Orthopedic Industry Strategic Report 2025-2030: Hip, Knee, Spine, Trauma, Shoulder, Extremities, Orthobiologics & Profile of 200 key players, 4th Edition

Table of Contents

Aims of the study, Methodology, Hip, knee, shoulder, spine, trauma, extremities, bone substitutes & orthopedic and spine cement segmentation, Synopsis, Executive summary

Executive summary

Summary of the orthopedic market: Market & trends, Competitive Landscape & Player strategies, Drivers & limiters, Key Success Factors for an orthopedic player

Synopsis: Innovation & new products, Robotics & 3D printing, Impact of inflation, Covid & FX rate

Opportunities: gaining market share through NPIs, level of Ebitda margin , long market visibility, solvency of payers, high barriers to entry & very active M&A

1. Orthopedic environment

• Orthopedics Macro environment: Political, Economic, Social / Culture, Technology, Environment, Legal & Regulatory
• Risks: regulatory burden, ASP almost frozen or declining, significant capex for instruments & CNC machines for orthopedic end-user market
• Milestones in the orthopedic industry: major acquisitions, recalls, divestments, new-comers
• Product withdrawal cases over the past 20 years, 2000-2020
• Market drivers: population growth, population over 65 years, health expenses, obesity, product mix impact
• Market drivers: demographic & economic: Global population growth 1950-2050 and people over 65
• Market drivers: health expenses & obesity rates, USA, France & UK, 1980-2025
• Market drivers: innovation and new products are the differentiating factors on the orthopedic market: innovative, advanced and mature products
• Market drivers: innovative surgeons, follower surgeons and conservative surgeons
• Market limiters: regulatory & certification, details, impact on the market
• Market limiter: reimbursement, a worldwide pricing regulation detailed for the USA, Germany, UK, Sweden, Italy, Belgium, Switzerland and France - Date of
• launch, Classification system and targets
• Market limiter: MDR (Medical Device Regulation): impact in Europe for implants and for instruments
• Market limiter: MDR: New deadline for Class III products fixed in December 2027
• Market limiter: Hip ASP erosion 2012-2024 in developed countries, USA, Australia, Japan & Europe
• Market limiter: Knee ASP erosion 2012-2024 in developed countries, USA, Australia, Japan & Europe

2. Orthopedic & spine market by region & forecasts

• Forecast Price for hip & knee 2024-2030: USA, Australia, Japan, Europe
• Drivers & limiters for Orthopedic products: matrix summarizing (volume, price) x (driver, argument, past impact & future impact)
• Worldwide implants market in 2024 in value by region (US$Bn): knee, hip & spine - USA, Europe & ROW
• Worldwide implants market in 2024 in value by region (US$Bn): trauma, shoulder & extremities - USA, Europe & ROW
• Hip & Knee by region (US$Bn): USA, Europe, Japan, Australia, South Korea & ROW
• Hip & knee ratio for 10,000 inhabitants, USA, Europe, South Korea, Australia, Japan, China & ROW. Growth by area for hip & knee CAGR 2024-2030
• Spine & trauma by region in 2024 (US$Bn): USA, Europe, South Korea, Australia, Japan - Rest Of the World
• Spine procedures: fusion (trauma, deformation, degenerative), non-fusion (spine dynamic) & vertebroplasty-kyphoplasty
• Shoulder & Extremities by region (US$Bn): USA, Europe, Japan, Australia, South Korea & ROW
• The life cycle of orthopedic products: growth forecasts by 2024-2030 for hip, knee, spine, trauma & extremities
• Worldwide orthopedic market in 2024 and forecasts 2024-2030 for hip, knee, spine, trauma, shoulder, extremities, orthobiologics and other

