U.S. Small Joint Orthopedic Devices Report Synopsis


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A Synopsis of the iData report which analyzes and evaluates the current state of the market including existing and potential markets, product average selling prices, and unit volumes. The report also highlights the opportunities and potential hazards involved, and presents strategies for successfully navigating the market landscape. Furthermore, it seeks to identify the trends and technologies that will affect the future of each market segment and prepares an unbiased critical assessment of such market drivers and limiters based on our “bottom up” approach, which includes primary and secondary research methods.

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U.S. Small Joint Orthopedic Devices Report Synopsis

  1. 1. U.S. Market for SmallBone & Joint Orthopedic Devices ~ Report Synopsis ~
  2. 2. U.S. Market for Small Bone & Joint Orthopedic DevicesIn 2012, the total U.S. market for small bone and jointorthopedic devices was valued at over $2 billion.The U.S. small bone and joint orthopedic device market includes shoulderreconstruction implants, elbow repair devices, hand and wrist devices, foot andankle devices and shape memory staples. All of these segments wereexperiencing positive growth in 2012, as the aging population continued to drivedemand along with the increased awareness for small bone and jointprocedures. Capitated pricing has been affecting the shoulder reconstructionand hand and wrist devices market segments, which is negatively impacting theoverall market. The ASPs of products in smaller market segments like the footand ankle devices and shape memory staples market segments however arenot being affected yet by capitated pricing. Overall, the strong positive growth inall segments will allow the entire market to grow rapidly over the 2012–2019forecast period.
  3. 3. U.S. Market for Small Bone & Joint Orthopedic Device Market, U.S., 2009 – 2019 Annual Growth Rate (%)Market Value (US$M) 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Year Source: iData Research Inc.
  4. 4. Shoulder Reconstruction MarketIn 2012, the reversed shoulder reconstruction market segment was the mostrapidly growing segment from the entire shoulder reconstruction market, witha growth of 13.1% over 2011.The shoulder reconstruction market is comprised of total shoulder implants, reversed shoulderimplants, partial shoulder implants, resurfacing implants and revision implants. Reversedshoulder implants were the most rapidly growing segment of the combined shoulderreconstruction market in 2012. Reversed shoulder implants are indicated for older patients withosteoarthritis that do not have a rotator cuff or have an irreparable rotator cuff. People are alsostarting to receive reversed shoulder implants for fractures instead of receiving hemi-arthroplasty. Since the entire rotator cuff is torn off in a fracture, reversed shoulder implants arebeing recommended by surgeons as a more suitable solution for this indication instead ofpartial shoulder implants. As a result of this recommendation trend, partial shoulder implantswere declining in unit sales growth in 2012; some of the loss in procedure volume was beingconverted to reversed shoulder procedures or total shoulder procedures. As procedurevolumes continue to climb, particularly for total and reversed shoulder implants, hospitals areturning more and more toward capitated pricing which is causing a slight deterioration in ASPs.However, since shoulder revision procedures are relatively low, they go more unnoticed byhospitals and thus are not yet affected by capitated pricing. Thus, ASPs will continue to slowlygrow over the forecast period for the shoulder revision market segment.
  5. 5. Shoulder Reconstruction Market Growth by Segment, U.S., 2012 Segment 1 Segment 2 Segment 3 Segment 4 Segment 5Annual Growth Rate (%) 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Year Source: iData Research Inc.
  6. 6. Elbow Repair MarketIn 2012, the elbow plate and screw market segment represented the largestportion of the total elbow repair market, exceeding revenue sales of $62.5million.The elbow repair market includes total elbow reconstruction prostheses, radial headprostheses and elbow plates and screws (for the olecranon and distal humerus). In 2012, semi-constrained total elbows were continuing to be adopted over unconstrained total elbows asdurability was a more pressing concern than the potential increase in mobility unconstrainedelbows offered. Unit sales of olecranon and distal humerus plates and screws were growing ahealthy rate as many radial head implant procedures also required use of these fracture repairdevices. Radial head implants were the most frequently used elbow joint replacement devicesin 2012. The radial head market has been increasing in competition over the past severalyears; moreover, recent literature suggests that press-fit radial head prostheses that try tocreate anatomic restoration of the joint do not have very good short to mid-term survival inpatients. They often need to be removed due to osteolysis of the proximal radius. Thus, non-press-fit (cemented) radial heads are expected to see the most growth over the forecast period.Capitated pricing has not yet affected ASP growth in the elbow repair market. The slow butsteady increase in prices will help fuel market growth along with the rise in procedures.
  7. 7. Elbow Repair Market by Segment, U.S., 2012 Segment 1 Segment 2 Segment 3Average Selling Price (US$) Number of Units Sold Note: The size of the bubble indicates the size of the market. Source: iData Research Inc.
