Total Ankle Replacement Market - Growth, Trends, COVID-19 Impact, and Forecasts (2022 - 2027)

Total Ankle Replacement Market - Growth, Trends, COVID-19 Impact, and Forecasts (2022 - 2027)

The Total Ankle Replacement Market is expected to witness a CAGR of 6.3% during the forecast period.

The COVID-19 pandemic has severely impacted the market growth as it had led to the cancelation or postponement of the scheduled treatment procedures along with a decreased number of new diagnoses and treatment procedures. Similarly, according to the National Joint Registry 18th Annual Report 2021, published in January 2021, titled ‘The COVID-19 induced joint replacement deficit in England, Wales, and Northern Ireland’, there was a significant deficit in the provision of joint replacement with 106,922 (48.8%) fewer procedures performed in 2020 as compared to 2019. In addition, (52%) fewer knee replacement procedures were performed in 2020, followed by 533 (53%) fewer ankle replacements. As per the same source, Wales and Northern Ireland were disproportionately impacted with an overall reduction of 8,001 (67%) and 2,833 (64%) joint replacement procedures, respectively. Thus, the fewer number of joint replacement procedures performed in England, Wales, and Northern Ireland has impacted the quality of life of patients suffering from various joint-related disorders and chronic pain. Also, according to the article published in the National Library of Medicine in November 2020, titled “The Effect of COVID-19 on Orthopedic Practices and Surgeons in Louisiana”, it was concluded from 99 survey responses that 81 of 97 responded reported delays in getting routine care for their orthopedic injuries. Hence, COVID-19 has had a significant impact on the studied market growth during the pandemic.

Certain factors that are propelling the market growth are the rising geriatric population and the growing prevalence of osteoarthritis and rheumatoid arthritis.

The increasing aging population is expected to increase the market growth as they are more prone to develop joint-related disorders due to decreasing bone density. For instance, according to an article published by the Journal of Family Medicine and Primary Care, in January 2021, titled ‘Prevalence of knee osteoarthritis, its determinants, and impact on the quality of life in elderly persons in rural Ballabgarh, Haryana’, it has been observed that 64.3% of the elder population is suffering from knee osteoarthritis and the elderly patients with knee osteoarthritis have considerably poorer quality-of-life. Thus, the increasing burden of knee osteoarthritis among the population is expected to increase the occurrence of pain inside and outside of the ankle. This condition is expected to increase the demand for ankle replacement due to chronic ankle pain, thereby propelling market growth.

Additionally, according to an article published by the Oxford Journals of rheumatology, in January 2021, titled ‘Ankle arthritis – an important signpost in rheumatologic practice, it has been observed that 15% of people worldwide suffer from symptomatic osteoarthritis of any joint, 6% to 10% from symptomatic knee osteoarthritis and just 1-4.4% from symptomatic ankle osteoarthritis. Also, as per the study published by the Sage Journal of Cartilage, in December 2021, titled ‘Health-Related Quality of Life in Ankle Osteoarthritis: A Case-Control Study, it has been observed that the prevalence of ankle osteoarthritis in professional foot players was between 9% - 19% and in rugby player was 4.6%. In addition, as per the same source, 70%-78% of the ankle osteoarthritis cases were post-traumatic effects in younger patients with a longer projected life span unlike hip and knee osteoarthritis and 22% were due to secondary causes such as rheumatoid arthritis (5%-12%), hemophiliac (1%-2%), septic (1%-2%), congenital (2%), and others. Patients with ankle osteoarthritis have a poor physical and mental quality of life. Thus, the increasing burden of ankle osteoarthritis among the population is expected to increase the demand for ankle replacements that reduce ankle pain, increase joint stability, and improve overall mobility which is expected to propel the market growth over the forecast period.

Furthermore, the rising company’s focus on developing advanced technology and rising product approvals is also contributing to the market growth. For instance, in December 2020, Exactech a developer and producer of innovative implants, instrumentation, and smart technologies for joint replacement surgery, performed the first ankle replacement procedure using Vantage Ankle PSI patient-specific surgical planning and 3D-printed instruments. Also, in February 2020, the United States Food and Drug Administration approved In2Bones Global’s Quantum Total Ankle for commercialization. The new total ankle replacement system treats patients who suffer from arthritis and is designed to improve patient mobility, increase stability, and technologically advance implant placement based on patient-specific anatomy.

However, the risks associated with total ankle replacement surgery are likely to impede the market growth over the forecast period.

