Global Joint Reconstruction Market Analysis Forecast 2018 2025 PDF

Global Joint Reconstruction Market: Focus on Procedure
Number, Type, and Country - Analysis and Forecast, 2018-2025
Global Joint Reconstruction Market -

Analysis And Forecast (2018-2025)
© 2018 BIS Research, All Copyrights Reserved
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© 2018 BIS Research, All Copyrights Reserved 2
Preface
• The rise in the prevalence of chronic diseases such as diabetes, osteoarthritis, avascular necrosis, and other forms of arthritis, have
significantly fuelled the demand for joint reconstruction surgeries. As per a 2001 World Health Organization (WHO) report, chronic
diseases accounted for approximately 60% of the total number of deaths in the world. Also, the number accounted for 46% of the
global burden of disease. It is also expected that the percentage will reach more than 57% by the end of 2020. With the increasing
life span and high life expectancy, the geriatric population is growing at a fast pace; thereby, increasing the demand for the better
treatment facilities with early diagnosis of chronic diseases. Frequent launch of joint reconstruction products and rising prevalence
of osteoarthritis are major factors behind high-paced growth of the market.
• The joint reconstruction market is expected to grow by 1.5X over the forecast period owing to an upsurge in the procedure volume
in developed regions. With the ongoing development in the developing economies, the market potential in these regions is
significantly high. The following report “Global Joint Reconstruction Market” explains the market scenario of overall procedures and
market value of the implants being used along with the factor impacting the growth of the market and the key challenges witnessed
by the key players in the market. The report also covers the competitive landscape of the market, industry attractiveness, and
market dynamics.
• The report has been segmented into two sections: product type and region. Each segment is further sub-segmented and provides
data for the market revenue for the historical years (2015-2016) and for the forecast years (2018-2025) and 2017 is considered as
the base year.

Preface
Key questions answered in the report:
• How did the joint reconstruction market evolve, and what is its scope in the future?
• What are the major market drivers, challenges, and opportunities in the global joint reconstruction market?
• What are the key strategies that are adopted by the key players to sustain in this market?
• What key factors are influencing the end users in the industry?
• What is the number of procedures performed and revenue generated by the products used in the global joint reconstruction
market?
• How does the parameters such as age, sex, birth, distribution of population, and incidence of diseases affect the market growth?
• What are the historical trends that exist in the market, and how the recent technological trends are going to change the overall
dynamics of the market?
• How will the industry evolve during the forecast period 2018-2025?
• Who are the key players in the global joint reconstruction market, and what are their contributions?
BIS Healthcare
September 2018

Table of Contents
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Executive Summary
1 Market Overview
1.1 Definition and Product Inclusions
1.2 Overview of Global Joint Reconstruction Market
1.3 Technology Trends and Innovations
1.4 Key Players Market Share Analysis
2 Market Dynamics
2.1 Overview
2.2 Impact Analysis
2.3 Market Drivers
2.4 Market Restraints
2.5 Market Opportunities
3 Competitive Landscape
3.1 Key Developments and Strategies
3.2 Mergers and Acquisitions
3.3 Product Launch
3.4 Joint Ventures, Collaborations and Partnerships

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3.5 Product Approvals
4 Industry Insights
4.1 Introduction
4.2 Globalization and Market Expansion
4.3 Demographics and Patient Statistics - North America
4.4 Demographics and Patient Statistics - Europe
4.5 Demographics and Patient Statistics - Asia Pacific
4.6 Demographics and Patient Statistics - Latin America
4.7 Pricing Analysis for Hip, Knee and Shoulder Joint Reconstruction
5 Global Joint Reconstruction Market Overview
5.1 Overview
5.2 Global Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
5.3 Global knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Types)
5.4 Global knee Arthroplasty Market (Procedure Type)
6 Global Joint Reconstruction Market (by Product Type)
6.1 Global Joint Reconstruction Market (by Product Type)

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6.2 Global Hip Joint Reconstruction Market Overview
6.3 Global Hip Joint Reconstruction Market By (Procedure Type: Primary, Revision and Hip Resurfacing)
6.4 Global Primary and Revision Hip Joint Reconstruction Market (By Fixation Type: Cemented, Uncemented, Hybrid and Others)
6.5 Global Primary and Revision Hip Joint Reconstruction Market (By Bearing Surface: MoP, CoP, CoC, MoM, Other)
6.6 Global Knee Joint Reconstruction Market Overview
6.7 Global Knee Joint Reconstruction Market (By Procedure Type: Primary and Revision)
6.8 Global Primary and Revision Knee Joint Reconstruction Market (By Fixation Type: Cemented, Uncemented, Hybrid and Others)
Global Primary and Revision Knee Joint Reconstruction Market (By Bearing Type : Unconstrained Fixed, Unconstrained Mobile, Posterior-
6.9
Stabilized Fixed, and Others)
6.10 Global Shoulder Joint Reconstruction Market Overview
6.11 Global Shoulder Joint Reconstruction Market Value (By Procedure Type)
7 North America Joint Reconstruction Market (Country Analysis)
7.1 North America Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
7.2 North America Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
7.3 North America Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
7.4 North America Shoulder Arthroplasty Market (Procedure Type)
7.5 The U.S. Joint Reconstruction Market Overview (Hip, Knee and Shoulder)

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7.6 The U.S. Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
7.7 U.S. Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
7.8 U.S. Shoulder Arthroplasty Market (Procedure Type)
7.9 Canada Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
7.10 Canada Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
7.11 Canada Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
7.12 Canada Shoulder Arthroplasty Market (Procedure Type)
8 Europe Joint Reconstruction Market (Country Analysis)
8.1 Europe Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
8.2 Europe Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
8.3 Europe Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
8.4 Europe Shoulder Arthroplasty Market (Procedure Type)
8.5 United Kingdom Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
8.6 United Kingdom Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
8.7 United Kingdom Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
8.8 United Kingdom Shoulder Arthroplasty Market (Procedure Type)

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8.9 Germany Joint Reconstruction Market Overview (Hip, Knee and Soulder)
8.10 Germany Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
8.11 Germany Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
8.12 Germany Shoulder Arthroplasty Market (Procedure Type)
8.13 Italy Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
8.14 Italy Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
8.15 Italy Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
8.16 Italy Shoulder Arthroplasty Market (Procedure Type)
8.17 Belgium Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
8.18 Belgium Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
8.19 Belgium Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
8.20 Belgium Shoulder Arthroplasty Market (Procedure Type)
8.21 Portugal Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
8.22 Portugal Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
8.23 Portugal Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
8.24 Portugal Shoulder Arthroplasty Market (Procedure Type)
8.25 Norway Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
8.26 Norway Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)

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8.27 Norway Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
8.28 Norway Shoulder Arthroplasty Market (Procedure Type)
8.29 Czech Republic Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
8.30 Czech Republic Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
8.31 Czech Republic Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
8.32 Czech Republic Shoulder Arthroplasty Market (Procedure Type)
8.33 Spain Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
8.34 Spain Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
8.35 Spain Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
8.36 Spain Shoulder Arthroplasty Market (Procedure Type)
8.37 Netherlands Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
8.38 Netherlands Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
8.39 Netherlands Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
8.40 Netherlands Shoulder Arthroplasty Market (Procedure Type)
8.41 Russia Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
8.42 Russia Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
8.43 Russia Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
8.44 Russia Shoulder Arthroplasty Market (Procedure Type)

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9 Asia Pacific Joint Reconstruction Market (Country Analysis)
9.1 Asia Pacific Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
9.2 Asia Pacific Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
9.3 Asia Pacific Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
9.4 Asia Pacific Shoulder Arthroplasty Market (Procedure Type)
9.5 China Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
9.6 China Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
9.7 China Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
9.8 China Shoulder Arthroplasty Market (Procedure Type)
9.9 Japan Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
9.10 Japan Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
9.11 Japan Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
9.12 Japan Shoulder Arthroplasty Market (Procedure Type)
9.13 Australia Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
9.14 Australia Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
9.15 Australia Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
9.16 Australia Shoulder Arthroplasty Market (Procedure Type)
9.17 South Korea Joint Reconstruction Market Overview (Hip, Knee and Shoulder)

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9.18 South Korea Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
9.19 South Korea Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
9.20 South Korea Shoulder Arthroplasty Market (Procedure Type)
10 Latin America Joint Reconstruction Market (Country Analysis)
10.1 Latin America Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
10.2 Latin America Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
10.3 Latin America Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
10.4 Latin America Shoulder Arthroplasty Market (Procedure Type)
10.5 Brazil Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
10.6 Brazil Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
10.7 Brazil Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
10.8 Brazil Shoulder Arthroplasty Market (Procedure Type)
10.9 Mexico Joint Reconstruction Market Overview (Hip, Knee and Shoulder)
10.10 Mexico Hip Arthroplasty Market (Procedure Type, Fixation Type and Bearing Surfaces)
10.11 Mexico Knee Arthroplasty Market (Procedure Type, Fixation Type and Bearing Type)
10.12 Mexico Shoulder Arthroplasty Market (Procedure Type)
11 Company Profiles
11.1 Altimed JSC

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11.1.1 Overview
11.1.2 Overall Product Portfolio
11.1.3 Product Offerings for Global Joint Reconstruction Market
11.1.4 Global Presence
11.1.5 SWOT Analysis
11.2 ARZZT
11.2.1 Overview
11.3 B. Braun Melsungen AG
11.3.1 Overview
11.3.4 Financials
11.3.4.1 Financial Summary

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11.3.6 Recent Developments
11.4 Beijing Chunlizhengda Medical Instruments Co., Ltd.
11.4.1 Overview
11.4.4 Financials
11.5 BioMedtrix, LLC
11.5.1 Overview
11.6 Biotech GmbH

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11.6.1 Overview
11.7 Biotechni S.A.S
11.7.1 Overview
11.8 CeramTec Group
11.8.1 Overview
11.8.4 Financials

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11.9 Corin Group PLC
11.9.1 Overview
11.10 Elite Surgical
11.10.1 Overview
11.11 Evolutis
11.11.1 Overview

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11.12 Exactech, Inc.
11.12.1 Overview
11.12.4 Financials
11.13 FX Solutions
11.13.1 Overview

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11.14 Group FH Ortho
11.14.1 Overview
11.15 JOHNSON & JOHNSON
11.15.1 Overview
11.15.4 Financials
11.16 JRI Orthopaedics Limited
11.16.1 Overview

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11.17 Lima Corporate
11.17.1 Overview
11.18 Marle Group
11.18.1 Overview

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11.19 Mathys AG Bettlach
11.19.1 Overview
11.19.4 Financials
11.20 MatOrtho Limited
11.20.1 Overview
11.21 Menix Group
11.21.1 Overview

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11.22 MicroPort Scientific Corporation
11.22.1 Overview
11.22.4 Financials
11.23 Peter Brehm GmbH
11.23.1 Overview
11.24 Smith & Nephew plc

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11.24.1 Overview
11.24.4 Financials
11.25 StelKast
11.25.1 Overview
11.26 Stryker Corporation
11.26.1 Overview
11.26.4 Financials
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11.27 Surgival (GRUPO COSÍAS)
11.27.1 Overview
11.28 Wright Medical Group N.V.
11.28.1 Overview
11.28.4 Financials
11.29 Zimmer Biomet Holdings, Inc.

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11.29.1 Overview
11.29.4 Financials
12 Report Scope & Methodology
12.1 Scope of the Report
12.2 Key Data Points From Secondary Sources
12.3 Data Triangulation
12.4 Top-Down Approach (Segmental Analysis)
12.5 Bottom-Up Approach (Segmental Analysis)
12.6 Estimation Parameters and Predictive Modelling
12.7 Assumptions and Limitations for Market Estimation

List of Tables
SR.NO List of Tables
1 FDA Cleared Joint Reconstruction Devices for Use (2016-2017)
4 FDA Cleared Shoulder Reconstruction Devices for Use (2016-2017)
5 FDA Cleared Shoulder Reconstruction Devices for Use (2016-2017)
6 First year cost of treatment for hip fractures in EU by country, 2012-2015
7 Estimated number of men and women with osteoporosis
8 Estimated number of men and women with osteoporosis
9 Estimated number of incident fractures by type and country, 2010
10 Estimated number of incident fractures by type and country, 2015
11 Population increase in those aged 70 years or over by country, 2013, 2025, 2050
12 Cost of treatment of osteoporosis ($US) and number of average days spent in a hospital
13 Percentage of Population (50 Years and Above), by Country
15 Average Price of Hip Reconstruction Implants
16 Hip Reconstruction
17 Average Price of Shoulder Reconstruction Implants
18 Shoulder Reconstruction
19 Average Price of Knee Reconstruction Implants
20 Knee Reconstruction
List of Tables
21 Global Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
22 Global Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
23 Global Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
24 Global Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
25 Global Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
26 Global Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
27 Global Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
28 Global Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
29 Global Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
30 Global Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
31 Global Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
32 Global Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
33 Global Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
34 Global Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
35 Global Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
36 Global Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
37 North America Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
38 North America Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
39 North America Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
40 North America Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
List of Tables
41 North America Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
42 North America Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
43 North America Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
44 North America Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
45 North America Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
46 North America Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
47 North America Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
48 North America Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
49 North America Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
50 North America Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
51 North America Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
52 North America Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
53 The U.S. Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
54 The U.S. Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
55 The U.S. Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
56 The U.S. Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
57 The U.S. Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
58 The U.S. Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
59 The U.S. Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
60 The U.S. Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
List of Tables
61 The U.S. Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
62 The U.S. Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
63 The U.S. Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
64 The U.S. Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
65 The U.S. Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
66 The U.S. Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
67 The U.S. Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
68 The U.S. Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
69 Canada Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
70 Canada Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
71 Canada Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
72 Canada Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
73 Canada Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
74 Canada Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
75 Canada Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
76 Canada Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
77 Canada Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
78 Canada Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
79 Canada Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
80 Canada Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
List of Tables
81 Canada Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type

82 Canada Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
83 Canada Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
84 Canada Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
85 Europe Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
86 Europe Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
87 Europe Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
88 Europe Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
89 Europe Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
90 Europe Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
91 Europe Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
92 Europe Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
93 Europe Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
94 Europe Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
95 Europe Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
96 Europe Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
97 Europe Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
98 Europe Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
99 Europe Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
100 Europe Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
List of Tables
101 United Kingdom Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
102 United Kingdom Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
103 United Kingdom Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
104 United Kingdom Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
105 United Kingdom Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
106 United Kingdom Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
107 United Kingdom Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
108 United Kingdom Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
109 United Kingdom Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
110 United Kingdom Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
111 United Kingdom Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
112 United Kingdom Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
113 United Kingdom Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
114 United Kingdom Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
115 United Kingdom Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
116 United Kingdom Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
117 Germany Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
118 Germany Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
119 Germany Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
120 Germany Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
List of Tables
121 Germany Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
122 Germany Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
123 Germany Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
124 Germany Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
125 Germany Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
126 Germany Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
127 Germany Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
128 Germany Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
129 Germany Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
130 Germany Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
131 Germany Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
132 Germany Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
133 Italy Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
134 Italy Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
135 Italy Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
136 Italy Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
137 Italy Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
138 Italy Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
139 Italy Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
140 Italy Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
List of Tables
141 Italy Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
142 Italy Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
143 Italy Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
144 Italy Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
145 Italy Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
146 Italy Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
147 Italy Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
148 Italy Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
149 Belgium Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
150 Belgium Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
151 Belgium Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
152 Belgium Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
153 Belgium Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
154 Belgium Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
155 Belgium Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
156 Belgium Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
157 Belgium Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
158 Belgium Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
159 Belgium Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
160 Belgium Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
List of Tables
161 Belgium Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
162 Belgium Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
163 Belgium Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
164 Belgium Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
165 Portugal Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
166 Portugal Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
167 Portugal Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
168 Portugal Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
169 Portugal Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
170 Portugal Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
171 Portugal Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
172 Portugal Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
173 Portugal Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
174 Portugal Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
175 Portugal Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
176 Portugal Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
177 Portugal Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
178 Portugal Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
179 Portugal Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
180 Portugal Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
List of Tables
181 Norway Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
182 Norway Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
183 Norway Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
184 Norway Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
185 Norway Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
186 Norway Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
187 Norway Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
188 Norway Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
189 Norway Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
190 Norway Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
191 Norway Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
192 Norway Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
193 Norway Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
194 Norway Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
195 Norway Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
196 Norway Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
197 Czech Republic Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
198 Czech Republic Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
199 Czech Republic Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
200 Czech Republic Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
List of Tables
201 Czech Republic Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
202 Czech Republic Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
203 Czech Republic Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
204 Czech Republic Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
205 Czech Republic Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
206 Czech Republic Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
207 Czech Republic Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
208 Czech Republic Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
209 Czech Republic Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
210 Czech Republic Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
211 Czech Republic Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
212 Czech Republic Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
213 Spain Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
214 Spain Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
215 Spain Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
216 Spain Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
217 Spain Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
218 Spain Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
219 Spain Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
220 Spain Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
List of Tables
221 Spain Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
222 Spain Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
223 Spain Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
224 Spain Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
225 Spain Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
226 Spain Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
227 Spain Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
228 Spain Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
229 Netherlands Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
230 Netherlands Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
231 Netherlands Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
232 Netherlands Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
233 Netherlands Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
234 Netherlands Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
235 Netherlands Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
236 Netherlands Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
237 Netherlands Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
238 Netherlands Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
239 Netherlands Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
240 Netherlands Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
List of Tables
241 Netherlands Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
242 Netherlands Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
243 Netherlands Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
244 Netherlands Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
245 Russia Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
246 Russia Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
247 Russia Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
248 Russia Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
249 Russia Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
250 Russia Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
251 Russia Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
252 Russia Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
253 Russia Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
254 Russia Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
255 Russia Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
256 Russia Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
257 Russia Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
258 Russia Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
259 Russia Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
260 Russia Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
List of Tables
261 Asia Pacific Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
262 Asia Pacific Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
263 Asia Pacific Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
264 Asia Pacific Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
265 Asia Pacific Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
266 Asia Pacific Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
267 Asia Pacific Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
268 Asia Pacific Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
269 Asia Pacific Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
270 Asia Pacific Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
271 Asia Pacific Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
272 Asia Pacific Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
273 Asia Pacific Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
274 Asia Pacific Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
275 Asia Pacific Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
276 Asia Pacific Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
277 China Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
278 China Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
279 China Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
280 China Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
List of Tables
281 China Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
282 China Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
283 China Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
284 China Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
285 China Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
286 China Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
287 China Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
288 China Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
289 China Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
290 289 China Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
291 China Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
292 China Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
293 Japan Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
294 Japan Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
295 Japan Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
296 Japan Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
297 Japan Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
298 Japan Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
299 Japan Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
300 Japan Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
List of Tables
301 Japan Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
302 Japan Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
303 Japan Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
304 Japan Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
305 Japan Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
306 Japan Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
307 Japan Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
308 Japan Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
309 Australia Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
310 Australia Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
311 Australia Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
312 Australia Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
313 Australia Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
314 Australia Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
315 Australia Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
316 Australia Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
317 Australia Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
318 Australia Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
319 Australia Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
320 Australia Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
List of Tables
321 Australia Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
322 Australia Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
323 Australia Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
324 Australia Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
325 South Korea Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
326 South Korea Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
327 South Korea Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
328 South Korea Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
329 South Korea Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
330 South Korea Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
331 South Korea Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
332 South Korea Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
333 South Korea Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
334 South Korea Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
335 South Korea Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
336 South Korea Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
337 South Korea Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
338 South Korea Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
339 South Korea Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
340 South Korea Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
List of Tables
341 Latin America Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
342 Latin America Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
343 Latin America Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
344 Latin America Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
345 Latin America Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
346 Latin America Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
347 Latin America Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
348 Latin America Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
349 Latin America Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
350 Latin America Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
351 Latin America Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
352 Latin America Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
353 Latin America Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
354 Latin America Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
355 Latin America Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
356 Latin America Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
357 Brazil Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
358 Brazil Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
359 Brazil Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
360 Brazil Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
List of Tables
361 Brazil Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
362 Brazil Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
363 Brazil Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
364 Brazil Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
365 Brazil Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
366 Brazil Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
367 Brazil Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
368 367 Brazil Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
369 Brazil Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
370 Brazil Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
371 Brazil Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
372 Brazil Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
373 Mexico Primary Hip Arthroplasty Market Value ($ Million) by Fixation Type
374 Mexico Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
375 Mexico Revision Hip Arthroplasty Market Value ($ Million) by Fixation Type
376 Mexico Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
377 Mexico Primary Hip Arthroplasty Market Value ($ Million) by Bearing Surface
378 Mexico Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
379 Mexico Revision Hip Arthroplasty Market Value ($ Million) by Bearing Surface
380 Mexico Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
List of Tables
381 Mexico Primary Knee Arthroplasty Market Value ($ Million) by Fixation Type
382 Mexico Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
383 Mexico Revision Knee Arthroplasty Market Value ($ Million) by Fixation Type
384 Mexico Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
385 Mexico Primary Knee Arthroplasty Market Value ($ Million) by Bearing Type
386 Mexico Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
387 Mexico Revision Knee Arthroplasty Market Value ($ Million) by Bearing Type
388 Mexico Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
389 Product Developments
392 Acquisitions, Mergers, Partnership, Collaborations, and Joint Ventures
393 Merger & Acquisition
394 Joint Ventures, Partnerships & Collaborations
395 Business Expansion
398 Product Launch
400 Joint Ventures, Partnerships & Collaborations

List of Tables
401 Product Launch
402 Acquisitions
406 Mergers & Acquisitions
408 Joint Ventures & Collaborations
409 Approvals
411 Joint Ventures & Collaborations
412 Approvals
413 Product Development
415 Product Launch
416 Product Launch
417 Acquisitions, and Business Expansion

List of Figures
SR.NO List of Figures
1 Global Knee Arthroplasty Market, 2015-2025 ($ Billion)
2 Global Hip Arthroplasty Market, 2015-2025 ($ Billion)
3 Global Shoulder Arthroplasty Market, 2015-2025 ($ Billion)
4 Market Share of Key Players (2016)
5 Market Share of Extremity Joint Reconstruction (2017)
6 Market Share of Key Players in Extremity Joint Reconstruction (2017)
7 Share of Key Developments and Strategies
8 Mergers and Acquisitions Share, by Companies
9 Product Launch Share, by Companies
10 Joint Ventures, Partnership and Collaborations Share, by Companies
11 Approval Share, by Companies
12 Hip Fracture Incidence Among Women Around the World
13 Hip Fracture Incidence Among Men Around the World
16 Average Price of Hip Reconstruction Implants
17 Hip Reconstruction
18 Average Price of Shoulder Reconstruction Implants
19 Shoulder Reconstruction
20 Average Price of Knee Reconstruction Implants

List of Figures
21 Knee Reconstruction
22 Pricing Analysis Hip Implants (2008-2016)
23 Global Hip Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
24 Global Knee Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
25 Global Shoulder Joint Reconstruction Market Value ($ Million)
26 Global Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
27 Global Hip Arthroplasty Market Value ($ Million) by Procedure Type
28 Global Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
29 Global Knee Arthroplasty Market Value ($ Million) by Procedure Type
30 Global Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
31 Global Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
32 Global Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
33 Global Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
35 Global Joint Reconstruction Market By Product Type
36 Global Hip Joint Reconstruction Market Value ($ Billion)
37 Global Hip Joint Reconstruction Procedure Volume (Thousand)
38 Global Hip Joint Reconstruction Market Value ($ Million) By Procedure Type
39 Global Hip Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
40 Global Primary Hip Joint Reconstruction Market Value ($ Million) By Fixation Type
List of Figures
41 Global Primary Hip Joint Reconstruction Procedure Volume (Thousand) By Fixation Type
42 Global Revision Hip Joint Reconstruction Market Value ($ Million) By Fixation Type
43 Global Revision Hip Joint Reconstruction Procedure Volume (Thousand) By Fixation Type
44 Global Primary Hip Joint Reconstruction Market Value ($ Million) By Bearing Surface
45 Global Primary Hip Joint Reconstruction Procedure Volume (Thousand) By Bearing Surface
46 Global Revision Hip Joint Reconstruction Market Value ($ Million) By Bearing Surface
47 Global Revision Hip Joint Reconstruction Procedure Volume (Thousand) By Bearing Surface
48 Global Knee Joint Reconstruction Market Value ($ Billion)
49 Global Knee Joint Reconstruction Procedure Volume (Thousand)
50 Global Knee Joint Reconstruction Market Value ($ Million) By Procedure Type
51 Global Knee Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
52 Global Primary Knee Joint Reconstruction Market Value ($ Million) By Fixation Type
53 Global Primary Knee Joint Reconstruction Procedure Volume (Thousand) By Fixation Type
54 Global Revision Knee Joint Reconstruction Market Value ($ Million) By Fixation Type
55 Global Revision Knee Joint Reconstruction Procedure Volume (Thousand) By Fixation Type
56 Global Primary Knee Joint Reconstruction Market Value Share By Fixation Type
57 Global Revision Knee Joint Reconstruction Market Value Share By Fixation Type
58 Global Primary Knee Joint Reconstruction Market Value ($ Million) By Bearing Type
59 Global Primary Knee Joint Reconstruction Procedure Volume (Thousand) By Bearing Type
60 Global Revision Knee Joint Reconstruction Market Value ($ Million) By Bearing Type
List of Figures
61 Global Revision Knee Hip Joint Reconstruction Procedure Volume (Thousand) By Bearing Type
62 Global Primary Knee Joint Reconstruction Market Value Share By Bearing Type
63 Global Revision Knee Joint Reconstruction Market Value Share By Bearing Type
64 Global Shoulder Joint Reconstruction Market Value ($ Billion)
65 Global Shoulder Joint Reconstruction Procedure Volume (Thousand)
67 Global Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
68 North America Hip Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
69 North America Knee Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
70 North America Shoulder Joint Reconstruction Market Value ($ Million)
71 North America Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
72 North America Hip Arthroplasty Market Value ($ Million) by Procedure Type
73 North America Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
74 North America Knee Arthroplasty Market Value ($ Million) by Procedure Type
75 North America Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
76 North America Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
77 North America Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
78 North America Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
79 North America Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
80 The U.S. Hip Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
List of Figures
81 The U.S. Knee Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
82 The U.S. Shoulder Joint Reconstruction Market Value ($ Million)
83 The U.S. Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
84 The U.S. Hip Arthroplasty Market Value ($ Million) by Procedure Type
85 The U.S. Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
86 The U.S. Knee Arthroplasty Market Value ($ Million) by Procedure Type
87 The U.S. Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
88 The U.S. Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
89 The U.S. Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
90 The U.S Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
91 The U.S Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
92 Canada Hip Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
93 Canada Knee Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
94 Canada Shoulder Joint Reconstruction Market Value ($ Million)
95 Canada Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
96 Canada Hip Arthroplasty Market Value ($ Million) by Procedure Type
97 Canada Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
98 Canada Knee Arthroplasty Market Value ($ Million) by Procedure Type
99 Canada Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
100 Canada Shoulder Arthroplasty Market Value ($ Million) by Procedure Type

List of Figures
101 Canada Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
102 Canada Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
103 Canada Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
104 Europe Hip Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
105 Europe Knee Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
106 Europe Shoulder Joint Reconstruction Market Value ($ Million)
107 Europe Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
108 Europe Hip Arthroplasty Market Value ($ Million) by Procedure Type
109 Europe Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
110 Europe Knee Arthroplasty Market Value ($ Million) by Procedure Type
111 Europe Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
112 Europe Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
113 Europe Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
114 Europe Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
115 Europe Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
116 United Kingdom Hip Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
117 United Kingdom Knee Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
118 United Kingdom Shoulder Joint Reconstruction Market Value ($ Million)
119 United Kingdom Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
120 United Kingdom Hip Arthroplasty Market Value ($ Million) by Procedure Type
List of Figures
121 United Kingdom Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
122 United Kingdom Knee Arthroplasty Market Value ($ Million) by Procedure Type
123 United Kingdom Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
124 United Kingdom Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
125 United Kingdom Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
126 United Kingdom Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
127 United Kingdom Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
128 Germany Hip Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
129 Germany Knee Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
130 Germany Shoulder Joint Reconstruction Market Value ($ Million)
131 Germany Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
132 Germany Hip Arthroplasty Market Value ($ Million) by Procedure Type
133 Germany Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
134 Germany Knee Arthroplasty Market Value ($ Million) by Procedure Type
135 Germany Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
136 Germany Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
137 Germany Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
138 Germany Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
139 Germany Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
140 Italy Hip Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
List of Figures
141 Italy Knee Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
142 Italy Shoulder Joint Reconstruction Market Value ($ Million)
143 Italy Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
144 Italy Hip Arthroplasty Market Value ($ Million) by Procedure Type
145 Italy Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
146 Italy Knee Arthroplasty Market Value ($ Million) by Procedure Type
147 Italy Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
148 Italy Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
149 Italy Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
150 Italy Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
151 Italy Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
152 Belgium Hip Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
153 Belgium Knee Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
154 Belgium Shoulder Joint Reconstruction Market Value ($ Million)
155 Belgium Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
156 Belgium Hip Arthroplasty Market Value ($ Million) by Procedure Type
157 Belgium Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
158 Belgium Knee Arthroplasty Market Value ($ Million) by Procedure Type
159 Belgium Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
160 Belgium Shoulder Arthroplasty Market Value ($ Million) by Procedure Type

List of Figures
161 Belgium Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
162 Belgium Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
163 Belgium Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
164 Portugal Hip Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
165 Portugal Knee Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
166 Portugal Shoulder Joint Reconstruction Market Value ($ Million)
167 Portugal Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
168 Portugal Hip Arthroplasty Market Value ($ Million) by Procedure Type
169 Portugal Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
170 Portugal Knee Arthroplasty Market Value ($ Million) by Procedure Type
171 Portugal Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
172 Portugal Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
173 Portugal Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
174 Portugal Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
175 Portugal Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
176 Norway Hip Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
177 Norway Knee Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
178 Norway Shoulder Joint Reconstruction Market Value ($ Million)
179 Norway Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
180 Norway Hip Arthroplasty Market Value ($ Million) by Procedure Type

List of Figures
181 Norway Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
182 Norway Knee Arthroplasty Market Value ($ Million) by Procedure Type
183 Norway Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
184 Norway Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
185 Norway Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
186 Norway Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
187 Norway Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
188 Czech Republic Hip Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
189 Czech Republic Knee Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
190 Czech Republic Shoulder Joint Reconstruction Market Value ($ Million)
191 Czech Republic Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
192 Czech Republic Hip Arthroplasty Market Value ($ Million) by Procedure Type
193 Czech Republic Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
194 Czech Republic Knee Arthroplasty Market Value ($ Million) by Procedure Type
195 Czech Republic Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
196 Czech Republic Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
197 Czech Republic Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
198 Czech Republic Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
199 Czech Republic Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
200 Spain Hip Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
List of Figures
201 Spain Knee Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
202 Spain Shoulder Joint Reconstruction Market Value ($ Million)
203 Spain Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
204 Spain Hip Arthroplasty Market Value ($ Million) by Procedure Type
205 Spain Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
206 Spain Knee Arthroplasty Market Value ($ Million) by Procedure Type
207 Spain Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
208 Spain Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
209 Spain Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
210 Spain Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
211 Spain Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
212 Netherlands Hip Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
213 Netherlands Knee Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
214 Netherlands Shoulder Joint Reconstruction Market Value ($ Million)
215 Netherlands Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
216 Netherlands Hip Arthroplasty Market Value ($ Million) by Procedure Type
217 Netherlands Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
218 Netherlands Knee Arthroplasty Market Value ($ Million) by Procedure Type
219 Netherlands Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
220 Netherlands Shoulder Arthroplasty Market Value ($ Million) by Procedure Type

List of Figures
221 Netherlands Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
222 Netherlands Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
223 Netherlands Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
224 Russia Hip Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
225 Russia Knee Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
226 Russia Shoulder Joint Reconstruction Market Value ($ Million)
227 Russia Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
228 Russia Hip Arthroplasty Market Value ($ Million) by Procedure Type
229 Russia Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
230 Russia Knee Arthroplasty Market Value ($ Million) by Procedure Type
231 Russia Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
232 Russia Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
233 Russia Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
234 Russia Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
235 Russia Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
236 Asia Pacific Hip Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
237 Asia Pacific Knee Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
238 Asia Pacific Shoulder Joint Reconstruction Market Value ($ Million)
239 Asia Pacific Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
240 Asia Pacific Hip Arthroplasty Market Value ($ Million) by Procedure Type
List of Figures
241 Asia Pacific Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
242 Asia Pacific Knee Arthroplasty Market Value ($ Million) by Procedure Type
243 Asia Pacific Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
244 Asia Pacific Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
245 Asia Pacific Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
246 Asia Pacific Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
247 Asia Pacific Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
248 China Hip Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
249 China Knee Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
250 China Shoulder Joint Reconstruction Market Value ($ Million)
251 China Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
252 China Hip Arthroplasty Market Value ($ Million) by Procedure Type
253 China Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
254 China Knee Arthroplasty Market Value ($ Million) by Procedure Type
255 China Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
256 China Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
257 China Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
258 China Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
259 China Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
260 Japan Hip Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
List of Figures
261 Japan Knee Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
262 Japan Shoulder Joint Reconstruction Market Value ($ Million)
263 Japan Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
264 Japan Hip Arthroplasty Market Value ($ Million) by Procedure Type
265 Japan Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
266 Japan Knee Arthroplasty Market Value ($ Million) by Procedure Type
267 Japan Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
268 Japan Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
269 Japan Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
270 Japan Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
271 Japan Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
272 Australia Hip Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
273 Australia Knee Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
274 Australia Shoulder Joint Reconstruction Market Value ($ Million)
275 Australia Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
276 Australia Hip Arthroplasty Market Value ($ Million) by Procedure Type
277 Australia Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
278 Australia Knee Arthroplasty Market Value ($ Million) by Procedure Type
279 Australia Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
280 Australia Shoulder Arthroplasty Market Value ($ Million) by Procedure Type

List of Figures
281 Australia Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
282 Australia Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
283 Australia Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
284 South Korea Hip Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
285 South Korea Knee Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
286 South Korea Shoulder Joint Reconstruction Market Value ($ Million)
287 South Korea Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
288 South Korea Hip Arthroplasty Market Value ($ Million) by Procedure Type
289 South Korea Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
290 South Korea Knee Arthroplasty Market Value ($ Million) by Procedure Type
291 South Korea Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
292 South Korea Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
293 South Korea Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
294 Latin America Hip Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
295 Latin America Knee Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
296 Latin America Shoulder Joint Reconstruction Market Value ($ Million)
297 Latin America Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
298 Latin America Hip Arthroplasty Market Value ($ Million) by Procedure Type
299 Latin America Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
300 Latin America Knee Arthroplasty Market Value ($ Million) by Procedure Type
List of Figures
301 Latin America Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
302 Latin America Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
303 Latin America Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
304 Latin America Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
305 Latin America Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
306 Brazil Hip Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
307 Brazil Knee Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
308 Brazil Shoulder Joint Reconstruction Market Value ($ Million)
309 Brazil Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
310 Brazil Hip Arthroplasty Market Value ($ Million) by Procedure Type
311 Brazil Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
312 Brazil Knee Arthroplasty Market Value ($ Million) by Procedure Type
313 Brazil Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
314 Brazil Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
315 Brazil Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
316 Brazil Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
317 Brazil Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
318 Mexico Hip Joint Reconstruction Market Value ($ Million) and Procedure Volume (Thousand)
319 Mexico Knee Joint Reconstruction Market Value ($ Billion) and Procedure Volume (Thousand)
320 Mexico Shoulder Joint Reconstruction Market Value ($ Million)

List of Figures
321 Mexico Shoulder Joint Reconstruction Market Procedure Volume (Thousand)
322 Mexico Hip Arthroplasty Market Value ($ Million) by Procedure Type
323 Mexico Hip Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
324 Mexico Knee Arthroplasty Market Value ($ Million) by Procedure Type
325 Mexico Knee Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
326 Mexico Shoulder Arthroplasty Market Value ($ Million) by Procedure Type
327 Mexico Shoulder Arthroplasty Market Procedure Volume (Thousand) by Procedure Type
328 Mexico Shoulder Joint Reconstruction Market Value ($ Million) By Procedure Type
329 Mexico Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
330 Overall Business Model
332 Overall Product Portfolio
333 Product Portfolio for Joint Reconstruction
334 Overall Financials (2014-2016)
335 Net Revenue by Region (2014-2016)
336 Revenue by Division (2014-2016)
337 Global Presence
338 B. Braun Melsungen AG SWOT Analysis

List of Figures
342 Global Presence
343 Altimed JSC SWOT Analysis
348 Global Presence
349 ARZZT SWOT Analysis
353 Global Presence
354 Biotechni S.A.S SWOT Analysis

List of Figures
361 Global Presence
362 Corin Group PLC SWOT Analysis
365 JOHNSON & JOHNSON Overall Financials (2014-2016)
366 JOHNSON & JOHNSON Net sales by Business Segments (2014-2016)
367 JOHNSON & JOHNSON Net sales by Region (2014-2016)
368 JOHNSON & JOHNSON Net Revenue by Medical Devices Business Segment (2014-2016)
369 JOHNSON & JOHNSON Net Revenue by Orthopedic Sub segment (2014-2016)
370 Global Presence
371 JOHNSON & JOHNSON SWOT Analysis
374 Global Presence
375 Elite Surgical. SWOT Analysis
380 Global Presence

List of Figures
381 Evolutis SWOT Analysis
387 Net Revenue By Region (2014-2016)
388 Net Revenue By Segment (2014-2016)
389 Global Presence
390 Exactech, Inc. SWOT Analysis
396 Global Presence
397 Group FH Ortho SWOT Analysis

List of Figures
402 Global Presence
403 JRI Orthopaedics Limited SWOT Analysis
406 Global Presence
407 Lima corporate SWOT Analysis
411 Global Presence
412 Marle Group SWOT Analysis
416 Global Presence
417 Peter Brehm GmbH SWOT Analysis

List of Figures
421 Global Presence
422 Menix Group SWOT Analysis
428 Net Revenue of Orthopedics by Region (2014-2016)
429 Net Revenue by Segment(2014-2016)
430 Global Presence
431 MicroPort Scientific Corporation SWOT Analysis
435 Net Revenue by Business Segments (2014-2016)
437 Global Presence
438 Smith & Nephew plc SWOT Analysis

List of Figures
444 Net Revenue by Orthopedic Business Segment (2014-2016)
445 Net Revenue by Neurotechnology and Spine Business Segment(2014-2016)
446 Global Presence
447 Stryker Corporation SWOT Analysis
452 Global Presence
453 Surgival (GRUPO COSÍAS) SWOT Analysis
456 Zimmer Biomet Holdings, Inc Overall Financials (2014-2016)
457 Zimmer Biomet Holdings, Inc Net sales by product segment (2014-2016)
458 Net sales by Region (2014-2016)
459 Global Presence
460 Zimmer Biomet holdings, Inc. SWOT Analysis

List of Figures
465 Net Revenue by Segment (2014-2016)
466 Global Presence
467 Beijing Chunlizhengda Medical Instruments Co., Ltd. SWOT Analysis
470 Global Presence
471 Biotech GmbH SWOT Analysis
475 Global Presence
476 FX Solutions SWOT Analysis

List of Figures
482 Global Presence
483 Wright Medical Group N.V. SWOT Analysis
486 Global Presence
487 StelKast SWOT Analysis
491 Global Presence
492 BioMedtrix, LLC SWOT Analysis
497 Net Revenue by Segment (2014-2016)
498 Global Presence
499 CeramTec Group SWOT Analysis

List of Figures
507 Global Presence
508 Mathys AG Bettlach SWOT Analysis
511 Global Presence
512 MatOrtho Limited SWOT Analysis
513 Snapshot of Market Segmentation
514 The Secondary Data Sources Used in this Study
515 Top-Down Approach
516 Bottom-Up Approach

EXECUTIVE
Summary

72
Executive Summary
Introduction
The growing prevalence of symptomatic osteoarthritis and post-traumatic arthritis due to the increasing geriatric population across the globe is
significantly driving the demand for joint reconstruction procedures. In addition, conditions such as osteoporosis, facture, trauma, and sports
injuries are also driving the growth of the joint reconstruction market. As of 2017, the U.S. occupied the largest share of the overall joint
reconstruction market. The other major markets with significant volume include Germany, France, Italy, the U.K., Japan, and China.
Hip replacement or hip arthroplasty is a surgical procedure in which the femoral head and/or the acetabulum of the hip ball-and-socket joint are
replaced by artificial prosthetic material. The market for hip arthroplasty product includes implants for primary total hip (cemented, cementless, and
hybrid hips), hip resurfacing, and revision hip arthroplasties.
The hip replacement sales market in 2017 was estimated at $5.83 billion in 2017 and is expected to reach $9.35 billion by 2025. The growing
prevalence of symptomatic osteoarthritis and post-traumatic arthritis due to the increasing geriatric population across the globe is driving the
demand for hip arthroplasty procedures. In addition, growing elderly population and underline conditions such as osteoarthritis, facture, trauma,
and sports injuries are also driving the growth of the hip arthroplasty market. As of 2017, the US occupied the largest share of the hip replacement
market. The other major markets with significant volume include Germany, France, Italy, the U.K., Japan, and China.
Over 650,000 hip arthroplasty procedures (including revision surgeries) were performed in Europe in 2016. The need for faster recovery, lesser
post-operative pain and cost-effective procedures is driving the demand for minimally invasive hip replacements across the globe. There has been
a moderate increase in the number of direct anterior hip arthroplasties in the recent years. The market growth is restrained by cost-cutting
measures as well as the regulatory environment including the need for premarket approval as mandated by the European Union, FAD, and other
agencies for the sales of metal-on-metal hips.

Executive Summary
Germany Driving the European Hip Arthroplasty Country Hip Procedure Volume, 2016
Market
Italy 109,329
 The demand for hip replacement is expected to remain strong in
Russia 41,350
most of the European countries. Germany accounted for the
greatest number of hip replacement unit sales due to the size of its Germany 2,45,170
population. In 2016, hip replacement surgery was performed 1.4 Japan 82,230
times as frequently in Germany as in the U.S. (284 vs. 204 cases
China 71,323
per 100,000 population per year). This places Germany in the
second position among OECD countries for hip replacement S. Korea 28,200
frequency, behind Switzerland. France and Italy had the second Brazil 24,230
and third highest unit sales respectively. However, unit sales
Belgium 24,260
growth is the fastest in Italy due to Italy’s economic recovery, thus
allowing for more hip replacements to be performed. However, the Norway 10,355
overall competitive landscape in the European countries continue
Portugal 8,038
to change with the decline in the average selling prices (ASPs) for
Czech Republic 17,736
orthopaedic implants. This downward pricing pressure can
significantly help local governments to manage their spending and Spain 50,127
reduce the number of expensive and unnecessary procedures. The Netherlands 34,104
Australia 46,733
Total 548,015
Source: Secondary Data, Expert Interviews, and BIS Research Analysis

Executive Summary
China: Expectant Leader of Hip Arthroplasty Market in Asia-Pacific by 2020
In Asia-Pacific, more than 323,236 hip replacement surgeries were carried out in 2017, and this number will continue to increase at an annual
growth rate of 3.63%. This will be driven by favorable demographics, heightened patient awareness, and government bids to attract investment in
the healthcare infrastructure. Japan, China, Australia, and South Korea continue to lead the region’s procedure volume and implant sales. In 2018,
the Japan arthroplasty registry recorded a whopping 7.42% increase in hip replacements as compared to that of 2017. In the year 2017, 161,005
hip arthroplasty procedures were performed in China, thus reporting an increase of 4.10% as compared to that of previous year.
The Latin America market is also booming with growing number of arthroplasty surgeries. Brazil was the single largest market with more than
25,252 hip arthroplasty surgeries performed in 2017. However, Chile has hip replacement frequency of 33/100,000 as compared to 11/100,000 in
Brazil and 8/100,000 in Mexico.
The average implant cost per case ranged from $5,500 to $6,000 for total knee replacement procedures and from $6,000 to $6,500 for total hip
replacement procedures. For total shoulder replacement, 2.5% of total variation in device costs was attributable to patient characteristics and
61.0% was attributable to hospital characteristics; the remaining 36.5% of variance was attributable to within-hospital variation, and not due to
patient or hospital characteristics. For total hip replacement, 4.4% of variance was attributed to patient characteristics, 36.1% was attributed to
hospital characteristics, and 59.5% was attributed to within-hospital variation and not due to patient or hospital characteristics.

Executive Summary
Global Hip Arthroplasty Market
Global Hip Arthroplasty Market, 2015-2025 ($Billion) Key Brands
10 8.82 9.35 Brands

8.31 Company
7.38 7.83
8 6.56 6.96
5.83 6.19 Taperloc
5.18 5.50
6
M/L Taper
4 Zimmer Biomet
Versys
2
Arcos
0
Accolade
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Restoration
Hip Arthroplasty Market Value ($Billion) Stryker
Secur-Fit
Omnifit
Key Manufactures Sales, 2016 ($Million) Summit
Corail
1,867.0 DePuy Synthes
Tri-Lock
SROM
1,300.0 1,280.0
Sales Breakup (by Components)
710.0 4.7%
597.0
Stem
16.0%
45.1% Shell/Liner
Head
Zimmer Biomet JOHNSON & Stryker B. Braun Smith & 34.2%
Holdings, Inc. JOHNSON Corporation Melsungen AG Nephew plc
Others

Executive Summary
Completive Landscape: Zimmer’s Acquisition of Biomet Have Vault Them to the Largest Company
 The hip implant market increased 6.08% between 2015 and 2016 and was estimated at $5.83 billion in 2017. The change in sales for hip and
knee implants are chronicled in the graphic at the right. Until 2005, the industry experienced double-digit growth, which was followed by five
years of single-digit percentage growth. Between 2010 and 2015, the industry actually contracted 1.4% due to a slowdown of procedures and
pricing pressure. However, the industry reported positive sales between 2016 and 2017.
 Zimmer Biomet is the leading competitor in the European hip replacement market. Zimmer Biomet sells hip and knee replacements as well as
bone cement. Zimmer’s acquisition of Biomet have vault them to the largest company with $1.90 billion in sales in 2016. Stryker also
maintained its position as the one of the leading hip implant vendors with $1.32 billion in sales. Stryker reported a 1.61% sales increase as
compared to Zimmer Biomet’s whooping 19.01% increase in 2016.
 DePuy Synthes reported a 1.0% increase in sales with a gain of 0.2 share points. Following these three companies, all of which had in excess
of multimillions in sales were Wright Medical, B. Braun and Smith & Nephew. Wright Medical’s sales of its hips and knees are now reported
under MicroPort. The noteworthy fact is that the category of other manufacturers had the largest sales increase of 6% in 2016. The other
manufacturers include some publicly traded companies such as Exactech and DJO Surgical, but also a number of smaller niche companies
that are successfully selling against the more established players.

Executive Summary
Shoulder Arthroplasty: Fastest Growing Among Joint Replacement Market
 Shoulder pathology is a growing concern for the aging population, athletes, and laborers. Shoulder osteoarthritis and rotator cuff disease
represent the two most common disorders of the shoulder leading to pain, disability, and degeneration. Shoulder arthroplasty offers reliable
pain relief, predictable improvement of function, and improved quality of life for a variety of shoulder arthropathies, including primary
osteoarthritis (OA). The two most common types of shoulder replacements performed are the standard total prosthetic replacement and the
reverse prosthetic replacement.
 Although shoulder joint replacement is less common than knee or hip replacement, it is now the fastest growing joint reconstruction surgery
globally. The rate of shoulder arthroplasties has increased considerably during the last five years, with an annual growth of 8.5% for reverse
polarity total prosthetic replacement and 7.1% for overall shoulder arthroplasty (TSA), both exceeding the annual increase in hip and knee
arthroplasty rates.
 The shoulder arthroplasty market was valued at $720.5 million in 2017 and is expected to reach $1.13 billion by 2025, registering a CAGR of
5.90% from 2018 to 2025. Shoulder arthroplasty procedures have witnessed an elevating demand over the years, owing to several benefits
offered by these procedures such as pain relief and restoring motion, strength, and function. The growth of the global shoulder arthroplasty
market is driven by an increase in the prevalence of arthritis-associated disorders, such as osteoarthritis and rheumatoid arthritis, and rise in
geriatric population. In addition, surge in adoption of reverse shoulder arthroplasty by surgeons and increase in the number of sports-related
injuries have significantly contributed to the market growth. However, postoperative complications associated with shoulder arthroplasties and
high costs of sophisticated shoulder arthroplasty devices hamper the market growth.

Executive Summary
Global Hip Arthroplasty Market, 2015-2025 ($Million) Country Hip Procedure Volume, 2016
Italy 7,326
1,768.2
1,646.3 Russia
1,532.9 1,094
1,427.3
1,328.9
1,237.4 Germany 33,598
1,152.1
1,072.7
998.8
930.0 Japan 3,420
China 1,631
S. Korea 947
Brazil 845
2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Belgium 2,311
Market Share (Revenue), 2016
Norway 658
Portugal 284
Czech Republic 916

DePuy Synthes
23%
30%
Spain 3,429
Wright Medical Group
The Netherlands 2,806

Zimmer Biomet Holdings, Inc.
18%
Australia 5,154
Others
29%
Total 64,419

Executive Summary
Germany Leading the European Shoulder Arthroplasty Market
 Since 2005, shoulder arthroplasties surgeries have been on the rise in most European countries, though a slight reduction could be detected for
shoulder resurfacing hemiarthroplasty in coming days. Moreover, total shoulder arthroplasties and reversed total shoulder arthroplasties are
expected to show positive growth across the globe. Women have experienced a three fold higher hemiarthroplasty, total shoulder and reversed
shoulder arthroplasties than men except for individuals who are younger than 60 years.
 In 2016, approximately 33,500 hip arthroplasty surgeries were performed in the Germany, followed by France, the U.K., and Italy. The
proportion of arthroplasties performed for fracture varied substantially in European countries, from 8% in the UK to more than 40% in
Scandinavia. The proportion performed for inflammatory arthritis was highest in Norway and Sweden. There was also a large variation in use of
shoulder arthroplasty for cuff-tear arthropathy, which ranged from 2% in Norway to 20% in the UK. In Asia Pacific, shoulder arthroplasty is still
emerging and expected to show highest growth rate during forecast period. Australia accounted for the greatest number of shoulder
replacement unit sales followed by Japan, South Korea, and China. Japan was the second largest market in the Asia-Pacific shoulder
arthroplasty market in 2016, and is projected to continue this trend throughout the forecast period. This is attributed to the expansion of key
market players offering arthroplasty devices in this country. For instance, Exactech Inc., a manufacturer of bone and joint restoration products
for extremities, announced the approval of first clinical use shoulder replacement systems in Japan in June 2017.
 In 2016, Zimmer maintained its position as the number one shoulder implant vendor globally. The rest of the players, such as Exactech, DJO
Surgical, and Smith & Nephew, have been fiercely competing against each other.

1. MARKET
OVERVIEW

81
Market Overview
1.1 Definition and Product Inclusions
What is Joint Reconstruction Therapy?
Joint reconstruction is an orthopedic surgery aimed at re-establishing the architecture of a joint in order to reinstate the proper
functioning of joint, thus reducing the pain in the process. The surgery involves elimination of damaged part of the joint and
replacing it with an artificially created joint that are designed to function as natural joints. The surgery is performed by a joint
reconstruction specialist with sound knowledge in diagnosis, treatment, and prevention of injuries and diseases related to
musculoskeletal system. The body parts which can undergo a joint reconstruction therapy are shoulder and elbow, wrist and
hand, and hip and knee. Some of the widely known joint reconstruction surgeries include total knee replacement, total hip
replacement, Anterior Cruciate Ligament (ACL) reconstruction, and chondroplasty, among others.
Product Inclusions:
The study majorly focusses on two broad categories of joint reconstruction therapy: hip joint reconstruction and shoulder joint
reconstruction. The hip joint reconstruction is further categorised into primary hip replacement, revision hip replacement and hip
resurfacing. Primary and revision hip replacement have been further categorised into three types: cemented, uncemented, and
hybrid.
The shoulder joint reconstruction has been categorized into total prosthetic replacement, semi-arthroplasty, reverse polarity total
prosthetic replacement, resurfacing total arthroplasty, and resurfacing hemi-arthroplasty.

Market Overview
• The global joint reconstruction (hip and shoulder) market is labyrinthine and is currently undergoing transformation just like any
other healthcare market.
• Currently, the joint reconstruction and replacement procedures performed by healthcare organizations (inpatient/outpatient
facilities) are facing challenges due to lowered reimbursement rates. As a result, these financially unrewarding payment
models are increasing healthcare costs which in turn is driving the need for value-based care.
• Moreover, public payers are also promoting a shift towards outpatient surgical procedures performed in Ambulatory Surgical
Centres (ASCs). This is probably due to the fact that ASCs have proven the capability to improve quality of care and patient
satisfaction while minimizing the costs. ASCs are also well-positioned to meet the challenges posed by rapidly increasing aging
population and number of chronic diseases.
• One of the major restraints for this market would be the continuously rising pricing pressure on joint reconstruction and spinal
implant procedures which is primarily driven by increasing involvement of physicians in making supply chain decisions resulting
in downward pricing for hospitals and the consolidation of suppliers.
• The market is somehow witnessing the presence of favourable regulatory requirements. For example: In the U.S., FDA is
responsible for clearing most of the orthopaedic products through its 510(k) regulatory process which requires a manufacturer
to demonstrate comparability with the existing FDA cleared products which in turn diminishes the need for backing the product
with clinical data. Hence, a manufacturer can easily incorporate unnecessary modifications in the product and raise prices.

Market Overview
• The hip joint reconstruction market is primarily driven by the rising number of hip reconstruction procedures and the rapidly increasing ageing
population across the globe
• The market is expected to witness a slow growth rate in terms of revenue in the next 10 years. This has lead to increased pricing pressure
between competitors in terms of product sales with decreasing prices of hip and knee implants in the market
• Decline in the rate of introduction of innovative products and uncertainty in the market is also adversely affecting the revenue generated from
the market. This might be due to fact that the healthcare market is suffering from reduced reimbursement rates and rising costs. As a result the
healthcare market is turning against premium pricing of products, which consequently will increase the pricing pressure on existing products
• Currently, the manufacturers are experiencing high selling expenses, and therefore are continuously exploring new ways to shift this high cost
on hospitals, by minimizing the cost free services initially provided to the hospitals
• Manufacturers are also making efforts to differentiate their products from that produced by their peers by incorporating innovative material
composition and by introducing new manufacturing techniques
• With the negative pricing trend that is currently prevailing in the market, manufacturers are exploring new strategies within the market and
opening new avenues for robotic surgical procedures and 3D printing techniques to improve clinical efficiency and facilitate cost savings
• The products in the hip joint reconstruction market undergoes FDA’s 510(k) pathway which requires the manufacturer to simply demonstrate the
comparability of its product with an already existing FDA cleared product. This pathway significantly reduces the cost of a manufacturer
introducing an innovative device in the market
• The introduction of an innovative product may often come with a premium price that may serve as a potent threat to a hospital’s cost saving
initiative provided that the product offers more benefits and improves outcomes than an existing product can and is backed by some clinical
evidences
• From reimbursement perspective, hip joint reconstruction procedures are reimbursable through bundled payment approach provided by the
Centers for Medicare and Medicaid Services (CMS). However, hospitals must be able to build strong relationship with manufacturers to escape
the impact of low reimbursement rates

Market Overview
• Extremity joint reconstruction devices can be applied on various parts of the body such as shoulder, elbow, ankle, and wrist,
among others. The major number of procedures are however done for shoulder replacement. Currently, the shoulder sub
segment is responsible for generating the maximum revenue for this market with the procedural growth rate of 7.1% every
year.
• The market initially evolved with the efforts made by small-mid sized companies to bring in differentiated devices and
innovative surgical procedures into the market. However, with the progression of time, many leading orthopaedic companies
acquired or merged with these companies to expand their existing product portfolio and maintain a leading position in this
market. These key development strategies adopted by the leading orthopaedic companies are also facilitating the chances of
inclusion of shoulder joint reconstruction procedures in bundled payments to hospitals.
• Unlike the hip joint reconstruction market, the extremities joint reconstruction market is witnessing increased research and
development expenses incurred by the companies for the introduction of new manufacturing techniques to ameliorate the
clinical efficacy of surgical implants. Some of the recently introduced products in this market include: OsteoMate Arthrodesis
Implant, AltiVate Anatomic Shoulder System, Equinoxe Preserve Stem, and Precision Jones Fracture Screw System, among
others. Larger manufacturers in this space are continuously diversifying their products for both total joint (hip and knee) and
extremity joint (shoulder) reconstruction implants to position themselves with changing reimbursement rates and preserving
average selling prices.

Market Overview - Global Addressable Market and
Future Potential
Figure 1: Global Knee Arthroplasty Market, 2015-2025 Figure2 : Global Hip Arthroplasty Market, 2015-2025
($Billion) ($Billion)
25.00 25.00
20.00
15.00
9.35
8.82
8.31
7.83
7.38
20.00
6.96
6.56
6.19
5.83
10.00
5.50
5.18
16.32
5.00
15.40
14.54
13.72
0.00
15.00
12.95
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
12.22
11.53
10.88
Figure3 : Global Shoulder Arthroplasty Market, 2015-2025

10.27
9.70
($Billion)
9.15
10.00
5.00
4.00
3.00
5.00
1.14
2.00
1.08
1.02
0.96
0.91
0.86
0.81
0.76
0.72
0.68
0.64
1.00
0.00 0.00
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Market Overview
Table 1: FDA Cleared Joint Reconstruction Devices for Use (2016-2017)
Vendor Device Name 510(k) No. 510(k) Approval Date
3Shape A/S Ortho System K161884 Apr 19, 2017
Amplitude Medical Anatomic total knee system K161414 Jan 19, 2017
iBalance UKA system vitamin E

Arthrex, Inc. K161060 Dec 15, 2016
tibial bearing
Bodycad Unicompartmental Knee
Bodycad Laboratories K163700 Mar 29, 2017
System
Consensus Orthopedics PS2 Knee System K160515 Dec 19, 2016
Corentec Co., Ltd. Lospa Knee System K160157 Dec 1, 2016
DJO Surgical — Encore Exprt Revision Hip K161610 Nov 9, 2016
Exprt Revision Hip system (Exprt

hip distal stem, Exprt
DJO Surgical — Encore K163497 Mar 2, 2017
hip standard offset proximal body
implant)
Exactech Inc. Alteon HA Femoral Stem K162732 Apr 26, 2017
Exactech Inc Truliant femoral components K170240 Feb 23, 2017
Integra LifeSciences InSitu Hip System K161184 Oct 14, 2016

Market Overview
Intellijoint Surgical Inc. Intellijoint Hip generation 2A system K162364 Mar 2, 2017
Kico Knee Innovation 360KS Implant Positioning System K163405 Mar 21, 2017
Initia total hip system and Bioceram

Kyocera Medical Corp K160895 Nov 1, 2016
Azul head
LimaCorporate S.P.A. Revision femoral stem K161226 Feb 10, 2017
Mako Surgical Corp. Mako total hip application K170593 Apr 18, 2017
Materialise total knee arthroplasty

Materialise NV K162273 Nov 7, 2016
guide system
Mazor Robotics Ltd. Mazor X K163221 Apr 4, 2017
Medacta International SA Moto partial knee system K162084 Jan 3, 2017
Meril Healthcare Destiknee total knee system K160771 Dec 19, 2016
OmniLife science Apex revision knee system K163332 Apr 26, 2017
Onefit Medical KneeEOS K161828 Oct 3, 2016

Market Overview
OrthAlign, Inc. KneeAlign 2 system K163379 Mar 2, 2017
Chimaera Hip Fracture System;

Orthofix SRL K161466 Jan 24, 2017
trochanteric nailing system
Pantheon Medical Balanced Plating

Pantheon Medical K162154 Apr 24, 2017
System
Pega Medical Inc. Y3 Proximal Femoral Plate System K163003 Mar 16, 2017
Stryker Corporation OrthoMap Versatile Hip System K162937 Feb 23, 2017
Stryker Leibinger GmbH OrthoMap Precision Knee system K162341 Oct 12, 2016
Total Joint Othopedics Klassic HD Hip System K161073 Oct 19, 2016
U2 total knee system, PSA tibial

United Orthopedic Corp K161360 Feb 1, 2017
insert
Zimmer Biomet Fitmore Hip Stem K170072 Feb 7, 2017

Zimmer Biomet Persona partial knee system K161592 Nov 3, 2016
Zimmer Biomet Ulna plating system K162424 Oct 12, 2016

Market Overview
Table 4: FDA Cleared Shoulder Reconstruction Devices for Use (2016-2017)

Arthrex, Inc. Univers Revers shoulder prosthesis system K161782 Nov 21, 2016
ExactechGPS total shoulder application, Equinoxe

Blue Ortho K162567 Apr 5, 2017
planning software
DJO Surgical — Encore AltiVate Anatomic Shoulder System K162024 Nov 21, 2016
Equinoxe Reverse shoulder compression screws, Reverse

Exactech Inc. K162325 Mar 6, 2017
shoulder glenosphere locking screw
FX Solutions Humelock Reversed Shoulder System K162455 Jan 17, 2017
Zimmer Biomet Anatomical Shoulder Domelock Dome Centric K161620 Nov 1, 2016
AAP Implantate AG Loqteq Distal Lateral Humerus Plate 2.7/3.5 K161696 Nov 23, 2016
Advanced
AOS Small Bone Nailing System K163014 Jan 24, 2017
Orthopaedic Solutions
Arthrosurface, Inc. ToeMate Hammertoe Correction System K170350 Mar 3, 2017
2.4/2.7mm variable angle LCP two-column volar distal radius

DePuy Synthes K163046 Feb 9, 2017
plate, extra-long
Graham Medical
Osteo-Wedge II Open Wedge Bone Locking Plate System K162179 Jan 10, 2017
Technologies

Market Overview
Table 5: FDA Cleared Shoulder Reconstruction Devices for Use (2016-2017)

KLS Martin Level One hand plating system K170124 Mar 9, 2017
Medline Industries Unite ankle fracture plating system K162829 Dec 9, 2016
Miami Device Solutions Distal Radius Plating System K162635 Oct 21, 2016
Newclip Technics Foot and Hand Motion K170012 Apr 24, 2017
Newclip Technics Footmotion Plating System K161448 Oct 31, 2016
Paragon 28 Titan 3-D Wedge System K162241 Apr 3, 2017
Renovo Life, LLC Renovo Life Small Bone IM Nail System K161254 Nov 7, 2016
Restore Surgical
ToeTac 10° Hammertoe Fixation System K161778 Nov 22, 2016
dba Instratek
Smith & Nephew, Inc. VLP Wrist Fracture System K161665 Nov 15, 2016
Stryker GmbH VariAx Distal Radius Plating System, VariAx 2 System K162841 Feb 21, 2017
Wright Medical Ortholoc 3Di Ankle Fracture Plating System K163044 Jan 26, 2017
Wright Medical Ortholoc 3Di Ankle Fusion Plating System line extension K163650 Apr 24, 2017
Wright Medical Ortholoc 3Di Small Bones Plating K163039 Mar 13, 2017

Market Overview
1.4 Market Share Concentration (Revenue)
Figure 4: Market Share of Key Players (2016) Despite the presence of a multitude of competitors in the global hip joint
reconstruction market, it is dominated by only a few manufacturers
Total Market Size – $16.82 Billion The sluggish growth in the market is stimulating the existing manufacturers
to diversify their current portfolios through acquisition of companies with
innovative products in other orthopedic related market sub-segments such
as spine, neurointerventional and extremity joints, among others, to
increase their sales revenue
Zimmer Biomet Holdings,
Inc. The fast growing sub-segments (spine and extremity including shoulder)
are capable of counterbalancing negative pricing pressure in the joint
26% 24% JOHNSON & JOHNSON reconstruction market for several years
Stryker Corporation Furthermore, due to high selling expenses incurred upon the
manufacturers, they continuously seek to reduce costs and ameliorate
operational efficiencies thus exploring options to shift this cost burden on
B. Braun Melsungen AG hospitals by minimizing the services provided to them. For an instance,
8%
17% DePuy Synthes in 2017 started charging hospitals for the delivery of
instrument trays
9% Smith & Nephew plc
16% The competitive rivalry in this market is also intense as manufacturers are
Others heavily spending on differentiating the products from that manufactured by
their peers by using innovative material composition and incorporating new
manufacturing know-how
The manufacturers are also expanding their consulting portfolio focussed

at new reimbursement models and ameliorating operating room
efficiencies

Market Overview
Figure 5: Market Share of Extremity Joint The extremity joint reconstruction market is comparatively a smaller
Reconstruction (2017) and less mature market as compared to its counterpart i.e. hips and
knee joint reconstruction market.
Total Market Size – $17.83 Billion The sub segments of this market include shoulder, ankle, hand,
elbow, foot, and wrist, with shoulders alone accounting for 78% of the
market constituting the largest sub segment of extremities
1% 1% reconstruction market.
The shoulders sub-segment is currently driving the majority of growth

with an annual increasing procedure rates of 7.1%. The products for
6% this segment was initially offered by midsized companies which later
was acquired by or merged with leading manufacturers in the total
7%
reconstruction market (for example: the recent acquisition of Cayenne
Shoulder Medical by Zimmer Biomet)
7%
Ankle Unlike the hip and knee reconstruction market, the innovation and
differentiation in the products offered by key players helped the
Hand
market in keeping the reducing price while expanding consumer base
Elbow
The market share of shoulder reconstruction sub segment is further
78% expected to increase with the rising number of sport related injuries
Foot
such as rotator cuff tears and increasing incidences of shoulder
Wrist osteoarthritis and shoulder fractures, among other conditions.
Source: BIS Research Analysis

Market Overview
Figure 6: Market Share of Key Players in Extremity Joint The market share for the extremity joint reconstruction market is given in
Reconstruction (2017) the adjacent figure which is currently dominated by three major leading
players such as Zimmer Biomet, DePuy Synthes and Wright Tornier
accounting for approximately 71% of the overall market
Total Market Size – $17.83 Billion Approximately, 78% of the extremities joint market is covered by the
shoulder sub segment with an overall 4-5% of procedural growth annually
Large orthopaedic manufacturers are continuously exploring new

strategies such as mergers and acquisitions in this space to maintain their
Zimmer Biomet leadership position and diversify their product portfolio. For example:
12% Wright Tornier acquired IMASCAP SAS,. in 2017 to expand its product
DePuy Synthes portfolio related to shoulder replacement surgery. Also, Zimmer Biomet
5% acquired Cayenne Medical to expand shoulder reconstruction portfolio
31%
Wright Tornier
5% In the year 2015, the market also witnessed the merger of Wright
Exactech Medical Group and Tornier. This merger was aimed at building a
comprehensive upper (shoulder) and lower extremity product portfolio to
7% Stryker extend the company’s leadership position in the market
These strategies have been the effective tools for leading orthopaedic
Integra
players such as Zimmer Biomet and DePuy Synthes to counterbalance the
Others decline in the prices of hip and knee implants in the joint reconstruction
19% market
21%
The increasing penetration of leading orthopaedic players in the
extremities market is a favourable condition for the overall market as this
will lead Centre of Medicare and Medicaid (CMS) to include shoulder
surgery procedures in its bundled payments

2. Market Dynamics
Drivers, Restraints, and Trends

95
Market Dynamics
2.1 Overview
DRIVERS
D
• Escalating Prevalence of Chronic Disease
• Growing Geriatric Population with Awareness Related to Available Medical Services
• Government Initiative for Overall Development of the Hip Replacement Market
Restraints
R • No Significant Cure for Osteoarthritis

• Evidence-based Osteoarthritis Interventions
Opportunities
• Development of Cost-effective Innovative Products
O
• Emergence of Outpatient Orthopaedic Procedures
• Advent of Personalized Medicines
• Robotics Technology

Market Dynamics
2.2 Impact Analysis of Market Drivers and Restraint
Drivers 1-2 years 3-5 years 6-10 years
Escalating Prevalence of Chronic

Medium Medium Medium
Disease
Growing Geriatric Population with

Awareness Related to Available Low Medium Medium
Medical Services
Government Initiative for Overall

Development of the Hip Replacement Low Medium High
Market
Restraint 1-2 years 3-5 years 6-10 years
No Significant Cure for Osteoarthritis Medium Medium Medium
Evidence-based Osteoarthritis
Low Medium Medium
Interventions

Market Dynamics
2.3 Market Drivers
Driver Description
 There is immense rise in the prevalence of osteoarthritis among huge populace and it is identified
1 Escalating Prevalence of as the key reason for the global need for joint reconstruction procedures. Women are more likely
Chronic Disease to get affected by osteoarthritis than men and the prevalence rate progresses with the age.
 According to Centers for Disease Control and Prevention (CDC), osteoarthritis affects more
than 30 million of the U.S. adults.
 According to the Arthritis Research UK, one-third of people aged 45 years and over in the
U.K. have treatment for osteoarthritis. An estimated of 8.75 million people in the U.K. had
undergone the treatment for osteoarthritis.
 According to the Australian Institute of Health and Welfare (AIHW), osteoarthritis affects
more than 9% of the Australian populace.
 Rising prevalence is expected to boost the growth of the osteoarthritis treatment market.
 There is an increasing awareness among the population regarding the risk factors associated with
Growing Geriatric Population
2 with Awareness Related to
osteoarthritis (such as obesity and overweight). This is primarily due to increasing government
Available Medical Services initiatives aimed at controlling the disease.
 However, with the new healthcare policies (especially Affordable Care Act) in place across diverse
countries such as the U.S., the affordability of diagnostic and treatment services have significantly
improved. Consequently, the life expectancy of the people is likely to increase during the forecast
period.
 Other factors such as increasing greying population and alternative medicines are expected to
boost the growth of the market.
 According to the World Health Organization (WHO) estimates, the global geriatric population would
increase from 524 million in 2010 to around 2 billion by 2050.

Market Dynamics
2.3 Market Drivers
Driver Description
 Governmental regulations are taking collaborative initiatives to sustain the escalating demand for
Government Initiative for
3 Overall Hip Replacement
hip and knee implants
 For instance, Medicare spent around $7.00 billion on hip and knee replacements in the
Market
year 2013. Moreover, an estimated 255 of the 400,000 such surgeries performed annually
would be covered under the new payment model of CMS (Centers for Medicare and
Medicaid Services) in the near future.
 According to the World Bank, Asia-Pacific and European countries are witnessing a spur in FDI.
Developing regions such as, India, Malaysia, Indonesia, and Mexico have outstripped economic
growth compared to developed regions. This, in turn, is expected to drive the growth in investment
across various healthcare sectors in these countries.

Market Dynamics
2.3 Market Restraint
Restraint Description
 Presently, there is no cure options available for osteoarthritis but the treatment is aimed at
1 No Significant Cure for managing the symptoms. Other factors such as lack of awareness regarding risks and symptoms
Osteoarthritis of osteoarthritis is expected to restrain the growth of the osteoarthritis treatment market.
 There is no simple diagnostic test available for the diagnosis of osteoarthritis. Diagnosis is based
on variable combination of patient reported symptoms and imaging of the joint. Mostly x-ray is
used to diagnose osteoarthritis, but it is often does not correlate with other symptoms of
osteoarthritis including joint pain.
 Diagnostics tool have low sensitivity and specificity and there is no biomarkers available for
diagnosis of osteoarthritis.
 Public healthcare systems lack a systematic approach to disseminate the evidence-based

osteoarthritis interventions. People suffering from osteoarthritis are often unaware of effective
Evidence-based
2 Osteoarthritis
evidence-based interventions. The evidence-based interventions may not be available in different
regions.
Interventions
 In addition, healthcare providers, public health practitioners lack the access to implement the
available evidence-based interventions. Too often, effective evidence based interventions are quite
underused and not available despite of their potential.
 Other factor such as lack of exact epidemiology and accurate information and systematic data
collection in different parts of the globe is expected to restraint the growth of the osteoarthritis
treatment market.

Market Dynamics
Opportunities Description
 The high costs of already marketed medical devices and implants for the treatment of orthopedic
1 Development of Cost disorders provide an excellent opportunity to medical device companies to develop cost effective
Effective Innovative Products implants, devices, instrumentation, surgeries, and delivery systems for treatment of bone, spine,
joint, and musculoskeletal disorders
 Medical device companies must develop certain strategies to reduce costs of devices and implants
as well as to develop products based on computer navigation, nanotechnology, 3D printing
technology and smart implants that aims at reducing costs as well as improving results and
outcomes
 In the recent years, outpatient orthopaedic procedures or ambulatory surgery are performed in
enormous quantity which provides a good opportunity for medical device companies to find new
2 Emergence of Outpatient approaches to develop innovative products required for ambulatory surgery centres (ASC)
Orthopaedic Procedures
 The emergence of minimally invasive surgical techniques and new pain management techniques
allow surgeons to perform procedures in an outpatient setting which will increase the demand for
ambulatory surgeries into hospitals

Market Dynamics
Opportunities Description
 Personalized medicines offer an outstanding opportunity in spine and other surgeries as well as
technology
3 Advent of Personalized
Medicines
 Patient match technology and customized surgical options, implants, and tools for a pre-planned
procedure is in huge demand
 Personalized medicines are based on an accurate positioning of the implant; thereby, potentially
increasing its survival rate, while patient matched guides reduce the volume of instrumentation
that helps hospital in reducing the time and costs related to assembling, washing, and sterilization
procedures
 The advent of robot-assisted surgical interventions based on innovative robotics technology

provides an excellent opportunity to medical device companies to develop products for the
4 Robotics Technology
treatment various orthopaedic disorders
 Robotics technology reduces the time and are results oriented as well

3. COMPETITIVE
LANDSCAPE

103
Competitive Landscape
Figure 7:
3.1 Key Developments and Strategies
Share of Key Developments and Strategies
 The global joint reconstruction market is highly fragmented

with an amalgamation of conglomerate corporations and Total Number of
small-medium enterprises. The significant demand for several
Strategies:70
types of joint reconstruction has provided the key market
players with significant opportunity to expand their services 44.29%
through different strategic approaches.
Product
 By tracking and analyzing the major developments witnessed 34.29% Launches
in the market for the past four years, it has been observed
Mergers and
that the companies are trying to expand their market share Acquisitions
through collaborations and product launches. The market
witnessed a significant number of mergers and
acquisitions(31), product launches (24), joint ventures, 2.86
collaborations, and partnerships (13), and product approvals %
from FDA (2). 18.57%
Joint Venture, Approvals

Collaborations
and
Partnerships

Figure 8:
3.2 Mergers and Acquisitions
Mergers and Acquisitions Share, by Companies
 Mergers and acquisitions remain the most preferred business Total Mergers and Acquisitions (31)
strategies employed by key players to stay competitive in the
market. These strategies account for approximately 44.29% of 3.23%
the overall key developments in the market. Several high-

medium scale enterprises have adopted this strategy to
9.68%
sustain in the competition. The market witnessed
16.13%
approximately 31 significant mergers and acquisition in the
past four years. 19.35%
6.45%
 Stryker Corporation registered the highest number of mergers
and acquisitions (25% of total product launches) witnessed by 3.23%
the market in the last three years. Followed by, companies 3.23%
namely Zimmer Biomet Holdings, Inc. and Johnson & Johnson,

9.68%
which registered second and third largest share of 19.35%
29.03%
and 16.13% in past three years.
 Other key companies who have made immense contribution in

the mergers and acquisition includes Exactech, Inc., Lima
Corin Group PLC Johnson & Johnson
Corporate, MicroPort Scientific Corporation, Smith & Nephew
Exactech, Inc. Lima Corporate
plc, and Wright Medical Group N.V., among others.
MicroPort Scientific Corporatio Smith & Nephew plc
Stryker Corporation Zimmer Biomet Holdings, Inc.
Wright Medical Group N.V.

Figure 9:
3.3 Product Launch
Product Launch Share, by Companies
 Product launch (approximately 34.29% of the total key Total Product Launches (24)
developments) is the second leading strategy adopted by the
key players in the global joint reconstruction market. Several
high-medium scale enterprises are frequently updating their
product portfolio with innovative, and application specific joint
12.50%
reconstruction products, to sustain in the competition. The
25.00%
market witnessed approximately 24 significant product 4.17%
launches in the past four years. 4.17%
 B Braun Melsungen AG registered the highest number of

product launches (25% of total product launches) witnessed 4.17%
16.67%
by the market in last three years. Followed by, companies
8.33%
namely MicroPort Scientific Corporation and BioMedtrix, LLC,
which registered second largest share of 12.50% in the past 4.17%
12.50% 8.33%
three years.
 Other key companies who have made immense contribution in

the product launches includes Corin Group PLC, Exactech,
B Braun Melsungen AG Corin Group PLC
Inc., Group FH Ortho, and Lima Corporate, among others.
Exactech, Inc. Group FH Ortho
Lima Corporate MicroPort Scientific Corporation
Smith & Nephew plc Wright Medical Group N.V.
StelKast BioMedtrix, LLC

3.4 Joint Venture, Collaborations and Figure 10: Joint Ventures, Partnership and Collaborations
Partnerships Share (by Companies)
The global joint reconstruction market witnessed 13 significant Total Joint Ventures, Partnership and Collaboration (13)
joint ventures, partnerships. and collaborations in the past three 7.69%
years. Most of the acquisitions were aimed at the expansion of
Corin Group PLC
product portfolio by acquiring joint reconstruction product 15.38%
providers with promising growth potential. Johnson & Johnson
Lima Corporate
 Johnson and Johnson is the leading company with 30.77% of 15.38% 30.77%
Marle Group
the such developments. Johnson and Johnson was followed
by Marle Group, Zimmer Biomet Holdings, Inc., and 7.69% Stryker Corporation
CeramTec Group, among others. Zimmer Biomet Holdings, Inc.
15.38%
CeramTec Group
7.69%
3.5 Product Approvals Figure 11: Approval Share (by Companies)
 Apart from product launches, joint ventures, collaborations, Total Aprroval (2)
partnerships, and M&As, companies also incorporated
strategies such as product approval.
 The aforementioned strategy collectively accounted for

2.86% share of the total number of the key developments,
50% 50%
witnessed by the market in the past three years.
Stryker Corporation Zimmer Biomet Holdings, Inc.

4. INDUSTRY
INSIGHTS

108
Industry Insights
4.1 Introduction
Figure 12: Hip Fracture Incidence among Women Around the World
Low
<200/100,000
Medium
200-300/100,000
High
>300/100,000

Industry Insights
4.1 Introduction
Figure 13: Hip Fracture Incidence among Men Around the World
Low
<100/100,000
Medium
100-150/100,000
High
>150/100,000

Industry Insights
4.2 Globalization and Market Expansion
The U.K.
Canada
In 2016, there were over
65,000 people (aged 60 years
China
In 2016, about 1.4 million
people were affected with and above) with hip fracture.
osteoporosis and almost In 2016, approximately 70
30,000 hip fractures were million of the population is
performed in that year. affected by osteoporosis
every year, out of which
687,000 being hip fractures.
India
The U.S. Osteoporosis affects around 25

million people every year and it
In 2016, approximately 44 million is expected that by 2020, the
with osteoporosis and almost annual incidence of hip
Brazil
300,000 people (aged 65 year and fractures would reach 600,000.
above) had been hospitalized for In 2016, approximately 20 million
hip fractures. people have osteoporosis and the
incidence of hip fractures is
expected to increase by more
than 35% in the upcoming
decades.
Industry Insights
4.3 Demographic and Patient Statistics – North America
• Hip Fracture Statistics: Hip fracture is among the most serious and life threatening fall injuries. It occurs due to a fracture in the proximal
end of the femur, pelvis or acetabulum. Since femur is one of the strongest bones in the body, it requires a strong force to break which
can result due to a high energy trauma, vehicle accident, gunshot, jump or fall. However, it is more prevalent among people aged 60
years or above due to their gradual decline in bone mineral density
• With the rapidly increasing aging population in the developed nations of North America such as the U.S. and Canada, the number of hip
fractures is expected to rise significantly in the next decade
• Currently, low bone mass and osteoporosis are estimated to be the major public health challenges in the U.S. affecting more than 44
million people. This population comprises of mainly men and women aged 50 years or above
• Currently, there are approximately 300,000 old age people who undergo hip fracture hospitalizations every year in the U.S., out of which
95% of the fractures are caused due to falling
• In Canada, there are approximately 30,000 hip fracture cases reported every year which is expected to quadruple by the end of 2030.
According to Osteoporosis Canada, the cost of the treatment of orthopaedic fractures is approximately 1.9 billion every year
• Apart from the cost, hip fracture patients also deal with long waiting times in the hospitals for hip or knee replacement surgeries
• Osteoporosis is also a major concern which leads to hip fractures in Canada. These fractures (osteoporotic) are more common than many
chronic diseases in Canada such as heart attack, stroke and breast cancer. Hip fractures are more common among women (one in three)
than men (one In five)

Industry Insights
4.3 Demographic and Patient Statistics - Europe
• With the rapidly rising aging population in Europe, people are more prone to developing osteoporosis which consequently leads to an
increased number of hip fractures.
• According to a study conducted by the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical
Industry Associations (EFPIA), approximately 3.5 million new cases of fragility fractures (fractures due to fall from a height) occur every
year in the European Union (EU) region.
• The same study claims that in the year 2010, the healthcare systems incurred a cost of €37 billion for the treatment of fragility fractures
out of which hip fractures contributed to 54% of the costs. The major reason for the fractures could be attributed to the rising incidences of
osteoporosis in the region that often causes bones to turn weak and fragile and poses a patient with higher risk of breakage of bone
• In the year 2010 alone, there were approximately 22 million women and 5.5 million men in the European Union diagnosed with
osteoporosis, and this number is expected to increase by 23% by the end of 2025 reaching a value of 33.9 million (according to IOF) due
to subtle changes in the demography of the population.
• Women in the region are more exposed to the threat of developing fragility fractures that could even lead to death. According to a study
by the International Osteoporosis Foundation (IOF) and European Federation of Pharmaceutical Industry Associations (EFPIA) in 2010,
hip fractures contributed to approximately 50% of the fracture related deaths in women. In men also, hip fractures contributed to
approximately 49% of fracture related deaths.
• Hip fractures are generally caused by direct falls from a standing position and the risk of falling increases with the increase in age and is
more predominant among elderly women.
• Another reason driving the rise of fracture rate is the amelioration in the socioeconomic conditions which translates into less amount of
time on physical activity. Physical activity is an important risk factor which enhances the risk to many life threatening diseases and
currently claims approximately one million lives (10% of the overall population) in the region. The lack of physical activity remains a
leading factor due to which numerous chronic diseases occur in the region and in turn costs healthcare systems approximately €910
million annually.
• In terms of prevalence, Germany is the nation in EU that is believed to have the highest number of people with osteoporosis with
approximately 1 million osteoporotic men and approximately four million osteoporotic women

Industry Insights
• The nation also witnesses the highest number of all types of fractures (incidence rate:725,000) due to a large population size and a high
fracture incidence rate in the country
• On the other hand, Malta and Luxembourg witness the lowest number of fracture of all types incidents (incidence rate: 3000)
• The occurrence of osteoporotic fractures is age dependent which is evident from the fact that approximately 3,900,000 women with
osteoporosis fall in the age group of 75-79 years of age
• However, due to a lower life expectancy among men than women, the highest number of people (approximately 800,000) with
osteoporosis fall within the age group of 60-64 years of age
• According to the International Osteoporosis Foundation (IOF), the total number of hip fractures in the entire European Union (EU) region
was 615,316 in the year 2010 which equates to approximately 1,685 hip fractures every day and 70 fractures per hour in the region
• The total number of deaths caused by these hip fractures were 20,772 in the year 2010
• The cost of treatment of osteoporosis related fractures contribute to approximately 3% of the total health spending in the countries within
the European union. The distribution of cost burden also varies from countries for example: the cost burden in Cyprus is approximately
5% of the health spending on the other hand, Luxemburg spends about 1% of its healthcare cost on the treatment of osteoporotic
fractures
• As per the UN world population projections, the number of people aged 65 or above was 19.2 % of the entire population in 2016 and this
number is substantially expected to reach over 25% by the end of 2030 and this will translate into more number of fracture.
• According to IOF, there will be an increase of 32% in the population over 80 years and a major portion of these individuals will be men
considering the a higher life expectancy among men than women which is expected to increase the men to women ratio by 51% to 60%
by the end of 2025. However, these demographic changes may vary from one country to the another. For example, in Bulgaria, the male
population (above 55 years) is expected to decrease by 1% whereas it is likely to increase in all the other countries in the region

Industry Insights
• The same study stated that the prevalence of osteoporosis, the major contributor to osteoporotic fractures, is likely to stay stagnant by the
end of 2025. However, the demographical changes of the regional population is expected to increase the number of people with
osteoporosis
• The number of people with osteoporosis is expected to reach approximately 34 million in the next seven years with 23% increase.
Similarly, the number of people with osteoporotic fractures is also expected to reach approximately 4.5 million by the end of 2025 from a
value of 3.5 million in 2010 (IOF)
• It is also expected that the developed nations in Europe are expected to witness a rise in the number of fractures. For example: Germany
is expected to witness the largest number of fractures (928,000 fractures) which is followed by the U.K. with approximately 682,000
fractures
• Hip fracture, being the largest contributor to the incidence of all types of fractures, is expected to increase at the highest rate both in
women (29%) and men (41%) by the end of 2025
• Furthermore, in the European region, the cost of treatment of osteoporosis and their related condition is expected to increase to € 46.8
billion by the year 2025 from 37.4 billion in 2010
Country-wise Demographic Statistics in Europe

• The U.K. : Hip fracture is among the most common and a very serious injury among the old age people in the U.K. which costs the
National Health System approximately £1 billion annually. In 2016, there were about 65,000 people aged 65 years or above with a hip
fracture of which only 40% people were hospitalised. The incidence of fracture after the age of 50 : (1 in 2 women and 1 in 5 women)
• The average cost of treatment of hip fractures is estimated to be £14,163 in the first year. With the rapidly increasing old age population,
the number of fractures and the cost associated is likely to increase
• Belgium: According to IOF, in 2010, there were approximately 80,000 new fragility fractures and approximately 600,000 people aged 50
and above with osteoporosis. The healthcare burden caused by these fractures was approximately 606 million annually which is expected
to reach € 733 million

Industry Insights
• by the end of 2025. Also, there were an estimated 10,761 women, and 4,199 men with hip fractures in 2010 in belgium. The number of
people with a prior hip fracture was 20749 men, and 53737 women
• Denmark: In Denmark, the high prevalence of osteoporosis is the leading cause of disability. In 2010, there were an estimated 61456
men, and 221912 women with osteoporosis. According to IOF, there were aproximately 66,000 new fragility fracture incidences in
Denmark in 2010
• The incidence of hip fracture was more predominant among women than man, there were 8,488 women with hip fracture in 2010 while
the number of men with a hip fracture was 3,533
• The new and prior fractures cost the nation approximately €1,055 million every year, and the burden is expected to increase by 27%, to
€1.3 billion, by the end of 2025
• France: According to IOF study, there were approximately 377,000 fragility fractures in the year 2010. The number of people with
osteoporosis also varied from men to women (men: 691112, and women: 2784,198). There were a total of 73630 hip fractures in the year
2010, out of which 54935 women, and 18695 men were diagnosed with hip fractures
• Finland: There was a total of 6548 hip fractures in Finland in the year 2010, constituting 4484 women, and 2064 men diagnosed with hip
fractures. The number of hip fractures increased at a steady pace until the late 1990s (approximately 70%)
• Czech Republic: There were approximately 72,000 fragility fractures in the year 2010, and a total of 530,000 people aged 50 or above
were diagnosed with osteoporosis. The incidence of hip fractures in 2010 was around 12091, out of which 8,330 women, and 3,761 men
were diagnosed with hip fractures, suggesting the predominance of the disease among women. Every year, the new and prior fractures
cost the nation a total of €273 million, which is expected to reach €352 million by the end of 2025 (an increase of 29%)
• Greece: Osteoporosis is one of the leading causes of fractures leading to disability among people. As of 2010, there were a total of
642,707 people with osteoporosis out of which 205202 were men, and 507505 were women. The incidence of hip fractures in 2010 was
14683, with 9942 women, and 4741 men diagnosed with hip fractures.The nation spends approximately $680 million each year on the
treatment of new and prior hip fractures, and the number is expected to increase by 20% by the year 2025

Industry Insights
• Romania: According to IOF, there were a total of 94,000 fragility fractures in the year 2010, and the number of people aged 50
or above diagnosed with osteoporosis was approximately 590,000 in the same year. The nation spends approximately €577
million every year on the treatment of new and prior fractures
• Spain: There were an estimated 2,449,255 people with osteoporois in Spain in the year 2010, with a high prevalence rate of
6.8. Further, the prevalence rate of osteoporosis among people aged 50 or above is 22.6 which is quite high as compared to
other EU nations. Also, the total number of people with hip fractures was 40,472 in the smae year in Spain. The nation spends
approximately 2,842 million every year on the treatment of new and prior fractures and the burden is expected to increase by
30% by the end of 2025
• Sweden: In the year 2010, there were approximately 107,000 new fragility fractures in Spain, and the number of people with
osteoporosis was found to be 523,095 in the same year. The prevalence of osteoporosis among people aged 50 or above was
estimated to be 22.4%. Also, there were approximately 20,000 cases of hip fractures, out of which 14,688 were women and
5,592 were men. The nation spends approximately €1,486 million annually on dealing with new and prior fractures, and the
number of expected to increase by 23% by the end of 2025
• Hip fracture is a major concern in Sweden as it accounts for as many days of hospital stay as myocardial infarction, and more
than prostate and breast cancer combined.
• Slovenia: According to IOF, there are approximately 16,000 new fragility cases every year. The total number of people with
osteoporosis was found to be approximately 110,032. However, the number significantly rises when it comes to people aged
50 or above (590,000 people in 2010). Also, the incidence of hip fractures among both men and women was estimated at
2,032. Furhthermore, the nation spends approximately €56 million every year on dealing with new and prior fractures, and the
number is expected to increase by 37% by the end of 2025.

