In 2006, U.S. sales of orthopedic implant, reconstruction, and trauma products totaled approximately $12.2 billion. Over the forecast period covered by this report, sales of these products are expected to increase at a compound annual rate of 6.9%, reaching more than $18.1 billion in the year 2012.

This new report from Medtech Insight includes analyses of products, technologies, current and forecast markets, competitors, and opportunities in the U.S. orthopedic implant, reconstruction, and trauma products market. These products are used to treat a variety of congenital, degenerative, and traumatic disorders of the skeletal system and are used in procedures such as bone fracture repair, spinal fusion, and total joint replacement (including knee, shoulder, small joint, and hip arthroplasty).

Approximately 56 million people in the U.S. fall prey to musculoskeletal injuries annually at a cost of approximately $215 billion. According to the Centers for Disease Control and Prevention, approximately 6 million fractures occur in the U.S. each year, and an estimated 1.5 million people suffer a fracture caused by bone disease.
Many experts predict a future epidemic of hip fractures due to the growing number of elderly in the U.S. and the prevalence of osteoporosis.

Orthopedic products covered in this report include implants that are used in hip, knee, shoulder, and small joint arthroplasty procedures; internal and external fixation devices for fracture management; osteoconductive and osteoinductive materials including allografts, synthetic bone substitutes, and bone morphogenetic protein products; as well as bone growth stimulation and arthroscopy products.

TABLE OF CONTENTS

EXECUTIVE SUMMARY

i.       Clinical Overview

ii.       Joint Replacement Products Market

iii.      Fracture Fixation Products Market

iv.      Allografts, Bone Morphogenetic Proteins, and Synthetic Bone Substitutes Products Market

v.      Bone Growth Stimulation Products Market

vi.      Arthroscopy Products Market

vii.     Combined Market Forecast

viii.    Methodology

Exhibit ES-1:    Joint Replacement Products, Combined Market Forecast, 2006-2012

Exhibit ES-2:    Fracture Fixation Products, Market Forecast, 2006-2012

Exhibit ES-3:    Allograft, Bone Morphogenetic Protein, and Synthetic Bone Substitute Products, Combined Market Forecast, 2006-2012

Exhibit ES-4:    Bone Growth Stimulation Products for Fracture Repair and Spinal Fusion, Combined Market Forecast, 2006-2012

Exhibit ES-5:    Arthroscopy Products, Combined Market Forecast, 2006-2012

Exhibit ES-6:    Orthopedic Implant, Reconstruction, and Trauma Products, Combined Market Forecast, 2006-2012

