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骨科产业策略报告（2024-2030）：髋关节、膝关节、脊椎、创伤、肩关节、四肢、骨科生物製剂及200家领先企业概况（第三版）
市场调查报告书
商品编码
1907773

骨科产业策略报告（2024-2030）：髋关节、膝关节、脊椎、创伤、肩关节、四肢、骨科生物製剂及200家领先企业概况（第三版）

Orthopedic Industry Strategic Report 2024-2030: Hip, Knee, Spine, Trauma, Shoulder, Extremities, Orthobiologics & Profile of 200 Key Players, 3rd Edition
出版日期: | 出版商: AVICENNE | 英文 400 Pages, 550 Exhibits, 200 Orthopedic Company Profiles | 商品交期: 最快1-2个工作天内

价格
简介目录

摘要：

骨科市场环境、驱动因素与限制因素

按地区划分的骨科市场及预测

竞争格局、主要公司排名及分布

骨科领域的创新与新技术－机器人技术、3D列印、REACH法规及其对美国钴铬合金、骨科生物製剂、一次性产品和门诊手术中心（ASC）的影响。

主要公司简介：200 家公司

  • 6 家主要公司：Zimmer Biomet、Depuy Synthes、Stryker、Smith & Nephew、Medtronic、NuvasIV.e、Globus
  • 48 家美国竞争对手：Exactech、Enovis、Arthrex、Conmed 等
  • 55 欧洲竞争对手：Aesculap、Link、Medacta、Corin、Amplitude 等
  • 31 家亚洲及拉丁美洲竞争对手：Microport、United、AK Medical、Teijin Nakashima 等

重点领域：髋关节、膝关节、肩关节、创伤、脊椎和四肢

目录

研究目标、研究方法、髋关节、膝关节、肩关节、脊椎的分割创伤、四肢、骨替代材料以及骨科和脊椎水泥，摘要和摘要整理

  • 摘要整理
  • 骨科市场概要：市场与趋势、竞争格局与参与者策略、驱动因素与限制因素、骨科企业的成功因素
  • 概要：创新与新产品、机器人与3D列印、通货膨胀、新冠疫情与汇率的影响
  • 机会：新产品上市带来的市占率成长、EBITDA利润率水准、长期市场可见度、支付方支付能力、高准入门槛以及活跃的併购活动

第一章 骨科环境

  • 骨科宏观环境：政治、经济、社会/文化、科技、环境、法律与监管风险
  • 风险：监管负担、平均售价接近冻结或下降，以及骨科终端用户市场在仪器和CNC工具机方面的大量资本投资
  • 骨科产业里程碑：重大收购、召回、资产剥离与新进业者
  • 过去20年（2000-2020）的产品召回状况
  • 市场驱动因素：人口成长、65岁以上人口、医疗成本、肥胖及产品组合影响
  • 市场驱动因素：人口统计与经济：1950-2050年全球人口成长及65岁以上人口
  • 市场驱动因素：1980-2025年美国、法国和英国的医疗保健成本和肥胖率
  • 市场驱动因素：创新和新产品是骨科市场的差异化因素：创新、先进和成熟产品
  • 市场驱动因素：创新外科医师、追随者和保守外科医师
  • 市场限制因素：监理与认证、详情及市场影响
  • 市场限制因素：报销、全球定价监管详情（美国、德国、英国、瑞典、义大利、比利时、瑞士和法国）、上市日期、分类系统和覆盖范围
  • 市场限制因素：医疗器材法规 (MDR)：对欧洲植入物和器械的影响
  • 市场限制因素：MDR：III 类产品的新截止日期：2027 年 12 月
  • 市场限制因素：已开发国家、美国、澳洲、日本和欧洲的髋关节平均售价下降（2012-2024 年）
  • 市场限制因素：已开发国家、美国、澳洲、日本和欧洲的膝关节平均售价下降（2012-2024）

