Orthopedics Markets

Orthopedics is a medical specialty that deals with the diagnosis and treatment of disorders and injuries to the skeletal system and the muscles, joints and ligaments associated with it. The orthopedics market has emerged as one of the most vibrant industries in the medical equipment sector. In the recent past, the orthopedics industry has witnessed major private equity transactions, several notable mergers and innovative product launches. As such, the orthopedics market has been experiencing a growth rate of nearly 5% to 7% annually. Five market leaders currently dominate the global market, each with about $2 billion or more in annual sales.

The purpose of this report is to provide a detailed analysis of the global market for orthopedics. The product segments covered in study include: reconstructive devices, fracture repair, arthroscopy/tissue repair, spinal implants/instrumentation, orthobiologics and other orthopedic products.

The study analyzes almost all of the companies known to be marketing, manufacturing or developing orthopedic products in the U.S. and worldwide. Each company is discussed in depth, with a section on its history, product line, business and marketing analysis, and a subjective commentary of the company's market position.

Also provided in this review are detailed tables, charts and figures with past and projected sales data by geographic region for the U.S., EMEA (Europe, Middle East, Africa), Japan, the Pacific Rim, Canada and Latin America.

Keywords: orthopedics, reconstructive devices, fracture repair, arthroscopy, tissue repair, spinal implants, orthobiologics SHOW LESS READ MORE >

1. Overview
1.1 Statement of Report
1.2 Scope of the Report
1.3 Methodology
1.4 Executive Summary

2. An Overview of Selected Orthopedic Surgical Procedures and Products
2.1 Scope of this Chapter
2.2 Surgery for Hip Implants
2.2.1 Cemented Hip Implants
2.2.2 Porous Hip Implants
2.2.3 Preparing for Hip Implant Surgery
2.2.4 Hip Surgery
2.2.5 Market Leaders in Hip and Knee Implants
2.2.6 Benefits of Hip and Knee Replacement
2.2.7 Most Common Hip Disorders
2.2.8 Total Hip Arthroplasty at the Global Level
2.3 Surgery for Knee Implants
2.3.1 Gender-Specific Knee
2.3.2 Viscosupplementation for the Osteoarthritis of the Knee
2.3.3 Synovial Injections and Efficacy
2.3.4 Market Leader's in Knee Products
2.3.5 Pricing Trends in Hip and Knee Implants
2.3.5.1 Total Hips
2.3.5.2 Partial Hips
2.3.6 Knee Implants
2.4 Shoulder Implants
2.4.1 Reverse Shoulder Replacement
2.4.2 Total Shoulder Replacement
2.4.3 Rotator Cuff Repair
2.5 Spine Anatomy
2.5.1 Spine Disorders
2.5.2 Spinal Implants
2.5.3 Spinal Fusion Surgery
2.5.4 Spinal Stabilization
2.5.5 Common Indications for Spine Surgery in the Elderly
2.5.6 Average Reimbursement by Spinal Indication
2.5.7 Medicare Reimbursements and Treatment Alternatives
2.5.8 Lumbar Spine Fusion: Providers and Reimbursement in the U.S.
2.5.9 Balloon Kyphoplasty
2.5.10 Elderly Spine Patients
2.5.11 Lumbar and Cervical Total Disc Replacement
2.5.12 Indications for Total Disc Replacement (TDR)
2.5.13 Percutaneous Procedures
2.5.14 Niche Markets in Spine
2.5.15 Complication Rates in Posterior Lumbar Fusion
2.6 Foot and Ankle
2.6.1 Ankle Fusion and Ankle Replacement
2.6.2 Deformities of Toes
2.6.3 Plantar Fascial Fibromatosis
2.6.4 Bunion
2.7 Finger Disorders
2.7.1 Carpal Tunnel Syndrome
2.8 Tennis Elbow
2.9 Trauma in Extremities
2.10 Arthroscopy
2.11 Extracorporeal Shock Wave Therapy
2.12 Bone Graft Materials
2.12.1 Allograft-Based Bone Graft Substitutes
2.12.2 Factor-Based Bone Graft Substitutes
2.12.3 Cell-Based Bone Graft Substitutes
2.12.4 Ceramic-Based Bone Graft Substitutes
2.12.5 Polymer-Based Bone Graft Substitutes
2.13 Electrical Stimulation in Fracture Healing
2.14 Materials Used in Orthopedic Implants
2.14.1 Implant Fabrication Process
2.14.2 Post-Fabrication Coatings
2.14.3 Forces Shaping the Implant Market
2.14.3.1 A New Class of Materials
2.14.4 Future Trends in Orthopedics

