In the U.S., growth will be influenced by the adoption of products that have only been available overseas, preference for motion-preserving technologies over fusion, and challenges with respect to reimbursement and coverage. In Europe, where aging populations will contribute to the demand for small joint implants, cost-containment efforts will influence prices and product purchases. AP and ROW countries feature differences in disease prevalence, demographics, and processes for reimbursement, regulatory approval, and product distribution.
This report examines the market for replacement, fixation, and fusion implants for the shoulder, elbow, wrist, fingers, ankle and foot, and provides a detailed analysis of the clinical and economic factors driving regional markets.
1. EXECUTIVE SUMMARY 1.1 Regional Analysis 1.1.1 The United States 1.1.2 Europe 1.1.3 AP & ROW 1.2 Product Analysis 1.2.1 Fingers and Hand 1.2.2 Wrist 1.2.3 Elbow 1.2.4 Shoulder 1.2.5 Ankle and Foot 1.2.6 Other Small Joint Implants Exhibit 1-1: Small Joint Implant Revenues by Region, 2007-2015 Exhibit 1-2: U.S. Small Joint Implant Market Forecast, 2007-2015 Exhibit 1-3: European Market Forecast for Small Joint Implants, 2007-2015 Exhibit 1-4: AP & ROW Small Joint Implant Market Forecast, 2007-2015 Exhibit 1-5: Global Small Joint Implant Revenues by Product, 2007-2015 2. OVERVIEW 2.1 U.S. 2.1.1 Disease Prevalence 2.1.2 Economic Factors 2.2 Europe 2.2.1 Disease Prevalence 2.2.2 Economic Factors 2.3 AP & ROW 2.3.1 Disease Prevalence 2.3.2 Economic Factors Exhibit 2-1: Regional Differences in Factors - Small Joint Implant Procedures Exhibit 2-2: Selected Studies of OA Prevalence in the U.S. Exhibit 2-3: Selected Studies of OA Prevalence and Incidence in Europe Exhibit 2-4: Selected Studies of OA Prevalence & Incidence in AP & ROW 3. JOINT REPLACEMENT PRODUCTS 3.1 Replacement Products for the Joints of the Fingers and Hand 3.1.1 Clinical Results 3.1.2 Companies and Products 3.2 Replacement Products for the Wrist and Distal Radioulnar Joint 3.2.1 Clinical Results 3.2.2 Companies and Products 3.3 Elbow Replacement Products 3.3.1 Clinical Results 3.3.2 Companies and Products 3.4 Shoulder Replacement Products 3.4.1 Clinical Results 3.4.2 Companies and Products 3.5 Replacement Products for the Ankle and Foot 3.5.1 Ankle Arthroplasty 3.5.1.1 Ankle Replacement Products 3.5.2 Foot Arthroplasty 3.5.3 Companies and Products Exhibit 3-1: Small Joint Implants by Type Exhibit 3-2: Features of Finger Joint Implants Exhibit 3-3: Clinical Studies of Replacement Products in the Fingers and Hand Exhibit 3-4: Selected Finger Joint Replacement Products in 2008 Exhibit 3-5: Advantages and Disadvantages of Wrist and DRUJ Implants Exhibit 3-6: Clinical Studies of Wrist and DRUJ Arthroplasty Exhibit 3-7: Selected Wrist and DRUJ Replacement Products in 2008 Exhibit 3-8: Features of Elbow Replacement Products Exhibit 3-9: Clinical Studies of Total Elbow Replacement Exhibit 3-10: Selected Elbow Replacement Products in 2008 Exhibit 3-11: Shoulder Replacement Products by Type Exhibit 3-12: Selected Studies of Shoulder Replacement Exhibit 3-13: Selected Shoulder Replacement Products