第二章 骨科及脊椎市场及区域预测

  • 2024-2030年髋关节与膝关节价格预测：美国、澳洲、日本、欧洲
  • 骨科产品驱动因素与限制因素：（销售、价格）×（驱动因素、讨论、过去影响、未来影响）总结矩阵
  • 2024年全球植入物市场：按地区划分的价值（十亿美元）：膝关节、髋关节、脊椎 - 美国、欧洲、世界其他地区
  • 2024年全球植入物市场：按地区划分的价值（十亿美元）：创伤、肩关节、四肢 - 美国、欧洲、世界其他地区
  • 按地区划分的髋关节和膝关节疾病（十亿美元）：美国、欧洲、日本、澳洲、韩国、世界其他地区
  • 髋关节和美国、欧洲、韩国、澳洲、日本、中国和世界其他地区每 10,000 人中的膝关节疾病发生率。 2024-2030年髋关节和膝关节手术区域复合年增长率
  • 2024年脊椎与创伤市场（十亿美元）：美国、欧洲、韩国、澳洲、日本 - 世界其他地区
  • 脊椎手术：融合术（创伤、畸形、退化）、非融合术（动态脊椎变化）、椎体成形术/椎体后凸成形术
  • 肩关节和四肢手术（十亿美元）：美国、欧洲、日本、澳洲、韩国、世界其他地区
  • 骨科产品生命週期：2024-2030年髋关节、膝关节、脊椎、创伤和四肢的成长预测
  • 2024年全球骨科市场及2024-2030年预测：髋关节、膝关节、脊椎、创伤、肩关节、四肢、骨科生物製剂及其他世界

第三章 进入策略：竞争格局、进入者排名与分散

  • 三种类型的竞争对手与领导企业竞争：公司类型 1（全国领导企业）、公司类型 2（全国性新进业者）和公司类型 3（本地供应商）。
  • 髋关节、膝关节和肩关节竞争对手成长：Colin 收入（2014-2024 年）、Medacta 收入（2014-2024 年）、Lima 收入（2014-2023 年）和 Wright 收入（2014-2019 年）。
  • 脊椎领域的竞争对手正在从领导企业手中夺取市场占有率，并崛起成为主要参与者。 Globus 营收（2014-2024 年）、NuvasIV.e 营收（2014-2022 年）、Depuy "脊椎及其他" 营收（2016-2024 年）、K2M 营收（2014-2018 年）
  • 除受新冠疫情影响的 2020 年外，竞争对手的市占率持续成长。在髋关节、膝关节、脊椎、创伤和整体骨科领域，竞争对手的市占率下降了 3% 至 6%。
  • 除受新冠疫情影响的 2020 年外，竞争对手的市占率持续成长。髋关节、膝关节、脊椎、创伤和整体骨科领域的竞争对手市场占有率趋势（2018-2024 年）
  • 领先企业与竞争对手：领先企业确保了利润率，竞争对手则实现了成长。从 2019 年到 2024 年，各厂商在市占率和骨科及脊椎收入成长方面均发生了变化。
  • 2019-2024 年：自 2019 年以来，只有 Stryker 维持了 6.5% 的年增长率。 Globus 与 NuvasIV.e 合併。其他主要厂商的成长速度放缓或出现下滑。整体而言，竞争对手的成长较为温和，但许多厂商实现了两位数的成长。
  • 为什么竞争对手的成长速度超过主要厂商？
  • 髋关节植入物市场高度集中，四家主要厂商占了 61% 的市场。 2024 年排名及分布：前 4 名/前 5-10 名/其他
  • 膝关节植入物市场高度集中，四家主要厂商占了 73% 的市占率。 2024 年排名及分布：前 4 名/前 5-10 名/其他
  • 脊椎植入物市场高度集中，四家主要厂商占了 59% 的市场。 2024 年排名及分布：前 4 名/前 5-10 名/其他
  • 创伤植入物市场高度集中，四家主要製造商占了 65% 的市场。 2024 年排名及分布：前 5 名/前 6-10 名/其他
  • 肩关节植入物市场高度集中，四家主要製造商占了 69% 的市场。 2024 年排名及分布：前 4 名/前 5-10 名/其他
  • 四肢植入物市场集中度中等，四家主要领导者仅占 44% 的市占率。 2024 年排名及分布：前 4 名/前 5-10 名/其他
  • 骨科生物製剂市场集中度中等，四家主要领导企业仅占 28% 的市占率。 2024 年排名及差异：前 4 名/前 5-10 名/其他