3. Orthopedics Market Analysis
3.1 Scope of this Chapter
3.2 Orthopedics Industry
3.3 Market Drivers in Orthopedics
3.3.1 Changing Lifestyle
3.3.2 Aging Population
3.3.3 Technology Advancements
3.3.4 Implants as Effective Alternatives to Drug Therapy
3.4 The Changing Focus of Medical Device Companies
3.5 The Primacy of Orthopedic Device Segment
3.6 Global Orthopedics Market
3.6.1 Market Leaders in Orthopedic Implants
3.6.2 Orthopedics Market Segment Overview
3.6.3 Global Orthopedics Market Leaders
3.6.4 Global Orthopedics Market by Geography
3.6.5 Future of Global Orthopedics Market
3.6.6 Global Spine Market
3.6.6.1 Future Market for Spinal Implants
3.7 Global Orthopedics Reconstructive Market
3.7.1 Future of Orthopedic Reconstruction Market
3.7.2 Global Trauma and Craniomaxillofacial Market
3.7.3 Future of Global Trauma and Craniomaxillofacial Market
3.8 Global Joint Replacement Market
3.9 Global Market for Fracture Repair
3.9.1 Patient Demographics in Bone Fractures
3.10 Craniomaxillofacial Reconstruction
3.11 Global Biomedical Metal Market
3.12 Global Orthobiologics Market
3.12.1 Spinal Fusion: 75% of All Bone Grafts
3.12.2 Foot and Ankle Fusions
3.12.3 Orthopedic Trauma
3.12.4 Reconstruction
3.12.5 Biologic Solutions in Sports Medicine
3.12.6 Future of Global Orthobiologics Market
3.13 Medsurg Equipment Market
3.13.1 Global Endoscopy Market
3.14 Global Market for Non-Invasive Orthopedics
3.15 Funding Scenario in Orthopedics
3.16 Orthopedics Market in the U.S.
3.16.1 Reimbursement and Healthcare Costs in the U.S.
3.16.2 Overspending on Orthopedics in the U.S.
3.17 U.S. Market for Musculoskeletal Products
3.18 U.S. Orthopedic Reconstruction Market
3.19 U.S. Back Pain Market
3.20 U.S. Market for Orthopedic Biomaterials
3.21 The Landscape for Spinal Products in the U.S.
3.21.1 Reimbursement for Spinal Procedures
3.21.2 Causes of Spinal Cord Injuries in the U.S.
3.21.3 Most Common Spine Ailments in the U.S.
3.21.4 Disc Displacements
3.21.4.1 Degenerative Disc Disease
3.21.4.2 Vertebral Dislocation
3.21.4.3 Spondylosis
3.21.4.4 The Growing Spinal Revenue
3.21.4.5 High Growth Rate by Large Companies
3.21.4.6 Medicare's Spine Surgery Burdens in the U.S.
3.21.4.7 Common Indications for Spine Surgery in the U.S.
3.21.4.8 Average Reimbursement by Indication
3.21.4.9 Medical Reimbursement and Treatment Alternatives
3.21.4.10 Comorbidities in Lumbar Fusion: Medicare vs. Private Pay
3.21.4.11 Providers and Reimbursement for Lumbar Spine Fusion in the U.S
3.21.4.12 Artificial Disc, Facet and Nucleus Replacement and Dynamic Stabilization
3.21.5 The U.S. Spine Market
3.22 Total Knee Arthroplasty in the U.S.
3.23 U.S. Market for Endoscopic Surgery Products
3.24 Market for Bone Graft Substitutes in the U.S.
3.25 U.S. Orthopedic Biomaterials Market
3.26 U.S. Market for Orthopedic Soft Tissue and Sports Medicine
3.27 Orthopedic Surgeons in the U.S.
3.28 Orthopedic Brace and Support Market in the U.S.
3.29 Orthopedics in Europe
3.30 Orthopedic Device Market in China
3.30.1 Growth Drivers
3.30.2 Chinese Orthopedics Market Size and Growth
3.30.3 Major Orthopedic Device Players in China

