Summary
In 2009, the combined orthopedic large joint replacement and bone cement market was valued at over $7 billion. Hip and knee arthroplasty has seen consistent double-digit revenue growth since the early 2000s. However, growth slowed during the recession that began in 2008, but nearly resumed its previous pace by the end of 2009. Although large joint arthroplasty is not the fastest growing orthopedic market, it has proven to be remarkably resilient due to the continued demand for hip and knee implants. This report covers these devices, as well as the total market for associated bone cement used for arthroplasty implantation.
The market includes:
? The knee reconstruction market
? The hip reconstruction market
? The bone cement market
Within the orthopedic large joint replacement and bone cement market, companies such as Biomet, DePuy Orthopaedics, Smith & Nephew, Stryker Orthopedics and Zimmer lead the market, among others. This report provides a comprehensive and detailed analysis of market revenues by device type, market forecasts through 2016, unit sales, average selling prices, market drivers and limiters and a detailed competitive analysis, including manufacturer market shares and product portfolios.
TABLE OF CONTENTS I
LIST OF FIGURES VI
LIST OF CHARTS IX
EXECUTIVE SUMMARY 1
1.1 TOTAL ORTHOPEDIC LARGE JOINT RECONSTRUCTIVE DEVICE MARKET 1
1.2 COMBINED KNEE IMPLANT MARKET 2
1.3 INTERPOSITIONAL DEVICE MARKET 2
1.4 TOTAL HIP REPLACEMENT MARKET BY FIXATION TYPE 3
1.5 COMBINED HIP REPLACEMENT MARKET 4
1.6 POLYETHYLENE BEARING TOTAL HIP REPLACEMENT MARKET 5
1.7 HIP RESURFACING MARKET 6
1.8 BONE CEMENT MARKET 7
1.9 LEADING COMPETITORS 8
RESEARCH METHODOLOGY 9
2.1 RESEARCH SCOPE 9
2.2 9-STEP METHODOLOGY 9
Step 1: Project Initiation & Team Selection 10
Step 2: Prepare Data Systems and Perform Secondary Research 11
Step 3: Preparation for Interviews & Questionnaire Design 12
Step 4: Performing Primary Research 13
Step 5: Research Analysis: Establishing Baseline Estimates 15
Step 6: Market Forecast and Analysis 15
Step 7: Identify Strategic Opportunities 17
Step 8: Final Review and Market Release 18
Step 9: Customer Feedback and Market Monitoring 19
U.S. MARKET FOR ORTHOPEDIC LARGE JOINT RECONSTRUCTIVE DEVICES 20
3.1 INTRODUCTION 20
3.1.1 Anatomy and Pathology 20
3.1.2 Treatment 22
3.1.3 Treatment Complications 23
3.2 OVERVIEW 24
3.2.1 General Product Classifications 24
3.2.2 Patient-Specific Products and Consumer Awareness 26
3.2.3 Press-Fitted versus Cemented Implantation 26
3.2.4 Simultaneous Bilateral Implantation 26
3.2.5 Minimally Invasive Surgery 27
3.2.6 Computer-Assisted Navigation Systems 27
3.2.7 Emerging Technologies 28
3.3 MARKET ANALYSIS AND FORECAST 29
3.3.1 Procedures 29
3.3.1.1 Total Procedures 29
3.3.1.2 Simultaneous Bilateral Implantation 30
3.3.2 Market Segments 31
3.4 MARKET DRIVERS AND LIMITERS 33
3.4.1 Market Drivers 33
3.4.2 Market Limiters 34
3.5 COMPETITIVE ANALYSIS 36
3.5.1 Overview 36
3.5.2 Leading Competitors 37
3.5.3 Other Notable Competitors 39
3.5.4 Market Concentration 43
3.6 MERGERS AND ACQUISITIONS 45
3.7 LITIGATION AND LEGAL ISSUES 46
KNEE RECONSTRUCTION MARKET 48
4.1 INTRODUCTION 48
4.1.1 Anatomy 48
4.1.2 Pathology 48