Industry Insights
Table 6: First year cost of treatment for hip fractures in the EU (by Country, 2012-2015)
Country Cost ($) Country Cost ($)

Belgium 11,426 Lithuania 4,810
Bulgaria 1,826 Luxembourg 12,616
Cyprus 14,821 Malta 9,084
Czech Republic 5,169
Netherlands 10,458
Denmark 25,117
Poland 4,881
Estonia 5,580
Portugal 12,031
Finland 16,066
Romania 2,168
France 12,030
Slovakia 4,690
Germany 19,218
Slovenia 5,306
Greece 12,550
Spa in 9,421
Hungary 3,594
Sweden 15,021
Ireland 15,230
UK 11,055
Italy 19,602
Latvia 4,522 EU27 13,816

Industry Insights
Table 7: Estimated number of men and women with osteoporosis (defined as a T-score of −2.5 SD or less at the femoral
neck), prevalence in men and in women over 50 years, and prevalence in the total population, 2010
Prevalence in Prevalence in
Prevalence in
Men with Women with Men and Women Male population female
Country total population
Osteoporosis osteoporosis with osteoporosis aged 50 or population aged
(%)
above (%) 50 or above (%)
Austria 89,862 368,685 458,547 6.5 22.2 5.5
Belgium 120,695 476,875 597,570 6.6 22.4 5.6
Bulgaria 81 336,425 417,907 6.4 20.9 5.6
Cyprus 9,263 31,032 40,295 6.2 19.3 3.7
Czech Republic 103,114 425,944 529,058 6.0 20.4 5.0
Denmark 61,456 221,912 283,368 6.5 21.1 5.1
Estonia 11,642 65,789 77,431 6.2 22.2 5.8
Finland 61,054 243,399 304,453 6.4 21.5 5.7
France 691,112 2,784,198 3,475,310 6.7 22.5 5.7
Germany 1,006,652 4,017,260 5,023,912 6.6 22.6 6.1
Greece 135,202 507,505 642,707 6.9 22.3 5.7
Hungary 94,949 452,158 547,107 6.2 21.1 5.5
Ireland 37,127 129,309 166,436 6.2 20.0 3.7
Italy 749,237 3,042,794 3,792,031 6.9 23.4 6.3

Industry Insights
Table 8: Estimated number of men and women with osteoporosis (defined as a T-score of −2.5 SD or less at the femoral
neck), prevalence in men and in women over 50 years, and prevalence in the total population, 2010
Prevalence in Prevalence in
Men and Prevalence in
Men with Women with Male population female population
Country Women with total
Osteoporosis osteoporosis aged 50 or aged 50 or above
osteoporosis population (%)
above (%) (%)
Latvia 19,210 111,236 130,446 6.1 22.3 5.8
Lithuania 27,136 148,375 175,511 6.1 21.7 5.3
Luxemburg 4,541 17,422 21,963 6.1 21.0 4.3
Malta 4,190 16,074 20,264 5.9 19.8 4.9
The Netherlands 175,244 643,258 818,502 6.3 20.8 4.9
Poland 338,756 1,509,772 1,848,528 5.8 20.1 4.8
Portugal 117,738 475,882 593,620 6.7 22.0 5.6
Romania 198,065 835,885 1,033,950 6.2 20.5 4.8
Slovakia 42,726 188,911 231,637 5.7 19.4 4.2
Slovenia 20,543 89,489 110,032 6.0 21.5 5.4
Spain 496,368 1,952,987 2,449,355 6.8 22.6 5.4
Sweden 113,722 409,373 523,095 6.9 22.4 5.6
The U.K. 679,424 2,527,331 3,206,755 6.7 21.9 5.2
EU27 5,490,510 22,029,280 27,519,790 6.6 22.1 5.5

Industry Insights
Table 9: Estimated Number of Incident Fractures (by Type and Country, 2010)
Hip Fractures Vertebral Fractures Forearm Fractures Other Fractures
Country Women Men Women Men Women Men Women Men
Austria 11,835 4,254 8,280 4,822 11,049 2,373 26,029 17,894
Belgium 10,761 4,199 7,566 4,480 10,263 2,095 23,809 16,720
Bulgaria 3,857 2,061 3,558 2,805 4,914 1,579 9,147 10,277
Cyprus 494 282 446 326 786 165 1,408 1,222
Czech Republic 8,330 3,761 6,406 4,623 9,364 2,550 19,642 17,519
Denmark 8,488 3,553 6,221 4,018 8,299 2,004 18,886 14,889
Estonia 1,229 384 942 451 1,186 222 2,628 1,646
Finland 4,484 2,064 3,269 2,385 4,334 1,202 9,818 8,849
France 54,935 18,695 36,069 19,556 47,131 8,969 117,952 73,467
Germany 95,672 34,178 74,336 39,291 99,112 19,342 215,271 147,572
Greece 9,942 4,741 8,248 5,061 12,309 2,268 24,483 18,466
Hungary 9,704 3,698 7,144 4,224 29,832 9,356 22,084 16,415
Ireland 2,294 892 1,677 996 2,519 482 5,530 3,695
Italy 67,595 22,944 47,921 23,540 61,523 10,156 145,243 86,478

Industry Insights
Table 10: Estimated Number of Incident Fractures (by Type and Country, 2015)
Hip Fractures Vertebral Fractures Forearm Fractures Other Fractures
Country Women Men Women Men Women Men Women Men
Latvia 2,022 613 1,558 728 1,985 367 4,368 2,664
Lithuania 1,986 646 1,584 835 2,087 456 4,385 3,095
Luxembourg 340 127 254 151 378 79 808 563
Malta 331 117 283 144 403 70 790 503
The Netherlands 9,367 4,028 7,169 4,455 10,318 2,152 21,944 16,514
Poland 19,665 7,981 15,835 10,609 22,211 6,018 45,124 40,221
Portugal 7,358 2,502 5,232 2,573 7,053 1,120 16,501 9,482
Romania 9,332 4,975 8,768 6,901 12,375 3,880 22,638 25,413
Slovakia 3,899 1,927 3,395 2,683 5,147 1,606 9,655 10,322
Slovenia 2,032 748 1,451 890 1,977 483 4,502 3,427
Spain 30,030 10,442 19,155 10,534 25,155 4,563 65,079 39,193
Sweden 14,688 5,592 10,509 5,983 13,556 2,837 31,650 22,231
The UK 56,136 23,107 40,121 25,803 59,007 9,913 189,933 131,853
EU27 446,806 168,509 327,398 188,868 464,272 96,309 1,059,304 740,591

Industry Insights
4.3 Demographic and Patient Statistics - Asia Pacific
Table 11: Population Increase in those Aged 70 Years or Over (by country, 2013, 2025, 2050)
% INCREASE % INCREASE
Country 2013 2025 2O50
(2013-2025) (2025-2050
Japan 2,30,11,747 3,06,40,589 3,57,75,911 33% 17%
Australia 22,27,695 33,12,469 49,72,125 49% 50%
New Zealand 4,14,050 6,03,259 9,27,683 46% 54%
Hong Kong* 7,30,013 11,43,437 19,38,160 57% 70%
Chinese Taipei 19,26,606 30,08,513 55,61,399 56% 85%
Republic of Korea 40,93,278 62,50,386 1,22,22,143 53% 96%
Thailand 43,28,866 68,09,826 1,36,47,275 57% 100%
China 8,11,25,217 13,16,79,177 26,31,52,529 62% 100%
Sri Lanka 11,45,310 19,25,891 38,83,004 68% 102%
Indonesia 1,03,66,493 1,58,21,035 4,08,37,224 53% 158%
India 4,12,84,460 6,51,50,062 16,54,93,550 58% 154%
Pakistan 51,35,174 73,92,939 2,09,17,420 44% 183%
Vietnam 35,93,065 52,54,769 1,58,76,455 46% 202%
Philippines 28,59,825 48,99,490 1,34,89,932 71% 175%
Malaysia 9,39,010 17,58,356 48,54,210 87% 176%
Singapore 2,89,462 5,87,675 15,31,599 103% 161%

Industry Insights
4.3 Demographic and Patient Statistics - Asia Pacific
Table 12: Cost of Treatment of Osteoporosis ($US) and Number of Average Days Spent in a Hospital
Country Cost Average no. of days spend in a hospital

Australia $21,824-31,605 7-12
China $3,645–5,000 15-20
Chinese Taipei $3,242 13
Public $772 Public 15

India
Private $2,360–3,860 Private 5-6
Private $7,000–9,000 Public 11-15

Indonesia
Public $5,000–8,000 Private 5-14
Japan $27,599 38
Malaysia $6,000 7
Hospital $12,336 Hospital 14

New Zealand
Rehab $9,986 Rehab 22
Pakistan $1,200–2,400 4-6
Philippines $2,200 25-50
Singapore $8,380 16
Thailand $2,064 20
Vietnam $1,000–4,000 14

Industry Insights
4.3 Demographic and Patient Statistics - Asia-Pacific
Population 22.2 million

Aged over 50 years 33%
Life expectancy 82 years
Hip fracture incidence per year 295/100,000 (women)
Australia Cost per hip fracture 21,824–31,605 USD
• Australia is expected to witness a steep rise in population in the upcoming years from 22.2 million to approximately 25 million by the end
of 2025 growing at a rate of 13% which is further expected to increase by 16% reaching 19 million by 2050 (WHO and World Bank). The
aging population in Australia currently accounts for 33% of the overall population which is further expected to increase by 41% by 2050.
This aging population will substantially contribute to the rising burden of osteoporosis in the country.
• The country is facing huge burden due to rise in the number of people with osteoporosis which is primarily due to low bone density and
poor skeletal health among people belonging to different age groups. For example, approximately 34% of the population is having a low
bone density and approximately 66% of people at the age of 50 years or above have poor skeletal health.
• Osteoporosis is predominant among women (81% of the women population) and people aged 50 or above (85.8%). Osteoporosis is also
directly related with the level of vitamin D present in a person’s body and the amount of calcium intake. Since, approximately 31% of the
Australian adults are vitamin D deficient, it maximises the chances of developing osteoporosis
• Fracture rates: According to a study by IOF, there were a total of 140,822 people aged 50 years or above having osteoporosis in the year
2012. Another study conducted in 2007-2008 claimed that there were an estimated 52,730 fragility fractures which also includes 17,192
hip fractures. As of now, approximately 90% of the hip fractures are treated surgically with an average wait time for surgery of 1-2 days
• Cost: Osteoporotic fractures pose a significant financial burden on the nation which is evident from the fact that it spends approximately
USD 1.65 billion every year on the treatment of osteoporosis

Industry Insights

Hip fracture incidence per year 123/100,000
Hong Kong Cost per hip fracture 10,782 USD
• The overall population of Hong Kong was approximately 7.18 million in the year 2013 and the average life expectancy of 82 years.
However, the population is expected to decrease by 14% by 2050 reaching to approximately 6.1 million. Considering the high life
expectancy of 82 years, the ageing population will substantially rise during the same period. Currently, approximately 45% of the
population is aged 50 years or above which will reach to nearly half of the overall population by the end of 2025
• According to Hong Kong Osteoporosis Study, there has been a decrease in the incidence of hip fractures and lower prevalence of
osteoporosis in the recent years. The prevalence of osteoporosis has significantly decreased from 9.6% to 3.6% at the total hip. This
lowering in prevalence of osteoporosis is primarily due to the health improvements such as increase bone density, adoption of healthier
lifestyles, greater access to anti osteoporotic drugs and increased awareness among people
• The hip fracture incidence rate in Hong Kong is much higher than that of china i.e. approximately 123/100,000 person. The stability in the
incidence of hip fractures have witnessed a decline in the past decade; however, the rapidly increasing ageing population is expected to
counterbalance the stability in the upcoming years
• Cost: There have been approximately 4,500 cases of hip fracture annually which accounts for about $52 million of hospital spending. In
terms of direct hospital and rehabilitation cost, the treatment of a hip fracture costs $10 000/fracture with an average hospital stay of seven
days. The per day cost of care for a patient with a hip fracture in a hospital is about $400.

Industry Insights
Population 1.35 billion

China Cost per hip fracture 3,600–5,000 USD
• According to the Chinese National Committee on Ageing, there were a total of 200 million people aged 60 years or above in China in the
year 2013 and the number is increasing at an unprecedented rate which is evident from the fact that by 2050, the old age population
would comprise of nearly half of the entire Chinese population. This might be due to the fact that the old age population (aged 50-75
years) are more exposed to the risk associated with osteoporosis. Further, according to the Chinese National Committee on Ageing,
approximately 26% of the population belongs to this group which accounts for approximately 357 million people of the nation. By the end
of 2025, it is expected that more than 37% of the population will be at risk of developing osteoporosis.
• Although, there are very less research studies on the prevalence of osteoporosis in China, there have been a few studies that claim the
prevalence of osteoporosis to be 40.1% of women and 22.5% of affected men aged 50 years or above
• In conjunction with the ageing population, lifestyle changes are also contributing to the rising number of cases of osteoporosis.
Amelioration in medical care has helped immensely in escalating the average life expectancy among people. Also, since approximately
45% of the Chinese population lives in urban areas, people experience decreased exposure to sunlight, lack of physical activity and low
vitamin and calcium intake which significantly increases the chances of developing osteoporosis
• Hip fractures: The incidence of hip fractures is continuously increasing in the urban regions of China. According to a study, the incidence
of hip fracture is approximately 229/100,000 per year in women and 129/100,000 per year in men among people aged 50 years or above
• According to IOF, the average hospital costs for the treatment of hip fractures varies between $3,600 and $5,000 with an average 15–20
days of hospital stays

Industry Insights
Population 1.32 billion

India Cost per hip fracture 772–3,860 USD
• India is the second most populous country after China with an average life expectancy of 67 years which is expected to increase to 71
years by the end of 2025. Rapidly ageing population is not an exception in India either with the current ageing population (aged 50 years
or above) contributing to almost 10% of the entire population which is further expected to increase by 22% at the end of 2025
• According to IOF, approximately 80% of the Indian population is Vitamin D deficient (below 20 ng/mL), which translates into increased
chances for developing hip fractures as approximately 80-90% of the patients with a hip fracture are Vitamin D deficient. Also, the
situation exacerbates with the rising incidence of osteoporosis and related fractures which is evident from the estimated 50 million people
with osteoporosis or low bone density
• Lifestyle changes such as increasing urbanisation, low calcium intake, low sun exposure, lower physical activity are also contributing to
the rising incidence of osteoporosis and related bone fractures
• Fracture rates: According to a research study conducted by Nutrition Foundation of India, the annual incidence of hip fracture is
163/100,000 per year in women and 121/100,000 per year in men among people aged 50 years or above
• Cost: The average cost of treatment varies from town, bed type, and type of hospital the treatment is being carried out i.e. public or
private. In private hospitals, the average cost varies from 2,360–3,860 USD while in public hospitals the cost is approximately $772. The
number of bed days also get reduced to 5-6 days in a private hospitals while it is about 15 days in a government or publicly funded
hospital

Industry Insights

Japan Cost per hip fracture 27,599 USD
• Japan is among the countries with the fastest growing ageing population owing to its low birth rates and high average life expectancy (84
years). As per IOF, this life expectancy is further expected to increase to more than 90 years in the decades to come. The overall
population is however continuously shrinking and is expected to fall to 123.3 million by 2025 from 127.2 million in 2013. As of now,
approximately half of the population belongs to the age group of 50 years and above. The number are more glaring when it comes to
people aged 70 years or above. It is expected that in the next 7 years, the number of people aged 70 or above would comprise of more
than 25% of the Japanese population
• Osteoporosis: The disease affects approximately 10% of the Japanese population aged 40 years or above with about 3 million men and
9.8 million women suffering from the disease. The current annual incidence rate of the disease is 0.6% in men and 2.3% in women aged
40-79 years
• The recent lifestyle changes is burdening Japan with osteoporosis with more number of people aged 50 years or above living in the urban
areas experiencing osteoporosis and related fractures due to less exposure to sunlight. The Japanese population is also witnessing high
prevalence of vitamin D deficiency with about 81.3% of the population being vitamin D deficient. This deficiency is predominant among
women and is associated with several lifestyle changes such as smoking, lack of physical activity and poor Vitamin D intake
• Fracture rates: According to IOF, the incidence of hip fractures in Japan is 50/100,000 per year in men and 180/100,000 per year in
women aged 40 years or above
• Cost: The average cost for the treatment of a hip fracture is approximately 27,599 USD and the patient needs to spend about a month in a
hospital

Industry Insights

Hip fracture incidence per year 218/100,000
New Zealand Cost per hip fracture 22,322 USD
• New Zealand is witnessing a steep rise in ageing population with a high average life expectancy (81 years) however, this rise is in a
nascent stage and is lower than many other Asian countries. According to IOF, this life expectancy is further expected to increase to 84
years by the end of 2050 and the overall population is expected to increase by 9% in the next seven years. Currently, the people at the
age of 50 or above constitute 34% of the overall population which is further going to experience an increase of 25% by the end of 2025
• Osteoporosis: According to a study conducted in 2007, there were an estimated 70,000 people aged 50 years or above suffering with
osteoporosis out of which 90% were female. However, due to under documentation of vertebral fractures and osteoporosis cases, the
actual determination of prevalence of osteoporosis is very difficult
• Lifestyle: Approximately 85% of the population live in urban areas which significantly increases the chances of developing osteoporosis
due to lesser physical activity levels and less exposure to sunlight (a major source of vitamin D)
• Fracture rates: According to “2007-2020” Burden of Osteoporosis report, the incidence of hip fracture was 218/100,000 per year and
140/100,000 per year in men. In terms of type, vertebral fractures are the most common in New Zealand contributing to approximately
33% of all the fracture types while hip fractures only contributes to 5% of all fracture type
• Cost: Osteoporosis New Zealand for the first time estimated the total cost of fracture in the year 2007. The total cost of the treatment of
fractures was estimated to be $248 million with additional $27.3 million for the management of osteoporosis related complications.

Industry Insights

South Korea Cost per hip fracture no data
• With the ageing population in South Korea, the number of osteoporotic fractures is expected to rise substantially in the upcoming years.
Currently, the ageing population contributes to approximately 35% of the overall population and this number is expected to increase 50-
60% in the upcoming decades in conjunction with rise in average life expectancy from 80 years (now) to 84 years. Also, the number of
people aged 70 or above is also expected to increase from 4 million (8% of the population) to 12 million (28% of the population) by the
end of 2050 which is an increase of about 200%.
• Osteoporosis: The prevalence of osteoporosis has been fairly determined by a study conducted by the Health Insurance Review and
Assessment Service (HIRA) according to which 6.1% of men and 33% of women aged 50 years or above were treated for osteoporosis in
the year 2009. The information collected by the Korea National Health and Nutrition Examination Survey also indicated a similar
prevalence rate of 7.5% in men and 35..5% in women
• Fracture rate: One common trend that is apparently an anomaly to the general trend that women have a higher mortality rate after one
year of hip fracture, while the Korean men have a higher mortality rate (approximately 2 times higher) after one year after hip fracture than
women. The increasing hip fracture rates are also influenced by deficiency of vitamin D leading to low bone mas density. According to the
HIRA database, the incidence of hip fractures increase from 146/100,000 in 2003 to 207/100,000 in 2008 in women and 62/100,000 in
2003 to 98/100,000 in 2008 in men

Industry Insights

Singapore Cost per hip fracture 8,380 USD
• The population in Singapore is ageing faster (especially people aged 70 years or above) than it was in the last decade and the number is
expected to increase by 103% in the coming decade. Another age group with the highest probability of developing osteoporosis related
fractures is the population aged 50 or above and this population is expected to reach 3.9 million from current 1.3 million constituting
approximately 46% of the entire population
• Osteoporosis: The incidence of osteoporosis related fractures among women is the highest in the Asia pacific region and if left under
treated may reach close to the statistics of the U.S. and Europe. According to IOF (2009), there were approximately 55,000 women aged
50 years or above suffering from osteoporosis and with ever rising ageing population; this number is further expected to increase in the
coming years
• Lifestyle: Singapore is among the most urbanized country in Asia and comprise of a mix of people from different part of the region
including Chinese, Malay, Indian and others. According to a study rising incidence of fractures is solely due to rapid urbanisation in the
region leading to lifestyle changes such as lack of physical activity, nutrition and exposure to sunlight
• Fracture rates: According to a study, Singapore is among the country with the highest incidence rate of hip fractures in the Asia pacific
region i.e. 152/100,000 per year in men and 402/100,000 per year in women
• Cost: Approximately, 90% of the hip fractures are treated with surgeries and an average of 16 days are spent in a hospital which
approximately costs $8,380. According to IOF, the cost of treating hip fractures will reach $145 million per year by 2050 including the cost
of managing fractures after the first year

Industry Insights
4.3 Demographic and Patient Statistics - Latin America
Table 13: Percentage of Population (50 Years and Above), Table 14: Percentage of Population (70 Years and Above),
by Country by Country
% of Population ≥ 50 Years % of Population ≥ 70 Years
Country Country
2011 2050 2011 2050 % Increase
Argentina 25.0 36.6 Argentina 3,203,061 7,354,684 129.6%
Brazil 20.0 37.0 Brazil 8,671,721 36,044,915 315.7%
Chile 25.3 42.8 Chile 1,037,461 3,234,614 211.8%
Mexico 17.8 37.0 Mexico 4,888,090 20,599,601 321.4%

Industry Insights
Argentina
• According to World Bank, the total population of Argentina was approximately $43.85 million in the year 2016 and the old age population
(aged 50 or above) accounts for around 10% of the overall population. Also, it is expected that by the end of 2050, the population will
increase by about 30% reaching to approximately 55% and the ageing population would reach to about 20 million.
• The country witnesses a variation in the prevalence rate of osteoporosis (major cause of fragility fractures in the region) due to varied
climatic condition across the nation.
• In Argentina, there are approximately 34,000 hip fractures every year with an average of 90 fractures per day. Also, an average hospital
cost of treatment of hip fractures is 3,800 per case which translates into approximately $129.2 million of annual hospital costs considering
the 34,000 fracture case every year. The annual rate of incidence of hip fractures is nearly 298 per 100 000 among women aged 50 or
above and 118 per 100 000 in men.
• According to IOF, by the end of 2050, it is expected that there will be approximately 63,000 hip fractures in women and close to 13,000
fractures in men.
• The cost of hospitalizations due to hip and vertebral fractures exceed nearly $190 million annually. Despite the high cost of treatment, the
federal government does not consider the disease a high priority.
• In terms of duration, hip fractures usually take approximately 4-5 days in a private hospital and around 6-7 days in a public hospital.
Brazil
• The population of Brazil is nearly 203 million now of which approximately 40 million people are above the age of 50 years which accounts
for 20% of the overall population and around 8.6 million of the population are represented by people aged 70 years or above.
• The rising life expectancy and increasing ageing population is substantially driving the incidence of hip as well as vertebral fractures.
Currently, there are approximately 121,000 hip fractures that occur every year in Brazil and the number is expected to increase reaching
to 140,000 by the end of 2020.

Industry Insights
• The hospitalization cost for the treatment of hip fracture is approximately $3,987 per patient with an average hospital stay of approximately
10-11 days
Chile
• The current population of Chile is close to 17 million of which the ageing population (50 years and older) represent approximately 25% of
the overall population. According to IOF, it is expected that that the ageing population will constitute around 43% of the population by then
end of 2050
• The population in Chile is also witnessing serious health as well as economic challenges due to increase in life expectancy and lowered
birth rate leading to an elevated number of ageing population. Since, the fractures due to osteoporosis are more prevalent among ageing
population, this becomes a public health issue for the government of Chile.
• However, as of now, the government does not reimburse the diagnosis as well as medication expenses related to osteoporosis
• In the year 2008, there were an estimated 5,236 hip fractures in women aged 45 years and above with approximately 2,104 hip fractures in
men aged 45 years and above
• The direct hospital cost of treatment of hip fractures is approximately $3,000-$7,000 which depends on the type of healthcare setting
(private or public) the fracture is being treated in
• The number of hospital days a patient need to stay is approximately 5-7 days for the treatment of a hip fracture
Mexico
• Like elsewhere across the globe, Mexico is not an exception to rapidly ageing population. The life expectancy has increased at a fast pace
in the last few decades from approximately 37 to 75 years old. Currently, the nation holds a population close to 113 million of which
approximately 18% is represented by people above the age of 50 years. People aged 70 years or above account for nearly 5% of the
population

Industry Insights
• In Mexico, there are approximately 169 women and 98 men per 100,000 people who had hip fractures and the number is expected to
increase in both the sexes.
• In the year 2005, the total number of hip fractures was registered to be 29,732 and the number is expected to reach 155,874 by the end
of 2050.
• On average, hip fracture cases costs approximately $4,365.50 per event with an average hospital stay of 10-11 days depending on the
type of healthcare setting (private or public).

Industry Insights
4.4 Pricing Analysis of Hip, Shoulder and Knee Implants
The prices shown in the following tables reflect only the average price The pricing pattern in terms of percentage changed over the
of hip, shoulder and knee reconstruction implant category and does period of 2016-2017
not provide the exact selling prices of particular products
Table 15: Average Price of Hip Reconstruction Implants Table 16: Hip Reconstruction
Supplier Average Price Category Change (percentage)

DePuy Synthes $5,552 Total hip 1.8%
Smith & Nephew $5,700
Partial hip 1.4%
Stryker $6,282
Zimmer Biomet $6,545 Hip revision 2.2%
Table 17: Average Price of Shoulder Reconstruction Implants Table 18: Shoulder Reconstruction

DePuy Synthes $5,550
DJO Surgical $4,880 Total shoulder 2.8%
Exactech $5,780
Partial shoulder 1.4%
Wright Medical $7,180
Zimmer Biomet $6,110 Shoulder revision 3.2%

Industry Insights
4.4 Pricing Analysis of Hip, Shoulder and Knee Implants
The prices shown in following tables reflect only the average price of The pricing pattern in terms of percentage changed over the
hip, shoulder and knee reconstruction implant category and does not period of 2016-2017
provide the exact selling prices of particular products
Table 19: Average Price of Knee Reconstruction Implants Table 20: Knee Reconstruction

DePuy Synthes $4,060 Total Knee 2.3%
Smith & Nephew $3,350
Partial Knee 3.4%
Stryker $3,890
Zimmer Biomet $5,070 Knee revision 1.3%

Industry Insights
4.4 Pricing Analysis of Hip and Shoulder Implants
The average cost of a hip, shoulder, and knee implant for the U.S. hospitals in 2016 declined to $5,874, a 1.2% decrease from
2015. This is the third decline in average selling price (ASP) in succession, as compared to an increase of 4.2% between 2009
and 2010. The largest decrease (3.2%) was reported for shoulder revision implants, while the second largest decline (2.8%) was
reported for total shoulder prosthetics. Partial hips decreased 2.2% between 2015 and 2016.
There have been several major shifts in total hip replacement over the last couple of years. The disappearance of “hard-on-hard”
constructs (metal on metal, and total hip resurfacing procedures). These categories accounted for as many as 37% of the total
hip procedures in 2007, but less than 2% in 2016; The increased use of ceramic heads which offset the large number of metal-
on-metal constructs; the advent of the so-called mobile bearing hips marketed by Stryker, Zimmer Biomet, and Medacta, which
accounted for 9% of the total hip procedures in 2016; and the disappearance of cemented hip stems. In 1999, cemented hip
stems (uncoated) accounted for about 54% of the total hips; in 2013, they accounted for about 5 to 8% of the hip stems.
Most of the categories of total hip constructs registered price declines between 2015 and 2016 coated femur/ ceramic head/poly
insert declined 2.1% to $6,111, coated femur, metal head/poly liner declined 1.8% to $5,852, and uncoated femur/poly liner
decreased 1% to $5,758. The combined mobile bearing hip constructs registered a 2.7% price decline to $6,175, which was the
highest price category of any of the total hip constructs monitored.

Industry Insights
4.4 Pricing Analysis of Hip and Shoulder Figure 14: Pricing ($/Unit) Analysis Hip Implants (2008-
Implants 2016)
 The percentage of hip stems designated as coated has 6,300.00

increased to 76% of the stems, compared to 15% uncoated, 5%
6,200.00
long or revision stems, and 3% other stems. This reflects the
movement toward higher technology and prices. The average
6,100.00
price for revision hip stems was found to be $6,394, which was
an increase of 12.5% from 2013; the pricing for coated hip stems 6,000.00
averaged $3,170, which was a significant 4.1% decline from

5,900.00
2013, and pricing for uncoated hip stems averaged $1,763,
down 2.4% from 2013.
5,800.00
 The size of the femoral heads were split into the 32mm and less, 5,700.00
36mm, and greater than 36mm. In 2016, 46% of the ceramic and
5,600.00
metal femoral heads were 32mm and less, 44% of them were
36mm, and the remaining 10% were larger than 36mm. Until
5,500.00
hardened acetabular liners appeared on the market in 2002,
femoral heads were available in sizes of 22, 26, 28, and 32 5,400.00
millimetre diameters.
5,300.00
2008 2009 2010 2011 2012 2013 2014 2015 2016

5. Global Joint
Reconstruction Market
Overview

141
Global Joint Reconstruction
5.1 Global Joint Reconstruction Market Overview
• The procedure number of joint reconstruction are growing rapidly. The ageing population and active lifestyle are the major driving
factors boosting the joint reconstruction market. Osteoarthritis is identified as the major factor among all the diseases requiring
total or partial joint replacement.
• Primary procedures having uncemented fixation with metal on polyethylene surface are the leading procedure type among all other
procedures for the hip joint replacement. Global primary knee replacement market value is expected to grow by 1.60X folds during
the forecast period 2018-2025 owing to high rate of hip, knee, and shoulder replacement.
• Additionally, in knee replacement, primary procedures having uncemented fixations with unconstrainted fixed bearing type are the
leading segments. The global primary knee replacement market value is expected to grow by 1.58X folds during the forecast period
2018-2025.
• Hip and knee replacement contributes more than 90% percent share in the global joint reconstruction market. However, shoulder,
ankle and elbow joint reconstruction contributes to less than 10% of the global joint reconstruction market.
• The joint reconstruction market is dominated by medical devices giants such as Zimmer Biomet, Johnson & Johnson, Stryker,
DePuy Synthes, Smith & Nephew. These companies contributes to more than 90% share in the global joint reconstruction market.
• Globally, primary procedures are dominating the market owing to high prevalence of joint related diseases such as osteoarthritis,
osteoporosis, and joint fractures. However, the revision procedures lower as compared to primary procedures because revision is
required when there is any kind of infection, lysis, fractures in the artificial prostheses and necrosis. Therefore the primary
procedure are likely to dominate the market over the forecast period 2018 – 2025.

Global Joint Reconstruction
Figure 15: Global Hip Joint Reconstruction Market, by Figure 16: Global Knee Joint Reconstruction Market (by
Value in $Billion and Procedure Volume in Thousand) Value in $Billion and Procedure Volume in Thousand)
14.54
15.40
16.32
8.82
9.35
13.72
8.31
2500 10.00 3000 18.00
12.95
7.83
12.22
7.38
11.53
9.00 16.00
6.96
10.88
10.27
6.56 2500
6.19
2000 8.00 14.00
9.70
5.83
9.15
5.50
5.18
7.00 2000 12.00
2,793.3
10.00
2,694.3
1500 6.00
2,601.4
2,513.9
2,431.0
1500
2,352.3
2,277.5
2,206.2
2,157.9
2,138.1
2,073.6
8.00
2,066.4
2,011.2
5.00
1,984.7
1,910.5
1,841.9
1,779.0
1,720.9
1,666.8
1,616.6
1000 6.00
1,571.9
1000 4.00
1,516.2
3.00 4.00
500
500 2.00 2.00
1.00 0 -
0 - 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Knee Joint Reconstruction Volume (Thousand)
Hip Joint Reconstruction Volume (Thousand) Hip Joint Reconstruction Value ($Billion) Knee Joint Reconstruction Value ($ Million)
Figure 17: Global Shoulder Joint Reconstruction Market Figure 18: Global Shoulder Joint Reconstruction Market
(by Value in $Million) (by Procedure Volume in Thousand)
1,076.1
1,139.6
1,016.1
1400
243.2
230.1
300
959.5
218.0
906.1
206.7
1200
855.6
196.3
808.0
186.6
763.0
250
177.4
720.5
168.8
680.4
1000
160.6
642.6
153.2
145.4
800 200
600 150
400 100
200 50
0
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Shoulder Reconstruction Market Value ($Million) Global Shoulder Joint Reconstruction Procedure Volume (Thousand)
5.2 Global Hip Arthroplasty Market Figure 19: Global Hip Arthroplasty Market Value
(by Procedure Type) $Million
• The global hip joint reconstruction market value for the year 2017
8,366.9
was estimated to be $5.83 billion and is likely to grow at a CAGR of
7,887.9
7,436.5
7,011.7
6.08% to reach the market value of $9.35 billion by the year 2025.
6,612.6
10000
6,235.0
5,878.2
5,541.9
9000
5,225.0
4,926.1
4,640.2
8000
• The total procedure volume for the hip joint reconstruction market 7000
was estimated to be 1,616.6 thousand in the year 2017. The 6000
procedure volume growing at a CAGR of 3.76% is likely to reach 5000
2,157.8 thousand. 4000
879.9
826.4
776.0
727.9
681.4
639.1
600.2
563.7
529.3
496.9
471.5
3000
106.8
102.6
98.6
94.7
90.9
87.3
83.8
80.5
77.2
74.3
70.6
2000
• The primary hip replacement market is expected to grow by 1.60X by 1000
the year 2025. Whereas, the primary uncemented hip fixation market 0
is expected to grow by 1.51X fold during the forecast period 2017- 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
2025.
Primary Hip Replacement Revision Hip Replacement Hip Resurfacing
• The revision hip replacement market is expected to grow by 1.66X by

the year 2025. Whereas, the revision cemented hip fixation market is
expected to grow by 1.38X fold during the forecast period 2017- Figure 20: Global Hip Arthroplasty Market
2025.
Procedure Volume (by Procedure Type) Thousand
• Osteoarthritis is the major reason for the hip joint replacement
across the globe. Other reasons for hip joint replacement are 3000
rheumatoid arthritis, post-traumatic arthritis, avascular necrosis,
1,927.2
1,846.4
1,774.2
1,708.6
and childhood hip diseases, among others.
1,648.4
2500
1,592.7
1,541.0
1,492.9
1,448.2
1,408.5
1,357.6
2000
• The key reason for the hip joint revision procedure are infection,
lysis, protheses worn out, and corrosion, among other reasons. 1500
1000
206.0
195.9
186.9
178.7
170.8
164.0
157.9
152.2
146.9
142.2
137.9
24.7
24.1
23.6
22.7
23.1
22.0
22.3
21.3
21.4
21.7
20.7
500
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Table 21: Global Primary Hip Arthroplasty Market Value, $Million (by Fixation Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 912.1 962.7 1,019.0 1,077.1 1,138.3 1,203.4 1,272.7 1,346.6 1,426.4 1,513.4 1,609.0 5.90%
Uncemented 3,178.6 3,352.9 3,532.9 3,722.9 3,924.1 4,136.2 4,359.3 4,593.1 4,839.6 5,098.3 5,368.5 5.37%
Hybrid 504.1 558.6 613.6 674.2 739.1 808.6 882.8 962.0 1,046.6 1,136.6 1,232.1 8.99%
Others 45.4 51.9 59.5 67.7 76.8 86.7 97.8 110.1 123.9 139.6 157.3 12.80%
Total 4,640.2 4,926.1 5,225.0 5,541.9 5,878.2 6,235.0 6,612.6 7,011.7 7,436.5 7,887.9 8,366.9 6.06%
Table 22: Global Primary Hip Arthroplasty Market and Procedure Volume, Thousand (by Fixation Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 266.9 275.3 282.4 290.1 298.4 307.4 317.2 328.1 340.2 354.1 370.4 3.55%
Uncemented 930.0 958.7 979.2 1,002.9 1,028.7 1,056.6 1,086.7 1,119.3 1,154.6 1,193.4 1,236.6 3.04%
Hybrid 147.5 159.7 170.1 181.6 193.8 206.6 220.1 234.5 249.8 266.2 284.0 6.59%
Others 13.3 14.8 16.5 18.2 20.1 22.2 24.4 26.8 29.6 32.6 36.2 10.29%
Total 1,357.6 1,408.5 1,448.2 1,492.9 1,541.0 1,592.7 1,648.4 1,708.6 1,774.2 1,846.4 1,927.2 3.72%

Table 23: Global Revision Hip Arthroplasty Market Value, $Million (by Fixation Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 111.3 115.8 121.4 126.9 132.5 138.3 144.2 150.1 156.0 162.0 167.9 4.08%
Uncemented 281.4 297.2 316.8 337.6 359.7 383.1 408.7 437.3 466.0 495.6 526.3 6.55%
Hybrid 69.6 73.9 79.9 86.7 94.0 102.1 111.0 121.0 131.9 143.9 157.3 8.89%
Others 9.2 10.0 11.2 12.5 13.9 15.6 17.4 19.6 22.1 24.9 28.3 12.41%
Total 471.5 496.9 529.3 563.7 600.2 639.1 681.4 727.9 776.0 826.4 879.9 6.57%
Table 24: Global Revision Hip Arthroplasty Market and Procedure Volume, Thousand (by Fixation Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 32.9 33.3 33.8 34.3 34.7 35.3 35.8 36.4 37.1 37.7 38.5 1.69%
Uncemented 76.8 78.6 80.6 82.9 85.2 87.7 90.5 93.9 97.1 100.6 104.4 3.35%
Hybrid 24.5 25.9 27.6 29.5 31.6 34.0 36.6 39.5 42.7 46.2 50.3 7.90%
Others 3.8 4.3 4.9 5.5 6.3 7.0 7.9 8.9 10.1 11.4 12.8 12.73%
Total 137.9 142.2 146.9 152.2 157.9 164.0 170.8 178.7 186.9 195.9 206.0 4.42%

Table 25: Global Primary Hip Arthroplasty Market Value, $Million (by Bearing Surface)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 2,195.7 2,282.1 2,394.1 2,512.9 2,638.9 2,772.9 2,915.2 3,067.1 3,230.8 3,407.4 3,598.6 5.26%
CoP 1,641.1 1,756.2 1,882.7 2,015.5 2,156.4 2,306.0 2,463.6 2,629.1 2,803.6 2,987.0 3,177.7 6.72%
CoC 629.6 665.0 708.9 756.2 806.4 858.8 914.0 971.6 1,031.6 1,094.3 1,159.7 6.30%
MoM 86.6 91.6 97.2 103.1 109.4 116.2 123.5 131.5 140.4 150.3 161.6 6.62%
Other 120.5 131.1 142.1 154.2 167.1 181.2 196.3 212.5 230.0 249.0 269.4 8.30%
Total 4,640.2 4,926.1 5,225.0 5,541.9 5,878.2 6,235.0 6,612.6 7,011.7 7,436.5 7,887.9 8,366.9 6.06%
Table 26: Global Primary Hip Arthroplasty Market and Procedure Volume, Thousand (by Bearing Surface)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 642.4 652.5 663.5 676.9 691.7 708.1 726.5 747.1 770.4 797.1 828.2 2.93%
CoP 480.2 502.2 521.9 543.0 565.4 589.2 614.3 640.9 669.2 699.6 732.4 4.37%
CoC 184.2 190.2 196.5 203.7 211.4 219.4 227.9 236.8 246.2 256.3 267.3 3.95%
MoM 25.4 26.2 26.9 27.8 28.7 29.7 30.8 32.0 33.5 35.1 37.2 4.25%
Other 35.3 37.5 39.4 41.5 43.8 46.3 48.9 51.8 54.9 58.3 62.1 5.91%
Total 1,357.6 1,408.5 1,448.2 1,492.9 1,541.0 1,592.7 1,648.4 1,708.6 1,774.2 1,846.4 1,927.2 3.71%

Table 27: Global Revision Hip Arthroplasty Market Value, $Million (by Bearing Surface)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 132.0 177.3 186.6 196.9 207.8 219.3 231.9 245.3 259.5 275.6 293.5 5.87%
CoP 176.1 188.9 204.0 219.7 236.6 254.4 274.0 296.1 318.3 341.1 364.1 7.48%
CoC 101.2 105.6 111.7 118.1 124.6 131.6 139.0 147.2 155.4 163.1 171.2 5.45%
MoM 8.2 8.4 8.9 9.4 10.0 10.6 11.3 12.1 13.1 14.2 15.7 7.54%
Other 15.4 16.7 18.1 19.6 21.3 23.1 25.1 27.2 29.7 32.4 35.4 8.85%
Total 471.5 496.9 529.3 563.7 600.2 639.1 681.4 727.9 776.0 826.4 879.9 6.57%
Table 28: Global Revision Hip Arthroplasty Market and Procedure Volume, Thousand (by Bearing Surface)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 66.2 68.4 70.8 73.6 76.6 79.9 83.5 87.6 91.9 96.9 102.6 4.85%
CoP 42.7 44.1 45.4 46.9 48.4 49.9 51.6 53.7 55.7 57.6 59.7 3.52%
CoC 21.9 22.0 22.2 22.5 22.7 23.0 23.4 23.8 24.3 24.6 25.1 1.56%
MoM 3.0 3.2 3.5 3.8 4.2 4.6 5.1 5.7 6.3 7.0 7.9 10.81%
Other 4.1 4.5 4.9 5.4 6.0 6.5 7.2 7.9 8.8 9.7 10.8 10.37%
Total 137.9 142.2 146.9 152.2 157.9 164.0 170.8 178.7 186.9 195.9 206.0 4.42%

Global Knee Arthroplasty Market
Figure 21: Global Knee Arthroplasty Market Value,

Global Knee Arthroplasty Market $Million (by Procedure Type)
14,832.5
15,772.5
• The global knee joint reconstruction market value for the year 2017
13,948.4
20,000.0
13,117.0
12,335.1
was estimated to be $10.27 billion and is likely to grow at a CAGR of
11,599.9
18,000.0
10,908.4
10,258.1
16,000.0
9,646.6
9,071.5
8,530.7
14,000.0
• The total procedure volume for the knee joint reconstruction market 12,000.0
was estimated to be 2,138.1 thousand in the year 2017. the 10,000.0
procedure volume growing at a CAGR of 3.43% is likely to reach 8,000.0
2,793.3 thousand. 6,000.0
626.7
623.5
626.1
625.0
619.1
620.8
613.8
603.6
589.9
572.3
550.4
4,000.0
• The primary knee replacement market is expected to grow by 1.63X 2,000.0
by the year 2025. Whereas, the primary uncemented knee fixation -
market is expected to grow by 1.51X fold during the forecast period 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
2017-2025. Primary Knee Replacement Revision Knee Replacement
• The revision hip replacement market is expected to grow by 0.87X by

the year 2025. Whereas, the revision cemented hip fixation market is
expected to grow by 0.78X fold during the forecast period 2017-2025. Figure 22: Global Knee Arthroplasty Market Procedure
Volume, Thousand (by Procedure Type)
• For knee replacement the key factor for replacement remains the
same (osteoarthritis) as in the hip replacement. There is no
significant cure available for osteoarthritis as therefore replacement 4,000.0
2,699.2
2,594.2
2,495.9
remains the only option to cure arthritis. Other reasons for knee joint
2,403.3
2,315.8
3,500.0
2,232.8
2,154.1
2,079.2
2,007.8
replacement are rheumatoid arthritis, post-traumatic arthritis,
1,940.2
1,875.2
3,000.0
avascular necrosis, and age related loss of bone density, among 2,500.0
others.
2,000.0
• The key reason for the knee joint revision procedure are infection, 1,500.0
136.1
133.3
130.3
127.0
lysis, protheses worn out, and corrosion among other reasons.
123.4
119.5
115.2
110.6
105.5
100.1
1,000.0
94.2
500.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Primary Knee Replacement Revision Knee Replacement

Table 29: Global Primary Knee Arthroplasty Market Value, $Million (by Fixation Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 2,753.0 2,915.6 3,098.7 3,293.8 3,503.0 3,727.4 3,967.7 4,225.2 4,500.8 4,795.1 5,109.1 6.47%
Uncemented 5,085.4 5,374.7 5,671.2 5,982.3 6,307.8 6,648.3 7,004.5 7,376.8 7,766.2 8,173.5 8,599.8 5.32%
Hybrid 140.0 166.5 195.8 229.0 266.4 308.7 356.4 410.2 470.8 539.0 615.6 15.17%
Others 552.3 614.8 680.9 753.1 831.1 915.4 1,006.5 1,104.7 1,210.6 1,324.9 1,448.0 9.79%
Total 8,530.7 9,071.5 9,646.6 10,258.1 10,908.4 11,599.9 12,335.1 13,117.0 13,948.4 14,832.5 15,772.5 6.34%
Table 30: Global Primary Knee Arthroplasty Market and Procedure Volume, Thousand (by Fixation Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 331.4 342.3 355.9 370.9 387.6 405.9 426.2 448.7 473.4 500.8 531.1 5.26%
Uncemented 1,391.5 1,430.8 1,469.5 1,509.3 1,549.8 1,591.3 1,633.7 1,677.0 1,721.6 1,767.4 1,814.9 2.67%
Hybrid 30.8 35.6 40.8 46.4 52.6 59.4 66.9 75.2 84.2 94.3 105.3 12.42%
Others 121.4 131.5 141.7 152.6 164.1 176.2 189.0 202.4 216.6 231.7 247.8 7.17%
Total 1,875.2 1,940.2 2,007.8 2,079.2 2,154.1 2,232.8 2,315.8 2,403.3 2,495.9 2,594.2 2,699.2 3.80%

Table 31: Global Revision Knee Arthroplasty Market Value, $Million (by Fixation Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 354.6 351.6 347.5 342.4 336.1 328.5 319.7 309.6 298.2 285.5 271.5 -3.26%
Uncemented 149.1 150.0 150.4 150.2 149.4 148.0 145.7 142.6 138.5 133.2 126.6 -2.42%
Hybrid 62.3 66.2 70.1 73.7 77.1 80.1 82.6 84.5 85.6 85.8 84.7 2.01%
Others 53.1 55.7 58.1 60.4 62.5 64.3 65.8 66.9 67.7 67.9 67.5 1.61%
Total 619.1 623.5 626.1 626.7 625.0 620.8 613.8 603.6 589.9 572.3 550.4 -1.84%
Table 32: Global Revision Knee Arthroplasty Market and Procedure Volume, Thousand (by Fixation Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 75.0 72.4 69.6 66.8 63.8 60.7 57.6 54.3 51.0 47.6 44.1 -5.75%
Uncemented 35.8 34.9 34.0 33.1 32.1 31.0 29.8 28.5 27.2 25.7 24.0 -4.48%
Hybrid 13.7 14.2 14.6 14.9 15.2 15.4 15.5 15.5 15.3 15.0 14.5 -0.42%
Others 11.7 11.9 12.1 12.2 12.3 12.4 12.4 12.3 12.1 11.9 11.6 -0.82%
Total 136.1 133.3 130.3 127.0 123.4 119.5 115.2 110.6 105.5 100.1 94.2 -4.18%

Table 33: Global Primary Knee Arthroplasty Market Value, $Million (by Bearing Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Unconstrained Fixed 5,630.3 6,079.9 6,564.2 7,085.8 7,647.7 8,252.9 8,904.7 9,606.7 10,362.8 11,177.0 12,053.7 7.89%
Unconstrained Mobile 787.2 802.6 816.6 828.8 839.0 846.8 851.7 853.4 851.4 845.0 833.7 0.08%
Posterior-Stabilized Fixed 1,723.2 1,795.8 1,870.5 1,947.5 2,026.7 2,108.1 2,191.7 2,277.3 2,364.9 2,454.4 2,545.7 3.90%
Others 389.9 393.2 395.3 395.9 394.9 392.0 387.0 379.6 369.4 356.1 339.3 -2.18%
Total 8,530.7 9,071.5 9,646.6 10,258.1 10,908.4 11,599.9 12,335.1 13,117.0 13,948.4 14,832.5 15,772.5 6.34%
Table 34: Global Primary Knee Arthroplasty Market and Procedure Volume, Thousand (by Bearing Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Unconstrained Mobile 173.0 171.7 170.0 168.0 165.7 163.0 159.9 156.4 152.3 147.8 142.7 -2.31%
Posterior-Stabilized Fixed 378.8 384.1 389.3 394.7 400.2 405.8 411.5 417.2 423.2 429.3 435.6 1.42%
Others 85.7 84.1 82.3 80.3 78.0 75.5 72.7 69.5 66.1 62.3 58.1 -4.52%
Total 1,875.2 1,940.2 2,007.8 2,079.2 2,154.1 2,232.8 2,315.8 2,403.3 2,495.9 2,594.2 2,699.2 3.80%

Table 35: Global Revision Knee Arthroplasty Market Value, $Million (by Bearing Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Unconstrained Fixed 362.5 363.0 362.4 360.7 357.8 353.4 347.4 339.7 330.1 318.4 304.3 -2.40%
Posterior-Stabilized Fixed 140.7 142.0 143.0 143.4 143.4 142.7 141.4 139.3 136.4 132.6 127.9 -1.63%
Others 13.1 15.1 17.1 19.1 21.0 22.8 24.5 26.0 27.3 28.2 28.8 6.05%
Total 619.1 623.5 626.1 626.7 625.0 620.8 613.8 603.6 589.9 572.3 550.4 -1.84%
Table 36: Global Revision Knee Arthroplasty Market and Procedure Volume, Thousand (by Bearing Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 2.9 3.2 3.6 3.9 4.2 4.4 4.6 4.8 4.9 4.9 4.9 3.52%
Total 136.1 133.3 130.3 127.0 123.4 119.5 115.2 110.6 105.5 100.1 94.2 -4.18%

Global Shoulder Arthroplasty Market
Figure 23: Global Shoulder Arthroplasty Market Value,

Global Shoulder Arthroplasty Market $Million (by Procedure Type)
• Shoulder joint replacement procedure are comparatively lower than
1,139.6
the hip and knee replacement procedures. The shoulder joint
1,076.1
1,016.1
replacement market comprises approximately 5% market share only. 1400
959.5
906.1
855.6
1200
808.0
763.0
720.5
680.4
• The global knee joint reconstruction market value for the year 2017
642.6
1000
was estimated to be $0.72 billion and is likely to grow at a CAGR of 800
5.90% to reach the market value of $1.13 billion by the year 2025. 600
400
• The total procedure volume for the knee joint reconstruction market
was estimated to be 160.64 thousand in the year 2017. the procedure 200
volume growing at a CAGR of 5.35% is likely to reach 243.18 0
thousand. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Global Shoulder Joint Reconstruction Market Value ($Million)

• The shoulder reverse polarity total prosthetic replacement segment is
expected to grow by 1.77X by the year 2025. Whereas, the total
prosthetic replacement is expected to grow by 1.46X fold during the
forecast period 2018-2025. Figure 24: Global Shoulder Arthroplasty Market
Procedure Volume, Thousand (by Procedure Type)
• The key reason for the replacement of shoulder joint are
osteoarthritis and cuff tear. Other reasons are sports injury,
accidental trauma and inflammatory arthritis among other reasons.
243.2
230.1
300
218.0
206.7
196.3
186.6
• In shoulder arthroplasty market, the reverse polarity total
177.4
168.8
250
160.6
153.2
145.4
replacement procedure is dominant. The reason pertaining to the high
200
growth of this segment are it provides active lifestyle to the patient
post replacement, less chances of revision, low mortality rate and 150
long shelf life of the prostheses. 100
50
• However, total prosthetic replacement is the second leading
procedure. It is the second most preferred among surgeon owing to 0
low cost, long shelf life of the prostheses, and less wearing. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Global Shoulder Joint Reconstruction Procedure Volume (thousand)

Global Shoulder Arthroplasty Market
Figure 25: Global Shoulder Joint Reconstruction Market Value, $Million (By Procedure Type)
700
600
500
400
300
200
100
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Total Prosthetic Replacement 215.8 225.7 236.8 248.7 261.0 273.9 287.4 301.4 316.1 331.3 347.2
Reverse Polarity Total Prosthetic Replacement 279.2 302.4 325.3 349.6 375.6 403.5 433.5 465.7 500.4 537.6 577.7
Resurfacing Total Arthroplasty 21.3 21.5 22.0 22.4 22.9 23.3 23.7 24.1 24.4 24.7 25.0
Hemi-arthroplasty 90.0 93.6 97.8 102.3 107.0 111.9 117.0 122.3 127.8 133.5 139.2
Resurfacing Hemi-arthroplasty 18.5 18.7 19.1 19.4 19.8 20.2 20.6 20.9 21.3 21.7 22.1
Revision Shoulder Arthroplasty 17.8 18.6 19.5 20.6 21.7 22.8 23.9 25.0 26.1 27.2 28.3
Figure 26: Global Shoulder Joint Reconstruction Procedure Volume, Thousand (By Procedure Type)
140
120
100
80
60
40
20
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Reverse Polarity Total Prosthetic
63.2 68.1 72.5 77.3 82.5 88.0 93.9 100.3 107.4 115.0 123.3
Replacement

6. Global Joint
Reconstruction Market
By Product Type

156
Product Type
Global Joint Reconstruction Market (by Product Figure 27: Global Joint Reconstruction Market (by
Type) Overview Product Type)
• Globally, approximately more than 80% of the joint reconstruction

procedure occur for hip and knee joint reconstruction.
• However, shoulder reconstruction procedure consists of

approximately 5% of the total joint reconstruction market.
• The global joint reconstruction market by product type is segmented

as hip, knee, and shoulder.
• The knee segment is the leading product segment for the global joint
reconstruction market. The segment leads both in terms of
procedural volume and the revenue generated by the products used
for the total knee arthroplasty. In the year 2017, the global Hip Knee
procedure volume of total knee arthroplasty was 2.1 million and the
value of the products used was estimated to be $ 10.27 billion.
• The hip segment is the second leading segment in terms of procedure

volume and value of the product used for the total hip arthroplasty
was 1.6 million and the value of the products used was estimated to
be $ 5.60 billion.
• Shoulder procedures accounted for 160,640.0 procedures in the year

2017. The market value of the procedures used for the total shoulder
replacement was estimated to be $ 0.72 billion.
• Globally, the female population remains dominant in the joint

reconstruction market as compared to the male population. The
reason behind this is higher prevalence of osteoarthritis and
osteoporosis among females as compared to males.
Shoulder

Product Type
Figure 28: Global Hip Joint Reconstruction Market Value

Global Hip Joint Reconstruction Market Overview ($Billion)
• The largest joint present in the human body is the hip joint, it is a
ball-and-socket joint. This joint is formed by the acetabulum, a part 15
of the pelvis bone. The ball is formed by the femoral head, which lies 13
8.75
on the upper end of the femur.
8.29
11
7.85
7.42
7.02
6.63
6.27
9
5.91
5.60
5.50
• The articular cartilage covers the bony surface of the ball and socket
5.18
7
region. The thin layer of synovial membrane surrounds the hip joint.
This membrane is significantly important for lubricating the cartilage 5
and avoiding friction. Synovial membrane produces a fluid that helps 3
in the lubrication. 1
-1 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• The major reasons pertaining to the total hip joint replacement
includes: osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, Global Hip Joint Reconstruction Market Value…
avascular necrosis, and childhood hip diseases, among others.
• The total hip joint reconstruction market value for the year 2017 was
estimated to be $5.60 billion and is likely to grow at a CAGR of 6.08% Figure 29: Global Hip Joint Reconstruction Procedure
to reach the market value of $8.75 billion by the year 2025. The key Volume (Thousand)
factors boosting the market growth are rising prevalence of the
osteoarthritis, osteoporosis and age related loss of bone density.
3500
2,157.9
• The total procedure volume for the hip joint reconstruction market
2,066.4
1,984.7
1,910.5
1,841.9
1,779.0
1,720.9
was estimated to be 1,616.6 thousand in the year 2017. the 3000
1,666.8
1,616.6
1,571.9
1,516.2
2,157.8 thousand. 2000
1500
• According to Arthritis Foundation, 30.8 million people in U.S. were 1000
suffering from osteoarthritis in 2015. 500
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Global Hip Joint Reconstruction Procedure Volume (Thousand)

Product Type
Global Hip Joint Reconstruction Market By Figure 30: Global Hip Joint Reconstruction Market Value,
Procedure Type $Million (by Procedure Type)
• Primary hip replacement includes total or partial hip replacement. 90

Primary hip replacement is required in case of osteoarthritis, hip 80
fracture, osteoporosis, and childhood injuries. 70
60
• Total hip replacement has helped most of the patient in living active 50
lifestyle as compared to partial hip replacement procedure. Primary 40
hip replacement market value was estimated to be $5.23 billion and 30
is forecasted to grow at a CAGR of 6.06% to reach market value of $ 20
8.37 billion. 10
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• The high pace growth of the primary hip replacement is attributed to Primary Hip Replacement 4,640 4,926 5,035 5,317 5,632 5,962 6,308 6,671 7,050 7,446 7,858
rising patient preference towards total/partial hip replacement, high Revision Hip Replacement 471.5 496.9 490.6 519.3 551.7 585.6 622.4 663.0 704.3 747.2 792.7
osteoarthritis prevalence and trauma. Hip Resurfacing 70.6 74.3 74.8 77.7 80.8 83.9 87.2 90.5 93.8 97.2 100.7
• The problem occur after the primary hip replacement by implant or

prosthesis produced from metal, plastic and/or ceramic components.
The problems include aseptic loosening, pain, lysis, dislocation, Figure 31: Global Hip Joint Reconstruction Procedure
implant wear and infection, among other problems. Volume, Thousand (by Procedure Type)
• The revision hip replacement is likely to increase with the increase in
the primary hip replacement owing to rise in rate of infection, pain 2000
1800
and wearing problems. Revision hip replacement market value was 1600
estimated to be $ 471.5 million and is forecasted to grow at a CAGR 1400
of 6.52% to reach market value of $ 879.9 million. 1200
1000
• The hip resurfacing is an alternative technique to joint replacement. 800
Most of the surgeons doesn’t suggest hip resurfacing it has an 600

400
associated risk of leaving capably harmful metal ions in the 200
bloodstream. Owing to this fact, the hip resurfacing in rarely used for 0
hip joint reconstruction. Hip resurfacing market value was estimated
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Primary Hip Replacement 1,357 1,408 1,448 1,492 1,541 1,592 1,648 1,708 1,774 1,846 1,927
to be $ 77.2 million and is forecasted to grow at a CAGR of 3.89% to Revision Hip Replacement 137.9 142.2 146.9 152.2 157.9 164.0 170.8 178.7 186.9 195.9 206.0
reach market value of $ 106.8 million. Hip Resurfacing 20.7 21.3 21.4 21.7 22.0 22.3 22.7 23.1 23.6 24.1 24.7

Product Type
Figure 32: Global Primary Hip Joint Reconstruction Figure 33: Global Primary Hip Joint Reconstruction
Market Value, $Million (by Fixation Type) Procedure Volume, Thousand (by Fixation Type)
6000 1400
5000 1200
1000
4000
800
3000
600
2000
400
1000
200
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 912.1 962.7 1,019.0 1,077.1 1,138.3 1,203.4 1,272.7 1,346.6 1,426.4 1,513.4 1,609.0 Cemented 266.9 275.3 282.4 290.1 298.4 307.4 317.2 328.1 340.2 354.1 370.4
Uncemented 3,178.6 3,352.9 3,532.9 3,722.9 3,924.1 4,136.2 4,359.3 4,593.1 4,839.6 5,098.3 5,368.5 Uncemented 930.0 958.7 979.2 1,002.9 1,028.7 1,056.6 1,086.7 1,119.3 1,154.6 1,193.4 1,236.6
Hybrid 504.1 558.6 613.6 674.2 739.1 808.6 882.8 962.0 1,046.6 1,136.6 1,232.1 Hybrid 147.5 159.7 170.1 181.6 193.8 206.6 220.1 234.5 249.8 266.2 284.0
Others 45.4 51.9 59.5 67.7 76.8 86.7 97.8 110.1 123.9 139.6 157.3 Others 13.3 14.8 16.5 18.2 20.1 22.2 24.4 26.8 29.6 32.6 36.2
Figure 34: Global Revision Hip Joint Reconstruction Figure 35: Global Revision Hip Joint Reconstruction
600 120
500 100
400 80
300 60
200 40
20
100
0
0 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 32.9 33.3 33.8 34.3 34.7 35.3 35.8 36.4 37.1 37.7 38.5
Cemented 111.3 115.8 121.4 126.9 132.5 138.3 144.2 150.1 156.0 162.0 167.9
Uncemented 76.8 78.6 80.6 82.9 85.2 87.7 90.5 93.9 97.1 100.6 104.4
Uncemented 281.4 297.2 316.8 337.6 359.7 383.1 408.7 437.3 466.0 495.6 526.3
Hybrid 24.5 25.9 27.6 29.5 31.6 34.0 36.6 39.5 42.7 46.2 50.3
Hybrid 69.6 73.9 79.9 86.7 94.0 102.1 111.0 121.0 131.9 143.9 157.3
Others 3.8 4.3 4.9 5.5 6.3 7.0 7.9 8.9 10.1 11.4 12.8
Others 9.2 10.0 11.2 12.5 13.9 15.6 17.4 19.6 22.1 24.9 28.3

Product Type
Global Primary and Revision Hip Joint Reconstruction Market (By Fixation Type)
• Cemented hip fixation consists of replacement of damaged ball and socket joint of hip with an artificial hip joint. This joint is fixed using the bone
cement. Bone cement is generally an acrylic polymer made up of polymethylmethacrylate (PMMA).
• Cemented hip fixation market is growing at a high pace owing to the launch of innovative products with antibacterial properties. The market for
primary cemented hip fixation is estimated to be $ 1,019.0 million in 2017. The market is likely to grow at a CAGR of 5.90% to reach the market
value of $ 1,609.0 million in the year 2025. The procedure volume for the primary cemented hip fixation is estimated to be 282.4 thousand in
2017 growing at a CAGR of 3.55% to reach 370.3 thousand procedures by the year 2025.
• Uncemented fixation for hip joint reconstruction is the most preferred type of procedure among the surgeons and patients. Uncemented fixation is
linked to comparatively lower mortality than cemented mode of joint reconstruction. Additionally, this mode of joint reconstruction is highly
successful and has helped most of the patient in living with an active lifestyle.
• Uncemented hip fixation market is growing at a decent pace owing to the above explained characteristics. The market for primary uncemented hip
fixation is estimated to be $ 3,532.9 million in 2017. The market is likely to grow at a CAGR of 5.37% to reach the market value of $ 5,368.5
million in the year 2025. The procedure volume for the primary uncemented hip fixation is estimated to be 979.2 thousand in 2017 growing at a
CAGR of 3.04% to reach 1,236.6 thousand procedures by the year 2025.
• The use of hybrid prostheses hip joint reconstruction is gaining popularity among the surgeons. It consist of cemented stems and Cementless
cups. Hybrid prostheses are costly therefore, they are less used as compared to cemented and uncemented prostheses. The market for primary
hybrid hip fixation is estimated to be $ 613.6 million in 2017. The market is likely to grow at a CAGR of 8.99% to reach the market value of $
1,232.1 million in the year 2025. The procedure volume for the primary hybrid hip fixation is estimated to be 170.0 thousand in 2017 growing at a
CAGR of 6.59% to reach 283.9 thousand procedures by the year 2025.
• The other type of prostheses or fixations used for the hip joint reconstruction are considered under the other segment. The other segment includes
market value and procedure number for the reverse hybrid and resurfacing fixation types. Such procedures are rarely occurring and consists of 1-
2% of the market share in the hip joint reconstruction. The market for primary other hip fixation is estimated to be $ 59.5 million in 2017. The
market is likely to grow at a CAGR of 12.80% to reach the market value of $ 157.3 million in the year 2025. The procedure volume for the
primary other hip fixation is estimated to be 16.4 thousand in 2017 growing at a CAGR of 10.29% to reach 36.1 thousand procedures by the year
2025.
• Uncemented procedures are likely remain dominant over the forecast period owing to features such as immensely successful operations, less
mortality, long life stability and preferred over cemented and hybrid prostheses by surgeons. Whereas, market for cemented and hybrid fixation is
highly potent and is likely to witness rise in the number of successful procedures incorporating such products.

Product Type
Figure 36: Global Primary Hip Joint Reconstruction Figure 37: Global Primary Hip Joint Reconstruction
Market Value, $Million (by Bearing Surface) Procedure Volume, Thousand (by Bearing Surface)
900
4000
800
3500
700
3000 600
2500 500
2000 400
1500 300
1000 200
500 100
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
MoP 2,195.7 2,282.1 2,394.1 2,512.9 2,638.9 2,772.9 2,915.2 3,067.1 3,230.8 3,407.4 3,598.6 MoP 642.4 652.5 663.5 676.9 691.7 708.1 726.5 747.1 770.4 797.1 828.2
CoP 1,641.1 1,756.2 1,882.7 2,015.5 2,156.4 2,306.0 2,463.6 2,629.1 2,803.6 2,987.0 3,177.7 CoP 480.2 502.2 521.9 543.0 565.4 589.2 614.3 640.9 669.2 699.6 732.4
CoC 629.6 665.0 708.9 756.2 806.4 858.8 914.0 971.6 1,031.6 1,094.3 1,159.7 CoC 184.2 190.2 196.5 203.7 211.4 219.4 227.9 236.8 246.2 256.3 267.3
MoM 86.6 91.6 97.2 103.1 109.4 116.2 123.5 131.5 140.4 150.3 161.6 MoM 25.4 26.2 26.9 27.8 28.7 29.7 30.8 32.0 33.5 35.1 37.2
Other 120.5 131.1 142.1 154.2 167.1 181.2 196.3 212.5 230.0 249.0 269.4 Other 35.3 37.5 39.4 41.5 43.8 46.3 48.9 51.8 54.9 58.3 62.1
Figure 38: Global Revision Hip Joint Reconstruction Figure 39: Global Revision Hip Joint Reconstruction
Market Value, $Million (by Bearing Surface) Procedure Volume, Thousand (by Bearing Surface)
400 120
350 100
300
80
250
200 60
150 40
100
20
50
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
MoP 170.5 177.3 186.6 196.9 207.8 219.3 231.9 245.3 259.5 275.6 293.5 MoP 66.2 68.4 70.8 73.6 76.6 79.9 83.5 87.6 91.9 96.9 102.6
CoP 176.1 188.9 204.0 219.7 236.6 254.4 274.0 296.1 318.3 341.1 364.1 CoP 42.7 44.1 45.4 46.9 48.4 49.9 51.6 53.7 55.7 57.6 59.7
CoC 101.2 105.6 111.7 118.1 124.6 131.6 139.0 147.2 155.4 163.1 171.2 CoC 21.9 22.0 22.2 22.5 22.7 23.0 23.4 23.8 24.3 24.6 25.1
MoM 8.2 8.4 8.9 9.4 10.0 10.6 11.3 12.1 13.1 14.2 15.7 MoM 3.0 3.2 3.5 3.8 4.2 4.6 5.1 5.7 6.3 7.0 7.9
Other 15.4 16.7 18.1 19.6 21.3 23.1 25.1 27.2 29.7 32.4 35.4 Other 4.1 4.5 4.9 5.4 6.0 6.5 7.2 7.9 8.8 9.7 10.8

Product Type
Global Primary and Revision Hip Joint Reconstruction Market (By Bearing Surface)
• The primary role of incorporating fixations having bearing surfaces is to ease out the friction and provide seamless mobility. The bearing surfaces
such as metal-on-polyethylene (MOP), ceramic-on-polyethylene (COP), ceramic-on-ceramic (COC), and metal-on-metal (MOM), among other type
of surfaces are used for hip joint reconstruction.
• Two class of bearing surfaces are used for joint reconstruction which includes hard-on-soft bearing and hard-on-hard bearing. MOP and COP are
part of hard-on-soft bearing whereas COC and MOM are part of hard-on-hard bearing surface.
• All bearing types have their own advantages and disadvantages. MOP and COP have advantages such as lesser coefficient of friction, better
lubrication, lower susceptibility to surface scratching. Disadvantage of MOP and COP includes release of metal ions causing oxidation and
roughening and periprosthetic osteolysis linked with the polyethylene wear particle. Whereas, in case of MOP and COC the advantages are that
these bearing surface generate minimal wear particles and even the size of the wear particles generated is too small (approx. 0.015 – 0.12 µm).
The disadvantage includes corrosion of the metal head and stem, squeaking noises, stripe wear, a rare bearing surface fracture or chipping while
insertion.
• The MOP remains dominant in the overall bearing surface segment owing to high end use, minimal friction and long term comfort. The market for
primary MOP bearing surface hip fixation is estimated to be $ 2,394.1 million in 2017. The market is likely to grow at a CAGR of 5.26% to reach
the market value of $ 3,598.6 million in the year 2025. The procedure volume for the primary MOP bearing surface hip fixation is estimated to be
663.5 thousand in 2017 growing at a CAGR of 2.93% to reach 828.2 thousand procedures by the year 2025.
• The COP is recently introduced in the market and is gaining popularity among the surgeons owing to characteristics such as minimal friction,
greater lubrication, and ease in mobility. The market for primary COP bearing surface hip fixation is estimated to be $ 1,882.7 million in 2017. The
market is likely to grow at a CAGR of 6.72% to reach the market value of $ 3,177.7 million in the year 2025. The procedure volume for the
primary COP bearing surface hip fixation is estimated to be 521.8 thousand in 2017 growing at a CAGR of 4.37% to reach 732.4 thousand
procedures by the year 2025.
• The market for primary COC bearing surface hip fixation is estimated to be $ 708.9 million in 2017. The market is likely to grow at a CAGR of
6.30% to reach the market value of $ 1,159.7 million in the year 2025. The procedure volume for the primary COC bearing surface hip fixation is
estimated to be 196.5 thousand in 2017 growing at a CAGR of 3.95% to reach 267.2 thousand procedures by the year 2025. The COC are
majorly used for its significant advantages such as ceramic is harder than metal counterparts, it is biologically inert in nature and produce least
wear. Ceramic on ceramic also has less coefficient of friction, inert wear particles and higher wettability properties. All such properties are major
reasons for market growth of COC bearing surface fixation for hip joint reconstruction.

Product Type
Global Knee Joint Reconstruction Market Figure 40: Global Knee Joint Reconstruction Market Value
Overview ($Billion)
• Total knee reconstruction is a surgical procedure carried to replace

25
the damaged surface of the knee joint. The damaged knee parts are
replaced with the artificial protheses that cemented, uncemented and
16.32
15.40
14.54
20
hybrid in nature based on the fixation type used.
13.72
12.95
12.22
11.53
10.88
10.27
15
9.70
• The knee consist of three parts the femur (thigh bone), the tibia (shin
9.15
bone) and the patella (kneecap). The femur and tibia is cushioned by 10
the meniscus (soft cartilage). The meniscus act as a cushion and help
in absorbing the shock. 5
• Osteoarthritis, inflammatory arthritis, injury and other problems in 0

the joint can result in the damage of this protective layer. The 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
damage causes pain and difficult in performing the daily task. Global Knee Joint Reconstruction Market Value ($Billion)
Therefore, knee reconstruction helps in replacing the damaged part
and providing patient the active lifestyle.
• The total knee joint reconstruction market value for the year 2017 Figure 41: Global Knee Joint Reconstruction Procedure
was estimated to be $10.27 billion and is likely to grow at a CAGR of Volume (Thousand)
• The total procedure volume for the knee joint reconstruction market 5000
was estimated to be 2,138.1 thousand in the year 2017. the
2,793.3
2,694.3
2,601.4
2,513.9
2,431.0
2,352.3
2,277.5
2,206.2
2,138.1
2,073.6
2,011.2
2,793.3 thousand.
3000
• The factors driving the market growth are rising prevalence of 2000
inflammatory diseases such as osteoarthritis, osteoporosis, and
inflammatory arthritis, among others. Other factors impacting the 1000
market growth are frequent launch of innovative knee reconstruction
products from key manufacturers such as Zimmer Biomet Holdings, 0
Inc., Johnson & Johnson Inc., Smith & Nephew plc, and Stryker 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Corporation among others.
Global Knee Joint Reconstruction Procedure Volume (Thousand)

Product Type
Global Knee Joint Reconstruction Market By Figure 42: Global Knee Joint Reconstruction Market
Procedure Type Value, $Million (by Procedure Type)
• Vast majority of total knee reconstruction surgeries are primary knee 180
replacement consisting of more than 90% of the total knee 160

reconstructions. 140
• Osteoarthritis is the major reason behind the most of the primary 120
knee replacement surgeries across the globe. Followed by avascular 100

necrosis, previous infection, trauma, and inflammatory arthritis, 80
among others reasons. Chronic inflammatory disorders, desire for 60
active lifestyle, knee injury and frequent launch of innovative joint 40
reconstruction products are primary reasons for the primary knee
20
replacement market
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• Primary knee replacement market value was estimated to be $9.65 Primary Knee Replacement 8,530 9,071 9,646 10,25 10,90 11,59 12,33 13,11 13,94 14,83 15,77
billion and is forecasted to grow at a CAGR of 6.34% to reach market Revision Knee Replacement 619.1 623.5 626.1 626.7 625.0 620.8 613.8 603.6 589.9 572.3 550.4
value of $15.77 billion. The procedure volume was estimated to be
2,007.8 thousand and is forecasted to grow at a CAGR of 3.80% to
reach procedure volume of 2,699.2 million.
• Primary knee replacement often leads to wears and tears, infections, Figure 43: Global Knee Joint Reconstruction Procedure
lysis, release of toxic metals ions and other problems that require the Volume, Thousand (by Procedure Type)
revision of the process.
• Revision knee replacement is done to remove the damaged artificial 3000
total/partial knee prostheses. The major reason for revision of the 2500
knee reconstruction includes aseptic loosening, pain, instability,
implant wear, lysis, malaligament, infection, dislocation, and implant 2000
fracture.
1500
• Revision knee replacement market value was estimated to be $626.1
million and is forecasted to decline at a CAGR of -1.84% to reach
1000
market value of $550.4 million. The procedure volume was estimated 500
to be 130.3 thousand and is forecasted to decline at a CAGR of -
4.18% to reach procedure volume of 94.2 thousand. 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Primary Knee Replacement 1,875 1,940 2,007 2,079 2,154 2,232 2,315 2,403 2,495 2,594 2,699
Revision Knee Replacement 136.1 133.3 130.3 127.0 123.4 119.5 115.2 110.6 105.5 100.1 94.2

Product Type
Figure 45: Global Primary Knee Joint Reconstruction Figure 46: Global Primary Knee Joint Reconstruction
10000 2000
9000 1800
8000 1600
7000 1400
6000 1200
5000 1000
4000 800
3000 600
2000 400
1000 200
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 2,753. 2,915. 3,098. 3,293. 3,503. 3,727. 3,967. 4,225. 4,500. 4,795. 5,109. Cemented 331.4 342.3 355.9 370.9 387.6 405.9 426.2 448.7 473.4 500.8 531.1
Uncemented 5,085. 5,374. 5,671. 5,982. 6,307. 6,648. 7,004. 7,376. 7,766. 8,173. 8,599. Uncemented 1,391.5 1,430.8 1,469.5 1,509.3 1,549.8 1,591.3 1,633.7 1,677.0 1,721.6 1,767.4 1,814.9
Hybrid 140.0 166.5 195.8 229.0 266.4 308.7 356.4 410.2 470.8 539.0 615.6 Hybrid 30.8 35.6 40.8 46.4 52.6 59.4 66.9 75.2 84.2 94.3 105.3
Others 552.3 614.8 680.9 753.1 831.1 915.4 1,006. 1,104. 1,210. 1,324. 1,448. Others 121.4 131.5 141.7 152.6 164.1 176.2 189.0 202.4 216.6 231.7 247.8
Figure 47: Global Revision Knee Joint Reconstruction Figure 48: Global Revision Knee Joint Reconstruction
Market Value, $Million ( by Fixation Type) Procedure Volume, Thousand (by Fixation Type)
80
400
70
350
60
300
50
250
200 40
150 30
100 20
50 10
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 354.6 351.6 347.5 342.4 336.1 328.5 319.7 309.6 298.2 285.5 271.5 Cemented 75.0 72.4 69.6 66.8 63.8 60.7 57.6 54.3 51.0 47.6 44.1
Uncemented 149.1 150.0 150.4 150.2 149.4 148.0 145.7 142.6 138.5 133.2 126.6 Uncemented 35.8 34.9 34.0 33.1 32.1 31.0 29.8 28.5 27.2 25.7 24.0
Hybrid 62.3 66.2 70.1 73.7 77.1 80.1 82.6 84.5 85.6 85.8 84.7 Hybrid 13.7 14.2 14.6 14.9 15.2 15.4 15.5 15.5 15.3 15.0 14.5
Others 53.1 55.7 58.1 60.4 62.5 64.3 65.8 66.9 67.7 67.9 67.5 Others 11.7 11.9 12.1 12.2 12.3 12.4 12.4 12.3 12.1 11.9 11.6

Product Type
Global Primary and Revision Knee Joint Figure 49: Global Primary Knee Joint Reconstruction
Reconstruction Market By Fixation Type Market Value Share (by Fixation Type)
• More than 50% of the knee replacement are uncemented fixations 80.00%
owing to its benefits such as less prone to revisions, low mortality 70.00%
as compared to cemented and hybrid fixations and better results 60.00%
post primary procedure. 50.00%
40.00%
• Cemented and hybrid fixation is also gaining momentum in the end 30.00%
use for the primary knee replacement surgery owing to ongoing 20.00%
innovation and use of antibiotic cement has resulted in better 10.00%
outcomes. 0.00%
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 17.67%17.64%17.72%17.84%17.99%18.18%18.41%18.67%18.97%19.30%19.68%
• However, as the use of uncemented fixation is rising the price of Uncemented 74.21%73.75%73.19%72.59%71.95%71.27%70.55%69.78%68.98%68.13%67.24%
the uncemented fixation is also increasing. Uncemented prostheses
Hybrid 1.64% 1.84% 2.03% 2.23% 2.44% 2.66% 2.89% 3.13% 3.38% 3.63% 3.90%
costliest among all the fixation, followed by cemented and hybrid
Other 6.47% 6.78% 7.06% 7.34% 7.62% 7.89% 8.16% 8.42% 8.68% 8.93% 9.18%
fixation.
• The market value for primary cemented knee fixation is estimated

to be $3,098.7 million in 2017. The market is likely to grow at a Figure 50: Global Revision Knee Joint Reconstruction
CAGR of 6.47% to reach the market value of $5,109.1 million in
Market Value Share (by Fixation Type)
the year 2025. The procedure volume for the primary cemented
knee fixation is estimated to be 355.9 thousand in 2017 growing at
a CAGR of 5.26% to reach 531.1 thousand procedures by the year 60.00%
2025. The increase of 1.5X is expected in the primary cemented 50.00%
knee replacement procedures over the forecast period. 40.00%
30.00%
• The primary uncemented knee fixation market value is estimated
20.00%
to be $5,671.2 million in 2017. The market is expected to grow at a
10.00%
CAGR of 5.32% to reach the market value of $8,599.8 million in
the year 2025. The procedure volume for the primary cemented 0.00%
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
knee fixation is estimated to be 1,469.5 thousand in 2017 growing Cemented 55.09%54.26%53.42%52.56%51.69%50.82%49.95%49.10%48.28%47.52%46.84%
at a CAGR of 2.67% to reach 1,814.9 thousand procedures by the Uncemented 26.27%26.19%26.11%26.05%25.99%25.93%25.88%25.81%25.73%25.63%25.50%
year 2025. The increase of 1.2X is expected in the primary Hybrid 10.06%10.62%11.19%11.76%12.33%12.89%13.45%13.99%14.51%14.98%15.40%
cemented knee replacement procedures over the forecast period. Other 8.58% 8.93% 9.28% 9.64% 9.99% 10.35%10.72%11.09%11.47%11.86%12.27%

Product Type
Figure 51: Global Primary Knee Joint Reconstruction Figure 52: Global Primary Knee Joint Reconstruction
Market Value, $Million (by Bearing Type) Procedure Volume, Thousand (By Bearing Type)
14000 2500
12000
2000
10000
8000 1500
6000 1000
4000
500
2000
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Unconstrained Fixed 5,630 6,079 6,564 7,085 7,647 8,252 8,904 9,606 10,36 11,17 12,05 Unconstrained Fixed 1,237 1,300 1,366 1,436 1,510 1,588 1,671 1,760 1,854 1,954 2,062
Unconstrained Mobile 787.2 802.6 816.6 828.8 839.0 846.8 851.7 853.4 851.4 845.0 833.7 Unconstrained Mobile 173.0 171.7 170.0 168.0 165.7 163.0 159.9 156.4 152.3 147.8 142.7
Posterior-Stabilized Fixed 1,723 1,795 1,870 1,947 2,026 2,108 2,191 2,277 2,364 2,454 2,545 Posterior-Stabilized Fixed 378.8 384.1 389.3 394.7 400.2 405.8 411.5 417.2 423.2 429.3 435.6
Others 389.9 393.2 395.3 395.9 394.9 392.0 387.0 379.6 369.4 356.1 339.3 Others 85.7 84.1 82.3 80.3 78.0 75.5 72.7 69.5 66.1 62.3 58.1
Figure 53: Global Revision Knee Joint Reconstruction Figure 54: Global Revision Knee Hip Joint Reconstruction
Market Value, $Million (by Bearing Type) Procedure Volume, Thousand (By Bearing Type)
90
400
80
350 70
300 60
250 50
200 40
150 30
100 20
50 10
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Unconstrained Fixed 362.5 363.0 362.4 360.7 357.8 353.4 347.4 339.7 330.1 318.4 304.3 Unconstrained Fixed 79.7 77.6 75.4 73.1 70.6 68.0 65.2 62.2 59.1 55.7 52.1
Unconstrained Mobile 102.8 103.3 103.6 103.4 102.9 101.9 100.5 98.6 96.1 93.0 89.4 Unconstrained Mobile 22.6 22.1 21.6 21.0 20.3 19.6 18.9 18.1 17.2 16.3 15.3
Posterior-Stabilized Fixed 140.7 142.0 143.0 143.4 143.4 142.7 141.4 139.3 136.4 132.6 127.9 Posterior-Stabilized Fixed 30.9 30.4 29.8 29.1 28.3 27.5 26.5 25.5 24.4 23.2 21.9
Others 13.1 15.1 17.1 19.1 21.0 22.8 24.5 26.0 27.3 28.2 28.8 Others 2.9 3.2 3.6 3.9 4.2 4.4 4.6 4.8 4.9 4.9 4.9

Product Type
Global Primary and Revision Knee Joint Figure 55: Global Primary Knee Joint Reconstruction
Reconstruction Market (by Bearing Type) Market Value Share (by Bearing Type)
• In the year 2017, there were approximately 70% primary 90.00%

procedures which includes uncemented fixations having 80.00%
unconstrainted fixed type of bearing. Additionally there were 70.00%
60.00%
approximately 15% primary procedures having cemented and
50.00%
unconstrained fixed or posterior stabilized fixed bearing type. 40.00%
30.00%
• There is 1.03X fold increase in the procedure volume of knee 20.00%
joint replacement market by bearing type in the year 2017 as 10.00%
compared to the year 2016. However, during the forecast the 0.00% 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
market is likely to grow by 1.34X fold owing to high adoption Unconstrained Fixed 66.00% 67.02% 68.05% 69.08% 70.11% 71.15% 72.19% 73.24% 74.29% 75.35% 76.42%
rate of knee reconstruction among the patients over the globe. Unconstrained Mobile 9.23% 8.85% 8.47% 8.08% 7.69% 7.30% 6.91% 6.51% 6.10% 5.70% 5.29%
Posterior-Stabilized Fixed 20.20% 19.80% 19.39% 18.99% 18.58% 18.17% 17.77% 17.36% 16.95% 16.55% 16.14%
Others 4.57% 4.33% 4.10% 3.86% 3.62% 3.38% 3.14% 2.89% 2.65% 2.40% 2.15%
• Knee joint reconstruction market in terms of bearing type is
majorly dominated by the fixed bearing type. Approximately
80% of the bearing type used for reconstruction are either
unconstrained fixed or posterior stabilized fixed. However, rest Figure 56: Global Revision Knee Joint Reconstruction
of the procedure incorporate the unconstrainted mobile type of Market Value Share (by Bearing Type)
bearing.
70.00%
• Other bearing types being used for the knee reconstruction 60.00%
includes posterior stabilised mobile, constrained condylar, and 50.00%
monobloc polyethylene tibia. Such bearing type are less used 40.00%
as compared to other bearings owing to high success, 30.00%
seamless mobility and comfort with the unconstrained fixed, 20.00%
unconstrained mobile and posterior-stabilized fixed bearing 10.00%
type. 0.00% 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Unconstrained Fixed 58.55% 58.22% 57.89% 57.56% 57.24% 56.92% 56.60% 56.29% 55.97% 55.64% 55.29%
Unconstrained Mobile 16.60% 16.57% 16.54% 16.50% 16.46% 16.42% 16.37% 16.33% 16.29% 16.25% 16.24%
Posterior-Stabilized Fixed 22.73% 22.78% 22.84% 22.89% 22.94% 22.99% 23.03% 23.08% 23.13% 23.18% 23.24%
Others 2.12% 2.43% 2.74% 3.05% 3.36% 3.68% 3.99% 4.31% 4.62% 4.93% 5.24%

Product Type
Global Shoulder Joint Reconstruction Market Figure 57: Global Shoulder Joint Reconstruction Market
Overview Value ($Billion)
• Shoulder replacement is less common as compared to hip and knee 2

joint reconstruction. However, there is significant rise in the number 1.8
of shoulder replacement owing to bone deformities such as 1.6
1.14
osteoporosis, sports related injury, cuff tear and osteoarthritis.
1.08
1.4
1.02
0.96
0.91
0.86
1.2
0.81
0.76
0.72
The shoulder is a ball socket joint consisting of head of the humerus
0.68
•
0.64
1
(upper arm bone) articulated with the socket of the glenoid. This 0.8
ball and socket joint aids in various types of movements of the arm. 0.6
This joint is lubricated by the synovial fluid. The strength and 0.4
stability is provided by the tendon and ligament. 0.2
0
• The shoulder joint replacement is provided when the cartilage 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
around the shoulder is damaged and the bones rub against each Global Shoulder Joint Reconstruction Market Value ($Billion)
other causing swelling, pain and stiffness in the joints. In the total
shoulder replacement both the humeral head and the socket is
replaced.
Figure 58: Global Shoulder Joint Reconstruction
• The total shoulder joint reconstruction market value for the year Procedure Volume (Thousand)
2017 was estimated to be $0.72 billion and is likely to grow at a
CAGR of 5.90% to reach the market value of $1.14 billion by the
243.2
year 2025. 300
230.1
218.0
206.7
196.3
186.6
250
177.4
The total procedure volume for the shoulder joint reconstruction
168.8
•
160.6
153.2
145.4
market was estimated to be 160.6 thousand in the year 2017. the 200
procedure volume growing at a CAGR of 5.35% is likely to reach
150
243.2 thousand.
100
• The most common reasons for patients undergoing shoulder 50
replacement were osteoarthritis majorly and cuff tear, among other
reasons. 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Product Type
Figure 59: Global Shoulder Joint Reconstruction Market Value, $Million (by Procedure Type)
700
600
500
400
300
200
100
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 60: Global Shoulder Joint Reconstruction Procedure Volume, Thousand (by Procedure Type)
140
120
100
80
60
40
20
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Product Type
Global Shoulder Joint Reconstruction Market Value (by Procedure Type)
• The reverse polarity total prosthetic replacement segment is the leading procedure type performed in the overall shoulder joint replacement
market. The market share for procedure volume of this procedure type was 45.15% in the year 2017 and is likely to capture 50.69% market
share by the end of the year 2025. Followed by total prosthetic replacement (32.87%) and hemi-arthroplasty (13.58%) in the year 2017.
• The market value of the total prosthetic replacement segment is likely to increase 1.77X folds by the year 2025 as compared to the year 2017.
Followed by total prosthetic replacement (1.46X) and hemi-arthroplasty (1.42X).
• The total prosthetic replacement segment market value for the year 2017 was estimated to be $236.8 million and is likely to grow at a CAGR of
4.89% to reach the market value of $347.2 million by the year 2025. The total procedure volume for the this segment was estimated to be 52.8
thousand in the year 2017. The procedure volume growing at a CAGR of 4.35% is likely to reach 74.0 thousand.
• The reverse polarity total prosthetic replacement segment market value for the year 2017 was estimated to be $325.3 million and is likely to grow
at a CAGR of 7.44% to reach the market value of $577.7 million by the year 2025. The total procedure volume for the this segment was estimated
to be 72.5 thousand in the year 2017. The procedure volume growing at a CAGR of 6.89% is likely to reach 123.2 thousand.
• The resurfacing total arthroplasty segment market value for the year 2017 was estimated to be $22.0 million and is likely to grow at a CAGR of
• The hemi-arthroplasty segment market value for the year 2017 was estimated to be $97.8 million and is likely to grow at a CAGR of 4.50% to
reach the market value of $139.2 million by the year 2025. The total procedure volume for the this segment was estimated to be 21.8 thousand in
the year 2017. The procedure volume growing at a CAGR of 3.97% is likely to reach 29.7 thousand.
• The resurfacing hemi-arthroplasty segment market value for the year 2017 was estimated to be $19.1 million and is likely to grow at a CAGR of
• The revision shoulder arthroplasty segment market value for the year 2017 was estimated to be $19.5 million and is likely to grow at a CAGR of

7. North America Joint Reconstruction
Market (Country-wise Analysis)
Summary

173
North America
North America Joint Reconstruction Market Overview
• The North America hip replacement market was valued $2.23 billion in 2017 and is expected to reach $3.96 billion in 2025. In 2017, primary hip
replacement increased by 1.23% and revision burden increased to 1.07% as compare to that of 2016. The future growth is expected to be driven
by the growing chronic conditions and younger patients undergoing joint replacement and requiring further revision surgeries during their lifetime.
• The North America shoulder replacement market was valued $287.4 million in 2017 and is expected to reach $444.1 million by 2025 growing at a
CAGR of 5.69% over the forecast period of 2018-2025. In 2016, the North America joint replacement market witnessed an increase in the
percentage of reverse shoulder arthroplasty procedures with a corresponding decrease in the percentage of resurfacing hemi-arthroplasty. The
percentage of prosthetic replacement has remained at 30.3% of all procedures in the year 2017; however, the cumulative trend is indicating
continuous increase over the forecast period.
• The North America knee replacement market was valued $4.47 billion in 2017 and expected to reach $8.27 billion by 2025 growing at a CAGR of
8.02% over the forecast period of 2018-2025. In North America, primary knee replacement is dominating the market along with uncemented
fixations and unconstrained fixed bearing types. The knee replacement market is dominating among all other type of replacement owing to age
related disorders, osteoarthritis affecting knee bone, and trauma related to sports and accident.
• In the North America region, the mean age of the people undergoing for primary and revision procedures is 67 that includes 59% of the females
population and 41% males population. However, female population undergoing total knee arthroplasty is higher (60.8%) as compared to females
undergoing total hip arthroplasty (56.3%). This is primarily because females are at high risk of suffering from osteoarthritis and osteoporosis as
compared to males.
• In the North America region, uncemented procedures are dominant owing to factors such as high preference among surgeons, long shelf life of the
fixation, less requirement of revision procedures as compared to cemented and hybrid fixations. The cost of uncemented prostheses is high as
compared to cemented and hybrid prostheses still it is highly used owing to previously explained benefits.

