TABLE OF CONTENTS
TABLE OF CONTENTS-I
LIST OF FIGURES- VII
LIST OF CHARTSX
EXECUTIVE SUMMARY 1
1.1 OVERALL SMALL JOINT MARKET. 1
1.2 EFFECT OF ECONOMIC DOWNTURN 3
1.3MARKET SEGMENTS 4
1.4 REVERSED SHOULDER MARKET. 5
1.5 ANKLE ARTHROPLASTY MARKET 6
1.6 DIGIT REPLACEMENT MARKET 7
1.7 NERVE CONDUIT MARKET 8
1.8 SEGMENT OVERLAP. 9
1.9 COMPETITIVE ANALYSIS 10
1.10MARKET CONCENTRATION. 11
RESEARCH METHODOLOGY. 12
2.1 RESEARCH SCOPE - 12
2.2 9-STEP METHODOLOGY . 12
2.2.1 Step 1: Project Initiation & Team Selection 13
2.2.2 Step 2: Prepare Data Systems and Perform Secondary Research 14
2.2.3 Step 3: Preparation for Interviews & Questionnaire Design 15
2.2.4 Step 4: Performing Primary Research 16
2.2.5 Step 5: Research Analysis: Establishing Baseline Estimates 18
2.2.6 Step 6: Market Forecast and Analysis 18
2.2.7 Step 7: Identify Strategic Opportunities 20
2.2.8 Step 8: Final Review and Market Release 21
2.2.9 Step 9: Customer Feedback and Market Monitoring 22
OVERVIEW OF COMBINED ORTHOPEDIC SMALL JOINT MARKET 23
3.1 INTRODUCTION - 23
3.1.1.1 Anatomy and Pathology.23
3.1.1.2 Treatment-25
3.1.2 Shoulder Joint Reconstruction Devices 26
3.1.3 Elbow Joint Reconstruction 27
3.1.4 Hand and Wrist Devices . 27
3.1.5 Foot and Ankle Devices 27
3.1.6 Digit Replacement 28
3.1.7 Nerve Conduits 28
3.1.8 Cannulated Screws and Plate Fixation Devices 28
3.2MARKET FORECAST AND ANALYSIS 29
3.2.1 Combined Small Joint Market 29
3.3MARKET DRIVERS AND LIMITERS 35
3.3.1 Market Drivers. 35
3.3.1.1 Aging Population35
3.3.1.2 Maturity of Large Joint Markets35
3.3.1.3 Product Innovation 35
3.3.1.4 Prevalence of Diabetes 36
3.3.1.5 Podiatric Surgeons 36
3.3.2 Market Limiters 36
3.3.2.1 Product Approval36
3.3.2.2 Anatomy -36
3.3.2.3 Surgical Capacity 36
3.4 COMPETITIVE ANALYSIS 38
3.4.1 Leading Competitors 38
3.4.2 Market Concentration. 44
3.5MERGERS AND ACQUISITIONS 46
SHOULDER RECONSTRUCTION MARKET 47
4.1 OVERVIEW - 47
4.1.1 Introduction - 47
4.1.1.1 Anatomy -47
4.1.1.2 Pathology-48
4.1.2 Joint Reconstruction Devices 48
4.1.2.1 Total Shoulder Implants 48
4.1.2.2 Reversed-Shoulder Implants48
4.1.2.3 Partial Shoulder Implants49
4.1.2.4 Resurfacing Implants .49
4.1.2.5 Shoulder Revision 49
4.2MARKET ANALYSIS AND FORECAST 50
4.2.1 Combined Shoulder Market 50
4.2.2 Total Shoulder Implant Market 53
4.2.3 Partial Shoulder Implant Market 55
4.2.4 Resurfacing Shoulder Implant Market. 57
4.2.5 Reversed-Shoulder Implant Market 59
4.2.6 Revision Shoulder Market 61
4.3 DRIVERS AND LIMITERS 63
4.3.1 Drivers - 63
4.3.2 Limiters - 63
4.4 COMPETITIVE ANALYSIS 65
ELBOW RECONSTRUCTION MARKET 69
5.1 OVERVIEW - 69
5.1.1 Introduction - 69
5.1.1.1 Anatomy -69
5.1.1.2 Pathology-69
5.1.2 Device Types - 70
5.1.2.1 Total Elbow Devices 70
5.1.2.2 Radial Head Elbow Devices 70
5.1.2.3 Contraindications 70
5.2MARKET ANALYSIS AND FORECAST 71
5.2.1 Combined Elbow Reconstruction Market . 71
5.2.2 Combined Total Elbow Implant Market 73
5.2.3 Semi-Constrained Total Elbow Implant Market 75
5.2.4 Unconstrained Total Elbow Implant Market 77
5.2.5 Radial Head Implant Market 79
5.3 DRIVERS AND LIMITERS 81
5.3.1 Market Drivers. 81
5.3.2 Market Limiters 82
5.4 COMPETITIVE ANALYSIS 83
HAND AND WRIST DEVICE MARKET 85
6.1 OVERVIEW - 85