1. CLINICAL OVERVIEW OF BONES AND JOINTS

1.1 Bone Structure and Function

1.1.1 Cellular Framework

1.1.1.1 Osteoblasts

1.1.1.2 Osteogenesis

1.1.1.3 Osteocytes

1.1.1.4 Osteoclasts

1.1.2 Collagen

1.1.3 Bone Marrow

1.2 Ligaments and Tendons

1.3 Joint Structure and Function

1.3.1 Knee

1.3.2 Hip

1.3.3 Shoulder

1.3.4 Spine

Exhibit 1-1:      Anatomy of Bone

Exhibit 1-2:      Structure of Bone

Exhibit 1-3:      Structure of Hydroxyapatite

Exhibit 1-4:      Structure of Collagen

Exhibit 1-5:      Anatomy of the Knee

Exhibit 1-6:      Anatomy of the Hip

Exhibit 1-7:      Anatomy of the Shoulder:  The Rotator Cuff

Exhibit 1-8:      Anatomy of the Shoulder:  The Glenoid Cavity

Exhibit 1-9:      Anatomy of the Spine

2. JOINT REPLACEMENT PRODUCTS MARKET

2.1 Hip Implants

2.1.1 Implant Procedure Types

2.1.1.1 Hip Arthroscopy

2.1.1.2 Hip Arthroplasty

2.1.1.2.1 Primary Hip Arthroplasty

2.1.1.2.2 Revision Hip Arthroplasty

2.1.1.2.3 Minimally Invasive Hip Arthroplasty

2.1.1.2.4 Hip Arthroplasty Navigation Systems

2.1.2 Hip Implant Designs and Materials

2.1.2.1 Modular versus Nonmodular

2.1.2.2 Cemented versus Cementless

2.1.2.3 Bearing Surfaces

2.1.2.3.1 Metal-on-Polyethylene

2.1.2.3.2 Ceramic-on-Ceramic

2.1.2.3.3 Metal-on-Metal

2.1.2.3.4 Bipolar Implants

2.2.2.3.5 Gender-Specific Hip Implants

2.1.3 Products

2.1.4 Market Analysis

2.1.4.1 Influence of Medicare and Third-Party Payers

2.1.4.2 Reimbursement and Pricing Trends

2.1.4.3 Gainsharing

2.1.4.4 Market Forecast

2.1.5 Competitive Analysis

2.2 Knee Implants

2.2.1 Treatment Options

2.2.1.1 Knee Arthroplasty

2.2.1.2 Minimally Invasive Procedures

2.2.2 Knee Implant Designs and Materials

2.2.2.1 Fixed Bearing

2.2.2.2 Mobile Bearing

2.2.2.3 Medial Pivot

2.2.2.4 Partial Knee

2.2.2.5 Gender-Specific Knee Implants

2.2.3 Products

2.2.4 Market Analysis

2.2.5 Competitive Analysis

2.3 Shoulder Implants

2.3.1 Products

2.3.2 Market Analysis

2.3.3 Competitive Analysis

2.4 Small Joint Implants

2.4.1 Products

2.4.2 Market Analysis

2.4.3 Competitive Analysis

2.5 Combined Joint Replacement Products Market, Competitive Analysis

Exhibit 2-1:      Total Joint Arthroplasty, Procedure Volumes Forecast, 2006-2012

Exhibit 2-2:      Joint Replacement Products, Combined Market Forecast, 2006-2012

Exhibit 2-3:      Normal Hip and Arthritic Hip

Exhibit 2-4:      Steps Involved in a Total Hip Arthroplasty Procedure

Exhibit 2-5:      Hip Implants, Standard versus Modular Components

Exhibit 2-6:      Hip Implants, Cemented versus Cementless

Exhibit 2-7:      Hip Implant Head/Acetabular Component Combinations and Volumetric Wear Rates

Exhibit 2-8:      Differences in Femoral Head Geometry in Men and Women

Exhibit 2-9:      Selected Hip Implant Products, Primary Stems

Exhibit 2-10:    2007, Selected Hip Implant Products, Primary Stems

Exhibit 2-11:    Selected Hip Implant Products, Primary Acetabular Components

Exhibit 2-12:    2007, Selected Hip Implant Products, Primary Acetabular Components

Exhibit 2-13:    Selected Hip Implant Products, Revision Stems

Exhibit 2-14:    2007, Selected Hip Implant Products, Revision Stems

Exhibit 2-15:    Selected Hip Implant Products, Revision Acetabular Components

Exhibit 2-16:    2007, Selected Hip Implant Products, Revision Acetabular Components

Exhibit 2-17:    Selected Hip Implant Products, Femoral Heads

Exhibit 2-18:    2007, Selected Hip Implant Products, Femoral Heads

Exhibit 2-19:    2004, Reimbursement for Total Joint Arthroplasty Procedures, by Patient Age Group

Exhibit 2-20:    2004, Reimbursement for Total Joint Arthroplasty Procedures, by Provider Type

Exhibit 2-21:    Gainsharing Example—Hospital, Physician, and Device Company Revenues, Medicare Diagnosis Related Group 209

Exhibit 2-22:    Trends in Physician Reimbursement and Device Company Sales Commissions for Hip Implants, 1992-2003

Exhibit 2-23:    Primary Hip Implants, Market Forecast, 2006-2012

Exhibit 2-24:    Total Hip Arthroplasty Procedures, Historical and Projected, 1995-2012

