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Extremity Reconstruction - US Analysis and Market Forecasts

Summary

The US extremity reconstruction market, which covers implant devices for the shoulder, elbow, wrist, digits, and ankle joints, is a dynamic market expected to grow through 2021. The growing aging population, rising prevalence of arthritis, and expanding indications for extremity implant devices, as well as patient preference to maintain an active lifestyle, are expected to drive growth in the extremity replacement market through the forecast period. Emerging extremity implant technologies focus on recreating patient anatomy and natural joint function. Additionally, manufacturers focus on less invasive implant designs to accommodate future revision procedures.

This report examines extremity implant device adoption and challenges faced by current competitors in the US market. The analysis also identifies unmet needs in the market, specifies the major drivers and barriers to device adoption, provides insight into marketed and pipeline products, and provides an understanding of physician perception and outlook with an overall emphasis on current and future industry trends in the US.

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Highlights

Key Questions Answered

- What is the current and future extremity reconstruction market outlook in the US? What trends are affecting this market?
- Which are the key, high growth markets that extremity implant manufacturers should expand into? Which markets are growing the fastest, and what are the top-selling products in each segment?
- What are the unmet needs with extremity reconstruction products currently on the market? How will emerging technologies fulfill these unmet needs?
- What clinical factors and technical specifications influence a physician to use one implant device over another? What is physician perception and market outlook of extremity reconstruction?
- What are the challenges and complications of extremity reconstruction that have hindered widespread adoption?
- With developing the next-generation of extremity implant products, what aspects of the technology are device manufacturers focused on optimizing? How will new entrants impact the US extremity reconstruction market?

Scope

- Annualized total extremity reconstruction market revenue by type of device, direct and indirect costs of disease, procedure trends, and market outlooks in the US through 2021.
- Key topics covered include strategic competitor assessment, market characterization, identification of unmet needs, reimbursement and regulatory considerations, evaluating market access in the US, and implications of the emerging technologies on the market.
- Pipeline analysis: Comprehensive data split across different stages of development, including a discussion of emerging trends and extremity implant products in development.
- Analysis of the current and future market competition in the US extremity reconstruction market. Insightful review of the key industry drivers, opportunities, barriers and challenges. Each trend is independently researched to provide qualitative analysis of its implications.

Reasons to buy

- “What Physicians Think” quotes provide a unique insight into how healthcare professionals are reacting to events within the industry, and what their responses could mean for industry strategists. In this report you will understand the perceptions of leading orthopedic surgeons from around the world. This information is essential for all strategic decision makers in every organization allowing them to act on high quality information.

