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The world knee and hip reconstruction market was estimated at over $14 billion in 2011, and expected to grow at a CAGR of 4.7 percent upto 2016. The market is characterized by a wide range of options, price variation and the elective nature of the procedure makes it particularly sensitive to economic trends. More 75 percent of the market is accounted for by developed economies; however highest growth rates are in emerging markets particularly China and India. The largest product segments are cemented knee and hip implants.
Factors driving the market inclue burgeoning rates of age-related conditions like osteoarthritis and osteoporosis, obesity-related conditions like diabetes that lead to peripheral neuropathies and sports-related injuries. A major driver in the mature markets has been the emergence of a younger patient population looking for high-functioning, longer-lasting technologies.
Factors restraininbg the market include: Economic slowdown; ASPs are being slashed to more affordable rates, regulatory impacts (recalls, medical device alerts and surveillance by joint registries in N. America and Europe); the hip market is mature in the US, W. Europe and Japan; cultural aversion to invasive procedures in most Asian countries and access to trained surgeons. Government sponsored reimbursement is being scaled back to increase fiscal efficiency. New companies find enormously high entry barriers that include both technology and regulatory hurdles.
Technology trends – materials (porous/ trabecular, antibiotic infused, more durable plastics like heavily cross-linked or ultra-high molecular weight polyethylene, graphitic surfaces that improve articulation, new combinations like ceramic on metal); designs (modular, gender and race-specific, patient-customized); fixation options now include hybrid implants that have cemented and cement-less components. Robotic surgery is optimizing precision of implantation while MIS devices are facilitating less traumatic surgery.
Leading players include: Zimmer, DePuy, Stryker, Smith and Nephew and Biomet. Other significant players include Aesculap, and Wright Medical among others.
Niche players with innovative products include Mako Surgical, BioPro Inc., CeramTec, ConfroMIS, and Corin Group among others.