Exhibit 2-25:    Revision Hip Implants, Market Forecast, 2006-2012

Exhibit 2-26:    2006, Hip Implants Market, Share by Supplier

Exhibit 2-27:    Basic Knee Function

Exhibit 2-28:    Knee Implants

Exhibit 2-29:    Quadriceps-Sparing Minimally Invasive Knee Procedure

Exhibit 2-30:    Gender-Based Differences in Knee Implant Designs

Exhibit 2-31:    Selected Knee Implants

Exhibit 2-32:    2007, Selected Knee Implant Products

Exhibit 2-33:    Primary Knee Implants, Market Forecast, 2006-2012

Exhibit 2-34:    Revision Knee Arthroplasty Implants, Market Forecast, 2006-2012

Exhibit 2-35:    2006, Knee Implants Market, Share by Supplier

Exhibit 2-36:    Shoulder Anatomy, Shoulder Replacement Device

Exhibit 2-37:    2007, Selected Shoulder Implant Products

Exhibit 2-38:    Shoulder Implants, Market Forecast, 2006-2012

Exhibit 2-39:    2006, Shoulder Implants Market, Share by Supplier

Exhibit 2-40:    Selected Small Joint Implants

Exhibit 2-41:    2007, Selected Small Joint Implant Products

Exhibit 2-42:    Small Joint Implants, Market Forecast, 2006-2012

Exhibit 2-43:    2006, Small Joint Implants Market, Share by Supplier

Exhibit 2-44:    2006, Joint Replacement Products Market, Share by Supplier

3. FRACTURE FIXATION PRODUCTS MARKET

3.1 Fracture Etiology

3.2 Long Bone Fracture Fixation

3.2.1 Humerus

3.2.2 Radius and Ulna

3.2.3 Femur

3.2.4 Tibia/Fibula

3.3 Fracture Break Patterns

3.4 Growth Plate Fractures

3.5 Fracture Healing Mechanisms

3.6 Fracture Repair Procedures

3.6.1 Dynamic Fixation

3.6.2 Static Fixation

3.7 External Fixation

3.7.1 Device Types

3.7.1.1 Soft Goods

3.7.1.2 External Frames

3.7.2 Products

3.7.3 Market Analysis

3.8 Internal Fixation

3.8.1 Device Types

3.8.1.1 Plates and Screws

3.8.1.1.1 Products

3.8.1.1.2 Market Analysis

3.8.1.2 Intramedullary Nails/Rods

3.8.1.2.1 Products

3.8.1.2.2 Market Analysis

3.8.1.3 Hip Screws

3.8.1.3.1 Products

3.8.1.3.2 Market Analysis

3.8.1.4 Miscellaneous Long Bone Internal Fixation Devices

3.9 Small Bone Fixation

3.9.1 Products

3.9.2 Market Analysis

3.10 Fracture Fixation Products, Combined Market Forecast

3.11 Fracture Fixation Products Market, Competitive Analysis

Exhibit 3-1:      2006, Incidence of Bone Fractures

Exhibit 3-2:      Classifications of Fractures

Exhibit 3-3:      Long Bone Fractures

Exhibit 3-4:      Fracture Healing Process

Exhibit 3-5:      External Fixation Devices

Exhibit 3-6:      2007, Selected External Fixation Products

Exhibit 3-7:      External Fixation Products, Market Forecast, 2006-2012

Exhibit 3-8:      Large Bone Fracture Treatment Method of Open Reduction and Internal Fixation (Plates and Screws)

Exhibit 3-9:      Compression Plating Procedure

Exhibit 3-10:    Characteristics of Cancellous and Cortical Bone Screws

Exhibit 3-11:    2007, Selected Open Reduction and Internal Fixation Plating Products (Plates and Screws)

Exhibit 3-12:    Plate Fixation of a Distal Radius Fracture

Exhibit 3-13:    Large Bone Open Reduction and Internal Fixation Products (Plates and Screws), Market Forecast, 2006-2012

Exhibit 3-14:    Dynamic versus Locking Fixation of Intramedullary Nails

Exhibit 3-15:    Radiographic Image of Statically Locked Intramedullary Nails

Exhibit 3-16:    2007, Selected Intramedullary Nail Products

Exhibit 3-17:    Intramedullary Nail Products, Market Forecast, 2006-2012

Exhibit 3-18:    Dynamic and Cannulated Hip Screw Mechanisms

Exhibit 3-19:    2007, Selected Hip Screw Products

Exhibit 3-20:    Hip Screw Products, Market Forecast, 2006-2012

Exhibit 3-21:    Miscellaneous Long Bone Internal Fixation Products, Market Forecast, 2006-2012

Exhibit 3-22:    2007, Selected Small Bone Fixation Products

Exhibit 3-23:    Small Bone Fracture Fixation Products, Market Forecast, 2006-2012

Exhibit 3-24:    Fracture Fixation Products, Combined Market Forecast, 2006-2012

Exhibit 3-25:    2006, Fracture Fixation Products Market, Share by Supplier

4. ALLOGRAFTS, BONE MORPHOGENETIC PROTEINS, AND SYNTHETIC BONE SUBSTITUTES PRODUCTS MARKET

4.1 Osteoconductive and Osteoinductive Materials

4.1.1 Allografts

4.1.1.1 Regulations Governing Allograft Providers

4.1.1.1.1 National Organ Transplant Act

4.1.1.1.2 United States Food and Drug Administration Requirements

4.1.1.2 Processing Bone

4.1.1.3 Recovering Tissue

4.1.1.4 Processing Tissue

4.1.1.5 Allograft Materials

4.1.1.5.1 Support Structures

4.1.1.5.2 Osteoconductive Fillers

4.1.1.5.3 Osteoinductive Materials

4.1.1.6 Allograft Tissue Providers

4.1.1.7 Market Analysis

4.1.1.8 Competitive Analysis

4.1.2 Synthetic Bone Substitutes

4.1.2.1 Products

4.1.2.2 Market Analysis

4.1.2.3 Competitive Analysis

4.1.3 Bone Morphogenetic Proteins

4.1.3.1 Products

4.1.3.2 Market Analysis

4.1.4 Combined Market Forecast

Exhibit 4-1:      Comparison of Selected Suppliers of Allograft Bone Tissue and Their Tissue Constructs