North America
Figure 61: North America Hip Joint Reconstruction Market Figure 62: North America Knee Joint Reconstruction
Value ($Billion) and Procedure Volume (Thousand) Market Value ($Billion) and Procedure Volume (Thousand)
8.27
3.96
7.65
3.64
1000 4.50
7.07
1600 9.00
3.36
6.54
3.12
900 4.00
6.06
2.90
1400 8.00
2.71
5.61
800 3.50
2.53
5.20
7.00
2.38
4.82
1200
2.24
700
4.47
2.11
3.00
2.01
4.15
6.00
3.86
600 1000
2.50 5.00
1,415.5
915.0
1,337.6
500
854.1
1,265.6
800
803.2
1,198.9
760.2
1,137.1
723.5 2.00
1,079.7
4.00
691.9
1,026.5
664.5
400
640.7
620.1
602.3
977.0
587.0
600
931.0
888.1
1.50
848.3
300 3.00
1.00 400 2.00
200
100 0.50 200 1.00
0 - 0 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Hip Joint Reconstruction Volume (Thousand) Hip Joint Reconstruction Value ($Billion) Knee Joint Reconstruction Volume (Thousand) Knee Joint Reconstruction Value ($Billion)
Figure 63: North America Shoulder Joint Reconstruction Figure 64: North America Shoulder Joint Reconstruction
Market Value ($Million) 444.1 Market Procedure Volume (Thousand)
94.8
120
417.9
89.3
394.0
84.5
372.2
80.2
352.2
500
76.3
333.9
100
72.8
317.1
69.6
301.6
66.7
287.4
64.1
273.9
61.7
262.9
59.5
400 80
300 60
200 40
100 20
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Shoulder Joint Reconstruction Market Value ($Million) Shoulder Joint Reconstruction Procedure Volume (Thousand)

North America
Figure 65: North America Hip Arthroplasty Market Value,

North America Hip Arthroplasty Market $Million (by Procedure Type)
3,413.5
• The North America primary hip replacement market value was
3,141.2
4000
2,905.4
estimated at $1.97 billion in 2017 and is expected to grow at a CAGR
2,699.7
2,519.4
3500
of 7.28% to reach a market value of $3.43 billion by the end of 2025.
2,359.0
2,215.5
2,086.7
1,970.2
The market is expected to grow by 1.73 fold over the forecast period. 3000
1,862.2
1,780.7
2500
• The North America primary hip replacement market volume was 2000
estimated to be 546.09 thousand in 2017 and is forecasted to grow at 1500
a CAGR of 4.91% to reach market volume of 786.24 thousand by the
506.1
460.5
418.9
381.3
347.2
316.4
288.3
262.9
239.8
218.5
201.1
1000
end of 2025.
44.5
41.2
38.3
35.8
33.6
31.6
29.9
28.3
26.8
25.4
24.4
500
• The North America revision hip replacement market is estimated to 0
grow by 2.11X in 2025 whereas the hip resurfacing market is 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
estimated to grow by 1.65X by 2025. Primary Hip Replacement Revision Hip Replacement Hip Resurfacing
• In North America, uncemented hip fixation is the leading owing to

better result, low mortality and long life stability. The segment is
estimated to be $1.40 billion in 2017 and is forecasted to grow at a Figure 66: North America Hip Arthroplasty Market
CAGR of 5.3% to reach market value of $2.10 billion by the end of Procedure Volume, Thousand (by Procedure Type)
2025. The market is expected to grow by 1.49X fold over the forecast
period. Whereas, the market volume was estimated to be 389.36
786.2
735.3
thousand in 2017 and is forecasted to grow at a CAGR of 3.01% to 900
693.1
657.9
628.0
reach market volume of 485.11 thousand by the end of 2025.
602.6
800
580.8
562.1
546.1
532.5
521.0
700
• The North America bearing surface segment is estimated to grow by 600
1.73X in 2025 whereas the leading bearing surface segment is MOP 500
which is estimated to grow by 1.56X by 2025. 400
118.5
109.2
100.9
300
93.6
87.1
81.2
75.8
71.0
• In North America, according to AJRR, 55.5% females have undergone
66.6
62.5
58.8
200
10.3
primary hip replacement whereas 45.5% males have undergone
9.7
9.2
8.7
8.4
8.1
7.8
7.4
7.6
7.3
7.1
100
primary hip replacement. 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

North America
Table 37: North America Primary Hip Arthroplasty Market Value, $Million (by Fixation Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 390.0 417.1 451.2 488.3 529.6 575.7 627.4 685.9 752.7 829.7 918.8 9.45%
Uncemented 1,312.4 1,350.1 1,404.8 1,462.8 1,526.5 1,597.1 1,675.4 1,762.9 1,862.3 1,975.7 2,106.0 5.34%
Hybrid 57.0 68.9 82.7 98.1 115.2 134.4 156.2 180.8 209.1 241.7 279.7 16.15%
Others 21.4 26.1 31.5 37.6 44.3 51.9 60.5 70.2 81.4 94.3 109.4 16.49%
Total 1,780.7 1,862.2 1,970.2 2,086.7 2,215.5 2,359.0 2,519.4 2,699.7 2,905.4 3,141.2 3,413.5 7.28%
Table 38: North America Primary Hip Arthroplasty Market and Procedure Volume, Thousand (by Fixation Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 114.0 119.2 125.0 131.5 138.8 147.0 156.3 167.1 179.5 194.1 211.5 7.02%
Uncemented 383.9 386.0 389.3 394.0 400.1 407.9 417.6 429.5 444.3 462.4 485.1 3.01%
Hybrid 16.6 19.7 22.9 26.4 30.2 34.3 38.9 44.0 49.9 56.6 64.4 13.59%
Others 6.2 7.4 8.7 10.1 11.6 13.2 15.0 17.1 19.4 22.0 25.1 13.90%
Total 520.9 532.4 546.0 562.1 580.8 602.5 628.0 657.8 693.1 735.2 786.2 4.91%

North America
Table 39: North America Revision Hip Arthroplasty Market Value, $Million (by Fixation Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 48.4 51.5 55.2 59.2 63.4 67.8 72.6 77.5 82.9 88.6 94.5 6.93%
Uncemented 104.2 112.5 122.6 133.6 145.6 158.8 173.3 189.2 206.7 225.9 246.8 9.16%
Hybrid 38.7 42.7 47.6 53.1 59.3 66.1 73.8 82.3 92.0 102.9 115.3 11.70%
Others 6.1 6.9 8.1 9.3 10.6 12.2 14.0 16.0 18.3 21.1 24.3 14.77%
Total 201.1 218.5 239.8 262.9 288.3 316.4 347.2 381.3 418.9 460.5 506.1 9.81%
Table 40: North America Revision Hip Arthroplasty Market and Procedure Volume, Thousand (by Fixation Type)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 14.3 14.8 15.3 15.9 16.6 17.2 18.0 18.8 19.6 20.6 21.6 4.47%
Uncemented 28.4 29.7 31.2 32.7 34.5 36.3 38.4 40.6 43.1 45.8 48.9 5.89%
Hybrid 13.5 14.9 16.4 18.1 19.9 22.0 24.2 26.8 29.7 33.0 36.8 10.69%
Others 2.5 3.0 3.5 4.1 4.7 5.5 6.3 7.3 8.3 9.6 11.0 15.10%
Total 58.8 62.5 66.5 70.9 75.8 81.1 87.0 93.6 100.9 109.1 118.5 7.60%

North America
Table 41: North America Primary Hip Arthroplasty Market Value, $Million (by Bearing Surface)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 1,291.0 1,333.4 1,393.0 1,456.7 1,526.8 1,604.5 1,691.0 1,787.9 1,898.1 2,024.1 2,169.2 5.85%
CoP 309.8 331.5 358.6 388.1 420.9 457.6 498.7 545.2 598.2 659.3 730.0 9.45%
CoC 94.4 104.3 116.2 129.4 144.0 160.4 178.8 199.7 223.6 251.2 283.1 11.84%
MoM 46.3 50.3 55.2 60.5 66.5 73.2 80.7 89.1 98.9 110.1 123.1 10.67%
Other 39.2 42.8 47.3 52.2 57.6 63.7 70.5 78.3 87.2 97.4 109.2 11.14%
Total 1,780.7 1,862.2 1,970.2 2,086.7 2,215.5 2,359.0 2,519.4 2,699.7 2,905.4 3,141.2 3,413.5 7.28%
Table 42: North America Primary Hip Arthroplasty Market and Procedure Volume, Thousand (by Bearing Surface)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 377.7 381.2 386.0 392.3 400.1 409.7 421.4 435.5 452.6 473.5 499.2 3.50%
CoP 90.6 94.7 99.3 104.5 110.3 116.9 124.3 132.8 142.7 154.4 168.2 7.03%
CoC 27.6 29.8 32.2 34.8 37.7 40.9 44.5 48.6 53.3 58.8 65.2 9.37%
MoM 13.5 14.3 15.2 16.3 17.4 18.6 20.1 21.7 23.5 25.7 28.3 8.20%
Other 11.4 12.2 13.1 14.0 15.1 16.2 17.5 19.0 20.7 22.7 25.1 8.68%
Total 520.9 532.4 546.0 562.1 580.8 602.5 628.0 657.8 693.1 735.2 786.2 4.91%

North America
Table 43: North America Revision Hip Arthroplasty Market Value, $Million (by Bearing Surface)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 105.4 112.3 121.0 130.5 140.7 151.8 163.9 177.0 191.4 207.7 225.8 8.15%
CoP 46.8 50.9 55.9 61.2 67.1 73.7 80.8 88.7 97.5 107.2 117.8 9.80%
CoC 15.5 16.8 18.4 20.1 22.0 24.1 26.4 28.9 31.7 34.7 38.1 9.51%
MoM 4.7 5.3 5.9 6.6 7.4 8.2 9.1 10.0 11.1 12.4 13.9 11.19%
Other 5.5 6.7 8.0 9.5 11.1 12.9 14.8 17.0 19.5 22.2 25.2 15.02%
Total 201.1 218.5 239.8 262.9 288.3 316.4 347.2 381.3 418.9 460.5 506.1 9.81%
Table 44: North America Revision Hip Arthroplasty Market and Procedure Volume, Thousand (by Bearing Surface)
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 40.9 43.3 45.9 48.7 51.8 55.2 59.0 63.1 67.8 73.0 78.9 7.12%
CoP 11.3 11.8 12.4 13.0 13.7 14.4 15.2 16.1 17.0 18.1 19.3 5.75%
CoC 3.3 3.5 3.6 3.8 4.0 4.2 4.4 4.6 4.9 5.2 5.5 5.48%
MoM 1.7 2.0 2.3 2.7 3.1 3.5 4.0 4.6 5.3 6.1 6.9 14.58%
Other 1.4 1.8 2.2 2.6 3.1 3.6 4.2 4.9 5.7 6.6 7.7 16.61%
Total 58.8 62.5 66.5 70.9 75.8 81.1 87.0 93.6 100.9 109.1 118.5 7.60%

North America
Figure 67: North America Knee Arthroplasty Market Value,

North America Knee Arthroplasty Market $Million (by Procedure Type)
• The North America primary knee replacement market value was
8,065.8
7,432.3
estimated at $4.24 billion in 2017 and is expected to grow at a CAGR 10000
6,850.1
of 8.39% to reach market value of $8.06 billion by the end of 2025.
6,315.7
9000
5,825.4
5,376.5
The market is expected to grow by 1.90X fold over the forecast 8000
4,964.9
4,587.7
period.
4,242.2
7000
3,924.5
3,634.2
6000
• The North America primary knee replacement market volume was 5000
estimated to be 882.96 thousand in 2017 and is forecasted to grow at 4000
a CAGR of 5.81% to reach market value of 1,380.31 thousand by the 3000
232.3
233.1
232.8
end of 2025.
230.6
231.1
228.1
227.8
225.0
222.6
215.3
205.4
2000
• The North America revision knee replacement market is estimated to 1000
grow by 2.11X in 2025. 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• In North America, uncemented knee fixation is the preferred fixation
type owing to long term benefits. The segment is estimated to be Primary Knee Replacement Revision Knee Replacement
$2.39 billion in 2017 and is expected to grow at a CAGR of 6.90% to
reach a market value of $4.07 billion by the end of 2025. The market
is expected to grow by 1.70X fold over the forecast period. Whereas, Figure 68: North America Knee Arthroplasty Market
the market volume was estimated to be 620.72 thousand in 2017 and Procedure Volume, Thousand (by Procedure Type)
is expected to grow at a CAGR of 4.21% to reach market volume of
859.93 thousand by the end of 2025.
1,380.3
1,299.9
1800
1,225.7
1,157.1
• The North America bearing type segment is estimated to grow by
1,093.7
1600
1,034.9
1.56X in 2025 whereas the leading bearing type segment is
980.4
1400
929.9
883.0
unconstrained fixed which is estimated to grow by 1.78X by 2025.
839.4
798.8
1200
• In North America, according to AJRR, 61.1% females have undergone 1000
primary knee surgeries whereas 38.9% males have undergone 800
primary knee surgery. 600 49.4
48.8
48.0
47.1
46.0
44.8
43.4
41.7
39.8
37.7
35.1
400
200
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

North America
Table 45: North America Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1,493.0 1,630.0 1,776.0 1,932.3 2,100.3 2,280.6 2,473.8 2,680.7 2,901.5 3,136.5 3,386.0 8.34%
Uncemented 2,110.7 2,248.1 2,395.6 2,554.3 2,725.4 2,910.0 3,108.9 3,323.7 3,555.4 3,805.3 4,074.7 6.90%
Hybrid 119.9 145.2 173.9 206.4 243.3 285.0 332.1 385.3 445.3 512.8 588.8 16.15%
Others 69.0 86.3 106.1 128.5 153.9 182.8 215.5 252.6 294.6 341.9 395.2 17.42%
Total 3,634.2 3,924.5 4,242.2 4,587.7 4,964.9 5,376.5 5,825.4 6,315.7 6,850.1 7,432.3 8,065.8 8.39%
Table 46: North America Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 179.7 191.4 204.0 217.6 232.4 248.4 265.8 284.7 305.2 327.6 352.0 7.11%
Uncemented 577.6 598.5 620.7 644.4 669.6 696.5 725.1 755.6 788.1 822.9 859.9 4.21%
Hybrid 26.4 31.1 36.2 41.8 48.0 54.9 62.3 70.6 79.7 89.7 100.8 13.38%
Others 15.2 18.5 22.1 26.0 30.4 35.2 40.5 46.3 52.7 59.8 67.6 14.61%
Total 798.8 839.4 883.0 929.9 980.4 1034.9 1093.7 1157.1 1225.7 1299.9 1380.3 5.81%

North America
Table 47: North America Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 48.9 46.9 44.8 42.5 40.0 37.3 34.5 31.4 28.2 24.9 21.4 -9.33%
Uncemented 108.1 108.5 108.6 108.2 107.2 105.7 103.5 100.5 96.7 91.8 86.0 -3.23%
Hybrid 55.3 58.8 62.3 65.5 68.5 71.2 73.5 75.2 76.1 76.2 75.2 1.98%
Others 4.7 5.9 7.1 8.4 9.6 10.7 11.8 12.8 13.6 14.2 14.6 8.26%
Total 225.0 228.1 230.6 232.3 233.1 232.8 231.1 227.8 222.6 215.3 205.4 -1.75%
Table 48: North America Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 10.3 9.7 9.0 8.3 7.6 6.9 6.2 5.5 4.8 4.1 3.5 -11.66%
Uncemented 25.9 25.3 24.6 23.8 23.0 22.1 21.2 20.1 19.0 17.7 16.3 -5.27%
Hybrid 12.2 12.6 13.0 13.3 13.5 13.7 13.8 13.8 13.6 13.3 12.9 -0.45%
Others 1.0 1.3 1.5 1.7 1.9 2.1 2.2 2.3 2.4 2.5 2.5 5.68%
Total 49.5 48.8 48.0 47.1 46.0 44.8 43.4 41.7 39.8 37.7 35.1 -4.09%

North America
Table 49: North America Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Posterior-Stabilized Fixed 719.6 761.3 806.0 853.3 903.6 957.0 1,013.6 1,073.7 1,137.1 1,204.0 1,274.4 5.90%
Others 189.0 192.3 195.1 197.3 198.6 198.9 198.1 195.8 191.8 185.8 177.4 -1.50%
Total 3,634.2 3,924.5 4,242.2 4,587.7 4,964.9 5,376.5 5,825.4 6,315.7 6,850.1 7,432.3 8,065.8 8.39%
Table 50: North America Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Unconstrained Fixed 520.8 557.3 596.9 639.8 686.3 736.9 791.8 851.7 916.8 988.0 1065.6 7.56%
Others 41.5 41.1 40.6 40.0 39.2 38.3 37.2 35.9 34.3 32.5 30.4 -3.85%
Total 798.8 839.4 883.0 929.9 980.4 1034.9 1093.7 1157.1 1225.7 1299.9 1380.3 5.81%

North America
Table 51: North America Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 4.0 5.2 6.5 7.7 8.9 10.0 11.1 12.1 12.9 13.6 14.0 8.94%
Total 225.0 228.1 230.6 232.3 233.1 232.8 231.1 227.8 222.6 215.3 205.4 -1.75%
Table 52: North America Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.9 1.1 1.3 1.6 1.8 1.9 2.1 2.2 2.3 2.4 2.4 6.34%
Total 49.5 48.8 48.0 47.1 46.0 44.8 43.4 41.7 39.8 37.7 35.1 -4.09%

North America
Figure 69: North America Shoulder Arthroplasty Market

North America Shoulder Arthroplasty Market Value ($Million) by Procedure Type
• The North America shoulder replacement market value was estimated
444.1
417.9
at $287.4 million in 2017 and is expected to grow at a CAGR of
394.0
372.2
500
5.69% to reach a market value of $444.1 million by the end of 2025.
352.2
333.9
450
317.1
301.6
The market is expected to grow by 1.54X fold over the forecast
287.4
273.9
400
262.9
period. 350
300
• The North America shoulder replacement market volume was 250
estimated to be 64.08 thousand in 2017 and is expected to grow at a 200
CAGR of 5.14% to reach a market value of 94.77 thousand by the 150
end of 2025. 100
50
• In North America, reverse polarity total prosthetic replacement 0
fixation is the leading segment. The market value of this segment was 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
estimated at $147.6 million in 2017 and is expected to grow at a
Shoulder Joint Reconstruction Market Value ($Million)
CAGR of 6.91% to reach a market value of $250.2 million by the end
of 2025. The market is expected to grow by 1.69X fold over the
forecast period. Whereas, the market volume was estimated to be
32.90 thousand in 2017 and is forecasted to grow at a CAGR of Figure 70: North America Shoulder Arthroplasty Market
6.36% to reach market volume of 53.39 thousand by the end of
2025. Procedure Volume (Thousand) by Procedure Type
• Shoulder replacement are increasing at high pace owing to boost in
the sports activities leading to rise in shoulder fractures.
94.8
120
89.3
Osteoarthritis is among one of the leading cause for shoulder
84.5
80.2
76.3
replacement. 100
72.8
69.6
66.7
64.1
61.7
59.5
80
60
40
20
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Shoulder Joint Reconstruction Procedure Volume (thousand)

North America
Figure 71: North America Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
300
250
200
150
100
50
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
131.7 138.9 147.6 156.7 166.8 177.7 189.6 202.7 217.0 232.8 250.2
Replacement
Figure 72: North America Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
60
50
40
30
20
10
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
29.8 31.3 32.9 34.7 36.6 38.7 41.1 43.7 46.6 49.8 53.4
Replacement
Revision Shoulder Arthroplasty - - - - - - - - - - -

The U.S.
The U.S. Joint Reconstruction Market Overview
• The U.S. hip replacement market was valued $2.03 billion in 2017 and is expected to reach $3.23 billion in 2025. In 2017, the primary hip
replacement market increased by 1.04% and revision burden increased to 0.93% as compare to 2016. Rise in hip fracture, osteoporosis and
osteoarthritis are the major factors contributing towards the rise in the market value and volume.
• The U.S. knee replacement market was valued $4.15 billion in 2017 and expected to reach $7.59 billion by 2025 growing at a CAGR of 7.86%
over the forecast period of 2018-2025. In the U.S., the uncemented fixation is identified as the dominant segment in terms of value and volume
contribution owing to high end use and high preference among surgeons. The dominating bearing type in the U.S. market was unconstrained fixed
as it provides long term stability and high success rate in replacement procedure.
• The U.S. shoulder replacement market was valued $257.3 million in 2017 and is expected to reach $376.2 million by 2025 growing at a CAGR of
4.87% over the forecast period of 2018-2025. The reverse polarity total prosthetic replacement segment is expected to grow by 1.60X by the year
2025 owing to rising end use in surgical procedures.
• According to Arthritis Foundation, one in every four 4 adults are affected by arthritis. There are about 100 types of arthritis that affects 64% of the
geriatric populace. Today approximately 50 million Americans are suffering from arthritis and 43% f people suffering from arthritis have arthritis-
attributable activity limitations. Owing to these factors there is immense market growth potential for joint reconstruction product manufacturers
dealing at domestic level and international players having regional presence.
• In the U.S. hip resurfacing is witnessing a decline and has reached to less than 1% of the total hip replacement owing to the fact that surgeons are
moving away from metal-on-metal prostheses. This procedure is being performed few hospital facilities in the U.S.
• Osteoarthritis being the major cause for joint reconstruction with 79% of the population undergoing replacement owing to this particular disease.
Avascular necrosis and rheumatoid arthritis are other major reason for the people undergoing joint replacement.

The U.S.
Figure 73: The U.S. Hip Joint Reconstruction Market Figure 74: The U.S. Knee Joint Reconstruction Market
Value ($Billion) and Procedure Volume (Thousand) Value ($Billion) and Procedure Volume (Thousand)
7.04
7.59
6.52
1400 8.00
3.23
6.05
3.06
2.88
5.60
1200 7.00
2.72
800 3.50
5.20
2.57
4.82
2.42
4.47
6.00
2.28
700 3.00
2.15
1000
4.15
2.03
3.85
1.92
3.58
600
1.83
2.50 5.00
800
1,299.4
1,231.0
500
1,167.2
4.00
1,107.7
2.00
1,052.1
746.8
1,000.2
716.6
600
688.8
400
663.3
951.7
639.9
618.4
906.3
598.7
3.00
863.8
580.6
1.50
564.1
824.0
549.0
535.3
786.8
300 400
1.00 2.00
200
0.50 200 1.00
100
0 - 0 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Hip Joint Reconstruction Volume (Thousand) Hip Joint Reconstruction Value ($Million) Knee Joint Reconstruction Volume (Thousand) Knee Joint Reconstruction Value ($Million)
Figure 75: The U.S. Shoulder Joint Reconstruction Market Figure 76: The U.S. Shoulder Joint Reconstruction Market
Value ($Million) Procedure Volume (Thousand)
80.3
76.7
73.4
376.2
500 90
70.3
358.9
67.4
342.3
64.7
326.4
62.1
311.1
80
59.7
296.5
57.4
282.8
55.2
269.6
400
53.2
257.3
70
245.3
235.1
60
300
50
200 40
30
100 20
10
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

The U.S.
Figure 77: The U.S. Hip Arthroplasty Market Value

The U.S. Hip Arthroplasty Market ($Million) by Procedure Type
• The U.S. primary hip replacement market value was estimated to be
2,744.0
$1.78 billion in 2017 and is expected to grow at a CAGR of 5.53% to
2,602.7
2,465.8
2,335.2
2,212.0
reach market value of $2.74 billion by the end of 2025. The market
2,095.4
3200
1,985.4
1,882.2
1,785.1
1,691.6
1,619.0
is expected to grow by 1.53X fold over the forecast period. 2700
2200
• US primary hip replacement market volume was estimated to be 1700
494.8 thousand in 2017 and is expected to grow at a CAGR of 3.20%
454.4
418.7
384.7
352.9
323.2
1200
295.7
270.3
246.9
225.3
205.1
188.4
to reach market volume of 632.0 thousand by the end of 2025.
36.2
34.6
32.9
31.3
29.8
28.4
27.0
25.7
24.5
23.3
22.4
700
200
• US revision hip replacement market is estimated to grow by 2.01X in
-300 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
2025 whereas the hip resurfacing market is estimated to grow by
1.47X by 2025.
• In the U.S., the uncemented hip fixation is the leading segment,
owing to high preference among surgeons. The segment market
value was estimated at $1.27 billion in 2017 and is forecasted to Figure 78: The U.S. Hip Arthroplasty Market Procedure
grow at a CAGR of 3.63% to reach market value of $1.69 billion by Volume (Thousand) by Procedure Type
the end of 2025. The market is expected to grow by 1.33X fold over
the forecast period. Whereas, the market volume was estimated to
588.3
609.2
632.0
569.0
551.4
700
535.3
be 352.8 thousand in 2017 and is forecasted to grow at a CAGR of
520.5
507.0
494.8
483.7
473.7
600
2025. 500
400
• US bearing surface segment is estimated to grow by 1.54X in 2025
300
whereas the leading bearing surface segment is MOP which is
106.4
99.3
92.7
86.6
estimated to grow by 1.38sX by 2025.
81.0
200
75.9
71.1
66.7
62.5
58.7
55.1
8.4
8.1
7.9
7.6
100
7.4
7.3
7.1
6.9
6.8
6.7
6.6
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

The U.S.
Table 53: The U.S. Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 354.6 378.9 408.8 440.5 474.6 511.3 550.9 593.3 638.9 687.4 738.6 7.66%
Uncemented 1193.2 1226.4 1272.8 1319.4 1368.0 1418.6 1471.0 1524.9 1580.6 1637.0 1692.9 3.63%
Hybrid 51.8 62.6 75.0 88.5 103.2 119.4 137.1 156.4 177.5 200.3 224.8 14.26%
Others 19.4 23.7 28.6 33.9 39.7 46.1 53.1 60.7 69.1 78.1 87.9 14.59%
Total 1619.0 1691.6 1785.1 1882.2 1985.4 2095.4 2212.0 2335.2 2465.8 2602.7 2744.0 5.53%
Table 54: The U.S. Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 103.7 108.3 113.3 118.6 124.4 130.6 137.3 144.5 152.4 160.8 170.0 5.27%
Uncemented 349.1 350.7 352.8 355.4 358.6 362.4 366.7 371.6 377.1 383.2 390.0 1.33%
Hybrid 15.2 17.9 20.8 23.8 27.1 30.5 34.2 38.1 42.4 46.9 51.8 11.74%
Others 5.7 6.8 7.9 9.1 10.4 11.8 13.2 14.8 16.5 18.3 20.2 12.04%
Total 473.7 483.7 494.8 507.0 520.5 535.3 551.4 569.1 588.3 609.2 632.0 3.20%

The U.S.
Table 55: The U.S. Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 45.3 48.3 51.9 55.6 59.4 63.4 67.6 71.7 76.1 80.5 84.9 6.24%
Uncemented 97.6 105.6 115.2 125.5 136.5 148.5 161.3 175.1 189.9 205.4 221.6 8.46%
Hybrid 36.3 40.0 44.7 49.9 55.6 61.8 68.7 76.2 84.5 93.6 103.5 10.99%
Others 5.7 6.5 7.6 8.7 10.0 11.4 13.0 14.8 16.8 19.2 21.8 14.04%
Total 188.4 205.1 225.3 246.9 270.3 295.7 323.2 352.9 384.7 418.7 454.4 9.11%
Table 56: The U.S. Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 13.4 13.9 14.5 15.0 15.6 16.2 16.8 17.4 18.1 18.8 19.5 3.80%
Uncemented 26.6 27.9 29.3 30.8 32.4 34.0 35.7 37.6 39.6 41.7 43.9 5.21%
Hybrid 12.7 14.0 15.5 17.0 18.7 20.6 22.6 24.9 27.3 30.1 33.1 9.98%
Others 2.4 2.8 3.3 3.9 4.5 5.2 5.9 6.8 7.7 8.7 9.9 14.37%
Total 55.1 58.7 62.5 66.7 71.1 75.9 81.1 86.6 92.7 99.3 106.4 6.91%

The U.S.
Table 57: The U.S. Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 1173.7 1211.2 1262.1 1313.9 1368.2 1425.2 1484.7 1546.5 1610.9 1677.1 1743.8 4.13%
CoP 281.7 301.1 324.9 350.0 377.2 406.4 437.9 471.5 507.7 546.3 586.8 7.66%
CoC 85.8 94.7 105.3 116.7 129.0 142.5 157.0 172.7 189.8 208.1 227.6 10.02%
MoM 42.1 45.7 50.0 54.6 59.6 65.0 70.8 77.1 83.9 91.2 98.9 8.86%
Other 35.6 38.9 42.8 47.1 51.6 56.6 61.9 67.7 74.0 80.7 87.8 9.32%
Total 1173.7 1211.2 1262.1 1313.9 1368.2 1425.2 1484.7 1546.5 1610.9 1677.1 1743.8 5.53%
Table 58: The U.S. Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 343.4 346.3 349.8 353.9 358.6 364.0 370.0 376.7 384.2 392.3 401.3 1.81%
CoP 82.4 86.1 90.1 94.3 98.9 103.8 109.2 115.0 121.2 127.9 135.3 5.29%
CoC 25.1 27.1 29.2 31.4 33.8 36.4 39.2 42.1 45.3 48.7 52.5 7.59%
MoM 12.3 13.1 13.9 14.7 15.6 16.6 17.6 18.8 20.0 21.3 22.8 6.44%
Other 10.4 11.1 11.9 12.7 13.5 14.5 15.4 16.5 17.7 18.9 20.2 6.90%
Total 473.7 483.7 494.8 507.0 520.5 535.3 551.4 569.1 588.3 609.2 632.0 3.20%

The U.S.
Table 59: The U.S. Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 98.7 105.5 113.7 122.5 131.9 141.9 152.6 163.8 175.8 188.9 202.7 7.46%
CoP 43.9 47.8 52.5 57.5 62.9 68.9 75.3 82.1 89.6 97.5 105.7 9.10%
CoC 14.5 15.8 17.3 18.9 20.7 22.6 24.6 26.8 29.1 31.6 34.2 8.81%
MoM 4.4 4.9 5.6 6.2 6.9 7.7 8.4 9.3 10.2 11.3 12.5 10.48%
Other 5.1 6.3 7.5 8.9 10.4 12.0 13.8 15.7 17.9 20.1 22.7 14.28%
Total 188.4 205.1 225.3 246.9 270.3 295.7 323.2 352.9 384.7 418.7 454.4 9.11%
Table 60: The U.S. Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 38.4 40.7 43.2 45.8 48.6 51.7 55.0 58.5 62.3 66.4 70.9 6.43%
CoP 10.6 11.2 11.7 12.3 12.9 13.5 14.2 14.9 15.7 16.5 17.3 5.07%
CoC 3.1 3.3 3.4 3.6 3.8 4.0 4.1 4.3 4.5 4.8 5.0 4.81%
MoM 1.6 1.9 2.2 2.5 2.9 3.3 3.8 4.3 4.9 5.6 6.3 13.84%
Other 1.4 1.7 2.1 2.5 2.9 3.4 4.0 4.6 5.3 6.1 6.9 15.87%
Total 55.1 58.7 62.5 66.7 71.1 75.9 81.1 86.6 92.7 99.3 106.4 6.91%

The U.S.
Figure 79: U.S. Knee Arthroplasty Market Value ($Million)

The U.S. Knee Arthroplasty Market by Procedure Type
• U.S. primary knee replacement market value was estimated to be
7,415.7
6,849.9
6,326.4
$3.94 billion in 2017 and is expected to grow at a CAGR of 8.24% to 9000
5,842.9
5,397.0
reach market value of $7.41 billion by the end of 2025. The market is 8000
4,986.5
4,608.4
4,260.5
7000
3,940.5
expected to grow by 1.74X over the forecast period.
3,645.1
3,374.2
6000
• US primary knee replacement market volume was estimated at 820.2 5000
4000
thousand in 2017 and is expected to grow at a CAGR of 5.65% to
3000
reach market value of 1,269.1 thousand by the end of 2025.
210.7
210.8
209.6
209.6
207.7
207.1
205.1
202.9
196.8
188.5
177.6
2000
1000
• US revision knee replacement market is estimated to grow by 0.84X
0
in 2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• In the U.S., the leading fixation type is uncemented fixation as it is Primary Knee Replacement Revision Knee Replacement
majorly being used for knee fixation and it has high rate of success
among all other segments. The segment market value is estimated to
be $2.22 billion in 2017 and is forecasted to grow at a CAGR of Figure 80: U.S. Knee Arthroplasty Market Procedure
6.75% to reach market value of $3.74 billion by the end of 2025. The Volume (Thousand) by Procedure Type
market is expected to grow by 1.68X fold over the forecast period.
Whereas, the market volume was estimated to be 576.6 thousand in
1,269.1
1,198.1
2017 and is forecasted to grow at a CAGR of 4.06% to reach market
1,132.0
1,070.5
1,013.2
volume of 790.6 thousand by the end of 2025.
959.8
1400
910.0
863.6
820.2
779.6
741.7
• US bearing type segment is estimated to grow by 1.88X in 2025 1200
1000
whereas the leading bearing type segment is unconstrained fixed
800
45.1
44.4
43.6
42.7
41.6
40.3
38.9
37.2
35.2
33.0
30.4
400
200
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

The U.S.
Table 61: The U.S. Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1386.2 1514.0 1649.7 1794.5 1949.5 2115.2 2291.9 2480.0 2679.7 2890.7 3113.0 8.19%
Uncemented 1959.7 2088.0 2225.2 2372.1 2529.7 2698.9 2880.3 3075.0 3283.6 3507.1 3746.3 6.75%
Hybrid 111.4 134.9 161.6 191.7 225.8 264.3 307.6 356.4 411.2 472.6 541.3 15.98%
Others 64.1 80.2 98.5 119.3 142.9 169.5 199.7 233.7 272.0 315.1 363.4 17.25%
Total 3374.2 3645.1 3940.5 4260.5 4608.4 4986.5 5397.0 5842.9 6326.4 6849.9 7415.7 8.24%
Table 62: The U.S. Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 166.9 177.8 189.5 202.1 215.7 230.4 246.2 263.3 281.9 301.9 323.6 6.96%
Uncemented 536.2 555.9 576.6 598.4 621.6 646.0 671.8 699.1 727.9 758.4 790.6 4.06%
Hybrid 24.5 28.8 33.6 38.9 44.6 50.9 57.8 65.3 73.6 82.7 92.6 13.21%
Others 14.1 17.2 20.5 24.2 28.2 32.6 37.5 42.8 48.7 55.1 62.2 14.45%
Total 741.7 779.6 820.2 863.6 910.0 959.8 1013.2 1070.5 1132.0 1198.1 1269.1 5.65%

The U.S.
Table 63: The U.S. Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 44.6 42.7 40.7 38.6 36.2 33.6 30.9 28.0 24.9 21.8 18.5 -9.95%
Uncemented 98.5 98.8 98.7 98.1 96.9 95.2 92.7 89.5 85.4 80.4 74.3 -3.89%
Hybrid 50.5 53.6 56.6 59.4 62.0 64.1 65.8 67.0 67.3 66.7 65.0 1.29%
Others 4.3 5.4 6.5 7.6 8.6 9.6 10.6 11.4 12.0 12.4 12.6 7.53%
Total 205.1 207.7 209.6 210.7 210.8 209.6 207.1 202.9 196.8 188.5 177.6 -2.41%
Table 64: The U.S. Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 9.4 8.8 8.2 7.5 6.9 6.2 5.6 4.9 4.3 3.6 3.0 -12.26%
Uncemented 23.6 23.0 22.3 21.6 20.8 19.9 19.0 17.9 16.8 15.5 14.1 -5.92%
Hybrid 11.1 11.5 11.8 12.0 12.2 12.3 12.4 12.3 12.0 11.7 11.1 -1.13%
Others 0.9 1.2 1.4 1.5 1.7 1.9 2.0 2.1 2.1 2.2 2.2 4.96%
Total 45.1 44.4 43.6 42.7 41.6 40.3 38.9 37.2 35.2 33.0 30.4 -4.75%

The U.S.
Table 65: The U.S. Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 175.5 178.6 181.3 183.2 184.3 184.5 183.5 181.1 177.1 171.2 163.1 -1.64%
Total 3374.2 3645.1 3940.5 4260.5 4608.4 4986.5 5397.0 5842.9 6326.4 6849.9 7415.7 8.24%
Table 66: The U.S. Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 38.6 38.2 37.7 37.1 36.4 35.5 34.5 33.2 31.7 30.0 27.9 -3.99%
Total 741.7 779.6 820.2 863.6 910.0 959.8 1013.2 1070.5 1132.0 1198.1 1269.1 5.65%

The U.S.
Table 67: The U.S. Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 3.7 4.8 5.9 7.0 8.0 9.0 9.9 10.8 11.4 11.9 12.1 8.20%
Total 205.1 207.7 209.6 210.7 210.8 209.6 207.1 202.9 196.8 188.5 177.6 -2.41%
Table 68: The U.S. Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.8 1.0 1.2 1.4 1.6 1.7 1.9 2.0 2.0 2.1 2.1 5.62%
Total 45.1 44.4 43.6 42.7 41.6 40.3 38.9 37.2 35.2 33.0 30.4 -4.75%

The U.S.
Figure 81: U.S. Shoulder Arthroplasty Market Value

U.S. Shoulder Arthroplasty Market ($Million) by Procedure Type
• US shoulder replacement market value was estimated at $257.3 500.0
376.2
358.9
342.3
450.0
326.4
million in 2017 and is expected to grow at a CAGR of 4.87% to reach
311.1
296.5
400.0
282.8
269.6
257.3
market value of $376.2 million by the end of 2025. The market is
245.3
235.1
350.0
300.0
expected to grow by 1.46X fold over the forecast period.
250.0
200.0
• US shoulder replacement market volume was estimated at 57.4 150.0
100.0
thousand in 2017 and is expected to grow at a CAGR of 4.33% to
50.0
reach market value of 80.3 thousand by the end of 2025. -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• In the U.S., reverse polarity total prosthetic replacement fixation is Shoulder Joint Reconstruction Market Value ($Million)
the leading segment. The market value of this segment is estimated
to be $132.1 million in 2017 and is forecasted to grow at a CAGR of
Figure 82: U.S. Shoulder Arthroplasty Market Procedure
6.09% to reach market value of $211.9 million by the end of 2025.
Volume (Thousand) by Procedure Type
80.3
76.7
73.4
70.3
thousand in 2017 and is forecasted to grow at a CAGR of 5.54% to 90.0
67.4
64.7
62.1
59.7
80.0
57.4
55.2
53.2
reach market volume of 45.2 thousand by the end of 2025. 70.0
60.0
50.0
40.0
30.0
20.0
10.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Joint Reconstruction Procedure Volume (thousand)

The U.S.
Figure 83: The U.S Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
250.0
200.0
150.0
100.0
50.0
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
117.8 124.4 132.1 140.1 148.7 157.8 167.5 177.8 188.5 200.0 211.9
Replacement
Figure 84: The U.S Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
50.0
45.0
40.0
35.0
30.0
25.0
20.0
15.0
10.0
5.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
26.7 28.0 29.5 31.0 32.6 34.4 36.3 38.3 40.5 42.8 45.2
Replacement

Canada
Canada Joint Reconstruction Market Overview
• The Canada hip replacement market was valued $201.9 million in 2017 and expected to reach $729.2 million in 2025. In 2017,
primary hip replacement increased by 3.07% and revision burden increased to 3.06% as compared to that of 2016. In Canada,
According to Canada Joint Replacement Registry (CJRR), major factors influencing the market value and volume growth are
degenerative arthritis (74.1%) and acute hip fracture (14.9%).
• Canada knee replacement market was valued $322.7 million in 2017 and expected to reach $677.9 million by 2025 growing at a
CAGR of 9.96% over the forecast period of 2018-2025. In Canada, the uncemented fixation is the leading segment in terms of value
and volume contribution owing to high end use and high preference among surgeons. The dominating bearing type in the US
market was unconstrained fixed as it provide long term stability and high success rate in replacement procedure.
• Canada shoulder replacement market was valued at $30.1 million in 2017 and expected to reach $67.9 million by 2025 growing at a
CAGR of 11.39% over the forecast period of 2018-2025. The reverse polarity total prosthetic replacement segment is expected to
grow by 2.47X by the year 2025 owing to rising end use in surgical procedures.
• According to CJRR, In Canada, there is 17.8% rise in the hip replacement procedure where in case of knee replacement procedures
there was an increase of 15.5% in the last five years (2012-2016). However, in the year 2016-2017, hip and knee replacement
procedures witnessed increase of about 8.3% and 7.1%.
• For deciding the rate of revision procedures, in case of hip replacement, the surgeon arthroplasty volume along with the method
applied for the femoral head fixation played a vital role in lowering down the rate of revision. Additionally, in case off knee
replacement procedures, age, sex and the extent of the procedure player a highly significant role in influencing the rate of revision.

Canada
Figure 84: Canada Hip Joint Reconstruction Market Value Figure 85: Canada Knee Joint Reconstruction Market
($Million) and Procedure Volume (Thousand) Value ($Million) and Procedure Volume (Thousand)
729.2
677.9
609.2
180 800 140 800
586.7
549.5
700
497.6
160 700 120
479.0
452.4
413.1
140 600
397.3
600
378.8
100
348.9
335.1
120
322.7
500
299.8
500
287.5
279.8
80
250.9
100
168.2
223.1
201.9
400 400
186.1
116.0
51.6 176.4
106.6
137.5
80 60
98.3
114.4
300 300
91.2
84.9
60
79.5
96.9
74.8
70.7
40
67.2
83.6
64.1
61.5
73.5
200 200
65.8
40
60.1
56.0
53.2
20 100 20 100
0 0 0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 86: Canada Shoulder Joint Reconstruction Market Figure 87: Canada Shoulder Joint Reconstruction Market
14.5
67.9
80
12.6
16
58.9
11.1
51.7
70 14
45.9
9.9
60
41.1
12
8.9
37.3
34.3
8.1
31.9
50
7.5
30.1
10
28.6
7.1
27.8
6.7
6.4
40 8 6.3
30 6
20
4
10
2
0
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Shoulder Joint Reconstruction Market Value ($Million) Shoulder Joint Reconstruction Procedure Volume (thousand)

Canada
Figure 88: Canada Hip Arthroplasty Market Value

Canada Hip Arthroplasty Market
($Million) by Procedure Type
• Canada primary hip replacement market value was estimated to be
669.5
$185.1 million in 2017 and is forecasted to grow at a CAGR of 800
538.5
700
439.5
600
period.
364.5
500
307.4
263.6
230.1
• Canada primary hip replacement market volume was estimated to be 400
204.5
185.1
170.6
161.7
51.3 thousand in 2017 and is forecasted to grow at a CAGR of 300
51.7
200
41.8
34.2
28.4
24.0
20.6
18.0
16.0
14.5
13.4
12.7
2025.
8.2
6.6
5.4
4.5
3.8
3.2
2.8
2.5
2.3
2.0
2.1
100
• Canada revision hip replacement market is estimated to grow by 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
3.56X in 2025 whereas the hip resurfacing market is estimated to
grow by 3.60X by 2025.
• In Canada, uncemented fixations remains the leading segment as a
globally accepted trend. The market value of this segment is
estimated to be $132.0 million in 2017 and is forecasted to grow at a
CAGR of 16.32% to reach market value of $413.1 million by the end Figure 89: Canada Hip Arthroplasty Market Procedure
of 2025. Volume (Thousand) by Procedure Type
• Canada bearing surface segment is estimated to grow by 3.62X in
2025 whereas the leading bearing surface segment is MOP which is
154.2
estimated to grow by 3.25X by 2025. 180
126.0
160
• According to CJRR, the use cemented fixation is likely to lower down
104.9
140
the revision risk by 2.8% within 3 years whereas for uncemented the
88.8
120
risk is 4.8%.
76.6
67.3
100
60.3
55.1
51.3
48.8
47.3
• Additionally, the risk of revision with uncemented fixation higher 80
when the surgeon has done less than 50 replacement in a particular 60
12.1
year. 40
9.9
8.2
7.0
6.0
5.3
4.7
4.3
4.0
3.8
3.7
1.9
1.6
1.3
1.1
0.9
0.8
0.7
0.7
0.6
0.6
20 0.6
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Canada
Table 69: Canada Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 35.4 38.2 42.4 47.9 55.0 64.3 76.5 92.6 113.9 142.2 180.2 20.85%
Uncemented 119.2 123.7 132.0 143.4 158.5 178.5 204.4 238.0 281.7 338.7 413.1 16.32%
Hybrid 5.2 6.3 7.8 9.6 12.0 15.0 19.1 24.4 31.6 41.4 54.9 28.25%
Others 1.9 2.4 3.0 3.7 4.6 5.8 7.4 9.5 12.3 16.2 21.4 28.63%
Total 161.7 170.6 185.1 204.5 230.1 263.6 307.4 364.5 439.5 538.5 669.5 18.46%
Table 70: Canada Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 10.4 10.9 11.8 12.9 14.4 16.4 19.1 22.6 27.2 33.3 41.5 18.17%
Uncemented 34.9 35.4 36.6 38.6 41.6 45.6 51.0 58.0 67.2 79.3 95.1 13.75%
Hybrid 1.5 1.8 2.2 2.6 3.1 3.8 4.8 6.0 7.6 9.7 12.6 25.43%
Others 0.6 0.7 0.8 1.0 1.2 1.5 1.8 2.3 2.9 3.8 4.9 25.76%
Total 47.3 48.8 51.3 55.1 60.3 67.3 76.6 88.8 104.9 126.0 154.2 15.84%

Canada
Table 71: Canada Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 3.1 3.2 3.3 3.6 4.0 4.4 5.0 5.8 6.8 8.0 9.7 15.12%
Uncemented 6.6 6.9 7.4 8.1 9.1 10.3 12.0 14.1 16.9 20.5 25.2 17.53%
Hybrid 2.4 2.6 2.9 3.2 3.7 4.3 5.1 6.1 7.5 9.3 11.8 20.26%
Others 0.4 0.4 0.5 0.6 0.7 0.8 1.0 1.2 1.5 1.9 2.5 23.56%
Total 12.7 13.4 14.5 16.0 18.0 20.6 24.0 28.4 34.2 41.8 51.7 18.22%
Table 72: Canada Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.9 0.9 0.9 1.0 1.0 1.1 1.2 1.4 1.6 1.9 2.2 12.47%
Uncemented 1.8 1.8 1.9 2.0 2.2 2.4 2.7 3.0 3.5 4.2 5.0 14.00%
Hybrid 0.9 0.9 1.0 1.1 1.2 1.4 1.7 2.0 2.4 3.0 3.8 19.17%
Others 0.2 0.2 0.2 0.3 0.3 0.4 0.4 0.5 0.7 0.9 1.1 23.92%
Total 3.7 3.8 4.0 4.3 4.7 5.3 6.0 7.0 8.2 9.9 12.1 15.84%

Canada
Table 73: Canada Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 117.3 122.1 130.9 142.8 158.6 179.3 206.3 241.4 287.2 347.0 425.5 16.88%
CoP 28.1 30.4 33.7 38.0 43.7 51.1 60.8 73.6 90.5 113.0 143.2 20.85%
CoC 8.6 9.6 10.9 12.7 15.0 17.9 21.8 27.0 33.8 43.1 55.5 23.49%
MoM 4.2 4.6 5.2 5.9 6.9 8.2 9.8 12.0 15.0 18.9 24.1 22.20%
Other 3.6 3.9 4.4 5.1 6.0 7.1 8.6 10.6 13.2 16.7 21.4 22.71%
Total 161.7 170.6 185.1 204.5 230.1 263.6 307.4 364.5 439.5 538.5 669.5 18.46%
Table 74: Canada Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 34.3 34.9 36.3 38.5 41.6 45.8 51.4 58.8 68.5 81.2 97.9 14.29%
CoP 8.2 8.7 9.3 10.2 11.5 13.1 15.2 17.9 21.6 26.5 33.0 18.18%
CoC 2.5 2.7 3.0 3.4 3.9 4.6 5.4 6.6 8.1 10.1 12.8 20.77%
MoM 1.2 1.3 1.4 1.6 1.8 2.1 2.5 2.9 3.6 4.4 5.6 19.47%
Other 1.0 1.1 1.2 1.4 1.6 1.8 2.1 2.6 3.1 3.9 4.9 20.00%
Total 47.3 48.8 51.3 55.1 60.3 67.3 76.6 88.8 104.9 126.0 154.2 15.84%

Canada
Table 75: Canada Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 6.7 6.9 7.3 8.0 8.8 9.9 11.3 13.2 15.6 18.8 23.1 16.44%
CoP 3.0 3.1 3.4 3.7 4.2 4.8 5.6 6.6 8.0 9.7 12.0 18.21%
CoC 1.0 1.0 1.1 1.2 1.4 1.6 1.8 2.2 2.6 3.1 3.9 17.91%
MoM 0.3 0.3 0.4 0.4 0.5 0.5 0.6 0.7 0.9 1.1 1.4 19.71%
Other 0.3 0.4 0.5 0.6 0.7 0.8 1.0 1.3 1.6 2.0 2.6 23.83%
Total 12.7 13.4 14.5 16.0 18.0 20.6 24.0 28.4 34.2 41.8 51.7 18.22%
Table 76: Canada Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 2.6 2.7 2.8 3.0 3.2 3.6 4.1 4.7 5.5 6.6 8.1 15.33%
CoP 0.7 0.7 0.8 0.8 0.9 0.9 1.1 1.2 1.4 1.6 2.0 13.85%
CoC 0.2 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.4 0.5 0.6 13.57%
MoM 0.1 0.1 0.1 0.2 0.2 0.2 0.3 0.3 0.4 0.6 0.7 23.35%
Other 0.1 0.1 0.1 0.2 0.2 0.2 0.3 0.4 0.5 0.6 0.8 25.55%
Total 3.7 3.8 4.0 4.3 4.7 5.3 6.0 7.0 8.2 9.9 12.1 15.84%

Canada
Figure 90: Canada Knee Arthroplasty Market Value

Canada Knee Arthroplasty Market ($Million) by Procedure Type
• Canada primary knee replacement market value was estimated to be
650.1
$322.7 million in 2017 and is forecasted to grow at a CAGR of 9.96% 800
582.4
523.7
to reach market value of $677.9 billion by the end of 2025. The 700
472.7
428.5
600
390.0
356.5
327.2
• Canada primary knee replacement market volume was estimated to 500
301.7
279.4
260.0
be 67.2 thousand in 2017 and is forecasted to grow at a CAGR of 400
7.33% to reach market value of 116.0 thousand by the end of 2025. 300
• Canada revision knee replacement market is estimated to grow by 200
27.8
26.8
25.8
24.9
24.0
23.1
22.3
21.6
21.0
20.4
19.9
3.56X in 2025. 100
0
• In Canada, the leading fixation type is uncemented fixation as it is 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
majorly being used for knee fixation and it has high rate of success
among all other segments. The segment market value is estimated to Primary Knee Replacement Revision Knee Replacement
be $132.0 million in 2017 and is forecasted to grow at a CAGR of
period. Figure 91: Canada Knee Arthroplasty Market Procedure
• According to CJRR, the risk of revision in males is higher than in
females within the 4 year of primary revision. As a trend, it has been
observed that the rate of revision has significantly decreased for both
111.3
101.9
the sexes with increasing age. 130
93.7
86.6
• The rate of revision is 2% for 75 year old men and above when 110
80.4
75.1
70.4
66.3
compared with 5.9% for those younger than 55 year. However, for
62.8
90
59.8
57.1
females having age 75 year or older the rate of revision is 1.5% 70
compared with the 4.3% for those younger than 55 years. Partial
knee replacement has higher risk of revision (3.5% -6.1%) as 50
compared to total knee replacement (1.6% to 1.9%). 30
4.8
4.7
4.6
4.6
4.5
4.5
4.4
4.4
4.4
4.4
4.4
10
-10 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Canada
Table 77: Canada Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 106.8 116.0 126.3 137.8 150.8 165.4 182.0 200.7 221.8 245.8 272.9 10.25%
Uncemented 151.0 160.1 170.4 182.2 195.7 211.1 228.7 248.8 271.8 298.2 328.4 8.78%
Hybrid 8.6 10.3 12.4 14.7 17.5 20.7 24.4 28.8 34.0 40.2 47.5 18.20%
Others 4.9 6.1 7.5 9.2 11.1 13.3 15.9 18.9 22.5 26.8 31.9 19.48%
Total 260.0 279.4 301.7 327.2 356.5 390.0 428.5 472.7 523.7 582.4 650.1 10.30%
Table 78: Canada Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 12.9 13.6 14.5 15.5 16.7 18.0 19.5 21.3 23.3 25.7 28.4 9.00%
Uncemented 41.3 42.6 44.2 46.0 48.1 50.5 53.3 56.6 60.3 64.5 69.3 6.04%
Hybrid 1.9 2.2 2.6 3.0 3.4 4.0 4.6 5.3 6.1 7.0 8.1 15.37%
Others 1.1 1.3 1.6 1.9 2.2 2.6 3.0 3.5 4.0 4.7 5.5 16.63%
Total 57.1 59.8 62.8 66.3 70.4 75.1 80.4 86.6 93.7 101.9 111.3 7.67%

Canada
Table 79: Canada Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 4.3 4.2 4.1 4.0 3.8 3.7 3.6 3.4 3.3 3.1 2.9 -4.35%
Uncemented 9.5 9.7 9.9 10.1 10.3 10.5 10.7 11.0 11.2 11.4 11.6 2.08%
Hybrid 4.9 5.3 5.7 6.1 6.6 7.1 7.6 8.2 8.8 9.5 10.2 7.58%
Others 0.4 0.5 0.7 0.8 0.9 1.1 1.2 1.4 1.6 1.8 2.0 14.21%
Total 19.9 20.4 21.0 21.6 22.3 23.1 24.0 24.9 25.8 26.8 27.8 3.65%
Table 80: Canada Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.9 0.9 0.8 0.8 0.7 0.7 0.6 0.6 0.6 0.5 0.5 -6.81%
Uncemented 2.3 2.3 2.2 2.2 2.2 2.2 2.2 2.2 2.2 2.2 2.2 -0.07%
Hybrid 1.1 1.1 1.2 1.2 1.3 1.4 1.4 1.5 1.6 1.7 1.7 5.01%
Others 0.1 0.1 0.1 0.2 0.2 0.2 0.2 0.3 0.3 0.3 0.3 11.48%
Total 4.4 4.4 4.4 4.4 4.4 4.5 4.5 4.6 4.6 4.7 4.8 1.17%

Canada
Table 81: Canada Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 13.5 13.7 13.9 14.1 14.3 14.4 14.6 14.7 14.7 14.6 14.3 0.23%
Total 260.0 279.4 301.7 327.2 356.5 390.0 428.5 472.7 523.7 582.4 650.1 10.30%
Table 82: Canada Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 3.0 2.9 2.9 2.9 2.8 2.8 2.7 2.7 2.6 2.5 2.4 -2.16%
Total 57.1 59.8 62.8 66.3 70.4 75.1 80.4 86.6 93.7 101.9 111.3 7.67%

Canada
Table 83: Canada Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.4 0.5 0.6 0.7 0.8 1.0 1.2 1.3 1.5 1.7 1.9 14.93%
Total 19.9 20.4 21.0 21.6 22.3 23.1 24.0 24.9 25.8 26.8 27.8 3.65%
Table 84: Canada Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.1 0.1 0.1 0.1 0.2 0.2 0.2 0.2 0.3 0.3 0.3 12.18%
Total 4.4 4.4 4.4 4.4 4.4 4.5 4.5 4.6 4.6 4.7 4.8 1.17%

Canada
Figure 92: Canada Shoulder Arthroplasty Market Value

Canada Shoulder Arthroplasty Market ($Million) by Procedure Type
• Canada shoulder replacement market value was estimated to be
67.9
80.0
$30.1 million in 2017 and is expected to grow at a CAGR of 11.39%
58.9
70.0
51.7
to reach market value of $67.9 million by the end of 2025. The
45.9
60.0
41.1
37.3
34.3
market is expected to grow by 2.25X fold over the forecast period. 50.0
31.9
30.1
28.6
27.8
40.0
• Canada shoulder replacement market volume was estimated to be 30.0
20.0
6.45 thousand in 2017 and is forecasted to grow at a CAGR of
10.0
10.82% to reach market value of 14.50 thousand by the end of -
2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

• In Canada, reverse polarity total prosthetic replacement fixation
remains the leading segment. The market value of this segment is
estimated to be $15.4 million in 2017 and is forecasted to grow at a Figure 93: Canada Shoulder Arthroplasty Market
CAGR of 12.68% to reach market value of $38.3 million by the end of Procedure Volume (Thousand) by Procedure Type
2025. The market is expected to grow by 2.47X fold over the
14.5
12.6
16.0
11.1
3.27 thousand in 2017 and is forecasted to grow at a CAGR of 14.0
9.9
12.0
8.9
8.1
7.5
7.1
10.0
6.7
6.4
6.3
2025. 8.0
6.0
4.0
2.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Shoulder Joint Reconstruction Procedure Volume (Thousand)

Canada
Figure 94: Canada Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
45
40
35
30
25
20
15
10
5
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
13.9 14.5 15.4 16.6 18.0 19.9 22.2 25.0 28.5 32.8 38.3
Replacement
Figure 95: Canada Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
9
8
7
6
5
4
3
2
1
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
3.2 3.3 3.4 3.7 4.0 4.3 4.8 5.4 6.1 7.0 8.2
Replacement

8. Europe Joint Reconstruction Market
(Country-wise Analysis)
Summary

216
Europe
Europe Joint Reconstruction Market Overview
• Europe hip replacement market was valued $2.32 billion in 2017 and is expected to reach $3.31 billion in 2025. In 2017, primary hip replacement
increased by 0.8% and revision burden increased to 2.3% as compared to that of 2016.
• Europe knee replacement market was valued $3.18 billion in 2017 and expected to reach $4.28 billion by 2025 growing at a CAGR of 3.74% over
the forecast period of 2018-2025.
• Europe shoulder replacement market was valued at $368.1 million in 2017 and expected to reach $560.3 million by 2025 growing at a CAGR of
5.34% over the forecast period of 2018-2025. In Europe, approximately 70% females have undergone shoulder replacement surgery whereas
30% males took up shoulder replacement.
• According to Internationa Osteoporosis Foundation, in Europe, 10-15% female population is at high risk of suffering from bone fracture. Whereas,
5-10% male population is at high risk of suffering from fracture owing to disease such as osteoporosis, vitamin D deficit, and other bone related
diseases. Therefore, there is immense opportunity for the manufacturers at domestic level and for new entrants.
• According to WHO, osteoarthritis is among the ten most disabling diseases in the developed countries. It is estimated by the WHO, that 10% men
and 18% women aged over 60 years have symptomatic osteoarthritis, that includes both the severe and the moderate forms. Other factors such
as obesity, smoking, physical inactivity, injuries, and alcoholism lead to increased risk of joint replacement. Mainly joint replacement is carried out
within the population above 60 years age. However, joint replacement is increasingly being performed for younger population owing to unhealthy
lifestyle trends.
• According to OECD, in 2014, countries such as Belgium, Austria, Germany, and Finland have higher rates of hip and knee replacement. The rate of
replacement of hip and knee was also very high in Switzerland and Norway. In 2014, the estimated price of hip replacement in the European
countries was approximately, EUR 5600 whereas for the knee replacement the price was approximately EUR 5700. However, the price trend
highly stable till date, very minor up and down has been witnessed in the prices of joint replacement in the last five years.

Europe
Figure 96: Europe Hip Joint Reconstruction Market Value Figure 97: Europe Knee Joint Reconstruction Market
($Billion) and Procedure Volume (Thousand) Value ($Billion) and Procedure Volume (Thousand)
3.31
3.19
3.07
4.29
2.94
4.14
900 3.50
2.81
4.00
760 5.00
3.86
2.69
3.72
2.56
3.59
800
2.44
3.45
3.32
3.00
2.32
740
3.18
2.20
3.06
2.10
2.95
700 4.00
2.50 720
600
2.00 700 3.00
500
764.0
680
748.3
733.8
732.8
717.4
701.8
724.9
686.9
400
672.2
657.7
716.3
1.50
643.4
628.9
615.3
707.7
2.00
699.1
660
690.3
300
681.3
672.1
1.00
662.7
640
655.4
647.6
200 1.00
100 0.50 620
0 0.00 600 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Hip Joint Reconstruction Volume (Thousand) Hip Joint Reconstruction Value ($Million) Knee Joint Reconstruction Volume (Thousand) Knee Joint Reconstruction Value ($ Million)
Figure 98: Europe Shoulder Joint Reconstruction Market Figure 99: Europe Shoulder Joint Reconstruction Market
119.6
114.2
560.3
109.1
534.2
104.1
508.6
700 140
483.3
99.4
458.8
94.8
434.9
90.4
411.7
120
86.1
600
389.3
82.1
368.1
78.2
347.2
74.5
329.4
500 100
400 80
300 60
200 40
100 20
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Europe
Figure 100: Europe Hip Arthroplasty Market Value

Europe Hip Arthroplasty Market ($Million) by Procedure Type
• Europe primary hip replacement market value was estimated to be

$2.10 billion in 2017 and is forecasted to grow at a CAGR of 4.58% to
3,026.4
2,914.3
2,797.6
2,679.1
2,561.0
2,443.7
3500
2,327.0
2,212.5
is expected to grow by 1.44X fold over the forecast period.
2,100.6
1,987.3
1,894.7
3000
• Europe primary hip replacement market volume was estimated to be 2500
2.26% to reach market volume of 697.1 thousand by the end of 1500
2025.
269.5
262.1
254.4
245.8
235.4
226.7
218.8
210.8
202.9
194.6
190.8
1000
17.47
17.41
17.55
17.63
17.67
17.62
17.51
17.36
17.11
16.81
16.43
• Europe revision hip replacement market is estimated to grow by 500
1.33X in 2025 whereas the hip resurfacing market is estimated to 0
grow by 0.94X by 2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• Uncemented hip fixation segment market value is estimated to be Primary Hip Replacement Revision Hip Replacement Hip Resurfacing
$1.41 billion in 2017 and is forecasted to grow at a CAGR of 4.25% to
reach market value of $1.98 billion by the end of 2025. The market is
expected to grow by 1.40X fold over the forecast period. Whereas,
the market volume was estimated to be 391.4 thousand in 2017 and Figure 101: Europe Hip Arthroplasty Market Procedure
is forecasted to grow at a CAGR of 1.94% to reach market volume of Volume (Thousand) by Procedure Type
• Europe bearing surface segment is estimated to grow by 1.44X in
697.1
682.2
667.4
652.9
638.4
624.2
610.0
596.0
800
582.2
568.2
estimated to grow by 1.52X by 2025.
554.3
700
• In Europe, According to National Joint Registry, 59.8% females have 600
undergone primary hip replacement whereas 40.2% male have 500
undergone primary hip replacement. 400
300
63.1
62.1
61.3
60.3
59.0
58.2
57.6
56.9
56.3
55.8
55.7
200
5.1
5.0
4.9
4.8
4.6
4.5
4.4
4.2
4.1
3.9
3.8
100
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Europe
Table 85: Europe Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 275.9 283.6 293.3 301.8 309.5 316.6 322.7 328.0 332.3 335.3 336.7 1.57%
Uncemented 1,283.4 1,341.0 1,412.1 1,482.1 1,553.8 1,626.4 1,699.1 1,771.8 1,844.3 1,915.3 1,982.8 4.25%
Hybrid 311.5 337.1 367.5 398.7 431.6 466.2 502.2 539.8 578.9 618.9 659.3 7.45%
Others 23.9 25.6 27.7 29.9 32.1 34.5 36.9 39.4 42.0 44.6 47.2 6.77%
Total 1,894.7 1,987.3 2,100.6 2,212.5 2,327.0 2,443.7 2,561.0 2,679.1 2,797.6 2,914.3 3,026.4 4.58%
Table 86: Europe Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 80.7 81.1 81.3 81.3 81.1 80.9 80.4 79.9 79.2 78.4 77.5 -0.68%
Uncemented 375.5 383.4 391.4 399.2 407.3 415.4 423.5 431.8 440.0 448.3 456.7 1.94%
Hybrid 91.1 96.4 101.9 107.4 113.2 119.1 125.2 131.6 138.2 145.0 152.0 5.08%
Others 7.0 7.3 7.7 8.0 8.4 8.8 9.2 9.6 10.0 10.4 10.9 4.39%
Total 554.3 568.2 582.2 596.0 610.0 624.2 638.4 652.9 667.4 682.2 697.1 2.26%

Europe
Table 87: Europe Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 36.9 36.8 37.9 38.8 39.7 40.6 41.4 42.1 42.7 43.2 43.4 1.61%
Uncemented 133.6 138.2 145.3 152.4 159.7 167.2 175.6 185.9 194.9 203.4 211.8 4.82%
Hybrid 20.5 20.6 21.5 22.4 23.3 24.3 25.3 26.4 27.5 28.4 29.4 3.95%
Others 3.1 3.0 3.1 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 2.77%
Total 190.8 194.6 202.9 210.8 218.8 226.7 235.4 245.8 254.4 262.1 269.5 3.57%
Table 88: Europe Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 10.9 10.6 10.6 10.5 10.4 10.3 10.3 10.2 10.1 10.1 10.0 -0.73%
Uncemented 36.4 36.5 37.0 37.4 37.8 38.3 38.9 39.9 40.6 41.3 42.0 1.67%
Hybrid 7.2 7.2 7.4 7.6 7.9 8.1 8.3 8.6 8.9 9.1 9.4 3.01%
Others 1.3 1.3 1.3 1.4 1.4 1.5 1.5 1.6 1.6 1.7 1.7 3.07%
Total 55.8 55.7 56.3 56.9 57.6 58.2 59.0 60.3 61.3 62.1 63.1 1.48%

Europe
Table 89: Europe Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 460.3 456.6 478.4 498.7 518.8 538.6 557.7 576.6 594.8 611.6 626.6 3.32%
CoP 1,094.0 1,153.1 1,226.0 1,299.5 1,375.7 1,454.7 1,535.0 1,616.9 1,700.2 1,783.8 1,865.6 5.30%
CoC 314.0 316.3 331.9 347.0 362.3 377.4 392.4 407.0 421.2 434.8 447.5 3.70%
MoM 14.0 13.4 13.3 13.1 12.9 12.5 12.1 11.5 10.8 10.0 9.1 -5.08%
Other 45.9 48.0 51.0 54.0 57.1 60.2 63.4 66.7 70.0 73.3 76.4 5.10%
Total 1,894.7 1,987.3 2,100.6 2,212.5 2,327.0 2,443.7 2,561.0 2,679.1 2,797.6 2,914.3 3,026.4 4.58%
Table 90: Europe Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 134.7 130.5 132.6 134.3 136.0 137.6 139.0 140.4 141.8 143.1 144.2 1.02%
CoP 320.1 329.7 339.8 350.1 360.7 371.7 382.8 394.1 405.8 417.8 430.0 2.98%
CoC 91.9 90.4 92.0 93.5 95.0 96.4 97.9 99.2 100.5 101.8 103.1 1.41%
MoM 4.1 3.8 3.7 3.5 3.4 3.2 3.0 2.8 2.6 2.3 2.1 -7.20%
Other 13.4 13.7 14.1 14.5 15.0 15.4 15.8 16.3 16.7 17.1 17.6 2.77%
Total 554.3 568.2 582.2 596.0 610.0 624.2 638.4 652.9 667.4 682.2 697.1 2.26%

Europe
Table 91: Europe Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 38.5 37.8 38.3 38.7 39.1 39.3 39.7 40.1 40.1 40.3 40.4 0.63%
CoP 102.5 108.5 116.6 124.7 133.3 142.3 152.3 164.2 175.4 186.5 197.2 6.77%
CoC 62.2 63.9 67.1 70.3 73.4 76.7 80.4 84.7 88.7 92.2 96.0 4.55%
MoM 2.1 1.9 1.8 1.7 1.6 1.6 1.5 1.4 1.3 1.3 1.2 -5.05%
Other 6.6 6.5 6.5 6.5 6.5 6.4 6.4 6.4 6.5 6.4 6.4 -0.03%
Total 190.8 194.6 202.9 210.8 218.8 226.7 235.4 245.8 254.4 262.1 269.5 3.57%
Table 92: Europe Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 15.0 14.6 14.5 14.5 14.4 14.3 14.3 14.3 14.2 14.2 14.1 -0.34%
CoP 24.9 25.3 26.0 26.6 27.3 27.9 28.7 29.8 30.7 31.5 32.3 2.84%
CoC 13.5 13.3 13.3 13.4 13.4 13.4 13.5 13.7 13.8 13.9 14.0 0.71%
MoM 0.8 0.7 0.7 0.7 0.7 0.7 0.7 0.6 0.6 0.6 0.6 -2.16%
Other 1.8 1.8 1.8 1.8 1.8 1.8 1.9 1.9 1.9 1.9 2.0 1.36%
Total 55.8 55.7 56.3 56.9 57.6 58.2 59.0 60.3 61.3 62.1 63.1 1.48%

Europe
Figure 102: Europe Knee Arthroplasty Market Value

Europe Knee Arthroplasty Market ($Million) by Procedure Type
• Europe primary knee replacement market value was estimated to be
4,107.4
3,957.5
$3.18 billion in 2017 and is forecasted to grow at a CAGR of 3.74%
3,809.7
3,663.8
3,520.1
3,378.8
3,239.9
5000
to reach market value of $4.28 billion by the end of 2025. The
3,103.6
2,970.2
2,849.0
2,729.9
4500
market is expected to grow by 1.38X fold over the forecast period. 4000
3500
• Europe primary knee replacement market volume was estimated to 3000
2500
be 618.2 thousand in 2017 and is forecasted to grow at a CAGR of 2000
1.60% to reach market value of 702.9 thousand by the end of 2025.
216.3
215.4
213.8
212.3
210.1
207.1
203.4
198.9
193.5
187.3
180.3
1500
1000
• Europe revision knee replacement market is estimated to grow by 500
0
0.84X in 2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• Uncemented knee fixation segment market value was estimated to Primary Knee Replacement Revision Knee Replacement
be $1.57 billion in 2017 and is forecasted to grow at a CAGR of
3.21% to reach market value of $2.04 billion by the end of 2025. The
market is expected to grow by 1.29X fold over the forecast period. Figure 103: Europe Knee Arthroplasty Market Procedure
Whereas, the market volume was estimated to be 391.4 thousand in Volume (Thousand) by Procedure Type
702.9
692.2
681.7
671.3
660.9
650.4
639.8
629.1
618.2
• Europe bearing type segment is estimated to grow by 1.38X in 2025
609.4
600.1
800
whereas the leading bearing type segment is unconstrained fixed 700
500
• In Europe, 56.8% females have undergone primary knee surgery 400
whereas 43.2% females have undergone primary knee surgery. 300
47.5
46.1
44.5
43.0
41.5
39.9
38.2
36.4
34.6
32.8
30.8
200
100
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Europe
Table 93: Europe Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 638.4 657.1 681.3 708.2 738.3 771.8 809.2 850.9 897.5 949.7 1,008.2 5.18%
Uncemented 1,795.3 1,871.5 1,943.6 2,022.9 2,100.7 2,176.5 2,249.5 2,319.2 2,385.0 2,445.9 2,501.3 3.08%
Hybrid 10.9 11.4 11.6 11.8 12.1 12.3 12.4 12.6 12.8 12.9 13.0 1.36%
Others 270.3 293.0 316.8 342.8 370.3 399.0 429.1 460.6 493.5 527.7 563.4 7.35%
Total 2,729.9 2,849.0 2,970.2 3,103.6 3,239.9 3,378.8 3,520.1 3,663.8 3,809.7 3,957.5 4,107.4 4.08%
Table 94: Europe Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 139.9 140.2 141.5 143.2 145.5 148.3 151.7 155.7 160.4 166.0 172.4 2.68%
Uncemented 398.3 404.0 408.4 413.9 418.8 422.9 426.3 428.9 430.7 431.7 431.8 0.61%
Hybrid 2.4 2.4 2.4 2.4 2.4 2.4 2.3 2.3 2.3 2.3 2.2 -1.06%
Others 59.4 62.8 65.9 69.5 73.1 76.8 80.6 84.4 88.3 92.3 96.4 4.79%
Total 600.1 609.4 618.2 629.1 639.8 650.4 660.9 671.3 681.7 692.2 702.9 1.60%

Europe
Table 95: Europe Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 155.9 154.2 152.0 149.8 147.0 143.6 139.7 135.1 129.9 124.1 117.8 -3.38%
Uncemented 30.4 30.3 30.3 30.3 30.4 30.4 30.4 30.3 30.3 30.1 29.9 -0.18%
Hybrid 3.7 3.9 4.1 4.3 4.4 4.6 4.7 4.8 4.9 4.9 4.9 2.10%
Others 26.6 27.2 27.6 28.1 28.5 28.7 28.8 28.8 28.6 28.3 27.8 -0.15%
Total 216.3 215.4 213.8 212.3 210.1 207.1 203.4 198.9 193.5 187.3 180.3 -2.31%
Table 96: Europe Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 34.2 32.9 31.6 30.3 29.0 27.6 26.2 24.7 23.2 21.7 20.1 -5.69%
Uncemented 6.7 6.5 6.3 6.2 6.0 5.9 5.7 5.6 5.4 5.3 5.1 -2.56%
Hybrid 0.8 0.8 0.8 0.9 0.9 0.9 0.9 0.9 0.9 0.9 0.8 -0.35%
Others 5.8 5.8 5.8 5.7 5.6 5.5 5.4 5.3 5.1 5.0 4.8 -2.54%
Total 47.5 46.1 44.5 43.0 41.5 39.9 38.2 36.4 34.6 32.8 30.8 -4.64%

Europe
Table 97: Europe Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 111.9 111.1 109.9 108.6 106.9 104.7 102.1 98.9 95.2 91.0 86.3 -3.24%
Total 2,729.9 2,849.0 2,970.2 3,103.6 3,239.9 3,378.8 3,520.1 3,663.8 3,809.7 3,957.5 4,107.4 4.08%
Table 98: Europe Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 24.6 23.8 22.9 22.0 21.1 20.2 19.2 18.1 17.0 15.9 14.8 -5.55%
Total 600.1 609.4 618.2 629.1 639.8 650.4 660.9 671.3 681.7 692.2 702.9 1.60%

Europe
Table 99: Europe Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 5.0 5.4 5.8 6.2 6.5 6.8 7.1 7.4 7.5 7.7 7.8 3.34%
Total 216.3 215.4 213.8 212.3 210.1 207.1 203.4 198.9 193.5 187.3 180.3 -2.31%
Table 100: Europe Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 1.1 1.2 1.2 1.2 1.3 1.3 1.3 1.3 1.4 1.3 1.3 0.88%
Total 47.5 46.1 44.5 43.0 41.5 39.9 38.2 36.4 34.6 32.8 30.8 -4.64%

Europe
Figure 104: Europe Shoulder Arthroplasty Market Value

Europe Shoulder Arthroplasty Market ($Million) by Procedure Type
• Europe shoulder replacement market value was estimated to be
560.3
534.2
700
508.6
483.3
$368.1 million in 2017 and is forecasted to grow at a CAGR of 5.34%
458.8
434.9
600
411.7
389.3
368.1
347.2
329.4
500
300
• Europe shoulder replacement market volume was estimated to be
200
82.1 thousand in 2017 and is forecasted to grow at a CAGR of 4.80%
100
to reach market value of 119.6 thousand by the end of 2025. 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• In Europe, reverse polarity total prosthetic replacement fixation is the
leading segment. The market value of this segment is estimated to be
to reach market value of $256.3 million by the end of 2025. The Figure 105: Europe Shoulder Arthroplasty Market
market is expected to grow by 1.76X fold over the forecast period. Procedure Volume (Thousand) by Procedure Type
119.6
114.2
109.1
104.1
140
99.4
94.8
90.4
120
86.1
82.1
78.2
74.5
100
80
60
40
20
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Europe
Figure 106: Europe Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
300
250
200
150
100
50
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 107: Europe Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
60
50
40
30
20
10
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
28.2 30.4 32.5 34.7 37.1 39.6 42.3 45.1 48.2 51.3 54.7
Replacement

The U.K.
United Kingdom Joint Reconstruction Market Overview
• The U.K. hip replacement market was valued $322.3 million in 2017 and is expected to reach $474.6 million in 2025. In 2017, primary hip
replacement increased by 0.9% and the revision burden increased to 10.3% as compared to that of 2016. Hip fracture, osteoarthritis, acute
injuries, and osteoporosis have played a significant role in the market growth.
• The U.K. knee replacement market was valued $506.1 million in 2017 and is expected to reach $711.1 million by 2025 growing at a CAGR of
4.38% over the forecast period of 2018-2025. In Europe, primary knee procedures are dominating whereas the uncemented fixations are the
most preferred among all other fixation. The unconstrained fixed bearing type is the most preferred among others bearing types.
• The U.K. shoulder replacement market was valued $28.6 million in 2017 and is expected to reach $52.2 million by 2025 growing at a CAGR of
7.81% over the forecast period of 2018-2025.