Table Of Contents

Extremity Reconstruction - US Analysis and Market Forecasts
1 Table of Contents
1.1 List of Tables
1.2 List of Figures
2 Executive Summary
2.1 Key Metrics in Major Markets
2.2 Technological Trends
2.3 Key Players in the Extremity Replacement Market
2.4 Extremities Market Future Outlook
2.5 What Do Physicians Think?
3 Introduction
3.1 Catalyst
3.2 Related Reports
4 Industry Overview
4.1 Overview
4.2 Procedure Trends
4.2.1 By Country
4.3 Market Access
4.3.1 Purchasing Decisions
4.3.2 Adoption
4.4 Brand Loyalty
4.5 Regulation
4.5.1 US
4.6 Reimbursement
4.6.1 US
4.7 Product Recalls
4.8 Mergers and Acquisitions
4.8.1 Wright Medical Merges with Tornier in $3.3 Billion All-Stock Deal (October 2015)
4.8.2 Integra LifeSciences to Acquire Total Ankle Replacement Portfolio from Tornier N.V. (September 2015)
4.8.3 Zimmer Acquires Biomet in $13.35 Billion Deal (June 2015)
4.8.4 Teijin Acquires Nakashima Medical for JPY 1.5 Billion (April 2015)
4.8.5 Stryker Acquires Small Bone Innovations for $375m (August-September 2014)
4.8.6 Wright Medical Acquires OrthoPro for $36m (February 2014)
4.8.7 Wright Medical Acquires Solana Surgical for $90m (January 2014)
4.8.8 Wright Medical Acquires Biotech International for $80m (November 2013)
4.8.9 Johnson and Johnson Acquires Synthes for $19.7 Billion (June 2012)
4.8.10 Integra LifeSciences Acquires Ascension Orthopedics for $65m (September 2011)
4.9 Economic Impact
4.9.1 Arthritis
4.9.2 High Revision Rates
5 Unmet Needs
5.1 Shoulder Replacement
5.1.1 Durable Glenoid Components
5.1.2 Augmented Glenoid Components
5.1.3 Grammont-Style Versus Frankle-Style
5.1.4 Addressing Complications of Reverse Shoulder Replacement
5.1.5 Bone-Sparing Stemless Designs: Pros and Cons
5.1.6 Revision Systems
5.1.7 Long-Term Follow-Up
5.1.8 Patient Awareness in Emerging Markets
5.1.9 Accurate Glenoid Component Positioning
5.1.10 Implant Sizing for APAC Patients
5.2 Elbow Replacement
5.2.1 Implant Survival and Fixation Techniques
5.2.2 Implant Positioning
5.2.3 Long-Term Follow-Up
5.3 Wrist Replacement
5.3.1 Long-Term Clinical Data
5.3.2 Limited Product Offerings
5.3.3 Failure and Revision Rates
5.3.4 Physiological Wrist Movement
5.3.5 Carpal Component Fixation
5.4 Digits Replacement
5.4.1 Pyrocarbon Implant Durability and Fixation
5.4.2 Improved Patient Functionality
5.5 Ankle Replacement
5.5.1 Long-Term Follow-Up
5.5.2 Commitment to Medical Education
5.5.3 Advanced Biological Fixation
5.5.4 Minimal Bone Resection
5.5.5 Mobile-Bearing Versus Fixed-Bearing
5.5.6 Bespoke Instrumentation
5.5.7 Custom Prostheses
5.5.8 Revision Components
6 Market Drivers, Barriers, and Opportunities
6.1 Driver: Rising Joint Disease Prevalence
6.1.1 Sport-Related Injuries
6.1.2 Trauma
6.1.3 Aging
6.1.4 Obesity
6.2 Driver: Increased Patient Awareness
6.3 Driver: Corporate Promotions and Continuing Medical Education
6.4 Driver: Expected Launch of CE-Marked Devices
6.5 Driver: Expanded Indications of Reverse Shoulder Replacement
6.6 Driver: Stemless Shoulder Implants in the EU
6.7 Driver: Superiority of Ankle Replacment over Ankle Fusion
6.8 Driver: Expanded Insurance Coverage for TAR
6.9 Barrier: Medical Device Excise Tax
6.10 Barrier: Postoperative Complications
6.11 Barrier: Long Learning Curve
6.12 Barrier: Alternatives to Total Joint Replacement
6.13 Barrier: Shoulder Replacement Reimbursement
6.14 Barrier: Preoperative Patient Selection for TAR
6.15 Opportunity: Pyrocarbon
6.16 Opportunity: Demand for a Comprehensive Reconstruction Portfolio
6.17 Opportunity: Computer-Assisted Navigation and Patient-Specific Instrumentation
6.18 Opportunity: Emerging Markets
6.19 Opportunity: Capitalizing on Wrist Market Fragmentation
6.20 Opportunity: TAR Expanded Indications
6.21 Opportunity: Fixed-Bearing TAR Implants in the EU
7 Competitive Assessment
7.1 Shoulder Replacement
7.1.1 Overview
7.1.2 Product Profiles - Anatomic Total Shoulder Replacement
7.1.3 Product Profiles - Anatomic Stemless Total Shoulder Replacement
7.1.4 Product Profiles - Reverse Total Shoulder Replacement 216
