Consolidation and maturation of the orthopaedic medical device market between 1999 and 2015

  • Nicolas S. PiuzziEmail author
  • Mitchell Ng
  • Simon Song
  • Stephen Bigach
  • Anton Khlopas
  • Sebastian Salas-Vega
  • Michael A. Mont


Orthopaedic surgeons often require highly specialized medical devices, implants, and equipment, which are usually offered by several vendors/companies. This study assesses long-term market trends for orthopaedic medical device companies and examines various implications for healthcare cost. Using S&P Capital IQ, a Wall Street database, financial data were gathered on orthopaedic device companies, ranked by worldwide sales, from 1999 to 2015. Annual sales were aggregated to calculate market share and compounded annual growth rates (CAGRs). Overall, the global orthopaedic device market grew at 12.0% CAGR from 1999 to 2008, before slowing to 2.8% from 2009 to 2015. Between 1999 and 2015, the top 5 companies increased total market share from 52.8 to 62.2%. The orthopaedic device market is not only consolidating under a few dominant players, but also growing at a decreasing rate, both of which signal a maturing industry. These trends are likely to shape patient care and healthcare costs in orthopaedic surgery in years to come.


Orthopaedics Medical devices Market share Industry growth 


Compliance with ethical standards

Conflict of interest

Dr. Piuzzi has nothing to disclose. Mr. Ng reports personal fees from Thessalus Capital, outside the submitted work; Mr. Song has nothing to disclose. Mr. Bigach has nothing to disclose. Dr. Khlopas has nothing to disclose. Dr. Salas-Vega has nothing to disclose. Dr. Mont reports other from Abbot, other from Cymedica, other from DJ Orthopaedics, other from Johnson & Johnson, other from Mallinckrodt Pharmaceuticals, other from Microport, other from Ongoing Care Solutions, other from OrthoSensor, other from Pacira, other from Peerwell, other from Performance Dynamics, other from Sage, other from Stryker, other from TissueGene, outside the submitted work.

Supplementary material

590_2019_2372_MOESM1_ESM.docx (41 kb)
Supplemental Table 1 Market capitalization and annual sales of top 10 orthopaedic medical device companies by market capitalization 1999 to 2015 (*all numbers in $M) (DOCX 46 kb)
590_2019_2372_MOESM2_ESM.docx (16 kb)
Supplemental Table 2 Since certain companies had reporting segments that did not relate to orthopaedic devices (e.g., Zimmer and Biomet report dental sales), revenue adjustments were made (DOCX 140 kb)


  1. 1.
    Gill PS (2013) Technological innovation and its effect on public health in the United States. J Multidiscip Healthc 6:31–40. CrossRefGoogle Scholar
  2. 2.
    Sorenson C, Drummond M, Bhuiyan Khan B (2013) Medical technology as a key driver of rising health expenditure: disentangling the relationship. Clinicoecon Outcomes Res 5:223–234. CrossRefGoogle Scholar
  3. 3.
    Aghion P, Bloom N, Blundell R et al (2005) Competition and Innovation: an inverted-U relationship. Q J Econ 120:701–728. Google Scholar
  4. 4.
    Ng M, Song S, Piuzzi NS et al (2017) Stem cell industry update: 2012–2016 reveals accelerated investment, but market capitalization and earnings lag. Cytotherapy 19:1131–1139. CrossRefGoogle Scholar
  5. 5.
    McElroy M, Pivec R, Issa K et al (2013) The effects of obesity and morbid obesity on outcomes in TKA. J Knee Surg 26:083–088. CrossRefGoogle Scholar
  6. 6.
    Etzioni DA, Liu JH, Maggard MA, Ko CY (2003) The aging population and its impact on the surgery workforce. Ann Surg 238:170–177. Google Scholar
  7. 7.
    Ulrich SD, Seyler TM, Bennett D et al (2008) Total hip arthroplasties: What are the reasons for revision? Int Orthop 32:597–604. CrossRefGoogle Scholar
  8. 8.
    Lespasio M, Piuzzi NS, Husni ME et al (2017) Knee osteoarthritis: a primer. Perm J. Google Scholar
  9. 9.
    Murray DW, Carr AJ, Bulstrode CJ (1995) Which primary total hip replacement? J Bone Joint Surg Br 77:520–527CrossRefGoogle Scholar
  10. 10.
    Manley MT, Sutton K (2008) Bearings of the future for total hip arthroplasty. J Arthroplasty 23:47–50.e1. CrossRefGoogle Scholar
  11. 11.
    BonifacioMark (2016) A Healthy Prognosis for Medtech M&A. In: Orthop. Des. TechnolGoogle Scholar
  12. 12.
    Okike K, Pollak R, O’Toole RV, Pollak AN (2017) Red–yellow–green. J Bone Jt Surg 99:e33. CrossRefGoogle Scholar
  13. 13.
    Wasterlain AS, Melamed E, Bello R et al (2017) The effect of price on surgeons’ choice of implants: a randomized controlled survey. J Hand Surg Am. Google Scholar
  14. 14.
    Piuzzi NS, Ng M, Chughtai M et al (2017) The stem-cell market for the treatment of knee osteoarthritis: a patient perspective. J Knee Surg. Google Scholar
  15. 15.
    Company Overview of Orthoworld, Inc. In: Bloomberg. Accessed 15 June 2018
  16. 16.
    Poor’s S& S&P Capital IQ. Accessed 15 June 2018
  17. 17.
    Phillips CH (2012) S&P Capital IQ. J Bus Finance Librariansh 17:279–286. CrossRefGoogle Scholar
  18. 18.
    Garde D (2012) Analysts: device market growth will outpace pharma by 2018. In: Fierce Biotech. Accessed 15 June 2018
  19. 19.
    Cunningham J, Dolan B, Kelly D, Young C (2015) Medical device sectoral overview. The Whitaker Institute, GalwayGoogle Scholar
  20. 20.
    Steinbrück K (1999) Epidemiologie von Sportverletzungen-25-Jahres-Analyse einer sportorthopädisch-traumatologischen Ambulanz. Sport Sport 13:38–52. CrossRefGoogle Scholar
  21. 21.
    George J, Piuzzi NS, Ng M et al (2017) Association between body mass index and thirty-day complications after total knee arthroplasty. J Arthroplasty. Google Scholar
  22. 22.
    Robinson JC, Pozen A, Tseng S, Bozic KJ (2012) Variability in costs associated with total hip and knee replacement implants. J Bone Joint Surg Am 94:1693–1698. CrossRefGoogle Scholar
  23. 23.
    Grennan M (2013) Price discrimination and bargaining: empirical evidence from medical devices. Am Econ Rev 103:145–177. CrossRefGoogle Scholar
  24. 24.
    Murphy J, Gray A, Cooper C et al (2016) Costs, quality of life and cost-effectiveness of arthroscopic and open repair for rotator cuff tears. Bone Joint J 98B:1648–1655. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryCleveland ClinicClevelandUSA
  2. 2.Instituto Universitario del Hospital Italiano de Buenos AiresBuenos AiresArgentina
  3. 3.Department of Biomedical EngineeringDuke UniversityDurhamUSA
  4. 4.The London School of Economics and Political ScienceLSE HealthLondonUK
  5. 5.Department of Orthopaedic SurgeryLenox Hill HospitalNew YorkUSA

Personalised recommendations