第四章：骨科领域的创新与新技术

  • 颠覆性创新历史：陶瓷、双动髋臼杯、短柄、前路手术、3D 列印髋关节、无骨水泥产品、机器人技术、特定陶瓷膝关节组件、肩关节反向置换术、椎间盘、3D 列印脊椎融合器
  • 市场驱动因素：骨科领域通常较为保守，颠覆性创新较少，且往往来自规模较小的公司，但小型渐进式创新却层出不穷。
  • Alphatec Spine 公司 82% 的营收来自新产品。
  • 史密斯医疗：平均每年推出的新产品数量。
  • 比较史密斯-内普公司和阿尔法泰克脊椎公司的创新程度。

骨科机器人

  • 骨科机器人市场：史赛克公司的MAKO、捷迈邦美公司的ROSA、史密斯-内普公司的Navio、美敦力公司的Mazor、德普机器人系统的Velys、OMNIlife Science公司的Omni Robotic、Corin公司的Apollo以及Tinavi。 导航辅助手术与机器人辅助手术比较：工具描述、功能、终端使用者价格、易用性、优缺点。
  • 史赛克公司收购Mako重振了骨科机器人市场，对器械市场产生了重大影响。
  • 骨科机器人手术：史赛克公司率先开拓了大众市场，接着是史密斯-内普公司、捷迈邦美公司、德普公司等。
  • 新一代Mako肩关节和脊椎手术系统于2024年推出，而Stryker Mako系统则于2017年至2024年间作为髋关节和膝关节手术的基础设备投入使用。
  • 新一代Rosa肩关节手术系统于2024年推出，而Zimmer Biomet Rosa系统则于2017年至2024年间作为髋关节和膝关节手术的基础设备投入使用。
  • 新一代Cori术前规划和建模系统（支援无影像和基于影像的规划）将于2024年推出，而Smith & Nephew Navio和Cori系统将作为髋关节和膝关节手术的基础设备投入使用，时间跨度为2020年至2024年。
  • 新一代Velys脊椎手术系统将于2024年推出，而Depuy Synthes Velys系统将作为髋关节和膝关节手术的基础设备投入使用，时间跨度为2021年至2024年。 2024年。
  • 机器人骨科系统基准测试：目前有多种骨科机器人系列，包括手持式和机械手臂的。 Mako、Rosa 和 Velys 提供机械手臂选项，而 Cori 为手持式。另一种差异在于是否需要 CT 扫描（无影像）。有些机器人不需要 CT 扫描。只有 Mako 使用导引切口。此外，Mako 和 Velys 可进行直接机器人切口，无需切口导引器。而 Cori 使用多个切口导引器，Rosa 仅使用胫骨切口。
  • Mako、Rosa、Velys 和 Cori 的 2024 年营运和购置成本基准
  • 产品基准：Mako 是临床上经验最丰富的机器人，但购置成本也较高。
  • 澳洲一直是骨科创新领域的先驱。德国和日本将是成长最快的市场。法国在机器人膝关节手术方面远远落后。 2020-2030年澳洲、日本、德国、义大利、英国和法国的机器人膝关节手术数量（千例）
  • 美国以外的机器人辅助手术：预计2024年至2030年间，美国以外的机器人膝关节手术数量将从10万例以上增至30万例以上。德国和英国预计将在数量方面领先。 2020年至2030年美国以外的机器人膝关节手术数量（千例）：澳洲、日本、德国、义大利、英国、法国、欧洲其他地区、世界其他地区