3. Player strategies: competitive landscape, players’ ranking & dispersion

• Three types of Challengers compete with the Majors: Challengers type 1 (country leader) / Challengers type 2 (country player) / Challengers type 3 (local vendors)
• Hip, knee & shoulder challengers growth: Corin, Medacta, Enovis and FX Solutions revenues
• Spine & Orthobiologics challengers are grabbing market share from the Majors and emerging as top players: Globus, Alphatec Spine, Depuy “Spine & other”
• and Bonesupport revenues
• Challengers have continuously gained market share except in 2020 due to Covid impact: challengers market shares collapsed for hip, knee, spine, trauma &
• total ortho
• Table of Contents: Orthopedic industry strategic report 2025-2030: Hip, Knee, Spine, Trauma, Shoulder, Extremities & Orthobiologics - Profile of 200 key players
• Published June 2026 - 4th Edition
• Challengers have continuously gained market share except in 2020 due to Covid impact: challengers market shares evolution from 2018 to 2025 for hip, knee,
• spine, trauma & total ortho
• Majors vs. Challengers: Majors saved their margins while Challengers got the growth, position of each players in terms of market shares and ortho & spine
• revenues growth from 2019 to 2025
• 2019-2024: Stryker is the only Major that has been growing at 6.5% per year since 2019. Globus merged with Nuvasive. The other Majors experienced slower
• growth or decline. Taken together, the challengers experienced moderate growth, but many of them have achieved double-digit growth.
• Reasons why Challengers are growing faster than Majors
• The hip implant market is highly concentrated, with the 4 majors : ranking & dispersion: Top 4 / Top 5-10 / Other
• The knee implant market is highly concentrated, with the 4 majors : ranking & dispersion : Top 4 / Top 5-10 / Other
• The spine implant market is highly concentrated, with the 4 majors : ranking & dispersion : Top 4 / Top 5-10 / Other
• The Trauma implant market is highly concentrated, with the 4 majors : ranking & dispersion: Top 5 / Top 6-10 / Other
• The shoulder implant market is highly concentrated, with the 4 majors : ranking & dispersion : Top 5 / Top 6-10 / Other
• The extremities implant market is moderately concentrated, the 4 leaders : ranking & dispersion : Top 4 / Top 5-10 / Other
• The Orthobiologics market is moderately concentrated, the 4 leaders : ranking & dispersion : Top 4 / Top 5-10 / Other

4. Innovations & new technologies in orthopedics

• History of disruptive innovations: ceramics, hip dual mobility cup, short stem, anterior approach surgery, 3D printing for hips, cementless products, robotics,
• specific ceramic parts for the knee, reversed for shoulder, disk, 3D printing cages for spine
• Market drivers: orthopedics is generally risk-averse with few disruptive innovations, often coming from small players, but many small incremental
• innovations.
• For Alphatec Spine 82% of revenues are driven by New Products
• Smith & Nephew: average new products launched per year
• Innovation level comparison between Smith & Nephew and Alphatec Spine

Orthopedic robotics

• Orthopedic robotic market: MAKO from Stryker, ROSA from Zimmer Biomet, Navio of Smith & Nephew, Mazor from Medtronic and Velys from Depuy robotic
• systems Omni robotic from OMNIlife science, Apollo from Corin, Tinavi…
• Navigation Vs robotic assisted surgery comparison: tools description, features, end-user price, easy to use, pro & cons
• Stryker with Mako’s acquisition boosted the orthopedic robotic market and have a huge impact on instruments market
• Orthopedic robotics surgeries: Stryker open the mass market, Smith & Nephew, Zimmer Biomet, Depuy and many others have followed
• New generations of Mako for shoulder and spine surgery launched & Stryker Mako installed base machines 2017-2025 for hip & knee
• New generations of Rosa for shoulder surgery launched & Zimmer Biomet Rosa installed base machines 2017-2025 for hip & knee
• New generations of Cori pre-operative planning and modelling which allows image-free and image-based planning launched in 2024 & Smith & Nephew
• Navio & Cori installed base machines 2020-2025 for hip & knee
• New generations of Velys for spine surgery launched i& Depuy Synthes Velys installed base machines 2021-2025 for hip & knee
• Robotic orthopedic system benchmark: there are several families of orthopedic robots, handheld or with a robotic arm. Mako, Rosa and Velys have chosen
• the robotic arm, while Cori is handheld. Another variant is the need for a CT Scan or not (Imageless); only Mako uses a CT Scan. Finally, the use of cutting
• guides is eliminated for Mako and Velys, who operate direct cuts by the robot, while Cori uses several cutting guides and Rosa only for tibial cuts.
• Mako, Rosa, Velys and Cori benchmark by operating cost and acquisition cost
• Product benchmarking: Mako is the robot with the most extensive clinical track record, but the acquisition cost is high.
• Australia was always a pioneer in the use of innovations in orthopedics. Germany and Japan will be the fastest-growing markets. In France, the robotized
• knee ratio lags far behind. Australian, Japanese, German, Italian, UK and French knee surgeries performed with robotics (in K units) 2020-2030
• Robotic-assisted surgeries outside the US: Between 2025 and 2030, the number of robotic knee operations outside the USA forecasts. Germany and the UK
• will lead the way in Europe in terms of volume. Outside US knee surgeries performed with robotics (in K units) 2020-2030: Australia, Japan, Germany, Italy,
• UK, France, Rest of Europe & Rest of the World