4.2 OVERVIEW 49
4.2.1 Implant Types 49
4.2.1.1 Total Knee Replacement 49
4.2.1.2 Partial Knee Replacement 49
4.2.1.3 Patellofemoral Replacement 49
4.2.1.4 Interpositional Knee Implants 50
4.2.1.5 Knee Revision 50
4.2.2 Fixation Method 51
4.2.3 Bearing Surface 51
4.2.4 Fixed verses Mobile Bearings 52
4.3 MARKET ANALYSIS AND FORECAST 53
4.3.1 Combined Knee Implant Market 53
4.3.2 Combined Total Knee Replacement Market 55
4.3.3 Total Knee Replacement Market by Cementation Type 57
4.3.3.1 Cementless Implant Market 57
4.3.3.2 All-Cemented Implant Market 59
4.3.3.3 Hybrid Cemented Implant Market 61
4.3.4 Total Market by Cruciate-Retaining or Sacrificing Construction 63
4.3.4.1 Cruciate-Retaining Device Market 63
4.3.4.2 Cruciate-Sacrificing Device Market 65
4.3.5 Total Knee Replacement Market by Bearing Type 67
4.3.5.1 Fixed Bearing Total Knee Replacement Market 67
4.3.5.2 Mobile Bearing Total Knee Replacement Market 69
4.3.6 Unicondylar Knee Implant Market 71
4.3.7 Interpositional Knee Implant Market 73
4.3.8 Patellofemoral Replacement Market 75
4.3.9 Revision Knee Implant Market 77
4.4 MARKET DRIVERS AND LIMITERS 79
4.4.1 Market Drivers 79
4.4.2 Market Limiters 80
4.5 COMPETITIVE ANALYSIS 82
4.5.1 Leading Competitors 82
4.5.2 Other Notable Competitors 85
HIP RECONSTRUCTION MARKET 88
5.1 INTRODUCTION 88
5.1.1.1 Anatomy 88
5.1.1.2 Pathology 88
5.1.1.3 Treatment 88
5.2 OVERVIEW 89
5.2.1 Implant Types 89
5.2.1.1 Total Hip Joint Replacement 89
5.2.1.2 Partial Hip Joint Replacement 89
5.2.1.3 Resurfacing Hip Joint Replacement 90
5.2.1.4 Revision Hip Joint Replacement 90
5.2.2 Fixation Method 90
5.2.3 Implant Material 91
5.2.4 Bearing Surface Technology 91
5.2.4.1 Polyethylene Bearings 91
5.2.4.2 Highly Cross-Linked Polyethylene Bearings 91
5.2.4.3 Metal Bearings 91
5.2.4.4 Ceramic Bearings 92
5.3 MARKET ANALYSIS AND FORECAST 93
5.3.1 Combined Hip Implant Market 93
5.3.2 Total Hip Joint Replacement Market 96
5.3.2.1 Combined Total Hip Replacement Market 96
5.3.2.2 Total Hip Replacement Market by Individual Components 97
5.3.3 Total Hip Replacement Market by Cementation Type 100
5.3.3.1 Cemented Hip Implant Market 100
5.3.3.2 Cementless Hip Implant Market 102
5.3.4 Total Hip Replacement Market by Bearing Type 104
5.3.4.1 Standard Polyethylene Bearing Market 106
5.3.4.2 Highly Cross-Linked Polyethylene Bearing Market 108
5.3.4.3 Metal Bearing Market 110
5.3.4.4 Ceramic Bearing Market 112
5.3.5 Combined Partial Hip Implant Market 114
5.3.6 Partial Hip Implant Market by Construction Type 116
5.3.6.1 Bipolar Partial Hip Implant Market 116
5.3.6.2 Unipolar Partial Hip Implant Market 118
5.3.7 Resurfacing Hip Implant Market 120
5.3.8 Revision Hip Implant Market 122
5.4 MARKET DRIVERS AND LIMITERS 124
5.4.1 Market Drivers 124
5.4.2 Market Limiters 124
5.5 COMPETITIVE ANALYSIS 126
5.5.1 Leading Competitors 126
5.5.2 Other Notable Competitors 128
BONE CEMENT MARKET 131
6.1 INTRODUCTION 131
6.2 OVERVIEW 132
6.3 MARKET ANALYSIS AND FORECAST 133
6.3.1 Combined Bone Cement Market 133
6.3.1.1 Premixed Antibiotic Bone Cement Market 135
6.3.1.2 Traditional Bone Cement Market 137
6.4 MARKET DRIVERS AND LIMITERS 141
6.4.1 Market Drivers 141
6.4.2 Market Limiters 142