4. Company Profiles
4.1 aap Implantate AG
4.1.1 aap's Bone Replacement Products
4.1.1.1 PerOssal
4.1.1.2 Ostim
4.1.1.3 Cerabone
4.1.2 Soft Tissue Regeneration
4.1.2.1 AdconGel
4.1.2.2 Jason
4.1.2.3 Hynoval
4.1.3 aap's Cementing Techniques
4.1.3.1 Easymix
4.1.3.2 MicroAire Hi Speed Pulse Lavage System
4.1.4 aap's Trauma Products
4.1.4.1 Angle-Stable Plates
4.1.4.2 Proximal Humerus Plate
4.1.4.3 Angle Stable Distal Radial Plate
4.1.4.4 Trauma Shoulder System
4.2 AlloSource
4.2.1 AlloSource's Selected Osteobiologics 1
4.2.1.1 AlloFuse DBM Putty
4.2.1.2 AlloSource's Spinal Grafts
4.2.1.3 Sports Medicine Grafts
4.3 Alphatec Spine
4.3.1 The Alphatec Solution
4.3.2 Alphatec's Business Performance
4.4 Amedica/U.S. Spine
4.4.1 Amedica/U.S. Spine's Products
4.4.1.1 Valeo C—Cervical Spacer
4.4.1.2 Valeo TL—Lumbar Spacer
4.4.1.3 Valeo PL—Lumbar Spacer
4.4.1.4 Valeo OL—Lumbar Spacer
4.4.1.5 Valeo AL—Lumbar Spacer
4.4.1.6 Valeo CP—Cervical Plate System
4.4.1.7 Valeo Concise—Anterior Cervical Plate System
4.4.1.8 Valeo PS—Pedicle Screw System
4.4.1.9 Valeo BP—Synthetic Bone Putty
4.5 Anika Therapeutics, Inc.
4.5.1 Anika's Products
4.5.1.1 Orthovisc
4.5.1.2 Monovisc™
4.5.1.3 Orthovisc mini
4.6 ApaTech
4.6.1 Actifuse ABX
4.7 Arteriocyte Medical Systems, Inc.
4.7.1 Arteriocyte's Role in Orthopedic Regenerative Medicine
4.8 Artimplant
4.8.1 Artimplant's Product Portfolio and Market
4.8.1.1 Resurfacing: Restoring the Joint Surface
4.8.1.2 Reinforcement of Tissue
4.8.1.3 Replenishment: Augmentation of Tissue Volume
4.9 ArthoCare Corporation
4.9.1 ArthoCare's Arthroscopic Business Segment
4.9.2 ArthoCare's Spine Business Segment
4.9.3 ArthoCare's Spine Products
4.9.3.1 SpineWand Product Line
4.9.3.2 The Parallax Product Line
4.10 Ascension Orthopedics, Inc.
4.10.1 Selected Products from Ascension
4.10.1.1 PyroCarbon MCP
4.10.1.2 PyroCarbon PIP
4.10.1.3 Silicone PIP
4.10.1.4 NuGrip CMC Implant
4.10.1.5 Ascension Movement Hemi Great Toe System
4.11 Aesculap
4.11.1 Selected Products from Aesculap/B. Braun
4.11.1.1 Bicontact Universal Hip System
4.11.1.2 Metha Short Hip Stem
4.11.1.3 Excia Hip Stem
4.11.1.4 Prevision Modular Hip Revision Stem
4.11.1.5 Plasmacup SC Acetabular Cup
4.11.1.6 MIOS Minimally-Invasive Orthopedic Solutions
4.11.1.7 e.motion Total Knee System
4.11.1.8 Columbus Total Knee System
4.11.1.9 EnduRo Rotating Hinge Knee System
4.11.1.10 Univation Unicondylar Knee System
4.11.1.11 Search Evolution Total Knee System
4.11.1.12 MIOS Minimally-Invasive Orthopedic Solution
4.12 AxioMed Spine Corporation
4.12.1 Freedom Lumbar Disc
4.13 Biocomposites Ltd.
4.14 Bacterin International, Inc.
4.15 BioMimetic Therapeutics, Inc.
4.15.1 BioMimetic's Product Candidates
4.16 BioSurface Engineering Technologies, Inc.
4.16.1 Amplex™
4.17 Bone Biologics, Inc.
4.17.1 UCB-1™
4.17.2 UCS-1™
4.18 BoneSupport AB
4.19 Biomet, Inc.
4.19.1 Biomet's Products
4.19.2 Reconstructive Products
4.19.2.1 Knee Systems
4.19.2.2 Hip Systems
4.19.3 Extremity Systems
4.19.4 Dental Reconstructive Devices
4.19.5 Spinal Products
4.19.5.1 Spine Fusion Stimulation Systems
4.19.5.2 Spinal Fixation Systems
4.19.6 Bone Substitute and Allograft Materials
4.20 Bone Solutions, Inc.
4.20.1 OsteoCrete Bone Void Filler
4.21 Ceramisys Ltd.
4.21.1 ReproBone™
4.22 Cerapedics, Inc.
4.23 Collagen Matrix, Inc.
4.23.1 OssiMend Bone Graft Matrix
4.23.2 OssiMend Block Bone Graft Matrix
4.23.3 OssiMend Putty Bone Graft Matrix
4.23.4 DuraMatrix-Onlay Collagen Dura Substitute Membrane
4.23.5 DuraMatrix Collagen Dura Substitute Membrane
4.23.6 TenoMend Collagen Tendon Wrap
4.23.7 OssiGuide Cancellous Granules
4.23.8 OssiPatch Collagen Bone Healing Protective Sheet
4.23.9 SynOss Synthetic Mineral
4.24 Conmed Linvatec Corporation
4.24.1 Conmed's Arthroscopy Products
4.24.2 Conmed's Powered Surgical Instruments
4.24.3 Conmed's Electrosurgery Products
4.24.4 Conmed's Patient Care Products
4.24.5 Conmed's Endosurgery Products
4.24.6 Conmed's Endoscopy Products
4.24.7 Conmed's Business Performance
4.25 Core Essence Orthopaedics, Inc.
4.25.1 TAC-tite™
4.25.2 The reVERTO Shape Memory Staple System
4.25.3 SEG-WAY Endoscopic Guide System
4.25.4 The reNOVO Suture Anchor System
4.25.5 PONTiS Endotendonous Repair System
4.26 Corin Group PLC
4.27 DePuy Spine, Inc.
4.27.1 DePuy Spine's Biologic Solutions
4.27.1.1 Symphony Platelet Concentrate System
4.27.1.2 Conduit TCP Granules
4.27.1.3 Healos Bone Graft Replacement
4.27.1.4 Healos Fx Injectable Bone Graft Replacement
4.27.1.5 Overview of Other Products from DePuy Spine, Inc.
4.28 DeRoyal, Inc.
4.28.1 DeRoyal's Orthopedic Product Portfolio
4.28.1.1 Cervical Collars and Traction
4.28.1.2 Clavicle Straps
4.28.1.3 Shoulder Immobilizers
4.28.1.4 Arm Slings and Elevators
4.28.1.5 Elbow Supports and Sleeves
4.28.1.6 Wrist and Thumb Splints
4.28.1.7 Aluminum Splints
4.28.1.8 Abdominal Binders and Rib Belts
4.28.1.9 Knee Immobilizers
4.28.1.10 Bucks Traction
4.28.1.11 Post-Op Shoes
4.29 DJO Finance, LLC (DJOFL)
4.29.1 DJOFL's Operating Segments
4.29.2 DJOFL's Products
4.29.3 DJOFL's Business Performance
4.30 Etex Corporation
4.31 Exactech, Inc.
4.31.1 Exatech's Products
4.31.1.1 Knee Implants
4.31.1.2 Hip Implants
4.31.1.3 Biologics and Spine
4.31.1.4 Extremities
4.31.1.5 Other Products
4.31.2 Exactech's Business Performance
4.32 Facet Solutions, Inc.
4.32.1 Acadia Facet Replacement System
4.33 Gentis, Inc.
4.33.1 Gentis' Technology
4.34 Genzyme Corporation
4.34.1 Genzyme's Biosurgery Unit Performance
4.35 Geron Corporation
4.36 Globus Medical, Inc.
4.37 GMReis
4.38 Graftys SA
4.39 Inion Oy
4.40 Integra LifeSciences Holdings Corporation
4.40.1 Integra's Orthopedic Products
4.40.1.1 Nerve and Tendons
4.40.1.2 Bone and Joint Fixation Devices and Instruments
4.40.1.3 Bone Graft Substitutes for Extremity Reconstruction
4.40.1.4 Spinal Fusion Devices
4.40.1.5 Supplemental Fixation Systems
4.40.1.6 Interbody/Vertebral Body Replacements
4.40.1.7 OrthoBiologics
4.40.1.8 Minimally-Invasive Solutions
4.40.2 Integra's Business Performance
4.41 Interventional Spine, Inc.
4.42 ISTO Technologies, Inc.
4.42.1 InQu
4.42.2 NuQu
4.42.3 DeNovo ET
4.43 K2M, Inc.
4.44 Kasios
4.45 Kensey Nash Corporation
4.46 Kyphon, Inc.
4.47 Lanx, Inc.
4.48 LDR Holding Corporation
4.48.1 ROI
4.48.2 ROI-T