3D Printing

• 3D Printing in Orthopedics: Zimmer opened up this market with Trabecular Tantalum then Lima (Enovis) & Adler, Italian-based companies, started mass
• market sales
• Story of Zimmer and Trabecular Tantalum 1997-2025
• Zimmer Trabecular metal product portfolio: Patellar knee implant, femoral et tibial cone augments, acetabular revision system, acetabular cup, reversed
• shoulder system, shoulder glenoid part, knee tibial plate, primary hip stem
• Metal 3D Printing: technologies and major players, EOS, Arcam, SLM Solutions, Concept Laser, other players by raw materials used and technologies
• Number of Arcam EBM installed base for orthopedic industry at Enovis 2007-2025 and % of hip cups and shoulder glenoid made by 3D printing machines
• Number of EBM installed base at AK MEDICAL & Implantcast
• Illustrative build-up speed and resolution of selected Metal 3D Printing systems: EBM Vs Selective Laser Melting (SLM) comparison between maximum build
• up speed in cm3/h and resolution
• Smith & Nephew uses 3D Printing: 20 EOS M290 for metal and 3 for plastic to produce hip cup & customized cutting blocks to manufacture customized
• cutting blocks and hip revision cup
• Table of Contents: Orthopedic industry strategic report 2025-2030: Hip, Knee, Spine, Trauma, Shoulder, Extremities & Orthobiologics - Profile of 200 key players
• Published June 2026 - 4th Edition
• Stryker has announced massive investments in 3D Printing, In 2016, a US$400 Million plan to build a 3D printing manufacturing facility in Cork, Ireland was
• released. Today, many of Stryker's products are made by 3D printing
• Current Stryker products made by 3D Printing: knee tibial plate, patellar knee implant, knee augment, cages, other
• Depuy Spine uses 3D Printing for prototyping complex surgical tools and announced investments in 3D printing
• DePuy Synthes has acquired 3D printing technology from Tissue Regeneration Systems
• DePuy Synthes Launched 3D Printed Titanium Facial Reconstruction Implants in US
• XILLOC for Cranio-Maxillofacial applications using PEEK and titanium alloys
• 3D printing machine suppliers for orthopedics, installed : EOS, ARCAM, CONCEPT LASER, SLM Solutions, 3D Systems and their customers. Number of installed
• base machines per machine manufacturer
• Addressable market should increase with lower 3D Printing cost: cost and complexity curve linked with addressable market
• 3D Printing is attractive for reconstructive implants to accelerate and improve osteo-integration.
• Number of implants produced using 3D Printing: Stryker , Zimmer Biomet, Enovis, Advita, Adler Ortho, etc.
• FDA clearance for medical devices using 3D Printing in USA
• 3D Printing has reached the mass market for a few key products: hip cups, tibial knee, spine cages, shoulder glenoid and several trauma have switched to 3D
• Printing
• 3D Printing today has a slight impact on the forging, casting & machining of implants. Our research shows that Stryker and challengers are most advanced in
• the use of 3D printing, particularly for hip cups, tibial knee plates and spinal cages. % of implants produced using 3D printing worldwide:
• 3D printing cages are gaining in market share over Peek and Titanium cages.
• 3D Printing and impact on the forging, casting & machining of hip cups
• Hip: manufacturing process and raw materials, 3D printing is not a threat to the forging of hip stems
• Knee: manufacturing process and raw materials: 3D printing is not a threat to the forging of tibial plates
• Cages for spine surgeries in the five main European countries
• Is 3D Printing the right option for the implant Contract Manufacturing business? Analysis of different products & players for reconstructive implants, standard
• cages, special cages and customized implants - Benefits / Drivers & Limiters for each products
• Is 3D Printing the right option for the instruments Contract Manufacturing business? Analysis of different products & players for customized cutting guides
• and complex instruments: Lincotek 3D Printing activity details
• Most large contract manufacturers are investing in 3D printing and, after an initial learning curve, are moving into the scale-up phase.
• The most manufactured orthopedic products by 3D Printing
• Standard manufacturing process Vs 3D Printing process: cost comparison for hip cup, knee tibial, spine cages and shoulder glenoid
• Trend of the installed bases of the main machine suppliers: the number of 3D Printing machines used in orthopedics 2015-2025
• 3D Printing In-house & Contract Manufacturing market 2015-2030 by hip cup, knee tibial plate, shoulder glenoid, spine cage, other parts: in value

