Hip and Knee Orthopedic Surgical Implants: Market Shares, Strategies, and Forecasts, Worldwide,

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1 Hip and Knee Orthopedic Surgical Implants: Market Shares, Strategies, and Forecasts, Worldwide, Table of Contents Hip and Knee Orthopedic Surgical Implants: Executive Summary The study is designed to give a comprehensive overview of the Hip and Knee Orthopedic Surgical Implants equipment market segment. Research represents a selection from the mountains of data available of the most relevant and cogent market materials, with selections made by the most senior analysts. Commentary on every aspect of the market from independent analysts creates an independent perspective in the evaluation of the market. In this manner the study presents a comprehensive overview of what is going on in this market, assisting managers with designing market strategies likely to succeed. Knee and Hip Orthopedic Implant Market Executive Summary 27 Knee and Hip Orthopedic Implant Market Driving Forces 27 Knee and Hip Surgical Robot Market Shares 31 Knee and Hip Surgical Implant Forecasts Knee and Hip Orthopedic Implants Market Description and Market Dynamics Challenges In The Field Of Healthcare Clinical Limited Financial Resources Clinical Economic Efficiency Reducing Fixed Costs Homogeneous Supplier Structure Optimizing Processes Orthopedic Reconstructive Implants Continuing Education Implant Industry Characterized by Frequent Patent Litigation Primary Customers 40 TOC-1

2 1.4 Knee Orthopaedic Reconstructive Implants Knee Replacement Hip Implants Hip Replacement Knee and Hip Orthopedic Implant Market Shares and Market Forecasts Knee and Hip Orthopedic Implant Market Driving Forces Knee and Hip Surgical Robot Market Shares Products Orthopedic Implant Surgical Companies Zimmer Persona Knee: The Personalized Knee System Zimmer Persona Knee - The Personalized Knee System Biomet Vanguard SSK 360 Revision System is the best-selling Biomet knee revision implant Zimmer Biomet Oxford Partial Knee Stryker Accolade II Johnson and Johnson / DePuy Surgical Orthopedic Implants Segments Johnson and Johnson / DePuy Hip Smith & Nephew Surgical Orthopedic Implants Segments Exactech Surgical Orthopedic Implants Segments Exactech Mathys Surgical Orthopedic Implants Segments, DJO ConforMIS Aesculap Bicontact Universal Hip System Wright Medical Technology 73 TOC-2

3 Wright Medical Technology Total Hip Replacement Total Hip Replacement Leaching Metal Debris Causes A Condition Called Metallosis Total Knee Replacement Other Surgical Orthopedic Implant Segments Knee and Hip Surgical Implant Forecasts Knee Implants Market Forecasts Hip Implant Market Forecasts Knee and Hip Surgical Implant Unit Analysis Knee and Hip Orthopedic Surgical Procedure Analysis Knee and Hip Surgical Robot Regional Analysis Orthopedic Implant Regional Positioning Zimmer Americas Zimmer Europe Charité Europe European Reconstructive Implant And Trauma Product Markets Asia Pacific Market For Reconstructive Implant And Trauma Products Asia Pacific Zimmer Local Distribution Facilities Knee and Hip Surgical Robot Products Zimmer Holdings / Biomet Hip Zimmer Fitmore Hip Stem Zimmer Continuum Acetabular system Zimmer Facing Lawsuits over Durom Acetabular Component Zimmer Holdings / Biomet Knee 106 TOC-3

4 3.1.5 Zimmer / Biomet Knee and Hip Biomet Knee reconstructive products Biomet Oxford Partial Knee Smith & Nephew Smith & Nephew Orthopaedic Product Line Smith & Nephew Hip Smith & Nephew Recall of Metal Liner Component Of Its Modular R Smith & Nephew Redapt Hip Implant Smith & Nephew Knee Smith & Nephew Knee Implant Systems Smith & Nephew LEGION HK Hinge Knee Replacement Johnson and Johnson / DePuy Hip DePuy s ASR XL Acetabular Total Hip Replacement System Recalled DePuy ATTUNE Knee System DePuy GLIDERIGHT Articulation Knee Implant DePuy AOX Polyethylene DePuy ORTHOVISC Knee Injections Stryker Stryker Triathlon Total Knee Implants Stryker MAKOplasty Robotic Arm Hip Replacement Solution Stryker MAKOplasty Surgical Robotic Total Hip Arthroplasty Stryker MAKO Surgical Knee Replacements Stryker s Mako Total Knee Application Receives FDA Clearance Stryker Knee and Hip Surgical Robot Products Benefits Stryker / Mako 163 TOC-4