The U.K.
Figure 108: U.K. Hip Joint Reconstruction Market Value Figure 109: U.K. Knee Joint Reconstruction Market Value
($Million) and Procedure Volume (Thousand) ($Million) and Procedure Volume (Thousand)
474.6
711.1
456.0
680.1
436.6
650.7
417.0
622.9
397.5
596.6
125 800.0
571.9
378.4
120 500.0
548.6
359.4
526.7
340.7
506.1
700.0
486.6
450.0
322.3
120
468.5
302.5
100
288.8
400.0 600.0
350.0 115
80 500.0
300.0 110
121.7
109.5
106.9
400.0
104.3
60 250.0
101.7
119.0
99.2
116.4
96.7
94.3
105
91.8
114.1
89.4
86.5
84.5
200.0
112.0
300.0
110.1
108.3
40
106.7
150.0
105.3
100
104.1
103.0
200.0
20 100.0
50.0 95 100.0
0 0.0 90 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 110: U.K. Shoulder Joint Reconstruction Market Figure 111: U.K. Shoulder Joint Reconstruction Market
11.1
10.4
52.2
48.5
12
9.7
60
45.1
9.0
41.8
8.4
38.8
10
7.8
35.9
50
7.3
33.3
6.8
30.8
6.4
28.6
5.9
26.4
40 8
5.6
24.5
30 6
20 4
10 2
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

The U.K.
Figure 112: United Kingdom Hip Arthroplasty Market

United Kingdom Hip Arthroplasty Market Value ($Million) by Procedure Type
• United Kingdom primary hip replacement market value was
443.6
425.1
406.2
387.1
500.0
368.2
349.8
CAGR of 5.07% to reach market value of $443.6 million by the end 450.0
331.5
313.7
296.2
400.0
277.4
of 2025. The market is expected to grow by 1.50X fold over the
262.2
350.0
forecast period. 300.0
250.0
• United Kingdom primary hip replacement market volume was 200.0
estimated to be 82.1 thousand in 2017 and is forecasted to grow at a 150.0
29.2
29.0
28.6
28.0
27.4
26.8
26.1
25.3
24.9
24.4
23.4
100.0
1.99
2.03
2.07
2.09
1.85
1.90
1.95
1.76
1.73
1.79
1.66
CAGR of 2.75% to reach market volume of 102.2 thousand by the 50.0
end of 2025. -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• United Kingdom revision hip replacement market is estimated to
grow by 1.20X in 2025 whereas the hip resurfacing market is
• Uncemented hip fixation segment market value is estimated to be Figure 113: United Kingdom Hip Arthroplasty Market
$105.4 million in 2017 and is forecasted to grow at a CAGR of - Procedure Volume (Thousand) by Procedure Type
102.2
99.5
96.9
120.0
94.3
91.8
89.3
86.9
84.5
82.1
thousand in 2017 and is forecasted to grow at a CAGR of -4.36% to
79.3
76.7
100.0
• United Kingdom bearing surface segment is estimated to grow by 60.0
1.49X in 2025 whereas the leading bearing surface segment is MOP 40.0
which is estimated to grow by 2.19X by 2025.
7.3
6.9
6.9
6.9
6.9
6.9
6.9
6.8
6.8
6.8
6.7
20.0
0.5
0.5
0.5
0.5
0.5
0.5
0.5
0.5
0.5
0.5
0.5
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

The U.K.
Table 101: United Kingdom Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 81.0 83.0 85.6 87.5 89.2 90.6 91.7 92.5 93.0 93.1 92.8 0.84%
Uncemented 103.3 104.0 105.4 105.7 105.4 104.6 103.1 101.0 98.3 94.8 90.5 -2.20%
Hybrid 75.5 87.7 101.9 116.7 132.6 149.7 167.8 187.3 207.9 229.4 251.8 11.61%
Others 2.4 2.8 3.3 3.8 4.3 4.9 5.5 6.2 6.9 7.7 8.4 12.22%
Total 262.2 277.4 296.2 313.7 331.5 349.8 368.2 387.1 406.2 425.1 443.6 5.07%
Table 102: United Kingdom Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 23.7 23.7 23.7 23.6 23.4 23.1 22.9 22.5 22.2 21.8 21.4 -1.40%
Uncemented 30.2 29.7 29.2 28.5 27.6 26.7 25.7 24.6 23.5 22.2 20.8 -4.36%
Hybrid 22.1 25.1 28.2 31.4 34.8 38.2 41.9 45.7 49.6 53.7 58.0 9.15%
Others 0.7 0.8 0.9 1.0 1.1 1.3 1.4 1.5 1.6 1.8 1.9 9.72%
Total 76.7 79.3 82.1 84.5 86.9 89.3 91.8 94.3 96.9 99.5 102.2 2.75%

The U.K.
Table: United Kingdom Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 8.6 8.0 8.2 8.3 8.4 8.5 8.5 8.6 8.5 8.5 8.4 0.16%
Uncemented 10.4 9.8 10.3 10.7 11.0 11.4 11.7 12.0 12.3 12.5 12.7 2.52%
Hybrid 4.5 4.3 4.5 4.8 5.0 5.2 5.4 5.6 5.8 6.0 6.2 3.74%
Others 0.8 0.7 0.7 0.8 0.8 0.8 0.8 0.9 0.9 0.9 0.9 3.11%
Total 24.9 23.4 24.4 25.3 26.1 26.8 27.4 28.0 28.6 29.0 29.2 2.10%
Table: United Kingdom Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 2.5 2.3 2.3 2.2 2.2 2.2 2.1 2.1 2.0 2.0 1.9 -2.15%
Uncemented 2.8 2.6 2.6 2.6 2.6 2.6 2.6 2.6 2.6 2.5 2.5 -0.56%
Hybrid 1.6 1.5 1.6 1.6 1.7 1.7 1.8 1.8 1.9 1.9 2.0 2.80%
Others 0.3 0.3 0.3 0.3 0.4 0.4 0.4 0.4 0.4 0.4 0.4 3.41%
Total 7.3 6.7 6.8 6.8 6.9 6.9 6.9 6.9 6.9 6.9 6.8 0.04%

The U.K.
Table 103: United Kingdom Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 174.4 158.6 165.6 171.4 177.2 182.6 187.6 192.6 197.3 201.1 204.1 2.52%
CoP 77.2 86.0 97.4 109.3 121.7 135.2 149.4 164.5 180.2 196.9 214.0 10.07%
CoC 39.9 29.7 30.0 29.9 29.7 29.0 28.4 27.5 26.4 25.1 23.7 -3.26%
MoM 2.7 2.1 2.0 1.9 1.8 1.7 1.5 1.4 1.2 0.9 0.7 -14.12%
Other 1.5 1.1 1.1 1.2 1.2 1.2 1.2 1.2 1.2 1.1 1.1 -0.52%
Total 262.2 277.4 296.2 313.7 331.5 349.8 368.2 387.1 406.2 425.1 443.6 5.07%
Table 104: United Kingdom Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 51.0 45.3 45.9 46.2 46.5 46.6 46.8 46.9 47.0 47.0 47.0 0.25%
CoP 22.6 24.6 27.0 29.4 31.9 34.5 37.3 40.1 43.0 46.1 49.3 7.65%
CoC 11.7 8.5 8.3 8.0 7.8 7.4 7.1 6.7 6.3 5.9 5.5 -5.40%
MoM 0.8 0.6 0.6 0.5 0.5 0.4 0.4 0.3 0.3 0.2 0.2 -16.04%
Other 0.4 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 -2.72%
Total 76.7 79.3 82.1 84.5 86.9 89.3 91.8 94.3 96.9 99.5 102.2 2.75%

The U.K.
Table 105: United Kingdom Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 8.9 7.9 7.8 7.7 7.5 7.2 7.0 6.8 6.3 6.1 5.8 -3.87%
CoP 6.1 6.5 7.7 8.8 10.1 11.4 12.7 14.2 15.7 17.4 18.4 11.16%
CoC 8.5 7.9 8.2 8.4 8.5 8.7 8.8 8.8 9.0 8.8 8.9 0.85%
MoM 1.2 1.0 1.0 0.9 0.9 0.9 0.8 0.8 0.8 0.7 0.7 -3.88%
Other 0.4 0.3 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 1.75%
Total 24.9 23.4 24.4 25.3 26.1 26.8 27.4 28.0 28.6 29.0 29.2 2.10%
Table 106: United Kingdom Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 3.4 3.0 3.0 2.9 2.8 2.6 2.5 2.4 2.2 2.1 2.0 -4.79%
CoP 1.5 1.5 1.7 1.9 2.1 2.2 2.4 2.6 2.8 2.9 3.0 7.06%
CoC 1.8 1.7 1.6 1.6 1.5 1.5 1.5 1.4 1.4 1.3 1.3 -2.86%
MoM 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 -0.96%
Other 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 3.16%
Total 7.3 6.7 6.8 6.8 6.9 6.9 6.9 6.9 6.9 6.9 6.8 0.04%

The U.K.
Figure 114: United Kingdom Knee Arthroplasty Market

United Kingdom Knee Arthroplasty Market Value ($Million) by Procedure Type
• United Kingdom primary knee replacement market value was
688.2
656.3
626.2
597.7
800
570.8
545.6
521.8
499.5
700
478.6
CAGR of 4.68% to reach market value of $688.2 million by the end of
458.9
440.5
600
2025. The market is expected to grow by 1.43 fold over the forecast
500
period. 400
300
• United Kingdom primary knee replacement market volume was
28.0
27.7
27.4
27.1
26.7
26.3
25.8
25.2
24.5
23.8
22.9
200
estimated to be 99.6 thousand in 2017 and is forecasted to grow at a 100
CAGR of 2.18% to reach market value of 117.8 thousand by the end 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
of 2025.
• United Kingdom revision knee replacement market is estimated to
grow by 0.83X in 2025.
• Cemented knee fixation segment market value is estimated to be Figure 115: United Kingdom Knee Arthroplasty Market
$416.9 million in 2017 and is forecasted to grow at a CAGR of 4.44% Procedure Volume (Thousand) by Procedure Type
117.8
114.8
112.0
109.5
107.2
105.0
103.0
101.3
140
99.6
98.1
96.8
2017 and is forecasted to grow at a CAGR of 1.95% to reach market 120
100
80
• United Kingdom bearing type segment is estimated to grow by 1.43X 60
in 2025 whereas the leading bearing type segment is unconstrained 40
6.2
5.9
5.7
5.5
5.3
5.1
4.8
4.6
4.4
4.2
3.9
fixed which is estimated to grow by 1.58X by 2025. 20
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

The U.K.
Table 107: United Kingdom Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 385.0 400.6 416.9 434.1 452.4 471.9 492.6 514.6 537.9 562.5 588.4 4.44%
Uncemented 10.1 9.6 9.1 8.5 7.8 7.1 6.3 5.4 4.4 3.3 2.1 -18.29%
Hybrid 1.8 1.8 1.9 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.8 4.68%
Others 43.6 46.8 50.7 54.9 59.5 64.4 69.6 75.3 81.4 87.9 95.0 8.13%
Total 440.5 458.9 478.6 499.5 521.8 545.6 570.8 597.7 626.2 656.3 688.2 4.68%
Table 108: United Kingdom Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 84.6 85.7 86.8 88.0 89.3 90.8 92.5 94.3 96.2 98.4 100.7 1.95%
Uncemented 2.2 2.0 1.9 1.7 1.5 1.4 1.2 1.0 0.8 0.6 0.4 -20.25%
Hybrid 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.5 0.5 2.18%
Others 9.6 10.1 10.6 11.1 11.7 12.4 13.1 13.8 14.6 15.4 16.3 5.55%
Total 96.8 98.1 99.6 101.3 103.0 105.0 107.2 109.5 112.0 114.8 117.8 2.18%

The U.K.
Table 109: United Kingdom Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 21.9 21.5 21.0 20.6 20.0 19.5 18.9 18.3 17.6 16.9 16.1 -3.45%
Uncemented 2.2 2.2 2.3 2.3 2.3 2.3 2.3 2.3 2.3 2.3 2.2 -0.21%
Hybrid 0.5 0.5 0.6 0.6 0.7 0.7 0.7 0.8 0.8 0.8 0.8 4.47%
Others 3.4 3.5 3.6 3.7 3.7 3.8 3.8 3.8 3.8 3.8 3.7 0.28%
Total 28.0 27.7 27.4 27.1 26.7 26.3 25.8 25.2 24.5 23.8 22.9 -2.39%
Table 110: United Kingdom Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 4.8 4.6 4.4 4.2 4.0 3.8 3.6 3.4 3.2 3.0 2.8 -5.76%
Uncemented 0.5 0.5 0.5 0.5 0.5 0.4 0.4 0.4 0.4 0.4 0.4 -2.60%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 1.98%
Others 0.8 0.8 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.6 -2.12%
Total 6.2 5.9 5.7 5.5 5.3 5.1 4.8 4.6 4.4 4.2 3.9 -4.72%

The U.K.
Table 111: United Kingdom Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 18.1 17.9 17.7 17.5 17.2 16.9 16.6 16.1 15.7 15.1 14.5 -2.68%
Total 440.5 458.9 478.6 499.5 521.8 545.6 570.8 597.7 626.2 656.3 688.2 4.68%
Table 112: United Kingdom Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 4.0 3.8 3.7 3.5 3.4 3.3 3.1 3.0 2.8 2.6 2.5 -5.01%
Total 96.8 98.1 99.6 101.3 103.0 105.0 107.2 109.5 112.0 114.8 117.8 2.18%

The U.K.
Table 113: United Kingdom Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.6 0.7 0.7 0.8 0.8 0.9 0.9 0.9 1.0 1.0 1.0 3.26%
Total 28.0 27.7 27.4 27.1 26.7 26.3 25.8 25.2 24.5 23.8 22.9 -2.39%
Table 114: United Kingdom Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.1 0.1 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.80%
Total 6.2 5.9 5.7 5.5 5.3 5.1 4.8 4.6 4.4 4.2 3.9 -4.72%

The U.K.
Figure 116: United Kingdom Shoulder Arthroplasty

United Kingdom Shoulder Arthroplasty Market Market Value ($Million) by Procedure Type
• United Kingdom shoulder replacement market value was estimated to
52.2
48.5
60
45.1
41.8
38.8
7.81% to reach market value of $52.2 million by the end of 2025. 50
35.9
33.3
30.8
28.6
40
26.4
24.5
period. 30
• United Kingdom shoulder replacement market volume was estimated 20

to be 6.4 thousand in 2017 and is forecasted to grow at a CAGR of 10
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• In United Kingdom, reverse polarity total prosthetic replacement
fixation is the leading segment. The market value of this segment is Shoulder Joint Reconstruction Market Value ($Million)

Figure 117: United Kingdom Shoulder Arthroplasty
Market Procedure Volume (Thousand) by Procedure Type
11.1
10.4
to reach market volume of 6.9 thousand by the end of 2025. 12
9.7
9.0
8.4
10
7.8
7.3
6.8
6.4
5.9
8
6 5.6
4
2
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

The U.K.
Figure 118: United Kingdom Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
35
30
25
20
15
10
5
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
11.1 13.4 14.8 16.4 18.2 20.1 22.1 24.4 26.9 29.6 32.5
Replacement
Figure 119: United Kingdom Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
8
7
6
5
4
3
2
1
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
2.5 3.0 3.3 3.6 4.0 4.4 4.8 5.3 5.8 6.3 6.9
Replacement

Germany
Germany Joint Reconstruction Market Overview
• Germany hip replacement market was valued $895.5 million in 2017 and is expected to reach $1,188.4 million in 2025. In 2017,
primary hip replacement increased by 0.87% and revision burden increased to 0.81% as compared to 2016. The Germany market
for hip arthroplasty is sophisticated and well-served. Germany has a handful of large producers of implants including B. Braun. The
demand for hip replacement would remain strong during the forecast period owing to increasing cases of fractured neck of the
femur in the elderly, rheumatoid arthritis, osteoarthritis, and osteoporosis in the elderly.
• Germany knee replacement market was valued $824.4 million in 2017 and is expected to reach $1,066.7 million by 2025 growing at
a CAGR of 3.22% over the forecast period of 2018-2025. In Germany, knee procedure having uncemented fixations and
unconstrained fixed and posterior-stabilized fixed bearing type are preferred by the surgeons owing to high comfort and ease in
mobility.
• Germany shoulder replacement market was valued $157.8 million in 2017 and is expected to reach $238.0 million by 2025 growing
at a CAGR of 5.24% over the forecast period of 2018-2025.

Germany
Figure 120: Germany Hip Joint Reconstruction Market Figure 121: Germany Knee Joint Reconstruction Market
Value ($Billion) and Procedure Volume (Thousand) Value ($Billion) and Procedure Volume (Thousand)
1.19
280 1.40
1.16
1.07
1.12
1.04
1.08
1.01
1.05
0.98
0.95
1.01
185 1.20
0.92
0.97 1.20
0.89
0.93
270
0.85
0.90
0.82
0.79
0.86
0.76
0.83
1.00 180 1.00

260
0.80 0.80
175
274.2
250
270.8
182.5
267.4
181.5
0.60
180.3
264.1
0.60
179.0
260.9
177.7
257.7
170
176.3
254.5
174.8
240
251.3
173.2
0.40
248.2
0.40
171.6
245.2
169.9
242.2
168.1
230 165 0.20
0.20
220 0.00 160 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 122: Germany Shoulder Joint Reconstruction Figure 123: Germany Shoulder Joint Reconstruction
Market Value ($Million) Market Procedure Volume (Thousand)
70
238.0
226.9
300
216.0
50.8
205.4
48.5
60
195.1
46.3
185.2
44.3
175.6
42.3
250
166.5
40.4
38.6
157.8
36.8
149.2
50
35.2
141.8
33.6
32.1
200
40
150
30
100
20
50 10
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Germany
Figure 124: Germany Hip Arthroplasty Market Value

Germany Hip Arthroplasty Market ($Million) by Procedure Type
• Germany primary hip replacement market value was estimated to be
1,094.5
1,061.1
1,025.7
1,500.0
989.4
952.9
916.1
1,300.0
879.5
to reach market value of $1,094.5 million by the end of 2025. The
843.2
807.4
771.1
742.6
1,100.0
900.0
• Germany primary hip replacement market volume was estimated to 700.0
be 223.78 thousand in 2017 and is forecasted to grow at a CAGR of 500.0
84.3
84.2
83.7
82.9
82.0
80.8
79.5
78.1
76.5
74.8
73.7
11.6
11.5
11.5
11.5
11.4
11.3
11.2
11.0
10.7
10.4
10.1
300.0
2025. 100.0
(100.0) 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• Germany revision hip replacement market is estimated to grow by
1.10X in 2025 whereas the hip resurfacing market is estimated to
• Uncemented hip fixation segment market value is estimated to be

$632.3 million in 2017 and is forecasted to grow at a CAGR of 3.87% Figure 125: Germany Hip Arthroplasty Market Procedure
to reach market value of $862.4 million by the end of 2025. The Volume (Thousand) by Procedure Type
400.0
350.0
252.1
248.4
244.7
241.1
237.5
234.0
230.6
227.1
223.8
220.5
217.3
300.0
• Germany bearing surface segment is estimated to grow by 1.36X in 250.0
2025 whereas the leading bearing surface segment is MOP which is 200.0
estimated to grow by 1.41X by 2025. 150.0
100.0
21.6
21.4
21.2
21.1
20.9
20.7
20.6
20.4
20.2
20.0
19.7
3.4
3.3
3.2
3.1
3.0
2.9
2.8
2.7
2.6
2.5
2.3
50.0
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Germany
Table 115: Germany Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 43.8 44.1 44.7 45.2 45.6 45.8 45.9 45.9 45.8 45.4 44.9 -0.09%
Uncemented 580.7 603.4 632.3 660.9 689.9 719.2 748.6 777.9 807.0 835.5 862.4 3.87%
Hybrid 106.9 111.7 117.7 123.7 129.8 136.0 142.3 148.6 155.0 161.3 167.3 4.41%
Others 11.1 11.8 12.6 13.4 14.3 15.1 16.0 16.9 17.9 18.8 19.7 5.67%
Total 742.6 771.1 807.4 843.2 879.5 916.1 952.9 989.4 1025.7 1061.1 1094.5 3.80%
Table 116: Germany Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 12.8 12.6 12.4 12.2 11.9 11.7 11.5 11.2 10.9 10.6 10.3 -2.31%
Uncemented 169.9 172.5 175.3 178.0 180.9 183.7 186.6 189.6 192.5 195.6 198.7 1.58%
Hybrid 31.3 32.0 32.6 33.3 34.0 34.8 35.5 36.2 37.0 37.8 38.6 2.11%
Others 3.3 3.4 3.5 3.6 3.7 3.9 4.0 4.1 4.3 4.4 4.5 3.32%
Total 217.3 220.5 223.8 227.2 230.6 234.0 237.5 241.1 244.7 248.4 252.1 1.50%

Germany
Table 117: Germany Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 7.9 7.8 7.7 7.5 7.4 7.2 6.9 6.7 6.4 6.1 5.8 -3.74%
Uncemented 62.4 64.2 66.5 68.6 70.8 72.9 75.0 76.9 78.7 80.3 81.6 2.51%
Hybrid 4.8 4.8 4.8 4.9 4.9 4.9 4.9 5.0 5.0 5.0 4.9 0.22%
Others 1.2 1.2 1.2 1.2 1.3 1.3 1.3 1.3 1.4 1.4 1.4 2.20%
Total 73.7 74.8 76.5 78.1 79.5 80.8 82.0 82.9 83.7 84.2 84.3 1.10%
Table 118: Germany Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 2.4 2.2 2.1 2.0 1.9 1.8 1.7 1.6 1.5 1.4 1.3 -5.96%
Uncemented 17.0 17.0 16.9 16.9 16.8 16.7 16.6 16.5 16.4 16.3 16.2 -0.57%
Hybrid 1.7 1.7 1.7 1.7 1.7 1.6 1.6 1.6 1.6 1.6 1.6 -0.69%
Others 0.5 0.5 0.5 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.7 2.49%
Total 21.6 21.4 21.3 21.1 20.9 20.7 20.6 20.4 20.2 20.0 19.7 -0.94%

Germany
Table 119: Germany Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 69.1 70.3 72.2 73.9 75.5 77.0 78.3 79.6 80.7 81.5 82.2 1.53%
CoP 571.8 596.8 628.1 659.3 691.2 723.6 756.4 789.3 822.3 854.8 885.9 4.31%
CoC 81.7 83.6 86.2 88.7 91.1 93.4 95.6 97.7 99.7 101.4 102.8 2.13%
MoM 3.7 3.5 3.4 3.2 3.0 2.7 2.5 2.2 1.8 1.5 1.1 -14.21%
Other 16.3 16.8 17.4 18.0 18.6 19.2 19.8 20.4 20.9 21.4 21.9 2.80%
Total 742.5 771.1 807.4 843.2 879.5 916.1 952.9 989.4 1025.7 1061.1 1094.5 3.80%
Table 120: Germany Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 20.2 20.1 20.0 19.9 19.8 19.7 19.5 19.4 19.2 19.1 18.9 -0.73%
CoP 167.3 170.6 174.1 177.6 181.2 184.9 188.6 192.4 196.3 200.2 204.2 2.01%
CoC 23.9 23.9 23.9 23.9 23.9 23.9 23.9 23.8 23.8 23.8 23.7 -0.12%
MoM 1.1 1.0 0.9 0.9 0.8 0.7 0.6 0.5 0.4 0.4 0.3 -16.12%
Other 4.8 4.8 4.8 4.9 4.9 4.9 4.9 5.0 5.0 5.0 5.0 0.52%
Total 217.3 220.5 223.8 227.2 230.6 234.0 237.5 241.1 244.7 248.4 252.1 1.50%

Germany
Table 121: Germany Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 12.2 12.0 12.0 11.9 11.9 11.8 11.7 11.5 11.4 11.2 11.0 -1.16%
CoP 41.1 42.8 45.0 47.1 49.3 51.4 53.6 55.7 57.8 59.8 61.5 3.88%
CoC 29.0 29.8 30.8 31.7 32.7 33.6 34.5 35.3 36.0 36.7 37.2 2.30%
MoM 0.4 0.3 0.3 0.3 0.3 0.2 0.2 0.2 0.2 0.2 0.2 -7.90%
Other 1.8 1.7 1.6 1.5 1.4 1.3 1.2 1.1 1.1 1.0 0.9 -6.88%
Total 73.7 74.8 76.5 78.1 79.5 80.8 82.0 82.9 83.7 84.2 84.3 1.10%
Table 122: Germany Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 4.7 4.6 4.6 4.5 4.4 4.3 4.2 4.1 4.0 3.9 3.9 -2.10%
CoP 10.0 10.0 10.0 10.1 10.1 10.1 10.1 10.1 10.1 10.1 10.1 0.05%
CoC 6.3 6.2 6.1 6.0 6.0 5.9 5.8 5.7 5.6 5.5 5.5 -1.47%
MoM 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -5.10%
Other 0.5 0.5 0.4 0.4 0.4 0.4 0.4 0.3 0.3 0.3 0.3 -5.59%
Total 21.6 21.4 21.3 21.1 20.9 20.7 20.6 20.4 20.2 20.0 19.7 -0.94%

Germany
Figure 126: Germany Knee Arthroplasty Market Value

Germany Knee Arthroplasty Market ($Million) by Procedure Type
• Germany primary knee replacement market value was estimated to
1,019.8
be $767.0 million in 2017 and is forecasted to grow at a CAGR of 1,500.0
988.5
956.8
924.8
3.57% to reach market value of $1,019.8 million by the end of 2025.
892.7
1,300.0
860.9
829.2
797.9
767.0
736.5
706.7
The market is expected to grow by 1.32X fold over the forecast 1,100.0
period. 900.0
700.0
• Germany primary knee replacement market volume was estimated to 500.0
58.1
57.8
57.4
56.7
55.9
54.9
53.8
52.4
50.8
49.0
46.9
1.09% to reach market value of 174.51 thousand by the end of 100.0
2025. (100.0) 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• Germany revision knee replacement market is estimated to grow by
0.81X in 2025.
• Uncemented knee fixation segment market value is estimated to be

$667.8 million in 2017 and is forecasted to grow at a CAGR of 3.29% Figure 127: Germany Knee Arthroplasty Market Procedure
to reach market value of $868.8 million by the end of 2025. The Volume (Thousand) by Procedure Type
400.0
350.0
300.0
• Germany bearing type segment is estimated to grow by 1.32X in
174.5
172.9
171.2
169.4
167.6
165.7
163.7
161.7
159.6
250.0
157.5
155.3
2025 whereas the leading bearing type segment is unconstrained 200.0
fixed which is estimated to grow by 1.46X by 2025. 150.0
100.0
12.8
12.4
11.9
11.5
11.0
10.6
10.1
9.6
9.1
8.6
8.0
50.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Germany
Table 123: Germany Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 16.3 14.7 14.3 13.8 13.3 12.6 11.9 11.1 10.2 9.2 8.2 -7.26%
Uncemented 617.6 642.9 667.8 692.8 718.1 743.5 768.9 794.4 819.6 844.5 868.8 3.29%
Hybrid 2.8 2.9 3.0 3.0 3.0 3.1 3.1 3.1 3.1 3.1 3.1 0.21%
Others 70.0 75.9 81.9 88.2 94.8 101.7 108.8 116.2 123.8 131.7 139.7 6.79%
Total 706.7 736.5 767.0 797.9 829.2 860.9 892.7 924.8 956.8 988.5 1019.8 3.57%
Table 124: Germany Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 3.6 3.2 3.0 2.8 2.6 2.4 2.2 2.0 1.8 1.6 1.4 -9.48%
Uncemented 135.8 137.5 139.0 140.4 141.8 143.1 144.4 145.6 146.7 147.7 148.7 0.82%
Hybrid 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.5 0.5 -2.18%
Others 15.4 16.2 17.1 17.9 18.7 19.6 20.4 21.3 22.2 23.0 23.9 4.24%
Total 155.3 157.5 159.7 161.7 163.8 165.7 167.6 169.4 171.2 172.9 174.5 1.09%

Germany
Table 125: Germany Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 45.5 44.9 44.3 43.5 42.6 41.6 40.4 39.1 37.7 36.1 34.4 -3.32%
Uncemented 4.5 4.6 4.6 4.6 4.6 4.6 4.5 4.5 4.4 4.3 4.2 -1.41%
Hybrid 1.0 1.0 1.1 1.1 1.2 1.2 1.2 1.2 1.2 1.2 1.2 1.26%
Others 7.1 7.3 7.4 7.5 7.6 7.6 7.6 7.5 7.5 7.3 7.2 -0.60%
Total 58.1 57.8 57.4 56.7 55.9 54.9 53.8 52.4 50.8 49.0 46.9 -2.68%
Table 126: Germany Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 10.0 9.6 9.2 8.8 8.4 8.0 7.6 7.2 6.7 6.3 5.9 -5.63%
Uncemented 1.0 1.0 1.0 0.9 0.9 0.9 0.9 0.8 0.8 0.8 0.7 -3.77%
Hybrid 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 -1.16%
Others 1.6 1.6 1.5 1.5 1.5 1.5 1.4 1.4 1.3 1.3 1.2 -2.98%
Total 12.8 12.4 11.9 11.5 11.1 10.6 10.1 9.6 9.1 8.6 8.0 -5.00%

Germany
Table 127: Germany Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 29.0 28.7 28.4 27.9 27.4 26.7 25.9 25.0 23.9 22.7 21.4 -3.72%
Total 706.7 736.5 767.0 797.9 829.2 860.9 892.7 924.8 956.8 988.5 1019.8 3.57%
Table 128: Germany Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 6.4 6.1 5.9 5.7 5.4 5.1 4.9 4.6 4.3 4.0 3.7 -6.02%
Total 155.3 157.5 159.7 161.7 163.8 165.7 167.6 169.4 171.2 172.9 174.5 1.09%

Germany
Table 129: Germany Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.9 2.0 2.0 2.0 2.96%
Total 58.1 57.8 57.4 56.7 55.9 54.9 53.8 52.4 50.8 49.0 46.9 -2.68%
Table 130: Germany Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.3 0.3 0.3 0.3 0.3 0.4 0.4 0.4 0.4 0.4 0.4 0.50%
Total 12.8 12.4 11.9 11.5 11.1 10.6 10.1 9.6 9.1 8.6 8.0 -5.00%

Germany
Figure 128: Germany Shoulder Arthroplasty Market Value

Germany Shoulder Arthroplasty Market ($Million) by Procedure Type
• Germany shoulder replacement market value was estimated to be
238.0
226.9
300.0
216.0
205.4
195.1
185.2
175.6
250.0
166.5
157.8
149.2
141.8
200.0
• Germany shoulder replacement market volume was estimated to be
100.0
• In Germany, reverse polarity total prosthetic replacement fixation is
50.0
the leading segment. The market value of this segment was
estimated to be $49.9 million in 2017 and is forecasted to grow at a -
CAGR of 8.64% to reach market value of $97.6 million by the end of 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
11.13 thousand in 2017 and is forecasted to grow at a CAGR of
2025. Figure 129: Germany Shoulder Arthroplasty Market
• Since 2005 shoulder arthroplasties have been on a rise in Germany, Procedure Volume (Thousand) by Procedure Type
whereas a slight reduction could be detected for shoulder resurfacing
hemiarthroplasty. Meanwhile total shoulder arthroplasties and
reversed total shoulder arthroplasties are still increasing. Women 70.0
50.8
have experienced a 3-fold higher hemiarthroplasty, total shoulder
48.5
46.3
44.3
60.0
42.3
and reversed shoulder arthroplasties than men except for individual
40.4
38.6
36.8
35.2
50.0
33.6
younger than 60 years. Osteoarthritis with 67.91 % for men and
32.1
60.65 % for women was the most coded main indication for shoulder 40.0
arthroplasty in Germany, followed by fracture with a gender switch 30.0
(21.20 % women; 12.22 % men). 20.0
10.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Germany
Figure 130: Germany Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
120
100
80
60
40
20
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
41.6 45.5 49.9 54.6 59.7 65.1 70.9 77.0 83.5 90.4 97.6
Replacement
Figure 131: Germany Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
25
20
15
10
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
9.4 10.2 11.1 12.1 13.1 14.2 15.4 16.6 17.9 19.3 20.8
Replacement

Italy
Italy Joint Reconstruction Market Overview
• Italy hip replacement market was valued $408.2 million in 2017 and is expected to reach $574.2 million in 2025. In 2017, primary
hip replacement increased by 0.82% and revision burden increased to 0.81% as compared to 2016. The growth driving factors are
rising hip fracture, acute trauma and high osteoarthritis prevalence among population.
• Italy knee replacement market was valued $330.5 million in 2017 and is expected to reach $412.6 million by 2025 growing at a
CAGR of 2.76% over the forecast period of 2018-2025. In Italy, uncemented and unconstrained fixed knee replacement procedure
is witnessing the rising trend among other segment owing to active lifestyle post replacement and long life of the prostheses
pertaining to lower risk of revision procedure.
• Italy shoulder replacement market was valued at $39.6 million in 2017 and is expected to reach $75.4 million by 2025 growing at a
CAGR of 8.14% over the forecast period of 2018-2025. In the year 2016, shoulder joint reconstruction market witnessed increase in
the percentage of reverse shoulder arthroplasty procedures with a corresponding decrease in the percentage of Resurfacing Hemi-
arthroplasty. The percentage of Total Prosthetic Replacement has remained at 37.2% of all procedures; however, the cumulative
trend is indicating continuous decrease in coming years.

Italy
Figure 132: Italy Hip Joint Reconstruction Market Value Figure 133: Italy Knee Joint Reconstruction Market Value
($Million) and Procedure Volume (Thousand) ($Million) and Procedure Volume (Thousand)
574.2
361.9
372.3
382.7
392.9
402.9
412.6
351.4
554.3
340.9
140.0 700.0 71.0 450.0
330.5
533.6
320.0
512.0
308.1
488.9
400.0
467.6
120.0 447.2 600.0
427.0
70.0
408.2
350.0
389.0
373.7
100.0 500.0 300.0

69.0
80.0 400.0 250.0
70.6
70.5
70.3
132.5
129.9
70.1
127.4
124.9
200.0
69.9
121.9
119.5
117.3
69.7
115.1
68.0
113.1
111.2
69.4
109.3
69.1
60.0 300.0 150.0
68.8
68.4
100.0
67.7
40.0 200.0 67.0
50.0
20.0 100.0 66.0 -
- - 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 134: Italy Shoulder Joint Reconstruction Market Figure 135: Italy Shoulder Joint Reconstruction Market
16.1
15.2
75.4
18.0
14.2
70.9
13.3
66.2
12.3
16.0
61.6
80.0
11.4
57.0
10.5
14.0
52.4
70.0
47.9
9.6
43.6
60.0 12.0
8.8
39.6
8.0
35.6
7.3
10.0
32.4
50.0
40.0 8.0
30.0 6.0
20.0 4.0
10.0 2.0
- -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Italy
Figure 136: Italy Hip Arthroplasty Market Value ($Million)

Italy Hip Arthroplasty Market by Procedure Type
• In 2016, a total of 102,490.36 hip arthroplasty were performed in the
523.2
505.9
487.7
Italy. Primary hip arthroplasty represents approximately 92.1% of the
469.0
600.0
450.1
431.2
hip procedures performed in Italy, with revision arthroplasty
412.2
393.5
376.1
500.0
358.4
accounting for the bulk of the remainder at about 7.8% . Hip
344.3
resurfacing in the Italy now accounts for less than 0.1% of the overall 400.0
arthroplasties.
300.0
• Primary arthritis was the diagnosis at the time of surgery for
200.0
approximately more than 70% of the patients undergoing hip
50.8
48.1
45.7
42.8
38.5
36.1
34.6
33.2
31.7
30.2
29.1
arthroplasty. Sequelae of LCA and DCA, and Fracture of the femoral 100.0
0.3
0.3
0.3
0.4
0.4
0.4
0.3
0.3
0.3
0.3
0.3
neck was the next most common diagnosis, accounting for 2 in 10
arthroplasties performed. Rheumatoid arthritis, as noted, accounts for -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
only a very small fraction of the procedures in 2016 (3%) as newer
medical therapies predominate in the treatment of this disease. Primary Hip Replacement Revision Hip Replacement
Hip Resurfacing
• Hip resurfacing represented less than 0.1% of the total hip
arthroplasty procedures, as surgeons have moved away from the
metal-on-metal articulations that predominate. This procedure Figure 137: Italy Hip Arthroplasty Market Procedure
remains highly concentrated among both hospitals and surgeons; in
2016, resurfacing was done in only 20 hospitals by 50 surgeons Volume (Thousand) by Procedure Type
• Femoral head size has remained relatively constant between 2012
and 2015, with 36mm heads used in approximately 50% of the
120.5
118.4
116.4
114.3
112.2
110.1
108.1
procedures performed. The increased stability afforded by larger
106.0
140.0
104.2
102.5
100.7
heads coupled with diminished volumetric wear concerns when these 120.0
heads are used with highly crosslinked or enhanced polyethylene 100.0
liners likely explains their popularity. The relative percentage of 28, 80.0
32, 36, and > 36mm heads used year-to-year has not changed
60.0
significantly between 2012 and 2016.
11.9
40.0
11.4
11.0
10.5
9.7
9.3
9.1
9.0
8.8
8.7
8.5
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
20.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Italy
Table 131: Italy Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 19.1 18.9 18.9 18.8 18.6 18.3 18.0 17.5 17.0 16.3 15.5 -2.70%
Uncemented 275.7 287.4 301.8 316.1 331.5 347.1 362.7 378.3 393.8 409.0 423.3 4.26%
Hybrid 45.2 47.5 50.3 53.1 56.2 59.3 62.4 65.6 68.9 72.1 75.2 5.08%
Others 4.3 4.7 5.1 5.5 6.0 6.5 7.0 7.5 8.1 8.6 9.2 7.54%
Total 344.3 358.4 376.1 393.5 412.2 431.2 450.1 469.0 487.7 505.9 523.2 4.15%
Table 132: Italy Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 5.6 5.4 5.2 5.1 4.9 4.7 4.5 4.3 4.0 3.8 3.6 -4.86%
Uncemented 80.7 82.2 83.7 85.2 86.9 88.7 90.4 92.2 94.0 95.7 97.5 1.95%
Hybrid 13.2 13.6 13.9 14.3 14.7 15.1 15.6 16.0 16.4 16.9 17.3 2.77%
Others 1.3 1.3 1.4 1.5 1.6 1.7 1.7 1.8 1.9 2.0 2.1 5.15%
Total 100.7 102.5 104.2 106.0 108.1 110.1 112.2 114.3 116.4 118.4 120.5 1.85%

Italy
Table 133: Italy Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 2.4 2.5 2.5 2.5 2.6 2.6 2.6 2.8 2.9 2.9 2.9 1.97%
Uncemented 24.4 25.7 27.2 28.8 30.4 32.0 34.6 38.9 42.0 44.8 48.0 7.58%
Hybrid 2.7 2.7 2.9 3.0 3.1 3.2 3.4 3.8 4.0 4.2 4.5 5.99%
Others 0.4 0.4 0.4 0.4 0.5 0.5 0.5 0.5 0.6 0.6 0.6 5.07%
Total 29.1 30.2 31.7 33.2 34.6 36.1 38.5 42.8 45.7 48.1 50.8 6.28%
Table 134: Italy Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 -0.37%
Uncemented 6.7 6.8 6.9 7.1 7.2 7.3 7.7 8.4 8.8 9.1 9.5 4.35%
Hybrid 0.9 1.0 1.0 1.0 1.0 1.1 1.1 1.2 1.3 1.4 1.4 5.04%
Others 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.3 0.3 0.3 5.38%
Total 8.5 8.7 8.8 9.0 9.1 9.3 9.7 10.5 11.0 11.4 11.9 4.14%

Italy
Table 135: Italy Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 26.9 27.4 28.0 28.6 29.2 29.8 30.3 30.7 31.1 31.3 31.4 1.34%
CoP 222.8 233.0 245.6 258.2 271.7 285.5 299.4 313.3 327.3 341.0 354.2 4.62%
CoC 93.2 96.6 100.9 105.0 109.5 114.0 118.4 122.7 127.0 131.1 134.9 3.64%
MoM 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 -2.91%
Other 1.1 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.9 2.0 2.1 6.76%
Total 344.3 358.4 376.1 393.5 412.2 431.2 450.1 469.0 487.7 505.9 523.2 4.15%
Table 136: Italy Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 7.9 7.8 7.8 7.7 7.7 7.6 7.6 7.5 7.4 7.3 7.2 -0.91%
CoP 65.2 66.6 68.1 69.6 71.2 72.9 74.7 76.4 78.1 79.9 81.6 2.32%
CoC 27.3 27.6 28.0 28.3 28.7 29.1 29.5 29.9 30.3 30.7 31.1 1.36%
MoM 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -5.07%
Other 0.3 0.3 0.3 0.4 0.4 0.4 0.4 0.4 0.4 0.5 0.5 4.40%
Total 100.7 102.5 104.2 106.0 108.1 110.1 112.2 114.3 116.4 118.4 120.5 1.85%

Italy
Table 137: Italy Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 3.2 3.3 3.3 3.4 3.4 3.5 3.6 3.9 4.0 4.1 4.2 3.28%
CoP 18.7 20.0 21.5 23.0 24.6 26.3 28.8 32.8 35.9 38.8 42.1 9.00%
CoC 11.5 12.1 12.8 13.5 14.3 15.1 16.2 18.2 19.7 21.0 22.5 7.56%
MoM 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -3.91%
Other 0.7 0.7 0.7 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.6 -0.38%
Total 29.1 30.2 31.7 33.2 34.6 36.1 38.5 42.8 45.7 48.1 50.8 6.28%
Table 138: Italy Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 1.3 1.3 1.3 1.3 1.3 1.3 1.3 1.4 1.4 1.4 1.5 2.29%
CoP 4.5 4.7 4.8 4.9 5.0 5.2 5.4 6.0 6.3 6.6 6.9 4.98%
CoC 2.5 2.5 2.5 2.6 2.6 2.6 2.7 3.0 3.1 3.2 3.3 3.60%
MoM 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -0.99%
Other 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 1.00%
Total 8.5 8.7 8.8 9.0 9.1 9.3 9.7 10.5 11.0 11.4 11.9 4.14%

Italy
Figure 138: Italy Knee Arthroplasty Market Value

Italy Knee Arthroplasty Market ($Million) by Procedure Type
394.5
• Italy primary knee replacement market value was estimated to be
383.9
373.1
362.2
351.2
340.2
450.0
329.2
318.3
307.5
296.7
284.6
400.0
to reach market value of $394.5 million by the end of 2025. The 350.0
300.0
200.0
• Italy primary knee replacement market volume was estimated to be 150.0
23.4
23.3
23.0
22.6
22.2
21.7
21.1
20.5
19.8
19.0
18.2
50.0
0.65% to reach market value of 67.51 thousand by the end of 2025. -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• Italy revision knee replacement market is estimated to grow by 0.78X
in 2025.
• Uncemented knee fixation segment market value was estimated to be

Figure 139: Italy Knee Arthroplasty Market Procedure
67.5
67.1
66.8
66.4
65.9
65.5
65.0
64.5
64.0
63.5
62.6
80.0
2017 and is forecasted to grow at a CAGR of 0.38% to reach market 70.0
60.0
50.0
40.0
• Italy bearing type segment is estimated to grow by 1.28X in 2025
30.0
whereas the leading bearing type segment is unconstrained fixed 20.0
5.1
5.0
4.8
4.6
4.4
4.2
4.0
3.8
3.5
3.3
3.1
which is estimated to grow by 1.42X by 2025. 10.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Italy
Table 139: Italy Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 6.5 5.9 5.7 5.5 5.3 5.0 4.7 4.3 4.0 3.6 3.2 -7.67%
Uncemented 248.8 259.0 267.7 276.4 285.1 293.8 302.5 311.1 319.6 328.0 336.1 2.83%
Hybrid 1.1 1.2 1.2 1.2 1.2 1.2 1.2 1.2 1.2 1.2 1.2 -0.23%
Others 28.2 30.6 32.8 35.2 37.6 40.2 42.8 45.5 48.3 51.1 54.0 6.32%
Total 284.6 296.7 307.5 318.3 329.2 340.2 351.2 362.2 373.1 383.9 394.5 3.11%
Table 140: Italy Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.4 1.3 1.2 1.1 1.0 1.0 0.9 0.8 0.7 0.6 0.5 -9.87%
Uncemented 54.7 55.4 55.7 56.0 56.3 56.6 56.8 57.0 57.2 57.4 57.5 0.38%
Hybrid 0.3 0.3 0.3 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 -2.61%
Others 6.2 6.5 6.8 7.1 7.4 7.7 8.0 8.3 8.6 9.0 9.3 3.78%
Total 62.6 63.5 64.0 64.5 65.0 65.5 65.9 66.4 66.8 67.2 67.5 0.65%

Italy
Table 141: Italy Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 18.3 18.1 17.8 17.4 16.9 16.4 15.9 15.3 14.7 14.0 13.3 -3.75%
Uncemented 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.7 1.7 1.6 -1.84%
Hybrid 0.4 0.4 0.4 0.4 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.82%
Others 2.9 2.9 3.0 3.0 3.0 3.0 3.0 3.0 2.9 2.9 2.8 -1.04%
Total 23.4 23.3 23.0 22.6 22.2 21.7 21.1 20.5 19.8 19.0 18.2 -3.10%
Table 142: Italy Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 4.0 3.9 3.7 3.5 3.3 3.2 3.0 2.8 2.6 2.5 2.3 -6.05%
Uncemented 0.4 0.4 0.4 0.4 0.4 0.4 0.3 0.3 0.3 0.3 0.3 -4.19%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -1.59%
Others 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.5 0.5 0.5 0.5 -3.40%
Total 5.2 5.0 4.8 4.6 4.4 4.2 4.0 3.8 3.5 3.3 3.1 -5.42%

Italy
Table 143: Italy Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 11.7 11.6 11.4 11.1 10.9 10.5 10.2 9.8 9.3 8.8 8.3 -4.14%
Total 284.6 296.7 307.5 318.3 329.2 340.2 351.2 362.2 373.1 383.9 394.5 3.11%
Table 144: Italy Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 2.6 2.5 2.4 2.3 2.2 2.0 1.9 1.8 1.7 1.5 1.4 -6.43%
Total 62.6 63.5 64.0 64.5 65.0 65.5 65.9 66.4 66.8 67.2 67.5 0.65%

Italy
Table 145: Italy Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.5 0.6 0.6 0.7 0.7 0.7 0.7 0.8 0.8 0.8 0.8 2.51%
Total 23.4 23.3 23.0 22.6 22.2 21.7 21.1 20.5 19.8 19.0 18.2 -3.10%
Table 146: Italy Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.06%
Total 5.2 5.0 4.8 4.6 4.4 4.2 4.0 3.8 3.5 3.3 3.1 -5.42%

Italy
Figure 140: Italy Shoulder Arthroplasty Market Value

Italy Shoulder Arthroplasty Market ($Million) by Procedure Type
• Italy shoulder replacement market value was estimated to be $39.6
75.4
90.0
70.9
66.2
million in 2017 and is forecasted to grow at a CAGR of 8.14% to
61.6
80.0
57.0
52.4
reach market value of $75.4 million by the end of 2025. The market 70.0
47.9
43.6
60.0
39.6
is expected to grow by 1.90X fold over the forecast period.
35.6
32.4
50.0
40.0
• Italy shoulder replacement market volume was estimated to be 8.82 30.0
10.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• In Italy, reverse polarity total prosthetic replacement fixation is the
leading segment. The market value of this segment was estimated to
10.27% to reach market value of $29.2 million by the end of 2025. Figure 141: Italy Shoulder Arthroplasty Market Procedure
The market is expected to grow by 2.23X fold over the forecast Volume (Thousand) by Procedure Type
thousand in 2017 and is forecasted to grow at a CAGR of 9.71% to
16.1
20.0
15.2
14.2
18.0
13.3
12.3
16.0
11.4
10.5
14.0
9.6
8.8
12.0
8.0
7.3
10.0
8.0
6.0
4.0
2.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Italy
Figure 142: Italy Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
35.0
30.0
25.0
20.0
15.0
10.0
5.0
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
10.3 11.6 13.1 14.8 16.5 18.5 20.5 22.6 24.8 27.0 29.2
Replacement
Figure 143: Italy Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
7.0
6.0
5.0
4.0
3.0
2.0
1.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
2.3 2.6 2.9 3.3 3.6 4.0 4.4 4.9 5.3 5.8 6.2
Replacement

Belgium
Belgium Joint Reconstruction Market Overview
• Belgium hip replacement market was valued $92.4 million in 2017 and is expected to reach $156.3 million in 2025. In 2017,
primary hip replacement increased by 0.50% and revision burden increased to 6.52% as compared to 2016. The Belgium hip
arthroplasty market has witnessed stagnant growth trend for past few years. However, with increasing elderly population, the
market is expected gain upward momentum during the forecast period. The Belgium hip arthroplasty market is primarily dominated
by MNcs such as Zimmer Biomet, Depuy Synthes, and Stryker.
• Belgium knee replacement market was valued at $113.0 million in 2017 and is expected to reach $151.8 million by 2025 growing at
a CAGR of 3.69% over the forecast period of 2018-2025. In Belgium, uncemented and unconstrained fixed knee replacement
procedure is witnessing the rising trend among other segment owing to active lifestyle post replacement and long life of the
prostheses pertaining to lower risk of revision procedure.
• Belgium shoulder replacement market was valued at $98.9 million in 2017 and is expected to reach $129.2 million by 2025 growing
at a CAGR of 3.34% over the forecast period of 2018-2025. This growth is anticipated owing to continuously increasing total
shoulder arthroplasties and reversed total shoulder arthroplasties. Moreover, growing baby boomers population in the country with
average life expectancy at 78 years is also boosting the market growth.

Belgium
Figure 144: Belgium Hip Joint Reconstruction Market Figure 145: Belgium Knee Joint Reconstruction Market
Value ($Million) and Procedure Volume (Thousand) Value ($Million) and Procedure Volume (Thousand)
147.1
151.8
142.2
156.3
137.3
132.4
148.2
127.5
140.2
122.6
40 180.0 27 160.0
117.8
132.2
113.0
124.0
108.3
103.8
115.8
35 160.0 140.0
107.9
26
100.1
30 140.0 120.0
92.4
84.8
120.0 25
78.8
25 100.0
100.0
20 24 80.0
36.1
34.7
26.0
33.5
32.2
25.7
80.0
30.9
25.4
29.6
25.2
28.3
27.0
60.0
24.9
15
25.6
24.5
24.3
23
23.0
60.0
24.2
23.9
23.5
10 40.0
23.2
40.0
22.8
22 20.0
5 20.0
0 - 21 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 146: Belgium Shoulder Joint Reconstruction Figure 147: Belgium Shoulder Joint Reconstruction
50
129.2
125.3
121.6
170
117.6
113.9
110.2
106.4
102.6
150 40
27.6
98.9
26.8
95.1
26.1
92.1
25.3
130
24.7
24.0
23.4
22.7
22.1
21.4
20.8
110 30
90
70 20
50
30 10
10
-10 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Belgium
Figure 148: Belgium Hip Arthroplasty Market Value

Belgium Hip Arthroplasty Market ($Million) by Procedure Type
• In 2016, 24.26 thousand hip arthroplasty surgeries were performed
144.3
136.5
in the Belgium. This is an increase on the previous year of 2015 of
128.8
160
121.1
5.3% for hip replacements. The most frequently performed procedure
113.3
105.5
140
was the primary hip replacement with 21.74 thousand (89%)
97.9
90.5
120
procedures, followed by revision hip replacement with 2.31 thousand
83.1
76.0
69.8
100
(10%) procedure. Based on the gender, Female dominated the
80
primary hip arthroplasty procedure volume in japan with 78%
compared to 22% of male in 2015. However, in the revision 60
arthroplasty, the percentage of male has increased in recent year and
11.3
11.0
10.7
10.3
10.0
40
9.5
9.2
8.9
8.5
8.2
8.1
in 2016 it was recorded at 23%.
0.7
0.7
0.7
0.7
0.7
0.7
0.7
0.7
0.7
0.7
0.7
20
0
• In 2016, approximately 67% of the patients with a hip arthroplasty 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
(THA) were operated due to osteoarthritis; 24% were due to fracture;
and remaining were due to avascular necrosis and other medical Primary Hip Replacement Revision Hip Replacement Hip Resurfacing
conditions. Moreover in revision procedures, osteoarthritis was the
primary diagnosis in 69% of patient while fracture was primary
diagnosis in 20% of the patient.
Figure 149: Belgium Hip Arthroplasty Market Procedure
• Based on the fixation type, Uncemented fixation was the most
common used fixation accounting for almost 83% of PHA operation. Volume (Thousand) by Procedure Type
Moreover, the recent trends indicate a gradual reduction in cemented
fixation across all types of Hip Arthroplasty. In most of the developed 50
countries Uncemented fixations are more preferred and have large
33.2
portion of all Hip Arthroplasty procedures. hybrid fixation was the
32.0
40
30.7
29.5
28.2
second most common used fixation accounting for almost 13% of PHA
27.0
25.7
24.4
23.0
operation, followed by cemented primary hip replacement. In revision
21.7
30
hip replacement, Uncemented fixation was the most common used 20.4
fixation accounting for almost 48% of PHA operation followed by 20
hybrid with 33% of all revision hip replacements
10
2.7
2.6
2.6
2.5
2.5
2.4
2.4
2.4
2.4
2.4
2.3
0.2
0.2
0.2
0.2
0.2
0.2
0.2
0.2
0.2
0.2
0.2
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Belgium
Table 147: Belgium Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 2.4 2.5 2.6 2.7 2.8 2.8 2.9 2.9 2.9 2.9 2.9 1.11%
Uncemented 58.4 63.6 69.7 76.0 82.4 88.9 95.7 102.4 109.1 115.9 122.7 7.08%
Hybrid 9.1 10.0 10.9 11.8 12.8 13.8 14.8 15.8 16.8 17.8 18.8 6.81%
Others - - - - - - - - - - - 0.00%
Total 69.9 76.0 83.1 90.5 97.9 105.5 113.3 121.1 128.8 136.5 144.3 6.89%
Table 148: Belgium Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 -1.14%
Uncemented 17.1 18.2 19.3 20.5 21.6 22.7 23.9 25.0 26.0 27.1 28.3 4.71%
Hybrid 2.7 2.8 3.0 3.2 3.4 3.5 3.7 3.9 4.0 4.2 4.3 4.45%
Others - - - - - - - - - - - 0.00%
Total 20.4 21.7 23.0 24.4 25.7 27.0 28.3 29.5 30.7 32.0 33.2 4.53%

Belgium
Table 149: Belgium Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.5 1.4 1.5 1.5 1.5 1.6 1.6 1.6 1.7 1.7 1.7 1.46%
Uncemented 4.3 4.3 4.6 4.9 5.1 5.4 5.8 6.1 6.4 6.7 7.0 5.40%
Hybrid 2.3 2.2 2.3 2.3 2.4 2.4 2.5 2.6 2.6 2.7 2.7 2.42%
Others - - - - - - - - - - - 0.00%
Total 8.2 8.1 8.5 8.9 9.2 9.5 10.0 10.3 10.7 11.1 11.3 3.59%
Table 150: Belgium Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 -0.87%
Uncemented 1.2 1.1 1.2 1.2 1.2 1.2 1.3 1.3 1.3 1.4 1.4 2.24%
Hybrid 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.9 0.9 0.9 1.50%
Others - - - - - - - - - - - 0.00%
Total 2.4 2.3 2.4 2.4 2.4 2.5 2.5 2.5 2.6 2.6 2.7 1.50%

Belgium
Table 151: Belgium Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 4.8 5.2 5.6 6.0 6.5 6.9 7.3 7.8 8.2 8.6 9.0 5.85%
CoP 22.4 24.8 27.6 30.6 33.7 36.9 40.2 43.7 47.2 50.8 54.5 8.61%
CoC 40.8 44.0 47.7 51.4 55.1 58.9 62.6 66.3 69.8 73.3 76.7 5.88%
MoM 0.3 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 1.64%
Other 1.6 1.7 1.9 2.1 2.3 2.5 2.7 2.9 3.2 3.4 3.6 8.11%
Total 69.9 76.0 83.1 90.5 97.9 105.5 113.3 121.1 128.8 136.5 144.3 6.89%
Table 152: Belgium Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 1.4 1.5 1.6 1.6 1.7 1.8 1.8 1.9 1.9 2.0 2.1 3.50%
CoP 6.6 7.1 7.7 8.2 8.8 9.4 10.0 10.7 11.3 11.9 12.6 6.22%
CoC 11.9 12.6 13.2 13.9 14.5 15.0 15.6 16.2 16.7 17.2 17.7 3.55%
MoM 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -0.62%
Other 0.5 0.5 0.5 0.6 0.6 0.6 0.7 0.7 0.8 0.8 0.8 5.72%
Total 20.4 21.7 23.0 24.4 25.7 27.0 28.3 29.5 30.7 32.0 33.2 4.53%

Belgium
Table 153: Belgium Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 1.3 1.3 1.3 1.4 1.4 1.4 1.4 1.5 1.5 1.5 1.5 1.62%
CoP 4.6 4.6 5.0 5.3 5.6 5.9 6.3 6.7 7.1 7.5 7.9 5.85%
CoC 3.2 3.2 3.4 3.6 3.8 4.0 4.3 4.5 4.7 4.9 5.1 5.11%
MoM 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -10.49%
Other 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.3 0.3 0.3 2.43%
Total 8.2 8.1 8.5 8.9 9.2 9.5 10.0 10.3 10.7 11.1 11.3 3.59%
Table 154: Belgium Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.65%
CoP 1.1 1.1 1.1 1.1 1.1 1.2 1.2 1.2 1.2 1.3 1.3 1.94%
CoC 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.8 1.24%
MoM 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -7.77%
Other 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 3.86%
Total 2.4 2.3 2.4 2.4 2.4 2.5 2.5 2.5 2.6 2.6 2.7 1.50%

Belgium
Figure 150: Belgium Knee Arthroplasty Market Value

Belgium Knee Arthroplasty Market ($Million) by Procedure Type
145.2
• Italy primary knee replacement market value was estimated to be
140.1
135.0
129.9
$105.2 million in 2017 and is forecasted to grow at a CAGR of
124.8
119.8
160
114.9
110.0
105.2
100.5
140
The market is expected to grow by 1.38 fold over the forecast
95.9
120
period.
100
80
• Italy primary knee replacement market volume was estimated to be
1.56% to reach market value of 24.84 thousand by the end of 40
7.9
7.9
7.9
7.8
7.7
7.6
7.5
7.4
7.2
6.9
6.7
2025. 20
0
• Italy revision knee replacement market is estimated to grow by 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
0.84X in 2025.

to reach market value of $123.7 million by the end of 2025. The Figure 151: Belgium Knee Arthroplasty Market Procedure
market is expected to grow by 1.35X fold over the forecast period. Volume (Thousand) by Procedure Type
Whereas, the market volume was estimated to be 19.06 thousand
in 2017 and is forecasted to grow at a CAGR of 1.28% to reach
market volume of 21.16 thousand by the end of 2025.
24.8
24.5
24.2
23.8
23.4
30
23.1
22.7
22.3
21.9
21.5
21.1
• Italy bearing type segment is estimated to grow by 1.38X in 2025 25
15
10
1.7
1.7
1.6
1.6
1.5
1.5
1.4
1.3
1.3
1.2
1.1
5
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Belgium
Table 155: Belgium Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 2.2 2.0 2.0 1.9 1.8 1.8 1.7 1.6 1.4 1.3 1.2 -6.84%
Uncemented 83.8 87.7 91.6 95.5 99.5 103.5 107.5 111.6 115.7 119.7 123.7 3.76%
Hybrid 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.67%
Others 9.5 10.3 11.2 12.2 13.1 14.2 15.2 16.3 17.5 18.7 19.9 7.28%
Total 95.9 100.5 105.2 110.0 114.9 119.8 124.8 129.9 135.0 140.1 145.2 4.04%
Table 156: Belgium Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.5 0.4 0.4 0.4 0.4 0.3 0.3 0.3 0.3 0.2 0.2 -9.06%
Uncemented 18.4 18.8 19.1 19.4 19.6 19.9 20.2 20.5 20.7 20.9 21.2 1.28%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -1.73%
Others 2.1 2.2 2.3 2.5 2.6 2.7 2.9 3.0 3.1 3.3 3.4 4.72%
Total 21.1 21.5 21.9 22.3 22.7 23.1 23.4 23.8 24.2 24.5 24.8 1.56%

Belgium
Table 157: Belgium Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 6.2 6.1 6.1 6.0 5.9 5.8 5.7 5.5 5.3 5.1 4.9 -2.88%
Uncemented 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.6 -0.95%
Hybrid 0.1 0.1 0.1 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 1.73%
Others 1.0 1.0 1.0 1.0 1.0 1.1 1.1 1.1 1.1 1.0 1.0 -0.14%
Total 7.9 7.9 7.9 7.8 7.7 7.6 7.5 7.4 7.2 6.9 6.7 -2.23%
Table 158: Belgium Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.4 1.3 1.3 1.2 1.2 1.1 1.1 1.0 1.0 0.9 0.8 -5.20%
Uncemented 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -3.32%
Hybrid 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -0.70%
Others 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 -2.53%
Total 1.7 1.7 1.6 1.6 1.5 1.5 1.4 1.4 1.3 1.2 1.1 -4.56%

Belgium
Table 159: Belgium Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 3.9 3.9 3.9 3.8 3.8 3.7 3.6 3.5 3.4 3.2 3.0 -3.28%
Total 95.9 100.5 105.2 110.0 114.9 119.8 124.8 129.9 135.0 140.1 145.2 4.04%
Table 160: Belgium Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.9 0.8 0.8 0.8 0.8 0.7 0.7 0.6 0.6 0.6 0.5 -5.59%
Total 21.1 21.5 21.9 22.3 22.7 23.1 23.4 23.8 24.2 24.5 24.8 1.56%

Belgium
Table 161: Belgium Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.2 0.2 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.3 0.3 3.43%
Total 7.9 7.9 7.9 7.8 7.7 7.6 7.5 7.4 7.2 6.9 6.7 -2.23%
Table 162: Belgium Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.0 0.0 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.96%
Total 1.7 1.7 1.6 1.6 1.5 1.5 1.4 1.4 1.3 1.2 1.1 -4.56%

Belgium
Figure 152: Belgium Shoulder Arthroplasty Market Value

Belgium Shoulder Arthroplasty Market ($Million) by Procedure Type
• In 2016, there were 21.41 thousand shoulder arthroplasty performed
129.2
125.3
170
121.6
117.6
113.9
in Belgium. The most frequently performed primary procedure was
110.2
106.4
150
102.6
98.9
95.1
the reverse polarity total shoulder replacement with 12.48 thousand 130
92.1
110
procedures, followed by primary total prosthetic replacement with 90
4.52 thousand procedures. The most common diagnosis for primary 70
50
joint replacements was osteoarthritis, followed by fracture. 30
10
-10 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 153: Belgium Shoulder Arthroplasty Market

Procedure Volume (Thousand) by Procedure Type
50
40
27.6
26.8
26.1
25.3
24.7
24.0
23.4
22.7
22.1
21.4
20.8
30
20
10
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Belgium
Figure 154: Belgium Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
90
80
70
60
50
40
30
20
10
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
53.3 55.4 58.0 60.5 63.1 65.6 68.2 70.8 73.6 76.2 79.0
Replacement
Figure 155: Belgium Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
18
16
14
12
10
8
6
4
2
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
12.1 12.5 12.9 13.4 13.8 14.3 14.8 15.3 15.8 16.3 16.9
Replacement
Resurfacing Total Arthroplasty - - - - - - - - - - -
Resurfacing Hemi-arthroplasty - - - - - - - - - - -

Portugal
Portugal Joint Reconstruction Market Overview
• Portugal hip replacement market was stood at $29.7 million in 2017 and is expected to reach $43.1 million in 2025. In 2017,
primary hip replacement increased by 0.96% and the revision burden (the ratio of implant revisions to the total number of
arthroplasties in a specific period) increased to 0.95% as compared to 2016. The growing prevalence of symptomatic osteoarthritis
and post-traumatic arthritis due to the growing aging segment of the population helping to propel hip arthroplasty market in
Portugal.
• Portugal knee replacement market was valued at $31.3 million in 2017 and is expected to reach $44.9 million by 2025 growing at a
CAGR of 4.76% over the forecast period of 2018-2025. In Portugal, uncemented and unconstrained fixed knee replacement
procedure is witnessing the rising trend among other segment owing to active lifestyle post replacement and long life of the
prostheses pertaining to lower risk of revision procedure.
• Portugal shoulder replacement market was valued at $1.4 million in 2017 and is expected to reach $2.2 million by 2025 growing at
a CAGR of 6.32% over the forecast period of 2018-2025. This growth is anticipated owing to continuously increasing total shoulder
arthroplasties and reversed total shoulder arthroplasties. Moreover, growing geriatric population in the country and increasing
incidences of key underline condition would further boost the market growth in coming years.

Portugal
Figure 156: Portugal Hip Joint Reconstruction Market Figure 157: Portugal Knee Joint Reconstruction Market
44.9
42.5
8 50.0
40.4
43.1
38.5
41.5
36.7
39.9
12 50.0
35.1
38.2
33.7
36.5
32.4
34.8
45.0
31.3
7.5 40.0
33.1
30.2
29.3
31.4
10
29.7
40.0
28.1
26.8
8 35.0
7 30.0
30.0
6 25.0
7.7
10.0
7.4
6.5 20.0
9.7
9.5
9.3
9.1
20.0
8.9
7.2
8.7
8.5
8.2
8.0
7.0
7.9
6.9
15.0
6.8
6.7
6.6
6.5
6.5
6.4
2 10.0 6 10.0
5.0
0 - 5.5 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 158: Portugal Shoulder Joint Reconstruction Figure 159: Portugal Shoulder Joint Reconstruction
0.5
0.4
2.2
0.4
2.1
2.5 0.5
0.4
2.0
0.4
1.9
0.4
1.8
0.3
1.7
0.3
2 0.4
1.5
0.3
1.4
0.3
1.4
0.3
1.3
1.2
1.5 0.3
1 0.2
0.5 0.1
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Portugal
Figure 160: Portugal Hip Arthroplasty Market Value

Portugal Hip Arthroplasty Market ($Million) by Procedure Type
• In 2016, 8.04 thousand hip arthroplasty surgeries were performed in

Portugal. The y-o-y growth of 2.40% was witnessed in the market in
38.7
37.2
45
35.8
34.3
2016. The most frequently performed procedure was the primary hip
32.7
40
31.2
29.7
replacement with 7.23 thousand (90%) procedures, followed by
28.2
26.7
35
25.3
24.1
revision hip replacement with 730 (9%) procedures. Based on the 30
gender, females dominated the primary hip arthroplasty procedure 25
volume in japan with 67% as compared to 33% of male in 2016. The 20
distribution by age group shows the expected concentration of 15
arthroplasties in individuals between 61 and 80 years of age, with a
4.3
4.1
3.9
3.7
3.5
10
3.3
3.1
2.9
2.7
2.6
2.4
percentage of 62% of the procedure.
0.3
0.3
0.3
0.3
0.3
0.3
0.3
0.2
0.2
0.2
0.2
5
• The primary osteoarthritis is the main cause for surgery with 57%, 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
although mitigated by the weight of the femoral neck fractures.
Moreover, if primary arthritis is not considered, it shoots up to 77%. Primary Hip Replacement Revision Hip Replacement Hip Resurfacing
• Based on the fixation type, cemented fixation is the most commonly
used fixation accounting for almost 66% of PHA operation. Moreover,
the recent trends indicate a gradual reduction in cemented fixation Figure 161: Portugal Hip Arthroplasty Market Procedure
across all types of hip-arthroplasty. Non-cemented implants are an
innovation of the 1980’s, which is the generation of the current
leaders of Portuguese orthopaedics. The old “cementers” of the
1960’s and 1970’s, are no longer active, and left a very small
8.9
8.7
8.5
10
amount of followers. Based on the size of the femoral head, the 28
8.3
8.2
8.0
7.8
7.6
7.4
mm is still dominant, but it is losing ground to the bigger head sizes,
7.2
7.1
8
where one can see a significant amount of large diameter heads
(=/> 40mm). The classical head is 22mm and it is residual. 6
1.0
1.0
0.9
0.9
0.9
0.8
0.8
0.8
0.8
0.7
0.7
2
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.0
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Portugal
Table 164: Portugal Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 15.8 16.7 17.7 18.8 19.9 21.0 22.2 23.4 24.5 25.7 26.8 5.20%
Uncemented 4.6 4.7 4.8 5.0 5.1 5.2 5.3 5.4 5.4 5.5 5.5 1.47%
Hybrid 3.4 3.6 3.8 4.1 4.3 4.6 4.8 5.1 5.3 5.6 5.8 5.16%
Others 0.3 0.3 0.4 0.4 0.4 0.4 0.5 0.5 0.5 0.6 0.6 6.09%
Total 24.1 25.3 26.7 28.2 29.7 31.2 32.7 34.3 35.8 37.2 38.7 4.60%
Table 165: Portugal Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 4.6 4.8 4.9 5.1 5.2 5.4 5.5 5.7 5.9 6.0 6.2 2.86%
Uncemented 1.3 1.3 1.3 1.3 1.3 1.3 1.3 1.3 1.3 1.3 1.3 -0.77%
Hybrid 1.0 1.0 1.1 1.1 1.1 1.2 1.2 1.2 1.3 1.3 1.3 2.84%
Others 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 3.73%
Total 7.1 7.2 7.4 7.6 7.8 8.0 8.2 8.4 8.5 8.7 8.9 2.29%

Portugal
Table 166: Portugal Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.7 1.8 2.0 2.2 2.3 2.5 2.7 2.9 3.0 3.2 3.4 6.77%
Uncemented 0.6 0.6 0.6 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 1.58%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 7.48%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 5.31%
Total 2.4 2.6 2.7 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.3 5.54%
Table 167: Portugal Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.5 0.5 0.6 0.6 0.6 0.6 0.7 0.7 0.7 0.8 0.8 4.32%
Uncemented 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.1 -1.47%
Hybrid 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 6.51%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 5.61%
Total 0.7 0.7 0.8 0.8 0.8 0.8 0.9 0.9 0.9 1.0 1.0 3.41%

Portugal
Table 168: Portugal Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 6.0 6.2 6.6 6.9 7.2 7.5 7.8 8.1 8.4 8.6 8.9 3.77%
CoP 13.5 14.2 15.0 15.9 16.8 17.7 18.6 19.5 20.4 21.3 22.2 4.89%
CoC 3.1 3.3 3.5 3.7 3.9 4.0 4.2 4.4 4.6 4.8 5.0 4.63%
MoM 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 -0.75%
Other 1.3 1.4 1.5 1.6 1.7 1.8 1.9 2.0 2.1 2.2 2.3 5.62%
Total 24.1 25.3 26.7 28.2 29.7 31.2 32.7 34.3 35.8 37.2 38.7 4.60%
Table 169: Portugal Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 1.8 1.8 1.8 1.9 1.9 1.9 1.9 2.0 2.0 2.0 2.1 1.47%
CoP 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.8 4.9 5.0 5.1 2.58%
CoC 0.9 0.9 1.0 1.0 1.0 1.0 1.1 1.1 1.1 1.1 1.2 2.32%
MoM 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.0 -2.96%
Other 0.4 0.4 0.4 0.4 0.4 0.5 0.5 0.5 0.5 0.5 0.5 3.28%
Total 7.1 7.2 7.4 7.6 7.8 8.0 8.2 8.4 8.5 8.7 8.9 2.29%

Portugal
Table 170: Portugal Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 0.6 0.6 0.6 0.6 0.7 0.7 0.7 0.7 0.8 0.8 0.8 3.52%
CoP 1.4 1.5 1.6 1.8 1.9 2.1 2.3 2.5 2.6 2.8 3.0 8.07%
CoC 0.6 0.6 0.6 0.7 0.7 0.8 0.9 0.9 1.0 1.0 1.1 6.84%
MoM 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -6.97%
Other 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 3.40%
Total 2.4 2.6 2.7 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.3 5.54%
Table 171: Portugal Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 0.2 0.2 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.3 0.3 2.53%
CoP 0.3 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.5 0.5 0.5 4.09%
CoC 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 0.2 0.2 0.2 2.91%
MoM 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -4.14%
Other 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 4.83%
Total 0.7 0.7 0.8 0.8 0.8 0.8 0.9 0.9 0.9 1.0 1.0 3.41%

Portugal
Figure 162: Portugal Knee Arthroplasty Market Value

Portugal Knee Arthroplasty Market ($Million) by Procedure Type
42.9
• Portugal primary knee replacement market value was estimated to
40.5
50.0
38.4
36.4
45.0
34.6
33.0
31.6
40.0
30.3
29.1
28.0
27.1
5.11% to reach market value of $42.9 million by the end of 2025. 35.0
30.0
The market is expected to grow by 1.48X fold over the forecast 25.0
period. 20.0
15.0
• Portugal primary knee replacement market volume was estimated to 10.0
2.2
2.2
2.2
2.2
2.1
2.1
2.1
2.1
2.0
2.0
2.0
5.0
be 6.05 thousand in 2017 and is forecasted to grow at a CAGR of -
2.60% to reach market value of 7.34 thousand by the end of 2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

• Portugal revision knee replacement market is estimated to grow by
0.91X in 2025.
Figure 163: Portugal Knee Arthroplasty Market Procedure
• Uncemented knee fixation segment market value was estimated to
7.3
7.1
6.9
6.7
6.5
6.4
6.2
6.1
6.1
6.0
6.0
7.0
period. Whereas, the market volume was estimated to be 5.27 6.0
4.0
3.0
2.0
0.5
• Portugal bearing type segment is estimated to grow by 1.48X in 2025

0.5
0.5
0.4
0.4
0.4
0.4
0.4
0.4
0.4
0.3
1.0
whereas the leading bearing type segment is unconstrained fixed -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Portugal
Table 172: Portugal Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.6 0.6 0.5 0.5 0.5 0.5 0.5 0.4 0.4 0.4 0.3 -5.88%
Uncemented 23.7 24.5 25.3 26.3 27.3 28.5 29.8 31.3 32.9 34.6 36.6 4.83%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 1.71%
Others 2.7 2.9 3.1 3.3 3.6 3.9 4.2 4.6 5.0 5.4 5.9 8.38%
Total 27.1 28.0 29.1 30.3 31.6 33.0 34.6 36.4 38.4 40.5 42.9 5.11%
Table 173: Portugal Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -8.13%
Uncemented 5.2 5.2 5.3 5.3 5.4 5.5 5.6 5.7 5.9 6.1 6.3 2.33%
Hybrid 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -0.72%
Others 0.6 0.6 0.7 0.7 0.7 0.8 0.8 0.8 0.9 0.9 1.0 5.80%
Total 6.0 6.0 6.1 6.1 6.2 6.4 6.5 6.7 6.9 7.1 7.3 2.60%

Portugal
Table 174: Portugal Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 1.7 1.7 1.7 1.7 1.6 1.6 1.6 1.5 1.5 1.5 1.5 -1.64%
Uncemented 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.30%
Hybrid 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 3.02%
Others 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 1.12%
Total 2.2 2.2 2.2 2.2 2.1 2.1 2.1 2.1 2.0 2.0 2.0 -1.22%
Table 175: Portugal Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.4 0.4 0.4 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 -4.22%
Uncemented 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -2.33%
Hybrid 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.32%
Others 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -1.53%
Total 0.5 0.5 0.5 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.3 -3.58%

Portugal
Table 176: Portugal Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 1.1 1.1 1.1 1.1 1.0 1.0 1.0 1.0 1.0 0.9 0.9 -2.28%
Total 27.1 28.0 29.1 30.3 31.6 33.0 34.6 36.4 38.4 40.5 42.9 5.11%
Table 177: Portugal Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 -4.62%
Total 6.0 6.0 6.1 6.1 6.2 6.4 6.5 6.7 6.9 7.1 7.3 2.60%

Portugal
Table 178: Portugal Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 4.50%
Total 2.2 2.2 2.2 2.2 2.1 2.1 2.1 2.1 2.0 2.0 2.0 -1.22%
Table 179: Portugal Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.00%
Total 0.5 0.5 0.5 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.3 -3.58%

Portugal
Figure 164: Portugal Shoulder Arthroplasty Market Value

Portugal Shoulder Arthroplasty Market ($Million) by Procedure Type
• In 2016, there were 284.1 shoulder arthroplasty performed in
2.2
2.1
2.5
2.0
Portugal. The growth in shoulder implants exceeded that of knees
1.9
1.8
1.7
2
1.5
and hip; however, this was largely because of the growing demand
1.4
1.4
1.3
1.2
for reverse polarity total prosthetic replacement. The most frequently 1.5
performed primary procedure was the Hemi-arthroplasty with 141.8 1

(49.9%) procedures, followed by primary total prosthetic 0.5
replacement with 64.5 (22.7%) procedures. Approximately 55% of
0
primary replacements were performed on the right shoulder joint. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Arthritis is still a leading cause with 56%, immediately followed by Global Shoulder Joint Reconstruction Market Value ($Million)
fractures with 28%.
Figure 165: Portugal Shoulder Arthroplasty Market

0.5
0.4
0.4
0.5
0.4
0.4
0.4
0.3
0.3
0.4
0.3
0.3
0.3
0.3
0.2
0.1
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Portugal
Figure 166: Portugal Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
1.2
1.0
0.8
0.6
0.4
0.2
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Replacement
Figure 167: Portugal Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
0.3
0.2
0.2
0.1
0.1
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
- - - - - - - - - - -
Replacement

Norway
Norway Joint Reconstruction Market Overview
• Norway hip replacement market was valued $39.15 million in 2017 and is expected to reach $64.93 million in 2025. In 2017, primary hip
replacement increased by 0.88% and revision burden increased to 0.85% as compared to that of 2016. The growing prevalence of Primary
osteoarthritis, hip fracture and Femoral head necrosis due to the growing elderly patient segment of the population driving the demand for hip
arthroplasty market in Norway.
• Norway knee replacement market was valued $26.37 million in 2017 and is expected to reach $33.96 million by 2025 growing at a CAGR of
3.00% over the forecast period of 2018-2025. In Norway, uncemented and unconstrained fixed knee replacement procedure is witnessing the
rising trend among other segment owing to active lifestyle post replacement and long life of the prostheses pertaining to lower risk of revision
procedure.
• Norway shoulder replacement market was valued $3.13 million in 2017 and is expected to reach $5.81 million by 2025 growing at a CAGR of
7.93% over the forecast period of 2018-2025. This growth is anticipated owing to continuously increasing reverse polarity total prosthetic
replacement and incidences of osteoarthritis.

Norway
Figure 168: Norway Hip Joint Reconstruction Market Figure 169: Norway Knee Joint Reconstruction Market
61.8
64.9
58.5
16 70.0
55.2
34.0
33.4
52.0
32.7
31.9
6 40.0
48.7
31.0
14
29.9
60.0
45.4
28.8
27.6
42.2
35.0
26.4
39.1
12
25.1
5.8
23.7
50.0
36.2
33.7
30.0
10 5.6
40.0 25.0
15.0
8
14.5
14.0
13.5
13.0 5.4 20.0
12.5
30.0
11.9
5.9
5.8
5.8
11.4
5.8
5.8
10.9
5.8
10.4
5.7
9.8
15.0
5.6
20.0 5.2
5.5
4
5.4
10.0
5.2
2 10.0 5
5.0
0 - 4.8 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 170: Norway Shoulder Joint Reconstruction Figure 171: Norway Shoulder Joint Reconstruction
1.2
5.8
1.2
1.4
5.5
1.1
5.1
1.0
6
4.8
1.0
1.2
0.9
4.4
0.8
4.1
0.8
3.8
0.7
3.4
0.7
3.1
0.6
2.9
4 0.8
2.6
3 0.6
2 0.4
1 0.2
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Global Shoulder Joint Reconstruction Market Value ($Million) Shoulder Joint Reconstruction Procedure Volume (Thousand)

Norway
Figure 172: Norway Hip Arthroplasty Market Value

Norway Hip Arthroplasty Market ($Million) by Procedure Type
• Approximately 9.35 thousand primary implant operations and 1.48
56.4
53.6
thousand revision hip arthroplasty operations, as well as 40 hip
50.7
60.0
47.8
44.9
resurfacing operations were recorded in Norway in 2016. The
42.0
39.2
50.0
majority (85%) of the hip operations are primary implants which are
36.4
33.7
referred as a primary hip arthroplasty, carried out in a cemented or
31.1
40.0
28.8
uncemented fashion. Current improvements in hip designs, surgical
techniques, fixation methods, prophylactic therapies, preadmission 30.0
education, and rehabilitation have contributed to improved patient 20.0
8.4
8.0
outcomes. The remaining (13%) revision operations were performed
7.7
7.3
7.0
6.5
6.1
5.7
5.3
5.0
4.8
on primary hip prostheses which are failed due to a verity of reasons 10.0
0.2
0.2
0.2
0.2
0.1
0.1
0.2
0.1
0.1
0.1
0.1
including osteoarthritis, fracture, femoral head necrosis, -
polyethylene wear, fracture or implant failure. Rate of revision 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
continued its downward trend from 14.5% in 2010 to 13% in 2016.
• In 2016, approximately 79% of the patients with a hip arthroplasty
(THA) were operated due to osteoarthritis; 9.4% were due to hip
fracture; and childhood diseases, femoral head necrosis, and other Figure 173: Norway Hip Arthroplasty Market Procedure
medical conditions. Moreover in revision procedures, primary
osteoarthritis was the primary diagnosis in 75% of patient while Volume (Thousand) by Procedure Type
fracture was primary diagnosis in 7% of the patient.
13.0
12.6
12.1
• Based on the fixation type, uncemented fixation is the most common
11.6
11.2
14.0
10.7
used fixation accounting for almost 37% of PHA operation, followed
10.3
9.8
12.0
9.3
by hybrid and cemented type. However, the recent trends indicate a
8.9
8.4
10.0
gradual reduction in cemented fixation across all types of Hip
Arthroplasty. The cemented type hip arthroplasty is expected to lose 8.0
5% market during the forecast period. 6.0
2.0
1.9
1.8
1.8
4.0
1.7
1.7
1.6
1.5
1.5
1.4
1.4
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Norway
Table 180: Norway Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 8.1 8.5 9.0 9.6 10.0 10.5 11.0 11.4 11.8 12.1 12.4 3.82%
Uncemented 10.7 11.6 12.8 13.9 15.1 16.4 17.7 19.0 20.4 21.8 23.1 7.52%
Hybrid 8.7 9.4 10.3 11.3 12.2 13.2 14.3 15.3 16.4 17.5 18.6 7.44%
Others 1.4 1.5 1.6 1.7 1.8 1.9 2.0 2.1 2.1 2.2 2.3 4.03%
Total 28.8 31.1 33.7 36.4 39.2 42.0 44.9 47.8 50.7 53.6 56.4 6.44%
Table 181: Norway Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 2.4 2.4 2.5 2.6 2.6 2.7 2.7 2.8 2.8 2.8 2.9 1.52%
Uncemented 3.1 3.3 3.5 3.8 4.0 4.2 4.4 4.6 4.9 5.1 5.3 5.14%
Hybrid 2.5 2.7 2.9 3.0 3.2 3.4 3.6 3.7 3.9 4.1 4.3 5.07%
Others 0.4 0.4 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1.71%
Total 8.4 8.9 9.4 9.8 10.3 10.7 11.2 11.6 12.1 12.6 13.0 4.09%

Norway
Table 182: Norway Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.3 1.4 1.4 1.5 1.5 1.6 1.7 1.7 1.7 1.8 1.8 2.91%
Uncemented 3.3 3.5 3.8 4.1 4.5 4.9 5.3 5.6 6.0 6.4 6.8 7.60%
Hybrid 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.4 0.4 0.4 0.4 7.93%
Others 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 3.30%
Total 4.8 5.0 5.3 5.7 6.1 6.5 7.0 7.3 7.7 8.0 8.4 5.73%
Table 183: Norway Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.54%
Uncemented 0.9 0.9 1.0 1.0 1.1 1.1 1.2 1.2 1.3 1.3 1.4 4.37%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 6.95%
Others 0.0 0.0 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 3.60%
Total 1.4 1.4 1.5 1.5 1.6 1.7 1.7 1.8 1.8 1.9 2.0 3.60%

Norway
Table 184: Norway Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 20.2 21.5 23.0 24.5 26.0 27.4 28.9 30.3 31.6 33.0 34.1 4.88%
CoP 6.1 6.7 7.6 8.4 9.3 10.3 11.3 12.4 13.5 14.6 15.8 9.40%
CoC 1.4 1.6 1.8 2.0 2.3 2.5 2.8 3.1 3.3 3.6 4.0 9.88%
MoM 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 -1.31%
Other 0.9 1.0 1.1 1.2 1.3 1.5 1.6 1.8 1.9 2.1 2.3 9.41%
Total 28.8 31.1 33.7 36.4 39.2 42.0 44.9 47.8 50.7 53.6 56.4 6.44%
Table 185: Norway Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 5.9 6.1 6.4 6.6 6.8 7.0 7.2 7.4 7.5 7.7 7.9 2.55%
CoP 1.8 1.9 2.1 2.3 2.5 2.6 2.8 3.0 3.2 3.4 3.6 6.99%
CoC 0.4 0.5 0.5 0.6 0.6 0.6 0.7 0.7 0.8 0.9 0.9 7.46%
MoM 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -3.51%
Other 0.3 0.3 0.3 0.3 0.4 0.4 0.4 0.4 0.5 0.5 0.5 6.99%
Total 8.4 8.9 9.4 9.8 10.3 10.7 11.2 11.6 12.1 12.6 13.0 4.09%

Norway
Table 186: Norway Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 2.0 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.6 2.7 2.8 3.49%
CoP 1.8 1.9 2.1 2.3 2.5 2.8 3.1 3.3 3.6 3.9 4.1 8.74%
CoC 0.5 0.6 0.6 0.7 0.8 0.8 0.9 1.0 1.1 1.2 1.3 9.22%
MoM 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -4.44%
Other 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.4 0.4 3.92%
Total 4.8 5.0 5.3 5.7 6.1 6.5 7.0 7.3 7.7 8.0 8.4 5.73%
Table 187: Norway Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 0.8 0.8 0.8 0.8 0.9 0.9 0.9 0.9 0.9 1.0 1.0 2.50%
CoP 0.4 0.5 0.5 0.5 0.5 0.6 0.6 0.6 0.6 0.7 0.7 4.73%
CoC 0.1 0.1 0.1 0.1 0.1 0.2 0.2 0.2 0.2 0.2 0.2 5.20%
MoM 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -1.53%
Other 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 5.36%
Total 1.4 1.4 1.5 1.5 1.6 1.7 1.7 1.8 1.8 1.9 2.0 3.60%

Norway
Figure 174: Norway Knee Arthroplasty Market Value

Norway Knee Arthroplasty Market ($Million) by Procedure Type
• Norway primary knee replacement market value was estimated to be
32.5
31.8
31.1
30.2
29.2
28.1
$24.53 million in 2017 and is forecasted to grow at a CAGR of 3.35% 35.0
27.0
25.8
24.5
23.2
30.0
21.9
25.0
15.0
• Norway primary knee replacement market volume was estimated to
10.0
1.84
1.83
1.82
1.82
1.80
1.80
1.76
1.71
1.65
1.58
1.49
5.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• Norway revision knee replacement market is estimated to grow by
0.81X in 2025.

Figure 175: Norway Knee Arthroplasty Market Procedure
5.6
5.6
5.6
5.5
5.5
5.4
5.3
5.2
5.1
5.0
6.0
4.8
2017 and is forecasted to grow at a CAGR of 0.60% to reach market 5.0
volume of 4.73 thousand by the end of 2025. 4.0
3.0
• Norway bearing type segment is estimated to grow by 1.32X in 2025
2.0
0.4
0.4
0.4
0.4
0.4
0.3
0.3
0.3
0.3
0.3
0.3
1.0
which is estimated to grow by 1.46X by 2025. -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Norway
Table 188: Norway Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.5 0.5 0.5 0.5 0.4 0.4 0.4 0.4 0.3 0.3 0.3 -7.46%
Uncemented 19.2 20.3 21.4 22.4 23.4 24.3 25.2 26.0 26.6 27.2 27.7 3.07%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.00%
Others 2.2 2.4 2.6 2.9 3.1 3.3 3.6 3.8 4.0 4.2 4.5 6.56%
Total 21.9 23.2 24.5 25.8 27.0 28.2 29.2 30.2 31.1 31.9 32.5 3.35%
Table 189: Norway Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.0 -9.67%
Uncemented 4.2 4.3 4.5 4.5 4.6 4.7 4.7 4.8 4.8 4.8 4.7 0.60%
Hybrid 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -2.39%
Others 0.5 0.5 0.6 0.6 0.6 0.6 0.7 0.7 0.7 0.7 0.8 4.01%
Total 4.8 5.0 5.1 5.2 5.3 5.4 5.5 5.5 5.6 5.6 5.6 0.88%

Norway
Table 190: Norway Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.4 1.4 1.4 1.4 1.4 1.4 1.3 1.3 1.2 1.2 1.1 -3.53%
Uncemented 0.1 0.1 0.2 0.2 0.2 0.2 0.2 0.2 0.1 0.1 0.1 -1.62%
Hybrid 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.04%
Others 0.2 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.2 0.2 0.2 -0.81%
Total 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.7 1.7 1.6 1.5 -2.88%
Table 191: Norway Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.2 0.2 0.2 0.2 -5.83%
Uncemented 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -3.97%
Hybrid 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -1.37%
Others 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.0 0.0 0.0 -3.18%
Total 0.4 0.4 0.4 0.4 0.4 0.4 0.3 0.3 0.3 0.3 0.3 -5.20%

Norway
Table 192: Norway Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.9 0.9 0.9 0.9 0.9 0.9 0.9 0.8 0.8 0.7 0.7 -3.93%
Total 21.9 23.2 24.5 25.8 27.0 28.2 29.2 30.2 31.1 31.9 32.5 3.35%
Table 193: Norway Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.1 0.1 0.1 -6.22%
Total 4.8 5.0 5.1 5.2 5.3 5.4 5.5 5.5 5.6 5.6 5.6 0.88%

Norway
Table 194: Norway Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 2.74%
Total 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.7 1.7 1.6 1.5 -2.88%
Table 195: Norway Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.28%
Total 0.4 0.4 0.4 0.4 0.4 0.4 0.3 0.3 0.3 0.3 0.3 -5.20%

Norway
Figure 176: Norway Shoulder Arthroplasty Market Value

Norway Shoulder Arthroplasty Market ($Million) by Procedure Type
• In 2016, there were 0.70 thousand shoulder arthroplasty performed 7.0
5.8
5.5
5.1
in Norway, mostly dominated by reverse prosthetic replacements. 6.0
4.8
4.4
4.1
The most frequently performed primary procedure was the reverse 5.0
3.8
3.4
3.1
polarity total shoulder replacement with 371 (53%) procedures, 4.0
2.9
2.6
followed by primary total prosthetic replacement with 167 (24%) 3.0
2.0
procedures. More than 50% of primary replacements were performed
1.0
on the right shoulder joint. The most common indications for primary
-
joint replacements were osteoarthritis and cuff tear arthropathy. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 177: Norway Shoulder Arthroplasty Market

1.2
1.2
1.4
1.1
1.0
1.2
1.0
0.9
0.8
1.0
0.8
0.7
0.7
0.6
0.8
0.6
0.4
0.2
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Norway
Figure 178: Norway Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
3.5
3.0
2.5
2.0
1.5
1.0
0.5
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
1.3 1.6 1.7 1.8 2.0 2.1 2.3 2.5 2.7 2.8 3.0
Replacement
Figure 179: Norway Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
0.7
0.6
0.5
0.4
0.3
0.2
0.1
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
0.3 0.4 0.4 0.4 0.4 0.5 0.5 0.5 0.6 0.6 0.6
Replacement

Czech Republic
Czech Republic Joint Reconstruction Market Overview
• Czech Republic hip replacement market was valued $66.7 million in 2017 and is expected to reach $108.6 million in 2025. In 2017, primary hip
replacement increased by 0.46% and revision burden increased to 0.46% as compared to 2016. The major underserved population for joint
replacement of the hip in late-stage arthritis in the Czech Republic driving procedural numbers up for the hip replacement market.
• Czech Republic knee replacement market was valued $66.1 million in 2017 and is expected to reach $81.5 million by 2025 growing at a CAGR of
2.47% over the forecast period of 2018-2025. In Czech Republic, the market for uncemented and unconstrained fixed prostheses are highly used
in primary procedures as it provides highly comfortable movement and enable active lifestyle to patients post operation.
• Czech Republic shoulder replacement market was valued $4.3 million in 2017 and is expected to reach $6.8 million by 2025 growing at a CAGR of
5.84% over the forecast period of 2018-2025. It is an emerging orthopaedic market that is expected to continue to grow but only moderately.
The market is based on and will be driven by the rising prevalence of osteoarthritis and the increasing demand for reverse polarity total prosthetic
replacement.