4.48.3 SpineTune TL
4.48.4 EasySpine
4.48.5 ROI-A
4.48.6 ROI-C™
4.49 LifeSpine, Inc.
4.50 Medartis
4.51 Medtronic, Inc.
4.51.1 Medtronic's Spinal Implant Products
4.52 Mekanika, Inc.
4.53 Mesoblast
4.53.1 Mesoblast's MPC Technology
4.53.2 Mesoblast's Cartilage Regeneration Technology
4.53.3 Mesoblast's Technology for Disc Regrowth
4.54 MiMedx Group, Inc.
4.54.1 HydroFix™
4.54.2 CollaFix
4.55 Nanotherapeutics, Inc.
4.55.1 Origen DBM
4.55.2 NanoFUSE™
4.56 NovaBone Products, LLC
4.56.1 NovaBone's Products
4.56.1.1 NovaBone
4.56.1.2 NovaBone Putty
4.56.1.3 NovaBone Particulate
4.56.1.4 NovaBone Morsels
4.56.1.5 NovaBone Dental Putty
4.56.1.6 PerioGlas
4.57 NuVasive, Inc.
4.57.1 NuVasive's Recent Product Introductions
4.57.2 The NuVasive Solutions
4.57.2.1 Maximum Access Surgery (MAS)
4.57.2.2 MAS—NeuroVision
4.57.2.3 MAS—MaXcess
4.57.2.4 MAS—Specialized Implants
4.57.2.5 MAS—Biologics
4.57.3 NuVasive's Business Performance
4.58 Olympus Terumo Biomaterials Corporation
4.59 Orteq Sports Medicine
4.59.1 Actifit
4.60 Orthofix International, NV
4.60.1 Orthofix's Business Segments and Market Sectors
4.60.2 Orthofix's Products
4.61 Orthomimetics Ltd.
4.61.1 Chondriomimetic
4.62 OrthoScan, Inc.
4.62.1 OrthoScan FD
4.62.2 OrthoScan UC
4.63 Orthovita, Inc.
4.63.1 Orthovita's Patents and Proprietary Intellectual Property
4.63.2 Orthovita's Business Performance
4.64 Össur hf
4.64.1 Bracing and Supports
4.64.2 Prosthetics
4.64.3 Compression Therapy
4.64.4 Ossur's Business Performance in 2009
4.65 Osteotech, Inc.
4.65.1 Osteotech's Products
4.65.2 Osteotech's Business Segments
4.66 Pioneer Surgical Orthobiologics, Inc.
4.67 ProChon Biotech Ltd.
4.67.1 BioCart™
4.68 Ranier Technology
4.68.1 Cadisc™-L
4.68.2 Cadisc™-C
4.69 ReGen Biologics, Inc.
4.69.1 Menaflex™
4.70 RTI Biologics, Inc.
4.70.1 RTI's Products and Distributors
4.71 Small Bone Innovations, Inc.
4.72 Smith & Nephew
4.73 SpinalKinetics™
4.73.1 M6 Artificial Disc
4.74 Spinal Restorations, Inc.
4.74.1 Biostat System
4.75 Spine Smith, LP
4.76 Soft Tissue Regeneration, Inc.
4.76.1 STR's Technology
4.77 Stryker Corporation
4.77.1 Stryker's Product Sales
4.77.2 Stryker's Orthopedic Implants
4.77.2.1 Stryker's Hip Implant Systems
4.77.2.2 Stryker's Primary Femoral Hip Systems
4.77.2.3 Stryker's Primary Acetabular Systems
4.77.2.4 Stryker's Revision Hip Systems
4.77.2.5 Stryker's Resurfacing Hip Systems
4.77.2.6 Stryker's Knee Implant Systems
4.77.2.7 Stryker's Other Joint Replacement Products
4.77.2.8 Stryker's Bone Cement
4.77.2.9 Stryker's Trauma Implant Systems
4.77.2.10 Stryker's Spinal Implant Systems
4.77.2.11 Craniomaxillofacial (CMF) Implant Systems
4.77.2.12 OP-1/BMP-7
4.77.3 Stryker's MedSurge Equipments
4.77.4 Stryker's Business Performance
4.78 Symmetry Medical, Inc.
4.78.1 Symmetry's Products
4.78.1.1 Symmetry's Implants
4.78.2 Symmetry's Instruments
4.78.3 Symmetry's Cases
4.78.4 Symmetry's Customers
4.78.5 Symmetry's Business Performance
4.79 Synovis Life Technologies, Inc.
4.79.1 Synovis' Biomaterial Products
4.79.2 Synovis' Microsurgery Products
4.80 Synthes, Inc.
4.80.1 Synthes' Business Performance by Geography
4.80.2 Trauma Products from Synthes
4.81 ThermoGenesis Corporation
4.81.1 The AutoXpress Platform or AXP
4.81.2 The MarrowXpress™
4.81.3 The BioArchive System
4.81.4 The Res-Q 60 BMC
4.81.5 Thermoline™
4.81.6 The CryoSeal Fibrin Sealant (CryoSeal) System
4.82 TiGenix NV
4.82.1 ChondroCelect
4.82.2 Chondromimetic
4.82.3 TGX003
4.82.4 Stem Cells
4.83 TissueGene, Inc.
4.83.1 Tissue Gene's Technology
4.84 Tissue Genesis, Inc.
4.84.1 Cell Isolation System™
4.85 Tornier, Inc
4.86 TranS1
4.86.1 TranS1's Solution
4.86.2 The Impressive Performance of TranS1's Business
4.87 Velcura Therapeutics, Inc.
4.88 Vertebron
4.88.1 Vertebron PSS—Pedicle Screw System
4.88.2 Vertebron SSP Semi-Constrained Cervical Plate
4.88.3 ACIF-Anterior Cervical and PLIF-Posterior Lumbar (Allografts)
4.88.4 PEEK Vertical Body Replacements Devices
4.88.5 Cervical Motion Preservation (CMP)
4.89 Wright Medical Group, Inc.
4.89.1 Wright's Products
4.89.2 Wright's Business Performance
4.90 X-Spine Systems, Inc.
4.91 Xylos Corporation
4.91.1 Xylos' Technology Applications in Musculoskeletal Disorders
4.92 Zimmer Holdings, Inc.
4.92.1 Zimmer's Customers
4.92.2 Zimmer's Products
4.92.2.1 NexGen Complete Knee Solution
4.92.2.2 Natural-Knee II System
4.92.2.3 Gender Solutions Natural-Knee Flex System
4.92.2.4 Innex Total Knee System
4.92.2.5 Zimmer Unicompartmental Knee Systems
4.92.2.6 Zimmer Patient-specific Instruments
4.92.2.7 Zimmer Segmental System
4.92.2.8 Zimmer M/L Taper Hip Prosthesis with Kinectiv Technology
4.92.2.9 Alloclassic (Zweymüller) Hip System
4.92.2.10 CLS Spotorno Hip System
4.92.2.11 Fitmore Hip Stem
4.92.2.12 VerSys Hip System
4.92.2.13 Continuum Acetabular System, Trilogy IT Acetabular System and Allofit IT Alloclassic Acetabular System
4.92.2.14 Zimmer MMC Cup
4.92.2.15 Trilogy Acetabular System
4.92.2.16 Bigliani/Flatow Complete Shoulder Solution Family
4.92.2.17 Trabecular Metal Glenoid
4.92.2.18 Trabecular Metal Reverse Shoulder System
4.92.2.19 Anatomical Shoulder System
4.92.2.20 Coonrad/Morrey Total Elbow
4.92.2.21 Tapered Screw-Vent Implant System
4.92.2.22 AdVent Implant System
4.92.2.23 Tapered SwissPlus Implant System
4.92.2.24 Zimmer Hex-Lock Contour Abutment and Restorative Products
4.92.2.25 Puros Allograft Products
4.92.2.26 Dynesys Dynamic Stabilization System
4.92.2.27 PathFinder Minimally-Invasive Pedicle Screw System
4.92.2.28 Sequoia Pedicle Screw System
4.92.2.29 Ardis Interbody System
4.92.2.30 Trinica Select Anterior Cervical Plating System
4.92.2.31 Biological Products
4.92.2.32 Wallis Posterior Dynamic Stabilization System
4.92.2.33 Zimmer Natural Nail System
4.92.2.34 NCB Polyaxial Locking Plate System
4.92.2.35 Zimmer Periarticular Locking Plate System
4.92.2.36 Zimmer Universal Locking System
4.92.2.37 Zimmer Cable-Ready System
4.92.2.38 Palacos Bone Cement
4.92.2.39 Hi-Fatigue Bone Cement
4.92.2.40 A.T.S Automatic Tourniquet Systems
4.92.2.41 Pulsavac Plus, Pulsavac Plus AC and Pulsavac Plus LP Wound Debridement System
4.92.2.42 Zimmer Blood Reinfusion System (ZBRS) and Hemovac Blood Management Systems
4.92.3 Zimmer's Research and Development