5 3.4.8 Stryker Knee Replacement System Microport Profemur Z Hip Stem System MicroPort Evolution Knee MicroPort Orthopedics Knee Replacement MicroPort Orthopedic Devices Corin DJO Hip DJO Revelation Hip System DJO Revelation micromax Hip DJO Linear Hip System DOJ LMR Hip DJO 3DKnee System DJO 3DKnee System DJO FMP Acetabular System DJO RSP Monoblock DJO Reverse Shoulder Prosthesis (RSP) DJO Turon Modular Shoulder System DJO e-plus Exactech Exactech Knee ConforMIS ConforMIS itotal CR Mimics Natural Shape Of The Knee ConforMIS in Development of the itotal Hip Medacta B. Braun / Aesculap AG 204 TOC-5

6 Aesculap Hip Arthroplasty Low Abrasion Ceramic Articulation And Bioactive Surface Coatings Aesculap Bicontact Universal Hip System Aesculap Knee Arthroplasty Waldemar LINK GmbH & Co LINK Hip Prostheses Mathys AG Mathys Stem Mathys Cup Mathys Hip Head Mathys Knee Portfolio Mathys Shoulder Portfolio Wright Medical Technology Knee and Hip Surgical Research, Technology, and Regulation Cemented / Cement-Free Implants Cement-Free Anchorage Cemented Anchorage Well Described Problem For Hip Replacements Allergy Considerations Smith-Nephew VERILAST Technology for Knees Smith & Nephew VERILAST Technology May Last Up To 30 Years Of Wear Hip Implant Failure Epidemic Of Failures Of Hip Implant Devices Implants Involved In These Lawsuits 236 TOC-6

7 4.4 Regulation U.S. Food and Drug Administration 237 U.S. Food and Drug Administration Regulatory FDA s Premarket Clearance and Approval Requirements (k) Clearance Pathway Premarket Approval Pathway Clinical Trials Pervasive and Continuing FDA Regulation Knee and Hip Surgical Company Descriptions B Braun / Aesculap B. Braun Products B.Braun Braun / Aesculap Revenue Aesculap Hip Arthroplasty Aesculap Knee Arthroplasty ConforMIS ConforMIS Fully Paid Up, Worldwide License Agreement with Wright Medical Group, ConforMIS itotal PS Knee Replacement Product Systems Voluntary Recall ConforMIS Makes The Implant Fit The Patient ConforMIS Revenue Third Quarter ConforMIS Third Quarter 2015 Financial Results DJO DJO Trademarks, Service Marks And Brand Names DJO Linear Hip System 257 TOC-7

8 5.3.3 DJO TaperFill Hip System DJO Revelation micromax Hip DJO Knee DJO e DJO Movation and S.U.R.E. System DJO Surgical DJO purchases the Biomet Cobalt HV Bone Cement and Optivac Cement Mixing from Zimmer Biomet DJO Advanced Technologies DJO Revenue DJO Sales by Business Segment Exactech Johnson and Johnson / Depuy Depuy Synthes Trauma Launches New Biologic Implant DePuy Synthes Companies of Johnson & Johnson J&J DePuy Synthes DePuy Synthes ASR Hips Failed Solutions In The Specialties Of Joint Reconstruction, Trauma Johnson and Johnson / DePuy Synthes Google Collaborating With Johnson & Johnson To Develop Surgical Robots DePuy Johnson & Johnson Johnson & Johnson / Ethicon Johnson & Johnson Business Johnson & Johnson Geographic Areas 279 TOC-8

9 5.6 Corin Corin Hip Components Corin Knee Components Mathys Medacta Medacta Business MicroPort Scientific Corporation MicroPort Orthopedic Devices MicroPort acquires OrthoRecon Business from Wright Medical Technologies Microport Hip Systems Shenzhen Advanced Institute Spinal Surgical Robot Smith & Nephew Smith & Nephew Revenue Smith & Nephew 2015 Q3 Highlights Stryker Corporation Stryker Revenue Stryker Results Of Operations Stryker Segment Orthopaedics Stryker Business Segment Operations Stryker Revenue Stryker Hip Recall: $1.4 Billion Settlement Stryker Regional Revenue Segment Stryker Robots Stryker / MAKO Surgical Stryker / Mako 312 TOC-9