Czech Republic
Figure 180: Czech Republic Hip Joint Reconstruction Market Figure 181: Czech Republic Knee Joint Reconstruction Market
108.6
103.0
81.5
80.4
79.0
77.4
75.5
97.5
73.4
30 120.0
71.1
14.4 90.0
92.0
68.7
86.7
66.1
63.4
81.5
60.6
14.2 80.0
76.3
25 100.0
71.5
66.7
14 70.0
62.0
57.9
20 80.0 60.0
13.8
50.0
15 60.0 13.6
14.2
14.2
25.0
14.1
14.1
24.1
40.0
14.1
23.3
14.0
22.4
21.6
13.9
20.8
13.9
20.0
13.4
19.3
18.5
17.7
13.8
10 40.0
16.9
30.0
13.6
13.2 20.0
13.3
5 20.0
13 10.0
0 - 12.8 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 182: Czech Republic Shoulder Joint Figure 183: Czech Republic Shoulder Joint
Reconstruction Market Value ($Million) Reconstruction Market Procedure Volume (Thousand)
1.5
1.4
1.6
6.8
1.3
6.5
1.2
6.1
1.2
1.4
5.8
1.1
5.5
1.1
5.2
1.0
4.9
1.0
6 1.2
0.9
4.6
0.9
4.3
4.1
3.8
5 1
4 0.8
3 0.6
2 0.4
1 0.2
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Czech Republic
Figure 184: Czech Republic Hip Arthroplasty Market

Czech Republic Hip Arthroplasty Market
Value ($Million) by Procedure Type
• In 2016, 17.74 thousand hip arthroplasty surgeries were performed 120.0
96.4
in the Czech Republic region. This is an increase on the previous year
91.5
86.5
of 2015 of 4.7% for hip replacements. The most frequently
81.7
100.0
77.0
72.4
performed procedure was the primary hip replacement with 15,793
67.8
63.5
80.0
59.4
(89%) procedures, followed by revision hip replacement with 1,944
55.2
51.6
(11%) procedure. Based on gender, females dominated the primary 60.0
hip arthroplasty procedure volume in Czech Republic with 70% as
compared to 30% of male in 2016. 40.0
12.1
11.5
10.9
10.3
9.7
9.1
8.5
7.9
7.4
6.8
6.3
20.0
(THA) were operated due to osteoarthritis; 18% were due to
-
-
fracture; and remaining were due to trauma, Charcot's, and other
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
medical conditions. Moreover in revision procedures, osteoarthritis
was the primary diagnosis in 72% of patient while fracture and Primary Hip Replacement Revision Hip Replacement Hip Resurfacing
trauma was primary diagnosis in 16 % of the patient.
• Based on the fixation type, uncemented fixation is the most common
used fixation accounting for almost 46% of PHA operation followed Figure 185: Czech Republic Hip Arthroplasty Market
by cemented and hybrid type. However, the recent trends indicate a
gradual reduction in cemented fixation across all types of hip Procedure Volume (Thousand) by Procedure Type
arthroplasty. The cemented hip arthroplasty fixation was recorded at
36% in 2016, and expected to reach 28% by 2025, a decrease of 8%
22.2
21.4
during the forecast period. Moreover, the demand for hybrid and
20.6
25.0
19.9
19.2
18.5
uncemented fixation is anticipated to increase during the forecast
17.8
17.1
16.5
15.8
period and reach 70% of the total fixation (a combination of both 20.0
15.1
cemented and un-cemented) by 2025.
15.0
10.0
2.8
2.7
2.6
2.5
2.4
2.3
2.2
2.1
2.0
1.9
1.8
5.0
-
-
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Czech Republic
Table 196: Czech Republic Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 19.1 20.0 21.0 21.9 22.8 23.7 24.6 25.4 26.1 26.9 27.5 3.31%
Uncemented 23.2 25.4 27.9 30.5 33.2 36.2 39.3 42.5 45.9 49.4 53.0 8.22%
Hybrid 9.3 9.9 10.5 11.1 11.8 12.5 13.2 13.8 14.5 15.2 15.9 5.19%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 51.6 55.2 59.4 63.5 67.8 72.4 77.0 81.7 86.5 91.5 96.4 6.13%
Table 197: Czech Republic Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 5.6 5.7 5.8 5.9 6.0 6.1 6.1 6.2 6.2 6.3 6.3 1.01%
Uncemented 6.8 7.3 7.7 8.2 8.7 9.3 9.8 10.4 10.9 11.6 12.2 5.82%
Hybrid 2.7 2.8 2.9 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 2.87%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 15.1 15.8 16.5 17.1 17.8 18.5 19.2 19.9 20.6 21.4 22.2 3.79%

Czech Republic
Table 198: Czech Republic Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 2.1 2.2 2.4 2.5 2.6 2.7 2.8 2.9 3.0 3.0 3.1 3.24%
Uncemented 2.8 3.1 3.4 3.8 4.1 4.5 5.0 5.4 5.9 6.4 6.9 9.04%
Hybrid 1.3 1.4 1.5 1.6 1.7 1.8 1.9 2.0 2.2 2.3 2.4 5.91%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 6.3 6.8 7.4 7.9 8.5 9.1 9.7 10.3 10.9 11.5 12.1 6.30%
Table 199: Czech Republic Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.6 0.6 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.87%
Uncemented 0.8 0.8 0.9 0.9 1.0 1.0 1.1 1.2 1.2 1.3 1.4 5.77%
Hybrid 0.5 0.5 0.5 0.6 0.6 0.6 0.6 0.7 0.7 0.7 0.8 4.95%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 1.8 1.9 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 4.16%

Czech Republic
Table 200: Czech Republic Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 24.3 25.7 27.4 29.1 30.8 32.6 34.4 36.1 37.9 39.7 41.5 5.19%
CoP 16.6 18.0 19.7 21.4 23.2 25.2 27.2 29.3 31.5 33.8 36.1 7.75%
CoC 7.6 8.2 8.8 9.4 10.1 10.8 11.5 12.2 12.9 13.7 14.4 6.27%
MoM 0.5 0.6 0.6 0.6 0.6 0.6 0.7 0.7 0.7 0.7 0.7 1.55%
Other 2.6 2.7 2.9 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 2.99%
Total 51.6 55.2 59.4 63.5 67.8 72.4 77.0 81.7 86.5 91.5 96.4 6.13%
Table 201: Czech Republic Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 7.1 7.4 7.6 7.8 8.1 8.3 8.6 8.8 9.0 9.3 9.6 2.85%
CoP 4.9 5.2 5.5 5.8 6.1 6.4 6.8 7.1 7.5 7.9 8.3 5.38%
CoC 2.2 2.3 2.4 2.5 2.7 2.8 2.9 3.0 3.1 3.2 3.3 3.92%
MoM 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 -0.71%
Other 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.71%
Total 15.1 15.8 16.5 17.1 17.8 18.5 19.2 19.9 20.6 21.4 22.2 3.78%

Czech Republic
Table 202: Czech Republic Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 1.4 1.5 1.6 1.7 1.8 1.8 1.9 2.0 2.0 2.1 2.2 3.67%
CoP 3.6 4.0 4.4 4.9 5.4 5.9 6.4 7.0 7.6 8.2 8.8 8.88%
CoC 1.4 1.6 1.7 1.9 2.1 2.3 2.5 2.7 2.9 3.2 3.4 8.55%
MoM 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -7.60%
Other 0.3 0.3 0.3 0.3 0.3 0.4 0.4 0.4 0.4 0.4 0.4 3.85%
Total 6.3 6.8 7.4 7.9 8.5 9.1 9.7 10.3 10.9 11.5 12.1 6.30%
Table 203: Czech Republic Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 0.6 0.6 0.6 0.6 0.7 0.7 0.7 0.7 0.7 0.7 0.8 2.67%
CoP 0.9 0.9 1.0 1.0 1.1 1.2 1.2 1.3 1.3 1.4 1.5 4.86%
CoC 0.3 0.3 0.4 0.4 0.4 0.4 0.4 0.4 0.5 0.5 0.5 4.56%
MoM 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -4.79%
Other 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 5.29%
Total 1.8 1.9 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 4.16%

Czech Republic
Figure 186: Czech Republic Knee Arthroplasty Market

Czech Republic Knee Arthroplasty Market Value ($Million) by Procedure Type
• Czech Republic primary knee replacement market value was
77.9
76.6
75.1
73.3
90.0
71.2
69.0
66.6
64.1
80.0
61.5
58.8
56.0
2025. The market is expected to grow by 1.26X fold over the 70.0
forecast period. 60.0
50.0
• Czech Republic primary knee replacement market volume was
40.0
estimated to be 12.80 thousand in 2017 and is forecasted to grow at
30.0
a CAGR of 0.36% to reach market value of 13.33 thousand by the
4.61
4.61
4.60
4.56
4.50
4.41
4.29
4.15
3.98
3.80
3.59
end of 2025. 20.0
10.0
• Czech Republic revision knee replacement market is estimated to -
grow by 0.77X in 2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
period. Whereas, the market volume was estimated to be 11.15 Figure 187: Czech Republic Knee Arthroplasty Market
thousand in 2017 and is forecasted to grow at a CAGR of 0.09% to Procedure Volume (Thousand) by Procedure Type
• Czech Republic bearing type segment is estimated to grow by 1.26X
13.4
13.4
13.4
13.4
13.3
13.3
13.2
13.0
in 2025 whereas the leading bearing type segment is unconstrained
12.8
12.6
16.0
12.3
fixed which is estimated to grow by 1.40X by 2025. 14.0
12.0
10.0
8.0
6.0
4.0
1.0
1.0
1.0
0.9
0.9
0.8
0.8
0.8
0.7
0.7
0.6
2.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Czech Republic
Table 204: Czech Republic Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.3 1.2 1.1 1.1 1.1 1.0 0.9 0.9 0.8 0.7 0.6 -7.93%
Uncemented 48.9 51.3 53.5 55.7 57.7 59.6 61.4 62.9 64.3 65.5 66.4 2.54%
Hybrid 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 -0.51%
Others 5.5 6.1 6.6 7.1 7.6 8.2 8.7 9.2 9.7 10.2 10.7 6.02%
Total 56.0 58.8 61.5 64.1 66.6 69.0 71.2 73.3 75.1 76.6 77.9 2.82%
Table 205: Czech Republic Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.3 0.3 0.2 0.2 0.2 0.2 0.2 0.2 0.1 0.1 0.1 -10.13%
Uncemented 10.8 11.0 11.2 11.3 11.4 11.5 11.5 11.5 11.5 11.5 11.4 0.09%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.0 0.0 0.0 0.0 -2.89%
Others 1.2 1.3 1.4 1.4 1.5 1.6 1.6 1.7 1.7 1.8 1.8 3.49%
Total 12.3 12.6 12.8 13.0 13.2 13.3 13.4 13.4 13.4 13.4 13.3 0.36%

Czech Republic
Table 206: Czech Republic Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 3.6 3.6 3.6 3.5 3.4 3.3 3.2 3.1 3.0 2.8 2.6 -4.02%
Uncemented 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.3 0.3 0.3 -2.12%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.53%
Others 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.5 -1.32%
Total 4.6 4.6 4.6 4.6 4.5 4.4 4.3 4.1 4.0 3.8 3.6 -3.38%
Table 207: Czech Republic Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.8 0.8 0.7 0.7 0.7 0.6 0.6 0.6 0.5 0.5 0.5 -6.31%
Uncemented 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -4.46%
Hybrid 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -1.87%
Others 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -3.68%
Total 1.0 1.0 1.0 0.9 0.9 0.9 0.8 0.8 0.7 0.7 0.6 -5.69%

Czech Republic
Table 208: Czech Republic Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 2.3 2.3 2.3 2.2 2.2 2.1 2.1 2.0 1.9 1.8 1.6 -4.42%
Total 56.0 58.8 61.5 64.1 66.6 69.0 71.2 73.3 75.1 76.6 77.9 2.82%
Table 209: Czech Republic Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.5 0.5 0.5 0.5 0.4 0.4 0.4 0.4 0.3 0.3 0.3 -6.70%
Total 12.3 12.6 12.8 13.0 13.2 13.3 13.4 13.4 13.4 13.4 13.3 0.36%

Czech Republic
Table210: Czech Republic Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.1 0.1 0.1 0.1 0.1 0.1 0.2 0.2 0.2 0.2 0.2 2.21%
Total 4.6 4.6 4.6 4.6 4.5 4.4 4.3 4.1 4.0 3.8 3.6 -3.38%
Table 211: Czech Republic Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -0.23%
Total 1.0 1.0 1.0 0.9 0.9 0.9 0.8 0.8 0.7 0.7 0.6 -5.69%

Czech Republic
Figure 188: Czech Republic Shoulder Arthroplasty Market

Czech Republic Shoulder Arthroplasty Market Value ($Million) by Procedure Type
• In 2016, there were 916 shoulder arthroplasty surgeries performed
6.8
8.0
6.5
6.1
in the Czech Republic. The growth in shoulder arthroplasty market is 7.0
5.8
5.5
5.2
4.9
6.0
expected owing to growing incidences of underline conditions such as
4.6
4.3
4.1
3.8
5.0
rotator cuff tear, and cuff tear arthropathy. The most frequently
4.0
performed primary procedure was the total prosthetic replacement 3.0
with 380 (41%) procedures, followed by primary reverse prosthetic 2.0
replacement with 334 (36%) procedures. The most common 1.0

-
indications for primary joint replacements were cuff tear arthropathy 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
(38%), followed by massive rotator cuff tear (23%). Global Shoulder Joint Reconstruction Market Value ($Million)
Figure 189: Czech Republic Shoulder Arthroplasty Market

1.5
1.4
1.6
1.3
1.2
1.2
1.4
1.1
1.1
1.0
1.0
1.2
0.9
0.9
1.0
0.8
0.6
0.4
0.2
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Czech Republic
Figure 190: Czech Republic Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
3.0
2.5
2.0
1.5
1.0
0.5
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
1.4 1.5 1.6 1.7 1.8 2.0 2.1 2.3 2.4 2.6 2.8
Replacement
Figure 191: Czech Republic Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
0.7
0.6
0.5
0.4
0.3
0.2
0.1
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
0.3 0.3 0.4 0.4 0.4 0.4 0.5 0.5 0.5 0.6 0.6
Replacement

Spain
Spain Joint Reconstruction Market Overview
• Spain hip replacement market was valued $183.1 million in 2017 and is expected to reach $236.0 million in 2025. In 2017, primary
hip replacement increased by 0.74% and revision burden increased to 0.84% as compared to 2016. The growing prevalence of
osteoarthritis, and Femoral neck fracture due to the growing aging segment of the population helping to propel hip arthroplasty
market in Spain.
• Spain knee replacement market was valued at $272.8 million in 2017 and is expected to reach $485.6 million by 2025 growing at a
CAGR of 7.84% over the forecast period of 2018-2025. In Czech Republic, market for uncemented and unconstrained fixed
prostheses are highly used in primary procedures as it provides highly comfortable movement and enable active lifestyle to patients
post operation.
• Spain shoulder replacement market was valued at $16.2 million in 2017 and is expected to reach $25.1 million by 2025 growing at
a CAGR of 5.54% over the forecast period of 2018-2025. This growth is anticipated owing to continuously increasing total shoulder
arthroplasties and reversed total shoulder arthroplasties. Shoulder arthritis in the young adult population represents a common
disease management dilemma in the Spain. With the younger population leading an active life, which can often include interest in
sports involving the shoulder, there is an increased demand for treatments that bring pain relief and a long-lasting improvement in
function.

Spain
Figure 192: Spain Hip Joint Reconstruction Market Value Figure 193: Spain Knee Joint Reconstruction Market
236.0
230.6
485.6
224.5
217.8
211.2
90 600.0
441.6
204.7
197.6
190.3
404.1
183.1
55 250.0
175.3
80
372.2
169.1
345.0
500.0
322.0
54 70
302.6
286.3
272.8
200.0
261.7
53
252.9
60 400.0
52 50
150.0
83.1
51 300.0
77.2
54.5
72.3
54.1
40
68.2
53.6
64.8
53.1
50
62.0
59.7
52.7
58.0
56.8
52.3
56.0
100.0
55.6
51.8
30 200.0
51.3
49
50.8
50.1
20
49.5
48 50.0 100.0
47 10
46 - 0 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 194: Spain Shoulder Joint Reconstruction Market Figure 195: Spain Shoulder Joint Reconstruction Market
Value ($Million) 25.1 Procedure Volume (Thousand)
24.0
30
22.8
5.4
5.1
21.7
4.9
20.5
4.7
19.4
25
4.4
18.3
4.2
17.2
4.0
5
16.2
3.8
15.2
3.6
14.4
3.4
20
3.3
4
15
3
10 2
5 1
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Spain
Figure 196: Spain Hip Arthroplasty Market Value

Spain Hip Arthroplasty Market
• In 2016, 50.3 thousand hip arthroplasty surgeries were performed in

Spain. The mean age of the patients that underwent THA has
209.9
204.9
199.2
193.1
250.0
187.1
remained constant at about 69 years and the ones who underwent a
181.1
174.7
168.0
161.5
154.4
PHA (Partial Hip Arthroplasty) remained constant at about 89 years .
148.7
200.0
The percentage of women decreased from 77.2% to 75.5% for the
PHA and from 54.3% to 52.2% for the THA in the last period. 150.0
• The main reason for surgery when it came to PHA was a femoral 100.0
neck fracture (95%). On the other hand, between 88.3% and 90.8%
23.3
22.8
22.4
21.8
21.2
20.6
20.0
19.4
18.8
18.1
17.6
of patients with a revision arthroplasty were operated on because 50.0
2.9
2.9
2.9
2.9
2.9
2.9
2.9
2.8
2.8
2.8
2.8
they developed complications with the primary hip arthroplasty
-
(90.8%.
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• The most frequently performed procedure was the primary hip
replacement with 88% procedures, followed by revision hip
replacement with 10.5% procedure. The most frequent primary total
hip arthroplasty in 2016 was the conventional total one (64.5% of
the classified arthroplasties) and for PHA, it was the bipolar and Figure 197: Spain Hip Arthroplasty Market Procedure
unipolar monobloc (15.7% and 15.4%. respectively. Between
periods, the bipolar partial arthroplasties increased from 1.6% to Volume (Thousand) by Procedure Type
18.3% as also did the superficial THA.
• Based on the fixation type, uncemented fixation is the most common 60.0
48.3
48.0
47.5
47.1
46.6
46.3
45.8
45.3
44.8
44.2
43.5
used fixation accounting for almost 74% of PHA operation followed 50.0
by hybrid and cemented fixation. In most of the developed countries
Uncemented fixations are more preferred and have large portion of 40.0
all Hip Arthroplasty procedures. Cemented arthroplasties decreased 30.0
between 2010-2016 period from 16.1% to a 8.7% for the primary
hip arthroplasty. 20.0
5.4
5.4
5.4
5.4
5.3
5.3
5.3
5.2
5.2
5.2
5.2
10.0
0.8
0.8
0.8
0.8
0.8
0.7
0.7
0.7
0.7
0.7
0.7
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Spain
Table 212: Spain Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 13.4 13.4 13.4 13.4 13.3 13.1 12.9 12.7 12.4 12.0 11.5 -2.06%
Uncemented 111.1 115.7 121.4 126.7 132.2 137.5 142.4 147.5 152.6 157.4 161.8 3.55%
Hybrid 22.0 23.0 24.3 25.4 26.6 27.8 28.9 30.1 31.2 32.3 33.3 3.95%
Others 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 3.0 3.1 3.2 3.24%
Total 148.7 154.4 161.5 168.0 174.7 181.1 187.1 193.1 199.2 204.9 209.9 3.23%
Table 213: Spain Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 3.9 3.8 3.7 3.6 3.5 3.4 3.2 3.1 3.0 2.8 2.7 -4.23%
Uncemented 32.5 33.1 33.7 34.1 34.7 35.1 35.5 35.9 36.4 36.9 37.3 1.26%
Hybrid 6.4 6.6 6.7 6.9 7.0 7.1 7.2 7.3 7.5 7.6 7.7 1.66%
Others 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.94%
Total 43.5 44.2 44.8 45.3 45.8 46.3 46.6 47.1 47.5 48.0 48.3 0.94%

Spain
Table 214: Spain Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 3.8 3.9 3.9 3.9 4.0 4.0 4.0 4.0 4.0 3.9 3.9 -0.24%
Uncemented 12.1 12.6 13.3 13.9 14.6 15.3 16.0 16.7 17.4 18.0 18.7 4.30%
Hybrid 1.6 1.6 1.7 1.8 1.8 1.9 1.9 2.0 2.0 2.1 2.1 2.76%
Others 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.91%
Total 17.6 18.1 18.8 19.4 20.0 20.6 21.2 21.8 22.4 22.8 23.3 2.63%
Table 215: Spain Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.1 1.1 1.1 1.1 1.0 1.0 1.0 1.0 0.9 0.9 0.9 -2.54%
Uncemented 3.3 3.3 3.4 3.4 3.5 3.5 3.5 3.6 3.6 3.7 3.7 1.17%
Hybrid 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.7 0.7 0.7 0.7 1.83%
Others 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 1.20%
Total 5.2 5.2 5.2 5.2 5.3 5.3 5.3 5.4 5.4 5.4 5.5 0.56%

Spain
Table 216: Spain Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 45.3 46.6 48.2 49.6 51.1 52.4 53.5 54.6 55.7 56.6 57.3 2.08%
CoP 76.9 80.2 84.3 88.1 92.0 95.7 99.3 102.9 106.6 110.1 113.2 3.66%
CoC 17.8 18.7 19.7 20.7 21.7 22.6 23.6 24.5 25.5 26.4 27.3 4.04%
MoM 1.9 1.9 1.9 1.8 1.8 1.8 1.7 1.7 1.6 1.6 1.5 -3.14%
Other 6.7 7.0 7.4 7.8 8.2 8.6 9.0 9.4 9.8 10.1 10.5 4.30%
Total 148.7 154.4 161.5 168.0 174.7 181.1 187.1 193.1 199.2 204.9 209.9 3.23%
Table 217: Spain Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 13.3 13.3 13.4 13.4 13.4 13.4 13.3 13.3 13.3 13.2 13.2 -0.19%
CoP 22.5 22.9 23.4 23.7 24.1 24.5 24.8 25.1 25.5 25.8 26.1 1.37%
CoC 5.2 5.3 5.5 5.6 5.7 5.8 5.9 6.0 6.1 6.2 6.3 1.74%
MoM 0.6 0.5 0.5 0.5 0.5 0.5 0.4 0.4 0.4 0.4 0.3 -5.30%
Other 2.0 2.0 2.1 2.1 2.2 2.2 2.2 2.3 2.3 2.4 2.4 1.99%
Total 43.5 44.2 44.8 45.3 45.8 46.3 46.6 47.1 47.5 48.0 48.3 0.94%

Spain
Table 218: Spain Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 3.8 3.8 3.8 3.9 3.9 3.9 3.9 4.0 4.0 4.0 4.0 0.41%
CoP 11.1 11.7 12.3 13.0 13.7 14.5 15.2 16.0 16.8 17.5 18.3 4.94%
CoC 2.2 2.4 2.5 2.6 2.8 2.9 3.1 3.2 3.4 3.6 3.7 5.05%
MoM 0.2 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -10.37%
Other 1.7 1.7 1.7 1.7 1.7 1.7 1.7 1.6 1.6 1.6 1.6 -0.59%
Total 17.6 18.1 18.8 19.4 20.0 20.6 21.2 21.8 22.4 22.8 23.3 2.63%
Table 219: Spain Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 1.5 1.5 1.5 1.4 1.4 1.4 1.4 1.4 1.4 1.4 1.4 -0.55%
CoP 2.7 2.7 2.8 2.8 2.8 2.8 2.9 2.9 2.9 3.0 3.0 1.07%
CoC 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1.18%
MoM 0.1 0.1 0.1 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -7.65%
Other 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.80%
Total 5.2 5.2 5.2 5.2 5.3 5.3 5.3 5.4 5.4 5.4 5.5 0.56%

Spain
Figure 198: Spain Knee Arthroplasty Market Value

Spain Knee Arthroplasty Market ($Million) by Procedure Type
• Spain primary knee replacement market value was estimated to be
464.2
420.8
383.8
500.0
352.3
325.4
450.0
302.7
283.4
267.3
400.0
253.8
242.6
233.7
350.0
• Spain primary knee replacement market volume was estimated to be 300.0
250.0
21.37
20.84
20.37
19.95
19.60
19.32
19.22
19.12
19.05
18.98
19.01
150.0
100.0
• Spain revision knee replacement market is estimated to grow by 50.0
-
1.13X in 2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• Cemented knee fixation segment market value was estimated to be Primary Knee Replacement Revision Knee Replacement
market is expected to grow by 1.79X fold over the forecast period. Figure 199: Spain Knee Arthroplasty Market Procedure
Whereas, the market volume was estimated to be 45.99 thousand in Volume (Thousand) by Procedure Type
79.4
73.6
90.0
68.7
• Spain bearing type segment is estimated to grow by 1.83X in 2025
64.5
61.1
80.0
58.3
56.0
54.2
52.8
51.9
51.4
70.0
50.0
40.0
30.0
20.0
4.2
4.1
4.0
3.9
3.8
3.7
3.7
3.7
3.6
3.6
3.7
10.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Spain
Table 220: Spain Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 204.3 211.8 221.0 232.1 245.5 261.4 280.3 302.6 328.8 359.5 395.5 7.91%
Uncemented 5.4 4.9 4.7 4.6 4.5 4.4 4.3 4.2 4.1 3.9 3.7 -3.11%
Hybrid 0.9 1.0 1.0 1.0 1.0 1.1 1.1 1.2 1.2 1.3 1.4 4.70%
Others 23.1 25.0 27.1 29.5 32.4 35.8 39.7 44.3 49.7 56.1 63.6 11.57%
Total 233.7 242.6 253.8 267.3 283.4 302.7 325.4 352.3 383.8 420.8 464.2 8.21%
Table 221: Spain Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 44.9 45.3 46.0 47.0 48.5 50.3 52.6 55.4 58.8 62.9 67.7 5.34%
Uncemented 1.2 1.0 1.0 0.9 0.9 0.9 0.8 0.8 0.7 0.7 0.6 -5.42%
Hybrid 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 2.20%
Others 5.1 5.3 5.6 6.0 6.4 6.9 7.5 8.1 8.9 9.8 10.9 8.91%
Total 51.4 51.9 52.8 54.2 56.0 58.3 61.1 64.5 68.7 73.6 79.4 5.62%

Spain
Table 222: Spain Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 1.5 1.5 1.5 1.5 1.6 1.6 1.7 1.7 1.8 1.8 1.9 3.01%
Uncemented 15.0 14.8 14.7 14.6 14.6 14.6 14.7 14.9 15.1 15.4 15.6 1.01%
Hybrid 0.3 0.3 0.4 0.4 0.4 0.4 0.4 0.5 0.5 0.5 0.6 5.80%
Others 2.4 2.4 2.4 2.5 2.6 2.7 2.8 2.9 3.0 3.1 3.3 3.85%
Total 19.2 19.0 19.0 19.0 19.1 19.3 19.6 20.0 20.4 20.8 21.4 1.68%
Table 223: Spain Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.55%
Uncemented 3.3 3.2 3.1 3.0 2.9 2.8 2.8 2.7 2.7 2.7 2.7 -1.41%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 3.27%
Others 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.6 0.6 1.37%
Total 4.2 4.1 4.0 3.9 3.8 3.7 3.7 3.7 3.6 3.7 3.7 -0.75%

Spain
Table 224: Spain Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 9.6 9.5 9.4 9.4 9.4 9.4 9.4 9.5 9.6 9.7 9.7 0.59%
Total 233.7 242.6 253.8 267.3 283.4 302.7 325.4 352.3 383.8 420.8 464.2 8.21%
Table 225: Spain Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 2.1 2.0 2.0 1.9 1.9 1.8 1.8 1.7 1.7 1.7 1.7 -1.81%
Total 51.4 51.9 52.8 54.2 56.0 58.3 61.1 64.5 68.7 73.6 79.4 5.62%

Spain
Table 226: Spain Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.4 0.5 0.5 0.6 0.6 0.6 0.7 0.7 0.8 0.9 0.9 7.57%
Total 19.2 19.0 19.0 19.0 19.1 19.3 19.6 20.0 20.4 20.8 21.4 1.68%
Table 227: Spain Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 0.2 5.00%
Total 4.2 4.1 4.0 3.9 3.8 3.7 3.7 3.7 3.6 3.7 3.7 -0.75%

Spain
Figure 200: Spain Shoulder Arthroplasty Market Value

Spain Shoulder Arthroplasty Market ($Million) by Procedure Type
• In 2016, there were 3,429 shoulder arthroplasty surgeries performed
25.1
24.0
30.0
22.8
in Spain. The growth in shoulder implants surgeries exceeded that of
21.7
20.5
19.4
25.0
18.3
17.2
knees and hip owing to the growing demand for reverse prosthetic
16.2
15.2
14.4
20.0
replacements. The most frequently performed primary procedure was
15.0
the total prosthetic replacement with 1,448 procedures, followed by
10.0
primary reverse prosthetic replacement with 1,072 procedures. The
5.0
number of resurfacing shoulder arthroplasty surgeries is continuously
-
decreasing and is expected to register a CAGR of –6% during the 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
forecast period. Shoulder Joint Reconstruction Market Value ($Million)
Figure 201: Spain Shoulder Arthroplasty Market

5.354
5.124
4.894
4.670
4.447
6.000
4.228
4.015
3.805
3.614
3.429
5.000
3.250
4.000
3.000
2.000
1.000
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Spain
Figure 202: Spain Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
12.0
10.0
8.0
6.0
4.0
2.0
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 203: Spain Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
2.5
2.0
1.5
1.0
0.5
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
1.0 1.1 1.2 1.2 1.3 1.4 1.6 1.7 1.8 1.9 2.0
Replacement

Netherlands
Netherlands Joint Reconstruction Market Overview
• Netherlands hip replacement market was valued $125.5 million in 2017 and is expected to reach $175.3 million in 2025. In 2017,
primary hip replacement increased by 0.44% and revision burden increased to 1.15% as compared to 2016. The growing
prevalence of elderly patient, underline conditions and positive reimbursement scenario would help market to sustain during the
forecast period.
• Netherlands knee replacement market was valued $116.6 million in 2017 and is expected to reach $144.3 million by 2025 growing
at a CAGR of 2.51% over the forecast period of 2018-2025. In the Netherlands, the market for uncemented and unconstrained fixed
prostheses are highly used in primary procedures as it provides highly comfortable movement and enable active lifestyle to patients
post operation.
• Netherlands shoulder replacement market was valued $13.0 million in 2017 and is expected to reach $16.9 million by 2025 growing
at a CAGR of 3.34% over the forecast period of 2018-2025. The demand for Total Prosthetic Replacement and reverse prosthetic
replacement would be remain positive; however, the revision shoulder arthroplasty is expected to decrease at a CAGR of -0.34%
during the forecast period.

Netherlands
Figure 204: Netherlands Hip Joint Reconstruction Market Figure 205: Netherlands Knee Joint Reconstruction Market
144.3
142.4
139.9
175.3
137.0
169.6
133.6
129.8
163.6
125.7
157.3
121.2
151.0
25.5 160.0
116.6
45 200.0
144.6
111.6
138.2
106.6
131.8
180.0
125.5
40 140.0
119.3
25
113.9
35 160.0
120.0
30 140.0 24.5
120.0 100.0
25
100.0 24 80.0
40.4
39.8
39.1
25.1
25.1
38.4
25.0
37.7
25.0
36.9
36.2
24.9
20
35.5
34.8
24.8
34.1
33.3
24.7
80.0
24.6
60.0
24.3
15 60.0 23.5
23.9
10 40.0
40.0
23.4
23 20.0
5 20.0
0 - 22.5 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 206: Netherlands Shoulder Joint Reconstruction Figure 207: Netherlands Shoulder Joint Reconstruction
3.6
16.9
16.4
3.5
3.4
15.9
3.3
15.4
20 4
3.2
14.9
3.1
14.4
3.1
13.9
3.0
13.5
2.9
13.0
2.8
3.5
12.5
2.7
12.1
15 3
2.5
10 2
1.5
5 1
0.5
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Netherlands
Figure 208: Netherlands Hip Arthroplasty Market Value

Netherlands Hip Arthroplasty Market ($Million) by Procedure Type
• Netherlands primary hip replacement market value was estimated to
156.4
151.4
145.9
140.3
180.0
134.5
128.7
122.9
160.0
117.1
111.4
105.8
100.8
140.0
period. 120.0
• Netherlands primary hip replacement market volume was estimated 100.0
to be 30.87 thousand in 2017 and is forecasted to grow at a CAGR of 80.0
1.91% to reach market volume of 36.03 thousand by the end of 60.0
18.8
18.2
17.6
17.0
16.4
15.8
15.2
14.6
14.1
13.5
13.1
2025. 40.0
20.0
-
• Netherlands revision hip replacement market is estimated to grow by -
1.33X in 2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
$72.3 million in 2017 and is forecasted to grow at a CAGR of -4.82%
Whereas, the market volume was estimated to be 20.05 thousand in Figure 209: Netherlands Hip Arthroplasty Market
2017 and is forecasted to grow at a CAGR of 2.50% to reach market Procedure Volume (Thousand) by Procedure Type
• Netherlands bearing surface segment is estimated to grow by 1.40X
36.0
35.4
in 2025 whereas the leading bearing surface segment is COP which is
34.8
34.2
33.5
32.9
32.2
40.0
31.6
30.9
30.2
29.5
35.0
30.0
25.0
20.0
15.0
4.4
4.3
4.3
4.2
4.1
4.1
4.0
4.0
3.9
3.9
3.8
10.0
5.0
-
-
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Netherlands
Table 228: Netherlands Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 25.8 26.5 27.3 28.0 28.7 29.4 29.9 30.4 30.8 31.1 31.3 1.58%
Uncemented 64.7 68.3 72.3 76.5 80.8 85.1 89.4 93.8 98.1 102.3 106.4 4.82%
Hybrid 8.2 8.7 9.4 10.0 10.7 11.4 12.0 12.7 13.5 14.2 14.9 5.80%
Others 2.1 2.2 2.4 2.6 2.7 2.9 3.1 3.3 3.5 3.7 3.9 6.28%
Total 100.8 105.8 111.4 117.1 122.9 128.7 134.5 140.3 145.9 151.4 156.4 4.22%
Table 229: Netherlands Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 7.6 7.6 7.6 7.6 7.5 7.5 7.5 7.4 7.4 7.3 7.2 -0.67%
Uncemented 18.9 19.5 20.1 20.6 21.2 21.7 22.3 22.9 23.4 24.0 24.5 2.50%
Hybrid 2.4 2.5 2.6 2.7 2.8 2.9 3.0 3.1 3.2 3.3 3.4 3.47%
Others 0.6 0.6 0.7 0.7 0.7 0.8 0.8 0.8 0.8 0.9 0.9 3.92%
Total 29.5 30.2 30.9 31.6 32.2 32.9 33.5 34.2 34.8 35.4 36.0 1.91%

Netherlands
Table 230: Netherlands Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 3.6 3.7 3.8 3.9 4.0 4.1 4.2 4.3 4.4 4.5 4.5 2.28%
Uncemented 8.5 8.9 9.4 9.9 10.4 11.0 11.6 12.2 12.8 13.5 14.1 5.21%
Hybrid 1.1 1.1 1.1 1.2 1.2 1.2 1.3 1.3 1.4 1.4 1.4 3.10%
Others 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 2.03%
Total 13.1 13.5 14.1 14.6 15.2 15.8 16.4 17.0 17.6 18.2 18.8 3.63%
Table 231: Netherlands Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.1 1.1 1.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 -0.08%
Uncemented 2.3 2.3 2.4 2.4 2.5 2.5 2.6 2.6 2.7 2.7 2.8 2.06%
Hybrid 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.5 0.5 2.17%
Others 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 2.33%
Total 3.8 3.9 3.9 4.0 4.0 4.1 4.1 4.2 4.3 4.3 4.4 1.54%

Netherlands
Table 232: Netherlands Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 30.9 32.0 33.3 34.6 35.9 37.1 38.3 39.4 40.5 41.4 42.3 2.90%
CoP 51.6 54.3 57.4 60.6 63.8 67.0 70.3 73.6 76.8 79.9 82.8 4.57%
CoC 8.9 9.4 10.0 10.7 11.3 12.0 12.6 13.3 14.0 14.7 15.3 5.32%
MoM 1.4 1.4 1.4 1.4 1.4 1.5 1.5 1.5 1.4 1.4 1.4 -0.17%
Other 8.1 8.6 9.2 9.8 10.5 11.2 11.8 12.5 13.2 13.9 14.5 5.73%
Total 100.8 105.8 111.4 117.1 122.9 128.7 134.5 140.3 145.9 151.4 156.4 4.22%
Table 233: Netherlands Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 9.0 9.2 9.2 9.3 9.4 9.5 9.5 9.6 9.7 9.7 9.7 0.61%
CoP 15.1 15.5 15.9 16.3 16.7 17.1 17.5 17.9 18.3 18.7 19.1 2.27%
CoC 2.6 2.7 2.8 2.9 3.0 3.1 3.2 3.3 3.3 3.4 3.5 3.00%
MoM 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.3 0.3 0.3 -2.40%
Other 2.4 2.5 2.6 2.7 2.8 2.9 3.0 3.1 3.2 3.3 3.4 3.39%
Total 29.5 30.2 30.9 31.6 32.2 32.9 33.5 34.2 34.8 35.4 36.0 1.91%

Netherlands
Table 234: Netherlands Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 2.6 2.6 2.6 2.7 2.7 2.7 2.8 2.8 2.8 2.9 2.9 1.25%
CoP 8.7 9.2 9.7 10.3 11.0 11.6 12.3 13.0 13.8 14.6 15.4 5.83%
CoC 2.2 2.4 2.5 2.7 2.8 3.0 3.2 3.4 3.6 3.8 4.1 6.15%
MoM 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -6.31%
Other 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.64%
Total 13.1 13.5 14.1 14.6 15.2 15.8 16.4 17.0 17.6 18.2 18.8 3.63%
Table 235: Netherlands Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 0.28%
CoP 2.1 2.1 2.2 2.2 2.2 2.3 2.3 2.4 2.4 2.5 2.5 1.93%
CoC 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.6 0.6 0.6 0.6 2.24%
MoM 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -3.46%
Other 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.3 2.04%
Total 3.8 3.9 3.9 4.0 4.0 4.1 4.1 4.2 4.3 4.3 4.4 1.54%

Netherlands
Figure 210: Netherlands Knee Arthroplasty Market Value

Netherlands Knee Arthroplasty Market ($Million) by Procedure Type
• Netherlands primary knee replacement market value was estimated
137.9
135.6
132.9
129.6
126.0
122.0
117.7
160.0
113.2
108.4
103.5
140.0
98.5
period. 120.0
100.0
• Netherlands primary knee replacement market volume was 80.0
estimated to be 22.14 thousand in 2017 and is forecasted to grow at 60.0
a CAGR of 0.40% to reach market value of 23.60 thousand by the
8.13
8.10
8.11
8.05
7.94
7.79
7.59
7.34
7.05
6.72
6.35
40.0
end of 2025.
20.0
• Netherlands revision knee replacement market is estimated to grow -
by 0.78X in 2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
period. Whereas, the market volume was estimated to be 19.65 Figure 211: Netherlands Knee Arthroplasty Market
thousand in 2017 and is forecasted to grow at a CAGR of 0.13% to Procedure Volume (Thousand) by Procedure Type
• Netherlands bearing type segment is estimated to grow by 1.27X in 30.0
23.8
23.8
23.7
23.7
23.6
23.5
23.3
22.9
22.6
22.1
2025 whereas the leading bearing type segment is unconstrained
21.6
25.0
fixed which is estimated to grow by 1.41X by 2025.
20.0
15.0
10.0 1.8
1.7
1.7
1.6
1.6
1.5
1.4
1.3
1.3
1.2
1.1
5.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Netherlands
Table 236: Netherlands Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 4.1 3.8 3.7 3.5 3.4 3.2 2.9 2.7 2.4 2.1 1.8 -9.06%
Uncemented 69.1 72.6 75.8 79.0 81.9 84.8 87.4 89.8 91.9 93.7 95.3 2.72%
Hybrid 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 -0.47%
Others 9.7 10.7 11.6 12.5 13.5 14.4 15.4 16.3 17.2 18.1 18.9 6.06%
Total 98.5 103.5 108.4 113.2 117.7 122.0 126.0 129.6 132.9 135.6 137.9 2.86%
Table 237: Netherlands Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.5 0.4 0.4 0.4 0.4 0.3 0.3 0.3 0.3 0.2 0.2 -10.10%
Uncemented 18.9 19.3 19.7 19.9 20.1 20.3 20.4 20.4 20.4 20.3 20.1 0.13%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -2.85%
Others 2.1 2.3 2.4 2.5 2.7 2.8 2.9 3.0 3.1 3.2 3.2 3.53%
Total 21.7 22.1 22.6 22.9 23.3 23.5 23.7 23.8 23.8 23.7 23.6 0.40%

Netherlands
Table 238: Netherlands Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 6.6 6.6 6.5 6.4 6.3 6.1 5.9 5.7 5.5 5.2 4.9 -3.80%
Uncemented 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.5 0.5 -2.36%
Hybrid 0.1 0.1 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.57%
Others 1.0 1.0 1.0 1.1 1.1 1.1 1.1 1.1 1.0 1.0 1.0 -1.28%
Total 8.1 8.1 8.1 8.1 7.9 7.8 7.6 7.3 7.1 6.7 6.3 -3.34%
Table 239: Netherlands Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.4 1.4 1.3 1.3 1.2 1.1 1.1 1.0 0.9 0.9 0.8 -6.28%
Uncemented 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -4.42%
Hybrid 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -1.83%
Others 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 -3.64%
Total 1.8 1.7 1.7 1.6 1.6 1.5 1.4 1.4 1.3 1.2 1.1 -5.65%

Netherlands
Table 240: Netherlands Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 4.0 4.0 4.0 4.0 3.9 3.8 3.7 3.5 3.3 3.1 2.9 -4.38%
Total 98.5 103.5 108.4 113.2 117.7 122.0 126.0 129.6 132.9 135.6 137.9 2.86%
Table 241: Netherlands Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.9 0.9 0.8 0.8 0.8 0.7 0.7 0.6 0.6 0.6 0.5 -6.66%
Total 21.7 22.1 22.6 22.9 23.3 23.5 23.7 23.8 23.8 23.7 23.6 0.40%

Netherlands
Table 242: Netherlands Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.2 0.2 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.3 0.3 2.26%
Total 8.1 8.1 8.1 8.1 7.9 7.8 7.6 7.3 7.1 6.7 6.3 -3.34%
Table 243: Netherlands Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.0 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -0.19%
Total 1.8 1.7 1.7 1.6 1.6 1.5 1.4 1.4 1.3 1.2 1.1 -5.65%

Netherlands
Figure 212: Netherlands Shoulder Arthroplasty Market

Netherlands Shoulder Arthroplasty Market Value ($Million) by Procedure Type
• In 2016, there were 2,806 shoulder arthroplasty surgeries performed
16.9
16.4
20.0
15.9
15.4
14.9
14.4
in the Netherlands. Reverse prosthetic shoulder arthroplasty 18.0
13.9
13.5
13.0
12.5
12.1
16.0
continues to demonstrate positive results in young patients and is 14.0
expected to show highest growth during the forecast period. The 12.0
10.0
most frequently performed primary procedure was the reverse 8.0
6.0
polarity total shoulder replacement with 1,644 procedures, followed
4.0
by primary total prosthetic replacement with 594 procedures. 2.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 213: Netherlands Shoulder Arthroplasty Market

3.6
3.5
3.4
3.3
4.0
3.2
3.1
3.1
3.0
2.9
3.5
2.8
2.7
3.0
2.5
2.0
1.5
1.0
0.5
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Netherlands
Figure 214: Netherlands Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
12.0
10.0
8.0
6.0
4.0
2.0
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
6.9 7.1 7.5 7.8 8.1 8.5 8.8 9.1 9.5 9.9 10.2
Replacement
Figure 215: Netherlands Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
2.5
2.0
1.5
1.0
0.5
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
1.6 1.6 1.7 1.8 1.8 1.9 1.9 2.0 2.1 2.1 2.2
Replacement

Russia
Russia Joint Reconstruction Market Overview
• Russia hip replacement market was valued $158.5 million in 2017 and is expected to reach $290.1 million in 2025. In 2017, primary
hip replacement increased by 9.5% and revision burden increased to 11.6% as compared to 2016. The market is still emerging in
stage and expected to show double digit growth for uncemented fixation implants. The hip arthroplasty market in the country in
mostly dominated by multinational companies with more than 80% of combined share in 2016.
• Russia knee replacement market was valued $897.0 million in 2017 and is expected to reach $1,153 million by 2025 growing at a
CAGR of 3.00% over the forecast period of 2018-2025. In Russia, market for uncemented and unconstrained fixed prostheses are
highly used in primary procedures as it provides highly comfortable movement and enable active lifestyle to patients post operation.
• Russia shoulder replacement market was valued $5.3 million in 2017 and is expected to reach $8.6 million by 2025 growing at a
CAGR of 6.14% over the forecast period of 2018-2025. This growth is anticipated owing to continuously increasing demand for
reverse prosthetic replacements. Rate of shoulder revision is high in Russia as compared to European countries. The total prosthetic
replacements are currently dominating the arthroplasty market and is expected to dominate the market throughout the forecast
period.

Russia
Figure 216: Russia Hip Joint Reconstruction Market Value Figure 217: Russia Knee Joint Reconstruction Market
1,155.3
1,136.9
290.1
1,113.5
1,085.7
272.2
1,053.9
1,018.6
80 350.0
254.4
205 1,400.0
237.0
980.4
220.0
939.6
70 300.0
897.0
203.6
863.2
828.0
200 1,200.0
187.8
60
173.1
250.0
158.5
195 1,000.0
144.6
132.4
50
200.0 190 800.0
40
66.9
199.3
198.9
198.8
63.8
197.9
197.7
150.0
60.8
196.1
57.8
185 600.0
54.9
193.6
30
52.0
49.3
46.6
190.5
43.9
41.4
38.8
100.0
186.7
180 400.0
184.6
20
182.0
10 50.0 175 200.0
0 - 170 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 218: Russia Shoulder Joint Reconstruction Market Figure 219: Russia Shoulder Joint Reconstruction Market
1.8
10
8.2
1.7
7.8
1.7
2
7.3
1.6
6.9
1.5
6.5
1.4
8
1.3
6.1
1.3
5.7
1.2
5.3
1.5
1.1
4.9
1.0
4.5
6
1
4
2 0.5
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Russia
Figure 220: Russia Hip Arthroplasty Market Value

Russia Hip Arthroplasty Market ($Million) by Procedure Type
• In 2016, 41.35 thousand hip arthroplasty surgeries were performed
263.1
in the Russia. This is an increase on the previous year of 2015 of
247.1
231.1
300
6.7% for hip replacements. The most frequently performed
215.5
200.2
185.6
procedure was the primary hip replacement with 37,900 procedures, 250
171.4
158.2
followed by revision hip replacement with 3,450 procedure. Based on
145.1
132.6
200
121.7
the gender, Female dominated the primary hip arthroplasty
procedure volume in japan with 78% compared to 22% of male in 150
2016. Based on the fixation type, uncemented fixation is the most 100
27.0
common used fixation accounting for almost 43% of PHA operation,
25.1
23.3
21.5
19.8
18.0
16.4
14.9
13.5
12.1
10.8
followed by cemented fixation at 38%. However, the recent trends 50
-
indicate a gradual reduction in cemented fixation across all types of 0
hip arthroplasty. In most of the developed countries Uncemented 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
fixations are more preferred and have large portion of all Hip
Arthroplasty procedures.
Figure 221: Russia Hip Arthroplasty Market Procedure

60.6
57.8
70
55.1
52.5
49.9
60
47.4
44.9
42.6
40.2
37.9
50
35.6
40
30
20
6.3
6.0
5.6
5.3
5.0
4.6
4.3
4.0
3.7
3.5
3.2
10
-
-
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Russia
Table 244: Russia Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 47.5 50.1 53.1 56.0 58.6 61.2 63.7 65.9 68.0 69.7 71.1 3.46%
Uncemented 51.1 56.9 63.5 70.7 78.1 86.3 94.9 104.1 113.7 123.8 134.2 9.58%
Hybrid 23.1 25.6 28.4 31.5 34.6 38.0 41.6 45.4 49.4 53.6 57.8 9.08%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 121.7 132.6 145.1 158.2 171.4 185.6 200.2 215.5 231.1 247.1 263.1 7.54%
Table 245: Russia Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 13.9 14.3 14.7 15.1 15.4 15.6 15.9 16.1 16.2 16.3 16.4 1.17%
Uncemented 15.0 16.3 17.6 19.1 20.5 22.0 23.7 25.4 27.1 29.0 30.9 7.16%
Hybrid 6.8 7.3 7.9 8.5 9.1 9.7 10.4 11.1 11.8 12.6 13.3 6.67%
Others - - - - - - - - - - - 0.00%
Total 35.6 37.9 40.2 42.6 44.9 47.4 49.9 52.5 55.1 57.8 60.6 5.16%

Russia
Table 246: Russia Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 3.8 4.2 4.6 5.1 5.5 5.9 6.3 6.8 7.2 7.6 8.0 6.76%
Uncemented 4.8 5.6 6.3 7.2 8.1 9.1 10.2 11.4 12.6 13.9 15.3 11.40%
Hybrid 2.0 2.2 2.4 2.6 2.9 3.1 3.4 3.7 4.0 4.2 4.5 8.10%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 10.8 12.1 13.5 14.9 16.4 18.0 19.8 21.5 23.3 25.1 27.0 8.85%
Table 247: Russia Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.1 1.2 1.3 1.4 1.4 1.5 1.6 1.7 1.7 1.8 1.8 4.30%
Uncemented 1.3 1.5 1.6 1.8 1.9 2.1 2.3 2.4 2.6 2.8 3.0 8.06%
Hybrid 0.7 0.8 0.8 0.9 1.0 1.0 1.1 1.2 1.3 1.4 1.5 7.13%
Others - - - - - - - - - - - 0.00%
Total 3.2 3.5 3.7 4.0 4.3 4.6 5.0 5.3 5.6 6.0 6.3 6.66%

Russia
Table 248: Russia Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 58.4 63.1 68.5 74.1 79.5 85.4 91.3 97.4 103.6 109.8 115.9 6.60%
CoP 35.3 39.0 43.2 47.8 52.4 57.5 62.9 68.5 74.4 80.5 86.8 8.90%
CoC 19.5 21.3 23.4 25.6 27.8 30.1 32.6 35.2 37.9 40.6 43.4 7.86%
MoM 2.7 2.8 2.8 2.9 2.9 3.0 3.0 2.9 2.9 2.8 2.6 -1.42%
Other 5.9 6.5 7.2 7.9 8.7 9.6 10.5 11.4 12.4 13.4 14.5 8.94%
Total 121.7 132.6 145.1 158.3 171.4 185.6 200.2 215.5 231.1 247.1 263.1 7.53%
Table 249: Russia Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 17.1 18.0 19.0 20.0 20.9 21.8 22.8 23.7 24.7 25.7 26.7 4.23%
CoP 10.3 11.1 12.0 12.9 13.8 14.7 15.7 16.7 17.8 18.9 20.0 6.50%
CoC 5.7 6.1 6.5 6.9 7.3 7.7 8.1 8.6 9.0 9.5 10.0 5.48%
MoM 0.8 0.8 0.8 0.8 0.8 0.8 0.7 0.7 0.7 0.7 0.6 -3.62%
Other 1.7 1.9 2.0 2.1 2.3 2.5 2.6 2.8 3.0 3.1 3.3 6.53%
Total 35.6 37.9 40.2 42.6 44.9 47.4 49.9 52.5 55.1 57.8 60.6 5.15%

Russia
Table 250: Russia Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 2.6 2.8 3.1 3.3 3.6 3.9 4.2 4.4 4.7 5.0 5.2 6.62%
CoP 5.5 6.3 7.2 8.1 9.2 10.4 11.7 13.1 14.5 16.1 17.7 11.74%
CoC 3.1 3.5 3.9 4.4 4.9 5.4 6.0 6.6 7.3 7.9 8.6 10.19%
MoM 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -2.32%
Other 0.4 0.5 0.5 0.6 0.6 0.7 0.7 0.8 0.8 0.8 0.9 6.48%
Total 10.8 12.1 13.5 14.9 16.4 18.0 19.8 21.5 23.3 25.1 27.0 8.85%
Table 251: Russia Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 1.0 1.1 1.2 1.3 1.3 1.4 1.5 1.6 1.7 1.8 1.8 5.60%
CoP 1.3 1.5 1.6 1.7 1.9 2.0 2.2 2.4 2.5 2.7 2.9 7.62%
CoC 0.7 0.7 0.8 0.8 0.9 1.0 1.0 1.1 1.1 1.2 1.3 6.13%
MoM 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.65%
Other 0.1 0.1 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.3 0.3 7.96%
Total 3.2 3.5 3.7 4.0 4.3 4.6 5.0 5.3 5.6 6.0 6.3 6.66%

Russia
Figure 222: Russia Knee Arthroplasty Market Value

Russia Knee Arthroplasty Market ($Million) by Procedure Type
• Russia primary knee replacement market value was estimated to be
1,104.5
1,083.2
1,057.4
1,027.5
1500
994.0
957.5
918.4
1300
877.3
834.5
to reach market value of $1,104.5 million by the end of 2025. The
800.3
765.0
1100
700
• Russia primary knee replacement market volume was estimated to
500
62.9
62.8
62.4
62.4
62.0
61.1
59.9
58.2
56.1
53.7
50.8
300
0.88% to reach market value of 189.01 thousand by the end of 100
-100
2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• Russia revision knee replacement market is estimated to grow by
0.81X in 2025.

Figure 223: Russia Knee Arthroplasty Market Procedure
189.5
189.2
189.0
188.3
186.6
184.3
The market is expected to grow by 1.30X fold over the forecast 250
181.4
177.8
173.7
171.2
168.2
period. Whereas, the market volume was estimated to be 151.23 200
thousand in 2017 and is forecasted to grow at a CAGR of 0.60% to 150

reach market volume of 161.04 thousand by the end of 2025. 100 13.8
13.4
13.0
12.6
12.2
11.8
11.2
10.7
10.0
• Russia bearing type segment is estimated to grow by 1.32X in 2025
9.4
8.7
50

2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Russia
Table 252: Russia Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 17.6 16.0 15.6 15.2 14.7 14.0 13.3 12.3 11.3 10.1 8.8 -7.46%
Uncemented 668.6 698.7 726.6 761.8 795.3 827.0 856.2 882.6 905.9 925.5 941.0 3.07%
Hybrid 3.1 3.2 3.2 3.3 3.4 3.4 3.4 3.4 3.4 3.4 3.3 0.00%
Others 75.7 82.4 89.1 97.0 105.0 113.1 121.2 129.1 136.9 144.3 151.3 6.56%
Total 765.0 800.3 834.5 877.3 918.4 957.5 994.0 1027.5 1057.4 1083.2 1104.5 3.35%
Table 253: Russia Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 3.9 3.4 3.2 3.1 2.9 2.7 2.5 2.3 2.0 1.8 1.5 -9.67%
Uncemented 147.0 149.4 151.2 154.4 157.1 159.2 160.7 161.7 162.1 161.9 161.0 0.60%
Hybrid 0.7 0.7 0.7 0.7 0.7 0.7 0.6 0.6 0.6 0.6 0.6 -2.39%
Others 16.7 17.6 18.6 19.7 20.7 21.8 22.8 23.7 24.5 25.2 25.9 4.01%
Total 168.2 171.2 173.7 177.8 181.4 184.3 186.6 188.3 189.2 189.5 189.0 0.88%

Russia
Table 254: Russia Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 49.2 48.8 48.2 47.9 47.2 46.3 45.0 43.5 41.6 39.5 37.2 -3.53%
Uncemented 4.9 5.0 5.0 5.1 5.1 5.1 5.1 5.0 4.9 4.7 4.5 -1.62%
Hybrid 1.1 1.1 1.2 1.2 1.3 1.3 1.3 1.4 1.4 1.3 1.3 1.04%
Others 7.7 7.9 8.1 8.2 8.4 8.4 8.4 8.4 8.3 8.0 7.8 -0.81%
Total 62.9 62.8 62.4 62.4 62.0 61.1 59.9 58.2 56.1 53.7 50.8 -2.88%
Table 255: Russia Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 10.8 10.4 10.0 9.7 9.3 8.9 8.5 8.0 7.5 6.9 6.4 -5.83%
Uncemented 1.1 1.1 1.0 1.0 1.0 1.0 1.0 0.9 0.9 0.8 0.8 -3.97%
Hybrid 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.3 0.2 0.2 0.2 -1.37%
Others 1.7 1.7 1.7 1.7 1.7 1.6 1.6 1.5 1.5 1.4 1.3 -3.18%
Total 13.8 13.4 13.0 12.7 12.2 11.8 11.2 10.7 10.0 9.4 8.7 -5.20%

Russia
Table 256: Russia Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 31.4 31.2 30.9 30.7 30.3 29.7 28.8 27.7 26.4 24.9 23.2 -3.93%
Total 765.0 800.3 834.5 877.3 918.4 957.5 994.0 1027.5 1057.4 1083.2 1104.5 3.35%
Table 257: Russia Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 6.9 6.7 6.4 6.2 6.0 5.7 5.4 5.1 4.7 4.4 4.0 -6.22%
Total 168.2 171.2 173.7 177.8 181.4 184.3 186.6 188.3 189.2 189.5 189.0 0.88%

Russia
Table 258: Russia Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 1.4 1.6 1.7 1.8 1.9 2.0 2.1 2.2 2.2 2.2 2.2 2.74%
Total 62.9 62.8 62.4 62.4 62.0 61.1 59.9 58.2 56.1 53.7 50.8 -2.88%
Table 259: Russia Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.3 0.3 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.28%
Total 13.8 13.4 13.0 12.7 12.2 11.8 11.2 10.7 10.0 9.4 8.7 -5.20%

Russia
Figure 224: Russia Shoulder Arthroplasty Market Value

Russia Shoulder Arthroplasty Market ($Million) by Procedure Type
• In 2016, there were 1,093.7 shoulder arthroplasty surgeries
8.6
10
8.2
7.8
performed in the Russia. Reverse prosthetic shoulder arthroplasty 9
7.3
6.9
6.5
8
6.1
demonstrates positive results in young patients and is expected to
5.7
7
5.3
4.9
4.5
show highest growth during the forecast period. The most frequently 6
5
performed primary procedure was the total prosthetic replacement 4
3
with 532 procedures, followed by reverse polarity replacement with
2
271 procedures. 1
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 225: Russia Shoulder Arthroplasty Market

2.5
1.8
1.7
1.7
2
1.6
1.5
1.4
1.3
1.3
1.2
1.5
1.1
1 1.0
0.5
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Russia
Figure 226: Russia Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
4.5
4
3.5
3
2.5
2
1.5
1
0.5
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
1.1 1.2 1.3 1.5 1.6 1.8 1.9 2.1 2.3 2.5 2.7
Replacement
Figure 227: Russia Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
0.2 0.3 0.3 0.3 0.4 0.4 0.4 0.5 0.5 0.5 0.6
Replacement

9. Asia-Pacific Joint Reconstruction
Summary

371
Asia Pacific
Asia Pacific Joint Reconstruction Market Overview
• Asia-Pacific hip replacement market was valued $1.17 billion in 2017 and is expected to reach $1.88 billion in 2025. In 2017, primary hip
replacement increased by -4.8% and revision burden increased to -2.1% as compare to 2016. The key factor likely to boost the market growth
over the forecast period are rising geriatric population, high prevalence of osteoarthritis, and osteoporosis.
• Asia Pacific knee replacement market was valued at $2.42 billion in 2017 and is expected to reach $3.47 billion by 2025 growing at a CAGR of
4.58% over the forecast period of 2018-2025. In Asia Pacific, most of the surgeries performed are primary surgeries and uncemented fixation is
mostly used.
• Asia Pacific shoulder replacement market was valued at $57.4 million in 2017 and is expected to reach $119.5 million by 2025 growing at a CAGR
of 9.38% over the forecast period of 2018-2025. The key driving force for shoulder replacement includes escalating aging population, high
prevalence of arthritis, extensive indications for reverse shoulder replacement, and patient preference towards living active lifestyle.
• According to AOANJRR, the number of primary hip replacement cases in the year 2016 increased by 3.7%. However, the revision burden has been
reported to decrease by 8.9%. The cemented fixation is reported to be associated with lowest risk of revision.
• According to AOANJRR, In 2016, the knee replacement increased 3.5% as compared to previous year. The revision burden has decline by 7.4%. In
case of shoulder replacement, the primary replacement increased by 11.1%. However, the revision burden has declined to lowest level of 9.1. The
utilization of total reverse shoulder keep on increase in the year 2016 and accounted for 69.3% of all total shoulder replacements. The reason
pertaining to such high growth of total reverse is that it is associated with least risk of revisions.

Asia Pacific
Figure 228: Asia Pacific Hip Joint Reconstruction Market Figure 229: Asia Pacific Knee Joint Reconstruction
Value ($Billion) and Procedure Volume (Thousand) Market Value ($Billion) and Procedure Volume (Thousand)
1.79
1.88
1.70
500 2.00
1.61
3.47
1.52
3.34
3.20
700 4.00
1.43
450 1.80
3.06
1.34
2.93
2.80
1.25
400 1.60
2.67
600 3.50
1.17
2.54
1.09
2.42
2.30
350 1.40
2.18
0.98
500 3.00
300 1.20 2.50
250 1.00 400
432.9
420.3
407.1
393.6
2.00
594.5
379.7
583.4
572.3
365.5
561.1
549.8
351.4
538.2
200 0.80
337.2
526.5
514.8
323.2
300
502.9
491.2
312.2
478.5
286.7
150 0.60 1.50

200 1.00
100 0.40
50 0.20 100 0.50
0 - 0 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Hip Joint Reconstruction Volume (Thousand) Hip Joint Reconstruction Value ($Billion) Knee Joint Reconstruction Volume (Thousand) Knee Joint Reconstruction Value ($Billion)
Figure 230: Asia Pacific Shoulder Joint Reconstruction Figure 231: Asia Pacific Shoulder Joint Reconstruction
25.5
119.5
30
23.4
109.6
21.6
140
100.5
19.8
25
18.2
92.0
120
16.7
84.1
15.4
76.8
14.1
20
70.1
100
12.8
63.8
11.8
57.4
52.4
80 15 9.9
43.9
60
10
40
5
20
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Asia Pacific
Figure 232: Asia Pacific Hip Arthroplasty Market Value

Asia Pacific Hip Arthroplasty Market ($Million) by Procedure Type
• Asia Pacific primary hip replacement market value was estimated to
1,755.0
1,670.1
1,581.4
1,491.0
1,400.6
2,000.0
1,310.7
1,222.9
market is expected to grow by 1.66X fold over the forecast period. 1,800.0
1,137.7
1,055.8
1,600.0
984.4
• Asia Pacific primary hip replacement market volume was estimated 1,400.0
878.4
to be 292.6 thousand in 2017 and is forecasted to grow at a CAGR of 1,200.0
1,000.0
2025. 600.0
88.4
88.1
87.9
87.3
86.8
86.0
84.2
82.0
79.6
77.6
74.2
36.2
36.3
35.9
35.4
34.7
33.9
32.9
31.8
30.7
29.8
27.5
400.0
• Asia Pacific revision hip replacement market is estimated to grow by 200.0
1.09X in 2025 whereas the hip resurfacing market is estimated to -
grow by 1.18X by 2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• Uncemented hip fixation segment market value was estimated to be Primary Hip Replacement Revision Hip Replacement Hip Resurfacing
to reach market value of $1,177 million by the end of 2025. The
Whereas, the market volume was estimated to be 183.6 thousand in Figure 233: Asia Pacific Hip Arthroplasty Market
2017 and is forecasted to grow at a CAGR of 4.91% to reach market Procedure Volume (Thousand) by Procedure Type
• Asia Pacific bearing surface segment is estimated to grow by 1.66X in
404.2
390.9
377.3
363.3
349.1
450.0
334.8
320.6
306.5
292.6
400.0
281.5
257.0
350.0
300.0
250.0
200.0
150.0
22.2
22.1
22.2
22.1
22.1
21.9
21.7
21.6
21.3
20.8
20.3
100.0
8.6
8.7
8.7
8.6
8.5
8.5
8.6
8.6
8.5
8.4
8.0
50.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Asia Pacific
Table 260: Asia Pacific Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 214.6 229.1 240.1 251.1 261.6 271.4 280.6 288.5 295.2 300.5 304.0 2.77%
Uncemented 536.7 611.9 662.2 720.0 780.9 844.2 909.9 976.8 1,044.5 1,112.0 1,177.6 7.28%
Hybrid 127.1 143.4 153.4 166.6 180.5 195.0 210.2 225.7 241.6 257.5 273.2 7.32%
Others - - - - - - - - - - - 0.00%
Total 878.4 984.4 1,055.8 1,137.7 1,222.9 1,310.7 1,400.6 1,491.0 1,581.4 1,670.1 1,755.0 6.39%
Table 261: Asia Pacific Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 62.8 65.5 66.6 67.6 68.6 69.3 69.9 70.3 70.4 70.3 70.0 0.49%
Uncemented 157.0 175.0 183.6 193.9 204.7 215.6 226.8 238.0 249.2 260.3 271.3 4.91%
Hybrid 37.2 41.0 42.5 44.9 47.3 49.8 52.4 55.0 57.7 60.3 63.0 4.96%
Others - - - - - - - - - - - 0.00%
Total 257.0 281.5 292.6 306.5 320.6 334.8 349.1 363.3 377.3 390.9 404.2 4.03%

Asia Pacific
Table 262: Asia Pacific Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 24.0 25.2 25.7 26.0 26.3 26.4 26.3 26.0 25.5 24.9 24.0 -1.14%
Uncemented 40.9 43.4 45.2 47.5 49.6 51.6 53.5 55.0 56.3 57.1 57.5 2.77%
Hybrid 9.8 9.9 10.0 10.2 10.4 10.6 10.7 10.8 10.8 10.8 10.7 0.65%
Others - - - - - - - - - - - 0.00%
Total 74.2 77.6 79.6 82.0 84.2 86.0 87.3 88.1 88.4 87.9 86.8 0.81%
Table 263: Asia Pacific Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 7.1 7.3 7.1 7.0 6.9 6.7 6.5 6.3 6.1 5.8 5.5 -3.41%
Uncemented 11.2 11.5 11.5 11.6 11.8 11.8 11.8 11.8 11.7 11.6 11.4 -0.32%
Hybrid 3.5 3.5 3.4 3.5 3.5 3.5 3.5 3.5 3.5 3.5 3.4 -0.26%
Others - - - - - - - - - - - 0.00%
Total 21.7 22.2 22.1 22.2 22.1 22.1 21.9 21.6 21.3 20.8 20.3 -1.23%

Asia Pacific
Table 264: Asia Pacific Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 411.9 457.7 486.4 519.5 553.2 587.3 621.5 655.0 687.8 719.2 748.1 5.35%
CoP 204.0 236.0 259.7 286.4 314.8 344.7 376.1 408.6 441.9 475.7 509.2 8.57%
CoC 206.2 228.2 243.1 260.7 279.2 298.2 317.6 337.3 356.9 376.0 394.3 6.09%
MoM 24.0 25.6 26.4 27.1 27.7 28.1 28.3 28.4 28.2 27.8 27.1 0.02%
Other 32.4 36.9 40.2 44.0 48.1 52.5 57.0 61.7 66.5 71.4 76.3 8.17%
Total 878.4 984.4 1,055.8 1,137.7 1,222.9 1,310.7 1,400.6 1,491.0 1,581.4 1,670.1 1,755.0 6.39%
Table 265: Asia Pacific Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 120.5 130.9 134.8 139.9 145.0 150.0 154.9 159.6 164.0 168.2 172.2 3.01%
CoP 59.7 67.5 72.0 77.2 82.5 88.1 93.8 99.6 105.5 111.4 117.4 6.18%
CoC 60.3 65.2 67.4 70.2 73.2 76.2 79.2 82.2 85.2 88.1 90.9 3.75%
MoM 7.0 7.3 7.3 7.3 7.2 7.2 7.1 6.9 6.7 6.5 6.2 -2.21%
Other 9.5 10.6 11.1 11.9 12.6 13.4 14.2 15.0 15.9 16.7 17.6 5.78%
Total 257.0 281.5 292.6 306.5 320.6 334.8 349.2 363.3 377.3 390.9 404.2 4.03%

Asia Pacific
Table 266: Asia Pacific Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 25.0 25.4 25.4 25.6 25.7 25.6 25.5 25.1 24.6 24.1 23.4 -1.30%
CoP 24.2 26.5 28.2 29.9 31.6 33.3 34.8 36.1 37.3 38.2 38.7 3.76%
CoC 22.2 23.5 24.5 25.7 26.9 28.1 29.1 30.1 30.9 31.4 31.8 3.09%
MoM 1.3 1.2 1.1 1.0 0.9 0.8 0.7 0.6 0.5 0.5 0.4 -11.80%
Other 3.2 3.3 3.3 3.3 3.3 3.3 3.3 3.3 3.2 3.2 3.1 -0.93%
Total 74.2 77.6 79.6 82.0 84.2 86.0 87.3 88.1 88.4 87.9 86.8 0.81%
Table 267: Asia Pacific Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 9.7 9.8 9.6 9.6 9.5 9.3 9.2 9.0 8.7 8.5 8.2 -2.24%
CoP 5.9 6.2 6.3 6.4 6.5 6.5 6.6 6.6 6.5 6.5 6.4 -0.07%
CoC 4.8 4.9 4.9 4.9 4.9 4.9 4.9 4.9 4.8 4.7 4.7 -0.70%
MoM 0.5 0.4 0.4 0.4 0.4 0.3 0.3 0.3 0.3 0.2 0.2 -9.12%
Other 0.8 0.9 0.9 0.9 0.9 0.9 1.0 1.0 1.0 1.0 0.9 0.44%
Total 21.7 22.2 22.1 22.2 22.1 22.1 21.9 21.6 21.3 20.8 20.3 -1.23%

Asia Pacific
Figure 234: Asia Pacific Knee Arthroplasty Market Value

Asia Pacific Knee Arthroplasty Market ($Million) by Procedure Type
• Asia Pacific primary knee replacement market value was estimated to
3,321.1
3,178.1
3,037.0
2,898.2
2,762.0
4000
2,628.2
2,497.9
2,371.2
2,248.1
3500
2,129.5
2,011.5
2500
• Asia Pacific primary knee replacement market volume was estimated 2000
to be 467.9 thousand in 2017 and is forecasted to grow at a CAGR of 1500
168.2
168.6
168.5
167.2
167.8
166.3
165.4
164.1
161.2
157.4
152.9
500
• Asia Pacific revision knee replacement market is estimated to grow
0
by 0.90X in 2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
market is expected to grow by 1.44X fold over the forecast period. Figure 235: Asia Pacific Knee Arthroplasty Market
Whereas, the market volume was estimated to be 407.4 thousand in Procedure Volume (Thousand) by Procedure Type
568.4
555.9
543.4
531.0
• Asia Pacific bearing type segment is estimated to grow by 1.47X in
518.6
505.9
700
493.3
480.6
467.9
455.5
442.1
2025 whereas the leading bearing type segment is unconstrained 600
fixed which is estimated to grow by 1.63X by 2025. 500
400
300
200
36.4
35.8
35.0
34.2
33.3
32.3
31.2
30.1
28.8
27.5
26.2
100
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Asia Pacific
Table 268: Asia Pacific Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 46.3 42.6 42.0 41.1 40.0 38.5 36.8 34.8 32.4 29.7 26.6 -6.04%
Uncemented 1,758.0 1,859.1 1,957.3 2,059.0 2,163.2 2,269.9 2,379.0 2,489.6 2,601.7 2,715.1 2,829.6 4.65%
Hybrid 8.0 8.5 8.7 9.0 9.2 9.3 9.5 9.7 9.8 9.9 10.0 1.53%
Others 199.1 219.3 240.0 262.1 285.6 310.4 336.7 364.2 393.1 423.4 455.0 8.20%
Total 2,011.5 2,129.5 2,248.1 2,371.2 2,497.9 2,628.2 2,762.0 2,898.2 3,037.0 3,178.1 3,321.1 4.93%
Table 269: Asia Pacific Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 10.2 9.1 8.7 8.3 7.9 7.4 6.9 6.4 5.8 5.2 4.5 -8.29%
Uncemented 386.4 397.6 407.4 417.3 427.2 436.9 446.6 456.1 465.5 474.9 484.2 2.15%
Hybrid 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.7 1.7 -0.89%
Others 43.8 46.9 50.0 53.1 56.4 59.8 63.2 66.7 70.3 74.1 77.9 5.61%
Total 442.1 455.5 467.9 480.6 493.3 505.9 518.6 531.0 543.4 555.9 568.4 2.42%

Asia Pacific
Table 270: Asia Pacific Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 129.4 129.9 129.8 129.3 128.4 127.0 125.1 122.6 119.6 116.0 111.9 -2.05%
Uncemented 12.9 13.2 13.5 13.7 13.9 14.0 14.1 14.1 14.0 13.8 13.6 -0.11%
Hybrid 2.8 3.0 3.2 3.3 3.5 3.6 3.7 3.8 3.9 4.0 4.0 2.59%
Others 20.4 21.1 21.7 22.3 22.7 23.2 23.5 23.6 23.7 23.6 23.4 0.71%
Total 165.4 167.2 168.2 168.6 168.5 167.8 166.3 164.1 161.2 157.4 152.9 -1.39%
Table 271: Asia Pacific Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 28.4 27.8 27.0 26.2 25.4 24.4 23.5 22.5 21.4 20.3 19.1 -4.39%
Uncemented 2.8 2.8 2.8 2.8 2.7 2.7 2.6 2.6 2.5 2.4 2.3 -2.50%
Hybrid 0.6 0.6 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.14%
Others 4.5 4.5 4.5 4.5 4.5 4.5 4.4 4.3 4.2 4.1 4.0 -1.70%
Total 36.4 35.8 35.0 34.2 33.3 32.3 31.2 30.1 28.8 27.5 26.2 -3.75%

Asia Pacific
Table 272: Asia Pacific Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 82.5 83.1 83.2 83.0 82.4 81.5 80.1 78.3 75.9 73.1 69.7 -2.45%
Total 2,011.5 2,129.5 2,248.1 2,371.2 2,497.9 2,628.2 2,762.0 2,898.2 3,037.0 3,178.1 3,321.1 4.93%
Table 273: Asia Pacific Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 18.1 17.8 17.3 16.8 16.3 15.7 15.0 14.3 13.6 12.8 11.9 -4.78%
Total 442.1 455.5 467.9 480.6 493.3 505.9 518.6 531.0 543.4 555.9 568.4 2.42%

Asia Pacific
Table 274: Asia Pacific Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 3.8 4.2 4.5 4.9 5.2 5.5 5.8 6.1 6.3 6.5 6.6 4.31%
Total 165.4 167.2 168.2 168.6 168.5 167.8 166.3 164.1 161.2 157.4 152.9 -1.39%
Table 275: Asia Pacific Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.8 0.9 0.9 1.0 1.0 1.1 1.1 1.1 1.1 1.1 1.1 1.82%
Total 36.4 35.8 35.0 34.2 33.3 32.3 31.2 30.1 28.8 27.5 26.2 -3.75%

Asia Pacific
Figure 236: Asia Pacific Shoulder Arthroplasty Market

Asia Pacific Shoulder Arthroplasty Market Value ($Million) by Procedure Type
119.5
• In 2016, there were 12.80 thousand shoulder arthroplasty surgeries
109.6
140
100.5
performed in the Asia Pacific region. Reverse prosthetic type shoulder
92.0
120
84.1
arthroplasty remains the highest performed procedure over the
76.8
100
70.1
63.8
57.4
forecast period. The most frequently performed primary procedure
52.4
80
43.9
was the reverse polarity total prosthetic replacement with 6.57 60
40
thousand procedures, followed by total prosthetic replacement with
20
3.85 thousand procedures.
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 237: Asia Pacific Shoulder Arthroplasty Market

25.5
30
23.4
21.6
19.8
25
18.2
16.7
15.4
14.1
20
12.8
11.8
15
9.9
10
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Asia Pacific
Figure 238: Asia Pacific Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Total Prosthetic Replacement 14.2 16.1 17.3 19.0 20.8 22.7 24.7 26.9 29.3 31.8 34.5 0.1
20.9 26.2 29.5 33.0 36.6 40.4 44.6 49.1 54.0 59.4 65.3 0.1
Replacement
Resurfacing Total Arthroplasty 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Hemi-arthroplasty 5.1 6.0 6.4 7.0 7.7 8.3 9.1 9.9 10.7 11.6 12.6 0.1
Figure 239: Asia Pacific Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
16.0
14.0
12.0
10.0
8.0
6.0
4.0
2.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
4.7 5.9 6.6 7.3 8.0 8.8 9.7 10.6 11.6 12.7 13.9
Replacement

China
China Joint Reconstruction Market Overview
• China hip replacement market was valued $580.8 million in 2017 and is expected to reach $907.1 million in 2025. In 2017, primary
hip replacement increased by 0.21% and revision burden increased to 0.12% as compare to 2016. China is the fastest growing hip
replacement market, in the world, and expected to show double digit growth during the forecast period. The rapid growth in China's
hip replacement market is fuelled by the country's rising middle class and aging population. The average selling price for hip
implants has risen slightly as a result of a growing penetration of high-end devices, cost pressures in the country remain high and a
substantial.
• China knee replacement market was valued $1,085.9 million in 2017 and is expected to reach $ 1,695.1 million by 2025 growing at
a CAGR of 5.62% over the forecast period of 2018-2025. In China, most of the surgeries performed are primary surgeries and
uncemented fixation is mostly used.
• China shoulder replacement market was valued $8.2 million in 2017 and is expected to reach $22.1 million by 2025 growing at a
CAGR of 13.1% over the forecast period of 2018-2025. This growth is anticipated owing to continuously increasing total shoulder
arthroplasties and reversed total shoulder arthroplasties.

China
Figure 240: China Hip Joint Reconstruction Market Value Figure 241: China Knee Joint Reconstruction Market
($Billion) and Procedure Volume (Thousand) Value ($Billion) and Procedure Volume (Thousand)
0.91
1.70
0.87
1.62
0.83
1.54
250 1.00
0.79
1.46
0.75
350 1.80
1.38
0.70
0.90
1.30
0.66
1.23
0.62
1.60
1.16
200 0.80 300
0.58
1.09
0.54
1.02
1.40
0.51
0.70
0.95
250
150 0.60 1.20
0.50 200 1.00
209.3
203.7
198.0
192.1
290.1
186.0
282.6
275.0
179.8
267.1
173.5
0.80
259.1
167.3
100 0.40
250.8
150
161.0
242.6
155.0
234.3
148.4
226.0
218.1
209.3
0.30 0.60
100
50 0.20 0.40
0.10 50 0.20
0 - 0 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Hip Joint Reconstruction Volume (Thousand) Hip Joint Reconstruction Value ($ Million) Knee Joint Reconstruction Volume (Thousand) Knee Joint Reconstruction Value ($ Million)
Figure 242: China Shoulder Joint Reconstruction Market Figure 243: China Shoulder Joint Reconstruction Market
4.71
22.1
4.19
19.6
25 5
3.72
17.3
3.31
15.3
2.94
20 4
13.6
2.61
12.0
2.32
10.6
2.06
1.84
15 3
1.63
9.3
1.45
8.2
7.2
6.4
10 2
5 1
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

China
Figure 244: China Hip Arthroplasty Market Value

China Hip Arthroplasty Market
• In 2016, 155,027 hip arthroplasty surgeries were performed in
844.1
805.9
765.9
725.1
China. This is an increase on the previous year of 2015 of 4.3% for
684.3
900.0
643.2
603.0
800.0
563.8
hip replacements. The most frequently performed procedure was the
525.7
489.1
700.0
455.8
primary hip replacement with 145,710 procedures, followed by 600.0
500.0
revision hip replacement with 11,275 procedure. Based on the 400.0
300.0
gender, Female dominated the primary hip arthroplasty procedure
48.3
48.1
47.7
46.9
46.0
44.8
43.5
42.1
40.6
39.0
37.5
200.0
15.7
15.7
15.7
15.6
15.5
15.4
15.2
14.9
14.5
14.1
13.7
volume in japan with 73% compared to 23% of male in 2016. Based 100.0
-
on the fixation type, uncemented fixation is the most common used 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
fixation accounting for almost 52% of PHA operation followed by
cemented at 37%. However, the recent trends indicate a gradual
reduction in cemented fixation across all types of Hip Arthroplasty.
Hybrid fixation is expected to register fastest growth during the
Figure 245: China Hip Arthroplasty Market Procedure
forecast period. In 2016, hybrid fixation has 11% share of total PHA
and expected to reach 14% by 2025.
194.4
250.0
188.6
182.7
176.7
170.6
164.3
158.1
151.9
145.7
200.0
139.8
133.4
150.0
100.0
11.5
11.5
11.5
11.5
11.5
11.4
11.4
11.3
11.3
11.2
11.0
50.0
4.0
4.0
4.0
4.0
4.0
4.0
3.9
3.8
3.8
3.7
3.6
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

China
Table 276: China Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 173.2 181.4 190.3 199.0 207.4 215.5 223.1 229.9 236.0 241.1 244.9 3.01%
Uncemented 232.5 252.6 274.9 298.5 323.2 349.0 375.7 402.8 430.4 458.1 485.3 7.19%
Hybrid 50.1 55.0 60.5 66.2 72.3 78.8 85.5 92.4 99.5 106.7 113.9 8.05%
Others - - - - - - - - - - - 0.00%
Total 455.8 489.1 525.7 563.8 603.0 643.2 684.3 725.1 765.9 805.9 844.1 5.93%
Table 277: China Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 50.7 51.9 52.8 53.6 54.4 55.0 55.6 56.0 56.3 56.4 56.4 0.72%
Uncemented 68.0 72.2 76.2 80.4 84.7 89.1 93.7 98.2 102.7 107.2 111.8 4.82%
Hybrid 14.7 15.7 16.8 17.9 19.0 20.1 21.3 22.5 23.8 25.0 26.3 5.67%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 133.4 139.8 145.7 151.9 158.1 164.3 170.6 176.7 182.7 188.6 194.4 3.59%

China
Table 278: China Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 16.0 16.4 16.8 17.2 17.5 17.7 17.9 17.9 17.9 17.8 17.5 0.27%
Uncemented 18.9 20.1 21.3 22.6 23.9 25.1 26.3 27.5 28.5 29.5 30.2 4.22%
Hybrid 3.1 3.2 3.4 3.5 3.6 3.7 3.8 3.9 4.0 4.0 4.1 2.21%
Others - - - - - - - - - - - 0.00%
Total 37.5 39.0 40.6 42.1 43.5 44.8 46.0 46.9 47.7 48.1 48.3 1.96%
Table 279: China Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 4.7 4.7 4.7 4.6 4.6 4.5 4.4 4.4 4.3 4.1 4.0 -2.04%
Uncemented 5.2 5.3 5.4 5.6 5.7 5.8 5.8 5.9 6.0 6.0 6.0 1.09%
Hybrid 1.1 1.1 1.2 1.2 1.2 1.2 1.3 1.3 1.3 1.3 1.3 1.28%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 11.0 11.2 11.3 11.4 11.5 11.5 11.5 11.5 11.5 11.4 11.3 -0.09%

China
Table 280: China Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 241.6 256.3 272.3 288.7 305.2 321.7 338.2 354.0 369.3 383.8 397.0 4.66%
CoP 114.0 125.2 137.7 151.1 165.2 180.1 195.7 211.7 228.1 244.9 261.5 8.15%
CoC 70.7 76.0 82.0 88.2 94.7 101.3 108.1 114.9 121.7 128.5 135.0 6.26%
MoM 13.7 14.2 14.7 15.2 15.7 16.1 16.4 16.7 16.9 16.9 16.9 1.51%
Other 16.0 17.4 18.9 20.6 22.3 24.1 26.0 27.9 29.9 31.8 33.8 7.33%
Total 455.8 489.1 525.7 563.8 603.0 643.2 684.3 725.1 765.9 805.9 844.1 5.93%
Table 281: China Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 70.7 73.3 75.5 77.8 80.0 82.2 84.3 86.2 88.1 89.8 91.4 2.33%
CoP 33.3 35.8 38.2 40.7 43.3 46.0 48.8 51.6 54.5 57.4 60.3 5.77%
CoC 20.7 21.7 22.7 23.8 24.8 25.9 27.0 28.0 29.1 30.1 31.1 3.92%
MoM 4.0 4.1 4.1 4.1 4.1 4.1 4.1 4.1 4.0 4.0 3.9 -0.76%
Other 4.7 5.0 5.3 5.5 5.9 6.2 6.5 6.8 7.1 7.5 7.8 4.96%
Total 133.4 139.8 145.7 151.9 158.1 164.3 170.6 176.7 182.7 188.6 194.4 3.59%

China
Table 282: China Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 13.3 13.4 13.6 13.8 13.9 14.0 14.0 13.9 13.8 13.6 13.4 -0.44%
CoP 14.2 15.2 16.3 17.4 18.6 19.7 20.8 21.9 22.9 23.8 24.6 5.06%
CoC 7.6 8.1 8.7 9.3 9.9 10.5 11.1 11.7 12.2 12.7 13.1 5.01%
MoM 0.8 0.7 0.6 0.6 0.5 0.5 0.4 0.4 0.3 0.3 0.3 -11.28%
Other 1.7 1.7 1.7 1.8 1.8 1.8 1.8 1.8 1.8 1.8 1.8 0.11%
Total 37.5 39.0 40.6 42.1 43.5 44.8 46.0 46.9 47.7 48.1 48.3 1.96%
Table 283: China Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 5.2 5.2 5.2 5.2 5.1 5.1 5.0 5.0 4.9 4.8 4.7 -1.39%
CoP 3.5 3.6 3.6 3.7 3.8 3.9 3.9 4.0 4.0 4.0 4.0 1.18%
CoC 1.7 1.7 1.7 1.8 1.8 1.8 1.9 1.9 1.9 1.9 1.9 1.14%
MoM 0.3 0.3 0.3 0.2 0.2 0.2 0.2 0.2 0.2 0.1 0.1 -8.59%
Other 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1.50%
Total 11.0 11.2 11.3 11.4 11.5 11.5 11.5 11.5 11.5 11.4 11.3 -0.09%

China
Figure 246: China Knee Arthroplasty Market Value

China Knee Arthroplasty Market
• China primary knee replacement market value was estimated to be $
1,620.5
1,539.7
1.09 billion in 2017 and is forecasted to grow at a CAGR of 5.62% to
1,459.2
1,379.8
2,000.0
1,301.8
1,224.9
1,150.7
1,800.0
1,079.2
1,010.4
is expected to grow by 1.56X fold over the forecast period. 1,600.0
945.5
879.8
1,400.0
1,200.0
• China primary knee replacement market volume was estimated to be
1,000.0
3.59% to reach market value of 194.42 thousand by the end of 600.0
78.4
78.2
78.1
77.6
77.4
76.8
76.3
75.6
74.2
74.6
72.4
400.0
2025. 200.0
-
• China revision knee replacement market is estimated to grow by 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
1.19X in 2025.
7.19% to reach market value of $485.3 million by the end of 2025. Figure 247: China Knee Arthroplasty Market Procedure
The market is expected to grow by 1.77X fold over the forecast Volume (Thousand) by Procedure Type
400.0
277.3
269.3
261.1
252.8
350.0
244.4
235.8
227.2
218.7
• China bearing type segment is estimated to grow by 1.60X in 2025
210.3
202.2
300.0
193.4
whereas the leading bearing type segment is unconstrained fixed 250.0
150.0
100.0 15.9
15.9
15.7
15.6
15.3
15.1
14.7
14.3
13.9
13.3
12.8
50.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

China
Table 284: China Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 20.2 18.9 18.9 18.7 18.4 18.0 17.4 16.6 15.6 14.4 13.0 -5.10%
Uncemented 769.0 825.4 879.7 937.1 996.5 1057.9 1121.2 1185.2 1250.1 1315.4 1380.7 5.69%
Hybrid 3.5 3.8 3.9 4.1 4.2 4.4 4.5 4.6 4.7 4.8 4.9 2.55%
Others 87.1 97.4 107.9 119.3 131.6 144.7 158.7 173.4 188.9 205.1 222.0 9.28%
Total 879.8 945.5 1010.4 1079.2 1150.7 1224.9 1301.8 1379.8 1459.2 1539.7 1620.5 5.98%
Table 285: China Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 4.5 4.0 3.9 3.8 3.6 3.5 3.3 3.0 2.8 2.5 2.2 -7.37%
Uncemented 169.0 176.5 183.1 189.9 196.8 203.6 210.5 217.2 223.7 230.1 236.3 3.17%
Hybrid 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.8 0.10%
Others 19.2 20.8 22.5 24.2 26.0 27.9 29.8 31.8 33.8 35.9 38.0 6.67%
Total 193.4 202.2 210.3 218.7 227.2 235.8 244.4 252.8 261.1 269.3 277.3 3.45%

China
Table 286: China Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 56.6 57.7 58.3 58.9 59.2 59.2 59.0 58.4 57.5 56.2 54.6 -1.07%
Uncemented 5.6 5.9 6.1 6.2 6.4 6.5 6.6 6.7 6.7 6.7 6.6 0.89%
Hybrid 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.8 1.9 1.9 1.9 3.62%
Others 8.9 9.4 9.7 10.1 10.5 10.8 11.1 11.3 11.4 11.4 11.4 1.71%
Total 72.4 74.2 75.6 76.8 77.6 78.2 78.4 78.1 77.4 76.3 74.6 -0.41%
Table 287: China Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 12.4 12.3 12.1 11.9 11.7 11.4 11.1 10.7 10.3 9.8 9.3 -3.43%
Uncemented 1.2 1.3 1.3 1.3 1.3 1.3 1.3 1.2 1.2 1.2 1.1 -1.52%
Hybrid 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 1.14%
Others 2.0 2.0 2.0 2.1 2.1 2.1 2.1 2.1 2.0 2.0 2.0 -0.72%
Total 15.9 15.9 15.7 15.6 15.3 15.1 14.7 14.3 13.9 13.3 12.8 -2.79%

China
Table 288: China Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 36.1 36.9 37.4 37.8 38.0 38.0 37.8 37.3 36.5 35.4 34.0 -1.48%
Total 879.8 945.5 1010.4 1079.2 1150.7 1224.9 1301.8 1379.8 1459.2 1539.7 1620.5 5.98%
Table: 289 China Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 7.9 7.9 7.8 7.7 7.5 7.3 7.1 6.8 6.5 6.2 5.8 -3.83%
Total 193.4 202.2 210.3 218.7 227.2 235.8 244.4 252.8 261.1 269.3 277.3 3.45%

China
Table 290: China Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 1.7 1.9 2.0 2.2 2.4 2.6 2.7 2.9 3.0 3.1 3.2 5.36%
Total 72.4 74.2 75.6 76.8 77.6 78.2 78.4 78.1 77.4 76.3 74.6 -0.41%
Table 291: China Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.4 0.4 0.4 0.5 0.5 0.5 0.5 0.5 0.5 0.6 0.6 2.84%
Total 15.9 15.9 15.7 15.6 15.3 15.1 14.7 14.3 13.9 13.3 12.8 -2.79%

China
Figure 248: China Shoulder Arthroplasty Market Value

China Shoulder Arthroplasty Market
• In 2016, there were 1836 shoulder arthroplasty performed in China.
22.1
25.0
19.6
The most frequently performed primary procedure was the total
17.3
15.3
20.0
prosthetic shoulder replacement with 978 procedures, followed by
13.6
12.0
10.6
primary reverse prosthetic replacement with 455 procedures. The 15.0
9.3
8.2
total reverse polarity prosthetic replacement is expected to register a
7.2
6.4
10.0
CAGR of 15.63% through forecast period 2018-2025.
5.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 249: China Shoulder Arthroplasty Market

4.7
4.2
5.0
3.7
3.3
4.0
2.9
2.6
2.3
3.0
2.1
1.8
1.6
2.0 1.5
1.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

China
Figure 250: China Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
12.0
10.0
8.0
6.0
4.0
2.0
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
1.7 2.0 2.4 2.8 3.2 3.8 4.4 5.1 5.9 6.9 7.9
Replacement
Figure 251: China Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
2.5
2.0
1.5
1.0
0.5
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
0.4 0.5 0.5 0.6 0.7 0.8 1.0 1.1 1.3 1.5 1.7
Replacement

Japan
Japan Joint Reconstruction Market Overview
• Japan hip replacement market was valued $317.9 million in 2017 and is expected to reach $579.4 million in 2025. In 2017, primary
hip replacement increased by -16.42% and revision burden increased to -15.76% as compare to 2016. In the recent time, a drastic
increase occurred in the number of patients with hip fractures in Japan owing to increasing burden of osteoporosis and rheumatoid
arthritis. Japan hip arthroplasty industry is estimated to grow at a comparatively high rate of 6.4% annually. This has thus
increased global interest in the Japan orthopaedics industry.
• Japan knee replacement market was valued at $786.4 million in 2017 and is expected to reach $918.7 million by 2025 growing at a
CAGR of 1.78% over the forecast period of 2018-2025. In Japan, most of the surgeries performed are primary surgeries and
uncemented fixation is mostly used.
• Japan shoulder replacement market was valued at $18.32 million in 2017 and is expected to reach $45.82 million by 2025 growing
at a CAGR of 12.1% over the forecast period of 2018-2025. The growing demand for reverse shoulder arthroplasty which help in
the better segregation of human cells onto the bone is a critical factor that incites growth in this market during the forecast period.
Moreover, growing prevalence of symptomatic shoulder arthritis and proximal humerus fracture due to aging also boosting shoulder
arthroplasty market in Japan.