6.1.1 Introduction - 85
6.1.1.1 Anatomy -85
6.1.1.2 Pathology-85
6.1.1.3 Treatment-86
6.1.1.4 Device Types.86
6.2MARKET ANALYSIS AND FORECAST 89
6.2.1 Combined Hand and Wrist Reconstruction Market 89
6.2.2 Total Wrist Implant Market 91
6.2.3 Wrist Fusion Market 93
6.2.4 Distal Radius Plate Market. 95
6.2.5 Ulnar Head Replacement Market 97
6.3 DRIVERS AND LIMITERS 99
6.3.1 Market Drivers. 99
6.3.2 Market Limiters 100
6.4 COMPETITIVE ANALYSIS 101
FOOT AND ANKLE DEVICE MARKET 108
7.1 OVERVIEW 108
7.1.1 Introduction 108
7.1.2 Treatment 108
7.2MARKET ANALYSIS AND FORECAST 111
7.2.1 Combined Foot and Ankle Reconstruction Market 111
7.2.2 Total Ankle Replacement Device Implant Market 113
7.2.3 Foot and Ankle Arthrodesis Market 115
7.2.3.1 Foot Arthrodesis Market by Segment 115
7.2.3.2 Ankle Fusion Market117
7.3 DRIVERS AND LIMITERS . 119
7.3.1 Total Ankle Replacement 119
7.3.1.1 Market Drivers119
7.3.1.2 Market Limiters 120
7.4 COMPETITIVE ANALYSIS 122
DIGIT REPLACEMENT MARKET 127
8.1 INTRODUCTION - 127
8.1.1 Hand Treatment . 127
8.1.2 Foot Treatment 129
8.2MARKET FORECAST AND ANALYSIS 130
8.2.1 Combined Market for Digit Implants. 130
8.2.1.1 Digit Implant Procedures 132
8.2.2 Market for Hand Digit Implants 133
8.2.3 Market for Foot Digit Implants. 135
8.3 DRIVERS AND LIMITERS . 137
8.3.1 Divers- 137
8.3.2 Limiters - 137
8.4 COMPETITIVE ANALYSIS 138
NERVE CONDUIT MARKET 141
9.1 INTRODUCTION - 141
9.1.1 Overview- 141
9.1.2 Product Types 141
9.2MARKET ANALYSIS AND FORECAST 143
9.3 DRIVERS AND LIMITERS . 145
9.3.1 Drivers 145
9.3.2 Limiters - 146
9.4 COMPETITIVE ANALYSIS 147
APPENDIX 1:ABBREVIATIONS. 149
APPENDIX 2: SMALL CANNULATED SCREW MARKET 150
11.1 INTRODUCTION - 150
11.1.1 Product Description 150
11.1.2 Definitional Distinction from Other Markets 151
11.2MARKET FORECAST AND ANALYSIS 152
11.2.1 Total Cannulated Screw Market . 152
11.2.1.1 Small Cannulated Screws (Diameter < 4mm) 154
11.3MARKET DRIVERS AND LIMITERS 156
11.3.1 Market Drivers. 156
11.3.2 Market Limiters 157
11.4 COMPETITIVE ANALYSIS 158
APPENDIX 3: SMALL AND MINI FRAGMENT PLATE AND SCREW MARKET161
12.1 INTRODUCTION - 161
12.1.1 History 161
12.1.2 Fracture Rates . 161
12.2 OVERVIEW 162
12.2.1.1 Product Description162
12.2.1.2 Locking Plates 163
12.2.2 Plate and Screw Unit Trends 163
12.3MARKET FORECAST AND ANALYSIS 164
12.3.1 Total Plates and Screw Market 164
12.3.2 Plates and Screws by Fragment Size 167
12.3.2.1 Combined Small and Mini Fragment Market 167
12.3.2.2 Total Small Fragment Market 169
12.3.2.3 Standard Small Fragment by Material 170
12.3.2.4 Total Mini Fragment Plate and Screw Market171
12.3.2.5 Standard Mini Fragment Plate and Screw Market by Material 172
12.4MARKET DRIVERS AND LIMITERS 173
12.4.1 Market Drivers. 173
12.4.2 Market Limiters 174
12.5 COMPETITIVE ANALYSIS 175
12.5.1 Total Plate and Screw Leading Competitors 175
APPENDIX 4: WRIST AND ANKLE EXTERNAL FIXATION 178
13.1 INTRODUCTION - 178
13.2MARKET FORECAST AND ANALYSIS 179
13.2.1 External Wrist Fixator Market 180
13.2.2 External Ankle Fixator Market 182
LIST OF FIGURES
EXECUTIVE SUMMARY 1
RESEARCH METHODOLOGY 12
OVERVIEW OF COMBINED ORTHOPEDIC SMALL JOINT MARKET. 23
Figure 3-1: Combined Small Joint and Bone Device Market, 2005-2015 32