10 MAKO Surgical RIO Robotic Arm Stryker Endoscopy Mako Surgical Business Mako Products Mako Surgical Strategy Mako Surgical Revenue THINK Surgical THINK Surgical TPLAN 3D Planning Workstation THINK Surgical TCAT Computer Assisted Tool Think Surgical Think Surgical Robodoc Waldemar LINK GmbH & Co Waldemar Link GmbH und Co. KG Wright Medical Technology Wright Revenue Wright Medical Group NV Revenue Wright Medical Group N.V. Revenue for 2015 Third Quarter Wright / Tornier Zimmer Biomet Zimmer Biomet Sales by Product Category Zimmer Biomet Zimmer Metal-on-Metal Hip Recall 355 TOC-10

11 List of Tables and Figures Figure ES-1 27 Knee and Hip Orthopedic Implant Market Driving Forces 27 Figure ES-2 28 Knee and Hip Orthopedic Implant Market Aspects 28 Table ES-3 29 Knee and Hip Orthopedic Implant Market Challenges 29 Table ES-4 30 Innovative Knee and Hip Orthopedic Implant Features 30 Figure ES-5 32 Hip and Knee Surgical Orthopedic Implants Market Shares, Shipments, Dollars, Worldwide Figure ES-6 33 Orthopedic Implants Market Forecasts, Dollars, Worldwide, Table Clinical Economic Efficiency 36 Figure Knee Replacement Operation Resurfaces The Damaged Knee Joint With Metal And Plastic Implants To Restore Movement 42 Table Hip Implant Surgeon Implant Decision Process Metrics 45 Table Hip Implant Surgery Challenges 46 Table TOC-11

12 Hip Implant Surgery Difficulties 46 Figure Orthopedic Hip Implant Instrumentation 47 Figure Knee and Hip Orthopedic Implant Market Driving Forces 49 Figure Knee and Hip Orthopedic Implant Market Aspects 50 Table Knee and Hip Orthopedic Implant Market Challenges 51 Table Innovative Knee and Hip Orthopedic Implant Features 52 Figure Hip and Knee Surgical Orthopedic Implants Market Shares, Shipments, Dollars, Worldwide Table Hip and Knee Surgical Orthopedic Implants Markets and Systems Shares, Dollars, Worldwide, Figure Zimmer Biomet Knee 58 Figure Zimmer Persona Knee 59 Table Zimmer Surgical Orthopedic Implants Segments, Dollars, Worldwide, Table Stryker Surgical Orthopedic Implants Segments, Dollars, Worldwide, Table TOC-12

13 Johnson and Johnson DePuy Surgical Orthopedic Implants Segments, Dollars, Worldwide, Figure Johnson and Johnson / Depuy Hip Implants 65 Table Smith & Nephew Surgical Orthopedic Implants Segments, Dollars, Worldwide, Table Exactech Surgical Orthopedic Implants Segments, Dollars, Worldwide, Figure Exactech Knee Implant Images 69 Table Mathys Surgical Orthopedic Implants Segments, Dollars, Worldwide, Table DJO Surgical Orthopedic Implants Segments, Dollars, Worldwide, Figure DJO Hip Implant 72 Table ConforMIS Surgical Orthopedic Implants Segments, Dollars, Worldwide, Table Wright Medical Technology Persona Knee features 74 Table Total Knee Replacement Leading Causes Of Dissatisfaction 76 Table Other Surgical Orthopedic Implant Segments, Dollars, Worldwide, Figure TOC-13

14 Orthopedic Implants Market Forecasts, Dollars, Worldwide, Table Total Orthopedic Surgical Implant Market Segment Forecasts Dollars, Worldwide, Table Surgical Orthopedic Implant Market Segments, Units and Dollars, Worldwide, Table Hip, Knee and Other Orthopedic Surgical Implant Market Segment Forecasts, Dollars, Worldwide, Figure Knee Implants Market Forecasts, Dollars, Worldwide, Table Knee Orthopedic Surgical Implant Market Segment Forecasts, Units, Dollars, and Dollars per Unit, United States and Worldwide, Figure Hip Implants Market Forecasts, Dollars, Worldwide, Table Hip Orthopedic Surgical Implant Market Segment Forecasts, Dollars, Units, Dollars per Unit, United States and Worldwide, Table Surgical Orthopedic Implant Knee and Hip Market Segments, Units and Dollars, Worldwide, Figure TOC-14