Appendix 1: Osteoporosis
Appendix 1.1: Osteoporosis—General
Appendix 1.2: Osteoporosis in Men
Appendix 1.3: Hip Fracture
Appendix 1.4: Vertebral Fracture
Appendix 1.5: Key statistics for Europe
Appendix 1.6: Key statistics for North America
Appendix 1.7: Key statistics for Latin America
Appendix 1.8: Key statistics for Middle East/North Africa
Appendix 1.9: Key statistics for Asia
Appendix 1.10: Key statistics for Oceania
Appendix 2: Statistics and Facts about Orthopedics and Orthopedic Practices in the U.S.
Appendix 3: Advances in Internal Bone Fixation
Appendix 3.1: Wires and Cables in Revision Surgery
Appendix 3.2: Problems from Broken Metal Cerclage Wires to Patients
Appendix 3.3: New Product Replacing Cerclage Cables
Appendix 4: Spinal Cord Injury Facts and Statistics
Appendix 5: Facts on Orthopedics, Clinical Trials, Regulatory and Reimbursement Issues
Appendix 5.1: Clinical Trial Facts
Appendix 5.2: Clinical Trial Enrollment
Appendix 5.3: Clinical Trial Participants
Appendix 5.4: Clinical Trial Spending and Other Facts
Appendix 5.5: Musculoskeletal Pharma/Biologic Facts
Appendix 5.6: Regulatory Facts
Appendix 5.7: 510(k) Applications
Appendix 5.8: Investigational Device Exemption and Premarket Approval Application (PMA)
Appendix 5.9: Reimbursement Facts
Appendix 5.9.1: National Healthcare Spending in the U.S.
Appendix 5.9.2: Reimbursement
Appendix 5.9.3: Medicare/Medicaid
Appendix 5.9.4: Insurance
Appendix 6: Medicare Rule and its Impact on Orthopedic Technology Firms
Appendix 6.1: Ills of the U.S. Orthopedics Market
Appendix 6.2: Current Orthopedics Business Environment