3D列印

  • 骨科领域的3D列印：Zimmer公司率先使用钽金属小梁材料开发了这一市场，随后义大利的Lima & Adler公司开始向大众市场销售该产品。
  • Zimmer 与小梁钽金属的故事 (1997-2025)
  • Zimmer 小梁金属产品组合：髌骨植入、股骨和胫骨锥形增强器、髋臼翻修系统、髋臼杯、反向肩关节系统、肩胛盂组件、膝胫钢板和初次髋关节柄
  • 金属 3D 列印：技术和主要参与者，EOS、Arcam、SLM Solutions、Concept Laser 和其他参与者（按使用的材料和技术分类）
  • 2007 年至 2023 年在利马骨科行业安装的 Arcam 电子束 3D 列印 (EBM) 数量以及 3D 列印髋臼杯和肩胛盂的百分比
  • 2010-2020 年 EBM 在医疗领域的应用数量
  • 部分金属 3D 列印的建造速度和解析度比较范例系统：电子束熔化 (EBM) 和选择性雷射熔化 (SLM) 的最大成型速度 (cm³/h) 和解析度比较
  • 史密斯和内普公司拥抱 3D 列印：该公司将使用 20 台 EOS M290 金属 3D 列印设备和 3 台塑胶 3D 列印设备，于 2024 年生产客製化切割模组和髋关节翻修杯。
  • 史赛克公司宣布对 3D 列印技术进行重大投资，并于 2016 年宣布计划在爱尔兰科克郡建造一座价值 4 亿美元的 3D 列印製造工厂。目前，史赛克公司的许多产品都是采用 3D 列印技术製造的。
  • 目前史赛克公司采用 3D 列印技术製造的产品：膝关节胫骨板、髌骨植入物、膝关节增高器、椎间融合器等。
  • 德普脊椎公司利用 3D 列印技术製作复杂手术器械的原型，并宣布对 3D 列印技术进行投资。
  • DePuy Synthes 收购 Tissue Regeneration Systems 的 3D 列印技术。
  • DePuy Synthes 在美国推出 3D 列印钛合金脸部重建植入物。
  • XILLOC 采用 PEEK 和钛合金，用于颅颜面外科手术。
  • 骨科 3D 列印机供应商（2024 年安装量）：EOS、ARCAM、CONCEPT LASER、SLM Solutions、3D Systems 及其客户。按製造商划分的已安装设备数量。
  • 随着 3D 列印成本的下降，潜在市场规模可望扩大：成本-复杂性曲线与潜在市场规模相关。
  • 3D 列印技术因其能够加速和改善骨整合，在重建植入物领域具有吸引力。
  • 采用 3D 列印技术製造的植入物数量：Stryker、Zimmer Biomet、Lima、Exactech、Adler Ortho 等。
  • 美国 FDA 对 3D 列印医疗器材的核准情况（2010-2024 年）
  • 3D 列印技术已在多个关键产品领域实现了大众市场渗透。髋关节杯、胫骨膝关节板、脊椎融合器、肩关节窝以及一些创伤性损伤的修復均已转向 3D 列印技术。
  • 目前，3D 列印技术对植入物的锻造、铸造和机械加工的影响甚微。我们的研究表明，Stryker 及其竞争对手在 3D 列印技术的应用方面最为先进，尤其是在髋关节杯、胫骨膝关节板和脊椎融合器领域。全球采用 3D 列印技术製造的植入物占比：2016-2030 年
  • 3D 列印的脊椎融合器正在超越 PEEK 和钛合金融合器，占更大的市场占有率。全球45%的椎间融合器和24%的髋臼杯均采用3D列印技术製造。
  • 3D列印及其对髋臼杯锻造、铸造和机械加工的影响
  • 欧洲五大主要国家的脊椎手术椎间融合器
  • 3D列印是否适合您的植入物合约製造业务？对各种产品和主要厂商的分析，包括重建植入物、标准椎间融合器、特殊椎间融合器和客製化植入物——每种产品的优势、驱动因素和限制因素
  • 3D列印是否适合您的医疗器材合约製造业务？用于製造客製化切割导板和复杂器械的各种产品和厂商的分析：Lincotek 3D列印业务详情
  • 大多数主要合约製造商已投资3D列印技术，并正在克服最初的学习曲线，进入规模化生产阶段。
  • 大多数3D列印骨科产品
  • 传统製造与3D列印：髋臼杯、膝胫钢板、脊椎融合器与肩关节球的成本比较
  • 主要机械供应商装置量趋势：骨科领域3D列印机数量（2015-2024）
  • 2015-2030年3D列印内部製造与合约製造市场：髋臼杯、膝胫钢板、肩关节球、脊椎融合器和其他组件（价值）

