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  ORTHOPEDIC INSTRUMENTATION
A Global Strategic Business Report

This report analyzes the worldwide markets for Orthopedic Instrumentation in Millions of US$. The major product segments analyzed are Reconstructive Sector (Hip Implants, Knee Implants, & Extremities), Fracture Fixation, Arthroscopy, Spinal Implants, and Other Products. The report provides separate comprehensive analytics for the US, Canada, Japan, Europe, Asia-Pacific, Latin America and Rest of World. Annual forecasts are provided for each region for the period of 2001 through 2015. A ten-year historic analysis is also provided for these markets with annual market analytics.The report profiles 200 companies including many key and niche players worldwide such as Acumed LLC, Arthrex, Inc., Biomet, Inc., Conmed Corp., DJO Surgical, Exactech, Inc., Innomed, Inc., Johnson & Johnson, DePuy, Inc., Medtronic Sofamor Danek, Inc., Orthofix International N.V., Smith and Nephew Plc, Stryker Corp., Synthes, Inc., Wright Medical Technology, Inc., and Zimmer Holdings, Inc. Market data and analytics are derived from primary and secondary research. Company profiles are mostly extracted from URL research and reported select online sources.

CODE:    MCP-3223  PAGES:    735
PRICE:    $4450  DATE:       October 2008
COMPANIES:  200  MARKET DATA TABLES:   213
Due to the proprietary nature, our previews are offered only to manufacturers, top-tier management consultants, investment banks, and investment research groups.

 TABLE OF CONTENTS  
  ORTHOPEDIC INSTRUMENTATION (Complete Report) Pages : 735   | $4450
   Study Reliability and Reporting Limitations.....I-1  
   Disclaimers.....I-2
Data Interpretation & Reporting Level.....I-2
CAGR Disparities Between Historic & Current Data.....I-2
  
   Quantitative Techniques & Analytics.....I-3
Product Definitions and Scope of Study.....I-3
  
   Reconstructive Sector.....I-4
Hip Implants.....I-4
Knee Implants.....I-4
Extremities.....I-4
Fracture Fixation.....I-4
Arthroscopy.....I-4
  