Japan
Figure 252: Japan Hip Joint Reconstruction Market Value Figure 253: Japan Knee Joint Reconstruction Market
579.4
918.8
913.1
903.8
891.2
875.4
549.2
856.8
835.5
160 700.0
516.9
812.0
786.4
483.4
758.8
730.0
166 1,000.0
449.5
140 600.0
415.6
382.2
164
349.5
120 500.0 800.0

318.0
287.6
100 162
226.6
400.0 600.0
80 160
133.7
165.0
164.9
128.7
164.6
164.3
123.4
163.7
117.9
300.0
163.3
112.1
106.2
162.3
158
100.2
60
161.7
400.0
94.2
160.5
88.2
159.7
82.2
200.0
66.3
40 156
157.2
100.0 200.0
20 154
0 - 152 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Hip Joint Reconstruction Volume (Thousand) Hip Joint Reconstruction Value ($ Million) Knee Joint Reconstruction Volume (Thousand) Knee Joint Reconstruction Value ($ Million)
Figure 254: Japan Shoulder Joint Reconstruction Market Figure 255: Japan Shoulder Joint Reconstruction Market
41.0
12
9.8
50
36.6
8.8
32.7
10
7.9
29.1
40
7.0
25.9
6.3
8
23.1
5.7
20.6
5.1
30
18.3
4.6
4.1
15.2
3.4
10.8
20
2.4
4
10 2
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Japan
Figure 256: Japan Hip Arthroplasty Market Value

Japan Hip Arthroplasty Market ($Million) by Procedure Type
• In 2016, 88,150 hip arthroplasty (HA) surgeries were performed in
556.0
524.1
the Japan. This is an increase on the previous year of 2015 of 24%
490.5
456.2
600.0
for hip replacements. The most frequently performed procedure was
421.9
388.0
354.8
the primary hip replacement with 80,922 (92%) procedures, 500.0
322.7
292.0
262.6
followed by revision hip replacement with 4,848 (8%) procedure. 400.0
205.8
This is anticipated due to increasing number of patient data in the 300.0
national registry. Based on the gender, Female dominated the 200.0
primary hip arthroplasty procedure volume in japan with 83.2%
17.9
17.8
17.8
17.5
17.4
17.0
16.8
15.9
14.7
14.3
13.1
11.0
10.8
11.0
10.6
10.3
10.0
9.6
9.1
8.6
8.1
6.6
100.0
compared to 16.8% of male in 2016. However, in the revision
-
arthroplasty, the percentage of male has increased in recent year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
and in 2017 it was recorded at 20%.
(THA) were operated due to Developmental Dislocation (Dysplasia)
DDH, of the Hip; 20% were due to osteoarthritis; and remaining Figure 257: Japan Hip Arthroplasty Market Procedure
were due to trauma, ION, and other medical conditions. Moreover in Volume (Thousand) by Procedure Type
revision procedures, DDH was the primary diagnosis in 45% of
patient while osteoarthritis was primary diagnosis in 11% of the
128.1
122.7
patient. Approximately 31.5% of the patients with a PHA were
117.0
111.2
140.0
105.2
referred to a rehabilitation and recovery centre on discharge.
99.1
93.0
120.0
86.9
80.9
75.1
• Based on the fixation type, uncemented fixation is the most common 100.0
60.2
used fixation accounting for almost 76% of PHA operation. However, 80.0
the recent trends indicate a gradual reduction in cemented fixation 60.0
across all types of Hip Arthroplasty. In most of the developed 40.0
4.9
4.8
4.8
4.7
4.6
4.4
4.2
4.1
3.8
3.5
3.1
2.6
2.6
2.5
2.6
2.6
2.5
2.5
2.4
2.4
2.3
1.9
countries Uncemented fixations are more preferred and have large 20.0
portion of all Hip Arthroplasty procedures with this technique. -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Japan
Table 292: Japan Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 25.7 31.4 33.3 35.0 36.5 37.8 38.8 39.5 39.7 39.6 39.0 1.53%
Uncemented 156.4 200.6 224.2 249.1 275.3 302.6 330.8 359.5 388.5 417.1 444.8 8.63%
Hybrid 23.7 30.6 34.5 38.6 42.9 47.5 52.3 57.2 62.3 67.3 72.2 9.38%
Others - - - - - - - - - - - 0.00%
Total 205.8 262.6 292.0 322.7 354.8 388.0 421.9 456.2 490.5 524.1 556.0 8.08%
Table 293: Japan Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 7.5 9.0 9.2 9.4 9.6 9.7 9.7 9.6 9.5 9.3 9.0 -0.72%
Uncemented 45.8 57.4 62.2 67.1 72.2 77.3 82.5 87.6 92.7 97.7 102.5 6.23%
Hybrid 6.9 8.8 9.6 10.4 11.3 12.1 13.0 14.0 14.9 15.8 16.7 6.97%
Others - - - - - - - - - - - 0.00%
Total 60.2 75.1 80.9 86.9 93.0 99.1 105.2 111.2 117.0 122.7 128.1 5.69%

Japan
Table 294: Japan Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 5.0 5.8 5.9 5.8 5.7 5.6 5.3 5.0 4.6 4.1 3.6 -6.85%
Uncemented 7.8 9.5 10.0 10.5 10.8 11.0 11.0 10.9 10.6 10.0 9.2 -1.84%
Hybrid 1.6 1.9 1.9 1.9 1.9 1.9 1.9 1.8 1.7 1.5 1.4 -4.78%
Others - - - - - - - - - - - 0.00%
Total 14.3 17.0 17.5 17.8 17.9 17.8 17.4 16.8 15.9 14.7 13.1 -4.24%
Table 295: Japan Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.5 1.7 1.6 1.6 1.5 1.4 1.3 1.2 1.1 1.0 0.8 -8.99%
Uncemented 2.1 2.5 2.6 2.6 2.6 2.5 2.4 2.3 2.2 2.0 1.8 -4.79%
Hybrid 0.6 0.7 0.7 0.7 0.7 0.6 0.6 0.6 0.5 0.5 0.4 -5.64%
Others - - - - - - - - - - - 0.00%
Total 4.2 4.9 4.9 4.8 4.7 4.6 4.4 4.1 3.8 3.5 3.1 -6.17%

Japan
Table 296: Japan Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 94.7 119.7 132.0 144.6 157.5 170.7 184.0 197.1 210.0 222.3 233.7 7.10%
CoP 59.7 77.6 87.9 98.9 110.7 123.2 136.2 149.8 163.8 177.8 191.7 9.92%
CoC 39.1 49.6 54.9 60.3 66.0 71.8 77.6 83.5 89.2 94.8 100.0 7.49%
MoM 5.1 6.2 6.4 6.6 6.7 6.8 6.8 6.6 6.4 6.0 5.6 -2.43%
Other 7.2 9.5 10.8 12.3 13.8 15.5 17.3 19.2 21.1 23.1 25.0 10.73%
Total 205.8 262.6 292.0 322.7 354.8 388.0 421.9 456.2 490.5 524.1 556.0 8.08%
Table 297: Japan Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 27.7 34.2 36.6 38.9 41.3 43.6 45.9 48.0 50.1 52.0 53.8 4.72%
CoP 17.5 22.2 24.4 26.6 29.0 31.5 34.0 36.5 39.1 41.7 44.2 7.49%
CoC 11.4 14.2 15.2 16.3 17.3 18.3 19.4 20.3 21.3 22.2 23.1 5.12%
MoM 1.5 1.8 1.8 1.8 1.8 1.7 1.7 1.6 1.5 1.4 1.3 -4.61%
Other 2.1 2.7 3.0 3.3 3.6 4.0 4.3 4.7 5.0 5.4 5.8 8.28%
Total 60.2 75.1 80.9 86.9 93.0 99.1 105.2 111.2 117.0 122.7 128.1 5.69%

Japan
Table 298: Japan Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 4.7 5.4 5.4 5.4 5.3 5.1 4.9 4.6 4.2 3.8 3.3 -6.59%
CoP 5.6 6.8 7.2 7.6 7.8 8.0 8.1 8.0 7.8 7.4 6.9 -1.38%
CoC 3.6 4.3 4.5 4.7 4.9 4.9 4.9 4.9 4.7 4.5 4.1 -2.08%
MoM 0.2 0.2 0.2 0.2 0.2 0.1 0.1 0.1 0.1 0.1 0.1 -13.39%
Other 0.6 0.8 0.8 0.8 0.8 0.7 0.7 0.7 0.6 0.6 0.5 -5.66%
Total 14.3 17.0 17.5 17.8 17.9 17.8 17.4 16.8 15.9 14.7 13.1 -4.24%
Table 299: Japan Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 1.8 2.1 2.1 2.0 2.0 1.9 1.8 1.6 1.5 1.3 1.2 -7.48%
CoP 1.4 1.6 1.6 1.6 1.6 1.6 1.5 1.5 1.4 1.3 1.1 -5.02%
CoC 0.8 0.9 0.9 0.9 0.9 0.9 0.8 0.8 0.7 0.7 0.6 -5.68%
MoM 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.0 0.0 0.0 -10.76%
Other 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 -4.35%
Total 4.2 4.9 4.9 4.8 4.7 4.6 4.4 4.1 3.8 3.5 3.1 -6.17%

Japan
Figure 258: Japan Knee Arthroplasty Market Value

Japan Knee Arthroplasty Market ($Million) by Procedure Type
• Japan primary knee replacement market value was estimated to be
878.4
870.0
858.3
843.4
825.6
805.4
782.7
758.1
731.7
1,000.0
703.6
674.5
900.0
to reach market value of $918.7 million by the end of 2025. The 800.0
700.0
market is expected to grow by 1.20 fold over the forecast period. 600.0
500.0
• Japan primary knee replacement market volume was estimated to be 400.0
300.0
55.5
55.2
54.7
53.9
52.8
51.4
49.7
47.8
45.6
43.1
40.4
152.29 thousand in 2017 and is forecasted to grow at a CAGR of - 200.0
100.0
0.31% to reach market value of 150.32 thousand by the end of -
2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

• Japan revision knee replacement market is estimated to grow by
0.74X in 2025.
Figure 259: Japan Knee Arthroplasty Market Procedure
155.0
155.0
154.6
154.5
153.7
153.6
152.3
152.2
150.5
150.3
148.3
140.0
thousand in 2017 and is forecasted to grow at a CAGR of -0.58% to 120.0
100.0
60.0 12.2
11.8
11.4
10.9
10.4
• Japan bearing type market is estimated to grow by 1.20X in 2025
9.9
9.3
8.8
8.2
7.5
6.9
40.0
20.0
whereas the leading bearing type segment is unconstrained fixed -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Japan
Table 300: Japan Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 15.5 14.1 13.7 13.1 12.5 11.8 11.0 10.1 9.2 8.1 7.0 -8.55%
Uncemented 589.5 614.2 637.1 658.3 677.9 695.6 711.2 724.5 735.3 743.3 748.4 1.85%
Hybrid 2.7 2.8 2.9 2.9 2.9 2.9 2.8 2.8 2.8 2.7 2.6 -1.18%
Others 66.8 72.5 78.1 83.8 89.5 95.1 100.6 106.0 111.1 115.9 120.3 5.30%
Total 674.5 703.6 731.7 758.1 782.7 805.4 825.6 843.4 858.3 870.0 878.4 2.13%
Table 301: Japan Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 3.4 3.0 2.8 2.7 2.5 2.3 2.1 1.9 1.6 1.4 1.2 -10.74%
Uncemented 129.6 131.4 132.6 133.4 133.9 133.9 133.5 132.7 131.6 130.0 128.1 -0.58%
Hybrid 0.6 0.6 0.6 0.6 0.6 0.6 0.5 0.5 0.5 0.5 0.5 -3.54%
Others 14.7 15.5 16.3 17.0 17.7 18.3 18.9 19.4 19.9 20.3 20.6 2.79%
Total 148.3 150.5 152.3 153.7 154.6 155.0 155.0 154.5 153.6 152.2 150.3 -0.31%

Japan
Table 302: Japan Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 43.4 42.9 42.3 41.4 40.2 38.9 37.4 35.7 33.8 31.8 29.6 -4.67%
Uncemented 4.3 4.4 4.4 4.4 4.4 4.3 4.2 4.1 4.0 3.8 3.6 -2.78%
Hybrid 0.9 1.0 1.0 1.1 1.1 1.1 1.1 1.1 1.1 1.1 1.1 -0.15%
Others 6.8 7.0 7.1 7.1 7.1 7.1 7.0 6.9 6.7 6.5 6.2 -1.98%
Total 55.5 55.2 54.7 53.9 52.8 51.4 49.7 47.8 45.6 43.1 40.4 -4.03%
Table 303: Japan Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 9.5 9.2 8.8 8.4 8.0 7.5 7.0 6.5 6.1 5.6 5.1 -6.95%
Uncemented 1.0 0.9 0.9 0.9 0.9 0.8 0.8 0.8 0.7 0.7 0.6 -5.10%
Hybrid 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 -2.53%
Others 1.5 1.5 1.5 1.4 1.4 1.4 1.3 1.3 1.2 1.1 1.1 -4.33%
Total 12.2 11.8 11.4 10.9 10.4 9.9 9.3 8.8 8.2 7.5 6.9 -6.32%

Japan
Table 304: Japan Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 27.7 27.4 27.1 26.5 25.8 25.0 23.9 22.8 21.5 20.0 18.5 -5.06%
Total 674.5 703.6 731.7 758.1 782.7 805.4 825.6 843.4 858.3 870.0 878.4 2.13%
Table 305: Japan Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 6.1 5.9 5.6 5.4 5.1 4.8 4.5 4.2 3.8 3.5 3.2 -7.33%
Total 148.3 150.5 152.3 153.7 154.6 155.0 155.0 154.5 153.6 152.2 150.3 -0.31%

Japan
Table 306: Japan Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 1.3 1.4 1.5 1.6 1.6 1.7 1.7 1.8 1.8 1.8 1.7 1.53%
Total 55.5 55.2 54.7 53.9 52.8 51.4 49.7 47.8 45.6 43.1 40.4 -4.03%
Table 307: Japan Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 -0.90%
Total 12.2 11.8 11.4 10.9 10.4 9.9 9.3 8.8 8.2 7.5 6.9 -6.32%

Japan
Figure 260: Japan Shoulder Arthroplasty Market Value

Japan Shoulder Arthroplasty Market ($Million) by Procedure Type
• A total of 4,085.02 shoulder procedures were carried out during 60.0
45.8
2016. The most frequently performed primary procedure was the
41.0
50.0
36.6
32.7
polarity total shoulder replacement with 2,250.0 (55%) procedures,
29.1
40.0
25.9
23.1
followed by total prosthetic replacement reverse 1,063.68 (26%)
20.6
30.0
18.3
15.2
procedures. Fifty four percent of primary replacements were
10.8
20.0
performed on the right shoulder joint. The most common indications
10.0
for primary joint replacements were osteoarthritis (64%) and
-
fracture (20%). The proportion of resurfacings (both total and 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
hemiarthroplasty) has continued to decline with time and the Shoulder Joint Reconstruction Market Value ($Million)
proportion of reverse polarity total replacements has increased again
in 2018.
Figure 261: Japan Shoulder Arthroplasty Market
20.0
15.0
9.8
8.8
7.9
7.0
10.0
6.3
5.7
5.1
4.6
4.1
3.4
5.0 2.4
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Japan
Figure 262: Japan Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
30.0
25.0
20.0
15.0
10.0
5.0
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
4.6 7.8 10.1 11.5 13.0 14.8 16.8 19.0 21.5 24.3 27.4
Replacement
Figure 263: Japan Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
7.0
6.0
5.0
4.0
3.0
2.0
1.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
1.1 1.8 2.3 2.5 2.9 3.2 3.6 4.1 4.6 5.2 5.9
Replacement

Australia
Australia Joint Reconstruction Market Overview
• Australia hip replacement market was valued $162.0 million in 2017 and is expected to reach $217.6 million in 2025. In 2017, primary hip
replacement increased by -8.93% and revision burden increased to 3.27% as compare to 2016. In 2016, hip replacement increased by 5% and
revision burden declined to 8%, which is the lowest level reported by the Registry. The future growth would be driven by the growing chronic
conditions, younger patients undergoing joint replacement and requiring further revision surgeries during their lifetime.
• Australia knee replacement market was valued $238.0 million in 2017 and is expected to reach $431.1 million by 2025 growing at a CAGR of
7.93% over the forecast period of 2018-2025. In Australia, most of the surgeries performed are primary surgeries and uncemented fixation is
mostly used.
• Australia shoulder replacement market was valued $26.4 million in 2017 and is expected to reach $43.9 million by 2025 growing at a CAGR of
6.07% over the forecast period of 2018-2025. The use of reverse polarity total prosthetic replacement continues to increase and in 2016
accounted for 57.8% of all total shoulder replacements. Growing elderly population in the country is one of the cardinal driving the shoulder
arthroplasty market in the region.

Australia
Figure 264: Australia Hip Joint Reconstruction Market Figure 265: Australia Knee Joint Reconstruction Market
431.1
394.8
80 500.0
217.6
211.3
362.9
204.5
197.5
334.8
51 250.0
190.4
70
183.3
310.1
176.1
169.0
288.4
400.0
163.4
50
162.0
269.4
153.1
60
252.7
200.0
238.0
49
225.2
214.0
48 50 300.0
150.0
73.8
47 40
69.1
50.2
64.9
61.3
49.5
58.2
46 200.0
55.5
48.8
30
53.2
51.2
100.0
49.5
48.2
48.2
47.0
47.5
45
46.8
46.7
20
46.2
45.5
44 100.0
44.9
44.8
50.0
43 10
42 0.0 0 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 266: Australia Shoulder Joint Reconstruction Figure 267: Australia Shoulder Joint Reconstruction
9.4
43.9
8.9
41.8
8.5
39.7
50 10
37.6
8.1
35.5
7.7
33.3
7.3
31.2
6.8
29.0
6.4
40 8
26.4
5.9
25.7
5.8
22.8
5.2
30 6
20 4
10 2
0
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Australia
Figure 268: Australia Hip Arthroplasty Market Value

Australia Hip Arthroplasty Market ($Million) by Procedure Type
• In 2016, a total of 46,731.3 hip arthroplasty were performed in the 250.0
194.0
187.8
Australia. This is an additional 1,935 hip procedures compared to the
181.2
174.5
167.8
number reported last year. In 2016, primary hip replacement
161.1
154.4
200.0
147.8
142.1
141.3
accounts for 87.0%, revision hip replacement accounts for 9.1% and
131.2
resurfacing hip replacement accounts for 3.9%. Moreover, the 150.0
number of hip replacement procedures undertaken in 2016 is 73.7%
higher than the number undertaken in 2003. The corresponding 100.0
increase in primary total hip replacement is 94.4%, primary partial
30.1%, and revision hip replacement 19.4%. The proportion of
16.7
16.6
16.4
16.1
15.9
15.8
15.6
15.2
14.9
14.9
14.5
50.0
6.9
6.9
6.9
6.8
6.7
6.6
6.5
6.4
6.4
6.2
6.2
revision hip procedures has declined from a peak of 12.9% in 2003 to
8% in 2016. This equates to 1,871 fewer revision procedures in 2016 -
than would have been expected if the proportion of revision 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
procedures had remained at 12.9%.
• The mean age of patients were 67.7 years in 2016. There has been
minimal change in the proportion of patients aged 55 to 64 years
(21.9% in 2003 to 24.0% in 2016) and younger than 55 years
(11.7% in 2003 to 12.6% in 2016). The use of uncemented fixation Figure 269: Australia Hip Arthroplasty Market Procedure
has increased from 51.3% in 2003 to 63.4% in 2016. Cemented Volume (Thousand) by Procedure Type
fixation has declined from 13.9% to 3.4% and hybrid fixation from
34.8% to 33.2% over the same period.
• In 2016, Osteoarthritis is was the principal diagnosis (88.5%),
44.7
44.0
43.2
42.5
41.8
41.1
40.6
40.5
39.8
50.0
39.2
followed by fractured neck of femur (4.3%), osteonecrosis (3.3%),
38.4
developmental dysplasia (1.2%) and rheumatoid arthritis (1.0%) for 40.0
primary replacements. Osteoarthritis has a lower rate of revision
compared to fractured neck of femur, osteonecrosis and rheumatoid 30.0
arthritis. The Exeter V40, Corail, Quadra-H, and Polarstem are the 20.0
most used femoral stems for total conventional hip replacement. The 4.6
4.3
4.0
4.0
4.0
4.0
4.0
4.0
3.9
3.9
3.9
Trident (Shell), Pinnacle, and R3 remain the most frequently used
1.8
1.8
10.0
1.7
1.7
1.7
1.7
1.7
1.7
1.6
1.6
1.6
acetabular prostheses for total conventional hip replacement.
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Australia
Table 308: Australia Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 5.0 5.2 5.0 5.0 5.1 5.1 5.1 5.0 5.0 4.9 4.9 -0.54%
Uncemented 82.8 89.6 89.0 93.0 97.1 101.2 105.3 109.4 113.5 117.5 121.2 3.86%
Hybrid 43.4 47.3 47.3 49.8 52.3 54.8 57.4 60.1 62.7 65.3 67.8 4.53%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 131.2 142.1 141.3 147.8 154.4 161.1 167.8 174.5 181.2 187.8 194.0 3.96%
Table 309: Australia Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.5 1.5 1.4 1.4 1.3 1.3 1.3 1.2 1.2 1.2 1.1 -2.75%
Uncemented 24.2 25.6 24.7 25.1 25.4 25.8 26.3 26.7 27.1 27.5 27.9 1.56%
Hybrid 12.7 13.5 13.1 13.4 13.7 14.0 14.3 14.6 15.0 15.3 15.6 2.23%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 38.4 40.6 39.2 39.8 40.5 41.2 41.8 42.5 43.2 44.0 44.7 1.66%

Australia
Table 310: Australia Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.7 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.5 0.5 0.5 -1.95%
Uncemented 10.6 10.0 9.9 10.2 10.5 10.8 11.2 11.5 11.8 12.0 12.2 2.66%
Hybrid 4.4 4.1 3.9 4.0 4.0 4.1 4.1 4.2 4.2 4.3 4.3 1.09%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 15.8 14.9 14.5 14.9 15.2 15.6 15.9 16.1 16.4 16.6 16.7 1.70%
Table 311: Australia Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.2 0.2 0.2 0.2 0.2 0.2 0.1 0.1 0.1 0.1 0.1 -4.21%
Uncemented 2.9 2.7 2.5 2.5 2.5 2.5 2.5 2.5 2.5 2.4 2.4 -0.42%
Hybrid 1.5 1.4 1.4 1.4 1.4 1.4 1.4 1.4 1.4 1.4 1.4 0.18%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 4.6 4.3 4.0 4.0 4.0 4.0 4.0 4.0 4.0 3.9 3.9 -0.35%

Australia
Table 312: Australia Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 65.4 70.7 70.2 73.2 76.3 79.4 82.5 85.6 88.7 91.7 94.5 3.72%
CoP 23.1 25.1 25.0 26.3 27.6 28.9 30.2 31.5 32.9 34.2 35.5 4.37%
CoC 34.3 37.3 37.2 39.1 40.9 42.8 44.7 46.7 48.6 50.5 52.3 4.27%
MoM 1.7 1.7 1.6 1.5 1.4 1.3 1.2 1.1 0.9 0.8 0.6 -12.12%
Other 6.6 7.3 7.3 7.8 8.2 8.7 9.1 9.6 10.1 10.6 11.1 5.18%
Total 131.2 142.1 141.3 147.8 154.4 161.1 167.8 174.5 181.2 187.8 194.0 3.96%
Table 313: Australia Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 19.2 20.2 19.4 19.7 20.0 20.3 20.6 20.9 21.2 21.5 21.8 1.42%
CoP 6.7 7.2 6.9 7.1 7.2 7.4 7.5 7.7 7.9 8.0 8.2 2.07%
CoC 10.1 10.7 10.3 10.5 10.7 10.9 11.2 11.4 11.6 11.8 12.1 1.97%
MoM 0.5 0.5 0.4 0.4 0.4 0.3 0.3 0.3 0.2 0.2 0.1 -14.08%
Other 1.9 2.1 2.0 2.1 2.2 2.2 2.3 2.3 2.4 2.5 2.6 2.85%
Total 38.4 40.6 39.2 39.8 40.5 41.2 41.8 42.5 43.2 44.0 44.7 1.66%

Australia
Table 314: Australia Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 6.3 5.8 5.6 5.6 5.7 5.7 5.7 5.7 5.7 5.7 5.7 0.14%
CoP 3.0 2.9 2.9 3.1 3.2 3.4 3.5 3.7 3.9 4.0 4.2 4.53%
CoC 5.4 5.2 5.1 5.4 5.6 5.9 6.1 6.3 6.6 6.8 7.0 3.79%
MoM 0.2 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.0 -12.12%
Other 0.7 0.7 0.6 0.7 0.7 0.7 0.7 0.6 0.6 0.6 0.6 -0.20%
Total 15.8 14.9 14.5 14.9 15.2 15.6 15.9 16.1 16.4 16.6 16.7 1.70%
Table 315: Australia Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 2.5 2.3 2.1 2.1 2.1 2.1 2.1 2.0 2.0 2.0 2.0 -0.82%
CoP 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.7 0.67%
CoC 1.2 1.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 -0.03%
MoM 0.1 0.1 0.1 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -9.45%
Other 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 1.19%
Total 4.6 4.3 4.0 4.0 4.0 4.0 4.0 4.0 4.0 3.9 3.9 -0.35%

Australia
Figure 270: Australia Knee Arthroplasty Market Value

Australia Knee Arthroplasty Market ($Million) by Procedure Type
• Australia primary knee replacement market value was estimated to
412.2
376.2
344.6
450.0
316.8
292.5
400.0
271.1
The market is expected to grow by 1.86 fold over the forecast period.
252.4
235.9
350.0
221.5
208.8
197.7
• Australia primary knee replacement market volume was estimated to 300.0
5.71% to reach market value of 70.53 thousand by the end of 2025. 200.0
150.0
• Australia revision knee replacement market is estimated to grow by
19.0
18.6
18.3
17.9
17.6
17.3
17.0
16.8
16.6
16.4
16.3
100.0
1.14X in 2025. 50.0
-
• Uncemented knee fixation segment market value was estimated to 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
8.00% to reach market value of $351.2 million by the end of 2025. Primary Knee Replacement Revision Knee Replacement
reach market volume of 60.09 thousand by the end of 2025. Figure 271: Australia Knee Arthroplasty Market
• Australia bearing type market is estimated to grow by 1.86X in 2025
70.5
65.8
80.0
61.7
58.1
54.9
70.0
52.2
49.8
47.8
46.1
44.6
43.5
60.0
50.0
40.0
30.0
20.0
3.6
3.5
3.4
3.4
3.4
3.3
3.3
3.3
3.3
3.3
3.2
10.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Australia
Table 316: Australia Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 4.5 4.2 4.1 4.1 4.0 4.0 3.9 3.8 3.7 3.5 3.3 -3.03%
Uncemented 172.8 182.2 192.8 204.8 218.5 234.2 251.9 272.2 295.2 321.4 351.2 8.00%
Hybrid 0.8 0.8 0.9 0.9 0.9 1.0 1.0 1.1 1.1 1.2 1.2 4.79%
Others 19.6 21.5 23.6 26.1 28.9 32.0 35.7 39.8 44.6 50.1 56.5 11.67%
Total 197.7 208.8 221.5 235.9 252.4 271.1 292.5 316.8 344.6 376.2 412.2 8.30%
Table 317: Australia Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.0 0.9 0.9 0.8 0.8 0.8 0.7 0.7 0.7 0.6 0.6 -5.34%
Uncemented 38.0 39.0 40.1 41.5 43.2 45.1 47.3 49.9 52.8 56.2 60.1 5.42%
Hybrid 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 2.29%
Others 4.3 4.6 4.9 5.3 5.7 6.2 6.7 7.3 8.0 8.8 9.7 9.00%
Total 43.5 44.7 46.1 47.8 49.8 52.2 54.9 58.1 61.7 65.8 70.5 5.71%

Australia
Table 318: Australia Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 12.7 12.7 12.8 12.9 13.0 13.1 13.0 13.4 13.6 13.7 13.9 1.09%
Uncemented 1.3 1.3 1.3 1.4 1.4 1.4 1.5 1.5 1.6 1.6 1.7 3.09%
Hybrid 0.3 0.3 0.3 0.3 0.4 0.4 0.4 0.4 0.4 0.5 0.5 5.88%
Others 2.0 2.1 2.1 2.2 2.3 2.4 2.4 2.6 2.7 2.8 2.9 3.94%
Total 16.3 16.4 16.6 16.8 17.0 17.3 17.6 17.9 18.3 18.6 19.0 1.77%
Table 319: Australia Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 2.8 2.7 2.7 2.6 2.6 2.5 2.5 2.5 2.4 2.4 2.4 -1.32%
Uncemented 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.63%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 3.36%
Others 0.4 0.4 0.4 0.5 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1.46%
Total 3.6 3.5 3.5 3.4 3.4 3.3 3.3 3.3 3.3 3.3 3.3 -0.66%

Australia
Table 320: Australia Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 8.1 8.1 8.2 8.3 8.3 8.4 8.5 8.6 8.6 8.7 8.7 0.68%
Total 197.7 208.8 221.5 235.9 252.4 271.1 292.5 316.8 344.6 376.2 412.2 8.30%
Table 321: Australia Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 1.8 1.7 1.7 1.7 1.6 1.6 1.6 1.6 1.5 1.5 1.5 -1.73%
Total 43.5 44.7 46.1 47.8 49.8 52.2 54.9 58.1 61.7 65.8 70.5 5.71%

Australia
Table 322: Australia Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.4 0.4 0.4 0.5 0.5 0.6 0.6 0.7 0.7 0.8 0.8 7.66%
Total 16.3 16.4 16.6 16.8 17.0 17.3 17.6 17.9 18.3 18.6 19.0 1.77%
Table 323: Australia Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 5.09%
Total 3.6 3.5 3.5 3.4 3.4 3.3 3.3 3.3 3.3 3.3 3.3 -0.66%

Australia
Figure 272: Australia Shoulder Arthroplasty Market Value

Australia Shoulder Arthroplasty Market ($Million) by Procedure Type
41.82
43.87
39.73
• Arthroplasty of the shoulder, over the years, has become a 50.00
37.61
35.47
45.00
33.32
commonly performed procedure in orthopaedic practices in
31.18
29.05
40.00
26.36
25.71
Australia. A total of 5,878 shoulder procedures carried out during 35.00
22.78
30.00
2016 were entered into the Australian registry. The most frequently 25.00
performed primary procedure was the reverse polarity total shoulder 20.00
15.00
replacement (58.8%) procedure, followed by total prosthetic 10.00
replacement (23.4%) procedure. 54% of primary replacements 5.00
-
were performed on the right shoulder joint. In primary total 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
conventional shoulder replacement, the use of cemented glenoid Shoulder Joint Reconstruction Market Value ($Million)
fixation continues to increase and its lower rate of revision is again
highlighted. Larger head sizes are associated with a lower rate of
revision. There is no difference related to fixation in total reverse
Figure 273: Australia Shoulder Arthroplasty Market
shoulder replacement, but there are differences related to
glenosphere size when used in the management of osteoarthritis.
9.4
8.9
8.5
10.0
8.1
7.7
7.3
6.8
6.4
8.0
5.9
5.8
5.2
6.0
4.0
2.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Australia
Figure 274: Australia Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
30.0
25.0
20.0
15.0
10.0
5.0
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
13.1 14.9 15.3 17.0 18.3 19.7 21.1 22.5 23.9 25.2 26.6
Replacement
Figure 275: Australia Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
6.0
5.0
4.0
3.0
2.0
1.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
3.0 3.3 3.4 3.8 4.0 4.3 4.6 4.8 5.1 5.4 5.7
Replacement

South Korea
South Korea Joint Reconstruction Market Overview
• South Korea hip replacement market was valued $105.2 million in 2017 and is expected to reach $172.4 million in 2025. In 2017,
primary hip replacement increased by 0.98% and revision burden increased to 0.87% as compare to 2016. The increased use of
multi-modal pain control programs is playing a significant role in shifting total joint replacements to outpatient settings in Korean
Hospitals. The need for faster recovery, lesser post-operative pain and cost-effective procedures is driving the demand for
minimally invasive hip replacements.
• South Korea knee replacement market was valued $305.9 million in 2017 and is expected to reach $429.0 million by 2025 growing
at a CAGR of 4.31% over the forecast period of 2018-2025. In South Korea, most of the surgeries performed are primary surgeries
and uncemented fixation is mostly used.
• South Korea shoulder replacement market was valued $4.5 million in 2017 and is expected to reach $7.8 million by 2025 growing
at a CAGR of 6.95% over the forecast period of 2018-2025. The market for reverse shoulder arthroplasty is being driven by the use
of trabecular metal implants. While challenges such as high revision rates and the need for training remain constant, the Korea
shoulder arthroplasty market is likely to continue growing at a CAGR of 6.95% from 2017 to 2025.

South Korea
Figure 276: South Korea Hip Joint Reconstruction Market Figure 277: South Korea Knee Joint Reconstruction
Value ($Million) and Procedure Volume (Thousand) Market Value ($Billion) and Procedure Volume (Thousand)
172.4
429.0
163.6
411.7
394.8
154.6
378.5
45 200.0
145.7
75
362.8
500.0
347.7
136.6
333.1
128.0
180.0
319.2
40
305.9
119.9
293.0
112.1
280.8
160.0
105.2
35 400.0
70
98.6
140.0
93.3
30
120.0 300.0
25
73.4
100.0 65
39.8
72.0
38.3
36.9
70.6
20
35.5
34.1
69.3
32.7
80.0 200.0
31.5
68.1
30.2
29.2
28.2
66.9
27.3
15
65.8
64.7
60.0
63.7
60
62.7
61.7
10 40.0 100.0
5 20.0
0 - 55 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 278: South Korea Shoulder Joint Reconstruction Figure 279: South Korea Shoulder Joint Reconstruction
1.7
1.6
10
7.8
1.5
1.8
7.3
1.4
6.8
1.3
1.6
6.4
1.2
8
6.0
1.1
1.1
5.6
1.4
1.0
5.2
0.9
4.8
0.9
4.5
1.2
4.2
6
3.9
1
4 0.8
0.6
2 0.4
0.2
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

South Korea
Figure 280: South Korea Hip Arthroplasty Market Value

South Korea Hip Arthroplasty Market ($Million) by Procedure Type
• South Korea primary hip replacement market value was estimated to
160.9
152.4
143.8
180.0
135.2
126.6
118.4
160.0
110.8
103.4
140.0
period.
96.8
90.6
85.6
120.0
• South Korea primary hip replacement market volume was estimated 100.0
to be 26.84 thousand in 2017 and is forecasted to grow at a CAGR of 80.0
2025. 40.0
8.7
8.6
8.4
8.2
8.0
7.8
7.5
7.3
7.0
6.8
6.6
3.0
2.7
2.5
2.3
2.0
1.8
1.6
1.5
1.3
1.2
1.1
20.0
• South Korea revision hip replacement market is estimated to grow by -
1.23X in 2025 whereas the hip resurfacing market is estimated to 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• Uncemented hip fixation segment market value was estimated to be
market is expected to grow by 1.70X fold over the forecast period. Figure 281: South Korea Hip Arthroplasty Market
Whereas, the market volume was estimated to be 20.53 thousand in Procedure Volume (Thousand) by Procedure Type
37.1
35.7
34.3
32.9
• South Korea bearing surface market is estimated to grow by 1.44X in 40.0
31.6
30.2
29.0
2025 whereas the leading bearing surface segment is “metal-on-
27.8
35.0
26.8
25.9
25.0
polyethylene” (MoP) which is estimated to grow by 1.59X by 2025. 30.0
25.0
20.0
15.0
10.0
2.0
2.0
2.0
2.0
2.0
2.0
2.0
2.0
2.0
1.9
1.9
0.7
0.6
0.6
0.6
0.5
0.5
0.4
0.4
0.4
0.3
0.3
5.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

South Korea
Table 324: South Korea Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 10.7 11.1 11.5 12.0 12.5 13.0 13.5 14.1 14.5 14.9 15.3 3.54%
Uncemented 65.1 69.1 74.1 79.3 85.3 91.5 98.1 105.1 112.1 119.2 126.3 6.87%
Hybrid 9.8 10.5 11.2 12.0 13.0 13.9 14.9 16.0 17.1 18.2 19.3 6.97%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 85.6 90.6 96.8 103.4 110.8 118.4 126.6 135.2 143.8 152.4 160.9 6.52%
Table 325: South Korea Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 3.1 3.2 3.2 3.2 3.3 3.3 3.4 3.4 3.5 3.5 3.5 1.24%
Uncemented 19.0 19.8 20.5 21.4 22.4 23.4 24.5 25.6 26.8 27.9 29.1 4.50%
Hybrid 2.9 3.0 3.1 3.2 3.4 3.6 3.7 3.9 4.1 4.3 4.5 4.61%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 25.1 25.9 26.8 27.9 29.0 30.3 31.6 32.9 34.3 35.7 37.1 4.17%

South Korea
Table 326: South Korea Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 2.3 2.4 2.4 2.4 2.5 2.5 2.5 2.5 2.5 2.5 2.5 0.25%
Uncemented 3.6 3.8 4.0 4.2 4.5 4.7 4.9 5.2 5.4 5.6 5.8 4.77%
Hybrid 0.7 0.8 0.8 0.8 0.8 0.9 0.9 0.9 0.9 0.9 1.0 2.44%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 6.6 6.8 7.0 7.3 7.5 7.8 8.0 8.2 8.4 8.6 8.7 2.53%
Table 327: South Korea Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.7 0.7 0.7 0.7 0.7 0.6 0.6 0.6 0.6 0.6 0.6 -2.06%
Uncemented 1.0 1.0 1.0 1.0 1.1 1.1 1.1 1.1 1.1 1.2 1.2 1.63%
Hybrid 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 1.51%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.00%
Total 1.9 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 0.47%

South Korea
Table 328: South Korea Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 10.2 11.0 12.0 13.0 14.2 15.5 16.8 18.3 19.8 21.3 22.9 8.38%
CoP 7.3 8.1 9.1 10.1 11.3 12.6 14.0 15.6 17.2 18.8 20.6 10.67%
CoC 62.1 65.2 69.0 73.1 77.6 82.3 87.2 92.3 97.3 102.2 106.9 5.59%
MoM 3.5 3.6 3.7 3.7 3.8 3.9 4.0 4.0 4.1 4.1 4.0 1.06%
Other 2.6 2.8 3.1 3.4 3.8 4.1 4.6 5.0 5.5 5.9 6.4 9.49%
Total 85.6 90.6 96.8 103.4 110.8 118.4 126.6 135.2 143.8 152.4 160.9 6.52%
Table 329: South Korea Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 3.0 3.1 3.3 3.5 3.7 4.0 4.2 4.5 4.7 5.0 5.3 5.97%
CoP 2.1 2.3 2.5 2.7 3.0 3.2 3.5 3.8 4.1 4.4 4.7 8.23%
CoC 18.2 18.6 19.1 19.7 20.4 21.0 21.7 22.5 23.2 23.9 24.6 3.26%
MoM 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 0.9 -1.20%
Other 0.8 0.8 0.9 0.9 1.0 1.1 1.1 1.2 1.3 1.4 1.5 7.07%
Total 25.1 25.9 26.8 27.9 29.0 30.3 31.6 32.9 34.3 35.7 37.1 4.17%

South Korea
Table 330: South Korea Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 0.7 0.7 0.8 0.8 0.8 0.9 0.9 0.9 0.9 1.0 1.0 2.82%
CoP 1.4 1.6 1.7 1.8 2.0 2.2 2.4 2.5 2.7 2.9 3.1 7.44%
CoC 5.7 5.8 6.1 6.3 6.5 6.7 7.0 7.2 7.4 7.5 7.6 2.82%
MoM 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.0 0.0 -11.96%
Other 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 0.2 0.2 0.2 3.90%
Total 6.6 6.8 7.0 7.3 7.5 7.8 8.0 8.2 8.4 8.6 8.7 2.53%
Table 331: South Korea Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 1.84%
CoP 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.5 0.5 0.5 0.5 3.48%
CoC 1.2 1.2 1.2 1.2 1.2 1.2 1.2 1.2 1.2 1.1 1.1 -0.96%
MoM 0.1 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -9.28%
Other 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.1 5.35%
Total 1.9 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 0.47%

South Korea
Figure 282: South Korea Knee Arthroplasty Market Value

South Korea Knee Arthroplasty Market ($Million) by Procedure Type
• South Korea primary knee replacement market value was estimated
410.1
392.2
374.9
500.0
358.2
to be $284,6 million in 2017 and is forecasted to grow at a CAGR of
342.2
326.8
450.0
312.1
298.0
284.6
400.0
271.7
259.5
350.0
The market is expected to grow by 1.44 fold over the forecast 300.0
250.0
period. 200.0
150.0
21.3
21.3
21.3
21.2
21.1
20.9
20.6
20.3
19.9
19.4
18.9
• South Korea primary knee replacement market volume was 100.0
50.0
estimated to be 59.23 thousand in 2017 and is forecasted to grow at -
a CAGR of 2.17% to reach market value of 70.18 thousand by the 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
end of 2025. Primary Knee Replacement Revision Knee Replacement
• South Korea revision knee replacement market is estimated to grow

by 0.89X in 2025. Figure 283: South Korea Knee Arthroplasty Market
70.2
68.6
67.1
65.6
64.2
62.9
80.0
61.6
60.4
59.2
58.1
57.0
70.0
40.0
30.0
4.7
4.6
4.4
4.3
4.2
4.0
3.9
3.7
3.6
3.4
3.2
10.0
• South Korea bearing type market is estimated to grow by 1.44X in -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
2025 whereas the leading bearing type segment is unconstrained

South Korea
Table 332: South Korea Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 6.0 5.4 5.3 5.2 5.0 4.8 4.6 4.3 4.0 3.7 3.3 -6.28%
Uncemented 226.8 237.2 247.8 258.8 270.3 282.2 294.7 307.7 321.2 335.1 349.4 4.38%
Hybrid 1.0 1.1 1.1 1.1 1.1 1.2 1.2 1.2 1.2 1.2 1.2 1.28%
Others 25.7 28.0 30.4 32.9 35.7 38.6 41.7 45.0 48.5 52.3 56.2 7.92%
Total 259.5 271.7 284.6 298.0 312.1 326.8 342.2 358.2 374.9 392.2 410.1 4.67%
Table 333: South Korea Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.3 1.2 1.1 1.1 1.0 0.9 0.9 0.8 0.7 0.6 0.6 -8.52%
Uncemented 49.9 50.7 51.6 52.5 53.4 54.3 55.3 56.4 57.5 58.6 59.8 1.89%
Hybrid 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 -1.14%
Others 5.7 6.0 6.3 6.7 7.1 7.4 7.8 8.3 8.7 9.1 9.6 5.35%
Total 57.0 58.1 59.2 60.4 61.6 62.9 64.2 65.6 67.1 68.6 70.2 2.17%

South Korea
Table 334: South Korea Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 16.7 16.6 16.4 16.3 16.0 15.8 15.5 15.2 14.8 14.3 13.8 -2.30%
Uncemented 1.7 1.7 1.7 1.7 1.7 1.7 1.7 1.7 1.7 1.7 1.7 -0.36%
Hybrid 0.4 0.4 0.4 0.4 0.4 0.4 0.5 0.5 0.5 0.5 0.5 2.34%
Others 2.6 2.7 2.7 2.8 2.8 2.9 2.9 2.9 2.9 2.9 2.9 0.45%
Total 21.3 21.3 21.3 21.2 21.1 20.9 20.6 20.3 19.9 19.4 18.9 -1.64%
Table 335: South Korea Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 3.7 3.6 3.4 3.3 3.2 3.0 2.9 2.8 2.6 2.5 2.4 -4.63%
Uncemented 0.4 0.4 0.4 0.4 0.3 0.3 0.3 0.3 0.3 0.3 0.3 -2.74%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -0.11%
Others 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.5 0.5 0.5 0.5 -1.95%
Total 4.7 4.6 4.4 4.3 4.2 4.0 3.9 3.7 3.6 3.4 3.2 -3.99%

South Korea
Table 336: South Korea Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 10.6 10.6 10.5 10.4 10.3 10.1 9.9 9.7 9.4 9.0 8.6 -2.70%
Total 259.5 271.7 284.6 298.0 312.1 326.8 342.2 358.2 374.9 392.2 410.1 4.67%
Table 337: South Korea Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.5 0.5 0.5 0.5 -5.02%
Total 4.7 4.6 4.4 4.3 4.2 4.0 3.9 3.7 3.6 3.4 3.2 2.17%

South Korea
Table 338: South Korea Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.5 0.5 0.6 0.6 0.7 0.7 0.7 0.8 0.8 0.8 0.8 4.05%
Total 21.3 21.3 21.3 21.2 21.1 20.9 20.6 20.3 19.9 19.4 18.9 -1.64%
Table 339: South Korea Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 1.57%
Total 4.7 4.6 4.4 4.3 4.2 4.0 3.9 3.7 3.6 3.4 3.2 -3.99%

South Korea
Figure 284: South Korea Shoulder Arthroplasty Market

South Korea Shoulder Arthroplasty Market
Value ($Million) by Procedure Type
• South Korea shoulder replacement market value was estimated to be
7.8
9.0
7.3
$4.5 million in 2017 and is forecasted to grow at a CAGR of 6.95% to
6.8
8.0
6.4
6.0
5.6
reach market value of $7.8 million by the end of 2025. The market is 7.0
5.2
4.8
6.0
4.5
4.2
3.9
5.0
4.0
• South Korea shoulder replacement market volume was estimated to 3.0
1.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• In South Korea, total prosthetic replacement fixation is the leading
segment. The market value of this segment is estimated to be $2.0
reach market value of $3.1 million by the end of 2025. The market is Figure 285: South Korea Shoulder Arthroplasty Market
expected to grow by 1.57X fold over the forecast period. Whereas, Procedure Volume (Thousand) by Procedure Type
the market volume was estimated to be 0.44 thousand in 2017 and
1.7
is forecasted to grow at a CAGR of 5.26% to reach market volume of
1.6
1.8
1.5
1.4
1.6
1.3
1.2
1.1
1.4
1.1
1.0
0.9
1.2
0.9
1.0
0.8
0.6
0.4
0.2
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

South Korea
Figure 286: South Korea Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
3.5
3.0
2.5
2.0
1.5
1.0
0.5
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
1.4 1.5 1.7 1.8 2.0 2.2 2.4 2.6 2.8 3.0 3.3
Replacement
Figure 287: South Korea Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
0.3 0.3 0.4 0.4 0.4 0.5 0.5 0.6 0.6 0.6 0.7
Replacement

10. Latin America Joint Reconstruction
Summary

442
Latin America
Latin America Joint Reconstruction Market Overview
• Latin America hip replacement market was valued $107.6 million in 2017 and is expected to reach $199.1 million in 2025. In 2017,
primary hip replacement increased by -0.03% and revision burden increased to -1.11% as compared to that of 2016. The market in
this region is growing at relatively low pace owing to less developed healthcare infrastructure and limited availability of domestic
manufacturers. However, with advancement in the medical facility and expansion of product portfolio from key manufacturers with
low cost product. The market expected to witness boost in the value and volume.
• Latin America knee replacement market was valued $199.6 million in 2017 and is expected to reach $289.9 million by 2025 growing
at a CAGR of 4.78% over the forecast period of 2018-2025. In Latin America, the most preferred procedure is primary surgeries
having uncemented fixation owing to immense comfort and active lifestyle it provides to patients.
• Latin America shoulder replacement market was valued $7.6 million in 2017 and is expected to reach $15.7 million by 2025 growing
at a CAGR of 9.46% over the forecast period of 2018-2025. The key driving force for shoulder replacement includes escalating
aging population, high prevalence of arthritis, extensive indications for reverse shoulder replacement, and patient preference
towards living active lifestyle.
• The joint reconstruction market in Latin America is at the nascent stage owing to ongoing development of healthcare facility and
lack for experienced surgeons. However, with the growth in the economy the Latin America market is expected to growth at higher
pace.

Latin America
Figure 288: Latin America Hip Joint Reconstruction Market Figure 289: Latin America Knee Joint Reconstruction
Value ($Million) and Procedure Volume (Thousand) Market Value ($Billion) and Procedure Volume (Thousand)
289.9
199.1
276.8
264.2
186.5
50 250.0 60 350.0
252.1
173.6
240.5
229.5
45
160.7
219.0
209.0
148.1
50 300.0
199.6
135.8
40 200.0
181.3
125.1
167.5
115.8
35 250.0
107.6
40
100.1
30 150.0
93.1
200.0
45.9
25 30
43.7
49.6
41.5
48.4
47.3
39.2
46.2
150.0
45.2
44.2
36.9
43.3
42.4
20 100.0
41.5
34.7
32.8
38.8
31.2
36.8
29.8
20
28.6
27.2
15 100.0
10 50.0 10 50.0
5
0 - 0 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 290: Latin America Shoulder Joint Reconstruction Figure 291: Latin America Shoulder Joint Reconstruction
Market Value ($Million) 15.7 Market Procedure Volume (Thousand)
3.3
4
14.3
18
3.1
13.1
3.5
2.8
12.0
16
2.6
10.9
2.4
10.0
14 3
2.2
9.1
2.0
12
8.3
1.8
2.5
7.6
1.7
7.0
1.6
10
6.4
2 1.4
8
6 1.5
4 1
2 0.5
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Latin America
Figure 292: Latin America Hip Arthroplasty Market Value

Latin America Hip Arthroplasty Market ($Million) by Procedure Type
• Latin America primary hip replacement market value was estimated
172.0
162.3
to be $98.4 million in 2017 and is forecasted to grow at a CAGR of 200.0
152.2
141.9
180.0
131.6
121.6
160.0
112.8
105.1
98.4
92.2
86.4
period. 120.0
100.0
• Latin America primary hip replacement market volume was estimated 80.0
60.0
to be 27.3 thousand in 2017 and is forecasted to grow at a CAGR of
17.5
15.9
14.3
12.8
11.4
10.0
40.0
9.6
8.9
8.4
7.9
7.2
7.0
6.2
6.1
5.5
5.1
4.2
3.4
2.8
2.2
1.7
4.91% to reach market volume of 39.6 thousand by the end of 2025.
1.3
20.0
-
• Latin America revision hip replacement market is estimated to grow 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
by 2.49X in 2025 whereas the hip resurfacing market is estimated to

$53.8 million in 2017 and is forecasted to grow at a CAGR of 8.39% Figure 293: Latin America Hip Arthroplasty Market
to reach market value of $102.1 million by the end of 2025. The Procedure Volume (Thousand) by Procedure Type
39.6
38.0
36.3
45.0
34.6
32.8
31.1
40.0
29.6
28.3
27.3
26.4
35.0
25.3
• Latin America bearing surface market is estimated to grow by 1.75X 30.0
in 2025 whereas the leading bearing surface segment is MOP which 25.0
is estimated to grow by 1.89X by 2025. 20.0
15.0
4.1
3.8
3.4
3.1
10.0
2.8
2.6
2.3
2.2
2.1
2.0
1.9
1.8
1.7
1.6
1.5
1.3
1.1
0.9
0.7
0.6
0.5
0.4
5.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Latin America
Table 340: Latin America Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 31.6 32.9 34.4 35.9 37.7 39.7 42.0 44.2 46.2 48.0 49.4 4.67%
Uncemented 46.0 49.9 53.8 58.1 62.9 68.5 74.9 81.6 88.4 95.3 102.1 8.39%
Hybrid 8.6 9.2 10.0 10.9 11.9 13.0 14.3 15.6 17.0 18.4 19.8 8.93%
Others 0.1 0.2 0.2 0.3 0.3 0.4 0.4 0.5 0.6 0.6 0.7 14.59%
Total 86.4 92.2 98.4 105.1 112.8 121.6 131.6 141.9 152.2 162.3 172.0 7.29%
Table 341: Latin America Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 9.3 9.4 9.5 9.7 9.9 10.1 10.5 10.8 11.0 11.2 11.4 2.34%
Uncemented 13.5 14.3 14.9 15.6 16.5 17.5 18.7 19.9 21.1 22.3 23.5 6.00%
Hybrid 2.5 2.6 2.8 2.9 3.1 3.3 3.6 3.8 4.1 4.3 4.6 6.53%
Others 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 12.04%
Total 25.3 26.4 27.3 28.3 29.6 31.1 32.8 34.6 36.3 38.0 39.6 4.91%

Latin America
Table 342: Latin America Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 2.0 2.3 2.5 2.8 3.2 3.6 4.0 4.4 4.9 5.4 5.9 11.04%
Uncemented 2.8 3.2 3.6 4.2 4.7 5.4 6.3 7.1 8.1 9.2 10.3 13.78%
Hybrid 0.6 0.7 0.8 0.9 1.0 1.1 1.3 1.4 1.6 1.8 2.0 11.37%
Others 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 0.2 14.04%
Total 5.5 6.2 7.0 7.9 8.9 10.0 11.4 12.8 14.3 15.9 17.5 12.04%
Table 343: Latin America Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.6 0.7 0.7 0.8 0.8 0.9 1.0 1.1 1.2 1.3 1.4 8.48%
Uncemented 0.8 0.8 0.9 1.0 1.1 1.2 1.4 1.5 1.7 1.9 2.0 10.37%
Hybrid 0.2 0.3 0.3 0.3 0.3 0.4 0.4 0.5 0.5 0.6 0.6 10.37%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.1 0.1 14.37%
Total 1.6 1.8 1.9 2.1 2.3 2.6 2.8 3.1 3.4 3.8 4.1 9.78%

Latin America
Table 344: Latin America Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 32.5 34.5 36.2 38.1 40.1 42.4 45.0 47.6 50.1 52.4 54.6 5.29%
CoP 33.3 35.7 38.5 41.5 45.0 49.1 53.7 58.5 63.3 68.1 72.8 8.36%
CoC 15.1 16.3 17.6 19.1 20.9 22.9 25.1 27.5 29.9 32.4 34.8 8.90%
MoM 2.3 2.4 2.4 2.4 2.4 2.5 2.5 2.5 2.5 2.4 2.3 -0.66%
Other 3.1 3.4 3.7 4.0 4.4 4.8 5.3 5.8 6.4 6.9 7.5 9.35%
Total 86.4 92.2 98.4 105.1 112.8 121.6 131.6 141.9 152.2 162.3 172.0 7.29%
Table 345: Latin America Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 9.5 9.9 10.0 10.3 10.5 10.8 11.2 11.6 11.9 12.3 12.6 2.95%
CoP 9.7 10.2 10.7 11.2 11.8 12.5 13.4 14.2 15.1 16.0 16.8 5.97%
CoC 4.4 4.7 4.9 5.2 5.5 5.8 6.3 6.7 7.1 7.6 8.0 6.50%
MoM 0.7 0.7 0.7 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.5 -2.88%
Other 0.9 1.0 1.0 1.1 1.1 1.2 1.3 1.4 1.5 1.6 1.7 6.93%
Total 25.3 26.4 27.3 28.3 29.6 31.1 32.8 34.6 36.3 38.0 39.6 4.91%

Latin America
Table 346: Latin America Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 1.6 1.8 2.0 2.1 2.3 2.5 2.8 3.0 3.3 3.6 3.9 8.85%
CoP 2.5 2.9 3.4 3.9 4.5 5.2 6.0 7.0 8.0 9.1 10.3 15.01%
CoC 1.3 1.5 1.7 2.0 2.3 2.7 3.1 3.6 4.1 4.7 5.4 15.21%
MoM 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 5.32%
Other 0.2 0.3 0.3 0.3 0.4 0.4 0.5 0.5 0.6 0.6 0.7 10.67%
Total 5.5 6.2 7.0 7.9 8.9 10.0 11.4 12.8 14.3 15.9 17.5 12.04%
Table 347: Latin America Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 0.6 0.7 0.7 0.8 0.9 0.9 1.0 1.1 1.2 1.3 1.3 7.81%
CoP 0.6 0.7 0.7 0.8 0.9 1.0 1.1 1.3 1.4 1.5 1.7 10.77%
CoC 0.3 0.3 0.3 0.4 0.4 0.5 0.5 0.6 0.6 0.7 0.8 10.97%
MoM 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.1 0.1 8.52%
Other 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 0.2 0.2 12.21%
Total 1.6 1.8 1.9 2.1 2.3 2.6 2.8 3.1 3.4 3.8 4.1 9.78%

Latin America
Figure 294: Latin America Knee Arthroplasty Market

Latin America Knee Arthroplasty Market Value ($Million) by Procedure Type
• Latin America primary knee replacement market value was estimated

400.0
278.1
264.6
251.6
350.0
239.3
227.5
216.3
205.7
300.0
195.7
186.1
168.5
155.2
The market is expected to grow by 1.49 fold over the forecast period. 250.0
200.0
• Latin America primary knee replacement market volume was 150.0
100.0
13.4
13.4
13.3
13.2
13.0
12.8
12.8
12.6
12.4
12.2
11.9
estimated to be 38.7 thousand in 2017 and is forecasted to grow at a
50.0
CAGR of 2.64% to reach market value of 47.6 thousand by the end -
of 2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

• Latin America revision knee replacement market is estimated to grow
by 0.88X in 2025.
Figure 295: Latin America Knee Arthroplasty Market
47.6
46.3
45.0
43.8
60.0
42.7
41.6
40.6
39.7
38.7
36.0
34.1
50.0
20.0
2.8
2.7
2.7
2.7
2.6
2.5
2.4
2.3
2.2
2.1
2.0
• Latin America bearing type market is estimated to grow by 1.49X in 10.0
2025 whereas the leading bearing type segment is unconstrained -

2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Latin America
Table 348: Latin America Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 7.3 7.7 8.2 8.6 9.1 9.6 10.1 10.6 11.3 11.9 12.6 5.58%
Uncemented 132.8 143.8 158.3 165.6 173.4 181.4 189.9 198.7 207.9 217.4 227.3 4.62%
Hybrid 1.2 1.4 1.6 1.7 1.9 2.2 2.4 2.7 3.0 3.4 3.8 11.76%
Others 13.9 15.7 18.0 19.6 21.3 23.2 25.1 27.2 29.5 31.9 34.4 8.34%
Total 155.2 168.5 186.1 195.7 205.7 216.3 227.5 239.3 251.6 264.6 278.1 5.15%
Table 349: Latin America Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.6 1.6 1.7 1.8 1.8 1.8 1.9 1.9 2.0 2.1 2.2 3.06%
Uncemented 29.2 30.7 32.9 33.6 34.2 34.9 35.6 36.4 37.2 38.0 38.9 2.12%
Hybrid 0.3 0.3 0.3 0.4 0.4 0.4 0.5 0.5 0.5 0.6 0.6 9.09%
Others 3.1 3.4 3.8 4.0 4.2 4.5 4.7 5.0 5.3 5.6 5.9 5.75%
Total 34.1 36.0 38.7 39.7 40.6 41.6 42.7 43.8 45.0 46.3 47.6 2.64%

Latin America
Table 350: Latin America Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 9.0 9.2 9.7 9.6 9.4 9.3 9.1 8.9 8.6 8.4 8.0 -2.43%
Uncemented 1.5 1.5 1.6 1.6 1.6 1.6 1.6 1.6 1.5 1.5 1.4 -1.52%
Hybrid 0.5 0.5 0.6 0.6 0.6 0.6 0.6 0.7 0.7 0.7 0.7 1.73%
Others 1.4 1.5 1.6 1.7 1.7 1.7 1.7 1.7 1.8 1.7 1.7 0.68%
Total 12.4 12.8 13.4 13.4 13.3 13.2 13.0 12.8 12.6 12.2 11.9 -1.71%
Table 351: Latin America Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 2.0 2.0 2.0 1.9 1.9 1.8 1.7 1.6 1.5 1.5 1.4 -4.76%
Uncemented 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.2 -3.87%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -0.70%
Others 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 -1.72%
Total 2.7 2.7 2.8 2.7 2.6 2.5 2.4 2.3 2.2 2.1 2.0 -4.06%

Latin America
Table 352: Latin America Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 6.6 6.8 7.1 7.0 7.0 6.9 6.8 6.6 6.4 6.2 5.9 -2.54%
Total 155.2 168.5 186.1 195.7 205.7 216.3 227.5 239.3 251.6 264.6 278.1 5.15%
Table 353: Latin America Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 1.4 1.5 1.5 1.4 1.4 1.3 1.3 1.2 1.1 1.1 1.0 -4.87%
Total 34.1 36.0 38.7 39.7 40.6 41.6 42.7 43.8 45.0 46.3 47.6 2.64%

Latin America
Table 354: Latin America Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.3 0.3 0.4 0.4 0.4 0.4 0.5 0.5 0.5 0.5 0.5 4.52%
Total 12.4 12.8 13.4 13.4 13.3 13.2 13.0 12.8 12.6 12.2 11.9 -1.71%
Table 355: Latin America Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 2.02%
Total 2.7 2.7 2.8 2.7 2.6 2.5 2.4 2.3 2.2 2.1 2.0 -4.06%

Latin America
Figure 296: Latin America Shoulder Arthroplasty Market

Latin America Shoulder Arthroplasty Market Value ($Million) by Procedure Type
• Latin America shoulder replacement market value was estimated to
15.7
14.3
18.0
13.1
16.0
12.0
10.9
14.0
10.0
9.1
12.0
8.3
7.6
period.
7.0
10.0
6.4
8.0
• Latin America shoulder replacement market volume was estimated to 6.0
2.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• In Latin America, total prosthetic replacement fixation is the leading
segment. The market value of this segment is estimated to be $3.2 Shoulder Joint Reconstruction Market Value ($Million)

reach market value of $6.1 million by the end of 2025. The market is
expected to grow by 1.93X fold over the forecast period. Whereas,
Figure 297: Latin America Shoulder Arthroplasty Market
3.3
4.0
3.1
3.5
2.8
2.6
2.4
3.0
2.2
2.0
1.8
2.5
1.7
1.6
1.4
2.0
1.5
1.0
0.5
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Latin America
Figure 298: Latin America Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
7.0
6.0
5.0
4.0
3.0
2.0
1.0
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
2.2 2.4 2.6 2.9 3.2 3.6 4.0 4.4 4.8 5.4 5.9
Replacement
Figure 299: Latin America Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
1.4
1.2
1.0
0.8
0.6
0.4
0.2
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
0.5 0.5 0.6 0.6 0.7 0.8 0.9 0.9 1.0 1.1 1.3
Replacement

Brazil
Brazil Joint Reconstruction Market Overview
• Brazil hip replacement market was valued $91.1 million in 2017 and is expected to reach $172.8 million in 2025. In 2017, primary
hip replacement increased by 0.86% and revision burden increased to 0.57% as compare to 2016. Brazil market is driven by aging
populations, improvements in surgical and pain management techniques and moderate incremental innovations, the Brazil market
for hip arthroplasty implants is expected to grow at a CAGR of 5% during the forecast period.
• Brazil knee replacement market was valued $176.0 million in 2017 and is expected to reach $246.8 million by 2025 growing at a
CAGR of 4.31% over the forecast period of 2018-2025. In Brazil, Knee replacement market is growing steadily but overtime the
market is likely to witness high paced growth as the prevalence of osteoarthritis, osteoporosis and incidences of knee fracture are
increasing in this country.
• Brazil shoulder replacement market was valued $4.1 million in 2017 and is expected to reach $8.1 million by 2025 growing at a
CAGR of 8.86% over the forecast period of 2018-2025. In 2016, there were 915 shoulder arthroplasty surgeries performed in the
Brazil. The growth in shoulder implants exceeded that of knees and hip; however, this was largely because of the growing
procedural volume across all categories.

Brazil
Figure 300: Brazil Hip Joint Reconstruction Market Value Figure 301: Brazil Knee Joint Reconstruction Market
($Million) and Procedure Volume (Thousand) Value ($Billion) and Procedure Volume (Thousand)
172.8
246.8
161.7
236.8
227.1
45 300.0
150.2
217.7
45 200.0
208.7
138.7
200.0
191.7
180.0 40
127.3
40
183.6
176.0
250.0
116.2
159.2
160.0
106.6
35 35
148.0
98.3
140.0 30 200.0
91.1
30
84.7
79.5
120.0 25
25
42.2
41.4
150.0
40.6
100.0
39.9
39.2
39.9
38.5
37.8
37.2
37.9
36.6
20
35.9
20
34.1
33.8
32.5
31.7
80.0
29.7
28.0
26.5
15 15 100.0
25.3
24.2
23.3
60.0
10 40.0 10
50.0
5 20.0 5
0 - 0 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Figure 302: Brazil Shoulder Joint Reconstruction Market Figure 303: Brazil Shoulder Joint Reconstruction Market
1.7
2
7.5
1.6
9
1.5
6.9
1.4
6.3
1.3
5.8
1.2
7 1.5
5.3
1.1
4.9
1.0
4.5
0.9
4.1
0.8
3.8
0.8
3.4
5 1
4
3
0.5
2
1
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Brazil
Figure 304: Brazil Hip Arthroplasty Market Value

Brazil Hip Arthroplasty Market
• Brazil primary hip replacement market value was estimated to be
149.8
141.2
132.2
160.0
122.9
113.7
104.6
140.0
96.7
89.9
120.0
83.9
78.6
• Brazil primary hip replacement market volume was estimated to be
74.3
100.0
2025.
13.8
12.5
11.2
40.0
9.9
9.3
8.7
8.1
7.6
6.9
6.7
5.9
5.8
5.2
4.8
4.6
4.1
3.9
3.2
2.6
2.0
1.5
• Brazil revision hip replacement market is estimated to grow by 2.66X
1.1
20.0
in 2025 whereas the hip resurfacing market is estimated to grow by -
4.65X by 2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Whereas, the market volume was estimated to be 12.05 thousand in Figure 305: Brazil Hip Arthroplasty Market Procedure
2017 and is forecasted to grow at a CAGR of 6.90% to reach market Volume (Thousand) by Procedure Type
• Brazil bearing surface segment is estimated to grow by 1.78X in
34.5
33.1
2025 whereas the leading bearing surface segment is MOP which is 40.0
31.5
30.0
28.3
estimated to grow by 1.90X by 2025. 35.0
26.7
25.4
24.2
23.3
22.5
30.0
21.7
25.0
20.0
15.0
10.0
3.2
3.0
2.7
2.4
2.2
2.2
2.0
1.9
1.8
1.7
1.6
1.4
1.4
1.3
1.2
1.2
1.0
0.8
0.7
0.6
0.4
0.3
5.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Brazil
Table 356: Brazil Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 29.0 29.9 31.0 32.4 33.9 35.6 37.5 39.4 41.0 42.4 43.5 4.30%
Uncemented 37.2 40.0 43.5 47.4 51.8 57.0 63.0 69.2 75.6 82.0 88.3 9.32%
Hybrid 8.2 8.7 9.4 10.2 11.0 12.0 13.2 14.4 15.6 16.8 18.0 8.49%
Others - - - - - - - - - - - 0.00%
Total 74.3 78.6 83.9 89.9 96.7 104.6 113.7 122.9 132.2 141.2 149.8 7.57%
Table 357: Brazil Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 8.5 8.5 8.6 8.7 8.9 9.1 9.4 9.6 9.8 9.9 10.0 1.99%
Uncemented 10.9 11.5 12.1 12.8 13.6 14.6 15.7 16.9 18.0 19.2 20.4 6.90%
Hybrid 2.4 2.5 2.6 2.7 2.9 3.1 3.3 3.5 3.7 3.9 4.1 6.10%
Others - - - - - - - - - - - 0.00%
Total 21.7 22.5 23.3 24.2 25.4 26.7 28.3 30.0 31.5 33.1 34.5 5.19%

Brazil
Table 358: Brazil Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.7 1.9 2.1 2.4 2.7 3.0 3.4 3.9 4.3 4.8 5.2 11.82%
Uncemented 2.0 2.3 2.7 3.1 3.6 4.2 4.9 5.7 6.6 7.5 8.5 15.23%
Hybrid 0.4 0.4 0.5 0.5 0.6 0.6 0.7 0.8 0.9 1.0 1.1 11.67%
Others - - - - - - - - - - - 0.00%
Total 4.1 4.6 5.2 5.9 6.7 7.6 8.7 9.9 11.2 12.5 13.8 12.94%
Table 359: Brazil Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.5 0.5 0.6 0.6 0.7 0.8 0.9 0.9 1.0 1.1 1.2 9.24%
Uncemented 0.6 0.6 0.7 0.8 0.9 1.0 1.1 1.2 1.4 1.5 1.7 11.77%
Hybrid 0.1 0.1 0.2 0.2 0.2 0.2 0.2 0.3 0.3 0.3 0.4 10.66%
Others - - - - - - - - - - - 0.00%
Total 1.2 1.3 1.4 1.6 1.8 2.0 2.2 2.4 2.7 3.0 3.2 10.66%

Brazil
Table 360: Brazil Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 23.8 24.8 26.0 27.4 29.0 30.9 33.0 35.1 37.0 38.9 40.5 5.72%
CoP 31.2 33.3 35.8 38.7 42.0 45.8 50.1 54.6 59.2 63.7 68.1 8.41%
CoC 14.5 15.5 16.8 18.2 19.8 21.7 23.9 26.1 28.4 30.7 32.9 8.84%
MoM 2.0 2.0 2.0 2.0 2.0 1.9 1.9 1.9 1.8 1.7 1.5 -3.81%
Other 2.8 3.0 3.3 3.6 3.9 4.3 4.8 5.3 5.8 6.3 6.7 9.35%
Total 74.3 78.6 83.9 89.9 96.7 104.6 113.7 122.9 132.2 141.2 149.7 7.57%
Table 361: Brazil Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 7.0 7.1 7.2 7.4 7.6 7.9 8.2 8.5 8.8 9.1 9.3 3.37%
CoP 9.1 9.5 9.9 10.4 11.0 11.7 12.5 13.3 14.1 14.9 15.7 6.02%
CoC 4.2 4.4 4.7 4.9 5.2 5.6 6.0 6.4 6.8 7.2 7.6 6.44%
MoM 0.6 0.6 0.6 0.5 0.5 0.5 0.5 0.5 0.4 0.4 0.3 -5.96%
Other 0.8 0.9 0.9 1.0 1.0 1.1 1.2 1.3 1.4 1.5 1.6 6.93%
Total 21.7 22.5 23.3 24.2 25.4 26.7 28.3 30.0 31.5 33.1 34.5 5.19%

Brazil
Table 362: Brazil Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 0.9 0.9 1.0 1.1 1.3 1.4 1.6 1.7 1.9 2.1 2.2 9.99%
CoP 2.2 2.5 2.9 3.4 4.0 4.6 5.4 6.3 7.3 8.3 9.5 15.69%
CoC 1.2 1.4 1.6 1.8 2.1 2.5 2.9 3.4 3.9 4.5 5.1 15.66%
MoM 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -3.89%
Other 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.4 0.4 0.4 0.5 9.49%
Total 4.1 4.6 5.2 5.9 6.7 7.6 8.7 9.9 11.2 12.5 13.8 12.94%
Table 363: Brazil Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 0.3 0.4 0.4 0.4 0.5 0.5 0.6 0.6 0.7 0.7 0.8 8.93%
CoP 0.5 0.6 0.7 0.7 0.8 0.9 1.0 1.2 1.3 1.4 1.6 11.42%
CoC 0.3 0.3 0.3 0.4 0.4 0.4 0.5 0.6 0.6 0.7 0.7 11.40%
MoM 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -0.97%
Other 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 11.01%
Total 1.2 1.3 1.4 1.6 1.8 2.0 2.2 2.4 2.7 3.0 3.2 10.66%

Brazil
Figure 306: Brazil Knee Arthroplasty Market Value

Brazil Knee Arthroplasty Market ($Million) by Procedure Type
235.9
• Brazil primary knee replacement market value was estimated to be
225.6
215.7
206.1
196.8
188.0
250.0
179.5
171.4
163.7
147.6
136.8
200.0
150.0
• Brazil primary knee replacement market volume was estimated to be
12.2
12.2
12.1
12.0
11.9
11.7
11.6
11.4
11.3
11.2
10.9
50.0
• Brazil revision knee replacement market is estimated to grow by
-
0.89X in 2025. 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
The market is expected to grow by 1.41X fold over the forecast Figure 307: Brazil Knee Arthroplasty Market Procedure
40.4
39.5
38.6
37.8
37.0
36.2
35.5
• Brazil bearing type market is estimated to grow by 1.44X in 2025 45.0
34.8
34.1
31.6
30.1
40.0
35.0
25.0
20.0
15.0
2.5
2.5
2.5
2.5
2.4
2.3
2.2
2.1
10.0
2.0
2.0
1.9
5.0
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Brazil
Table 364: Brazil Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 3.1 3.0 3.1 3.0 2.9 2.8 2.6 2.5 2.3 2.1 1.9 -6.28%
Uncemented 119.6 128.9 142.5 148.9 155.5 162.4 169.5 177.0 184.8 192.8 201.0 4.38%
Hybrid 0.5 0.6 0.6 0.6 0.7 0.7 0.7 0.7 0.7 0.7 0.7 1.28%
Others 13.5 15.2 17.5 19.0 20.5 22.2 24.0 25.9 27.9 30.1 32.3 7.92%
Total 136.8 147.6 163.7 171.4 179.5 188.0 196.8 206.1 215.7 225.6 235.9 4.67%
Table 365: Brazil Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.7 0.6 0.6 0.6 0.6 0.5 0.5 0.5 0.4 0.4 0.3 -8.52%
Uncemented 26.3 27.6 29.7 30.2 30.7 31.3 31.8 32.4 33.1 33.7 34.4 1.89%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -1.14%
Others 3.0 3.3 3.6 3.8 4.1 4.3 4.5 4.7 5.0 5.3 5.5 5.35%
Total 30.1 31.6 34.1 34.8 35.5 36.2 37.0 37.8 38.6 39.5 40.4 2.17%

Brazil
Table 366: Brazil Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 8.8 9.0 9.5 9.4 9.2 9.1 8.9 8.7 8.5 8.2 7.9 -2.30%
Uncemented 0.9 0.9 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 -0.36%
Hybrid 0.2 0.2 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.3 0.3 2.34%
Others 1.4 1.5 1.6 1.6 1.6 1.7 1.7 1.7 1.7 1.7 1.7 0.45%
Total 11.3 11.6 12.2 12.2 12.1 12.0 11.9 11.7 11.4 11.2 10.9 -1.64%
Table: 367 Brazil Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 1.9 1.9 2.0 1.9 1.8 1.8 1.7 1.6 1.5 1.4 1.4 -4.63%
Uncemented 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 -2.74%
Hybrid 0.0 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -0.11%
Others 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 -1.95%
Total 2.5 2.5 2.6 2.5 2.4 2.3 2.2 2.1 2.1 2.0 1.9 -3.99%

Brazil
Table 368: Brazil Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 5.6 5.8 6.1 6.0 5.9 5.8 5.7 5.6 5.4 5.2 5.0 -2.70%
Total 136.8 147.6 163.7 171.4 179.5 188.0 196.8 206.1 215.7 225.6 235.9 4.67%
Table 369: Brazil Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 1.2 1.2 1.3 1.2 1.2 1.1 1.1 1.0 1.0 0.9 0.9 -5.02%
Total 30.1 31.6 34.1 34.8 35.5 36.2 37.0 37.8 38.6 39.5 40.4 2.17%

Brazil
Table 370: Brazil Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.3 0.3 0.3 0.4 0.4 0.4 0.4 0.4 0.4 0.5 0.5 4.05%
Total 11.3 11.6 12.2 12.2 12.1 12.0 11.9 11.7 11.4 11.2 10.9 -1.64%
Table 371: Brazil Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 1.57%
Total 2.5 2.5 2.6 2.5 2.4 2.3 2.2 2.1 2.1 2.0 1.9 -3.99%

Brazil
Figure 308: Brazil Shoulder Arthroplasty Market Value

Brazil Shoulder Arthroplasty Market ($Million) by Procedure Type
• Brazil shoulder replacement market value was estimated to be $4.1
8.1
9.0
7.5
6.9
8.0
6.3
5.8
reach market value of $8.1 million by the end of 2025. The market is 7.0
5.3
4.9
6.0
4.5
4.1
3.8
5.0
3.4
4.0
• Brazil shoulder replacement market volume was estimated to be 0.91 3.0
1.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• In Brazil, total prosthetic replacement fixation is the leading
reach market value of $3.2 million by the end of 2025. The market is Figure 309: Brazil Shoulder Arthroplasty Market
1.7
is forecasted to grow at a CAGR of 7.49% to reach market volume of 2.0
1.6
1.5
1.4
1.3
1.2
1.5
1.1
1.0
0.9
0.8
0.8
1.0
0.5
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Brazil
Figure 310: Brazil Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
3.5
3.0
2.5
2.0
1.5
1.0
0.5
0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
1.2 1.3 1.4 1.6 1.7 1.9 2.1 2.3 2.6 2.8 3.1
Replacement
Figure 311: Brazil Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
-
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
0.3 0.3 0.3 0.3 0.4 0.4 0.5 0.5 0.5 0.6 0.7
Replacement

Mexico
Mexico Joint Reconstruction Market Overview
• Mexico hip replacement market was valued $16.5 million in 2017 and is expected to reach $26.2 million in 2025. In 2017, primary
hip replacement increased by -5.50% and revision burden increased to -5.88% as compared to that of 2016. Mexico market is
primarily driven by the developing healthcare facility, set up of new hospitals and care centres and rising population suffering from
bone related disorders (osteoarthritis and osteoporosis among others).
• Mexico knee replacement market was valued $23.6 million in 2017 and is expected to reach $43.1 million by 2025 growing at a
CAGR of 7.86% over the forecast period of 2018-2025. In Mexico, primary knee replacement procedures are dominating the
market with 94.9% market share in 2017.
• Mexico shoulder replacement market was valued $3.5 million in 2017 and is expected to reach $7.6 million by 2025 growing at a
CAGR of 10.1% over the forecast period of 2018-2025. In 2016 there were 783 shoulder arthroplasty performed in the Mexico.