REACH & impact on Co-Cr

• EU Regulation 2017/745 says that a CMR substance
• Cobalt-Chrome is used today in 6 major orthopedic products: femoral knee, dual mobility liner, hip and shoulder heads, bipolar cups and tibial knee plates.
• The use of Co-Cr varies depending on the geographical area. REACH regulation: ban on Co-Cr for implants?
• REACH regulation: no ban on Co-Cr for implants is expected,, Co-Cr implants have to be CMR-labeled, which will not have a major impact on Co-Cr use. Co-Cr
• will continue to be used for implants that have been manufactured for several decades and have a very long track-record. Only new hip product development
• projects will be affected. Co-Cr hip implants will be flat or slightly down.
• Co-Cr has been used for decades for friction parts in implants
• Oxinium Hip & Knee is a breakthrough bearing solution comparable to ceramic bearings.
• Anti-allergic solutions against nickel, cobalt, etc. have been developed for several decades

Orthobiologics

• Use of antibiotics for orthopedic cements: need for cements with new antibiotics
• Cement price / mix: mix effect offsetting small price erosion that is common in the orthopedic industry
• Synthetic or natural bone substitutes, allografts, growth factors, Demineralized Bone Matrix (DBM), xenografts, autografts segmentation
• Main bone grafts on the market: injectables and antibiotics are the main drivers: injectable & non-injectable

Inflation impact

• Impact of inflation on the end-user market and on contract manufacturing: Majors OEMs & Majors CMOs quotes
• FX rate variation
• Impact of exchange rate fluctuations on the major orthopedic companies

Tariffs impact

• Impact of Tariffs on OEMs and CMOs
• Table of Contents: Orthopedic industry strategic report 2025-2030: Hip, Knee, Spine, Trauma, Shoulder, Extremities & Orthobiologics - Profile of 200 key players
• Published June 2026 - 4th Edition

Single use

• Single-use trend: the introduction of single-use starts with the less expensive cutting tools: drills, taps, burrs, pins, sawblades, rasps & acetabular reamers
• Single use in the USA & Europe: trauma and extremities are the largest consumers of single-use cutting tools and disposable kits - % of single use USA and
• Europe 2018-2026
• Cutting tools: 3D printing's contribution is to lighten and reduce the number of parts and generate cost savings

Ambulatory Surgery Center - ASC in the USA

• Ambulatory Surgery Center - ASC in the USA, expected to skyrocket for hip, knee, spine and trauma non-complex surgeries!

5. Player profiles:

• 6 Majors
• Players: US$100M -> US$1B
• Players: US$40M -> US$100M
• Players: US$20M -> US$40M
• Players: US$10M -> US$20M
• Conclusions, Executive summary
• Appendices