6.5 COMPETITIVE ANALYSIS 143
ABBREVIATIONS 146
LIST OF FIGURES
EXECUTIVE SUMMARY 1
RESEARCH METHODOLOGY 9
U.S. MARKET FOR ORTHOPEDIC LARGE JOINT RECONSTRUCTIVE DEVICES 20
Figure 3 1: Combined Orthopedic Large Joint Reconstructive Device Market, U.S., 2006-2016 29
Figure 3 2: Combined Orthopedic Large Joint Reconstruction Market by Segment, U.S., 2006-2016 31
Figure 3 3: Drivers and Limiters, Combined Orthopedic Large Joint Reconstruction Market, U.S., 2009 35
Figure 3 4: Leading Competitors, Combined Orthopedic Large Joint Reconstruction Market, U.S., 2009 41
Figure 3 5: Market Concentration, Orthopedic Large Joint Reconstruction Market, U.S., 2009 43
KNEE RECONSTRUCTION MARKET 48
Figure 4 1: Combined Knee Implant Market, U.S., 2006-2016 53
Figure 4 2: Total Knee Replacement Market, U.S., 2006-2016 55
Figure 4 3: Cementless Total Knee Implant Market, U.S., 2006-2016 57
Figure 4 4: Cemented Total Knee Implant Market, U.S., 2006-2016 59
Figure 4 5: Hybrid Total Knee Replacement Market, U.S., 2006-2016 61
Figure 4 6: Cruciate-Retaining Total Knee Replacement Market, U.S.,
2006-2016 63
Figure 4 7: Cruciate-Sacrificing Total Knee Replacement Market, U.S.,
2006-2016 65
Figure 4 8: Fixed Bearing Total Knee Replacement Market, U.S., 2006-2016 67
Figure 4 9: Mobile Bearing Total Knee Replacement Market, U.S.,
2006-2016 69
Figure 4 10: Unicondylar Knee Implant Market, U.S., 2006-2016 71
Figure 4 11: Interpositional Knee Implant Market, U.S., 2006-2016 73
Figure 4 12: Pateollofemoral Replacement Market, U.S., 2006-2016 75
Figure 4 13: Revision Knee Implant Market, U.S., 2006-2016 77
Figure 4 14: Drivers and Limiters, Knee Reconstruction Market, U.S., 2009 81
Figure 4 15: Leading Competitors, Knee Reconstruction Market, U.S., 2009 86
HIP RECONSTRUCTION MARKET 88
Figure 5 1: Combined Hip Implant Market, U.S., 2006-2016 94
Figure 5 2: Combined Hip Implant Market by Segment, U.S., 2006-2016 94
Figure 5 3: Combined Total Hip Replacement Market, U.S., 2006-2016 96
Figure 5 4: Total Hip Replacement Market by Component, U.S., 2009 97
Figure 5 5: Cemented Hip Implant Market, U.S., 2006-2016 100
Figure 5 6: Cementless Hip Implant Market, U.S., 2006-2016 102
Figure 5 7: Hip Implant Market Penetration by Segment, U.S., 2006-2016 104
Figure 5 8: Standard Polyethylene Bearing Total Hip Implant Market, U.S.,
2006-2016 106
Figure 5 9: Highly Cross-Linked Polyethylene Bearing Total Hip Implant Market, U.S., 2006-2016 108
Figure 5 10: Metal Bearing Total Hip Implant Market, U.S., 2006-2016 110
Figure 5 11: Ceramic Bearing Total Hip Implant Market, U.S., 2006-2016 112
Figure 5 12: Combined Partial Hip Implant Market, U.S., 2006-2016 114
Figure 5 13: Bipolar Partial Hip Implant Market, U.S., 2006-2016 116
Figure 5 14: Unipolar Partial Hip Implant Market, U.S., 2006-2016 118
Figure 5 15: Hip Resurfacing Implant Market, U.S., 2006-2016 120
Figure 5 16: Revision Hip Implant Market, U.S., 2006-2016 122
Figure 5 17: Drivers and Limiters, Hip Reconstruction Market, 2009 125
Figure 5 18 Leading Competitors, Hip Reconstruction Market, U.S., 2009 129
BONE CEMENT MARKET 131
Figure 6 1: Combined Bone Cement Market, U.S., 2006-2016 133
Figure 6 2: Premixed Antibiotic Bone Cement Market, U.S., 2006-2016 135