INDEX OF FIGURES

Figure 2.1: Trends in Implant Price, Physician and Hospital Medicare Payment, 1991 and 2010
Figure 2.2: Trend in Total and Femoral Resurfacing Hip Procedures, 2005-2009
Figure 2.3: Percent Market Share of Coated Hip Stems by Company, 2009
Figure 2.4: Percent Market Share of Uncoated Femur/Poly Liner Constructs by Company, 2009
Figure 2.5: Percent of Cases by Construct Type, 2008
Figure 2.6: Percent Cases by Knee Implant Construct Type, 2008
Figure 2.7: Lumbar TDR Revenue, 2007-2015
Figure 2.8: Cervical TDR Revenue, 2007-2015
Figure 2.9: Common Primary Diagnoses Associated with Inpatient Decompression Procedures
Figure 2.10: Percutaneous Discectomy Procedures by Site of Care
Figure 2.11: Percent Distribution of Spinal Deformity Diagnoses
Figure 2.12: Usage of Instrumentation in Lumbar Fusion
Figure 2.13: Most Common Complications from Posterior Lumbar Fusion in Males Figure 2.14: Leading Companies in Foot and Ankle Surgical Products
Figure 2.15: Percent Ankle Fusion and Ankle Replacement Procedures in the U.S.
Figure 2.16: Progression of Bunion Disorder in Males and Females, 2004-2010
Figure 2.17: Carpal Tunnel Syndrome Occurrences by Gender
Figure 2.18: Common Associated Diagnoses Treated by ESWT Procedure
Figure 3.1: Growth of North American Population Aged 65 and Over, 2010-2020
Figure 3.2: Growth of Western European Population Aged 65 and Over, 2010-2020 Figure 3.3: Life Expectancy in North America, 2010-2020
Figure 3.4: The Top Seven Medical Device Segments in the U.S., 2009
Figure 3.5: Percent Market Share of the Sub-Sectors of Orthopedics, 2009
Figure 3.6: Percent Global Market for Orthopedics by Product Segment, 2009
Figure 3.7: Global Orthopedics Market by Company, 2009
Figure 3.8: Percent Global Orthopedic Market by Geography, 2009
Figure 3.9: Global Market for Orthopedics, 2009-2016
Figure 3.10: Global Spinal Market Share by Company, 2009
Figure 3.11: Global Market for Spinal Implants, 2009-2016
Figure 3.12: Global Orthopedics Reconstructive Market Share by Company, 2009
Figure 3.13: Market for Orthopedic Reconstruction Devices, 2009-2016
Figure 3.14: Global Trauma and Craniomaxillofacial Market Share by Company, 2009
Figure 3.15: Global Market for Trauma and Craniomaxillofacial Products, 2009-2016 Figure 3.16: Market Share in Global Joint Replacement by Company, 2009
Figure 3.17: Percent Global Fracture Repair Market by Segment, 2009
Figure 3.18: Global Fracture Repair Market Share by Company, 2009
Figure 3.19: Fractures by Patient's Age
Figure 3.20: Global Market Share of Craniomaxillofacial Products by Market Leaders, 2009
Figure 3.21: Growth of Global Surgical Instruments Market, 2009-2015
Figure 3.22: Global Orthobiologics Market Share by Company, 2009
Figure 3.23: Global Market for Orthobiologic Products, 2009-2016
Figure 3.24: Global Orthopedic Operating Room Equipment Market Share by Company, 2009
Figure 3.25: Global Endoscopy Market by Company, 2009
Figure 3.26: Global Market for Non-Invasive Orthopedics, 2009-2016
Figure 3.27: Percent Breakdown of Costs for Hip/Knee Replacement Surgeries in the U.S., 2009
Figure 3.28: Percent U.S. Market for Musculoskeletal Products, 2009
Figure 3.29: Percent U.S. Orthopedic Reconstructive Products Market, 2009
Figure 3.30: Percent U.S. Fixation Market, 2009
Figure 3.31: U.S. Spinal Products Market, 2009
Figure 3.32: U.S. Spinal Products Market, 2009-2016
Figure 3.33: U.S. Market for Back Pain Drugs, 2008-2018
Figure 3.34: U.S. Market for Biomaterials in Orthopedics, 2009-2016
Figure 3.35: Spine Company Market Share Summary, 2010
Figure 3.36: Spine Diagnoses in People Younger than 65 Years of Age in the U.S. Figure 3.37: Causes of Spinal Cord Injuries
Figure 3.38: Lumbar Fusion by Approach
Figure 3.39: Primary Inpatient Procedures in Treating Lumbar Spinal Stenosis
Figure 3.40: Incidence of Diabetes: Medicare Population and Private Pay Population Figure 3.41: Average Charges per Region
Figure 3.42: Payment Distribution in Total Knee Replacement
Figure 3.43: Growth of Endoscopic Surgery Products in the U.S., 2009-2014
Figure 3.44: U.S. Market for Orthopedic Biomaterials, 2009-2016
Figure 3.45: U.S. Market for Soft Tissue and Sports Medicine, 2009-2016
Figure 3.46: Percent of Orthopedic Surgeons by Sub-Specialties, 2009
Figure 3.47: U.S. Market for Orthopedic Braces and Supports, 2005 and 2009
Figure 3.48: Orthopedics Reconstructive Market Leaders in Europe, 2008
Figure 3.49: European Trauma Market Share by Company, 2008
Figure 3.50: The Size of Aging Population (65+) in Selected Countries, 2008
Figure 3.51: Prevalence of Arthritis in Selected Countries, 2008
Figure 3.52: Growth of Chinese Orthopedics Market, 2006-2009
Figure 4.1: Alphatec's Business Performance, 2005-2009
Figure 4.2: Biomet's Percent Business Performance by Product Category, 2009
Figure 4.3: Conmed's Business Performance, 2005-2009
Figure 4.4: Exactech's Overall Business Performance, 2005-2009
Figure 4.5: Integra's Overall Business Performance, 2005-2009
Figure 4.6: Medtronic's Percent Revenue by Operating Segments, 2010
Figure 4.7: NuVasive's Business Growth, 2005-2009
Figure 4.8: Orthofix's Overall Business Performance, 2005-2009
Figure 4.9: Orthovita's Business Performance, 2005-2009
Figure 4.10: Stryker's Overall Business Performance, 2005-2009
Figure 4.11: Synthes' Percent Market Share by Geography, 2009
Figure 4.12: TranS1's Impressive Growth in Business, 2005-2009
Figure 4.13: Wright's Overall Business Performance, 2005-2009
Figure 4.14: Zimmer's Percent Business Performance by Geography, 2009
Figure A5.1: Share of Clinical Trial Funding by Source, 2009
Figure A5.2: Clinical Study Participant's Primary Concerns
Figure A5.3: Factors Impacting Clinical Study Participation
Figure A5.4: Capital Raised by Device Companies for PMA and 510k Approvals, 2005-2009
Figure A5.5: Total FDA PMA Submissions and Approvals, 2004-2009
Figure A6.1: Percent Change in Medicare Payment According to 2010 IPPS Rule
Figure A6.2: Economic Inequality Between Orthopedic Surgeon and Sales Representative, 2009
Figure A6.3: Percent Generic and Brand Name Prescriptions, 1984 and 2009