Exhibit 4-2:      Allografts Used in Arthroplasty, Market Forecast, 2006-2012

Exhibit 4-3:      Allografts Used in Fracture Repair, Market Forecast, 2006-2012

Exhibit 4-4:      Orthopedic Allografts, Market Forecast, 2006-2012

Exhibit 4-5:      2006, Orthopedic Allografts Market, Share by Supplier

Exhibit 4-6:      2007, Selected Synthetic Bone Substitute Products

Exhibit 4-7:      Synthetic Bone Substitute Products, Market Forecast, 2006-2012

Exhibit 4-8:      2006, Synthetic Bone Substitute Products Market, Share by Supplier

Exhibit 4-9:      2007, Selected Bone Morphogenetic Protein Products

Exhibit 4-10:    Bone Morphogenetic Protein Products, Market Forecast, 2006-2012

Exhibit 4-11:    Allograft, Bone Morphogenetic Protein, and Synthetic Bone Substitute Products, Combined Market Forecast, 2006-2012

5. BONE GROWTH STIMULATION PRODUCTS MARKET

5.1 Pulsed Electromagnetic Field Bone Growth Stimulation

5.2 Capacitive Coupling Bone Growth Stimulation

5.3 Ultrasound Bone Growth Stimulation

5.4 Reimbursement

5.5 Products

5.5.1 Fracture Healing Bone Growth Stimulators

5.5.2 Spinal Fusion Bone Growth Stimulators

5.6 Market Forecast

5.6.1 Fracture Healing Bone Growth Stimulators

5.6.2 Spinal Fusion Bone Growth Stimulators

5.7 Competitive Analysis

Exhibit 5-1:      2007, Indications for Bone Growth Stimulation Products

Exhibit 5-2:      2007, Selected Bone Growth Stimulation Products Used in Fracture Repair

Exhibit 5-3:      2007, Selected Bone Growth Stimulation Products Used in Spinal Fusion

Exhibit 5-4:      Bone Growth Stimulation Products for Fracture Repair and Spinal Fusion, Combined Market Forecast, 2006-2012

Exhibit 5-5:      2006, Market for Bone Growth Stimulation Products for Fracture Repair, Share by Supplier

Exhibit 5-6:      2006, Market for Bone Growth Stimulation Products for Spinal Fusion, Share by Supplier

Exhibit 5-7:      2006, Combined Market for Bone Growth Stimulation Products for Fracture Repair and Spinal Fusion, Share by Supplier

6. ARTHROSCOPY PRODUCTS MARKET

6.1 Arthroscopic Treatment Overview

6.1.1 Background

6.1.2 Innovations

6.2 Arthroscopy for Sports Injuries

6.3 Products

6.4 Arthroscopy Market Analysis

6.4.1 Procedure Volumes

6.4.1.1 Knee Arthroscopy Procedure Volumes

6.4.1.2 Shoulder Arthroscopy Procedure Volumes

6.4.2 Market Forecast

6.4.2.1 Knee Arthroscopy Market Forecast

6.4.2.2 Shoulder Arthroscopy Market Forecast

6.4.3 Competitive Analysis

6.4.4 Emerging Markets

Exhibit 6-1:      Common Knee Injuries

Exhibit 6-2:      Arthroscopic Access Ports for the Knee

Exhibit 6-3:      2007, Selected Arthroscopy Products

Exhibit 6-4:      Arthroscopy, Knee and Shoulder Procedure Volumes Forecast, 2006-2012

Exhibit 6-5:      Arthroscopy Products, Combined Market Forecast, 2006-2012

Exhibit 6-6:      Knee Arthroscopy Products, Market Forecast, 2006-2012

Exhibit 6-7:      Shoulder Arthroscopy Products, Market Forecast, 2006-2012

Exhibit 6-8:      Arthroscopy Products, Sales by Device Type, 2006 and 2012

Exhibit 6-9:      Arthroscopy Products, Sales by Procedure Type, 2006 and 2012

Exhibit 6-10:    2006, Combined Arthroscopy Products Market, Share by Supplier

7. COMPANY PROFILES

7.1       Acumed LLC

7.2       Arthrex, Inc.

7.3       Biomet, Inc.

7.4       Johnson & Johnson

7.5       Medtronic, Inc.

7.6       Musculoskeletal Transplant Foundation

7.7       Orthofix, Inc.

7.8       Smith & Nephew PLC

7.9       Stryker Corporation

7.10     Synthes, Inc.

7.11     Wright Medical Group, Inc.

7.12     Zimmer Holdings, Inc.

APPENDIX:     COMPANY LISTING