15 Other Implants Market Forecasts, Dollars, Worldwide, Table Surgical Orthopedic Implant Market Segments, Units and Dollars, Worldwide, Table Hip, Knee, and Other Orthopedic Surgical Implant Market Segment Forecasts, Units, United States and Worldwide, Figure Orthopedic Surgical Implant Regional Market Segments, Dollars, Worldwide, Table Orthopedic Surgical Robot Regional Market Segments, Dollars, Figure Zimmer Holdings / Biomet Hip 97 Table Zimmer Significant Hip Brands 98 Figure Zimmer Continuum Acetabular System 101 Figure Zimmer Continuum Acetabular Orthopedic Implant Hip System 102 Figure Zimmer Continuum Acetabular System Meets Individual Patient Needs 102 Table Zimmer Continuum Acetabular System Features 103 Table Zimmer Trabecular Metal Material Characteristics 104 TOC-15

16 Table Zimmer Significant Knee Brands: 106 Figure Zimmer Holdings / Biomet Knee 107 Table Zimmer Personalized Total Knee Arthroplasty System Functions 108 Figure Zimmer Holdings / Biomet Knee Components 110 Figure Zimmer Holdings / Biomet Implantable Knee Component Unlock and Pull 111 Table Biomet Key Products Description 112 Table Biomet Knee Reconstructive Key Products 114 Figure Smith & Nephew Product Line 116 Table Smith & Nephew REFLECTION Ceramic Acetabular Hip Features 119 Figure Smith & Nephew REFLECTION Ceramic Acetabular Hip System 120 Figure Smith-nephew Reflection Ceramic Acetabular Hip System Optimized Neck 121 Figure Smith & Nephew Hip Implant 122 TOC-16

17 Figure Smith & Nephew Hip Implant CLose-up 123 Smith & Nephew Redapt Hip Implant 124 Figure Smith & Nephew Journey BCS Knee Implant 126 Figure Smith & Nephew Legion TKS Total Knee System 127 Figure Johnson and Johnson / Depuy Hip Implants 129 Table Johnson & Johnson DePuy ASR & Pinnacle Hip Replacement Orthopedics Features 130 Figure DePuy ATTUNE Knee Implant System Works With Knee Muscles And Ligaments 134 Figure DePuy ATTUNE Knee 135 Figure DePuy ATTUNE Knee Side View 136 Figure Innovative Technology of the DePuy ATTUNE Knee 138 Figure Anika Therapeutics Hyaluronic Acid Knee Injections 140 Figure Stryker Implant Products 141 Table TOC-17

18 Stryker Mobile Bearing Hip System Stability and Longevity Features 144 Table Stryker Mobile Bearing Hip System Advanced Fixation Features 145 Table Stryker ADM X3 and WDM X3 Hip System 145 Figure Stryker Triathlon Total Knee 146 Figure Stryker Mako Advanced RIO Robotic Arm 147 Figure Stryker MAKOplasty Robotic Arm Solution 148 Figure Stryker MAKOplasty Hip Arthroplasty 149 Figure Stryker MAKOplasty Hip Arthroplasty 150 Table Stryker MAKOplasty Surgical Robotic Total Hip Arthroplasty Features 151 Figure Stryker Hip Joint Kinematics 152 Figure Stryker RIO Robotic Arm Interactive Orthopedic System 153 Figure Stryker MAKOplasty 154 Figure Stryker Mako RESTORIS Hip System Components 157 TOC-18

19 Table Stryker Mako Diverse Family of RESTORIS Hip Implant Systems 158 Figure MAKO Surgical Maker Of Robots To Assist In Knee Replacements 159 Figure Stryker Mako Robotic Stations for Surgery Planning and Bone Cutting 161 Figure Stryker Knee and Hip Surgical Robot For Bone Cutting 162 Figure Stryker Knee Surgical Robot Precision Cutter Decreases Need For Bone Resurfacing 163 Figure Stryker Mako Surgical Preoperative and Post Operative Knee Surgery Images 165 Table Stryker Mako Surgical Robot Knee Arthroplasty Benefits 166 Figure Microport Profemur Z Hip Stem System 169 Figure MicroPort Orthopedics Knee Replacement 170 Table MicroPort Implant Medical Conditions Treated: 171 Table MicroPort Medical Solutions: 173 Figure MicroPort Hips and Knees 174 Figure TOC-19

20 MicroPort Knees 176 Figure MicroPort Evolution Medial-Pivot Knee System 178 Table MicroPort e MP Knee System Flexion Stability Features 179 Figure Corin Hip Product Line 180 Figure Corin Product Line 181 Table Early Intervention and Primary Hip Implants 182 Figure DJO Hip Implant 183 Figure DJO Revelation Lateral Flare Total Hip 184 Figure DJO Revelation micromax Hip 184 Figure DJO Linear Hip System 185 Figure DOJ LMR Hip 186 Figure DJO 3DKnee System 187 Figure DJO 3DKnee System 188 TOC-20