in 2008 Exhibit 3-14: Selected Joint Replacement Devices for the Ankle and Foot in 2008 4. INTERNAL FIXATION FOR FUSION & SMALL JOINT STABILIZATION 4.1 Internal Fixation Products for Small Joints of the Upper Extremities 4.1.1 Fingers 4.1.2 Wrist & Hand 4.1.3 Elbow 4.1.4 Shoulder 4.2 Internal Fixation Products for Small Joints of the Lower Extremities 4.2.1 Products and Suppliers Exhibit 4-1: Internal Fixation Products by Type Exhibit 4-2: Shoulder Fracture by Type Exhibit 4-3: Selected Fixation Products 5. SMALL JOINT PROCEDURE VOLUMES AND MARKET FORECASTS 5.1 U.S. Procedure Volumes and Market Forecasts 5.1.1 Small Joint Replacements 5.1.1.1 Fingers and Hand 5.1.1.1.1 Procedure Volumes 5.1.1.1.2 Market Analysis 5.1.1.2 Wrist 5.1.1.2.1 Procedure Forecast 5.1.1.2.2 Market Analysis 5.1.1.3 Elbow 5.1.1.3.1 Procedure Forecast 5.1.1.3.2 Market Analysis 5.1.1.4 Shoulder 5.1.1.4.1 Procedure Forecast 5.1.1.4.2 Market Analysis 5.1.1.5 Ankle 5.1.1.5.1 Procedure Forecast 5.1.1.5.2 Market Analysis 5.1.1.6 Other Joints in the Foot 5.1.1.6.1 Procedure Forecast 5.1.1.6.2 Market Analysis 5.1.2 Internal Fixation for Arthrodesis and Small Joint Repair 5.1.2.1 Procedure Forecast 5.1.2.2 Market Analysis 5.1.3 Company Analysis 5.2 International Regions - Procedure Volumes and Market Forecasts 5.2.1 Europe 5.2.1.1 Fingers and Hand 5.2.1.1.1 Procedure Forecast 5.2.1.1.2 Market Analysis 5.2.1.2 Wrist 5.2.1.2.1 Procedure Forecast 5.2.1.2.2 Market Analysis 5.2.1.3 Elbow 5.2.1.3.1 Procedure Forecast 5.2.1.3.2 Market Analysis 5.2.1.4 Shoulder 5.2.1.4.1 Procedure Forecast 5.2.1.4.2 Market Analysis 5.2.1.5 Ankle 5.2.1.5.1 Procedure Forecast 5.2.1.5.2 Market Analysis 5.2.1.6 Other Joints in the Foot 5.2.1.6.1 Procedure Forecast 5.2.1.6.2 Market Analysis 5.2.1.7 Internal Fixation for Arthrodesis and Small Joint Repair 5.2.1.7.1 Procedure Forecast 5.2.1.7.2 Market Analysis 5.2.2 AP & ROW 5.2.2.1 Finger and Hand 5.2.2.1.1 Procedure Forecast 5.2.2.1.2 Market Analysis 5.2.2.2 Wrist 5.2.2.3 Elbow 5.2.2.3.1 Procedure Forecast 5.2.2.3.2 Market Analysis 5.2.2.4 Shoulder 5.2.2.4.1 Procedure Forecast 5.2.2.4.2 Market Forecast 5.2.2.5 Ankle 5.2.2.6 Other Joints in the Foot 5.2.2.6.1 Procedure Forecast 5.2.2.6.2 Market Analysis 5.2.2.7 Internal Fixation for Arthrodesis and Small Joint Repair 5.2.2.7.1 Procedure Forecast 5.2.2.7.2 Market Analysis 5.2.2.8 Company Analysis Exhibit 5-1: Small Joint Implant Revenues by Region, 2007-2015 Exhibit 5-2: Small Joint Implant Revenues by Product Segment, 2007-2015 Exhibit 5-3: U.S. Small Joint Implant Procedure Forecast, 2007-2015 Exhibit 5-4: U.S. Market Forecast for Small Joint Implants, 2007-2015 Exhibit 5-5: Finger Joint Replacements, U.S. Procedure Forecast, 2007-2015 Exhibit 5-6: Finger Arthroplasties by Joint, U.S. Procedure Forecast, 2007-2015 Exhibit 5-7: Finger Joint Replacements, U.S. Market Forecast, 2007-2015 Exhibit 5-8: MCP Joint Replacement Devices, U.S. Market Forecast, 2007-2015 Exhibit 5-9: PIP Joint Replacement Devices, U.S. Market Forecast, 2007-2015 Exhibit 5-10: CMC & Other Joint Replacements, U.S. Market Forecast,2007-2015 Exhibit 5-11: Finger Joints by Material, U.S. Market Forecast, 