Figure 3-2: Market Drivers and Limiters, Orthopedic Small Joint and Bones,
2008 37
Figure 3-4: Leading Competitors, Combined Orthopedic Small Joint Market,
2008 42
Figure 3-5: Market Concentration, Orthopedic Small Joint Market, 2008 44
SHOULDER RECONSTRUCTION MARKET 47
Figure 4-1: Combined Shoulder Market, U.S. 2005-2015 . 51
Figure 4-2: Combined Shoulder Market by Segment, U.S. 2005-2015 51
Figure 4-3: Total Shoulder Market, U.S. 2005-2015 53
Figure 4-4: Partial Shoulder Market, U.S. 2005-2015 55
Figure 4-5: Resurfacing Shoulder Market, U.S. 2005-2015 57
Figure 4-6: Reversed Shoulder Market, U.S. 2005-2015 59
Figure 4-7: Revision Shoulder Market, U.S. 2005-2015 . 61
Figure 4-8: Drivers and Limiters for Combined Shoulder Implant Market, U.S.,
2007 64
Figure 4-9: Leading Competitors, Shoulder Reconstruction Market, 2008. 67
ELBOW RECONSTRUCTION MARKET. 69
Figure 5-1: Combined Elbow Market, U.S., 2005-2015 72
Figure 5-2: Combined Elbow Market by Segment, U.S., 2005-2015 72
Figure 5-3: Combined Total Elbow Device Market, U.S., 2005-2015 . 73
Figure 5-4: Semi-Constrained Total Elbow Device Market, U.S., 2005-2015. 75
Figure 5-5: Unconstrained Total Elbow Device Market, U.S., 2005-2015 77
Figure 5-6: Radial Head Implant Market, U.S., 2005 -2015 79
Figure 5-7: Drivers and Limiters for Combined Elbow Implant Market, U.S.
2008 82
Figure 5-8: Leading Competitors, Elbow Reconstruction Market, 2008. 84
HAND AND WRIST DEVICE MARKET . 85
Figure 6-1: Combined Hand and Wrist Market by Segment, U.S., 2005-2015 89
Figure 6-2: Total Wrist Replacement Device Market, U.S., 2005-2015 91
Figure 6-3: Wrist Fusion Market, U.S., 2005-2015 . 93
Figure 6-4: Distal Radius Plate Market, U.S., 2005-2015. 95
Figure 6-5: Ulnar Head Replacement Market, U.S., 2005-2015 . 97
Figure 6-6: Drivers and Limiters, Total Wrist Replacement Market, U.S., 2008 . 100
Figure 6-7: Hand and Wrist Device Market, 2008 104
Figure 6-8: Leading Competitors Total Wrist Replacement Market, 2008 105
Figure 6-9: Leading Competitors, Distal Radius Market, 2008. 106
Figure 6-10: Leading Competitors, Ulnar Head Replacement Market, 2008 . 107
FOOT AND ANKLE DEVICE MARKET 108
Figure 7-1: Combined Foot and Ankle Market by Segment, U.S., 2005-2015 111
Figure 7-2: Total Ankle Replacement Device Market, U.S., 2005-2015 113
Figure 7-3: Combined Foot Arthrodesis Market, 2005-2015 115
Figure 7-4: Ankle Fusion Market, U.S., 2005-2015 117
Figure 7-5: Market Drivers and Limiters, Total Ankle Replacement Market, U.S.,
2008 121
Figure 7-6: Leading Competitors, Combined Foot and Ankle Arthroplasty
Market, 2008 124
Figure 7-7: Leading Competitors, Total Ankle Replacement Market, 2008. 125
Figure 7-8: Leading Competitors, Combined Foot and Ankle Fusion Market,
2008 126
DIGIT REPLACEMENT MARKET . 127
Figure 8-1: Hand Digit Arthroplasty Procedures, 2005-2015. 129
Figure 8-2: Combined Market for Digit Implants, U.S., 2005-2015 130
Figure 8-3: Combined Digit Implant Procedures, U.S., 2008 132
Figure 8-4: Hand Digit Implant Market, U.S., 2005-2015 133
Figure 8-5: Foot Digit Implant Market, U.S., 2005-2015 135
Figure 8-6: Drivers and Limiters, Digit Replacement Market, 2008 . 137
Figure 8-7: Leading Competitors, Digit Replacement Market, 2008. 139