7.2 Elbow Replacement
7.2.1 Overview
7.2.2 Product Profiles
7.3 Wrist Replacement
7.3.1 Overview
7.3.2 Product Profiles
7.4 Digits Replacement
7.4.1 Overview
7.4.2 Product Profiles
7.5 Ankle Replacement
7.5.1 Overview
7.5.2 Product Profiles - Two-Component Fixed-Bearing
7.5.3 Product Profiles - Three-Component Mobile-Bearing
8 Pipeline Assessment
8.1 Overview
8.2 Product Profiles
8.2.1 AFT Proximal Humerus Fracture Prosthesis (Shoulder Options)
8.2.2 Akilos Total Ankle System (Implants International)
8.2.3 aSpire Total Shoulder Arthroplasty System (Shoulder Options)
8.2.4 Comprehensive Nano Stemless Shoulder (Zimmer Biomet)
8.2.5 Helical Conservative Shoulder Prosthesis (University of Missouri)
8.2.6 INBONE Calcaneal Stem Implant (Wright Medical)
8.2.7 Luna Stemless Humeral Prosthesis (Shoulder Options)
8.2.8 PyroCarbon Modular Radial Head (Integra LifeSciences)
8.2.9 NDSU Total Ankle Replacement Device (NDSU Research Foundation)
8.2.10 Vantage Ankle System (Exactech)
9 Clinical Trials to Watch
9.1 Overview
9.2 Discovery Elbow Long-Term Survivorship Study
9.3 Prospective Post Market Clinical Follow-up Study of the Zimmer Trabecular Metal Reverse Shoulder System
9.4 An Observational Cohort Study Evaluating the Safety and Performance of Aequalis Resurfacing Head Implant in a Consecutive Series of Patients with Shoulder Arthroplasty
9.5 Sidus(TM) Stem-Free Shoulder - A Multi-center, Prospective, Non-controlled Post Market Clinical Follow-up Study
9.6 A Prospective, Randomized, Multicenter Study Comparing the Safety and Effectiveness of Arthrex's Eclipse Shoulder Prosthesis to the Univers II Shoulder Prosthesis in Patients with a Degenerative Joint Disease
9.7 Prospective Post Market Clinical Follow-Up (PMCF) Study of the Zimmer Trabecular Metal Total Ankle
9.8 Motec Versus Remotion Total Wrist Arthroplasty - A Prospective Randomized Study
9.9 A Post-market Clinical Follow-up Study of the TITAN Reverse Shoulder System Used in Primary or Revision Total Shoulder Arthroplasty
9.10 A Prospective Multi-Center Study of the Safety and Effectiveness of the Tornier Simpliciti Shoulder System in Shoulder Arthroplasty
9.11 Retrospective and Prospective Clinical Outcomes Study of the Zimmer Nexel Total Elbow
10 Current and Future Players
10.1 Overview
10.2 Trends in Corporate Strategy
10.3 Acumed
10.3.1 Overview
10.3.2 Portfolio Assessment
10.3.3 SWOT Analysis
10.4 Arthrex
10.4.1 Overview
10.4.2 Portfolio Assessment
10.4.3 SWOT Analysis
10.5 Corin Group
10.5.1 Overview
10.5.2 Portfolio Assessment
10.5.3 SWOT Analysis
10.6 DePuy Synthes (Johnson and Johnson)
10.6.1 Overview
10.6.2 Portfolio Assessment
10.6.3 SWOT Analysis
10.7 DJO Global
10.7.1 Overview
10.7.2 Portfolio Assessment
10.7.3 SWOT Analysis
10.8 Exactech
10.8.1 Overview
10.8.2 Portfolio Assessment
10.8.3 SWOT Analysis
10.9 Integra LifeSciences
10.9.1 Overview
10.9.2 Portfolio Assessment
10.9.3 SWOT Analysis
10.10 Kyocera Medical Corporation
10.10.1 Overview
10.10.2 Portfolio Assessment
10.10.3 SWOT Analysis
10.11 Lima Corporate
10.11.1 Overview
10.11.2 Portfolio Assessment
10.11.3 SWOT Analysis
10.12 Smith and Nephew
10.12.1 Overview
10.12.2 Portfolio Assessment
10.12.3 SWOT Analysis
10.13 Stryker
10.13.1 Overview
10.13.2 Portfolio Assessment
10.13.3 SWOT Analysis
10.14 Tornier
10.14.1 Overview
10.14.2 Portfolio Assessment
10.14.3 SWOT Analysis
10.15 Wright Medical Group
10.15.1 Overview
10.15.2 Portfolio Assessment
10.15.3 SWOT Analysis
10.16 Zimmer Biomet Holdings
10.16.1 Overview
10.16.2 Portfolio Assessment
10.16.3 SWOT Analysis
10.17 Other Players
11 Market Outlook
11.1 Company Market Share
11.1.1 By Region
11.2 By Geography
11.2.1 US
12 Appendix
12.1 Bibliography
12.2 Abbreviations
12.3 Methodology
12.3.1 Overview
12.3.2 Coverage
12.3.3 Secondary Research
12.4 Forecasting Methodology
12.5 Physicians and Specialists Included in This Study
12.5.1 Key Opinion Leaders
12.6 Primary Research Summary
12.7 About the Authors
12.7.1 Analysts
12.7.2 Global Head of Medical Devices
12.8 About GlobalData
12.9 Contact Us
12.10 Disclaimer