REACH法规与钴铬合金的影响

  • 钴铬合金目前用于六种主要骨科产品：股骨膝关节、双动衬垫、髋关节和肩关节头、双极髋臼杯和胫骨膝关节钢板。钴铬合金的使用情况因地区而异。 REACH法规：植入物中禁用钴铬合金。
  • REACH法规：目前没有计画禁止在植入物中使用钴铬合金，但自2025年5月起，钴铬合金植入物必须贴有CMR标籤。这不会对钴铬合金的使用产生重大影响。钴铬合金将继续用于已生产数十年且拥有悠久使用历史的植入物中。只有新的髋关节产品开发项目会受到影响。预计钴铬合金髋关节植入物的数量将保持稳定或略微下降。
  • 钴铬合金已在植入物的摩擦部件中使用数十年。
  • Oxinium髋膝关节是一种创新的轴承解决方案，可与陶瓷轴承相媲美。
  • 针对镍、钴等的抗过敏解决方案已研发数十年。

骨科生物製剂

  • 骨科骨水泥中的抗生素使用：新型抗生素骨水泥的需求
  • 骨水泥价格/配方：配方效应抵销骨科产业常见的小价格下降
  • 依合成或天然骨替代物、同种异体移植、生长因子、脱矿骨基质 (DBM)、异种移植和自体移植进行细分
  • 主要骨移植市场：注射和抗生素是主要驱动因素：注射剂与非注射剂的比较

通货膨胀的影响

  • 通货膨胀对终端用户市场和合约生产的影响：主要原始设备製造商 (OEM) 和合约生产商 (CMO) 的评论
  • 1 月以来的汇率波动2018 年至 2022 年 9 月：欧元兑美元贬值约 20%。瑞士法郎、日圆和其他货币将在 2023 年下跌。
  • 汇率波动对主要骨科公司的影响

一次性耗材

  • 一次性耗材趋势：一次性耗材将以价格低廉的切割工具为主，例如钻头、丝锥、锉刀、销钉、锯片、锉刀和髋臼扩孔器。
  • 美国和欧洲的一次性耗材：创伤和四肢是使用一次性切割工具和一次性工具包的最大领域——美国和欧洲一次性耗材市场占有率（2018-2026 年）
  • 切割工具：3D 列印技术有助于製造更轻、零件更少、成本更低的工具。

美国门诊手术中心 - ASC

  • 美国门诊手术中心 (ASC) 预计将迎来非复杂髋关节、膝关节、脊椎和创伤手术的激增。

第五章 参与者概况：

  • 六大主要参与者，年收入 90 亿美元至 20 亿美元
  • 参与者：年收入 10 亿美元至 1 亿美元
  • 参与者：年收入 10 亿美元至 4,000 万美元
  • 参与者：年收入 4000 美元至 2000 美元
  • 参与者：年收入 2000 美元至 1000 美元
  • 参与者：年收入 1000 美元
  • 结论，摘要整理
  • 附录
简介目录
Product Code: IMP 11-2025

Overview:

Orthopedic environment, drivers & limiters.

Orthopedic market by region & forecasts.

Competitive landscape & players' ranking & dispersion.

Innovations & new technologies in orthopedics: Robotics, 3D printing, REACH & impact on Co-Cr, Orthobiologics, single-use, Ambulatory Surgery Center - ASC in the USA.

Player profiles: 200.

  • 6 Majors: Zimmer Biomet, Depuy Synthes, Stryker, Smith & Nephew, Medtronic, Nuvasive & Globus
  • 48 US Challengers: Exactech, Enovis, Arthrex, Conmed, etc.
  • 55 European Challengers: Aesculap, Link, Medacta, Corin, Amplitude, etc.
  • 31 Asian & Latin America Challengers: Microport, United, AK Medical, Teijin Nakashima, etc.

Focus area: Hip, Knee , Shoulder, Trauma, Spine, Extremities.