2007-2015 Exhibit 5-12: Wrist Replacements, U.S. Procedure Forecast, 2007-2015 Exhibit 5-13: Wrist Replacements, U.S. Market Forecast, 2007-2015 Exhibit 5-14: Elbow Replacements, U.S. Procedure Forecast, 2007-2015 Exhibit 5-15: U.S. Market Forecast for Elbow Replacement Products, 2007-2015 Exhibit 5-16: U.S. Market Forecast, Total Elbows by Type, 2007-2015 Exhibit 5-17: U.S. Market Forecast for Partial Elbow Replacements, 2007-2015 Exhibit 5-18: U.S. Procedure Forecast for Shoulder Replacement, 2007-2015 Exhibit 5-19: U.S. Procedure Forecast, Total Shoulder Replacement, 2007-2015 Exhibit 5-20: U.S. Procedure Forecast, Partial Shoulder Replacement, 2007-2015 Exhibit 5-21: U.S. Market Forecast for Shoulder Replacement, 2007-2015 Exhibit 5-22: U.S. Market Forecast, Total Shoulder Replacements, 2007-2015 Exhibit 5-23: U.S. Market Forecast, Partial Shoulder Replacements, 2007-2015 Exhibit 5-24: U.S. Procedure Forecast for Total Ankle Replacements, 2007-2015 Exhibit 5-25: U.S. Market Forecast, Total Ankle Replacements, 2007-2015 Exhibit 5-26: U.S. Procedure Forecast, Joint Replacements, Toes&Foot,2007-2015 Exhibit 5-27: U.S. Market Forecast, Joint Replacements,Toes & Foot, 2007-2015 Exhibit 5-28: U.S. Market Forecast, Toe & Foot by Type, 2007-2015 Exhibit 5-29: Wrist Fusions, U.S. Procedure Forecast, 2007-2015 Exhibit 5-30: Fusions/Int. Fixation, Fingers & Hand, U.S. Procedures, 2007-2015 Exhibit 5-31: Fusions/Internal Fixation for the Elbow, U.S. Procedures,2007-2015 Exhibit 5-32: Internal Fixation, Proximal Humerus, U.S. Procedures, 2007-2015 Exhibit 5-33: Internal Fixation, Ankle & Foot, U.S. Procedure Forecast,2007-2015 Exhibit 5-34: U.S. Mkt Forecast, Int. Fixation, Arthrodesis & Repair, 2007-2015 Exhibit 5-35: Supplier Shares in 2008 Exhibit 5-36: Small Joint Implants, European Procedure Forecast, 2007-2015 Exhibit 5-37: Small Joint Implants, European Market Forecast, 2007-2015 Exhibit 5-38: Finger Joint Replacements, European Procedures, 2007-2015 Exhibit 5-39: Finger Arthroplasties by Joint, European Procedures, 2007-2015 Exhibit 5-40: Finger Joint Replacements, European Market Forecast, 2007-2015 Exhibit 5-41: MCP Replacement Devices, European Market Forecast, 2007-2015 Exhibit 5-42: PIP Replacement Devices, European Market Forecast, 2007-2015 Exhibit 5-43: CMC and Other, European Market Forecast, 2007-2015 Exhibit 5-44: Finger Joints by Material, European Market Forecast, 2007-2015 Exhibit 5-45: Wrist Replacements, European Procedure Forecast, 2007-2015 Exhibit 5-46: Wrist Replacements, European Market Forecast, 2007-2015 Exhibit 5-47: Elbow Replacements, European Procedure Forecast, 2007-2015 Exhibit 5-48: European Market Forecast, Elbow Replacements, 2007-2015 Exhibit 5-49: European Market Forecast, Total Elbows by Type, 2007-2015 Exhibit 5-50: European Procedure Forecast for Shoulder Replacement, 2007-2015 5-73 Exhibit 5-51: European Procedure Forecast, Total Shoulders, 2007-2015 Exhibit 5-52: European Procedure Forecast, Partial Shoulders, 2007-2015 Exhibit 5-53: European Market Forecast for Shoulder Replacement, 2007-2015 Exhibit 5-54: European Market Forecast, Total Shoulders, 2007-2015 Exhibit 5-55: European Market Forecast, Partial Shoulders, 2007-2015 Exhibit 5-56: European Procedure Forecast, Total Ankles, 2007-2015 Exhibit 5-57: European Market Forecast, Total Ankles, 2007-2015 Exhibit 5-58: European Procedure Forecast, Toes and Foot, 2007-2015 Exhibit 5-59: European Market Forecast, Toes and Foot, 2007-2015 Exhibit 5-60: European Market Forecast, Toes and Foot by Type, 2007-2015 Exhibit 5-61: Wrist Fusions, European Procedure Forecast, 2007-2015 Exhibit 5-62: Fusions/Int. Fixation,Fingers&Hand,Europe Procedures,2007-2015 Exhibit 5-63: Fusions/Internal Fixation, Elbow, European Procedures, 2007-2015 Exhibit 5-64: Int. Fixation, Proximal Humerus, European Procedures, 2007-2015 Exhibit 5-65: Internal Fixation, Ankle & Foot, European Procedures, 2007-2015 Exhibit 5-66: Europe Mkt Forecast, Int. Fixation, Arthrodesis&Repair,2007-2015 Exhibit 5-67: AP & ROW Small Joint Implants, Procedure Forecast, 2007-2015 Exhibit 5-68: AP & ROW Small Joint Implants, Market Forecast, 2007-2015 Exhibit 5-69: Finger Joint Replacements, AP & ROW Procedures, 2007-2015 Exhibit 5-70: Finger Arthroplasties by Joint, AP & ROW Procedures, 2007-2015 Exhibit 5-71: Finger Joint Replacements, AP&ROW Market Forecast, 2007-2015 Exhibit 5-72: MCP Replacement Devices,AP&ROW Market Forecast,2007-2015 Exhibit 5-73: PIP Replacement Devices, AP&ROW Market Forecast, 2007-2015 Exhibit 5-74: CMC and Other Devices, AP&ROW Market Forecast, 2007-2015 Exhibit 5-75: Finger Joints by Material, AP & ROW Market Forecast, 2007-2015 Exhibit 5-76: Wrist Replacements, AP & ROW Procedure Forecast, 2007-2015 Exhibit 5-77: Wrist Replacements, AP & ROW Market Forecast, 2007-2015 Exhibit 5-78: Elbow Replacements, AP & ROW Procedure Forecast, 2007-2015 Exhibit 5-79: AP & ROW Market Forecast, Elbow Replacements, 2007-2015 Exhibit 5-80: AP & ROW Market Forecast, Total Elbows by Type, 2007-2015 Exhibit 5-81: AP & ROW Procedures, Shoulder Replacements, 2007-2015 Exhibit 5-82: AP & ROW Procedures, Total Shoulder Replacements, 2007-2015 Exhibit 5-83: AP & ROW Procedure Forecast,for Partial Shoulders, 2007-2015 Exhibit 5-84: AP & ROW Market Forecast, Shoulder Replacements, 2007-2015 Exhibit 5-85: AP & ROW Market Forecast, Total Shoulders, 2007-2015 Exhibit 5-86: AP & ROW Market Forecast, Partial Shoulders, 2007-2015 Exhibit 5-87: AP & ROW Procedure & Market Forecast,Total Ankles,2007-2015 Exhibit 5-88: AP & ROW Procedure Forecast, Joints of Toes & Foot, 2007-2015 Exhibit 5-89: AP & ROW Market Forecast, Joints of Toes & Foot, 2007-2015 Exhibit 5-90: AP & ROW Market Forecast, Toe&Foot Joints by Type, 2007-2015 Exhibit 5-91: Wrist Fusions, AP & ROW Procedure Forecast, 2007-2015 Exhibit 5-92: Fusions/Internal Fixation Procedures, Fingers & Hand, 2007-2015 Exhibit 5-93: Fusions/Int. Fixation, Elbow, AP & ROW Procedures, 2007-2015 Exhibit 5-94: Int. Fixation,Proximal Humerus,AP&ROW Procedures,2007-2015 Exhibit 5-95: Int. Fixation, Ankle&Foot, AP & ROW Procedures, 2007-2015 Exhibit 5-96: Int. Fixation, AP & ROW Market Forecast, 2007-2015 Exhibit 5-97: Supplier Shares in Europe and AP & ROW, 2008 6. COMPANY PROFILES Exhibit 6-1: Selected Suppliers of Small Joint Implants in 2008