INDEX OF TABLES

Table 2.1: Selected Hip Products from the Top Two Market Leaders
Table 2.2: The Most Common Large Joint Disorders: Disorders of the Hip
Table 2.3: The Available Viscosupplements in the Market
Table 2.4: Injections and Following Procedures, 2004 and 2005
Table 2.5: Cost of Synovial Injections
Table 2.6: Knee Products from the Zimmer
Table 2.7: Change in Hip and Knee Implant List Prices, 2009 and 2010
Table 2.8: Total Hips/Resurfacing Prices by Manufacturer and Implant Type, 2009
Table 2.9: Partial Hips Prices by Manufacturer and Implant Type, 2009
Table 2.10: Knees Prices by Manufacturer and Implant Type, 2009
Table 2.11: Case Share of Total Hip Implant Assemblies, 2009
Table 2.12: Change in Femoral Resurfacing List Prices, 2009 and 2010
Table 2.13: Change in Metal-on-Metal Hip Implant List Prices, 2009 and 2010
Table 2.14: Change in Ceramic-on-Ceramic List Prices, 2009 and 2010
Table 2.15: Change in Coated Stem Poly Liner Hip Implant List Price, 2009 and 2010 Table 2.16: Case Shares of Partial Hip Implant Assemblies, 2009
Table 2.17: Change in Bipolar Hip Implant List prices, 2009 and 2010
Table 2.18: Change in Modular Endoprostheses List Prices, 2009 and 2010
Table 2.19: Change in Coated Knee Implant List Prices, 2009 and 2010
Table 2.20: Change in Uncoated Knee Implant List Prices, 2009 and 2010
Table 2.21: Change in Hybrid Knee Implant List Prices, 2009 and 2010
Table 2.22: Change in Knee with All Poly Tibia List Prices, 2009 and 2010
Table 2.23: Change in Unicondylar Knee Implant List Prices, 2009 and 2010
Table 2.24: Top Five Shoulder-related Diagnoses and the Baby Boomer Population
Table 2.25: Pedicle-based Motion Preservation Devices and Their Indications
Table 2.26: Primary Inpatient Diagnoses of Spinal Disorders
Table 2.27: Average Reimbursement for Spine Indications
Table 2.28: Spinal Procedure Reimbursements
Table 2.29: Common Providers of Posterior Lumbar Fusion in Elderly Patients
Table 2.30: VCF Treatment by Site of Care and Levels Treated
Table 2.31: Age Ranges of the Most Common Spine Diagnoses
Table 2.32: Procedure Volumes for Patients More Than 64 Years of Age, 2007 and 2009
Table 2.33: TDR and Spine Fusion Primary Diagnoses
Table 2.34: Deformities of Toes Diagnoses, 2004-2007
Table 2.35: Average Charges for Toe Deformities
Table 2.36: Procedures for Treating Plantar Fascial Fibromatosis
Table 2.37: Percent Treatment Options for Tennis Elbow
Table 2.38: Most Common Fracture Diagnoses in Extremities, 2004-2007
Table 2.39: Bone Graft Substitutes
Table 3.1: Musculoskeletal Diagnoses Delineated by Age
Table 3.2: Global Orthopedic Product Sales by Market Segment and Geography, 2009 Table 3.3: Key Market Players in Orthopedic Implants
Table 3.4: Orthopedic Companies with Their Sales and Product Lines, 2009
Table 3.5: Global Market for Orthopedics by Product Segment, 2009
Table 3.6: Global Orthopedics Market by Company, 2009
Table 3.7: Global Orthopedic Market by Geography, 2009
Table 3.8: Global Market for Non-Invasive Orthopedics, 2009
Table 3.9: Orthopedics Companies (Excluding Spine and Hip/Knee) and Funding Received, 2008
Table 3.10: U.S. Healthcare Spending vs. Orthopedics Breakout, 2000-2009
Table 3.11: Industry EBITDA Margins, 2009
Table 3.12: The Differences Between Pharma and Orthopedic Product Cycles
Table 3.13: Spinal Products launched or in Clinical Studies in the last few years
Table 3.14: Spine Company Market Share by Company, 2010
Table 3.15: Spine Implant and Related Biologics Industry Revenue, 2007-2012
Table 3.16: Spine Company Market Share, 2007-2012
Table 3.17: Reimbursement for Spinal Procedures, 2008-2010
Table 3.18: The Aging Spine in the U.S. Population, 2010-2050
Table 3.19: Spine Disorders as a Percentage of Common Diagnoses
Table 3.20: Quarterly and Estimated Annual Sales Revenue for Spine Product Companies, 2008-2010
Table 3.21: Primary Inpatient Diagnoses
Table 3.22: Average Reimbursement for Spine Indications
Table 3.23: Procedure Reimbursement
Table 3.24: Common Providers of Post Lumbar Fusions in Aged Patients (ICD-9 Code 81.08)
Table 3.25: Artificial Disc Landscape
Table 3.26: Facet and Nucleus Replacement Landscape
Table 3.27: Dynamic Stabilization Landscape
Table 3.28: State TKA Rank by Volume in the U.S.
Table 3.29: U.S. Market for Bone Graft Substitutes, 2008 and 2009
Table 3.30: Leading Players of Orthopedics in China, 2009
Table 3.31: Leading Players in Spine Market in China, 2009
Table 4.1: Alphatec's Current Products, 2009
Table 4.2: Products from U.S. Spine
Table 4.3: Artimplant's Products and Projects, 2009
Table 4.4: ArthoCare's Sports Medicine Products
Table 4.5: Biocomposites Ltd.'s Products
Table 4.6: Products from Bacterin International, Inc.
Table 4.7: BioMimetic's Clinical Study Programs and Product Candidates, 2009
Table 4.8: Advantages and Disadvantages of Current Therapies
Table 4.9: BoneSupport's Products
Table 4.10: Biomet's Business Performance by Geography, 2007-2009
Table 4.11: Biomet's Business Performance by Product Category, 2007-2009
Table 4.12: Conmed's Arthroscopy Products, 2009
Table 4.13: Conmed's Powered Surgical Instruments, 2009
Table 4.14: Conmed's Electrosurgery Products, 2009
Table 4.15: Conmed's Patient Care Products, 2009
Table 4.16: Conmed's Endosurgery Products, 2009
Table 4.17: Conmed's Endoscopy Products, 2009
Table 4.18: Corin's Business Performance by Geography and Product Type, 2008 and 2009
Table 4.19: DePuy's Other Products in Orthopedics
Table 4.20: DJOFL's Domestic Rehabilitation Products, 2009
Table 4.21: DJOFL's Domestic Surgical Implant Products, 2009
Table 4.22: DJOFL's Business Performance, 2008 and 2009
Table 4.23: Orthopedic Products from Etex
Table 4.24: Exactech's Business Performance by Product Line, 2007-2009
Table 4.25: Overview of Genzyme's Biosurgery Products
Table 4.26: Genzymes Business in Biosurgery Products, 2008 and 2009
Table 4.27: Geron's hESC-derived Product Candidates for Orthopedic Applications Table 4.28: Globus' Product Portfolio
Table 4.29: GMReis' Spine, Orthopedic and Biologic Products
Table 4.30: Products from Graftys SA
Table 4.31: Inion's Product Portfolio
Table 4.32: Integra's Revenue by Business Segment, 2007-2009
Table 4.33: Products from Interventional Spine
Table 4.34: Orthopedic Products from K2M
Table 4.35: Products from Kasios
Table 4.36: Kensey Nash's Orthopedic Products
Table 4.37: Kyphon's Orthopedic Products
Table 4.38: Products from Lanx
Table 4.39: Orthopedic Products from LifeSpine
Table 4.40: Medartis' Product Portfolio
Table 4.41: Medtronic's Net Sales of Spinal Products, 2008-2010
Table 4.42: Mekanika's Products
Table 4.43: Nanotherapeutics' Product Pipeline
Table 4.44: Products from Olympus Terumo Biomaterial Corporation
Table 4.45: Orthofix's Business Performance by Business Segment, 2007-2009
Table 4.46: Orthofix's Business Performance by Product type, 2007-2009
Table 4.47: Orthofix's Products and Primary Applications
Table 4.48: Orthovita's Patented Products, 2010
Table 4.49: Össur's Business Performance by Geography, 2009
Table 4.50: Osteotech's Products
Table 4.51: Osteotech's Business by Business Segment, 2007-2009
Table 4.52: Osteotech's Business by Geography, 2007-2009
Table 4.53: Overview of Pioneer's Spine Products
Table 4.54: RTI's Business Performance, 2007-2009
Table 4.55: RTI's Products and Distributors
Table 4.56: Orthopedic Products from Small Bone Innovations
Table 4.57: Smith & Nephew's Orthopedic Products
Table 4.58: Spine Smith's Product Portfolio
Table 4.59: Stryker's Business Performance by Domestic/International/Business Segment, 2007-2009
Table 4.60: Symmetry's Business Performance by Product Category, 2008 and 2009
Table 4.61: Synovis' Business Performance by Product Line, 2007-2009
Table 4.62: Synthes' Business Performance by Geography, 2009
Table 4.63: Products from Tornier, Inc.
Table 4.64: Velcura's Product Pipeline
Table 4.65: Wright's Products, 2009
Table 4.66: Wright's Business Performance by Product Line, 2008 and 2009
Table 4.67: X-Spine's Orthopedic Products
Table 4.68: Zimmer's Orthopedics Business by Geography, 2005-2009
Table 4.69: Zimmer's Global Business by Product Category and Region, 2008 and 2009
Table 4.70: Global Market and Zimmer's Market Share, 2009
Table A3.1: Number of Hip Arthroplasties in the U.S., 2010 and 2030
Table A3.2: Number of Fractures during Hip Replacement Surgeries, 2010 and 2030 Table A3.3: Number of Fractures in the U.S., 2006