21 Table DJO EMPOWR 3D Knee System: Key design Features 189 Figure DJO Foundation Knee System 190 Figure Exactech Knee Implant Images 193 Figure Exactech Knee Implant 194 Figure Exactech Knee System 194 Figure ConforMIS itotal Customized Knee Replacement 197 Figure ConforMIS itotal CR Mimics Natural Shape Of The Knee 199 Table ConforMIS ifit Technology Platform Key Elements 202 Source: WinterGreen Research, Inc. 202 Figure ConforMIS itotal Hip 203 Figure B. Braun / Aesculap Bicontact System Implant Components 206 Figure B. Braun / Aesculap Implant System Components 207 Figure Aesculap Knee Arthroplasty Components 210 TOC-21

22 Table Link Target Product Markets 212 Figure LINK Prosthesis Standard Stems 213 Figure Link Primary Instrumentation 215 Figure Link Cementless And Cemented Hip Stems And Hip Cups For Revision Surgery 215 Figure Link Prosthesis Heads 216 Figure Mathys AG Primary Hip Modules 217 Figure Mathys AG Primary Hip Monobloc and Bipolar / Hemi Modules 218 Figure Mathys AG Primary Cemented and Uncemented Hip Modules 219 Figure Mathys AG Primary Hip Revision Modules 220 Table Mathys AG Hip Implant Stems That Are Anchored Cement-Free 221 Figure Mathys AG Hip Implant Stems 222 Figure Mathys Modular Cups Can Be Implanted With Cement-Free Or Cemented Anchorage 223 Figure TOC-22

23 Mathys Ceramic Hip Heads 224 Figure Mathys Knee Portfolio 225 Figure Mathys Uni Knee and Revision Knee 226 Figure Mathys Shoulder Portfolio 227 Figure Smith & Nephew Hip Stem For Cement-Free (Left) And Cemented (Right) Anchorage 230 Figure Smith & Nephew Metal Content of Implants 232 Table U.S. Food and Drug Administration Regulatory Governance Of Activities 238 Table Continuing FDA Regulation 241 Table B. Braun Products 244 Table B. Braun Product Descriptions 245 Figure DJO Hip, Knee, Upper Extremity, and Cement Solutions 255 Figure DJO Linear Hip System 257 Figure DJO TaperFill Hip System 258 TOC-23

24 Figure DJO Empowr 3D Knee 259 Figure DJO e+ 260 Figure Movation and S.U.R.E. System 261 Figure DJO Provides ArmorCoat Implant Protection For Maximum Performance 262 Figure Johnson and Johnson / Depuy Hip Implants 270 Figure Depuy Synthes Biologic Implant 271 Table Johnson and Johnson Family of Companies Comprises: 275 Table Johnson & Johnson Business 279 Figure Corin Orthopaedic Hip Implant 281 Figure Corin Knee Components 282 Figure Mathys Worldwide Presence 283 Table MicroPort Advanced Technology Product Segments Addressed 286 Table TOC-24

25 Microport Hip Systems 287 Figure Smith & Nephew Laser Surgical Instrument 289 Figure Stryker Joint Implants 307 Figure Stryker Patient Specific Pre-Operative Planning 308 Figure Stryker Patient Specific Pre-Operative Planning 309 Table Stryker Better Fit Orthopedics 309 Table Stryker Osteoarthritis Affects Compartments Of The Knee 310 Figure Stryker / MAKO Surgical RIO Robotic Arm Interactive System 311 Figure MAKO Surgical Restoris 318 Figure Mako Robotic Arm Technology Assists in Total Hip Replacement 320 Figure MAKO Surgical 321 Figure MAKO Surgical Implants 322 Table MAKO Robotic Surgery Benefits 327 TOC-25

26 Figure THINK Surgical TPLAN 3D Planning Workstation 331 Figure THINK Surgical TPLAN Workstation 332 Figure THINK Surgical TCAT Computer Assisted Tool 333 Figure Think Surgical Planning 335 Figure Think Surgical Robodoc 336 Figure LINK Prosthetic Stems Precision Turning 337 Figure Link Baking Ceramic Molds at VACUCAST 338 Table Zimmer Biomet Musculoskeletal Healthcare Offerings 354 Table Zimmer Metal On Metal Hip Replacement Difficulties and Side Effects. 356 TOC-26

27 TOC-27

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