NERVE CONDUIT MARKET 141
Figure 9-1: Nerve Conduit Market, U.S., 2005-2015 143
Figure 9-2: Drivers and Limiters, Nerve Conduit Market, 2008 . 146
Figure 9-3: Leading Competitors, Nerve Conduit Market . 148
APPENDIX 1:ABBREVIATIONS 149
APPENDIX 2: SMALL CANNULATED SCREW MARKET 150
Figure 11-1: Combined Cannulated Screw Market, U.S., 2005-2015 152
Figure 11-2: Combined Cannulated Screw Market by Size, U.S., 2005-2015 153
Figure 11-3: Small Cannulated Screw Market, U.S., 2005-2015 154
Figure 11-4: Market Driver and Limiters, Cannulated Screws, U.S., 2008 157
Figure 11-5 Leading Competitors, Cannulated Screw Market, U.S., 2008 159
APPENDIX 3: SMALL AND MINI FRAGMENT PLATE AND SCREW
MARKET . 161
Figure 12-1: Plate and Screw Fragment Sizes 162
Figure 12-2: Total Plate and Screw Market, U.S., 2005-2015 164
Figure 12-3: Total Plate and Screw Units by Segment, U.S., 2005-2015 165
Figure 12-4: Small and Mini Fragment Plate and Screw Markets by Segment,
2005-2015 167
Figure 12-5: Locking Small Fragment Market, 2005-2015 . 169
Figure 12-6: Standard Small Fragment Market, 2005-2015 169
Figure 12-7: Stainless Steel Standard Small Fragment Market, 2005-2015 170
Figure 12-8: Titanium Standard Small Fragment Market, 2005-2015 170
Figure 12-9: Locking Mini Fragment Market, 2005-2015 171
Figure 12-10: Standard Mini Fragment Market, 2005-2015 171
Figure 12-11: Steel Standard Mini Fragment Market, 2005-2015 172
Figure 12-12: Titanium Standard Mini Fragment Market, 2005-2015 172
Figure 12-13: Market Drivers and Limiters for Plates and Screws, U.S., 2008 174
Figure 12-14: Leading Competitors, Total Plate and Screw Market, U.S., 2008 . 176
APPENDIX 4: WRIST AND ANKLE EXTERNAL FIXATION. 178
Figure 13-1: External Wrist Fixator Market, U.S., 2005-2015 . 180
Figure 13-2: External Ankle Fixator Market, U.S., 2005-2015 182
LIST OF CHART S
EXECUTIVE SUMMARY 1
Chart 1-1: Combined Small Joint and Bone Market, U.S., 2005-2015 1
Chart 1-2: Segment Growth Rates, Small Joint and Bone Device Markets, 2005-2015 3
Chart 1-3: Small Joint and Bone Market By Segment, 2008 4
Chart 1-4: Shoulder Reconstruction Market By Segment, 2008. 5
Chart 1-5: Market Value of Ankle Replacement Verses Ankle Fusion, 2005-2015 6
Chart 1-6: Digit Replacement Market, 2005-2015. 7
Chart 1-7: Nerve Conduit Market, 2005-2015 . 8
Chart 1-8: Overlap Between Device Segments, Small Joints and Bones, 2008 9
Chart 1-9: Leading Competitors, Small Joint and Bone Device Market, 2008. 10
Chart 1-10: Market Concentration, Small Joint and Bone Device Market, 2008 11
RESEARCH METHODOLOGY 12
OVERVIEW OF COMBINED ORTHOPEDIC SMALL JOINT MARKET. 23
Chart 3-1: Combined Small Joint and Bone Device Market Segments, 2008. 31
Chart 3-2: Combined Small Joint and Bone Device Market, 2005-2015 33
Chart 3-3: Market Segment Growth Rates, Orthopedic Small Joint Market, 2005
– 2015 - 34
Chart 3-4: Leading Competitors, Combined Orthopedic Small Joint Market,
2008 43
Chart 3-5: Market Concentration, Orthopedic Small Joint Market, 2008 45
SHOULDER RECONSTRUCTION MARKET 47
Chart 4-1: Combined Shoulder Market, U.S. 2005-2015 50
Chart 4-2: Shoulder Procedures per Million by Country, 2008 52
Chart 4-3: Total Shoulder Market, U.S. 2005-2015. 54