Table of Contents

Aims of the study, Methodology, Hip, knee, shoulder, spine, trauma, extremities, bone substitutes & orthopedic and spine cement segmentation, Synopsis, Executive summary

  • Executive summary
  • 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

1. Orthopedic environment

  • Orthopedics Macro environment: Political, Economic, Social / Culture, Technology, Environment, Legal & Regulatory
  • Risks: regulatory burden, ASP almost frozen or declining, significant capex for instruments & CNC machines for orthopedic end-user market
  • Milestones in the orthopedic industry: major acquisitions, recalls, divestments, new-comers
  • Product withdrawal cases over the past 20 years, 2000-2020
  • Market drivers: population growth, population over 65 years, health expenses, obesity, product mix impact
  • 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, 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
  • Market limiter: MDR (Medical Device Regulation): impact in Europe for implants and for instruments
  • Market limiter: MDR: New deadline for Class III products fixed in December 2027
  • Market limiter: Hip ASP erosion 2012-2024 in developed countries, USA, Australia, Japan & Europe
  • Market limiter: Knee ASP erosion 2012-2024 in developed countries, USA, Australia, Japan & Europe

2. Orthopedic & spine market by region & forecasts

  • Forecast Price for hip & knee 2024-2030: USA, Australia, Japan, Europe
  • Drivers & limiters for Orthopedic products: matrix summarizing (volume, price) x (driver, argument, past impact & future impact)
  • Worldwide implants market in 2024 in value by region (US$Bn): knee, hip & spine - USA, Europe & ROW
  • Worldwide implants market in 2024 in value by region (US$Bn): trauma, shoulder & extremities - USA, Europe & ROW
  • Hip & Knee by region (US$Bn): USA, Europe, Japan, Australia, South Korea & ROW
  • Hip & knee ratio for 10,000 inhabitants, USA, Europe, South Korea, Australia, Japan, China & ROW. Growth by area for hip & knee CAGR 2024-2030
  • Spine & trauma by region in 2024 (US$Bn): USA, Europe, South Korea, Australia, Japan - Rest Of the World
  • Spine procedures: fusion (trauma, deformation, degenerative), non-fusion (spine dynamic) & vertebroplasty-kyphoplasty
  • Shoulder & Extremities by region (US$Bn): USA, Europe, Japan, Australia, South Korea & ROW
  • The life cycle of orthopedic products: growth forecasts by 2024-2030 for hip, knee, spine, trauma & extremities
  • Worldwide orthopedic market in 2024 and forecasts 2024-2030 for hip, knee, spine, trauma, shoulder, extremities, orthobiologics and other

3. Player strategies: 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 2014-2024, Medacta revenues 2014-2024, Lima revenues 2014-2023 ,Wright revenues 2014-2019
  • Spine challengers are grabbing market share from the Majors and emerging as top players: Globus revenues 2014-2024, Nuvasive revenues 2014-2022 , Depuy "Spine & other" revenues 2016-2024, 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 2018 to 2024 for hip, knee, spine, trauma & total ortho
  • 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 2019 to 2024
  • 2019-2024: Stryker is the only Major that has been growing at 6.5% per year since 2019. Globus merged with Nuvasive. The other Majors experienced slower growth or decline. Taken together, the challengers experienced moderate growth, but many of them have achieved double-digit growth
  • Reasons why Challengers are growing faster than Majors
  • The hip implant market is highly concentrated, with the 4 majors accounting for 61% of the market: ranking & dispersion in 2024: 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 2024: Top 4 / Top 5-10 / Other
  • The spine implant market is highly concentrated, with the 4 majors accounting for 59% of the market: ranking & dispersion in 2024: Top 4 / Top 5-10 / Other
  • The Trauma implant market is highly concentrated, with the 4 majors accounting for 65% of the market: ranking & dispersion in 2024: Top 5 / Top 6-10 / Other
  • The shoulder implant market is highly concentrated, with the 4 majors accounting for 69% of the market: ranking & dispersion in 2024: Top 4 / Top 5-10 / Other
  • The extremities implant market is moderately concentrated, the 4 leaders accounting for only 44% of the market: ranking & dispersion in 2024: Top 4 / Top 5-10 / Other
  • The Orthobiologics market is moderately concentrated, the 4 leaders accounting for only 28% of the market: ranking & dispersion in 2024: Top 4 / Top 5-10 / Other