  8. 8. Hand & Wrist MarketThe hand and wrist market is expected to grow at a CAGR of 4.8%over the forecast period, with wrist fusion plates being the fastestgrowing segment in this market.The hand and wrist device market includes total wrist implants, wrist fusion plates, distalradius plates, ulnar head implants and hand digit implants. Although the wrist fusionsegment comprised of the lowest revenues in the hand and wrist market, it was thefastest-growing segment of the total hand and wrist market in 2012 and is expected togrow the fastest over the forecast period. This is due to recent skepticism of total wristarthroplasty (TWA) by many surgeons who are choosing to stay with wrist fusions asthe standard of care in most cases. Hand digit implant devices were the slowestgrowing segment in the hand and wrist device market. These implants includeprostheses for the CMC, PIP and MCP joints with CMC thumb arthroplasties growingthe most rapidly of all the finger arthroplasties. The demand for these implants issomewhat dampened by the increasing efficacy of rheumatoid arthritis drugs; however,with more text messaging related injuries becoming prevalent and the ever rising agingpopulation, this market will still experience positive growth over the forecast period.Due to the recent acquisition of Synthes, the global leader of the trauma market, byJohnson & Johnson in June 2012, there has been a shift in market shares in both thedistal radius and wrist fusion market segments. Additionally, the acquisition of DePuy’sTrauma business by Biomet, has given a considerable boost to Biomet’s total share ofthe overall hand and wrist market.
  9. 9. Hand & Wrist Device Units Sold by Segment, U.S., 2009 – 2019 Segment 1 Segment 2 Segment 3 Segment 4 Segment 5 2009 2010 2011 2012 2013Year 2014 2015 2016 2017 2018 2019 Percent of Units Sold (%) Source: iData Research Inc.
  10. 10. Foot & Ankle Device MarketThe price of ankle replacement prostheses were over eight times higher thanthat of ankle arthrodesis devices, and their increased use is expected tocontinue to be a major contributor to the growth of the foot and ankle devicemarket over the forecast period.The foot and ankle device market was the most highly segmented market in the small boneand joint orthopedic device market and includes ankle prostheses, ankle arthrodesis screws,forefoot and midfoot devices, subtalar implants, foot digit implants, hammertoe devices andfoot and ankle external fixators. Although the foot and ankle device market was one thesmallest in the total small bone and joint device market, it was also the most rapidly growing.By 2019 it will surpass the size of the elbow repair market. Strong growth in the hammertoemarket due to increased efforts to educate patients about these procedures will be a largecontributor to overall foot and ankle market growth. Additionally, changes in the anklereplacement market involving the increased adoption of three-piece mobile bearing deviceshave been fueling market growth. There is a slight price premium on mobile bearing devicesand thus their continued adoption will contribute to foot and ankle market growth over theforecast period. The ankle arthrodesis market growth is increasingly being limited by stronggrowth of the ankle arthroplasty market as ankle replacements become more and moreaccepted as an alternate procedure to treating ankle arthritis.
  11. 11. Percent of Units Sold, Foot & Ankle Device Market, U.S., 2009 & 2019Segment 1 Segment 2 Segment 3 Segment 4 Segment 5Segment 6 Segment 7 2009 2019 Source: iData Research Inc.
  12. 12. Shape Memory Staple MarketIn 2012, the shape memory staple market was largely driven byunit growth. It will continue growing rapidly at a CAGR of 9.4%.Staples are available in two popular forms: mechanical compression and shapememory type staples. The shape memory staple consists only of those staplesmade from nitinol materials that change their shape when they reach atransition temperature that is higher than their storage temperature.Compression staples are used for internal fixation and are designed to applystatic or dynamic compression to two planar surfaces of bone.Shape memory staples are being increasingly preferred over mechanicalcompression staples because they allow for consistent compression across thefusion site, providing maximum force and allowing for better fusion to occur.The temperature sensitivity and enduring holding power make shape memorystaples more attractive to surgeons than mechanical compression staples fortrauma fixation, especially in the foot/ankle region. The better performance ofthese devices, which are priced at a premium, will continue to fuel strongmarket growth. Although the ASPs have been growing very slowly, marketgrowth has been mainly driven by the rapid unit sales growth which willcontinue to be the main driving force for growth in this market.
  13. 13. Unit & ASP Growth, Shape Memory Staple Market, U.S., 2009 – 2019 Annual Growth Rate (%) 2009 2012 Year 2019 ASP Growth Unit Growth Source: iData Research Inc.
  14. 14. Leading CompetitorsIn 2012, the recently formed DePuy Synthes Companies ofJohnson & Johnson held the leading position in the small boneand joint orthopedic device market largely due to their lead inplate and screw devices for wrist, feet and elbow fracture repair.DePuy Synthes are not usually considered to be a dominant competitor in thesmall bone and joint orthopedic device market, yet they dominated the distalradius plate segment, the olecranon and distal humerus plate segment, theankle arthrodesis segment and also the forefoot and midfoot device segment.Although the devices in the aforementioned segments are trauma fixationdevices, they are also sold by a number of small joint specialist companies.Another point of distinction is that although these two markets are more maturethan other extremity device segments, they have a broad clinical need, whichcorresponds to greater overall sales revenues. Outside of these segments,there is less disparity between market shares for the remaining segments of thecombined small bone and joint device market.Contingent upon the EUs approval for Depuy’s acquisition of Synthes was thatDePuy would sell their Orthopedic Trauma business to Biomet. This initialacquisition, that included the divisions in the U.S., U.K., Australia, NewZealand, Japan and Switzerland, was finalized in June 2012. Since then,Biomet have acquired all of DePuy’s trauma accounts and have maintained thesame pricing on these products to ensure a smooth transition. This acquisitionhas given Biomet a strong boost in their market share of several small boneand joint market segments in 2012.
  15. 15. Leading Competitors, Small Bone & Joint Orthopedic Device Market, U.S., 2012Others DePuy Synthes Source: iData Research Inc.