Key Market TrendsHINTEGRA Total Ankle Replacement Segment Expects to Register a High CAGR in the Total Ankle Replacement Market Over the Forecast Period

Total ankle replacement, a form of ankle arthroplasty or joint replacement surgery, involves prosthetics being used to replace the damaged parts of the ankle. The HINTEGRA prosthesis is a non-constrained three-component system made up of a mobile bearing consisting of ultra-high molecular weight polyethylene, a talar component, and a tibial component that provides axial rotation and normal flexion-extension mobility.

The HINTEGRA total ankle replacement segment is expected to witness significant growth in the studied market over the forecast period owing to the factors such as increasing adoption of ankle replacement surgery as a treatment option for various ankle-related issues such as ankle chronic pain, ankle arthritis, end-stage ankle osteoarthritis, and others and the high preference of these devices and the surging aging population.

Total ankle replacement (TAR), which offers better results, has taken the lead in the management of end-stage ankle osteoarthritis. For instance, according to a report published by the Journal of Bone and Joint Surgery, in May 2022, titled ‘Long-Term Survival of HINTEGRA Total Ankle Replacement in 683 Patients: A Concise 20-Year Follow-up of a Previous Report’, the long-term survival of patients with HINTEGRA implant was assessed and it has been observed that the cumulative survival rate was 95% at 5 years, 86% at 10 years and 82% at 15 years. The high survival rate of the HINTEGRA total ankle replacement design is expected to fuel market growth over the forecast period.

Thus, owing to the aforementioned factors the segment is expected to grow over the forecast period.

North America Dominates the Market and Expects to do Same Over the Forecast Period

North America is expected to hold a significant share in the total ankle replacement market and show the same trend over the forecast period.

The factors attributed to the market growth are the rising prevalence of rheumatoid arthritis and osteoarthritis, high awareness among the people regarding ankle treatment, presence of well-established healthcare infrastructure, availability of reimbursements, and high healthcare spending in the region.

The increasing burden of joint-related disorders such as rheumatoid arthritis and osteoarthritis among the population is expected to increase the market growth. For instance, according to Statistics Canada 2021, approximately 5.9 million adult Canadians had arthritis in 2020. The prevalence of arthritis increases with age and is higher among females. In addition, according to the Centers for Disease Control and Prevention (CDC) updated in October 2021, about 1 in 4 United States adults (23.7%) or about 58.5 million people have doctor-diagnosed arthritis. Similarly, according to the Government of Canada in September 2020, approximately 374,000 (1.2%) Canadians aged 16 years and older live with diagnosed rheumatoid arthritis. Thus, the demand for ankle replacement increases with the increasing cases of arthritis and knee pain in patients, which affects the ankle by increasing compression on the foot and is expected to increase the market growth over the forecast period.

In addition, the growing geriatric population who are more prone to develop joint-related disorders, and ankle replacement is recommended for patients older than 60 years who do not participate in high-impact activities, such as running, and who are not overweight. For instance, according to the 2022 statistics published by the United Nations Population Fund, in the United States, a large proportion of the living population is aged 15-64 years and accounts for 65% in 2022. In addition, as per the same source, 17% of the population is aged 65 years and above in 2022. This is expected to increase the demand for ankle replacement surgeries, thereby fueling market growth.

Furthermore, the rising company focus on adopting various business strategies such as merger, acquisition, product launches and others are expected to increase the market growth over the forecast period. For instance, in January 2021, DJO, LLC acquired Trilliant Surgical, a national provider of foot and ankle orthopedic implants. This acquisition helps the company to expand its portfolio in the foot and ankle replacement market in the United States. Also, in July 2020, Vilex, LLC acquired DT MedTech, LLC along with its product line including Hintermann Series System Total Ankle Replacement (TAR). The TAR system includes the Hintermann Series H3 (H3) 3-piece, mobile-bearing TAR prosthesis. Under this acquisition, DT MedTech continued to manufacture all its products under the DT MedTech Quality System and market its products outside the United States through its existing distribution network, and the Hintermann Series System will be supported in the United States through the sales organization of Vilex.

Thus, owing to the aforementioned factors the studied market is expected to grow in the region over the forecast period.

Competitive Landscape

Globally, only a few major players control the major share of the market studied, which is primarily due to the need for high technological expertise in the development of devices and regulatory challenges involved in the development of total ankle replacement devices. Thus, the market is fairly consolidated. Some of the key players in the market are Johnson & Johnson, Stryker Corporation, MatOrtho, Zimmer Biomet, Exactech Inc., and Corin Group.

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