Figure 6 3: Traditional Bone Cement Market, U.S., 2006-2016 137
Figure 6 4: Arthroplasty Procedures Involving Bone Cement, U.S.,
2006-2016 139
Figure 6 5: Drivers and Limiters, Bone Cement Market, U.S., 2009 142
Figure 6 6: Leading Competitors, Bone Cement Market, U.S., 2009 144
ABBREVIATIONS 146
LIST OF CHARTS
EXECUTIVE SUMMARY 1
Chart 1 1: Total Orthopedic Large Joint Reconstructive Device Market, U.S., 2006-2016 1
Chart 1 2: Knee Implant Market by Segment, U.S., 2009 2
Chart 1 3: Annual Revenue Growth Rates, Interpositional Device and Unicondylar Implant Markets, U.S., 2006-2016 2
Chart 1 4: Total Hip Replacement Market by Fixation Type, U.S., 2006-2016 3
Chart 1 5: Total Hip Replacement Market by Average Selling Price of Bearing Type, U.S., 2009 4
Chart 1 6: Unit Volume of Polyethylene Liners, Total Hip Replacement Market, U.S., 2006-2016 5
Chart 1 7: Hip Resurfacing Market, U.S., 2006-2016 6
Chart 1 8: Bone Cement Usage by Indication, U.S., 2006-2016 7
Chart 1 9: Leading Competitors, Large Joint Replacement Market, U.S., 2009 8
RESEARCH METHODOLOGY 9
U.S. MARKET FOR ORTHOPEDIC LARGE JOINT RECONSTRUCTIVE DEVICES 20
Chart 3 1: Simultaneous Bilateral Implantation, Orthopedic Large Joint Reconstruction Market, U.S., 2009 30
Chart 3 2: Combined Orthopedic Large Joint Reconstruction Market by Segment, U.S., 2006-2016 32
Chart 3 3: Leading Competitors, Combined Orthopedic Large Joint Reconstructive Market, U.S., 2009 42
Chart 3 4: Market Concentration, Orthopedic Large Joint Reconstruction Market, U.S., 2009 44
KNEE RECONSTRUCTION MARKET 48
Chart 4 1: Combined Knee Implant Market, U.S., 2006-2016 54
Chart 4 2: Total Knee Replacement Market, U.S., 2006-2016 56
Chart 4 3: Cementless Total Knee Implant Market, U.S., 2006-2016 58
Chart 4 4: Cemented Total Knee Implant Market, U.S., 2006-2016 60
Chart 4 5: Hybrid Total Knee Replacement Market, U.S., 2006-2016 62
Chart 4 6: Cruciate-Retaining Total Knee Replacement Market, U.S.,
2006-2016 64
Chart 4 7: Cruciate-Sacrificing Total Knee Replacement Market, U.S.,
2006-2016 66
Chart 4 8: Fixed Bearing Total Knee Replacement Market, U.S., 2006-2016 68
Chart 4 9: Mobile Bearing Total Knee Replacement Market, U.S., 2006-2016 70
Chart 4 10: Unicondylar Knee Implant Market, U.S., 2006-2016 72
Chart 4 11: Interpositional Knee Implant Market, U.S., 2006-2016 74
Chart 4 12: Pateollofemoral Replacement Market, U.S., 2006-2016 76
Chart 4 13: Revision Knee Implant Market, U.S., 2006-2016 78
Chart 4 14: Leading Competitors, Knee Reconstruction Market, U.S., 2009 87
HIP RECONSTRUCTION MARKET 88
Chart 5 1: Combined Hip Implant Market, U.S., 2006-2016 95
Chart 5 2: Total Hip Implant Market by Component, U.S., 2009 98
Chart 5 3: Combined Total Implant Market, U.S., 2006-2016 99
Chart 5 4: Cemented Hip Implant Market, U.S., 2006-2016 101
Chart 5 5: Cementless Hip Implant Market, U.S., 2006-2016 103
Chart 5 6: Hip Implant Market Penetration by Segment, U.S., 2006-2016 105
Chart 5 7: Standard Polyethylene Bearing Total Hip Implant Market, U.S.,
2006-2016 107
Chart 5 8: Highly Cross-Linked Polyethylene Bearing Total Hip Implant Market, U.S., 2006-2016 109
Chart 5 9: Metal Bearing Total Hip Implant Market, U.S., 2006-2016 111