Mexico
Figure 312: Mexico Hip Joint Reconstruction Market Value Figure 313: Mexico Knee Joint Reconstruction Market
($Million) and Procedure Volume (Thousand) Value ($Billion) and Procedure Volume (Thousand)
43.1
26.2
40.0
8 50.0
24.8
7 30.0
23.4
37.1
22.1
34.4
7
20.8
31.8
19.6
6 25.0
18.5
40.0
29.5
17.5
27.4
6
16.5
25.4
15.4
23.6
22.1
13.6
20.0 5 30.0
19.5
4
4
7.4
15.0
7.0
6.1
6.6
5.8
6.3
3
5.6
20.0
5.4
6.0
5.2
5.7
3
5.0
4.9
5.4
4.7
5.1
4.6
4.4
4.9
10.0
4.7
4.0
4.3
2 2
5.0 10.0
1 1
0 - 0 -
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Hip Joint Reconstruction Volume (Thousand) Hip Joint Reconstruction Value ($Million) Knee Joint Reconstruction Volume (Thousand) Knee Joint Reconstruction Value ($ Million)
Figure 314: Mexico Shoulder Joint Reconstruction Market Figure 315: Mexico Shoulder Joint Reconstruction Market
1.6
7.6
1.8
1.5
6.8
1.3
1.6
6.2
1.2
5.6
1.1
1.4
5.1
1.0
4.6
0.9
1.2
4.2
0.9
3.8
0.8
5
3.5
0.7
1
0.7
3.2
2.9
4 0.8
3 0.6
2 0.4
1 0.2
0 0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Mexico
Figure 316: Mexico Hip Arthroplasty Market Value

Mexico Hip Arthroplasty Market ($Million) by Procedure Type
• Mexico primary hip replacement market value was estimated to be
22.2
21.1
$14.5 million in 2017 and is forecasted to grow at a CAGR of 5.53% 25
20.0
18.9
17.9
17.0
16.1
15.3
20
14.5
13.5
12.1
15
• Mexico primary hip replacement market volume was estimated to be
4.01 thousand in 2017 and is forecasted to grow at a CAGR of 3.20% 10
3.7
3.4
to reach market volume of 5.12 thousand by the end of 2025.
3.1
2.9
2.6
2.4
2.2
2.0
1.8
1.6
1.4
5
0.3
0.3
0.3
0.3
0.2
0.2
0.2
0.2
0.2
0.2
0.2
• Mexico revision hip replacement market is estimated to grow by
0
2.01X in 2025 whereas the hip resurfacing market is estimated to 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
to reach market value of $13.7 million by the end of 2025. The Figure 317: Mexico Hip Arthroplasty Market Procedure
market is expected to grow by 1.33X fold over the forecast period. Volume (Thousand) by Procedure Type
6
5.1
4.9
4.8
4.6
4.5
4.3
4.2
5
4.1
4.0
3.9
• Mexico bearing surface market is estimated to grow by 1.54X in 2025
3.5
4
whereas the leading bearing surface segment is MOP which is
estimated to grow by 1.38X by 2025. 3
0.9
0.8
0.8
0.7
0.7
0.6
0.6
0.5
0.5
0.5
0.4
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.0
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Mexico
Table 372: Mexico Primary Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 2.6 3.0 3.3 3.6 3.8 4.1 4.5 4.8 5.2 5.6 6.0 7.66%
Uncemented 8.9 9.8 10.3 10.7 11.1 11.5 11.9 12.4 12.8 13.3 13.7 3.63%
Hybrid 0.4 0.5 0.6 0.7 0.8 1.0 1.1 1.3 1.4 1.6 1.8 14.26%
Others 0.1 0.2 0.2 0.3 0.3 0.4 0.4 0.5 0.6 0.6 0.7 14.59%
Total 12.1 13.5 14.5 15.3 16.1 17.0 17.9 18.9 20.0 21.1 22.2 5.53%
Table 373: Mexico Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.8 0.9 0.9 1.0 1.0 1.1 1.1 1.2 1.2 1.3 1.4 5.27%
Uncemented 2.6 2.8 2.9 2.9 2.9 2.9 3.0 3.0 3.1 3.1 3.2 1.33%
Hybrid 0.1 0.1 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.4 0.4 11.74%
Others 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 0.2 12.04%
Total 3.5 3.9 4.0 4.1 4.2 4.3 4.5 4.6 4.8 4.9 5.1 3.20%

Mexico
Table 374: Mexico Revision Hip Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.3 0.4 0.4 0.5 0.5 0.5 0.5 0.6 0.6 0.7 0.7 6.24%
Uncemented 0.7 0.8 0.9 1.0 1.1 1.2 1.3 1.4 1.5 1.7 1.8 8.46%
Hybrid 0.3 0.3 0.4 0.4 0.5 0.5 0.6 0.6 0.7 0.8 0.8 10.99%
Others 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 0.2 14.04%
Total 1.4 1.6 1.8 2.0 2.2 2.4 2.6 2.9 3.1 3.4 3.7 9.11%
Table 375: Mexico Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 0.2 0.2 3.80%
Uncemented 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.4 5.21%
Hybrid 0.1 0.1 0.1 0.1 0.2 0.2 0.2 0.2 0.2 0.2 0.3 9.98%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.1 0.1 0.1 14.37%
Total 0.4 0.5 0.5 0.5 0.6 0.6 0.7 0.7 0.8 0.8 0.9 6.91%

Mexico
Table 376: Mexico Primary Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 8.7 9.7 10.2 10.7 11.1 11.6 12.0 12.5 13.1 13.6 14.1 4.13%
CoP 2.1 2.4 2.6 2.8 3.1 3.3 3.5 3.8 4.1 4.4 4.8 7.66%
CoC 0.6 0.8 0.9 0.9 1.0 1.2 1.3 1.4 1.5 1.7 1.8 10.02%
MoM 0.3 0.4 0.4 0.4 0.5 0.5 0.6 0.6 0.7 0.7 0.8 8.86%
Other 0.3 0.3 0.3 0.4 0.4 0.5 0.5 0.5 0.6 0.7 0.7 9.32%
Total 12.1 13.5 14.5 15.3 16.1 17.0 17.9 18.9 20.0 21.1 22.2 5.53%
Table 377: Mexico Primary Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 2.6 2.8 2.8 2.9 2.9 3.0 3.0 3.1 3.1 3.2 3.3 1.81%
CoP 0.6 0.7 0.7 0.8 0.8 0.8 0.9 0.9 1.0 1.0 1.1 5.29%
CoC 0.2 0.2 0.2 0.3 0.3 0.3 0.3 0.3 0.4 0.4 0.4 7.59%
MoM 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 0.2 0.2 0.2 6.44%
Other 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 0.2 6.90%
Total 3.5 3.9 4.0 4.1 4.2 4.3 4.5 4.6 4.8 4.9 5.1 3.20%

Mexico
Table 378: Mexico Revision Hip Arthroplasty Market Value ($Million) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 0.7 0.8 0.9 1.0 1.1 1.2 1.2 1.3 1.4 1.5 1.6 7.46%
CoP 0.3 0.4 0.4 0.5 0.5 0.6 0.6 0.7 0.7 0.8 0.9 9.10%
CoC 0.1 0.1 0.1 0.2 0.2 0.2 0.2 0.2 0.2 0.3 0.3 8.81%
MoM 0.0 0.0 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 10.48%
Other 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2 0.2 14.28%
Total 1.4 1.6 1.8 2.0 2.2 2.4 2.6 2.9 3.1 3.4 3.7 9.11%
Table 379: Mexico Revision Hip Arthroplasty Market and Procedure Volume (Thousand) by Bearing Surface
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
MoP 0.3 0.3 0.4 0.4 0.4 0.4 0.5 0.5 0.5 0.5 0.6 6.43%
CoP 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 5.07%
CoC 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.81%
MoM 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 13.84%
Other 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 15.87%
Total 0.4 0.5 0.5 0.5 0.6 0.6 0.7 0.7 0.8 0.8 0.9 6.91%

Mexico
Figure 319: Mexico Knee Arthroplasty Market Value

Mexico Knee Arthroplasty Market ($Million) by Procedure Type
42.1
• Mexico primary knee replacement market value was estimated to be
38.9
35.9
45
33.2
30.7
40
28.3
26.2
35
24.2
22.4
20.9
30
• Mexico primary knee replacement market volume was estimated to
18.4
25
20
15
• Mexico revision knee replacement market is estimated to grow by 10
1.2
1.2
1.2
1.2
1.2
1.2
1.2
1.1
1.1
1.1
1.0
0.84X in 2025. 5
0
• Uncemented knee fixation segment market value was estimated to 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
6.61% to reach market value of $26.3 million by the end of 2025. Primary Knee Replacement Revision Knee Replacement
reach market volume of 4.49 thousand by the end of 2025. Figure 320: Mexico Knee Arthroplasty Market Procedure
• Mexico bearing type market is estimated to grow by 1.88X in 2025
7.2
6.8
8
6.4
6.1
5.8
7
5.5
5.2
4.9
4.7
6
4.5
5 4.0
4
3
2
0.3
0.2
0.2
0.2
0.2
0.2
0.2
0.2
0.2
0.2
0.2
1
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Mexico
Table 380: Mexico Primary Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 4.1 4.8 5.2 5.7 6.2 6.8 7.5 8.2 9.0 9.8 10.7 9.58%
Uncemented 13.3 14.9 15.7 16.8 17.9 19.1 20.3 21.7 23.1 24.6 26.3 6.61%
Hybrid 0.6 0.8 0.9 1.1 1.3 1.5 1.7 2.0 2.3 2.7 3.1 15.98%
Others 0.3 0.5 0.6 0.7 0.8 1.0 1.1 1.3 1.5 1.8 2.1 17.25%
Total 18.4 20.9 22.4 24.2 26.2 28.3 30.7 33.2 35.9 38.9 42.1 8.24%
Table 381: Mexico Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.9 1.0 1.1 1.2 1.2 1.3 1.4 1.5 1.6 1.7 1.8 6.96%
Uncemented 2.9 3.2 3.3 3.4 3.5 3.7 3.8 4.0 4.1 4.3 4.5 4.06%
Hybrid 0.1 0.2 0.2 0.2 0.3 0.3 0.3 0.4 0.4 0.5 0.5 13.21%
Others 0.1 0.1 0.1 0.1 0.2 0.2 0.2 0.2 0.3 0.3 0.4 14.45%
Total 4.0 4.5 4.7 4.9 5.2 5.5 5.8 6.1 6.4 6.8 7.2 5.65%

Mexico
Table 382: Mexico Revision Knee Arthroplasty Market Value ($Million) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Cemented 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.1 0.1 0.1 -10.11%
Uncemented 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.6 0.5 0.5 0.5 -3.61%
Hybrid 0.3 0.3 0.3 0.3 0.4 0.4 0.4 0.4 0.4 0.4 0.4 1.29%
Others 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.1 0.1 0.1 0.1 7.53%
Total 1.1 1.2 1.2 1.2 1.2 1.2 1.2 1.2 1.1 1.1 1.0 -2.41%
Table 383: Mexico Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Fixation Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Cemented 0.1 0.1 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -12.26%
Uncemented 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -5.92%
Hybrid 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 -1.13%
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.96%
Total 0.3 0.3 0.3 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 -4.75%

Mexico
Table 384: Mexico Primary Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 0.9 -1.64%
Total 18.4 20.9 22.4 24.2 26.2 28.3 30.7 33.2 35.9 38.9 42.1 8.24%
Table 385: Mexico Primary Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 -3.99%
Total 4.0 4.5 4.7 4.9 5.2 5.5 5.8 6.1 6.4 6.8 7.2 5.65%

Mexico
Table 386: Mexico Revision Knee Arthroplasty Market Value ($Million) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.1 0.1 0.1 0.1 8.20%
Total 1.1 1.2 1.2 1.2 1.2 1.2 1.2 1.2 1.1 1.1 1.0 -2.41%
Table 387: Mexico Revision Knee Arthroplasty Market and Procedure Volume (Thousand) by Bearing Type
Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 CAGR
Others 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 5.62%
Total 0.3 0.3 0.3 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 -4.75%

Mexico
Figure 321: Mexico Shoulder Arthroplasty Market Value

Mexico Shoulder Arthroplasty Market ($Million) by Procedure Type
7.6
• Mexico shoulder replacement market value was estimated to be $3.5
6.8
8.0
6.2
million in 2017 and is forecasted to grow at a CAGR of 10.13% to 7.0
5.6
5.1
6.0
4.6
reach market value of $7.6 million by the end of 2025. The market is
4.2
3.8
5.0
3.5
3.2
2.9
4.0
3.0
• Mexico shoulder replacement market volume was estimated to be
2.0
1.0
to reach market value of 1.61 thousand by the end of 2025. 0.0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
• In Mexico, total prosthetic replacement fixation is the leading
reach market value of $3.0 million by the end of 2025. The market is Figure 322: Mexico Shoulder Arthroplasty Market
1.61
1.46
1.8
1.33
1.21
1.6
1.11
1.01
1.4
0.93
0.85
0.78
1.2
0.72
0.67
1
0.8
0.6
0.4
0.2
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

Mexico
Figure 323: Mexico Shoulder Joint Reconstruction Market Value ($Million) By Procedure Type
3.5
3
2.5
2
1.5
1
0.5
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
1.0 1.1 1.2 1.3 1.5 1.7 1.8 2.0 2.3 2.5 2.8
Replacement
Figure 324: Mexico Shoulder Joint Reconstruction Procedure Volume (Thousand) By Procedure Type
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
0.2 0.2 0.3 0.3 0.3 0.4 0.4 0.4 0.5 0.5 0.6
Replacement

11. COMPANY
PROFILES

Global Joint Reconstruction Market Competitive Overview
 The extremity joint reconstruction market is comparatively a smaller and less mature market as compared to its counterpart i.e.
the hips and knee joint reconstruction market.
 The sub-segments of this market include shoulder, ankle, hand, elbow, foot, and wrist, with shoulders alone accounting for 78% of
the market constituting the largest sub segment of extremity joint reconstruction market.
 The shoulders sub-segment is currently driving the majority of growth with an annual increasing procedure rates of 7.1%. The
products for this segment was initially offered by midsized companies which later was acquired by or merged with leading
manufacturers in the total reconstruction market (for example: The recent acquisition of Cayenne Medical by Zimmer Biomet).
 The extremity joint reconstruction market is currently dominated by three leading players: Zimmer Biomet, DePuy Synthes, and
Wright Tornier. These companies occupy a total of 71% of the overall market.

Altimed JSC
5.2.1 Overview
Particular Specifications (as of 2017)
Website www.altimed.by
Dimitrova 5, office 12, 220004 Minsk

Contact Details Republic of Belarus
Tel: +375 (17) 203-45-38
Year of Establishment 1996
Ownership Type Private
Company Type Orthopedic Implant Provider
Competitors Smith & Nephew plc, Stryker Corporation, Zimmer Biomet Holdings, Inc., Wright Medical Group, and JRI Orthopedics Ltd, among others
Subsidiaries Altimed International SA
Related Products & Services Cementless femoral stem, Cemented femoral stem, Austin Moore Endoprosthesis, and Ceramic femoral head, among others
Other Products & Services Small fragment T-plate, T-butress plate, L-butress plate, and Spoon plate, among others
Source: Altimed JSC Website and BIS Research Analysis

Altimed JSC
5.2.2 Corporate Summary
 Altimed JSC is engaged in developing and manufacturing of medical Figure 334:

implants, such as hip joint implants and trauma implants and related Overall Product Portfolio
instruments. In addition, the company is also involved in the
development of knee implant, dental implant, and spinal disc.
 The company is actively engaged in various partnerships for business

expansion. The company addresses the needs of orthopedic implant
industry through its different product categories, namely:
Hip Joint Endoprostheses
1. Hip Joint Endoprostheses: This category offers implants to restore the
function of hip joint. The products under this category are press-fit Altimed JSC
cup, threaded cup, protrusion ring, and cementless femoral stem.
Trauma Implants
2. Trauma Implants: This category offers wide range of products for the
trauma. The category offers bone screws, plates, pins, and wires.
Some of the products under this category are small fragment T-plate,
T-butress plate, L-butress plate, and poon plate, among others.

Altimed JSC
5.2.3 Product Offerings for Joint Reconstruction Market
Figure 335:
Product Portfolio for Joint Reconstruction
Hip Joint Endoprostheses
Femoral Femoral Acetabular Additional

Stems Heads Components Components
1. Cementless femoral
1. Press-fit cup
stem 1. Ceramic femoral
2. Threaded cup 1. Cancellous screw
2. Cemented femoral head
3. Cemented HB 6.5
stem 2. Metallic femoral
acetabular cup 2. Centralizer
3. Austin Moore head
4. Protrusion ring
Endoprosthesis

Altimed JSC
Figure 336:
Trauma Implants
Straight Plates Figured Plates
1. T-Plate
1. Broad Plate DCP 2. L-Plate
2. Small Fragment Plate DCP 3. Small Fragment
Y-Plate

Altimed JSC
 The company holds strong market presence in the regions namely Figure 337:
Republic of Belarus and Switzerland. The company also has over Global Presence
six partners worldwide to meet the market demand.
Belarus
Switzerland

Altimed JSC
5.2.5 Altimed JSC: SWOT Analysis
Figure 338:
Altimed JSC SWOT Analysis
STRENGTHS WEAKNESSES
• The company offers wide range of innovative products such as Cementless • Over dependence on local distribution channels
femoral stem, Cemented femoral stem, and Austin Moore Endoprosthesis, • Limited geographical presence
among others
• The company has notable partners such as Altimed International, CeramTec
AG and McKenna Precision Castings among others
• The materials used for production of devices are provided by leading
European suppliers and meet international standards
Altimed JSC
• Increasing production capacity can enable participation in the growing • Europe is subject to drastic changes in trade policies which may hamper
demand for medical technology products sales within the region
• Ultra modern production processes may improve competitiveness • Increased pricing pressure due to healthcare cost containment
• Expansion into the emerging healthcare markets such as Asia Pacific and • Supply shortage in procurement market
Middle East • Stringent regulatory requirements
OPPORTUNITIES THREATS
ARZZT
5.3.1 Overview
Website www.arzzt.com
2002 Timberloch Place, Suite 200 The Woodlands, TX 77380, U.S.

Contact Details
Tel: 832-442-2310
Company Type Orthopedic Implant Manufacturer
Related Products & Services Femoral Head, Femoral Stem, and Acetabular Cup, among others
Other Products & Services Lumbar Level, Cervical H Plate, Curve Plate, Plate wirh Bridge Curve, and Line Plate with Bridge, among others
Source: ARZZT Website and BIS Research Analysis

ARZZT
 The company is engaged in designing and manufacturing of the implants Figure 339:
as well as orthopaedic and surgical instruments. The company also
Overall Product Portfolio
posses many national and international certifications for safe and efficient
products. Trauma
 The company address the needs of orthopedic and surgical industry

through its five product segments namely: Minimally Invasive
1. Trauma: This segment of the company develops, manufactures,

markets, and distributes implants for trauma patients. Some of the ARZZT Spine
renowned products are Cannulated Femoral Nail, Retrograde Femoral
Nail, Solid Tibial Nail, and Steel and Titanium Humerus Nail, among
others. Hip
2. Minimally Invasive: The segment of the company offers products for

minimally invasive injuries. Some of the key products of the segment Maxillofacial
include locking screw 5.0, crosslink connector 6.0MM, condylar buttress
plate, and pedicular bar, among others.

ARZZT
3. Spine: The segment offers products for cervical and thoracolumbar Figure 340:
injuries. The products of the segment are Cervical H plate and Lumbar
level.
Trauma
4. Hip: This segment of the company manufactures implants for hip injury
patients. Some of the renowned products are Femoral Head, Femoral
Stem, and Acetabular cup, among others. Minimally Invasive
5. Maxillofacial: This segment of the company offers products for

maxillofacial injuries. Some of the products of the segment are curve
ARZZT Spine
plate, plate with bridge curve, and plate 2 Y, among others.
Hip
Maxillofacial

ARZZT
Figure 341:
Metal Acetabular Cup with Unicenter

Poly Liner
Cementless Hip System Femoral Head
Femoral Stem
Hip
Acetabular Cup
Cemented Hip Femoral Head
Femoral Stem

ARZZT
Figure 342:
Humerus Steel and Titanium Humerus Nail
Trauma Femur
Tibial

ARZZT
 The company holds strong market presence in the regions namely Figure 343:
the U.S. and Mexico, among others.
Global Presence
 Additionally, the company supplies its products in many countries

including both established and emerging markets to better serve
the local markets by acknowledging their specific requirements.
The U.S.
Mexico

ARZZT
5.3.5 ARZZT: SWOT Analysis
Figure 344:
ARZZT SWOT Analysis
• Offers wide ranging orthopedic products such as Femoral Head, • Over dependence on local distribution channels
Femoral Stem, and Acetabular Cup, among others
• More than 35 years of experience in implants, surgical instruments
and orthopedics and has a vast distributor network
• The products are designed based on European technologies and the
manufacturing procedures are internationally certified and recognized
ARZZT
• New product and process innovations can help the company meet the • Protectionist foreign trade policies within the European Union
growing demand for medical technology products • Stringent regulatory requirements for product registration
• Privatization in the field of dialysis services
• The new trade agreement Comprehensive Economic and Trade
Agreement (CETA) between Canada and European Union may open
new sales opportunities

B. Braun Melsungen AG
5.1.1 Overview
Website www.bbraun.com
Carl-Braun-Straße 1
Contact Details 34212 Melsungen, Hessen, Germany
Tel: +49-5661-710
Ownership Type Public
Company Type Orthopedic Implant Systems Provider
Net Revenue $7.16 Billion (as of December, 2016)
Number of Employees 58,037 (as of December, 2016)
Competitors Smith & nephew plc, Stryker Corporation, Zimmer Biomet Holdings, Inc., Wright Medical Group, and JRI Orthopedics Ltd, among others
B.Braun Aesculap Implant Systems, LLC (U.S.), B.Braun Medical(India) Pvt.Ltd, B.Braun Medical(H.K.) Ltd., and B.Braun Surgical
Subsidiaries
GmBH(Germany), among others
Aesculap Total Hip Solution, Metha Short Hip Stem System, Excia T Standard Hip Stem Sstem, Bipolar Head, and Plasmafit PRO Acetabular
Related Products & Services
System with Vitelene Liner
Other Products & Services Hypodermic Needles, Central Venous Catheters, IV Drugs, and Regional Anesthesia, among others
2016: EURO 1 = $1.106

Exchange Rates 2015: EURO 1 = $1.11
2014: EURO 1 = $ 1.328
Source: B. Braun Melsungen AG Website and BIS Research Analysis

5.1.2 Overall Business Model
 The company addresses the needs of healthcare and medical research Figure 325:
industry through its four operating divisions, namely:
Overall Business Model
1. B. Braun Hospital Care: This division of the company deals with infusion
B. Braun Hospital Care
therapy, nutrition therapy, and pain therapy. The division supplies
infusion equipment and supplies, infusion and injection solutions,
intravenous catheters, products for clinical nutrition, and pumps and
their associated systems for inpatient and outpatient care. Some of the B. Braun Aesculap
renowned products of this segment are Infusomat fmS, Infusomat P,
and Easypump II ST/LT. B. Braun Melsungen AG
2. B. Braun Aesculap: The B. Braun Aesculap division of the company

B. Braun Out Patient Market
offers wide range of products aiding the process of surgery. The division
hold its expertise in different fields namely orthopedic joint replacement,
regenerative therapy, neurosurgery and interventional vascular
diagnostics and therapy, among others. B. Braun Avitum

3. B. Braun Out-Patient Market (OPM): This division of the company Figure 326:
focuses on the patients with chronic diseases outside the hospital
setting. The division is mainly focused on infection prevention, diabetes,
incontinence and urology, stoma, and wound management. B. Braun Hospital Care
4. B. Braun Avitum: The B. Braun Avitum division of the company offers

wide range of products for people with chronic and acute kidney failure.
The division focuses on different therapy areas namely haemodialysis, B. Braun Aesculap
acute dialysis, and apheresis.
B. Braun Out Patient Market
B. Braun Avitum

Figure 327: Overall Product Portfolio
Cardio-Thoracic Surgery
Diabetes Care
Infection Prevention
Laparoscopic Surgery
Orthopedic Joint Replacement
Wound Management
B. Braun Melsungen AG Continence Care& Urology
Extracorporeal Blood Treatment
Infusion Therapy
Neurosurgery
Pain Therapy
Nutrition Therapy
Ostomy Care

Figure 328:
Aesculap Impant Systems, LLC
Hip Arthroplasty Knee Arthroplasty Navigation
Aesculap Total Hip Solution
Metha Short Hip Stem System
Excia T Standard Hip Stem System
Bipolar Head
Plasmafit PRO Acetabular System with

Vitelene Liner

5.1.5 Financials
Figure 329: Figure 330:

B. Braun Melsungen AG: Overall Financials B. Braun Melsungen AG: Net Revenue by
(2014-2016) Region (2014-2016)
7,300.0 1200
2,552.1
7,200.0
Net Income and Operating Income

3,000.0
2,291.9
1000
2,219.0
7,100.0 2,500.0
1,699.8
1,585.2
800
1,448.1
Net Revenue
2,000.0
1,328.5
Market Size
1,287.0
7,000.0
($Million)
($Million)
1,214.0
1,191.1
($Million)
1,155.8
1,148.9
1,500.0
6,900.0 600
1,000.0
495.5
442.7
434.0
6,800.0
233.8
225.8
224.2
400 500.0
6,700.0
0.0
200
6,600.0
6,500.0 0
2014 2015 2016
Net Revenue 7,213.3 6,804.4 7,161.1
Operating Income 561.6 536.0 644.3
Net Income 420.2 354.9 438.2 2014 2015 2016

5.1.5 Financials
Figure 331:
3,358.5 B. Braun Melsungen AG: Revenue by Division (2014-2016)
4,000.0
3,310.0
3,170.3
3,500.0
3,000.0
Market Size
1,990.1
($Million)
1,909.0
1,868.2
2,500.0
2,000.0
1045.8
1,500.0
980.5
939.1
865.4
855.6
822.6
1,000.0
500.0
0.0
2014 2015 2016
B.Braun Hospital Care B.Braun Aesculap B.Braun Out Patient Market B.Braun Avitum

5.1.6 Financial Summary
 The financial year (FY) of the company begins in January and ends in December. It is a healthcare company that develops, manufactures and supplies
medical devices for anesthesia, intensive care, cardiology, extracorporeal blood treatment, and surgery. The latest net revenue generated by the
company (as of December 2016) is $7161.1 million. The revenue increased by 5.6% at constant exchange rates as compared to $6804.4 million in
FY2015. This revenue increase was driven by growth in the revenue from the B. Braun Avitum division and other divisions. Another reason for the
increase in the net sales revenue was the increased growth in local currencies (10.8 %) in the Asia-Pacific region.
 The company operates under four divisions, namely B.Braun Hospital Care, B.Braun Aesculap, B.Braun Out Patient Market, and B.Braun Avitum. The
joint reconstruction market falls under B.Braun Aesculap Implant Systems, LLC division. The revenue from sales in B.Braun Aesculap increased by
3.7% at constant exchange rate to $1907.9 million in FY2016. This increase in the B.Braun Aesculap division was driven by increased sales of knee
implants, endoscopy products, instrument containers, and technical service. Moreover, Germany reported strong sales growth despite the decline in
prices for implants and stents. However, this decline in prices was offset by an increase in prices in the Latin American markets which resulted in the
increase of the revenue.
 The revenue from sales in B.Braun Hospital Care increased by 4.7% at constant exchange rate to $3310 million. This increase in the B.Braun Hospital
Care division was driven by increased sales of automatic infusion pumps, infusion equipment, and regional anesthesia products. Moreover, Latin
America and Asia reported high growth rates in local currency, which resulted in the increase of the revenue. Further, B.Braun Out Patient Market sales
increased by 5.5% from $822.6 million in 2015 to $865.4 million in FY2016. The growth in B.Braun Out Patient Market was driven by high growth in local
currency in the Latin America and Asia-Pacific regions. The sales almost remained constant in Europe for FY2016.
 The revenue of the company increased from the business in North America, from $1,585.2 million in 2015 to $1,699.8 million in 2016. The sale receipts
from Europe almost remained stagnant at $2,291.9 million in 2016. The receipts from sales in Asia witnessed significant growth from $1,191.1 million in
2015 to $1,287 million in 2016.

 The company holds strong market presence in the regions namely the Figure 332: Global Presence
U.S., Switzerland, Germany, Italy, France, Spain, Brazil, India, Japan,
and China, among others. The company also posses 20 manufacturing
bases worldwide to meet the market demand. Switzerland China
Germany
 Additionally, the company established operating units in more than 60 Italy

France
countries which include both the established and the emerging
markets to better serve the local markets by acknowledging their
specific requirements.
Japan
 The company has 58,037 employees worldwide (as of December
2016). U.S.
India
Brazil

Table 388:
Product Developments
Company Product Product Type Date Description
Aesculap Implant Systems, LLC introduced the modulift

Modulift Vertebral Body vertebral body replacement (VBR), a latest generation
(Aesculap Implant Systems, Replacement System July-15
Replacement System device with the best in class anatomical restoration
LLC)
capabilities with a high degree of tactile feedback
Aesculap Implant Systems, LLC received approval

from the U.S. FDA for the commercial sale of the activL
(Aesculap Implant Systems, activL Artificial Disc Replacement System Jun-15
Artificial Disc, for the treatment of one level number
LLC)
degenerative disc disease
Aesculap Implant Systems, LLC introduced the
(Aesculap Implant Systems, ProSpace Interbody System Lumbar Interbody System Jan-15
ProSpace interbody system for PLIF procedures
LLC)
Aesculap Implant Systems, LLC received FDA 510(K)

B. Braun Melsungen AG approval for the Aesculap odontoid fracture fixation
Aesculap odontoid fracture
(Aesculap Implant Systems, Replacement System Jan-15 system. The system is intended for fracture fixation of
fixation system
LLC) small bones and small bone fragments including
odontoid fractures.

Table 389:
Aesculap Implant Systems, LLC launched the plasmafit

B. Braun Melsungen AG pro acetabular system with the vitelene liner. This
plasmafit pro acetabular
(Aesculap Implant Systems, Hip Arthroplasty system Oct-14 system provides high stability and performance when
system with the vitelene liner
LLC) used in conjunction with a prosthetic femoral head and
hip stem as treatment for total hip arthroplasty
univation X unicondylar knee Aesculap Implant Systems, LLC launched univation X
(Aesculap Implant Systems, Knee Implant System May-14
implant system unicondylar knee implant system
LLC)

5.1.9 B. Braun Melsungen AG: SWOT Analysis
Figure 333:
B. Braun Melsungen AG SWOT Analysis
• Successful brand of implant products such as Columbus A S Revision Knee • Internal pressure of high capital venture
System, Advanced Surface Technology, and Metha Short Hip System • High indebtedness of $2.07 billion as of FY2016
• Aesculap Academy, a division of B.Braun Melsungen AG, has a reputation
of providing medical training to more than 75,000 medical practitioners every
year
• Expansion of global reach aided by acquisitions such as Dismed
Pharmaceutical (Pty) Ltd. and Dismed Criticare (Pty) Ltd., among others
• Development of advanced products for degenerative knee and hip conditions • Protectionist trade policies existing within the European Union will put
with additional features and accessories considerable strain on trade in Europe
• The new agreement between the European Union and Canada (EU-Canada • Commodity price changes
Comprehensive Economic and Trade Agreement) could significantly provide • Supply shortages in the procurement market
new sales opportunities
• Cross selling of products may enhance profitability
Beijing Chunlizhengda Medical Instruments Co., Ltd.
5.21.1 Overview
Website www.clzd.com
No. 10 Xinmi Xi Er Road, Southern District of Tongzhou, Economic Development Zone, Tongzhou District
Contact Details Beijing, China
Tel: 010-58611761
Net Revenue $18.39 Million (as of June, 2017)
Number of Employees 391 (as of December, 2016).
Subsidiaries Beijing Zhao Yi Te Medical Devices Co., Ltd.
Related Products & Services High Rough Stem BB, Micro Slot 130 Stem, Cemented Stem BC3, Acetabular Cup 46 Type A, and Bipolar Head, among others
XM Primary Knee System, XN Knee Joint Prosthesis (Mobile), XM Revision Knee System, and XN Knee Joint Prosthesis (Fixed), among
Other Products & Services
others
Source: Beijing Chunlizhengda Medical Instruments Co., Ltd. Website and BIS Research Analysis

 Beijing Chunlizhengda Medical Instruments Co., Ltd. is involved in Figure 456:

developing and manufacturing orthopedic medical devices, including joint
prosthesis products and spinal products.
 The company addresses the needs of the orthopedics medical device

industry through its three product segments, namely:
Standard Joint Prosthesis
Products
1. Standard Joint Prosthesis Products: This segment of the company deals
with hip and knee replacement systems. The products under this
Beijing Chunlizhengda Medical
category are High Rough Stem BB, Micro Slot 130 Stem, Cemented Stem Custom Joint Prosthesis Products
Instruments Co., Ltd.
BC3, Acetabular Cup 46 Type A, and Bipolar Head, among others.
2. Custom Joint Prosthesis Products: The segment of the company offers a

Spinal Products
wide range of customized products for the treatment of various fractures
of hip, elbow, pelvic, knee, and shoulder. The segment offers Hemi-
Pelvic Prosthesis, Modular Artificial Hip System, and Cuatom/Modular
Proximal Tibial Artificial Knee System, among others.

3. Spinal Products: This segment of the company deals with spine Figure 457:
replacement systems. The products under this category are CF Posterior Overall Business Model
Spinal Internal Fixation System, CS Anterior Spinal Fixation System, and
Posterior Cervical Fixation System, among others.
Standard Joint Prosthesis

Products
Beijing Chunlizhengda Medical

Custom Joint Prosthesis Products
Instruments Co., Ltd.
Spinal Products

Figure 458: Product Portfolio for Joint Reconstruction
Standard Joint Prosthesis Products Custom Joint Prosthesis Products Spinal Products
1. Micro Slot 130 Stem 1. Modular Artificial Hip System

2. High Rough Stem BB 2. Total Humerus Prosthesis
3. Micro Slot 140 Stem 3. Modular Proximal Humerus
4. Micro Slot 155 Stem Shoulder Prosthesis
5. High Rough 160 Stem 4. Inversion Shoulder Prosthesis
6. High Rough Stem BE 5. Artificial Shoulder with Fracture
7. High Rough Stem BE1 6. Artificial Shoulder with Bone
8. Cemented Stem BC1 Disease
9. Grooves Stem BC2 7. Scapula Prosthesis
10. Cemented Stem BC3
11. Acetabular Cup 46 Type A
12. Acetabular Cup 46 Type B
13. Modular Acetabular Cup 48
14. 50 Total Acetabular Cup
17. Ceramic Head and Insert
18. Bipolar Head
5.21.4 Financials

Beijing Chunlizhengda Medical Instruments Co., Beijing Chunlizhengda Medical Instruments
Ltd.: Overall Financials (2014-2016) Co., Ltd.: Net Revenue by Segment (2014-
35.0 12.0 2016)
30.0
25.9
30.0
10.0

25.0
21.5
25.0
8.0 20.0
Market Size
Net Revenue
15.0
($Million)
20.0
($Million)
($Million)
6.0 15.0
15.0
10.0
4.0
4.9
4.8
4.6
10.0
5.0
2.1
2.0
0.7
2.0
5.0
0.0
2014 2015 2016
0.0 0.0
2014 2015 2016
Net Revenue 21.9 28.4 31.3 Standard Joint Prosthesis Products
Net Income 6.0 6.1 9.6 Custom Joint Prosthesis Products
Operating Income 6.9 7.0 10.7 Spinal Products

 The financial year (FY) of the company begins in January and ends in December. It is an orthopedic medical device company that develops,
manufactures, markets, distributes, and sells medical devices which include joint prosthesis products and spinal products. The latest net revenue
generated by the company (as of December 2016) amounted to $31.3 million. This revenue increased by 10.08% at constant exchange rates as
compared to $28.4 million in FY2015. This revenue increase was driven by the growth in the revenue from the sales of standard joint and ceramic hip
joint prosthesis products, the optimization of product structure, and the enhancement of service standards.
 The company operates under three product segments, namely standard joint prosthesis products, custom joint prosthesis products, and spinal products.
The revenue from the sales in the standard joint prosthesis products segment rose by 20.5% at constant exchange rate to $25.9 million in FY2016. This
increase in the standard joint prosthesis products segment revenue was attributed to the increased sales of standard joint and ceramic hip joint
prosthesis products.

 The company holds a strong market presence in China to meet Figure 461:
Global Presence
the market demand.
 The company employs 391 people worldwide (as of December

2016). China

5.21.7 Beijing Chunlizhengda Medical Instruments Co., Ltd.: SWOT Analysis
Figure 462:
Beijing Chunlizhengda Medical Instruments Co., Ltd. SWOT Analysis
• Constant and substantial gross profit margin (22.8% profit margin since • High operating expanses, reducing the profit margin of operations
FY2015)
• Increased demand and acceptance for orthopaedic implants due to the
inclusion of medical devices in medical care insurance coverage under
China healthcare reform
• Increasing aging population, continuous growth in healthcare expenditure
and improvements in public healthcare infrastructure
• Strong R&D capabilities of joint prosthesis products supported by
comprehensive feedback system
• Expansion of product portfolio as orthopaedic implant market is expected to • Difficulties and delays in manufacturing internally, and within the supply chain
grow owing to the China healthcare reform and government policies • Threat of stringent regulations of regulatory bodies for certifications on
• Market expansion through increased manufacturing facilities in Europe, and international standards
Asia Pacific.

BioMedtrix, LLC
5.26.1 Overview
Website www.biomedtrix.com
9 Whippany Rd, Ste B2-7, Whippany, NJ 07981, U.S.

Contact Details
Tel: +973-331-7800
Company Type Veterinary Orthopedic Implant Provider
Related Products & Services CFX (Cemented Fixation) Total Hip System, and BFX (Biologic Fixation) System, and BFX EBM Titanium Stem, among others
Other Products & Services Canine Total Knee System, TATE Elbow System, I-Loc IM Fixator, and TPLO Curve, among others
Source: BioMedtrix, LLC Website and BIS Research Analysis

BioMedtrix, LLC
 BioMedtrix is engaged in developing and manufacturing veterinary orthopedic Figure 483:

implants. Moreover, the company is focussed on addressing the clinical needs
in the canine hip, knee, elbow, and trauma injuries.
Knee
 The company is actively engaged in various sponsorships and collaborations
with the world’s foremost surgeons to support the development of new
programs to address the veterinary needs. The company addresses the needs
Hip
of the orthopedic implant industry through its different product categories,
namely:
BioMedtrix, LLC Elbow
1. Knee: This product category offers products for total knee replacement and
knee revision procedures. The canine total knee system is the only product
offered under this category. Nail
2. Hip: This category offers universal hip system, CFX micro and nano hip
system for total hip replacement procedures. Bone

BioMedtrix, LLC
3. Elbow: This product category offers products for elbow replacement Figure 484:
and elbow revision procedures. TATE elbow system is the only product
offered under this category.
Knee
4. Nail: This category offers interlocking nail system for the repair of
traumatic long bone fractures. I-Lock IM Fixator is the only product
offered under this category. Hip
5. Bone: The category offers TPLO Curve and MultiPurpose bone plates
with HyProtect antimicrobial coating for bone injuries. BioMedtrix, LLC Elbow
Nail
Bone

BioMedtrix, LLC
CFX (Cemented Fixation) Total

Hip System
BFX (Biologic Fixation) Total Hip

System
CFX Micro & Nano Hip System
Hips
BFX EBM Titanium Stem
BFX Collared Stem
BFX Lateral Bolt Stem

BioMedtrix, LLC
 The company holds a strong market presence in the U.S. to Figure 486:
Global Presence
meet the market demand.
The U.S.

BioMedtrix, LLC
Table 415:
Product Launch
Company 1 Product Name Product Type Date Description
BioMedtrix, LLC launched the Lateral Bolt Stem as a

BioMedtrix, LLC BFX EBM Lateral Bolt Stem Orthopaedic 2016
part of the Universal Hip System.
22mm I.D. CFX & BFX

BioMedtrix, LLC launched 22mm I.D. CFX & BFX
BioMedtrix, LLC Cups and 22mm O.D. Orthopaedic N/A
Cups and 22mm O.D. Femoral Heads.
Femoral Heads
BioMedtrix, LLC launched BFX EBM Collared Stem

BioMedtrix, LLC BFX EBM Collared Stem Orthopaedic N/A
as a part of the Universal Hip System.

BioMedtrix, LLC
5.26.6 BioMedtrix, LLC: SWOT Analysis
Figure 487:
BioMedtrix, LLC SWOT Analysis
• Core business in the orthopedic implants market with new concepts in • Ventured into intensely competitive market in which the competition to
modularity and innovative materials. Successful products in the market, such
develop and commercialize efficient product is very significant
as CFX Micro & Nano Hip System
• The company conducts CE approved product workshops throughout the
U.S. and Europe and provides detailed applications and surgical techniques
for product such BFX system and CFX system
• Almost, 95% of the U.S. veterinary universities represents BioMedtrix
procedures for workshops
BioMedtrix, LLC
• Ability to develop new products for humans, and improve the existing • Threat of changes in ISO manufacturing standards
products and technologies in the implants segment • Regulations of the regulatory bodies and local governments regarding the
• Market expansion by introducing the products in the Asia-Pacific market type and use of materials for implants
• Provide product workshops for product awareness
• Focus more on less contested, higher growth sectors of the orthopedic
market
Biotech GmbH
5.22.1 Overview
Website www.biotech-medical.com
Biotech GmbH,
Hagenauer Str. 17-19,
Contact Details
65203 Wiesbaden, Germany
Tel: 49 611 89063143
Company Type Orthopedic Implants Manufacturer
Parent Company Suarez Corporation Industries
Number of Employees 50 (as per LinkedIn)
DePuy Synthes, Mathys Orthopedics, Smith & Nephew plc., Lima Corporate, Zimmer Biomet, Inc., and B.Braun Melsungen AG, among
Competitors
others
BA Total Hip System, Modular Hip System, BET Stem, Modular Bipolar Head System, Modular Head System, and Tumor System Hip,
among others
Other Products & Services Intra Medullary Nailing, Bone Plate and Screw, and Pectus Correcting, among others
Source: Biotech GmbH Website and BIS Research Analysis

Biotech GmbH
Biotech GmbH is one of the leading manufacturers and distributors of Figure 463:
high quality orthopedic, trauma, spine implants and instruments, and
surgical power tool systems.
1. Orthopedics: The orthopedic segment includes products such as hip

prosthesis, knee prosthesis, shoulder prosthesis, and radius head, Orthopedic
among others.
2. Trauma: The trauma segment is focused on products such as intra

medullary nailing, bone implant and screw, and pectus correcting,
Biotech GmBH Trauma
among others.
3. Spine: The spine segment includes products such as spinal screw

fixation and interbody fusion, among others.
Spine

Biotech GmbH
Orthopedics
Hip Shoulder
1. BA total Hip System 1. BP Total Shoulder System

2. BA revision Hip Stem System
3. Modular Hip System
4. Modular Revision Hip System
5. Tumor System Hip
6. BET Stem
7. Short Anatomical Stem System
8. Biotech Quattro Stem System
9. BA Cemented and Uncemented
Cup System
10. Modular Bipolar Head System
11. Modular Head System

Biotech GmbH
 The Biotech Group has its manufacturing facilities in Germany, Figure 465:
and Hungary, where Orthopedic, trauma, and spine systems are
Global Presence
produced. The company annually sells thousands of hip, knee,
and trauma implants in the countries such as Croatia, Turkey,
Iran, Iraq, K.S.A., Greece, Thailand, Spain, Guatemala, and
Russia, among others.
Hungary
Germany

Biotech GmbH
5.22.5 Biotech GmbH: SWOT Analysis
Figure 466:
Biotech GmbH SWOT Analysis
• Highly diversified product portfolio catering to the needs of the implants • High reliance on the European markets
market
• The company has its distribution networks in more than 20 countries across
Europe, and Asia
Biotech GmbH
• Ability to develop new products and improve the existing products and • Difficulties and delays in manufacturing internally, and within the supply chain
technologies in the implants segment • Regulations of regulatory bodies and local governments regarding the type
• Market expansion through increased operations in the emerging markets of and use of raw materials for implants
Europe, and Asia Pacific • Extensive competition from other industrial players in the implants market
• Development of implants with improved durability negating the requirement
of repeated surgeries

Biotechni S.A.S
5.4.1 Overview
Website www.biotechni.com
Z.I Athélia II, 178 avenue du Serpolet, 13600 La Ciotat, France

Contact Details
Tel: +33-044-298-1430
Related Products & Services GEO, ARTE, APOGEE, IGLOO, GYPTIS, and MULTI, among others
Other Products & Services Cervical cage ANATOMIX, Lumbar cage ANATOMIX, and SLICK’S, among others
Source: Biotechni S.A.S Website and BIS Research Analysis

Biotechni S.A.S
 The company is involved in the manufacturing of orthopedic implants and Figure 345:
holds its presence across Europe and Asia-Pacific. The company also
received the 10A distinction from the Orthopedic Data Evaluation Panel
(ODEP) for its Filler 3ND.
Cervical Implant
 The company address the needs of orthopedic implant industry through
its four product segments, namely:
1. Cervical Implant: This segment of the company develops, manufactures,

Shoulder
markets and distributes implants for cervical injuries. Cervical cage
ANATOMIX is the only product available in the segment. Biotechni S.A.S
2. Shoulder: The segment of the company offers products for shoulder

Lumbar Implant
injuries. Some of the products of the segment are GEO and ARTE,
among others.
Hip

Biotechni S.A.S
3. Lumbar Implant: The segment offers products for lumbar injuries. The Figure 346:
products of the segment are SLICK’S and Lumbar cage ANATOMIX.
4. Hip: This segment of the company manufactures implants for hip

injuries. Some of the products of this segment are GEO, ARTE, Cervical Implant
APOGEE, IGLOO, GYPTIS, and MULTI, among others.
Shoulder
Biotechni S.A.S
Lumbar Implant
Hip

Biotechni S.A.S
Figure 347:
Fortress ND Range
Primary Femoral Stems
Filler 3ND Range
To Be Cemented Stem Filler
Stems
TTHR Easy Revision Stem
Revision/Reconstruction Stem
TTHR Reconstruction Stem
Hip Dysplasia Stem TTH
IGLOO
MULTI
Cups
GYPTIS
APOGEE

Biotechni S.A.S
 The company holds strong market presence in the regions namely the Figure 348:
U.S., the U.K., Germany, Japan, and Australia, among others.
Global Presence
 Additionally, the company supplies its products to the several

countries including both established and emerging markets to better
serve the local markets by acknowledging their specific requirements. Germany
The U.K.
Japan
The
U.S.
Australia

Biotechni S.A.S
5.4.5 Biotechni S.A.S: SWOT Analysis
Figure 349:
Biotechni S.A.S SWOT Analysis
• The company has an international presence and offers innovative • Extensive dependence on local distribution channels for expansion of
orthopedic implants such as Cervical cage ANATOMIX, Lumbar cage global reach
ANATOMIX, and SLICK’S, among others.
• The company is ISO 9001 certified and also has an array of patents
• Biotechni S.A.S evaluates its products through close collaboration
with renowned surgeons
Biotechni S.A.S
• Cross selling of products may enhance profitability • Commodity price changes

• Developing new processes and products may improve competitive • Stringent regulatory requirements
positioning • Change in tax laws can significantly hamper company’s profitability
• New trade agreements between Canada and the European Union • Supply shortages in the procurement market
may bring new sales opportunities

CeramTec Group
5.27.1 Overview
Website www.ceramtec.com
CeramTec-Platz 1–9, 73207 Plochingen

Germany
Contact Details
Tel: +49.7153.611-0
Net Revenue $545.9 Million (as of December, 2016)
Number of Employees 3187 (as of December, 2016)
CeramTec-ETEC GmbH, Emil Müller GmbH, CeramTec India Innovative Ceramic Engineering Pvt. Ltd., CeramTec Italian Commercial, and
Subsidiaries
CeramTec Korea Ltd., Innovative Ceramic Engineering, among others
Related Products & Services BIOLOX CONTOURA, BIOLOX OPTION, and BIOLOX DUO, among others
Other Products & Services Piezoelectric Standard Actuators, Piezo-ceramic Materials, and SPK Cutting Materials, among others
Source: CeramTec Group Website and BIS Research Analysis

CeramTec Group
 CeramTec Group is involved in the manufacturing of technical ceramics Figure 488:

and specializes in the development, manufacturing, and sales of parts,
components, and products made from ceramic materials.
 The company addresses the needs of the medical device industry

through its two business segments, namely:
Medical Applications
1. Medical Applications: This segment of the company focuses on BIOLOX
ceramic components for medical implants. The products under this CeramTec Group
category are BIOLOX delta Ball Head, BIOLOX forte Ball Head Portfolio,
Industrial Applications
and BIOLOX Monoblock Cup Inserts, among others.
2. Industrial Applications: The segment of the company offers a wide range

of highly specialized, performance-critical components for a myriad of
applications in the automotive, aeronautics/defence, machinery,
electronics, medical equipment and other industries. The segment offers
products like Piezoelectric Standard Actuators, Piezo-ceramic Materials,
and SPK Cutting Materials, among others.

CeramTec Group
Medical Applications
Joint Replacement
Knee Joint Shoulder Joint

Ball Heads Cup Inserts Material Combinations
Components Components
1. BIOLOX CONTOURA 1. BIOLOX Monoblock 1. BIOLOX delta

2. BIOLOX OPTION Cup Inserts
3. BIOLOX DUO 2. BIOLOX Modular Cup
Inserts

CeramTec Group
5.27.4 Financials
Figure 490: CeramTec Group: Overall Financials Figure 491: CeramTec Group: Net Revenue
(2014-2016) by Region (2014-2016)
700.0 90.0
268.9
300.0
80.0
600.0
233.3
232.4
70.0 250.0
500.0
60.0
178.7
200.0
Net Revenue
147.3
400.0
($Million)
144.6
Market Size
($Million)
50.0
($Million)
150.0
300.0 40.0
92.7
91.5
80.8
74.1
30.0 100.0
69.6
67.9
200.0
20.0
50.0
17.8
17.2
16.7
100.0
10.0
0.0
0.0 0.0 Europe Germany North Asia Rest of
2014 2015 2016
Net Revenue America World
630.8 556.5 545.9
Net Income 41.7 15.9 5.7 2014 2015 2016

CeramTec Group
5.27.4 Financials
Figure 492: CeramTec Group: Net Revenue by Segment (2014-2016)
450.0
394.9
353.7
400.0
340.6
350.0
300.0
236.0
Market Size
($Million)
205.3
250.0
202.8
200.0
150.0
100.0
50.0
0.0
2014 2015 2016
Medical Applications Industrial Applications

CeramTec Group
 The financial year (FY) of the company begins in January and ends in December. It is engaged in the manufacturing of technical ceramics and
specializes in the development, manufacturing, and sales of parts, components, and products made from ceramic materials. The latest net
revenue generated by the company (as of December 2016) amounted to $545.9 million. This revenue declined by 15.9% at constant exchange
rates as compared to $556.5 million in FY2015. The revenue declined due to the decrease in the sales from the industrial applications segment.
 The company operates under two product segments, namely Medical applications and Industrial applications. The revenue from the sales in the
medical applications segment increased by 1.23% at constant exchange rate to $205.3 million in FY2016. This increase in the Medical
applications segment revenue was due to the increase in the sales of BIOLOX-based ceramics and other products. Further, the revenue from
the sales in the industrial applications segment declined by 3.8% as compared to $353.7 million in FY2015. This decline was attributed to the
lower project activity in Ethylene Oxide catalyst due to the reduced demand from the Chinese end market customers, the non-repetition of extra
volumes in 2015 from a key customer for electronic substrate tapes, and the slow demand from the construction and textile machinery markets.
 In addition, the revenue of the company increased from business in Germany, from $144.6 million in 2015 to $147.3 million in 2016, because of
the growth in the medical applications business in Germany. The sale receipts from Europe almost remained stagnant at $233.3 million in 2016.
The receipts from sales in Asia witnessed a slight decline, from $69.6 million in 2015 to $67.9 million in 2016.

CeramTec Group
 The company holds a strong market presence in the regions Figure 493:
Global Presence
namely the U.S., Germany, Italy, Spain, Brazil, India, and
China, among others. The company has 20 production bases
worldwide to meet the market demand. China
Germany
 Additionally, the company has established operating units in
Italy
more than 10 countries, which include both established and
emerging markets, to better serve the local markets by
acknowledging their specific requirements.
 The company employs 3,187 people worldwide (as of

The
December 2016). U.S.
India
Brazil

CeramTec Group
Table 416:
Acquisitions, and Business Expansion
Company 1 Company 2 Date Description
BC Partners entered into an agreement to acquire

CeramTec Group BC Partners Oct-17
CeramTec Group from its current owner Cinven.
CeramTec Group N/A Sep-14 CeramTec Group inaugurated CeramTec Platz in Lauf.

CeramTec Group
5.27.8 CeramTec Group: SWOT Analysis
Figure 494:
CeramTec Group SWOT Analysis
• Successful brand of implant products such as BIOLOX CONTOURA, • Ventured into intensely competitive products market
BIOLOX OPTION, and BIOLOX DUO, among others • Extensive dependence on the European market
• BIOLOX Academy provides product training with respect to joint
replacement
CeramTec Group
• Business expansion through joint ventures and acquisitions of local small • Impact of inflation and fluctuations in the currency exchange rates
scale players • Difficulties and delays in manufacturing internally, and within the supply chain
• Expansion of product portfolio through the development of new products in • Threat of patent expiration and infringement
different segments of the implants market
• Market expansion through increased manufacturing facilities in North
America, and Asia Pacific.

Corin Group PLC
5.5.1 Overview
Website www.coringroup.com
The Corinium Centre, Cirencester, GL7 1YJ, U.K.

Contact Details
Tel: +44-128-565-9866
Related Products & Services Trinity, MiniHip, MetaFix, and TaperFit, among others
Other Products & Services Unity Knee, Uniglide, Rotaglide, and LARS, among others
Source: Corin Group PLC Website and BIS Research Analysis

Corin Group PLC
 Corin Group PLC is actively engaged in orthopedic implant industry for the Figure 350:
development of various replacement surgeries. The company is investing in new
technologies for better product development. Hips
 The company is also involved in surgeon education with their Corin Academy for
better product portfolio. The education involves hands-on cadaveric instructional Tornier Hips
workshops and international conferences.
Knees
 The company addresses the needs of orthopedic implant industry through its eight
product categories, namely:
Tornier Knees
1. Hips: This product category develops, manufactures, markets, and distributes
Corin Group PLC
implants for hip replacement. Some of the offerings of the category include
Extremities
Revival, TaperFit, MetaFix, and MiniHip.
2. Tornier Hips: The product category offers products for tornier hip injuries. Some
Trauma
of the products include Dynacup One-C, Oceane, and Linea, among others.
Care
Ligaments

Corin Group PLC
3. Knees: The product category offers products for knee injuries. The Figure 351:
products of the category include LARS, Rotaglide, and Uniglide, among
others. Hips
4. Tornier Knees: The product category offer products for tornier knee
Tornier Hips
injuries. Some of the products include KneeTec - PFJ, U-KneeTec, and
HLS KneeTec, among others.
Knees
5. Extremities: This product category develops implants for extremities

replacements such as ankle replacement, ligament replacement, and Tornier Knees
shoulder replacement, among others. Some of the offerings of the Corin Group PLC
category include Zenith, LARS, and Oxford. Extremities
6. Trauma: The product category offers products for hip fractures and
Trauma
hemiarthroplasty. Some of the products include DHS Screw,
Hemiarthroplasty heads, and Hemiarthroplasty stems, among others.
Care
Ligaments

Corin Group PLC
7. Care: The product category offers products for wound debridement Figure 352:
across a variety of surgical applications. The products of the category
include Solomax, and Multilok Hand Operating Table. Hips
8. Ligaments: The product category offers products for autogenous and

Tornier Hips
allogenous tissue reconstructions.
Knees
Tornier Knees
Corin Group PLC
Extremities
Trauma
Care
Ligaments

Corin Group PLC
Figure 353:
Trinity
Corin OPS
MiniHip
Hips TriFit T S
MetaFix
TaperFit
Revival

Corin Group PLC
Figure 354:
Dynacup One-C
Linea
Meije duo
Oceane
Tornier Hips Oceane revision
Dual Mobility
Dual Mobility revision cup
Dynacup
Linea revision

Corin Group PLC
Figure 355:
Zenith
Extremities LARS
Shoulder Oxford Shoulder Replacement
DHS Screw
Hemiarthroplasty heads
Bipolar heads
Hip
Trauma TaperFit
Upper Limb
Thompson and Austin Moore
MetaFix

Corin Group PLC
 The company holds strong market presence in the regions Figure 356:
Global Presence
namely the U.S., the U.K., Germany, Japan, and Australia,
among others.
 Additionally, the company supplies its products in many

Germany
countries which include both the established and the emerging
markets to better serve the local markets by acknowledging The U.K.
their specific requirements.
Japan
The
U.S.
Australia

Corin Group PLC
Table 390:
Humelock Corin Group announced the launch of the Humelock Reversed Shoulder
Corin Group Reversed System, a device used to treat patients with both a massive rotator cuff tear
Medical Device Feb-17
PLC Shoulder and a severe form of shoulder arthritis. The condition, known as cuff tear
System arthropathy, causes pain and reduced mobility in the arm and shoulder.
Table 391:
Acquisitions, Mergers, Partnership, Collaborations, and Joint Ventures
Company 2/
Company 1 Strategy Date Description
Organization(s)
Corin, entered into a joint venture agreement with Ossis, a New Zealand-based
Corin Group PLC Ossis Agreement Nov-17 implant maker. The two companies partnered to provide the same cutting-edge
technology for customised implants.
Wright Medical Corin Orthopaedics Holdings Limited completed the acquisition of the Tornier
Corin Group PLC Acquisition Oct-16
Group N.V. Hip and Knee business from Wright Medical Group N.V. (Wright).

Corin Group PLC
5.5.6 Corin Group PLC: SWOT Analysis
Figure 357:
Corin Group PLC SWOT Analysis
• The company offers wide range of successful brands such as Oxford, • Extensive dependence on local distribution channels for expansion of
Trinity, MiniHip, and MetaFix, among others. global reach
• The company uses OPS technology which is based on computational
modelling techniques
Corin Group PLC
• Expansion of business footprint may improve competitive positioning • The U.K.’s referendum vote in favor of leaving the European Union
of the company could adversely affect business
• Cross selling opportunities • Currency fluctuations may adversely affect profitability
• Ultra modern production processes may improve company’s
competitiveness
• Privatization in the field of dialysis services

Elite Surgical.
5.7.1 Overview
Website www.elitesurgical.com
54 De Havilland crescent,
Persequor Technopark,
Contact Details Persequor, Pretoria, 0020
South Africa
Tel: +27-12-386-0012
Number of Employees 50+ (as per website)
Biotech GmbH, DePuy Synthes, Mathys Orthopedics, Smith & Nephew plc., Zimmer Biomet, Inc., and Elite Surgical, among
Competitors
others
Related Products & Services VECTIS REVERSE Shoulder, VECTIS ANATOMIC Shoulder, and DURUS BONE CEMENT, among others
Other Products & Services UNIQ PARTIAL KNEE,BIOLIGN VBR, BIOLIGN CERVICAL DISC, and STACC CERVICAL STAND ALONE, among others
Source: Elite Surgical Website and BIS Research Analysis

Elite Surgical.
Lima Corporate, is a global medical device manufacturer, contributing Figure 367:

extensively to the research and development of orthopedics market. Overall Product Portfolio
The company operates in five product segments namely spine,
arthroplasty, sports medicine, cranial, and instruments. Spine
1. Spine: This spine segment offers wide range of products such as

PEEK spacers to total cervical discs replacement.
Arthroplasty
2. Arthroplasty: This segment includes high end products that
improve quality of life and restore movement to those with
degenerative disease damage.
3. Sport Medicine: This segment includes number of products to Elite Surgical Sports Medicine
help make surgeries to knees, shoulders, feet, ankles, and other

body parts easier, safer, and less invasive.
4. Cranial: Elite’s cranial fixation system is configured to meet the Cranial

demands of any cranial fixation procedure.
5. Instruments: Elite possesses world class instruments for various

surgeries. Instruments

Elite Surgical.
Figure 368:
VECTIS REVERSE SHOULDER
VECTIS ANATOMIC SHOULDER
Elite Surgical. Arthroplasty MR2H TUMOUR HIP PROSTHESIS
ACORN DUAL MOBILITY
DURUS BONE CEMENT

Elite Surgical.
 Lima Corporate has its headquarters in South Africa Figure 369:

Global Presence
 The company has 50+ employees in their new facility at
Persequor Technopark in the capital city of Pretoria
South
Africa

Elite Surgical.
5.7.5 Elite Surgical: SWOT Analysis
Figure 370:
Elite Surgical. SWOT Analysis
• The company is compliant with European CE, American FDA and • Ventured into highly competitive market in which the competition to
ISO series of quality certifications develop and commercialize efficient product is very significant
• The development of the vertifix pedicle screw system in conjugation
with a leading Johannesburg spinal specialist
• Highly diversified product portfolio catering the needs of implants
market
Elite Surgical
• Cross selling opportunity • Supply shortages in the procurement market

• Diversification of product portfolio • Increased trade restrictions
• Increasing production capacity may help the company maintain • Pricing pressure due to healthcare cost containment
competitive positioning
• The opening of new healthcare markets such as Asia and Middle East
could provide enormous sales opportunities

Evolutis
5.8.1 Overview
Website www.evolutisfrance.com
Avenue de la liberation, 42720 Briennon

France
Contact Details
Tel: +33 (0)4 77 60 7999
Subsidiaries Evolutis Medikal A.Ş
Related Products & Services UNIC Reverse, UNIC Anatomic, UNIC Stemless, UNIC Trauma, JUST UNIC, and UNIC for CTA, among others
Other Products & Services FIXION Ligamentoplasty, ROLFLEX System, Anatomic ROLFLEX, and Universal ROLFLEX, among others
Source: Evolutis Website and BIS Research Analysis

Evolutis
 Evolutis holds its expertise in the development and manufacturing of Figure 371:
orthopedic implants. The company expands its portfolio with development
of four new projects on average every year.
 The company is focused on latest technologies for better product

Shoulder
development. In addition, it partners with several local distribution
channels for expansion of global reach.
 Internationally Evolutis partnered with direct subsidiaries (Turkey and Hand/Wrist

Hong-Kong) and distributors (the U.K., Spain, Germany, Australia, New
Zealand, and India, among others) for market expansion.
Evolutis Hip
 The company address the needs of orthopedic implant industry through
its five product categories, namely:
Knee
1. Shoulder: This product category develops, and manufactures implants
for primary and revision shoulder replacement. Some of the offerings of
the category include Humeral Revision, UNIC Trauma, UNIC Reverse,
Trauma
and UNIC Anatomic, among others.

Evolutis
2. Hand/Wrist: The product category offers products for hand or wrist Figure 372:
injuries. Some of the products include ISIS trapezio-metacarpal
prosthesis and Nail-O-Flex distal radius nail.
3. Hip: The product category offers products for acetabulum and femur
Shoulder
replacement. The products of the category include CAPTIV SCW,
CAPTIV PRF, and CAPTIV DM, among others.
4. Knee: The product category offers products for knee replacement. Some Hand/Wrist
of the products include PS Rolflex TONIC, UC Rolflex TONIC, and
Anatomic ROLFLEX, among others.
Evolutis Hip
5. Trauma: This product category manufactures implants for upper limb
and lower limb replacement. It also provides screws, instruments sets,
and suture anchors. Some of the offerings of the category include Knee
Metaizeau nail for ESIN technique, Proximal Femoral Nail System PFNS
II, and ANCHOR Ligament reinsertion and repair suture.
Trauma

Evolutis
UNIC STEMLESS
UNIC Reverse
UNIC Anatomic
Primary
UNIC Trauma
JUST UNIC
Shoulder
UNIC for CTA
Humeral Revision
Revision
Revision glenoid base

Evolutis
Captiv FREELINER
CAPTIV DM
CAPTIV OTM
CAPTIV SCW
CAPTIV PRF
Acetabulum CAPITOLE I & T
CAPITOLE "U"
CAPITOLE R - RA
C cup & Cross-Shell
MOONSTONE
Hip EMERGENCE
The STEMSYS solution
STEMSYS MI
HACTIV
Femur
OPALE
PRIUS
EMERGENCE
Minimally Invasive Hip Surgery

Anterior Approach Instruments Instruments

Evolutis
 The company holds strong market presence in the regions Figure 375:
Global Presence
namely France and Turkey.
 Additionally, the company supplies its products in many

countries which includes both the established and the
emerging markets to better serve the local markets by
acknowledging their specific requirements. France
Turkey

Evolutis
5.8.5 Evolutis: SWOT Analysis
Figure 376:
Evolutis SWOT Analysis
• Successful brand of products such as UNIC STEMLESS, UNIC • Extensive dependence on local distribution channels for expansion of
Reverse, and UNIC Anatomic, among others. global reach
• Vast distributor network strengthening the global presence
• Growing demand for joint reconstruction implants, one of the
company’s principle products
Evolutis
• New process and product innovations • Commodity price changes

• Increasing production capacity can improve competitive positioning • Compliance with changing regulatory requirements
• Opportunities to work with local governments • Lowered reimbursement rates provided by third party payors
• Expansion into emerging healthcare markets such as Asia Pacific and • Increasing trade restrictions
Middle East

Exactech, Inc.
5.9.1 Overview
Website www.exac.com
2320 NW 66th Court, Gainesville, FL, 32653, U.S.

Contact Details
Tel: +(352) 377-1140
Number of Employees 733 (as of December, 2016)
Exactech (UK), Ltd., Exactech KK (Tokyo), Exactech France, SAS, Exectech Deutschland, GmbH, and Exactech Australia, PTY LTD., among
Subsidiaries
others
Alteon Neck Preserving Stem, Alteon Tapered Wedge Stem, Novation Element Stem, and Novation Tapered and Splined Stems, among
others
Other Products & Services Truliant System, Truliant Revision, Optetrak Logic Primary, Optetrak Logic Revision, and ExactechGPS Knee, among others
Source: Exactech, Inc. Website and BIS Research Analysis

Exactech, Inc.
 Exactech is involved in developing, manufacturing, marketing, distributing, Figure 377:

and selling orthopaedic implant devices, related surgical instruments, and
biologic services to the hospitals and physicians in the U.S. and
internationally as well. Extremities
 The company addresses the needs of the orthopedic implant industry

through its five segments, namely:
Knee
1. Extremities: This segment of the company deals with shoulder
replacement system. The segment includes treatment options for both
degenerative disease (anatomic and reverse total shoulder systems) and
trauma (platform fracture stem and fracture plate). The products under Exactech, Inc. Hip
this category include Equinoxe Platform Shoulder System, and
InterSpace Shoulder, among others.
2. Knee: The knee segment of the company offers a wide range of products Biologics/Spine
aiding the process of knee replacement. The segment offers Truliant
Primary, Truliant Revision, and ExactechGPS Knee, among others.
Others
Source: Exactech, Inc.Website and BIS Research Analysis

Exactech, Inc.
3. Hip: This segment of the company deals with the hip replacement Figure 378:
system. The segment includes treatment options for hip arthroplasty.
The products under this category include Alteon Neck Preserving Stem
and Novation Element Stem, among others. Extremities
4. Biologics/Spine: The biologics segment of the company offers a wide

range of products aiding the process of healing and regeneration of
bone and soft tissue. The segment offers Ossilix & Ossilix MP Calcium Knee
Phosphate Cement, Optecure & Optecure +ccc DBM Bone Graft, and
TenoMend Collagen Tendon Wrap, among others.
5. Others: This segment offers products related to implant surgeries such Exactech, Inc. Hip
as spacers and bone cement. The products under this category include
Cemex bone cement system and AcuDriver Automated Osteotome
System, among others.
Biologics/Spine
Others
Source: Exactech, Inc.Website and BIS Research Analysis

Exactech, Inc.
Hip
Primary Femoral Stems Acetabular Fracture Revision Femoral Stems
Alteon Neck Preserving Stem Novation InteGrip Novation CFS

Alteon Monobloc
Femoral Stems
Alteon Tapered Wedge Stem Connexion GXL

Polyethylene Liner Bipolar/Unipolar Heads AcuMatch M-Series Stem
Novation Element Stem BIOLOX delta InterSpace Hip
Novation Tapered and

Splined Stems Novation Crown Cup

Exactech, Inc.
Equinoxe Platform System
Equinoxe Primary System
Equinoxe Reverse System
Equinoxe Fracture System
Equinoxe Humeral Reconstruction

Shoulder
Prosthesis
Equinoxe Preserve Stem
ExactechGPS Shoulder Application
Equinoxe Resurfacing Head
InterSpace Shoulder

Exactech, Inc.
5.9.4 Financials

Exactech, Inc.: Overall Financials (2014-2016) Exactech, Inc.: Net Revenue By Region (2014-
260.0 180.0 2016)
200.0
176.8
168.1
165.6
255.0 150.0
180.0

160.0
250.0 120.0
140.0
Net Revenue
($Million)
($Million)
Market Size
120.0
($Million)
245.0 90.0
82.8
100.0
80.8
73.7
240.0 60.0 80.0
60.0
235.0 30.0
40.0
20.0
230.0 0.0
2014 2015 2016
0.0
Net Revenue 248.4 241.8 257.6 Domestic International
Net Income 16.5 14.8 0.2
Operating Income 147.9 145.9 169.7 2014 2015 2016

Exactech, Inc.
5.9.4 Financials
Figure 383:
Exactech, Inc.: Net Revenue By Segment (2014-2016)
120.0
100.3
100.0
86.7
81.4
80.8
76.2
80.0 73.1
Market Size
($Million)
60.0
46.7
43.8
43.1
40.0
24.1
22.8
19.5
18.3
16.2
14.8
20.0
0.0
Extremity Knee Hip Biologics/Spine Other
2014 2015 2016

Exactech, Inc.
 The financial year (FY) of the company begins in January and ends in December. It is a healthcare company that develops,
manufactures, and supplies orthopaedic implant devices, related surgical instruments, and biologic services to the hospitals and
physicians in the U.S. and to other international regions as well. The latest net revenue generated by the company (as of December
2016) is $257.6 million. This revenue increased by 6.5% at constant exchange rates as compared to $241.8 million in FY2015. This
revenue increase was driven by the growth in the revenue from the extremities segment, knee segment, and hip segment. Another reason
for the increase in the net revenue from sales was the continued robust growth in the international sales.
 The company operates under five segments, namely extremities, knee, hip, biologics/spine, and others. The revenue from the sales in
extremities increased by 15.7% at constant exchange rate to $100.3 million in FY2016. This increase in the Extremities segment revenue
was attributed to the market acceptance of Equinoxe platform shoulder system, with its reverse components, and launch of Humeral
Reconstruction Prosthesis for complex shoulder surgeries. Further, Hip implant sales increased due to the launch of Alteon hip system.
 In addition to this, the international sales increased by 10% to $80.8 million in FY2016, as compared to $73.7 million in FY2015. The
revenue from the domestic sales increased during the year 2016 as a result of the improvements in the domestic sales organization and
the impact of new product launches. Internationally, the sales increased as a result of the improved sales in certain international markets
and the acquisition of Australian distributor.

Exactech, Inc.
Global Presence
namely the U.S., the U.K., Germany, France, Japan, and
Australia, among others, to meet the market demand.
 Additionally, the company has established operating units in

Germany
numerous countries which include both established and
The U.K.
emerging markets to better serve the local markets by and
acknowledging their specific requirements. France

2016). Japan
The
U.S.
Australia

Exactech, Inc.
Table 395:
Exactech, Inc. marked the first clinical use of recently approved
Exactech, Shoulder, Knee, and Hip shoulder, knee, and hip replacement systems in Japan. These surgeries
Medical Device June-17
Inc. Replacement Systems coincide with the series of new product introductions the company
reported in the U.S.
ExactechGPS, Equinoxe
Exactech launched ExactechGPS, Equinoxe Humeral Reconstruction
Exactech, Humeral Reconstruction
Medical Device March-17 Prosthesis, and Vantage Total Ankle System at the AAOS 2017 Annual
Inc. Prosthesis, and Vantage Total
Meeting.
Ankle System
Table 396:
Merger & Acquisition
Company Company 2 Date Description
Exactech, Inc. amended its merger agreement with TPG Capital and certain of its
Exactech, Inc. TPG Capital Dec-17
affiliates which was previously announced on October 23, 2017.
Exactech, Inc. completed the acquisition of its independent distribution partner,

Exactech, Inc. Exactech Australia Pty Ltd. February-16
Exactech Australia Pty Ltd, effective Feb. 1, 2016.

Exactech, Inc.
5.9.8 Exactech, Inc.: SWOT Analysis
Figure 385:
Exactech, Inc. SWOT Analysis
• Successful brand of implant products such as Alteon Neck Preserving • Internal pressure of high capital venture
Stem, Alteon Tapered Wedge Stem, Novation Element Stem, and • High indebtedness of $20 million as of FY2016
Novation Tapered and Splined Stems, among others.
• Expansion of global reach aided by acquisitions, such as Australian
Distributor, among others
Exactech, Inc.
• The global presence of the company can help expand relationships • Change in commodity pricing
and business with local governments • Supply shortages in the procurement market
• Product innovation, portfolio management and new business models • Interruptions and breaches of the Company’s information technology
• Cross selling opportunity systems
• Increasing trade restrictions may restrict business expansion in the
European Union
FX Solutions
5.23.1 Overview
Website www.fxsolutions.fr
1663 rue de Majornas

01440 Viriat - France
Contact Details
Tel: +33 4 74 52 44 01
Smith & Nephew plc, Stryker Corporation, Zimmer Biomet Holdings, Inc., Wright Medical Group, and JRI Orthopedics Ltd,
Competitors
among others
Related Products &

Humelock II (Hemi/Totale), Humelock Reversed, Easytech, Easytech Reversed, and Humeris, among others
Services
Other Products & Services Acrolig, and InSpace, among others
Source: FX Solutions Website and BIS Research Analysis

FX Solutions
 FX Solutions is engaged in developing and manufacturing Figure 467:

orthopedic implants for shoulder replacement procedures in
trauma or degenerative pathology. The company addresses the
needs of the shoulder orthopedic implant industry through its
different product categories, namely: Arthroplasty
1. Arthroplasty: This product category offers various shoulder

implants such as Humelock II (Hemi/Totale), Humelock FX Solutions Arthroscopy
Reversed, Easytech, Easytech Reversed, and Humeris, for total

shoulder replacement procedures.
Osteosynthesis
2. Arthroscopy: The category offers shoulder replacement implants
to address patients' needs for minimally invasive surgical
procedure.
3. Osteosynthesis: This category offers various implants for the

reduction and internal fixation of a bone fracture.

FX Solutions
Humelock II (Hemi / Total)
Humelock Reversed
Easytech
Arthroplasty
Easytech Reversed
Humeris
Smartloop

FX Solutions
Arthroscopy InSpace
PRCT II
Smartloop
Osteosynthesis
Acrolig
Flexnail

FX Solutions
Global Presence
namely France, the U.S., the U.K., and Germany to meet the
market demand.
Germany
The U.K.
The
U.S.

FX Solutions
5.23.5 FX Solutions: SWOT Analysis
Figure 471:
FX Solutions SWOT Analysis
• The company provides implant solutions based on the need of orthopaedic • Extensive dependence on the European markets
surgeons, especially with problems in treating shoulder trauma, and
degenerative pathologies
• Successful launch of Humelock revesed shoulder system for treating severe
shoulder arthritis in the U.S., U.K., and Germany
FX Solutions
• Market expansion into emerging markets such as Asia-Pacific, Middle East • Unfavorable currency fluctuations
and Africa • Failure to develop and commercialize new products and technologies could
• The recent agreement between European Union and Canada would increase decrease the demand for company’s product in the market
sales opportunities

Group FH Ortho
5.10.1 Overview
Website www.groupfhortho.com
3 rue de la Forêt, F 68990 HEIMSBRUNN, France

Contact Details
Tel: +33 3 89 81 90 92
Smith & Nephew plc., Stryker Corporation, Zimmer Biomet Holdings, Inc., Wright Medical Group, and JRI Orthopedics Ltd,
Competitors
among others
Subsidiaries FH Orthopedics S.A.S., FH Ortho Inc., FH Ortho Ltd., Implants Industrie, and FH Industrie
Related Products &

Arrow Universal Shoulder Prosthesis, Arrow Resurfacing Cup, Arrow Link, and Telegraph Humeral Nail, among others
Services
Other Products & Services Eurocer 200+, Eurocer 400, Eurobone 2, and Ostibone, among others
Source: Group FH Ortho Website and BIS Research Analysis

Group FH Ortho
 Group FH Ortho is engaged in developing and manufacturing implants Figure 386:

and instruments for bone-related surgeries. The company is actively
engaged in conducting educational and training programs with
Sport Surgery
workshops, conferences, and live and recorded surgeries.
 The company addresses the needs of the orthopedic implant industry Upper Limb
through its different product categories, namely:
1. Sport Surgery: This product category offers implants for ligament, Bone Substitutes
tendon, and meniscus reconstruction. The different sub-categories
under sport surgery are Achilles tendon repair, ankle ligament
Group FH Ortho Hip
reconstruction, and knee ligament reconstruction. Some of the
products offered by the category are TLS system and Tenolig.
Foot
2. Upper Limb: This category offers implants for shoulder arthroplasty
and fractures. The different sub-categories are implants, nails,
Knee
resurfacing, and trauma. Some of the products offered are Arrow
Universal Shoulder Prosthesis, Arrow Link, and Telegraph Humeral Nail.
Spine

Group FH Ortho
3. Bone Substitutes: This product category offers solid and injectable Figure 387:
synthetic bone substitutes for various bone defects. Some of the
products offered by the category are Eurocer 400, Eurobone, and
Sport Surgery
Eurocer 200+.
4. Hip: This category offers cemented and cementless hip implants for Upper Limb
degenerative conditions and trauma. The different sub-categories
under hip implants are cups, heads, nails, and stems. Some of the
Bone Substitutes
products offered are Hip’n go cemented and cementless primary
straight stems, heads, revision heads, and coriolis cups.
Group FH Ortho Hip
5. Foot: The category offers implants and minimally invasive surgical
techniques for foot and ankle. The different sub-categories are forefoot,
Foot
and hindfoot. Some of the products offered are EZ Weil, Hindfoot screw,
and Bioresorbable K-wire.
Knee
Spine

Group FH Ortho
6. Knee: The category offers cemented and cementless knee implants with Figure 388:
fixed and mobile bearings. Some of the products offered are FHK –
Mobile-bearing total knee arthroplasty and FHK – Fixed-bearing total
Sport Surgery
knee arthroplasty.
7. Spine: The category offers cervical and lumbar disc replacement Upper Limb
implants. The products offered are CP ESP prosthetic cervical disc and
LP ESP prosthetic lumbar disc.
Bone Substitutes
Group FH Ortho Hip
Foot
Knee
Spine

Group FH Ortho
Upper Limb
Implants Nails Resurfacing Trauma
1. ARROW universal 1. TELEGRAPH humeral 1. ARROW resurfacing 1. STS – Shoulder

shoulder prosthesis nail cup Trauma System
2. BEHAC elastic nail 2. Arrow link

Group FH Ortho
Hip
Cups Heads Nails Stems
1. Hip’n go cementless 1. Heads 1. TFP 1. Hip’n go cemented and

press-fit cups 2. Revision heads cementless primary straight
2. Hip’n go dual mobility 3. Pharo bipolar head stems
cups 2. ESOP anatomical modular
3. ESOP (ATLAS) cups cementless stem
4. Coriolis cups 3. PHARO cemented and
cementless bipolar femoral
implants

Group FH Ortho
 The company has three subsidiaries, one each in the U.K., the Figure 391:
Global Presence
U.S., and Poland. The company holds a strong market
presence in the U.S., the U.K., Poland, and France to meet the
market demand.
Poland
 The company also has four 4 commercialization facilities in the
U.S., the U.K., France, and Poland and one fabrication facility The U.K.
in France.
The
U.S.

Group FH Ortho
Table 397:
Product Launch
Group FH Ortho launched femoral components,

Group FH Ortho FHK Implants- Size 7 Orthopaedic May-17 tibial inserts, and tibial trays in size 7 for fixed
and mobile bearing FHK prosthesis.

Group FH Ortho
5.10.6 Group FH Ortho: SWOT Analysis
Figure 392:
Group FH Ortho SWOT Analysis
• Several successful hip replacement products such as Hip’n go • Ventured into an intensely competitive market in which the
cemented, and cementless primary straight stems, heads, revision competition to develop and commercialize an efficient product is very
heads, and coriolis cups, among others. significant
• Core business in the orthopedic implants market with new concepts
in modularity, and innovative materials. Successful products in the
market such as CFX Micro & Nano Hip System.
Group FH Ortho
• Expansion of product portfolio through the development of new • Lowered reimbursement rates for medical devices
products in different segments of the implants market • Unfavorable currency fluctuations
• Business expansion through joint ventures and acquisitions of local • Threat of patent expiration and infringement
small scale players • Regulations of regulatory bodies and local governments regarding the
type and use of materials for implants

JOHNSON & JOHNSON
5.6.1 Overview
Website www.jnj.com
One Johnson & Johnson Plaza New Brunswick,

Contact Details New Jersey 08933, U.S.
Tel: (732) 524-0400
Net Revenue $56.25 Billion (as of Q3, 2017)
Number of Employees 126,400 (as of December 2016)
Smith & nephew plc, Stryker Corporation, Zimmer Biomet Holdings, Inc., Wright Medical Group, and JRI Orthopedics Ltd, among
Competitors
others
DePuy Synthes (U.S.), Alza (U.S.), Lifescan Inc. (U.S.), Janssen Pharmaceuticals (Belgium), and Ethicon Inc. (U.S.), among
Subsidiaries
others
ACTIS Total Hip System, CORAIL Revision Stem, CORAIL Total Hip System, GRIPTION TF Acetabular Revision System, Hip
Access Kit, Hip in a Box Model, and Hip Straight Blade, among others
Other Products & Services Therapeutic Catheters, CARTO Mapping Systems, Sinus Catheters, and Drugs, among others
Source: JOHNSON & JOHNSON Website and BIS Research Analysis

JOHNSON & JOHNSON
JOHNSON & JOHNSON, is a company the deals with the needs Figure 358:
of different markets such as consumer, knees, hips, S.E.T, Spine
and CMF, and dental.
Consumer Products
1. Consumer: The consumer segment includes products used in
baby care, oral care, beauty, over the counter pharmaceutical,
women’s health , and wound care market.
JOHNSON & JOHNSON Pharmaceutical Products
2. Pharmaceutical: The pharmaceutical segment is focused on
five therapeutic areas namely immunology, infectious diseases
and vaccines, neuroscience, oncology, cardiovascular, and
metabolic diseases. Medical Devices
3. Medical Devices: The medical devices segment includes

products used in orthopedic, surgery, cardiovascular, diabetes
care, and vision care fields.

JOHNSON & JOHNSON
Figure 359
Medical Devices
Hip Shoulder
1. ACTIS Total Hip System 1. DELTA XTEND Reverse Shoulder

2. CORAIL Revision Stem System
3. CORAIL Total Hip System 2. GLOBAL ADVANTAGE Shoulder
4. GRIPTION TF Acetabular Arthroplasty System
Revision System 3. GLOBAL AP Shoulder
5. Hip Access Kit Arthroplasty System
6. Hip in a Box Model 4. GLOBAL ENABEL Glenoid
7. Hip Straight Blade Exposure System
8. PINNACLE Hip Solutions 5. GLOBAL UNITED Anatomic
9. PINNACLE Revision Acetabular Platform Shoulder
Cup System 6. GLOBAL APG+ IMPLANT System
10. RECLAIM Modular Revision Hip 7. GLOBAL FX Shoulder System
System 8. GLOBAL STEPTECH Anchor Peg
11. SUMMIT Tapered Hip System Glenoid
12. TRI-LOCK Bone Preservation 9. Shoulder Extraction Instruments
Stem

JOHNSON & JOHNSON
5.6.4 Financials
Figure 360: JOHNSON & JOHNSON Overall Financials (2014-2016)

75 25
Operating Income and Net

Net Revenue
74
20
( $Billion)
73
Income ($Billion)
72 15
71
70 10
69 5
68
67 0
2014 2015 2016
Net Revenue 74.33 70.07 71.89
Net Income 16.32 15.40 16.54
Figure 361: JOHNSON & JOHNSON Net sales by Figure 362: JOHNSON & JOHNSON Net sales
Business Segments (2014-2016) by Region (2014-2016)
33.46
39.54
32.31
31.43
40
27.52
25.13
25.11
40
30 37.81
Market size
34.78
38
Market size
34.38
($Billion)
14.49
36
($Billion)
13.5
13.3
20 36
34.07
34
10
32
0 30
2014 2015 2016 U.S. International
Consumer Pharmaceutical Medical devices 2014 2015 2016

JOHNSON & JOHNSON
5.6.4 Financials

JOHNSON & JOHNSON Net Revenue by JOHNSON & JOHNSON Net Revenue by
Medical Devices Business Segment (2014- Orthopedic Sub segment (2014-2016)
2016)
12
4.13
4.5
9.71
9.67
3.88
3.9
9.33
9.29
9.26
9.21
10 4
3.5
8
2.64
2.56
3
2.52
6 2.5
Market size
($Billion)
Market size
1.53
1.52
1.49
($Billion)
1.36
1.36
1.33
4
2.81
2.78
1.5
2.6
2.14
2.03
1.92
2.2
1.84
1.78
1
0.96
2
0.5
0.08
0.06
0 0
2014 2015 2016 2014 2015 2016
Orthopaedics Surgery Vision Care

Hips Knees Trauma Spine & Other
Cardiovascular Diabetes Care Diagnostics

JOHNSON & JOHNSON
 The financial year (FY) of the company starts in January and ends in December. The company generated a net revenue of $56.25 billion
in the third quarter of FY2017 reporting a rise of $2.47 billion when compared with that of FY2016. Johnson & Johnson (J&J) reported a
net revenue of $71.89 billion in FY2016 with an increase of 2.5% in net revenue when compared with that of FY2015. The increase in the
revenue was attributed to an increase in the sales of pharmaceutical products negating the downfall in other operating segments. The
company noted a net income of $16.54 billion in FY2016, reporting an increase of $1.14 billion when compered to the net earnings of
FY2015. Since 2014, the company maintained a good 22% profit margin.
 The company operates in three reportable segments namely Consumer, Pharmaceutical, and Medical devices. The pharmaceutical
segment continue to be its lucrative segment generating $33.46 billion revenue in FY2016. The segment reported a rise of 2% in sales
when compared with that of FY2015. The medical devices segment is the major contributor to the implants market. It includes products
catering needs of diverse fields namely Orthopedics, Surgery, Vision Care, Cardiovascular, Diabetes Care, and Diagnostics. The segment
registered a net sales of $25.11 billion in FY2016 which is approximately same as that of FY2015. The growth of the segment was
negatively impacted by continued pricing pressures. The orthopedics, vision care and cardiovascular sub-segments have significant
product offerings to implants market.
 The company reports its sales based on geographic destination in two bifurcations namely the U.S. and International. The company
generates almost equal amounts of revenue from both the bifurcations. The U.S. being its primary market, reported a net sales of $37.81
billion in FY2016 reporting an increase of $1.81 billion when compared with that of FY2015. The growth is attributed to general increase in
demand for the products.

JOHNSON & JOHNSON
 The Johnson & Johnson business operations is conducted in Figure 365:

Global Presence
more than 230 operating companies located in 60 countries.
 Within the U.S., 7 facilities are used by the consumer

segment, seven by the pharmaceutical segment and 21 by the
medical devices segment. Outside the U.S., 30 facilities are
used by the consumer segment, 17 by the pharmaceutical The U.K.
segment and 37 by the medical devices segment.
 The company has 1,26,400 employees worldwide (as of

December 2016). Europe
The Asia Pacific
U.S.
Africa

JOHNSON & JOHNSON
Table 392:
DePuy Synthes, Inc. announced that it has acquired Sentio, LLC a private company that
DePuy Synthes (J&J) Sentio, LLC Jun-17
markets innovative nerve localization technology for spine surgery
DePuy Synthes, Inc. announced that it has acquired Tissue Regeneration System’s 3D
DePuy Synthes (J&J) Tissue Regeneration Systems, Inc. Apr-17
Printing Technologies to Treat Bone Defects
DePuy Synthes announced asset purchase of Interventional Spine Expandable Cage

DePuy Synthes (J&J) Interventional Spine, Inc., Jan-17
Technology to expand its portfolio
DePuy Synthes acquired Biomedical Enterprises, Inc. to strengthen its portfolio for foot,
DePuy Synthes (J&J) Biomedical Enterprises, Inc. May-16
ankle, hand and wrist
Johnson & Johnson Synthes Jun-12 J&J acquired Synthes to join with DePuy franchise and improve its orthopaedic offerings
Table 393:
Joint Ventures, Partnerships & Collaborations
Johnson & Johnson’s 3D DePuy Johnson & Johnson’s 3D Printing Center of Excellence announced partnership with its
Mar-17
Printing Center of Excellence Synthes and Ethicon family of companies to develop bioprinted knee meniscus tissue .
DePuy Synthes announced agreement to develop Interventional Spine Expandable

DePuy Synthes (J&J) Interventional Spine, Inc., Jan-17
Cage Technology to expand its portfolio
DePuy Synthes announced agreement with Materialise to develop 3D printed implants

DePuy Synthes (J&J) Materialise Jul-16
for facial and skull implants

JOHNSON & JOHNSON
Table 394:
Business Expansion
Company 1 Date Description
Depuy opened Institute for Advanced Education and Research In

DePuy Synthes (J&J) Jul-11
Orthopaedic and Neurological Care In India

JOHNSON & JOHNSON
5.6.8 JOHNSON & JOHNSON: SWOT Analysis
Figure 366:
JOHNSON & JOHNSON SWOT Analysis
• Highly diversified product portfolio catering the needs of cardiovascular, • Ventured into highly competitive products market
ophthalmic, cosmetic, and orthopedic implants market • High reliance on global supply chains that may adversely affect the supply
• Ever increasing R&D investment ($9.09 billion, 12.6% of net sales)
and pricing of raw materials
• Focused organic growth through acquisitions aiding the innovation of new
products and expansion of product portfolio (acquisitions worth $4.50 billion
in FY2016)
• New products introduced in past five years accounted for around 22% of
2016 sales
JOHNSON & JOHNSON
• Ability to develop new products and improved existing products and • Impact of inflation and fluctuations in the currency exchange rates
technologies in the implants segment • Difficulties and delays in manufacturing internally and within the supply chain
• Market expansion through increased operations in emerging markets of • Threat of patent expiration and infringement
Europe and Asia Pacific • Regulations of regulatory bodies and local governments regarding the type
• Development of implants with improved durability negating the requirement and use of raw materials for implants

JRI Orthopaedics Limited
5.11.1 Overview
Particular
Particular Specifications
Specifications (as
(as of
of 2017)
2017)
Website www.jri-ltd.com
Website www.jri-ltd.com
18 Churchill Way, 35A Business Park, Chapeltown, Sheffield S35 2PY
U.K.
Contact Details
18
Tel:Churchill Way,345
+44 (0) 114 35A Business Park, Chapeltown, Sheffield S35 2PY
3200
U.K.
Contact Details
Tel: +44 (0) 114 345 3200
Related Products &

Ownership Humelock II (Hemi/Totale), Humelock Reversed, Easytech, Easytech Reversed, and Humeris, among others
Services Type Private
Other Products
Company Type & Services Acrolig, andImplant
Orthopedic InSpace, amongProvider
Systems others
Smith & Nephew plc, Stryker Corporation, Zimmer Biomet Holdings, Inc., Wright Medical Group, and Lima Corporate, among
Competitors
others
Related Products &

Avanteon Hip System, Tribofit Hip System, Furlong Evolution, and Securus Revision Hip System, among others
Services
Other Products & Services MaioRegen, Repros, ENGipore, RegenOss, and SINTlife, among others
Source: JRI Orthopaedics Limited Website and BIS Research Analysis

 JRI Orthopaedics Limited is engaged in developing and Figure 393:

manufacturing orthopedic implants for hip, knee, and shoulder
arthoplasty, and a range of orthobiologics. The company is wholly
Hips
owned by Orthopeadic Research UK (ORUK), and actively invests in
orthopaedic research.
Shoulders
 The company addresses the needs of the orthopedic implant
industry through its different product categories, namely:
JRI Orthopaedics Limited Orthobiologics

1. Hips: This product category offers various types of hip implants
such as Avanteon Hip System, Tribofit Hip System, Furlong
Evolution, and Securus Revision Hip System, for total hip
Custom Products
replacement, repair or reconstruction procedures.
2. Shoulders: The category offers shoulder replacement, repair, or

Instruments
reconstruction implants to address the patients' needs for shoulder
replacement surgical procedures.

