Topic/Category: Ortho/Growth & Challenges

During the peak periods of crowding due to COVID-19, hospitals were forced to cancel any elective procedures. This created negative reverberations for specialists and the industries that support specialized care. Orthopedic operations, including procedures for spinal conditions, are often considered elective, so providers had no choice but to delay surgery until hospital capacity rebounded. Throughout 2021, facilities began opening operating suites, and recovery beds for elective procedures, so orthopedic and spinal operations have resumed in most facilities.

The market experienced a temporary surge as healthcare providers rushed to take care of a backlog of patients in 2021. According to tracking from LSI Global Procedure Volumes, markets are normalizing in 2022, but all segments of the orthopedic and spinal technologies market are on track for growth through 2026. LSI US Procedure Volume Tracker shows the US market volume mirroring global trends. Overall, LSI Market Reports Summary data estimates orthopedic and spine surgery comprise a $41.5 billion market.

The Impact of COVID on the Ortho/Spine Technologies Market

The market for orthopedic and spinal surgical supplies comprises four segments: reconstructive implants, trauma products, spinal products, and “other” devices. The pandemic had varying impacts on the different segments, as noted in LSI Medtech Pro Covid-19 Impact Tracker.

Reconstructive Implants

Reconstructive implants include hip, knee, and extremity implants used in joint replacement procedures. The bulk of joint replacements are considered elective, and as such, they were delayed in 2020 when hospitals deprioritized non-emergency treatments. Analysts found that total sales in this segment declined 18% in 2020, with the decline concentrated in knees, followed by extremities and hips.

LSI analysts predicted that two-thirds of postponed procedures will be made up in 2021 and 2022, with a continued trend of increased sales into 2023. The market is expected to return to normal in 2024. Overall, the real annual sales growth is projected to be 4.6% from 2019 through 2024. This is a substantial increase over normal gains in this segment, which tend to sit at just above 3.5%.

Traumatic Injury Treatment

Orthopedic and spinal surgery for traumatic injuries was considered necessary care during 2020. Regardless, the number of traumatic cases performed dropped 7% in 2020, likely due in part to a decrease in vehicular accidents due to reduced travel. The market is recovering as the economy returns to normal. This segment is projected to see a typical growth rate of around 3% from 2022 onward.

Spinal Surgery

Spine surgeries fared better than expected during the pandemic. Sales declined less than 13% in 2020 to just under $7.2 billion. New technologies simplified spine procedures, reduced OR time, and decreased the need for in-patient recovery. Procedures could happen at ambulatory surgical centers, thus blunting the effects of COVID-19 restrictions in hospitals. These technological gains are expected to have a lasting effect and drive future sales in this segment.

Other Products

Other products used in orthopedic and spine surgery include orthopedic bracing and soft goods, ortho-biologicals, bone cement and related products, prosthetics, craniomaxillofacial (CMF) implants, and other micro fixation devices, bone growth stimulators, and ancillary surgical supplies. The market for orthopedic bracing, soft goods, and prosthetics was less impacted by the pandemic. The markets for the remaining items dropped 11% in 2020. Sales began to rebound in 2021, and gains are expected to increase at an accelerated rate through 2022 before returning to normal growth.

Where Is the Advanced Ortho/Spine Market Heading?

Demand for reconstructive surgery is expected to continue to rise as the global population ages, driving demand for age-related orthopedic interventions.

As people age, they experience degenerative bone, disc, and joint conditions, many of which require orthopedic or spinal surges to manage. Moreover, the current generation of people over 50 are living active, economically productive lives. This is a global trend among middle-class “boomer” era adults in established and emerging economies. They will seek treatment for bone and spine issues to maintain their quality of life.

Health trends indicate that orthopedic complaints with a surgical solution will grow in prevalence. Back pain is expected to overtake arthritis as the leading musculoskeletal complaint, as LSI noted in Markets by Technology 2020. That is in addition to the continuing global obesity epidemic, which will drive demand for products targeting weight-bearing joints.

The advent of COVID-19 drove innovation that will likely increase the capacity to perform procedures. The loss of access to hospital facilities drove new partnerships between orthopedic surgeons and ambulatory surgical centers. These outpatient facilities are expected to be a venue of choice for orthopedic and spinal procedures in the future. The use of these facilities may reduce costs for patients and insurers, thus removing barriers to accessing orthopedic and spine treatment. The result may be a higher volume of procedures driving increased sales in the relevant medical device markets.

As medical providers rely more on surgical robotics technology in orthopedic and spine surgery, demand for these technologies will climb. Life Science Intelligence analysts project that by 2023, global sales for orthopedic robotics will rise 24% from real sales in 2018. The surgical robotics market represents an opportunity for companies that can fill the demand for those technologies.

As noted in the LSI Medtech Pro Global Devices & Diagnostics Markets Report the development and refinement of medical robotic systems are expected to progress rapidly through 2025. Combined global sales could increase from $5.35 billion in 2020 to $9.3 billion in 2025, for an 11.7% real annual growth rate.

In addition to robotic systems, new innovations utilized within the OR are poised to support the demand for orthopedic interventions. Some startups developing new products that seek to improve the outcomes of orthopedic procedures include:

• Accelus: Accelus is the result of the 2021 mergers of Fusion Robotics and Integrity Implants. The company is behind the REMI robotic navigation system for improved accuracy in spinal surgery.
• Augmedics: In 2019, Augmedics received FDA clearance for its ViZOR, an Augmented-Reality Surgical Visualization System. The virtual-reality-based system uses optics to project the meniscal imaging directly onto a surgeon’s retina for improved visualization. Over time, the system will develop machine learning to guide surgical decision-making.
• Osso VR: Osso VR focuses on using virtual reality technology for training in surgical techniques and technology.
• Orthotaxy: J&J acquired this company in 2018 with plans to market its surgical planning software and patient-specific surgical guides. The system enables surgeons to plan implant placement based on preoperative CT or MRI images.

Analysts predict additional startups will be entering the robotic surgery space throughout 2022 and beyond. LSI Startup Tracker follows developments in the Medtech markets for the most current updates.

Visit LSI’s Medtech Pro for more market data around this important market segment, supporting those who want to understand what’s driving the market growth, where it stands now, and where it’s going over the next five years — as well as other Medtech market segments.