Solutions, Concept Laser, other players by raw materials used and technologies
- Number of Arcam EBM installed base for orthopedic industry at Lima 2007-2023 and % of hip cups and shoulder glenoid made by 3D printing machines
- Number of EBM installed base at AK MEDICAL 2010-2020
- Illustrative build-up speed and resolution of selected Metal 3D Printing systems: EBM Vs Selective Laser Melting (SLM) comparison between maximum build-
- up speed in cm3/h and resolution
- Smith & Nephew uses 3D Printing: 20 EOS M290 for metal and 3 for plastic to produce hip cup & customized cutting blocks in 2023 to manufacture
- customized cutting blocks and hip revision cup
- Stryker has announced massive investments in 3D Printing, In 2016, a US$400 Million plan to build a 3D printing manufacturing facility in Cork, Ireland was
- released. Today, many of Stryker's products are made by 3D printing
- Current Stryker products made by 3D Printing: knee tibial plate, patellar knee implant, knee augment, cages, other
- Depuy Spine uses 3D Printing for prototyping complex surgical tools
- Depuy announced investments in 3D printing
- DePuy Synthes has acquired 3D printing technology from Tissue Regeneration Systems
- DePuy Synthes Launched 3D Printed Titanium Facial Reconstruction Implants in US
- XILLOC for Cranio-Maxillofacial applications using PEEK and titanium alloys
- 3D printing machine suppliers for orthopedics, installed base: EOS, ARCAM, CONCEPT LASER, SLM Solutions, 3D Systems and their customers. Number of
- installed base machines per machine manufacturer
- Addressable market should increase with lower 3D Printing cost: cost and complexity curve linked with addressable market
- Table of Contents of Orthopedic End-User Markets & Technologies 2023-2030 & Profile of 140 key players
- Published August 2024 – 2nd Edition
- 3D Printing is attractive for reconstructive implants to accelerate and improve osteo-integration.
- Number of implants produced using 3D Printing: Stryker , Zimmer Biomet , Lima , Exactech, Adler Ortho, etc.
- FDA clearance for medical devices using 3D Printing in USA 2010-2023
- 3D Printing has reached the mass market for a few key products: hip cups, tibial knee, spine cages, shoulder glenoid and several trauma have switched to 3D
- Printing
- 3D Printing and impact on the forging, casting & machining of implants.
- Cages for spine surgeries in the five main European countries
- Is 3D Printing the right option for the implant Contract Manufacturing business? Analysis of different products & players for reconstructive implants, standard
- cages, special cages and customized implants - Benefits / Drivers & Limiters for each products
- The most manufactured orthopedic products by 3D Printing
- Standard manufacturing process Vs 3D Printing process: cost comparison for hip cup, knee tibial, spine cages and shoulder glenoid
- Trend of the installed bases of the main machine suppliers: the number of 3D Printing machines used in orthopedics 2015-2023
- 3D Printing In-house & Contract Manufacturing market 2015-2030 by hip cup, knee tibial plate, shoulder glenoid, spine cage, other parts: in value
- REACH & impact on Co-Cr
- EU Regulation 2017/745 says that a CMR substance
- Cobalt-Chrome usage in the main orthopedic products
- REACH regulation: ban on Co-Cr for implants ?
- Co-Cr has been used for decades for friction parts in implants
- Oxinium Hip & Knee is a breakthrough bearing solution comparable to ceramic bearings.
- Anti-allergic solutions against nickel, cobalt, etc. have been developed for several decades
- Orthobiologics
- Use of antibiotics for orthopedic cements: need for cements with new antibiotics
- Synthetic or natural bone substitutes, allografts
- Main bone grafts on the market: injectables and antibiotics are the main drivers: injectable & non-injectable
- Covid & Inflation impact
- Impact of inflation on the end-user market and on contract manufacturing: Majors OEMs & Majors CMOs quotes
- FX rate variation from January 2018 to September 2022:The Euro has devalued by almost 20% Vs the US Dollar! In the year 2023, Swiss franc , Yens, etc..
- Impact of exchange rate fluctuations on the major orthopedic companies
- Single use
- Single-use trend: the introduction of single-use starts with the less expensive cutting tools: drills, taps, burrs, pins, sawblades, rasps & acetabular reamers
- Single use in the USA & Europe: trauma and extremities are the largest consumers of single-use cutting tools and disposable kits - % of single use USA and Europe 2018-2026
- Ambulatory Surgery Center – ASC in the USA
- Ambulatory Surgery Center – ASC in the USA, expected to skyrocket for hip, knee, spine and trauma non-complex surgeries!
- 5. Player profiles:
- 6 Major profiles Zimmer Biomet, Depuy Synthes, Stryker, etc
- 48 US Challengers Exactech, Enovis, Arthrex, etc
- 55 European Challengers Aesculap, Link, Medacta, Corin, Amplitude, etc
- 31 Asian & Latin America challengers Microport, United, AK Medical, Teijin Nakashima, etc
- Conclusions, Executive summary
- Appendices
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