1.1 List of Tables
Table 1: FDA Classifications - Extremity Joint Implants
Table 2: Medicare Coding Guide for Extremity Arthroplasty - 2015
Table 3: CPT Coding for Physician Payment in Extremity Arthroplasty - 2015
Table 4: Product Recalls (2014-2015)
Table 5: Mergers and Acquisitions (2011-2015)
Table 6: Direct and Indirect Costs of Arthritis
Table 7: Advantages and Disadvantages of Ankle Fusion and Total Ankle Replacement
Table 8: Product Profile - Univers II
Table 9: Product Profile - Global Advantage
Table 10: Product Profile - Global Fx
Table 11: Product Profile - Global AP
Table 12: Product Profile - Global Unite
Table 13: Product Profile - Foundation Shoulder System
Table 14: Product Profile - Turon
Table 15: Product Profile - Equinoxe
Table 16: Product Profile - SEVIIN
Table 17: Product Profile - TITAN Modular Shoulder System
Table 18: Product Profile - SMR Modular Shoulder System
Table 19: Product Profile - Cofield 2
Table 20: Product Profile - Neer 3
Table 21: Product Profile - Promos Standard
Table 22: Product Profile - Solar Total Shoulder System
Table 23: Product Profile - ReUnion HA Fracture System
Table 24: Product Profile - Aequalis Primary
Table 25: Product Profile - Aequalis Fracture stem
Table 26: Product Profile - Affiniti
Table 27: Product Profile - Aequalis Ascend
Table 28: Product Profile - Ascend Flex Convertible Shoulder System
Table 29: Product Profile - Bigliani/Flatow
Table 30: Product Profile - Anatomical Shoulder System
Table 31: Product Profile - Comprehensive Total Shoulder System
Table 32: Product Profile - Comprehensive Fracture System
Table 33: Product Profile - Trabecular Metal
Table 34: Product Profile - Eclipse
Table 35: Product Profile - Simpliciti
Table 36: Product Profile - InSpyre
Table 37: Product Profile - Comprehensive Nano
Table 38: Product Profile - T.E.S.S. Anatomic
Table 39: Product Profile - Sidus Stem-Free Shoulder
Table 40: Product Profile - Univers Revers Shoulder Prosthesis
Table 41: Product Profile - Delta Xtend Reverse Shoulder System
Table 42: Product Profile - Reverse Shoulder Prosthesis (RSP)
Table 43: Product Profile - Equinoxe Reverse Shoulder System
Table 44: Product Profile - SMR Reverse
Table 45: Product Profile - Promos Reverse
Table 46: Product Profile - ReUnion RSA
Table 47: Product Profile - Aequalis Reversed II
Table 48: Product Profile - Aequalis Reversed Fracture
Table 49: Product Profile - Anatomical Reverse
Table 50: Product Profile - T.E.S.S. Reverse
Table 51: Product Profile - Comprehensive Reverse Shoulder
Table 52: Product Profile - Trabecular Metal Reverse
Table 53: Product Profile - Discovery Elbow
Table 54: Product Profile - Solar Total Elbow
Table 55: Product Profile - Latitude EV
Table 56: Product Profile - Coonrad-Morrey
Table 57: Product Profile - Nexel
Table 58: Other Marketed Elbow Replacement Implants
Table 59: Marketed Radial Head Replacement Implants
Table 60: Product Profile - Freedom Wrist
Table 61: Product Profile - Universal 2 Total Wrist
Table 62: Product Profile - ReMotion Total Wrist
Table 63: Product Profile - Motec Wrist
Table 64: Product Profile - Maestro Total Wrist
Table 65: Product Profile - MWP III Total Wrist
Table 66: Marketed Finger Digits Implants
Table 67: Product Profile - TNK
Table 68: Product Profile - Salto Talaris
Table 69: Product Profile - INBONE II Total Ankle
Table 70: Product Profile - INFINITY Total Ankle System
Table 71: Product Profile - Zimmer Trabecular Metal Total Ankle
Table 72: Product Profile - Zenith
Table 73: Product Profile - HINTEGRA Total Ankle Prosthesis
Table 74: Product Profile - BOX
Table 75: Product Profile - STAR
Table 76: Product Profile - Salto
Table 77: Product Profile - CCI Evolution
Table 78: Product Profile - AFT Proximal Humerus Fracture Prosthesis
Table 79: SWOT Analysis - AFT Proximal Humerus Fracture Prosthesis
Table 80: Product Profile - Akilos Total Ankle System
Table 81: SWOT Analysis - Akilos Total Ankle System
Table 82: Product Profile - aSpire Total Shoulder System