- aap Implantate AG
- AlloSource's Selected Osteobiologics
- Alphatec Spine
- Amedica/U S Spine
- Anika Therapeutics, Inc
- Actifuse ABX
- Arteriocyte Medical Systems, Inc
- Artimplant
- ArthoCare Corporation
- Ascension Orthopedics, Inc
- Aesculap
- AxioMed Spine Corporation
- Biocomposites Ltd
- Bacterin International, Inc
- BioMimetic Therapeutics, Inc
- BioSurface Engineering Technologies, Inc
- Bone Biologics, Inc
- BoneSupport AB
- Biomet, Inc
- Bone Solutions, Inc
- Ceramisys Ltd
- Cerapedics, Inc
- Collagen Matrix, Inc
- Conmed Linvatec Corporation
- Core Essence Orthopaedics, Inc
- Corin Group PLC
- DePuy Spine, Inc
- DeRoyal, Inc
- DJO Finance, LLC (DJOFL)
- Etex Corporation
- Exactech, Inc
- Facet Solutions, Inc
- Gentis, Inc
- Genzyme Corporation
- Geron Corporation
- Globus Medical, Inc
- GMReis
- Graftys SA
- Inion Oy
- Integra LifeSciences Holdings Corporation
- Interventional Spine, Inc
- ISTO Technologies, Inc
- K M, Inc
- Kasios
- Kensey Nash Corporation
- Kyphon, Inc
- Lanx, Inc
- LDR Holding Corporation
- LifeSpine, Inc
- Medartis
- Medtronic, Inc
- Mekanika, Inc
- Mesoblast
- MiMedx Group, Inc
- Nanotherapeutics, Inc
- NovaBone Products, LLC
- NuVasive, Inc
- Olympus Terumo Biomaterials Corporation
- Orteq Sports Medicine
- Orthofix International, NV
- Orthomimetics Ltd
- OrthoScan, Inc
- Orthovita, Inc
- Össur hf
- Osteotech, Inc
- Pioneer Surgical Orthobiologics, Inc
- ProChon Biotech Ltd
- Cadisc™-L
- Menaflex™
- RTI Biologics, Inc
- Small Bone Innovations, Inc
- Smith & Nephew
- SpinalKinetics™
- M Artificial Disc
- Spinal Restorations, Inc
- Biostat System
- Spine Smith, LP
- Soft Tissue Regeneration, Inc
- STR's Technology
- Stryker Corporation
- Stryker's Product Sales
- Stryker's Orthopedic Implants
- Stryker's Hip Implant Systems
- Stryker's Primary Femoral Hip Systems
- Stryker's Primary Acetabular Systems
- Stryker's Revision Hip Systems
- Stryker's Resurfacing Hip Systems
- Stryker's Knee Implant Systems
- Stryker's Other Joint Replacement Products
- Stryker's Bone Cement
- Stryker's Trauma Implant Systems
- Stryker's Spinal Implant Systems
- Craniomaxillofacial (CMF) Implant Systems
- OP- /BMP-
- Stryker's MedSurge Equipments
- Stryker's Business Performance
- Symmetry Medical, Inc
- Synovis Life Technologies, Inc
- Synthes, Inc
- ThermoGenesis Corporation
- TiGenix NV
- TissueGene, Inc
- Tissue Genesis, Inc
- Tornier, Inc
- TranS
- Velcura Therapeutics, Inc
- Vertebron
- Wright Medical Group, Inc
- X-Spine Systems, Inc
- Xylos Corporation
- Zimmer Holdings, Inc