3. Orthobiologics: This product category offers various Figure 394:

orthobiologics such as MaioRegen, Repros, ENGipore,
RegenOss, and SINTlife, for fast recovery from injuries.
Hips
4. Custom Products: The category offers orthopaedic implants with
a customised fit according to the patient’s bone anatomy,
developed through precise processing, and computer-aided Shoulders
design technologies.
5. Instruments: The category offers instruments for hip and shoulder JRI Orthopaedics Limited Orthobiologics
implant surgical procedures. The products offered include
Trephine Instrumentation Set, Cement Removal Instrumentation
Set, and Flexible Osteotome Instrumentation Set, among others. Custom Products
Instruments

Figure 395:
In-House Manufacturers Distributors
Avanteon Hip System
Furlong Evolution
Furlong H-A.C Revision Straight MRP Titan Proximal Femoral Replacement

Stems (PFR)
Hips Furlong H-A.C. Hips
Furlong Hemiarthroplasty System MRS Comfort Revision Cup
Securus Revision System
Tribofit Hip System

Figure 396:
Custom Product aMace
VAIOS Surface Replacement
Shoulders
VAOIS Shoulder System

 The company holds a strong market presence in the U.K. to Figure 397:
Global Presence
meet the market demand.
The U.K.

5.11.5 JRI Orthopaedics Limited: SWOT Analysis
Figure 398:
JRI Orthopaedics Limited SWOT Analysis
• Highly diversified product portfolio catering to the hip, and shoulder implants • Extensive dependence on the Europe market
market. • Ventured into an intensely competitive market in which the competition to
• Growing demand for joint reconstruction implants, one of the company’s develop and commercialize efficient products is very significant
principle products.
• Development of implants with improved durability negating the requirement • U.K.’s referendum vote in favour of leaving European Union could adversely
of repeated surgeries, and developing more patient specific prosthetics impact businesses
• Business expansion through joint ventures and acquisitions of local small • Lowered reimbursement rates for medical devices
scale players • Extensive competition from other industrial players in the implant market
• Cross selling opportunity • Unfavorable currency fluctuations
• Undergoing Public Private Partnerships • Fluctuations in product demand due to unfavourable global economic
conditions

Lima Corporate
5.12.1 Overview
Website www.limacorporate.com
Via Nazionale, 52
33038 - Villanova di San Daniele del Friuli (UD)
Contact Details
Italy
Tel +39 0432 945511
Net Revenue $162.3 Million(as of Q3, 2017)
Number of Employees 845 (as per website)
Biotech GmbH, DePuy Synthes, Mathys Orthopedics, Smith & Nephew plc., Zimmer Biomet, Inc., and Elite Surgical, among
Competitors
others
Subsidiaries Lima USA, Inc., Lima France, and BioSuMa S.r.l (Italy)
Large Joint Primary Hip Stems, Cups, Acetabular Liners, Modular Heads, Large Joint Revision Hip Stems and Cups, and
SMR Shoulder System, among others
Other Products & Services Large Joint Primary knee, Large Joint Revision Knee, and Extremities and Fixation, among others
Source: Lima Corporate Website and BIS Research Analysis

Lima Corporate
Lima Corporate is a global medical device company which offers Figure 399:
reconstructive and fixation orthopedic solutions. The company
operates in three products segments, namely large joint primary and
revision implants, extremities and fixation, and a dedicated patient
specific prosthesis division known as promade.
1. Large joint primary and revision implants: This segment includes Large joint Primary/Revision
Products
products such as Hip Stems, Cups, Acetabular Liners, Modular
Heads, multigen plus, and physica system, among others, for hip,
and knee implants.
Lima Corporate Extremities and Fixation
2. Extremities and Fixation: The segment is focused on products
such as SMR anatomic, SMR reverse, AXIOMA TT Metal Back
and Bone Graft Instrumentation, and SMR Stemless, among
others. Promade Exclusive Implants
3. Promade Exclusie Implants: The segment includes patient

specific prosthesis, in collaboration with surgeons.

Lima Corporate
Orthopedics
Large Joint Primary Hip Large Joint Revision Hip Extremities
1. COLLO-MIS 1. C2 Revision 1. SMR Anatomic

2. FRIENDLY Short 2. Revision Stem 2. AMR Reverse
3. MINIMA 3. DELTA-ONE-TT 3. AMR Trauma
4. H-MAX 4. DELTA-REVISION TT 4. SMR Resurfacing
5. DELTA-FINS 5. SMR Stemless
6. Acetabular Plates & 6. SMR Revision
Cemented Cups
7. Acetabular Liners
8. Modular Heads

Lima Corporate
 Lima Corporate has established direct subsidiaries in 24 Figure 401:

countries across Europe, Asia-Pacific, the U.S., and Latin Global Presence
America, a few of the countries in these regions include France,
Germany, Italy, Spain, the U.K., Japan, Australia, and South Belgium
Korea. In addition, the company has approximately 21 Germany
Switzerland
distributors, and covers around 43 countries worldwide. Also, the
company has three production plants. The U.K.
 The company has 845 employees worldwide (as of December Italy Poland
France
2016).
Spain S.Kore Japan

Portugal a
The
U.S.
Brazil
South
Africa Australia
New
Zealand

Lima Corporate
Table 398:
Lima Corporate announced that it has completed the
acquisition of the Zimmer Unicompartmental High Flex
Lima Corporate Zimmer Biomet (Japan) Dec-15
Knee (ZUK) System, and the Discovery Elbow System
from Zimmer Biomet Holdings Inc. for the Japanese market
Table 399:
Joint Ventures, Partnerships & Collaborations
Lima Corporate announced that it has entered into a
Hospital for Special Surgery
Lima Corporate Mar-16 partnership with the Hospital for Special Surgery (HSS), for
(HSS)
the development of a new product.
Table 400:
Product Launch
SMR Bone Graft Lima Corporate announced that it has
Instruments and Lima launched two products, SMR Bone Graft
Lima Corporate Orthopaedic May-17
Personalized Surgical Instruments, and Lima Personalized Surgical
Instruments (LPSI) Instruments (LPSI), for shoulder replacement
Lima Corporate launched SMR Stemless for

Lima Corporate SMR Stemless Orthopaedic Aug-15
Shoulder Surgery in Rome

Lima Corporate
5.12.6 Lima Corporate: SWOT Analysis
Figure 402:
Lima corporate SWOT Analysis
• The development of products in conjugation with the trabecular titanium • Continued loss in the company’s operations ($15.5 million in September,
technology. 2016 to $39.26 million by the end of September, 2017)
• Core business in the orthopedic implants market with new concepts in
modularity, and innovative materials. Successful products in the market such
as SMR shoulder replacement system.
• The company has established 24 direct subsidiaries across Europe, Asia
Pacific, the U.S., and Latin America
Lima Corporate
• New product and process innovation may improve competitive positioning • Regulations of regulatory bodies and local governments regarding the type
• Development of implants with improved durability negating the requirement and use of raw materials for implants
of repeated surgeries • Intense competition from other industrial players in the implant market
• Collaboration with local governments • Fluctuations in currency exchange
• Cross selling opportunities

Marle Group
5.13.1 Overview
Website www.marle.fr
BP 46, ZI rue Lavoisier, F-52800 Nogent

France
Contact Details
Tel: +33 (0)325 318 579
Competitors
among others
Subsidiaries ATS, Marle, Sferic, Marle Finishing, H.M.P., and SMB Medical
Related Products &

Femoral stem, Acetabular cup, and Humeral replacement system, among others
Services
Knee replacement system, Spine replacement system, Ankle replacement system, Rasp and Handle replacement system,
among others
Source: Marle Group Website and BIS Research Analysis

Marle Group
 Marle Group is engaged in developing and manufacturing implants Figure 403:

and instruments for bone-related surgeries of hip, knee, shoulder,
spine, and extremities.
 The company offers a wide combination of technologies to Hip

manufacture the most diverse implant geometries with the highest
quality and cost-efficiency. The technologies used are forging,
casting, heat treatments, milling, grinding, turning, electroerosion, Knee
polishing, anodizing, coating, laser marking, polyamide 3D printing,
testing, ultrasonic cleaning, and clean room packaging.
Marle Group Shoulder, Ankle and Elbow
Spine
1. Hip: This product category offers various implants such as femoral
stems and acetabular cup for total hip replacement and hip
reconstruction. Rasp and Handle

Marle Group
2. Knee: This product category offers various implants for total knee Figure 404:
replacement and knee reconstruction.
3. Shoulder, Ankle, and Elbow: The category offers various implants

Hip
for shoulder replacement, ankle replacement, and elbow
replacement procedures.
4. Spine: This product category offers various implants for total spine Knee
replacement and spine reconstruction.
5. Rasp and Handle: This product category offers various instruments Marle Group Shoulder, Ankle and Elbow
for sculpting bone procedures.
Spine
Rasp and Handle

Marle Group
Figure 405:
Femoral Stem
Hip
Acetabular Cup
Humeral Replacement
Shoulder
System
Source: Marle GroupWebsite, BIS Research Analysis

Marle Group
 The company holds a strong market presence in Switzerland and Figure 406:
France to meet the market demand. Global Presence
Switzerland
France

Marle Group
Table 401:
Acquisitions
Marle Group acquired SMB Medical for machining, finishing services with its
Marle Group SMB Medical Jul-17 accredited metallurgical laboratory. This acquisition was made in context of
developing a complete supply chain solution for Marle's products.
Marle Group acquired Finortho SAS for manual polishing, electrolytic polishing,
Marle Group Finortho SAS Oct-15 vibratory finishing, micro bead blasting, cleaning, passivation, laser marking,
anodizing, and manufacturing with 3D printing of polyamide.

Marle Group
5.13.6 Marle Group: SWOT Analysis
Figure 407:
Marle Group SWOT Analysis
• Core business in the orthopaedic implants market with new concepts in • Extensive dependency on the local distribution channels for the expansion of
modularity, and innovative materials. global reach
• Growing demand for joint reconstruction implants, one of the company’s
principle products.
Marle Group
• Product and process innovation • Commodity price changes

• Cross selling opportunities • Increased trade restrictions
• Increasing production capacity may improve competitive positioning • Change in tax laws may adversely affect profitability
• Expansion into emerging markets such as Asia Pacific and Middle East

Mathys AG Bettlach
5.28.1 Overview
Website www.mathysmedical.com
Robert Mathys Strasse 5, 2544 Bettlach

Switzerland
Contact Details
Tel: +41 32 644 16 44
Net Revenue $131.2 Million (as of 2016)
Number of Employees 568 (as of first half of 2017)
Subsidiaries Mathys Orthopaedics Pty Ltd, Mathys Orthopaedics GmbH, Mathys Orthopedie S.A.S, and Mathys KK, among others
Related Products & Services CCA, Optimys, Twinsys Uncemented, Twinsys Cemented, CCE, CCB, RM Classic, and RM Pressfit, among others
Other Products & Services Balansys Bicondylar, Balansys UNI, Balansys Revision, and Cyclos, among others
Source: Mathys AG Bettlach Website and BIS Research Analysis

Mathys AG Bettlach
 Mathys AG Bettlach is engaged in developing, producing, and Figure 495:

distributing products for artificial joint replacement (hip, knee,
shoulder, and finger) and synthetic bone graft substitutes.
 The company generated a net sales of CHF 62.1 million during the Knee
first half of 2017. Thus, Mathys reported a growth of 3.3% as
compared to the first half of 2016. Also, the number of employees
increased by 6 during the first half of 2017 and reached to 568. Hip
 The company is also involved in providing continuous training to the

medical professionals. The company addresses the needs of the Mathys AG Bettlach Shoulder
orthopedic implant industry through its different product categories,
namely:
Bone Graft Substitute
1. Knee: This category offers products for knee replacement or knee
revision. The products under this category are Balansys Bicondylar,
Balansys UNI, and Balansys Revision. Sports Medicine

Mathys AG Bettlach
2. Hip: This category offers a wide range of products for hip Figure 496:
replacement. The category offers stems, cups, and heads for hip
replacement. Some of the products under this category are CCA,
Optimys, Twinsys Uncemented, and Twinsys Cemented.
Knee
3. Shoulder: This category develops, and manufactures products for
shoulder replacement. The products under this category are
Affinis Short, Affinis, Affinis Inverse, and Affinis Fracture/Affinis Hip
Fracture Inverse.
4. Bone Graft Substitute: This category manufactures products for

Mathys AG Bettlach Shoulder
trauma or disease-related bone loss. The only product under this
category is Cyclos.
Bone Graft Substitute

5. Sports Medicine: This category offers products for ruptured
anterior cruciate ligaments. The only product under this category
is Ligamys.
Sports Medicine

Mathys AG Bettlach
Figure 497:
Optimys
Twinsys Uncemented
Stems
Twinsys Cemented
Hip Cups
CCA
Heads

Mathys AG Bettlach
Figure 498:
RM Pressfit Vitamys
Anexys
Stems
RM Pressfit
Hip Cups
RM Classic
Heads
CCB
CCE

Mathys AG Bettlach
Figure 499:
Symarec
Stems
Bionit 2
Hip Cups
Bipolar and Hemiheads
Heads
Ceramys
Ceramys Revision Head
Metal Heads

Mathys AG Bettlach
Figure 500:
Affinis Short
Affinis
Shoulder
Affinis Inverse
Affinis Fracture/ Affinis Fracture Inverse

Mathys AG Bettlach
5.28.4 Financials
 The financial year (FY) of the company begins in January and ends Figure 501:
in December. It is a healthcare company that develops, Mathys AG Bettlach: Overall Financials (2014-
2016)
manufactures, and supplies orthopaedic implants, and synthetic
bone graft substitutes. The latest net revenue generated by the 135.0
company (as of 2016) is $131.2 million. The company operates 131.2

under five product categories, namely knee, hip, shoulder, bone 130.0
graft substitute, and sports medicine.
125.0
 The revenue generated in 2016 increased by 14.7%, increasing to
Net Revenue
($Million)
$131.2 million from $114.4 million.
120.0
117.8
115.0 114.4
110.0
105.0
2014 2015 2016
Net Revenue 117.8 114.4 131.2

Mathys AG Bettlach
namely the U.K., Switzerland, Germany, Australia, Japan, and
Global Presence
China, among others. The company has over 30 marketing

partners worldwide to meet the market demand.
Switzerland China
Germany
2016). U.K.
Japan
Australia

Mathys AG Bettlach
5.28.6 Mathys AG Bettlach: SWOT Analysis
Figure 503:
Mathys AG Bettlach SWOT Analysis
• Market expansion through innovative products such as Balansys Bicondylar, • Extensive dependency on the local marketing partners for the expansion of
Balansys UNI, Balansys Revision, and Cyclos, among others global reach
• Better product development through collaboration with doctors
Mathys AG Bettlach
• Development of personalized joint reconstruction implants • Intense competition with other market players of the joint reconstruction
• Business expansion through collaborations with different players and market
organizations in the orthopedics implant market • Fluctuations in product demand due to unfavorable global economic
conditions

MatOrtho Limited
5.29.1 Overview
Website www.matortho.com
13 Mole Business Park, Randalls Road, Leatherhead, Surrey KT22 7BA

U.K.
Contact Details
Tel: +44 (0)1372 224 200
Competitors
among others
Subsidiaries MatOrtho Australia Pty Limited
Related Products &

ADEPT Hip Resurfacing System
Services
SAIPH Knee System, Medial Rotation Knee, BOX Total Ankle Replacement, and Proximal Interphalangeal Replacement,
among others
Source: MatOrtho Limited Website and BIS Research Analysis

MatOrtho Limited
 The company is engaged in the field of orthopedic implants and addresses Figure 504:
the needs of the orthopedic implant industry through its different products for
knee, ankle, and hip replacement, among others.
SAIPH Knee System
 The company is focused on the total joint replacement technology for the
development of safe and high quality products. Medial Rotation Knee
 The company is also actively investing in clinical research and education for
better clinical outcomes. It is also collaborating with numerous clinicians and BOX Ankle
researchers in the world and supports healthcare professional training.
Proximal Interphalangeal
 MatOrtho Education is engaged in various courses, from hands-on MatOrtho Limited
Replacement
cadaveric instructional workshops to international conferences.
Total Metacarpophalangeal
Replacement
ADEPT Hip Resurfacing

System
Tuke Saw

MatOrtho Limited
Figure 505:
Hip ADEPT Hip Resurfacing System

MatOrtho Limited
 The company holds a strong market presence in the regions, Figure 506:
namely the U.K. and Australia.
Global Presence
 Additionally, the company supplies its products in numerous

countries which include both the established and emerging
markets, to better serve the local markets by acknowledging
their specific requirements. The
U.K.
Australia

MatOrtho Limited
5.29.5 MatOrtho Limited: SWOT Analysis
Figure 507:
MatOrtho Limited SWOT Analysis
• Successful brand of products such as Medical Rotation Knee, BOX Ankle, • Extensive dependency on the local distribution channels for the expansion of
and SAIPH Knee System, among others. global reach
• Investments in clinical research and education for better product
development
• Educational courses and training programs for healthcare professionals
MatOrtho Limited
• Development of advance joint reconstruction implants due to collaboration • Intense competition with other market players of the joint reconstruction
with many surgeons market
• Strict regulatory regulations in terms of product registration and validation

Menix Group
5.15.1 Overview
Website www.dediennesante.com
315 CHARLES TELLIER STREET, 30034 NÎMES CEDEX 1, France

Contact Details
Tel: +33 (0)4 66 28 06 85
Company Type Orthopaedic Implant Provider
Number of Employees 270 (as of 2015)
Competitors
among others
Subsidiaries SERF (Society for Study, Research and Manufacturing), Global D, and Oneortho
Related Products &

NOVAE SUNFIT TH, NOVAE E TH, NOVAE COPTOS TH, and NOVAE STICK / K, among others
Services
Other Products & Services CCC TRI, TRI CCC R, Shiva, Freedom, Secured Screw Diam 2MM, and Screws Canules Diam 2.3 & 3MM, among others
Source: Menix Group Website and BIS Research Analysis

Menix Group
 Menix Group was formed by the merger of SERF and Dedienne Figure 413:
Santé in 2008. The company is involved in the development and
manufacturing of orthopaedic implants, dental implants, and
craniomaxillofacial implants.
 The company has a group of companies, namely SERF, Global D,

Knee
and Oneortho Medical. SERF is engaged in the orthopedics implant
industry for hip, knee, and extremities. Global D is involved in the
development of dental implants, maxillofacial, and pre-implant and
Menix Group Hip
orthodontic surgeries.
 Oneortho Medical develops customized joint implants, and single-use

Sports Surgery
surgical instruments using rapid manufacturing techniques such as
3D printing. It is actively investing in new technologies for better
personalized products.

Menix Group
 The company addresses the needs of the orthopedic implant industry Figure 414:
1. Knee: This category offers products for knee replacement. Some of

the products are CCC TRI, TRI CCC R, S.Hi.VA Total Knee
Prosthesis, and Freedom.
Knee
2. Hip: This category develops and manufactures products for hip
replacement. The category offers cotyles and femoral implants for hip
replacement. Some of the products under this category are Libra, Menix Group Hip
Hype, and TSF.
3. Sports Surgery: This category offers products for ligament repair Sports Surgery
process.

Menix Group
NOVAE SUNFIT TH
NOVAE E TH
NOVAE COPTOS TH
Cotyles
NOVAE STICK / K
COTYLE HYPE
CHIBF E BIPOLAR CUP

Hip
Libra
Hype
Femoral Implants SAGITTA EVL
SAGITTA EVL R
TSF

Menix Group
 The company holds a strong market presence in France. Figure 416:

Global Presence
 Additionally, the company supplies its products in many countries
which include both established and emerging markets, to better
serve the local markets by acknowledging their specific
requirements.
France

Menix Group
5.15.5 Menix Group: SWOT Analysis
Figure 417:
Menix Group SWOT Analysis
• Market expansion through innovative products such as NOVAE SUNFIT TH, • Extensive dependency on the local distribution channels for the expansion of
NOVAE E TH, NOVAE COPTOS TH, and NOVAE STICK / K, among others global reach
• Scope growth through acquisitions aimed to strengthen the product portfolio
(Acquisition of Oneortho Medical in 2015)
• Growing demand for joint reconstruction implants, one of the company’s
principle products
Menix Group
• Development of advance joint reconstruction implants • Intense competition with other market players of the joint reconstruction
• Business expansion through collaborations with different players in the market
orthopedics implants market • Unfavorable currency fluctuations
• Market expansion by introducing geographically personalized products in the • Fluctuations in product demand due to unfavorable global economic
emerging markets conditions

MicroPort Scientific Corporation
5.16.1 Overview
Website www.microport.com
1601 Zhangdong Road, Zhangjiang Hi-Tech Park, Shanghai 201203

China
Contact Details
Tel: (1) (866) 8720211
Number of Employees 2,910 (as of December, 2016).
Competitors
among others
Shanghai MicroPort Medical (Group) Co., Ltd., MicroPort Orthopedics Inc., Shanghai MicroPort Orthopedics Co., Ltd.,
Subsidiaries
MicroPort Endovascular (Shanghai) Co., Ltd., and MicroPort Endovascular (Shanghai) Co., Ltd., among others
Related Products &

PROFEMUR Z Hip Stem System, PROFEMUR RENAISSANCE Hip Stem System, and BIOLOX Delta Ceramic, among others
Services
EVOLUTION Medial-Pivot Knee System, ADVANCE Total Knee Arthroplasty System, and PROPHECY Pre-Operative
Navigation Guides, among others
Source: MicroPort Scientific Corporation Website and BIS Research Analysis

 Microport Scientific Corporation is involved in developing, manufacturing, Figure 418:

marketing, distributing, and selling medical devices with the latest medical
technology for the treatment of various diseases.
Orthopedics
 The company addresses the needs of the medical device industry through
its seven segments, namely:
Cardiovascular
1. Orthopedics: This segment of the company deals with hip, trauma, spine,
and knee replacement systems. The segment includes reconstructive
Endovascular
joints, spine and trauma, and other professional implants, and equipment.
The products under this category are PROFEMUR Z Hip Stem System,
MicroPort Scientific
PROFEMUR RENAISSANCE Hip Stem System, and BIOLOX Delta Electrophysiology
Corporation
Ceramic, among others.
2. Cardiovascular: The knee segment of the company offers a wide range of Neurovascular
products for the treatment of coronary artery related diseases. The

segment offers target eluting coronary stent system, drug-eluting Surgical
coronary stent system, and PTCA balloon catheters, among others.
Diabetes

3. Endovascular: The segment focuses on providing a range of products Figure 419:

and services for the interventional treatment of thoracic and abdominal
aortic aneurysm, peripheral vascular disease, aortic dissection, and other
Orthopedics
endovascular related diseases. The products under this category are
hercules balloon dilation catheter, stent graft in surgical operation, and
AAA/TAA stent graft system. Cardiovascular
4. Electrophysiology: The segment is focused on the manufacturing and

Endovascular
marketing of minimally invasive medical devices for the treatment of
electrophysiological diseases. The segment offers products such as
ablation catheter, diagnostic catheter, 3D EP navigation system, and MicroPort Scientific
Electrophysiology
Corporation
optimablate system.
5. Neurovascular: The segment specializes in providing products and Neurovascular

services for the treatment of neurovascular diseases including Cerebral
Aneurysms, Intracranial Atherosclerotic Diseases (ICAD), Carotid Artery
Surgical
Diseases (CAD), and other neurovasculature related diseases. The
products offered are intracranial stent system, intracranial stent graft
system, and distal protective device. Diabetes

6. Surgical: The segment focuses on providing extracorporeal circulation Figure 420:

products and occlusion series products used for congenital heart disease.
The products under this category are membrane oxygenation, and
Orthopedics
occluder.
7. Diabetes: The segment is engaged in the development and

Cardiovascular
manufacturing of medical devices for the management, supervision, and
treatment of diabetes, and endocrine disease. The segment offers
products such as insulin pump, and hypophyseal hormone infusion pump. Endovascular
MicroPort Scientific
Electrophysiology
Corporation
Neurovascular
Surgical
Diabetes

Orthopedics
Hips Knees Spine Trauma
1. PROFEMUR Z Hip Stem 1. Locking

System Compression Plate
2. PROFEMUR System
RENAISSANCE Hip Stem
System
3. PROFEMUR Modular Neck
4. LINEAGE Acetabular Cup
System
5. BIOLOX Delta Ceramic
6. PROFEMUR TL Hip Stem
System

5.16.4 Financials
Figure 422: MicroPort Scientific Corporation: Figure 423: MicroPort Scientific Corporation:
Overall Financials (2014-2016) Net Revenue of Orthopedics by Region (2014-
Net Income and Operating

500.0 80.0 2016)
Income ($Million)
Net Revenue
400.0
87.9
87.5
60.0
83.8
($Million)
300.0 100.0
62.8
59.1
58.8
Market Size
40.0
($Million)
200.0 80.0
37.1
29.6
20.0
27.9
60.0
23.3
100.0
21.1
20.1
10.6
40.0
9.7
0.0 0.0
6.6
2014 2015 2016 20.0
Net Revenue 355.3 375.8 389.9 0.0
Net Income 59.6 11.4 15.1 U.S. EMEA Japan PRC Others
Operating Income 39.4 10.0 45.9 2014 2015 2016
Figure 424: MicroPort Scientific Corporation: Net Revenue by Segment(2014-2016)

210.4
210.2
205.2
225.0
137.9
132.6
200.0
111.9
175.0
Market Size
($Million)
150.0
125.0
100.0
18.9
16.2
75.0
14.1
8.8
7.9
7.0
6.3
50.0
6.1
5.8
5.8
5.5
4.8
2.1
2.0
1.6
25.0
0.0
2014 2015 2016
Orthopedics Cardiovascular Endovascular Electrophysiology Neurovascular Surgical Diabetes

 The financial year (FY) of the company begins in January and ends in December. It is a healthcare company that develops, manufactures,
markets, distributes, and sells medical devices with latest medical technology for the treatment of various diseases. The latest net
revenue generated by the company (as of December 2016) is $389.9 million. This revenue increased by 3.7% at constant exchange
rates, as compared to $375.8 million in FY2015. This revenue increase was driven by the growth in the revenue from the cardiovascular
and orthopedic segments. Another reason for the increase in the net revenue from sales was the robust growth in China.
 The company operates under seven segments, namely cardiovascular, orthopedic, endovascular, electrophysiology, neurovascular,
surgical, and diabetes. The revenue from the sales in the orthopedics segment increased by 2.39% at constant exchange rate to $210.2
million in FY2016. This increase in the revenue generated from the orthopedics segment was due to the increase in the revenue from the
international market (outside China), and market acceptance of the U.S. orthopaedics products in the China market.
 In addition to this, revenue generated from the Cardiovascular segment increased by 4.06% to $137.9 million in FY2016, as compared to
$132.6 million in FY2015. The growth in the revenue was attributed to the increased sales of Firehawk Coronary Rapamycin Target
Eluting Stent (Firehawk), and the Firebird2 Coronary Rapamycin-Eluting CoCr Coronary Stent (Firebird2).
 Furthermore, the sales from China, and Japan rose by 9.1%, and 6.1%, respectively in FY2016. This increase was attributed to the brand
and channel development in the key markets which enhanced the awareness of products of the company and improved the depth and
coverage of sales.

namely the U.S., Canada, the U.K., Germany, France, Japan, and Global Presence
China, among others, to meet the market demand.
 Additionally, the company has established operating units in Canad

numerous countries, which include both established and emerging a China
Germany
markets, to better serve the local markets by acknowledging their
specific requirements. The U.K.
 The company employs 2,910 people worldwide (as of December,

2016).
Japan
The
U.S.

Table 402:
MicroPort
Procotyl Prime MicroPort Orthopedics launched its Procotyl Prime Acetabular Cup
Scientific Medical Device Aug-17
Acetabular Cup System System in the U.S.
Corporation
MicroPort MicroPort Orthopedics Inc. launched Profemur Preserve Hip Stem, a
Profemur Preserve Hip
Scientific Medical Device Aug-15 short stem designed to support the growing market of bone and tissue
Stem
Corporation preserving surgical techniques.
Femoral Head Biolox
MicroPort Shanghai MicroPort Orthopedics Co. received registration certificates
Delta Ceramic, Rim-
Scientific Medical Device Jul-15 from the China Food and Drug Administration ("CFDA") for its Femoral
Lock Biolox Delta
Corporation Head Biolox Delta Ceramic and Rim-Lock Biolox Delta Ceramic Liner.
Ceramic Liner
Table 403:
MicroPort Orthopedics Inc. and MB Innovations entered into a multi-product development
agreement for orthopedic instruments. MBI agreed to initially provide design and development
expertise in support of the development of MPO's portfolio of instruments and instrument
MicroPort Scientific MB
Jul-14 systems associated with its Fast Recovery, tissue-sparing approach to hip arthroplasty
Corporation Innovations
procedures. During the term of the development agreement, there may be additional
development programs initiated to develop other differentiated implants and instruments that
are used for both hip, and knee arthroplasty procedures.

5.16.8 MicroPort Scientific Corporation: SWOT Analysis
Figure 426:
MicroPort Scientific Corporation SWOT Analysis
• Highly diversified product portfolio catering to the needs of the • Ventured into intensely competitive products market
cardiovascular, endovascular, diabetes, surgical, and orthopedic medical • High operating expanses, reducing the profit margin of the operations.
devices market
• Growing demand of joint reconstruction implants. The company’s
reconstruction revenue increased by 2.39%, with increase in the revenue
from the international market (outside China) in FY2016.
• Ability to develop new products and improve the existing products and • Impact of inflation and fluctuations in the currency exchange rates
technologies in the implants segment • Threat of patent expiration and infringement
• Market expansion through increased operations in the emerging markets of
Europe, and Asia Pacific
• Development of implants with improved durability negating the requirement

Peter Brehm GmbH
5.14.1 Overview
Website www.peter-brehm.de.com
Am Mühlberg 30, 91085 Weisendorf, Germany

Contact Details
Tel: +49 9135 71030
Company Type Orthopaedic Implant Provider
Number of Employees 160
Competitors
among others
Subsidiaries Peter Brehm Switzerland GmbH, Peter Brehm GmbH Austria, and Peter Brehm Japan Inc.
Related Products &

AEON-TITAN, VEKTOR-TITAN, PHÖNIX-TITAN, MRS-TITAN COMFORT, and MRP-TITAN, among others
Services
Other Products & Services BPK-S INTEGRATION, KAM-TITAN, and IBS-TITAN, among others
Source: Peter Brehm GmbH Website and BIS Research Analysis

Peter Brehm GmbH
 Peter Brehm GmbH is engaged in the fields of hip and knee Figure 408:
arthroplasty and spine surgery. The company is expanding its
business by various project collaborations, such as business
partner mediation between PETER BREHM GmbH and AHK Italy.
 The company is also actively involved in collaborations and

Hip
partnerships with academic institutions for better innovation and
development of products.
Knee
 The company addresses the needs of the orthopedic implant
industry through its five product categories, namely: Peter Brehm GmbH
1. Hip: The product category offers products for hip replacement, Spinal Column
and hip reconstruction/revision. The products of the category

include MRP-TITAN, AEON TITAN, VECTOR TITAN, and
Special
MRP-TITAN COMFORT, among others.

Peter Brehm GmbH
2. Knee: The product category offers products for knee replacement and Figure 409:
reconstruction. Some of the products are BPK-S INTEGRATION, and
KAM TITANIUM.
3. Spinal Column: The product category offers a wide range of spine

fixateur and cages. Some of the products are WSI MX/PX-TITAN
Expertise and IBS-TITAN. Hip
4. Special/Custom Made: The product category offers completely

personalized implants for the patients. Knee
Peter Brehm GmbH
Spinal Column
Special

Peter Brehm GmbH
Figure 410:
MRP-TITAN
MRS-TITAN COMFORT
Hip VECTOR TITAN
PHOENIX TITAN
AEON TITAN

Peter Brehm GmbH
namely Switzerland, Austria, and Japan. Global Presence
 Additionally, the company supplies its products in many countries,

which include both established and emerging markets, to better
serve the local markets by acknowledging their specific Switzerland
requirements.
Austria
Japan

Peter Brehm GmbH
5.14.5 Peter Brehm GmbH: SWOT Analysis
Figure 412:
Peter Brehm GmbH SWOT Analysis
• Successful brand of products such as AEON-TITAN, VEKTOR-TITAN, • Extensive dependency on the local distribution channels for the expansion of
PHÖNIX-TITAN, and MRS-TITAN COMFORT, among others. global reach
• Growing demand for the joint reconstruction implants, one of the company’s
principle product lines
Peter Brehm GmbH
• Product and process innovation • Intense competition with other market players of the joint reconstruction
• The new trade agreement between the European Union and Canada may market
provide new sales opportunities • Unfavorable currency fluctuations
• To participate in public private partnerships • Commodity price changes
• Expansion into remerging markets such as Asia Pacific and Middle East • Increasing trade restrictions
• Fluctuations in product demand due to unfavorable global economic
conditions

Smith & Nephew plc
5.17.1 Overview
Website www.smith-nephew.com
15 Adam Street
Contact Details London WC2N 6LA, U.K.
Tel: +44-0-7401-7646
Company Type Orthopedics Implant Manufacturer
Number of Employees 15,644 (as of December, 2016)
Stryker Corporation, Zimmer Biomet, Inc.,B.Braun Melsungen AG, Wright Medical Group N.V., Globus Medical Inc, and DePuy
Competitors
Synthes, among others
ArthroCare Corporation (U.S.), Neotherix Limited (U.K.), ArthroCare UK Limited (U.K.), Plus Orthopedics Hellas SA (Greece),
Subsidiaries
Bioventus LLC (U.S.), and Blue Sky Medical Group, Inc. (U.S.), among the others
Related Products & Accord Cable System, ANTHOLOGY Hip System, BIRMINGHAM HIP, OXINIUM, POLARSTEM, R3 Acetabular Cups, and
Services REDAPT, among others
Other Products & Services Advanced Wound Management, Advanced Wound Bioactives, and Advanced Wound Devices, among others
Source: Smith & Nephew plc Website, BIS Research Analysis

Smith & Nephew plc
Smith & Nephew plc. is a company which addresses the needs of Figure 427:
different markets such as knee implants, hip implants, sports medicine
joint repair, arthroscopic enabling technologies, trauma and
Advanced Wound
extremities, other surgical businesses, advanced wound care, Management
advanced wound bioactives, and advanced wound devices.

1. Knee Implants: The knee replacement surgery involves replacing Orthopedic
Reconstruction
the worn, damaged portion of a knee with an artificial joint.
2. Hip Implants: This segment offers products for reconstruction of the
hip joint. Robotics- assistance
3. Sports Medicine Joint Repair: This segment offers a broad array of Smith & Nephew plc
instruments, technologies, and implants required to perform
Sports Medicines
minimally invasive surgery of the joints of knee, hip, and shoulder.
4. Trauma and Extremities: This segment provides solutions to
stabilize severe fractures, correct bone deformities, treat arthritis, Trauma & Extremities
and heal soft tissue complications.
5. Other Surgical Business: Includes ear, nose, and throat and the
Ear, Nose and Throat
NAVIO robotic surgical business.

Smith & Nephew plc
1. Arthroscopic Enabling Technologies: Products in the franchise are often used in conjugation with the products from sports medicine joint
repair to facilitate access to joint spaces.
2. Advanced Wound Care: Consists of several groups of brands including exudate management, and infection management.
3. Advanced Wound Bioactives: Comprises novel, cost effective biopharmaceuticals that provide a unique approach to debridement,
dermal repair, and tissue regeneration.
4. Advanced Wound Devices: Comprises Negative Pressure Wound Therapy (NPWT), and surgical debridement businesses.

Smith & Nephew plc
ACCORD Cable
System
ANTHOLOGY Hip
System
BIRMINGHAM HIP
OXINIUM
Smith & Nephew plc Orthopedic

POLARSTEM
Reconstruction
R3 Acetabular System
REDAPT
SMF- Short Monolithic

Femoral Hip
VERILAST Technology
for Hips

Smith & Nephew plc
5.17.4 Financials
Figure 429: Smith & Nephew plc: Overall Figure 431: Smith & Nephew plc: Net Revenue
Financials (2014-2016) by Region (2014-2016)
4.7 1200
2306.0
2299.0
2217.0
2116.0
2104.0
Net Revenue
2012.0
1000
($Billion)
4.65 800 2500
Market Size
($Million)
600
2000
4.6 400
200 1500
301.0
299.0
266.0
4.55 0 1000
2014 2015 2016
500
Net Revenue 4.61 4.63 4.66
0
Net Income 714 559 1062 U.K. U.S. Other
Operating Income 749 628 801 2014 2015 2016
Figure 430: Smith & Nephew plc: Net Revenue by Business Segments (2014-2016)
932.0
883.0
873.0
805.0
755.0
719.0
654.0
631.0
631.0
604.0
597.0
596.0
587.0
548.0
522.0
506.0
1000
497.0
475.0
Market Size
344.0
342.0
322.0
800
($Million)
214.0
205.0
192.0
172.0
167.0
147.0
600
400
200
0
2014 2015 2016
Sports Medicine Joint Repair Arthroscopic Enabling Technologies Trauma & Extremities
Other Surgical Businesses Knee Implants Hip Implants
Advanced Wound Care Advanced Wound Bioactives Advanced Wound Devices

Smith & Nephew plc
 The financial year (FY) starts in January and ends in December. The company generated a net revenue of $4,682 million in the third
quarter of FY2017. Smith & Nephew plc generated a net revenue of $4.66 billion in the FY2016, which was $35 million higher than
FY2015. The growth was a result of the general increase in the sales of products in the established markets.
 The company operates in nine reportable segments, namely Sports Medicine Joint Repair, Arthroscopic Enabling Technologies, Trauma
& Extremities, Other Surgical Businesses, Knee Implants, Hip Implants, Advanced Wound Care, Advanced Wound Bioactives, and
Advanced Wound Devices. The significant contributors to the implants market are Sports Medicine Joint Repair, Arthroscopic Enabling
Technologies, Trauma & Extremities, Knee Implants, and Hip Implants segments. The knee implants segments dominates the other
segments in terms of sales, registering a net sale of $932 million in FY2016, reporting an increase of $49 million when compared with that
of FY2015. The rise in the revenue was attributed to the general increase in the sales of in the established markets. The knee implants
segment was followed by the advanced wound care segment in terms of revenue which registered a net sales of $719 million in FY2016.
 The company operates mainly in the U.K. and the U.S. The U.S. market dominates the other markets in terms of sales, registering a net
sales of $2.29 billion in FY2016, reporting a rise of $0.08 billion when compared with that of FY2015. The company generates a
significant 45% revenue from the other parts of the world, apart from the U.S., and the U.K., which shows the strength of the company’s
global marketing system. The rise in the revenue was attributed to the general increase in the sales of products in the established
markets, except china.

Smith & Nephew plc
 The company holds a strong market presence in the U.S., followed Figure 432: Global Presence
by Australia, Canada, Europe, Japan, and New Zealand. The
emerging markets include China, India, Russia, Middle East,
Africa, and Latin America. Switzerland China
Germany
 The company has operational manufacturing facilities both in the
The U.K.
established and emerging markets, including the U.S., Germany, Ireland
Switzerland, the U.K., China, Russia, Costa Rica, and Curacao, to
better serve the local markets by acknowledging their specific
Netherlands
requirements.
Sweden
Japan
2016).
The U.S. U.A.E
India
Mexico
Brazil
South Africa Australia

Smith & Nephew plc
Table 404:
REDAPT Revision Smith & Nephew Plc launched its first 3D printed
Smith & Nephew plc Orthopaedic March-16
Acetabular Hip implant
POLARSTEM cementless Smith & Nephew Plc launched its new cementless
Smith & Nephew plc Orthopaedic February-14
hip stem hip stem for total hip replacement
REDAPT Revision Smith & Nephew Plc launched its personalized hip
Smith & Nephew plc Orthopaedic November-12
Femoral System replacement solutions
POLARCUP Dual Mobility Smith & Nephew Plc launched its POLARCUP
Smith & Nephew plc Orthopaedic February-12
Hip System Dual Mobility Hip System for the U.S. markets
Table 405:
Mergers & Acquisitions
Smith & Nephew Plc. acquired distribution and manufacturing
Smith & Nephew plc DeOst LLC and DC LLC February-16 business of the Russian DeOst LLC and DC LLC companies to
expand its business through established network
Smith & Nephew Plc. acquired Turkish distribution rights of

Smith & Nephew plc Plato Grup July-13
orthopaedic reconstruction devices from Plato Grup
Smith & Nephew Plc. acquired Brazilian distribution rights of

Smith & Nephew plc Pró Cirurgia Especializada (PCE). April-13
orthopaedic reconstruction devices

Smith & Nephew plc
5.17.8 Smith & Nephew plc: SWOT Analysis
Figure 433:
Smith & Nephew plc SWOT Analysis
• Growing demand of joint reconstruction implants. The company’s • High operating expanses, reducing the profit margin of the operations
reconstruction revenue increased by 4%, with 6% growth in the knee
implants, and 1% growth in the sales of hip implants by the end of
November, 2017.
• Expansion of global reach aided by the acquisition of distribution rights from
the companies such as DeOst LLC and DC LLC, Plato Group, and Pro
Cirurgia Especializada (PCE), among others
Smith & Nephew plc
• Business expansion through joint ventures and acquisitions of local small • Regulations of regulatory bodies and local governments regarding the type
scale players and use of materials for implants
• Expansion of product portfolio through the development of new products in • Threat of replacement or substitution products with the growing popularity
different segments of the implants market • Unfavorable currency fluctuations
• Market expansion through increased manufacturing facilities in Europe, and • Reduced reimbursement levels and increasing pricing pressures
Asia Pacific.

StelKast
5.25.1 Overview
Website www.stelkast.com
200 Hidden Valley Road, McMurray, PA 15317, U.S.

Contact Details
Tel: 888-273-1583
Competitors
among others
Related Products & Acetabular Systems, Bipolar System, Unipolar System, Progeny Hip System, ProClass Hip System, and Provident Hip Stem,
Services among others
Other Products & Services Unicondylar Knee System, Proven Gen-Flex Cruciate Retaining Knee System, and EXp Knee, among others
Source: StelKast Website and BIS Research Analysis

StelKast
 StelKast is engaged in developing and manufacturing orthopedic Figure 479:

implants for knee and hip replacement procedures. The company
utilizes its EXp polyethylene technology for the development of its
products.

Hip
1. Hip: This product category offers various implants such as

acetabular systems, bipolar system, unipolar system, progeny hip StelKast Knee
system, proclass hip system, and provident hip stem, for total hip
replacement procedures.
Precision Surgical Instruments
2. Knee: The category offers knee replacement implants to address the
patients' needs, from minimally invasive Unicondylar to complete
Revision options.
3. Precision Surgical Instruments: This category offers various surgical

instruments for bone-related surgeries.

StelKast
EXp Blended Antioxidant Acetabular

Liners
Acetabular Systems
Bipolar System
Unipolar System
Hip
ProClass Hip Stem
Progeny Hip Stem
Protract Hip Stem
Provident Hip Stem

StelKast
 The company holds a strong market presence in the U.S., to meet Figure 481:
Global Presence
the market demand.
The
U.S.

StelKast
Table 414:
Product Launch
Company Product Name Product Type Date Description
StelKast received FDA 510(k) clearance of its

StelKast EXp Acetabular Liners Orthopaedic Apr-11
new EXp Acetabular Liners.

StelKast
5.25.6 StelKast: SWOT Analysis
Figure 482:
StelKast SWOT Analysis
• Core business in the knee and hip orthopedic implants market with new • Extensive dependency on the various distribution channels for the
concepts in modularity, and clinical techniques international market
• Over dependence on the U.S. market
StelKast
• Business expansion product development for upper extremities • Approvals by FDA and other regulatory bodies for the product launch

Stryker Corporation
5.18.1 Overview
Website www.stryker.com
2825 Airview Boulevard

Contact Details Kalamazoo, MI 49002, U.S.
Tel: 269-385-2600
Competitors Smith & Nephew PLC, Wright Medical Group N.V, Zimmer Biomet, Inc., B.Braun Melsungen AG, and DePuy Synthes,
among others
Subsidiaries Small Bone Innovations, Inc. (U.S.), Stryker Ireland Limited (Ireland), Stryker Trauma SA (Switzerland), Spinecore, Inc. (U.S.),
and Stryker Biotech LLC (U.S.), among others
Related Products & Services Accolade II, Anato, Anatomic Dual Mobility, Direct Superior Approach (Procedure), Mako Total Hip (System), Modular Dual
mobility, Secur-Fit Advanced, Triathlon, Trialthlon Tritanium, Trident, and X3, among others
Other Products & Services Orthopedic Power Tools, Orthobiologics, Bone Cement, Pressure Monitors, and Personal Protection Systems, among others
Source: Stryker Corporation Website and BIS Research Analysis

Stryker Corporation
Stryker Corporation is a company which addresses the needs of Figure 434:

different markets such as orthopedics, medSurg, and
neurotechnology and spine, through the following segments:
1. Orthopedics: Orthopedics products consist primarily of the
implants used in hip and knee joint replacements, and trauma
and extremity surgeries.
2. MedSurg: MedSurg products include surgical equipment and Medical and Surgical Equipment
surgical navigation systems, endoscopic and communications
systems, patient handling, emergency medical equipment and
intensive care disposable products, and other medical device
Stryker Corporation Orthopedics
products used in a variety of medical specialties.
3. Neurotechnology and Spine: These products include both
neurosurgical and neurovascular devices. Spinal implants
offerings include cervical, thoracolumbar and interbody
Neurotechnology
systems used in spine injuries, deformity, and degenerative
therapies.

Stryker Corporation
Upper Extremities
Joint Replacement Trauma & Extremities
1. Accolade II 1. AxSOS 3 Ti Proximal Humerus

2. Anato 2. Plating (System)
3. Anatomic Dual Mobility 3. ReUnion RFX
4. Direct Superior Approach 4. ReUnion RSA
(Procedure) 5. ReUnion TSA
5. Mako Total Hip (System) 6. T2 Humeral
6. Modular Dual mobility 7. T2 Proximal Humeral
7. Secur-Fit Advanced 8. VariAx 2 Clavicle
8. Trident
9. X3

Stryker Corporation
5.18.4 Financials
Figure 436: Stryker Corporation: Overall Financials (2014-2016)

11.5 2.5
Net Revenue
Net Income and Operating

11 2
($Billion)
10.5
1.5
Income ($Billion)
10
1
9.5
9 0.5
8.5 0
2014 2015 2016
Net Revenue 9.67 9.94 11.32
Net Income 0.51 1.43 1.64
Figure 437: Stryker Corporation: Net Revenue Figure 438: Stryker Corporation: Net Revenue
by Business Segments (2014-2016) by Region (2014-2016)
4.89
8.24
6
4.42
4.22
10
4.15
7.11
3.89
3.78
6.55
5
Market Size
Market Size
8
($Billion)
($Billion)
4
6
1.82
1.74
3.11
3.07
3
2.83
2
2 4
1 2
0 0
2014 2015 2016 U.S. International
Orthopaedics MedSurge Neurotechnology and Spine 2014 2015 2016

Stryker Corporation
5.18.4 Financials
Figure 439: Stryker Corporation: Net Revenue Figure 440: Stryker Corporation: Net Revenue
by Orthopedic Business Segment (2014-2016) by Neurotechnology and Spine Business
Segment (2014-2016)
1.49
1.6
1.39
1.4
1.4
1.36
1.25
1.29
1.29
1.28
1.4
1.26
1.23
1.08
1.2
1.00
1.2
1
1
0.75
0.74
0.74
Market Size
Market Size
($Billion)
($Billion)
0.8
0.8
0.6
0.6
0.4
0.28
0.4
0.26
0.23
0.2
0.2
0
0
2014 2015 2016
2014 2015 2016
Knees Hips Trauma and Extremities Others Neurotechnology Spine

Stryker Corporation
 The financial year of the company begins in January & ends in December. The company generated a net revenue of $8.97 billion in the third
quarter of the fiscal year 2017, registering a hike by 9.9% as compared to the third quarter revenue of 2016. The net revenue generated in the
FY2016 amounted to $11.32 billion, which increased by 13.9% when compared with that of FY2015. This growth was attributed to the
acquisitions and the international expansion of operations of certain key offerings. The company managed to earn a profit of $1.67 billion in the
fiscal year 2016, which was $208 million more than that of FY2015. The net profit margin continued to be 14.5% from the fiscal year 2015.
 The company mainly operates in three segments, namely Orthopaedics, MedSurg, and Neurotechnology & Spine. Both the Orthopaedics and
Neurotechnology & Spine segments contribute to the implants market. The orthopaedics segment registered a net sales of $4.42 billion in
FY2016 with an increase of 4.7% when compared with that of FY2015. The hike in the sales volume of the orthopaedic segment was primarily
due to the increased shipment of knees, instruments, endoscopy, neurotechnology, trauma, and extremities. The neurotechnology & spine
segment generated a net revenue of $2 billion in FY2016, reporting a growth of 9.9% when compared with that of FY2015. The hike in the sales
was attributed to the growing demand for neurotechnology product line.
 The company reports its region wise sales in two segments, namely the U.S. and International. It generates a substantial 70% revenue from the
U.S. market. The company generated $8.24 billion revenue in FY2016 from the U.S. market reporting 15.9% increase in the sales when
compared with that of FY2015.

Stryker Corporation
 The company holds a strong market presence in the U.S. Figure 441:
Global Presence
Approximately 73% of the net sales in the FY 2016 was
generated from the customers in the U.S. The international
Austria
locations include regions such as Canada, the U.K., Germany China
Switzerland
Switzerland, Germany, Italy, Austria, Brazil, Japan, Australia,
Canad
New Zealand, the U.A.E, and China, among others. a U.K.
 The local revenue generating operations have been combined Italy Poland
into 6 geographic areas, namely the U.S., Europe, Middle East

Africa, Asia-Pacific, and other foreign countries which include Japan
U.A.E
Canada, and the Latin America region. U.S.
 The company employs 33,000 people worldwide (as of December, Brazil
2016). South
Africa Australi
a

Stryker Corporation
Table 406: Mergers & Acquisitions

Stryker Corporation announced that it has completed the acquisition of

NOVADAQ Technologies, Inc., a leading provider of fluorescence
Stryker Corporation NOVADAQ Technologies, Inc. September-17
imaging technologies in cardiac, microsurgical, and reconstructive
procedures
Stanmore Implants Worldwide Stryker acquired Stanmore Implants company, an innovative implants
Stryker Corporation Apr-16
Limited company for £35.6 million
Stryker acquired the North American assets of Small Bone

Stryker Corporation Small Bone Innovations, Inc. Aug-14
Innovations, Inc.
Stryker acquired Pivot Medical, Inc. to expand its hip arthroscopy

Stryker Corporation Pivot Medical, Inc. Mar-14
business
Trauson Holdings Company Stryker acquired Trauson Holdings company to expand its global foot
Stryker Corporation Mar-13
Limited print
Stryker acquired Surpass Medical, Ltd., a company focused to

Stryker Corporation Surpass Medical, Ltd. Nov-12
develop next generation implants to treat brain aneurysms
Stryker acquired Memometal Technologies S.A., a medical device

Stryker Corporation Memometal Technologies S.A. Jul-11
company focused in the neurovascular market
Stryker acquired the whooping $900 million revenue generating

Stryker Corporation Boston Scientific Jan-11
Neurovascular segment from Boston Scientific
Stryker acquired a bio implantable porous polyethylene products

Stryker Corporation Porex Surgical Oct-10
manufacturer for facial implants named Porex Surgical

Stryker Corporation
Table 407:
Joint Ventures & Collaborations
Stryker announced its partnership agreement with the Indo

Indo UK Institute of Health
Stryker Corporation November-16 UK Institute of Health to serve as an official partner for the
(IUIH)
orthopaedic products sale in India
Table 408:
Approvals
Company Country Regulatory Body Date Description
Stryker received approval for the use of 3D

Stryker Corporation U.S. FDA March-16
printed Titanium implant.

Stryker Corporation
5.18.8 Stryker Corporation: SWOT Analysis
Figure 442:
Stryker Corporation SWOT Analysis
• Leading provider of Orthopedic implants and Joint replacement solutions. • Extensive dependence on the U.S. markets
The Mako product offering in total hip applications provides a • Ventured into an intensely competitive market in which the competition to
comprehensive solution in the robotic assisted reconstructive surgery develop and commercialize efficient products is very significant
• Growth through acquisitions, and international footprint expansion
• Constant and substantial profit margin (14.5% profit margin since FY2015)
• The company owns approximately 2,184 U.S. patents, and 3,454
international patents
Stryker Corporation
• Expansion of product portfolio through the development of new products in • Unfavorable currency fluctuations
different segments of the implants market • Threat of patent expiration and infringement
scale players and use of materials for implants
• Market expansion through increased operations in India or China to increase
the revenue

Surgival (GRUPO COSÍAS)
5.19.1 Overview
Website www.surgival.com
Parque Tecnológico, Leonardo Da Vinci, 12-14, 46980 Paterna (Valencia), Spain

Contact Details
Tel: +34 96 131 80 50
Competitors
among others
Subsidiaries Surgival National – Spain
Related Products &

Femoral Head, Biarticular Head, Endocephalic Femoral Head, And KAREY HA Stem, among others
Services
GENUTECH primary knee prosthesis system, Genutech CCK revision knee prosthesis system, and Genutech straight
revision stem, among others
Source: Surgival (GRUPO COSÍAS) Website and BIS Research Analysis

 Surgival is engaged in developing and manufacturing implants and Figure 443:

surgical instruments for Orthopaedics, and Traumatology. In addition,
the company consists of two companies specialized in the production,
marketing, and distribution of implants for traumatology, prosthesis
for orthopedic surgery, and surgical instrumentation. Knee
 The company is actively engaged in associations with FENIN

(Spanish federation of healthy technology companies), and Hip
technological research centres such as the IBV (Biomechanical
Institute of Valencia), the AIMME (Metal-Mechanic Institute), and
many others, for prototyping, product validation, and assessment. Surgival (GRUPO COSÍAS) Trauma
 The company addresses the needs of the orthopedic implants

industry through its different product categories, namely: Biomaterials & Cements
1. Knee: This product category offers products for total knee

replacement and knee revision procedures. Some of the products
Instruments
under this category are GENUTECH primary knee prosthesis
system, and Genutech CCK revision knee prosthesis system.

2. Hip: This product category offers different types of products such as Figure 444:
heads, stems, and cups, for total hip replacement, and hip revision
procedures. Some of the products under this category are Femoral
head, biarticular head, endocephalic femoral head, and KAREY HA Knee
stem.
3. Trauma: The category offers a wide range of screws, plates, nails,

Hip
wires, and staples for trauma patients. Some of the products under
this category are Buttress plate, narrow plate, narrow thin plate, and
narrow plate self-compression. Surgival (GRUPO COSÍAS) Trauma
4. Biomaterials & Cements: This category offers biomaterials and bone

cements which are used in orthopedic implant procedures.
Biomaterials & Cements
5. Instruments: The category manufactures complete instrument sets

for orthopedic implant procedures. Some of the products under this
Instruments
category are full set plate DB test (DHS-DC S), full set titanium
cannulated screws, and set standard screw large fragments.

Hips
Stems Heads Cups
1. Self-locking titanium
stem 1. Femoral head 1. Müller Antiluxante cup
2. Self-locking nitrogen 2. Biarticular head 2. Müller type standard
stainless steel stem 3. Endocephalic femoral cup
3. Self-locking titanium head 3. KHA cup
plasma spray stem 4. SHY cup
4. Self-locking
hydroxyapatite stem
5. KAREY HA Stem
6. KAREY HA Revision
Stem
7. KAREY C Stem
8. KAREY C Revision
Stem
9. HIC Cemented Stem
10. HIC Cementless Stem
11. Shine C Stem

Trauma
Plates
1. Narrow thin plate

2. Broad thin plate
3. Broad plate
4. Broad plate self-
compression

 The company holds strong market presence in Spain to meet the Figure 447:
Global Presence
market demand.
Spain

5.19.5 Surgival (GRUPO COSÍAS): SWOT Analysis
Figure 448:
Surgival (GRUPO COSÍAS) SWOT Analysis
• Associations with FENIN (Spanish federation of healthy technology • Over dependence on the European markets
companies) and technological research centres such as the IBV
(Biomechanical Institute of Valencia), the AIMME (Metal-Mechanic Institute)
• Development of personalized joint reconstruction implants in collaboration • Unfavorable currency fluctuations

with the surgeons • Threat of regulations of regulatory bodies and local governments regarding
• Business expansion through establishing manufacturing facilities in the U.S. the type and use of materials for implants
and Asia-Pacific markets

5.24.1 Overview
Website www.wright.com
Fraser House, 56 Kingston Road

Contact Details Staines-upon-Thames, Middlesex TW18 4NL, U.K.
Tel: +44 (0)845 833 4435
Net Revenue $527.38 Million(as of Q3, 2017)
Number of Employees 2394 (as of December 2016)
Competitors
Smith & Nephew PLC,, Stryker Corporation, B.Braun Melsungen AG, Zimmer Biomet, Inc., and DePuy Synthes, among others
BioMimetic Therapeutics USA, Inc (U.S.), INBONE Technologies, Inc (U.S.), OrthoHelix Surgical Designs, Inc (U.S.), and Biotech International
Subsidiaries
SAS (France), among others
AEQUALIS ASCEND FLEX, AEQUALIS RESURFACING SYSTEM, AEQUALIS REVERSED II,AFFINITI CORTILOC,BIO-RSA,PITON, and
SIMPLICITI, among others
DBM Putty with Small Cancellous Chips, Injectable DBM Composite, AUGMENT, and Absorbable Biologic Scaffolding Solutions, among
others
Source: Wright Medical Group N.V. Website and BIS Research Analysis
Wright Medical Group N.V. is a company addressing the needs of Figure 472:
different markets such as biologics, foot & ankle, and upper
extremities.
Biologics
1. Upper Extremities: This segment includes joint implants and
bone fixation devices for shoulder, elbow, wrist, and hand.
2. Lower Extremities: This segment includes joint implants and
bone fixation devices for foot and ankle. Foot & Ankle
3. Biologics: This segment includes products used to support the
treatment of damaged bone, tendons, and soft tissues. Wright Medical Group N.V.
4. Sports Medicine and Other: This segment includes products

Upper Extremities
used across several anatomic sites to repair tissue and bone
injuries.
Sports Medicine and Other

Upper Extremities
Shoulder
Shoulder Implant System Components
1. AEQUALIS ASCEND FLEX 1. AEQUALIS IM NAIL

2. AEQUALIS PERFORM 2. AEQUALIS REV II
REVERSED 3. APPROACH
3. AEQUALIS ADJUSTABLE 4. ARTHROPASS II
REVERSED 5. ARTHROTUNNELER
4. AEQUALIS FX TUNNELPRO SYSTEM
5. AEQUALIS PERFORM 6. BIOFIBER
6. AEQUALIS RESURFACING HEAD 7. BLUEPRINT
7. AEQUALIS REVERSED FX 8. FORCE FIBER
8. AEQUALIS REVERSED II 9. INSITE
9. AFFINITI CORTILOC 10. NICELOOP
10. BIO-RSA 11. PHANTOM FIBER
11. PITON
12. SIMPLICITI
5.24.4 Financials
Figure 474: Wright Medical Group N.V.: Overall Figure 475: Wright Medical Group N.V.: Net
Financials (2014-2016) Revenue by Business Segments (2014-2016)
Net Income/Loss and Operating

800 0
288.00
285.60
Income/Loss ($Million)
-100
Net Revenue
600
238.20
350
($Million)
195.60
-200
400 300
Market Size
($Million)
-300 250
200
93.40
-400 200
83.50
70.20
66.00
0 -500 150
26.60
23.10
13.20
2014 2015 2016 100
9.60
Net Revenue 298 405.3 690.3 50
Operating 0
-99.8 -188.7 -122.9 2014 2015 2016
Income/Loss
Net Income -259.6 -298.7 -432.3 Lower extremities Upper extremities Biologics Sports med & other
Figure 476: Wright Medical Group N.V.: Net Revenue by Region (2014-2016)
507.5
600
299.8
Market Size
500
($Million)
400
212
117.2
300
65.5
62.6
48.9
42.8
36.9
200
100
0
U.S. EMEA Other
2014 2015 2016
 The financial year (FY) of the company begins in January and ends in December. The company generated a net revenue of $527.38
million in the third quarter of the fiscal year 2017, registering a hike by 5% as compared to the first quarter revenue of 2016. The company
generated a net revenue of $690.3 million in FY2016, registering a rise by 12% when compared with that of FY2015. The rise in the net
sales was attributed to the growth in the demand for SIMPLICIT shoulder system, AUGMENT Bone Graft, and INFINITY Total Ankle
Replacement system. The company incurred a net loss of $432.3 million in FY2016 which was $133.6 million more than that of FY2015.
The company has been operating in loss since 2012.
 The company operates in four reportable segments, namely Lower extremities, Upper extremities, Biologics, and Sports med & other.
Until FY2015, the Lower extremities segment dominated the other segments in terms of net sales, but in FY2016 the Upper extremities
segment registered a robust growth in performance, dominating the Lower extremities segment. The upper extremities reconstruction
involves implants to replace and reconstruct the diseased joints and bones in hand, wrist, elbow, and shoulder. It is estimated that the
shoulder division constitutes approximately 60% of the upper extremities market. The upper extremities segment generated a net sales of
$288 million in FY2016, registering a rise of 244% when compared with that of FY2015. The company claims that the launch of new
products, and increased productivity of the sales force are the major reasons which contributed to the growth.
 The company reports its region wise sales in two bifurcations, namely the U.S., and EMEA. It generates a significant 74% of the total
revenue from the U.S. market. The company generated $507.5 million revenue in FY2016 from the U.S. market, registering 70% increase
in the sales when compared with that of FY2015. The company reported a significant debt of $780.4 million in the year 2016.

Global Presence
namely the U.S., the U.K., Ireland, Switzerland, Germany, Italy,
Brazil, Japan, Australia, and China, among others.
France
 The international sales and distribution system currently consists Germany China
Switzerland
of 15 direct sales offices, and approximately 90 distributors selling Canad The U.K.
a Ireland
the products in over 50 countries. In addition, the company has
subsidiaries with direct sales offices in the U.K., France, Netherland
s
Germany, Italy, Denmark, Netherlands, Canada, Japan, and Italy
Australia, among others.
Japan
 The company employs 2,394 people worldwide (as of December, 2016). The
U.S.
Brazil
Australi
a

Table 412:
Product Development

Aequalis Ascend
Wright Medical Launched its convertible shoulder
Wright Medical Group N.V Convertible Shoulder Orthopaedic Jun-11
implant system
Implant System
Table 413:

Wright Medical announced that it has acquired IMASCAP
SAS, a leader in the development of software-based
Wright Medical Group N.V IMASCAP SAS Dec-17
solutions, for preoperative planning of shoulder
replacement surgery
Wright Medical group and a subsidiary of Tornier N.V.

Wright Medical Group N.V Tornier N.V. October-15
merged together to develop high growth extremities
Wright Medical Group N.V. acquired OrthoPro, LLC, a high

Wright Medical Group N.V OrthoPro, LLC February-14
growth extremities company, for $32.5 million

5.24.8 Wright Medical Group N.V.: SWOT Analysis
Figure 478:
Wright Medical Group N.V. SWOT Analysis
• Highly diversified product portfolio catering to the needs of the orthopedic • Continued operations in losses due to high operational costs, thereby
implants market, provides approximately 180 extremities products increasing the internal pressure (until FY 2016, the accumulated deficit was
• Focused market expansion through new product launches and acquisitions $1,206 million)
aiding the growth of the implants market share. Acquisition of IMASCAP • Extensive dependence on the U.S. market
SAS in December, 2017 , a leader in the development of software-based • Ventured into intensely competitive markets
solutions, for preoperative planning of shoulder replacement surgery
• High R&D investment ( $50 million in FY2016, 7% of the net sales)
• Major trends in the upper extremities market include next-generation joint • Threat of patent expiration and infringement
arthroplasty systems, bone preserving solutions, virtual planning systems, • Failure or delayed approvals from the FDA or other regulatory bodies for
and revision of failed previous shoulder replacements in older patients. product launches
• More focus on accelerating growth in extremities and biologics business • Pressure on product pricing due to changes in healthcare loss and
reimbursement policies

5.20.1 Overview
Website www.zimmerbiomet.in
345 East Main Street

Contact Details Warsaw, Indiana, U.S.
Tel: (574) 267-6131
Smith & Nephew plc., Stryker Corporation, DePuy Synthes, Wright Medical Group N.V, and B.Braun Melsungen AG, among
Competitors
others
Biomet, Inc. (U.S.), Accelero Health Partners, LLC (U.S.), Implant Innovations Holdings, LLC (U.S.), and Zimmer Austria
Subsidiaries
GmbH (Austria), among others
Continuum Acetabular System, Original M.E. Müller Straight Stem, Zimmer M/L Taper with Kinectiv Technology, Zimmer
Related Products &
M/L Taper Hip Prosthesis, Bigliani/Flatow The Complete Shoulder Solution, and Zimmer Trabecular Metal Glenoid Fixation,
Services
among others
Other Products & Services Persona, Nexgen, Vanguard, Polaris, Taperloc, and Spinal Fusion Stimulator, among others
Source: Zimmer Biomet Holdings Website and BIS Research Analysis

Zimmer Biomet Holdings, Inc. is a company addressing the needs of Figure 449:
different implant markets for knees, hips, S.E.T, Spine and CMF, Dental,
and other. Orthopedics
1. Knees: Knee replacement surgeries include joint replacement
procedures, and revision procedures for the replacement, repair or
enhancement of an implant or component from a previous Sports Medicine
procedure.
2. Hips: Total hip replacement surgeries include joint replacement as
well as revision procedures. Spine and CMF
3. S.E.T: This product category includes surgical, sports medicine,
Zimmer Biomet Holdings,
biologics, foot and ankle, extremities and trauma products. Inc.
4. Spine and CMF: This product division designs, manufactures, and Biologics
distributes medical devices and surgical instruments to deliver
solutions for degenerative conditions, and deformities of the spine
and neck. Diagnostics
5. Dental: This division manufactures dental reconstructive implants.
6. Other: This product category includes bone cement, and office
based technology products. Dental

Orthopedics
Hips Shoulder
1. Trabecular Metal Reverse S

1. Zimmer M/L Taper Hip Prost houlder System
hesis 2. Comprehensive Shoulder
2. Taperloc Hip System 3. Signature Glenoid Shoulder
3. Arcos Modular Hip System System
4. Continuum Acetabular Syst 4. Zimmer PSI Shoulder for
em Trabecular Metal Reverse
5. G7 Acetabular System Glenoid

5.20.4 Financials
Figure 451:Zimmer Biomet Holdings, Inc Overall Financials (2014-2016)

9 1000
Net Income & Net Operating

8 900
Net Revenue
7 800
($Billion)
6 700
Income ($Million)
5 600
500
4 400
3 300
2 200
1 100
0 0
2014 2015 2016
Net Revenue 4.67 5.99 7.68
Net income 719.2 146.2 304.6
Operating income 939.4 153.2 399.6
Figure 452: Zimmer Biomet Holdings, Inc Net Figure 453: Zimmer-Biomet Holdings, Inc : Net
sales by product segment (2014-2016) sales by Region (2014-2016)
2751.9
4802.2
2276.8
6000.0
3662.4
1895.2
1867.9
Market Size
Market Size
1645.4
3000.0 ($Million)
($Million)
1533.0
5000.0
2594.2
1326.4
1214.6
2500.0
1730.4
4000.0
1417.8
863.2
2000.0
1269.5
1151.3
662.0
3000.0
427.9
404.4
917.6
1500.0
335.7
328.8
809.6
242.8
233.3
207.2
138.5
1000.0 2000.0
500.0 1000.0
0.0 0.0
2014 2015 2016 America EMEA Asia Pacific
Knees Hips S.E.T Dental Spine & CMF Other 2014 2015 2016

 The financial year of the company starts in January & ends in December. The company generated a net revenue of $5.74 billion in the third
quarter of the fiscal year 2016. In 2016, the net revenue generated amounted to $7,683.9 million, which was higher as compared to 2015. The
revenue grew by 28% as compared to 2015. The net income & operating income also increased as compared to 2015. The net income &
operating income for FY2016 amounted to $304.6 million & $399.6 million, respectively. The revenue increased mainly due to the addition of
Biomet sales, increased revenue from the Asia Pacific region, and 50 new product launches. Also, the completion of Biomet merger led to the
negation of any expenses related to the merger.
 The company mainly operates in six segments, namely knees, hips, S.E.T, spine and CMF, dental, and other. The knee segment generated
maximum revenue as compared to the other product segments. In FY2016, the knee segment contributed to 35.81% of the total net sales,
followed by the hip segment which accounted for 24.31%. The knee segment showed growth mainly due to the launch of products like Persona,
and increased demand of products. The growth in the hip segment was attributed to the launch of products like G7 acetabular system. The
S.E.T segment also reported growth due to acquisitions, better performance by brands, improved sales, and expansion of sales force.
 On the basis of geography, America emerged as the largest market, contributing $4,802.2 million in FY2016. In America, the U.S. contributes to
93% of the total net sales. A 31.1% increase in the sales was observed in America in 2016, as compared to 2015. The EMEA, and Asia pacific
reported 22 and 25.5% increase in the net sales, respectively, as compared to 2015. The knee & hip segments also showed significant
performance in the Asia Pacific region.

 The company holds a strong market presence in the Americas, Figure 454:
Global Presence
which comprises the U.S. and Canada. Approximately 93% of
the total net sales are generated from the U.S. market. The
Belgium
EMEA geographic segment is the second largest operating
Germany
segment, accounting for 57% of the net sales, and includes Switzerland
Canad
regions such as France, Germany, Italy, Spain, and the U.K. a The
U.K.
 The Asia-Pacific segment includes the key markets such as Poland
Italy
Japan, Australia, New Zealand, Korea, China, India, and France
Singapore, among others, accounting for 44% of the total Japan

Spain
regional sale. The
Portugal
India
U.S.
Brazil
2016).
South
Africa Australia
New
Zealand

Table 409:

Zimmer Biomet announced that it has acquired
RespondWell, an telerehabilitation technology designed to
Zimmer Biomet Holdings, Inc. RespondWell Oct-16
provide personalized, clinician-supervised post-surgical
physical therapy in the comfort of a patient's home
Zimmer Biomet announced that it has acquired LDR
Zimmer Biomet Holdings, Inc. LDR Holding Corporation Jun-16 corporation to enhance innovation, and growth of its spine
business
Zimmer acquired Cayenne Medical, Inc. , a Arizona based
Zimmer Biomet Holdings, Inc. Cayenne Medical, Inc. May-16 company focused on the development of reconstruction
solutions
Zimmer acquired Ortho Transmission, LLC with the aim to
Zimmer Biomet Holdings, Inc. Ortho Transmission, LLC Mar-16 develop technologies to serve the patients who have
undergone limb amputation
Zimmer acquired Normed Medizin-Technik GmbH
NORMED Medizin-Technik
Zimmer Biomet Holdings, Inc. Jun-13 company, a developer of innovative technologies for
GmbH
reconstructions therapies
Zimmer acquired Knee Creations, LLC company to

Zimmer Biomet Holdings, Inc. Knee Creations, LLC May-13
enhance its product portfolio

Table 410:
Joint Ventures & Collaborations
Zimmer Biomet ventured into an agreement with Lateral

Zimmer Biomet Holdings, Inc. Lateral Interbody System Oct-13
Interbody System availing the global distribution rights
Zimmer Biomet ventured into an agreement with

Zimmer Biomet Holdings, Inc. SpineCraft Jul-13
SpineCraft availing the global distribution rights
Table 411:
Approvals
Company Country Regulatory Body Date Description
Zimmer Biomet announced that it has received the U.S.

FDA clearance for the Sidus Stem-Free Shoulder
Zimmer Biomet Holdings, system as a total shoulder arthroplasty solution for
U.S. U.S. FDA Jan-18
Inc. patients with good bone stock that have either
osteoarthritis, post-traumatic arthrosis, and focal
avascular necrosis of the humeral head
Source: Zimmer Biomet Holdings Website and BIS Research

Analysis
5.20.8 Zimmer Biomet Holdings, Inc.: SWOT Analysis
Figure 455:
Zimmer Biomet holdings, Inc. SWOT Analysis
• Several successful hip replacement products such as Zimmer M/L Taper Hip • Extensive dependence on the U.S. market, approximately 93% of the net
Prosthesis, and G7 Acetabular System sales is generated by the U.S. region
• The company has made significant internal and external investments to • Sales in 2016 were negatively affected by various shipment delays, and
further broaden the product portfolio which includes the acquisition of the manufacturing forecasting constraints
companies such as LDR Corporation, Cayenne Medical, Inc., and CD • Ventured into intensely competitive market
Diagnostics, among others
• Growing demand in S.E.T division, primarily driven by growing emphasis on • Difficulties in employing and managing foreign operations
sales force • Wide range of local product preferences and product requirements
scale players and use of raw materials for implants
• Market expansion through increased operations in the emerging markets of • Unfavorable currency fluctuations
Europe, and Asia Pacific

12. REPORT SCOPE
& METHODOLOGY

711
Report Scope and Methodology
The report comprises a comprehensive study of the global joint reconstruction market (hip and shoulder), including a detailed
analysis in terms of geographical regions. The study also presents a detailed analysis of the push and pull forces of the market
and the estimation and forecast for the market size over the forecast period 2015-2025.
This comprehensive market share analysis of the companies would help the new entrants identify and device new key business
strategies to leverage on the extremely profitable global joint reconstruction market (hip and shoulder) and also to explore the
extensive product portfolio of the leading companies for strengthening their presence in the market.
The market overview segment provides a multidimensional view of the global market. The research provides comprehensive
analysis of product sales, manufacturers, and demand (by geographical regions). The research covers all the major geographical
segments of the global joint reconstruction market (hip and shoulder) and provides historical data, comprehensive analysis, and
statistically derived forecast for all the regions included in this study.

The scope of this report pertains to a detailed study of solutions associated with the global joint reconstruction market (hip and shoulder).
The market has been identified as and segmented into:
Figure 508: Snapshot of Market Segmentation
Product Type Region
Hip Joint Knee Joint Shoulder Joint North Latin Hip Joint Knee Joint Shoulder Joint
Europe Asia Pacific
Reconstruction Reconstruction Reconstruction America America Reconstruction Reconstruction Reconstruction
Procedure Procedure Procedure Hip Joint Knee Joint Shoulder Joint Hip Joint Knee Joint Shoulder Joint Hip Joint Knee Joint Shoulder Joint Procedure Procedure Procedure
Type Type Type Reconstruction Reconstruction Reconstruction Reconstruction Reconstruction Reconstruction Reconstruction Reconstruction Reconstruction Type Type Type
Fixation Fixation Procedure Procedure Procedure Procedure Procedure Procedure Procedure Procedure Procedure Fixation Fixation
Type Type Type Type Type Type Type Type Type Type Type Type Type
Bearing Bearing Fixation Fixation Fixation Fixation Fixation Fixation Bearing Bearing
Surfaces Type Type Type Type Type Type Type Surfaces Type
Bearing Bearing Bearing Bearing Bearing Bearing

Surfaces Type Surfaces Type Surfaces Type

Figure: Research Methodology
The market size of Global Joint Reconstruction Market (Hip

Scope Definition Research Design Market Study
and Shoulder) in terms of $million for the year 2016 and 2017
was estimated using a bottom-up approach. This approach
Qualitative Quantitative
involved estimation of market revenue for each product and
summing them up to arrive at the total global number. For
calculating the adoption rate of global joint reconstruction
Data Validation Data Analysis Data Collection
Report market (hip and shoulder) products, the company’s annual
Writing
Primary Interviews/ Top- Botto Primary Secondary reports, press releases, blogs, articles, and white papers were
Secondary Research down m-Up Data Data
referred and key opinion leaders with significant experience in
this market segment were contacted. While estimating the
The research methodology was an efficient combination of primary and market growth for each product over the forecast period from
secondary research. For secondary research, several articles, blogs, 2015 to 2025, factors such as manufacturer’s geographical
websites and documents related to the Global Joint Reconstruction presence, partnerships and collaborations, products and
Market (Hip and Shoulder) were reviewed. The product literature, press approval status, as well as patents and availability were
releases and annual reports of the key market players (public listed considered. For products, for which no real-time data was
companies) have been reviewed. As a part of primary research, in-depth available in public domain, personnel from the respective
interviews were conducted with a wide range of eminent industry companies were contacted in order to gain valuable
participants and the key opinion leaders that helped in understanding information pertaining to the product in different regions and
several facets of the market with respect to Global Joint Reconstruction their corresponding prices.
Market (Hip and Shoulder) software vendors as well as marketers,
software developers and end users.

1.3 Key Data Points From Secondary Sources
Figure 509: The Secondary Data Sources Used in this Study
PARAMETERS SOURCES
• Company Financials
MARKET SIZE • Associations
(Value )
(Segmentation breakups, split-ups, and percentage shares) • Magazines & Journals
• Press Releases
• Paid Databases
• Annual Reports
• Investors Presentations
REVENUE OF COMPANIES
• SEC Filings
• Public Databases
• Company Websites
QUALITATIVE INFORMATION
• Annual Reports
(Qualitative insights into various aspects of the market, key trends, and
emerging areas of innovation) • Press Releases, and
• BIS Data Repository
The stock analyst websites considered for this study include: Seeking Alpha, Yahoo Finance, Wiki Finance and the Wall Street Journal. The
company sources referred include: Annual Reports, Press releases, SEC Filings, Investor Presentations and Financial Disclosures. The
major government and regulatory sources included are National Joint Registries across the Europe, National Institute of Health (NIH ), World
Health Organization (WHO), National Centre for Biotechnology Information (NCBI) and European Medical Agency, among others. The public
and private databases referred are Medline, Pubmed, national Library of Medicine, Thin Database and CMS Datasets.

1.4 Data Triangulation
PRIMARY SOURCES SECONDARY SOURCES
INTERVIEWS WITH:
• Leading global joint • National Joint Registry
reconstruction market (hip and
SUPPLY SIDE
shoulder) vendors across the • National Institute of Health (NIH)

globe • Food Drug and Administration (FDA)
• World Health Organization (WHO)
SOURCES • American Medical Association (AMA)
• PubMed
• Arthroplasty Database
INTERVIEWS WITH: DATA • OECD
• Healthcare organizations TRIANGULATION
implementing Global Joint PRIMARY
Reconstruction Market (Hip SOURCE
DEMAND SIDE
and Shoulder) applications

SECONDARY
and tools SOURCE
• Purchase departments Annual Reports, SEC Filings, Investor
• Healthcare professionals Presentations, Websites and Press
performing hip and shoulder Releases of top players, News Articles,
joint reconstruction procedures Journals, and Paid Databases
Information Data Collected

Top-Down Approach (Segmental Analysis)
Global Joint Reconstruction Market

Figure 510: Top-down Approach
(Hip and Shoulder)
The Global Market Size is Validated Through Primary

Interviews (Supply Side Experts)
Global Joint Reconstruction Market Size
Secondary: Annual Reports, Presentations, Press Release,

Journals, Paid Databases, and BIS Research Repository
Percentage Split for the Market Primary: Supply Side Experts
Segments of Global Market
Primary: Supply Side Experts

Percentage Split by
Secondary: Company Websites, Press Releases, and News
Product Type
Articles
Geographical Split
by Region and Secondary: Annual Reports, Presentations, Press Release,
Countries Journals, Paid Databases, and BIS Research Repository

Bottom-Up Approach (Segmental Analysis)
Figure 511: Bottom-up Approach Global Market
Total Market Size ($Billion) =

Global Joint Revenue from market
Reconstruction
Market Value
Summation of Revenue of
Each Type of Product
Secondary: Annual Reports, Presentations, Press
Percentage Split of Market by Releases, Journals, Paid Databases, and BIS
Product and by Country Research Repository
Revenue Split into Type of Product and

Regions
Secondary: Annual Reports, Presentations, Press
Release, Journals, Paid Databases, and BIS
Research Repository
Revenue of Top Ten Players of Global Market

1.5 Estimation Parameters and Predictive Modelling
 Where no hard data was available, modelling was used in order to produce comprehensive data sets. A rigorous methodology was
adopted in which the available hard data was cross referenced with the following data types to produce estimates:
Demographic Data Macro Economic Indicators Industry Indicators
• Hospital readmission rate • GDP • Expenditure

• Rate of medical errors or adverse • Inflation Rate • Technology Stage
events • Healthcare Expenditure • Healthcare Infrastructure
• Healthcare Regulations • Sector Growth
• Economic Growth

1.6 Assumptions and Limitations for Market Estimation
Assumptions:
• Year 2017 has been considered as the base year, while the values for 2018 have been estimated and those for 2018 to 2025 have been
forecasted
• All the numbers are adjusted off to one digits after decimal. However, the real figures have been utilized for CAGR estimation; CAGR is
calculated from 2018 and 2025
• The market has been mapped based on geographical regions. Germany, Netherlands, Spain, Italy, Belgium, Norway, Portugal, Russia,
Czech Republic, China, Japan, Australia, South Korea, and Brazil are the that are considered.
• The base currency considered for this study is U.S. $. Monetary forms other than $ are changed over to $ for every single factual
computation considering the average transformation rate for the specific year. The average exchange rates have been taken from Oanda
website
Assumptions:
• Technologies currently implemented are expected to persist through the forecast period
• For the market forecast the constant currency value has been considered to reduce data redundancy

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Global Joint Reconstruction Market: Focus on Procedure

Number, Type, and Country - Analysis and Forecast, 2018-2025

Global Joint Reconstruction Market -

Copyright © 2018 BIS Research

Global Joint Reconstruction Market -

Global Joint Reconstruction Market -

Key questions answered in the report:

Global Joint Reconstruction Market -

1.1 Definition and Product Inclusions

1.2 Overview of Global Joint Reconstruction Market

1.3 Technology Trends and Innovations

1.4 Key Players Market Share Analysis

2.2 Impact Analysis

2.3 Market Drivers

2.4 Market Restraints

2.5 Market Opportunities

3.1 Key Developments and Strategies

3.2 Mergers and Acquisitions

3.3 Product Launch

3.4 Joint Ventures, Collaborations and Partnerships

Global Joint Reconstruction Market -

3.5 Product Approvals

4.2 Globalization and Market Expansion

4.3 Demographics and Patient Statistics - North America

4.4 Demographics and Patient Statistics - Europe

4.5 Demographics and Patient Statistics - Asia Pacific

4.6 Demographics and Patient Statistics - Latin America

5 Global Joint Reconstruction Market Overview

5.4 Global knee Arthroplasty Market (Procedure Type)

6 Global Joint Reconstruction Market (by Product Type)

6.1 Global Joint Reconstruction Market (by Product Type)

Global Joint Reconstruction Market -

6.2 Global Hip Joint Reconstruction Market Overview

6.6 Global Knee Joint Reconstruction Market Overview

6.10 Global Shoulder Joint Reconstruction Market Overview

7 North America Joint Reconstruction Market (Country Analysis)

7.4 North America Shoulder Arthroplasty Market (Procedure Type)

Global Joint Reconstruction Market -

7.8 U.S. Shoulder Arthroplasty Market (Procedure Type)

7.12 Canada Shoulder Arthroplasty Market (Procedure Type)

8 Europe Joint Reconstruction Market (Country Analysis)

8.4 Europe Shoulder Arthroplasty Market (Procedure Type)

8.8 United Kingdom Shoulder Arthroplasty Market (Procedure Type)

Global Joint Reconstruction Market -

8.12 Germany Shoulder Arthroplasty Market (Procedure Type)

8.16 Italy Shoulder Arthroplasty Market (Procedure Type)

8.20 Belgium Shoulder Arthroplasty Market (Procedure Type)

8.24 Portugal Shoulder Arthroplasty Market (Procedure Type)

Global Joint Reconstruction Market -

8.28 Norway Shoulder Arthroplasty Market (Procedure Type)

8.32 Czech Republic Shoulder Arthroplasty Market (Procedure Type)

8.36 Spain Shoulder Arthroplasty Market (Procedure Type)

8.40 Netherlands Shoulder Arthroplasty Market (Procedure Type)

8.44 Russia Shoulder Arthroplasty Market (Procedure Type)

Global Joint Reconstruction Market -

9 Asia Pacific Joint Reconstruction Market (Country Analysis)

9.4 Asia Pacific Shoulder Arthroplasty Market (Procedure Type)

9.8 China Shoulder Arthroplasty Market (Procedure Type)

9.12 Japan Shoulder Arthroplasty Market (Procedure Type)

9.16 Australia Shoulder Arthroplasty Market (Procedure Type)

Global Joint Reconstruction Market -

9.20 South Korea Shoulder Arthroplasty Market (Procedure Type)

10 Latin America Joint Reconstruction Market (Country Analysis)