Table 83: SWOT Analysis - aSpire Total Shoulder System
Table 84: Product Profile - Comprehensive Nano Stemless Shoulder
Table 85: SWOT Analysis - Comprehensive Nano Stemless Shoulder
Table 86: Product Profile - Helical Conservative Shoulder Prosthesis
Table 87: SWOT Analysis - Helical Conservative Shoulder Prosthesis
Table 88: Product Profile - INBONE Calcaneal Stem
Table 89: SWOT Analysis - INBONE Calcaneal Stem
Table 90: Product Profile - Luna
Table 91: SWOT Analysis - Luna
Table 92: Product Profile - PyroCarbon Modular Radial Head
Table 93: SWOT Analysis - PyroCarbon Modular Radial Head
Table 94: Product Profile - NDSU Total Ankle Replacement
Table 95: SWOT Analysis - NDSU Total Ankle Replacement
Table 96: Product Profile - Vantage Ankle System
Table 97: Discovery Elbow Long-Term Survivorship Study
Table 98: Prospective Post Market Clinical Follow-up Study of the Zimmer Trabecular Metal Reverse Shoulder System
Table 99: An Observational Cohort Study Evaluating the Safety and Performance of Aequalis Resurfacing Head Implant in a Consecutive Series of Patients with Shoulder Arthroplasty
Table 100: Sidus(TM) Stem-Free Shoulder - A Multi-center, Prospective, Non-controlled Post Market Clinical Follow-up Study
Table 101: A Prospective, Randomized, Multicenter Study Comparing the Safety and Effectiveness of Arthrex's Eclipse Shoulder Prosthesis to the Univers II Shoulder Prosthesis in Patients with a Degenerative Joint Disease
Table 102: Prospective Post Market Clinical Follow-Up (PMCF) Study of the Zimmer Trabecular Metal Total Ankle
Table 103: Motec Versus Remotion Total Wrist Arthroplasty - A Prospective Randomized Study
Table 104: A Post-market Clinical Follow-up Study of the TITAN Reverse Shoulder System Used in Primary or Revision Total Shoulder Arthroplasty
Table 105: A Prospective Multi-Center Study of the Safety and Effectiveness of the Tornier Simpliciti Shoulder System in Shoulder Arthroplasty
Table 106: Retrospective and Prospective Clinical Outcomes Study of the Zimmer Nexel Total Elbow
Table 107: Company Profile - Acumed
Table 108: SWOT Analysis - Acumed
Table 109: Company Profile - Arthrex
Table 110: SWOT Analysis - Arthrex
Table 111: Company Profile - Corin Group
Table 112: SWOT Analysis - Corin Group
Table 113: Company Profile - DePuy
Table 114: SWOT Analysis - DePuy
Table 115: Company Profile - DJO
Table 116: SWOT Analysis - DJO
Table 117: Company Profile - Exactech
Table 118: SWOT Analysis - Exactech
Table 119: Company Profile - Integra LifeSciences
Table 120: SWOT Analysis - Integra LifeSciences
Table 121: Company Profile - KMC
Table 122: SWOT Analysis - KMC
Table 123: Company Profile - Lima
Table 124: SWOT Analysis - Lima
Table 125: Company Profile - Smith and Nephew
Table 126: SWOT Analysis - Smith and Nephew
Table 127: Company Profile - Stryker
Table 128: SWOT Analysis - Stryker
Table 129: Company Profile - Tornier
Table 130: SWOT Analysis - Tornier
Table 131: Company Profile - Wright Medical
Table 132: SWOT Analysis - Wright Medical
Table 133: Company Profile - Zimmer Biomet
Table 134: SWOT Analysis - Zimmer Biomet
Table 135: Other Players in the Global Extremity Replacement Market
Table 136: US Market Value Forecast by Market Segment for Extremity Replacement, $m, 2012-2021

1.2 List of Figures
Figure 1: US Procedure Volume Forecast by Market Segment, 2012-2021
Figure 2: US Procedure Volume Comparison by Market Segment, 2014 and 2021
Figure 3: US Shoulder Replacement Procedure Volume Forecast by Segment, 2012-2021
Figure 4: US Shoulder Replacement Procedure Volume Comparison by Segment, 2014 and 2021
Figure 5: US Company Market Shares for Extremity Replacement, 2014
Figure 6: US Market Value Forecast by Market Segment for Extremity Replacement, $m, 2012-2021
Figure 7: US Market Value Comparison by Market Segment for Extremity Replacement, 2014 and 2021
Figure 8: Primary Research Participants by Country

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