Chart 4-4: Partial Shoulder Market, U.S. 2005-2015 56
Chart 4-5: Resurfacing Shoulder Market, U.S. 2005-2015 58
Chart 4-6: Reversed Shoulder Market, U.S. 2005-2015 60
Chart 4-7: Revision Shoulder Market, U.S. 2005-2015 62
Chart 4-8: Leading Competitors, Shoulder Reconstruction Market, 2008 68
ELBOW RECONSTRUCTION MARKET. 69
Chart 5-1: Combined Elbow Market, U.S., 2005-2015 . 71
Chart 5-2: Combined Total Elbow Device Market, U.S., 2005-2015 74
Chart 5-3: Semi-constrained Total Elbow Device Market, U.S., 2005-2015 . 76
Chart 5-4: Unconstrained Total Elbow Device Market, U.S., 2005-2015 78
Chart 5-5: Radial Head Implant Market, U.S., 2005-2015 80
Chart 5-6: Leading Competitors, Elbow Reconstruction Market, 2008 84
HAND AND WRIST DEVICE MARKET . 85
Chart 6-1: Combined Hand and Wrist Market, U.S., 2005-2015 90
Chart 6-2: Total Wrist Replacement Device Market, Market, U.S., 2005-2015 92
Chart 6-3: Wrist Fusion Market, U.S., 2005-2015 94
Chart 6-4: Distal Radius Plate Market, U.S., 2005-2015 96
Chart 6-5: Ulnar Head Replacement Market, U.S., 2005-2015. 98
Chart 6-6: Hand and Wrist Device Market, 2008 . 104
Chart 6-7: Leading Competitors Total Wrist Replacement Market, 2008. 105
Chart 6-8: Leading Competitors, Distal Radius Market, 2008 . 106
Chart 6-9: Leading Competitors, Ulnar Head Replacement Market, 2008 107
FOOT AND ANKLE DEVICE MARKET 108
Chart 7-1: Combined Foot and Ankle Market, U.S., 2005-2015. 112
Chart 7-2: Total Ankle Replacement Device Market, U.S., 2005-2015 . 114
Chart 7-3: Combined Foot Arthrodesis Market, 2005-2015 116
Chart 7-4: Ankle Fusion Market, U.S., 2005-2015 118
Chart 7-5: Leading Competitors, Combined Foot and Ankle Arthroplasty Market,
2008 124
Chart 7-6: Leading Competitors, Total Ankle Replacement Market, 2008 125
Chart 7-7: Leading Competitors, Combined Foot and Ankle Fusion Market,
2008 126
DIGIT REPLACEMENT MARKET . 127
Chart 8-1: Combined Market for Digit Implants, U.S., 2005-2015. 131
Chart 8-2: Combined Digit Implant Procedures, U.S., 2008 132
Chart 8-3: Hand Digit Implant Market, U.S., 2005-2015 134
Chart 8-4: Foot Digit Implant Market, U.S., 2005-2015 . 136
Chart 8-5: Leading Competitors, Digit Replacement Market, 2008 140
NERVE CONDUIT MARKET 141
Chart 9-1: Nerve Conduit Market, U.S., 2005-2015 144
APPENDIX 1:ABBREVIATIONS 149
APPENDIX 2: SMALL CANNULATED SCREW MARKET 150
Chart 11-1: Combined Cannulated Screw Market, U.S., 2005-2015 153
Chart 11-2: Small Cannulated Screw Market, U.S., 2005-2015 . 155
Chart 11-3 Leading Competitors, Cannulated Screw Market, U.S., 2008 . 160
APPENDIX 3: SMALL AND MINI FRAGMENT PLATE AND SCREW
MARKET . 161
Chart 12-1: Percentage of Units Sold, Plate and Screw Fixation Systems, 2008 . 163
Chart 12-2: Fragment Sizes as a Percentage of Total Market Value-Plate and
Screw Market, 2008 165
Chart 12-3 Total Plate and Screw Market, U.S., 2004-2014 166
Chart 12-4: Small and Mini Fragment Plate and Screw Markets by Segment,
2005-2015 168
Chart 12-5: Leading Competitors, Plate and Screw Market, 2008 177
APPENDIX 4: WRIST AND ANKLE EXTERNAL FIXATION. 178
Chart 13-1: External Wrist Fixator Market, U.S., 2005-2015 181
Chart 13-2: External Ankle Fixator Market, U.S., 2005-2015 183