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
  • Market drivers: orthopedics is generally risk-averse with few disruptive innovations, often coming from small players, but many small incremental innovations
  • For Alphatec Spine 82% of revenues are driven by New Products
  • Smith & Nephew: average new products launched per year
  • 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 Omni robotic from OMNIlife science, Apollo from Corin, Tinavi
  • 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 launched in 2024 & Stryker Mako installed base machines 2017-2024 for hip & knee
  • New generations of Rosa for shoulder surgery launched in 2024 & Zimmer Biomet Rosa installed base machines 2017-2024 for hip & knee
  • New generations of Cori pre-operative planning and modelling which allows image-free and image-based planning launched in 2024 & Smith & Nephew Navio & Cori installed base machines 2020-2024 for hip & knee
  • New generations of Velys for spine surgery launched in 2024 & Depuy Synthes Velys installed base machines 2021-2024 for hip & knee
  • Robotic orthopedic system benchmark: there are several families of orthopedic robots, handheld or with a robotic arm. Mako, Rosa and Velys have chosen the robotic arm, while Cori is handheld. Another variant is the need for a CT Scan or not (Imageless); only Mako uses a CT Scan. Finally, the use of cutting guides is eliminated for Mako and Velys, who operate direct cuts by the robot, while Cori uses several cutting guides and Rosa only for tibial cuts
  • Mako, Rosa, Velys and Cori benchmark in 2024 by operating cost and acquisition cost
  • Product benchmarking: Mako is the robot with the most extensive clinical track record, but the acquisition cost is high
  • Australia was always a pioneer in the use of innovations in orthopedics. Germany and Japan will be the fastest-growing markets. In France, the robotized knee ratio lags far behind. Australian, Japanese, German, Italian, UK and French knee surgeries performed with robotics (in K units) 2020-2030
  • Robotic-assisted surgeries outside the US: Between 2024 and 2030, the number of robotic knee operations outside the USA will rise from 100,000+ to over 300,000. Germany and the UK will lead the way in terms of volume. Outside US knee surgeries performed with robotics (in K units) 2020-2030: Australia, Japan, Germany, Italy, UK, France, Rest of Europe & Rest of the World

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 2024 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 and 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 in 2024: 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
  • 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 2010-2024
  • 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 today has a slight impact on the forging, casting & machining of implants. Our research shows that Stryker and challengers are most advanced in the use of 3D printing, particularly for hip cups, tibial knee plates and spinal cages. % of implants produced using 3D printing worldwide: 2016-2030
  • 3D printing cages are gaining in market share over Peek and Titanium cages. 45% of the world's cages are 3D printed, 24% of hip cups are too
  • 3D Printing and impact on the forging, casting & machining of hip cups
  • 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
  • Is 3D Printing the right option for the instruments Contract Manufacturing business? Analysis of different products & players for customized cutting guides and complex instruments: Lincotek 3D Printing activity details
  • Most large contract manufacturers are investing in 3D printing and, after an initial learning curve, are moving into the scale-up phase
  • 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 2015-2024
  • 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 is used today in 6 major orthopedic products: femoral knee, dual mobility liner, hip and shoulder heads, bipolar cups and tibial knee plates. The use of Co-Cr varies depending on the geographical area. REACH regulation: ban on Co-Cr for implants?
  • REACH regulation: no ban on Co-Cr for implants is expected, but from May 2025, Co-Cr implants have to be CMR-labeled, which will not have a major impact on Co-Cr use. Co-Cr will continue to be used for implants that have been manufactured for several decades and have a very long track-record. Only new hip product development projects will be affected. Co-Cr hip implants will be flat or slightly down
  • 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
  • Cement price / mix: mix effect offsetting small price erosion that is common in the orthopedic industry
  • Synthetic or natural bone substitutes, allografts, growth factors, Demineralized Bone Matrix (DBM), xenografts, autografts segmentation
  • Main bone grafts on the market: injectables and antibiotics are the main drivers: injectable & non-injectable

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
  • Cutting tools: 3D printing's contribution is to lighten and reduce the number of parts and generate cost savings

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 Majors from US$9B -> US$2B
  • Players: US$1B -> US$100M
  • Players: US$100M -> $40M
  • Players: US$40M -> US$20M
  • Players: US$20M -> US$10M
  • Players: US$10M ->
  • Conclusions, Executive summary
  • Appendices