   Spinal Products.....I-5
Other Products.....I-5
  
   Emerging Technologies- Redefining the Future.....II-1
Industry Dynamics and Changing Scenario.....II-1
1$100
   Current & Future Analysis.....II-2
Growth Drivers, Trends & Issues.....II-2
Aging Population Drives Demand.....II-2
1$100
   Prevalence of Osteoporosis, Arthritis and other Joint Diseases Fuel Market Growth.....II-3
Table 1: Select Musculoskeletal Conditions - Percentage Breakdown by Age Group (includes corresponding Graph/Chart).....II-3
Obesity - Another Catalyst to Growth.....II-3
1$350
   Increasing Life Expectancy Rates.....II-4
Cost Containment Issues.....II-4
Developing Markets- High Potential.....II-4
1$100
   Revision Procedures Buoy Growth.....II-5
Minimally Invasive Surgery – Attracts Attention.....II-5
Advanced Materials & Technologies Foster Growth.....II-5
1$100
   Advanced Coatings – Enhancing Lifespan of Implants.....II-6
Demand for Premium Implants Continues.....II-6
Growing Demand for Total Hip Replacement in Young People.....II-6
1$100
   Hip Resurfacing Replacement – for Younger Generation.....II-71$100
   Gender-Specific Orthopedic Devices Gain Momentum.....II-8
Spinal and Orthobiologics Products Spearhead Growth.....II-8
Synthetic Substitutes, Growth Factors and Composites.....II-8
1$100
   Stem Cell and Gene Therapy.....II-9
Growing Presence of Mid-Tier Firms & Start-Ups in Spinal Segment.....II-9
Focus Shifts to External R&D Operations.....II-9
Rising Production Costs & Complexities in Documentation – Major Challenges.....II-9
2$200
   A. Reconstructive Sector.....II-11
Procedure of Joint Replacement: Past and Present.....II-11
1$100
   Insertion of implants.....II-12
Revision Surgery: A Painful Procedure.....II-12
Cost of Implants - Determining Factors.....II-12
1$100
   Hip Prosthesis.....II-13
Total Hip Replacement.....II-13
Conditions Requiring Total Hip Replacement.....II-13
Materials Used.....II-13
Cemented Hip Implants.....II-13
Cementless Hip Implants.....II-13
1$100
   Complications Following THR.....II-14
Partial Hip Replacement.....II-14
Revision Hip Procedures.....II-14
Types of Hip Implants.....II-14
Ceramic-on-Ceramic.....II-14
1$100
   Metal-on-Metal.....II-15
Highly Cross-Linked Polyethylene.....II-15
Ceramic-on-polyethylene.....II-15
Metal-on-polyethylene.....II-15
Knee Prosthesis.....II-15
1$100
   Functional Aspects of the Knee.....II-16
Implant Design.....II-16
1$100
   Unicondylar Knee Replacements.....II-17
Fixed and Mobile Bearing Knees.....II-17
Mobile Bearing Total Knee Replacement Prosthesis.....II-17
Secondary Joint Prosthesis/Extremeties.....II-17
Shoulder Prosthesis.....II-17
1$100
   Ankle Prosthesis.....II-18
Elbow Prosthesis.....II-18
Finger Prosthesis.....II-18
Reconstructive Market Analysis.....II-18
1$100
   Highlights.....II-19
Table 2: Hip Implant Procedures in US and Europe (2006): Percentage Breakdown By Number of Procedures for Primary Hip, Revision Hip and Endoprosthesis (includes corresponding Graph/Chart).....II-19
1$350
   Countering Rising Hip Implant Prices.....II-20
Tooth ‘N Trouble.....II-20
Future of Reconstructive Sector.....II-20
1$100
   B. Fracture Fixation.....II-21
Osteoporosis - A Bone Breaking Factor.....II-21
Fracture Fixation Procedures.....II-21
Product Overview.....II-21
Internal Fixation.....II-21
1$100
   External Fixation.....II-22
Intramedulary Fixation.....II-22
Maxillofacial Fixation Products.....II-22
1$100
   Bone Growth Stimulators.....II-23
Select Techniques Used in Fracture Fixation.....II-23
Bone Graft System.....II-23
Osteo-Clage Cerclage Cable System.....II-23
Polarus Humeral Fixation System.....II-23
Stableloc External Fixator.....II-23
Nature of a Fracture.....II-23
1$100
   Trends and Developments in the Fracture Fixation Market.....II-24
Novel Technologies Boost External Fixation Device Market.....II-24
Increase in Less Invasive Fracture Repair Procedures.....II-24
New Technologies Rekindle Market for Trauma Products.....II-24
1$100
   Intramedullary Nails Threatened by LCP Systems.....II-25
Locking Compression Plates Might Lose its Superfluous Growth.....II-25
1$100
   Market Analysis.....II-26
Aging Population and Active Life Styles Offer Steady Growth.....II-26
C. Arthroscopy.....II-26
Arthroscopy: A Keyhole Surgery.....II-26
Arthroscopy - A Broad Perspective.....II-26
1$100
   Arthroscopic Procedure.....II-27
Arthroscopy and its Complications:.....II-27
1$100
   Knee Arthroscopy.....II-28
Hip Arthroscopy.....II-28
Shoulder Arthroscopy.....II-28
1$100
   Arthroscopically Assisted Anterior Approach.....II-29
Arthroscopy of the Elbow.....II-29
Ankle Arthroscopy.....II-29
Developments Likely to Foster Future Growth.....II-29
Multi-Electrode Procedure.....II-29
Electrothermal Arthroscopy by Oratec.....II-29
1$100
   Market Analysis.....II-30
D. Spinal Implants and Instrumentation.....II-30
Spinal Fusion - Lending Support to the Troubled Backs.....II-30
2$200
   Table 3: Spinal Implant Market Worldwide (2004) - Percentage Breakdown by Number of Surgeries for Degenerative Lumbar, Cervical, Deformities, Thoraco-Lumbar Traumas and Thoraco-Lumbar Tumors (includes corresponding Graph/Chart).....II-32

Table 4: Spinal Products Market Worldwide (2004) - Percentage Breakdown by Implant Type for Pedicel Screws, Plates, Rods; Fusion Cages, and Others (includes corresponding Graph/Chart).....II-32
Spinal Implants Market: Primary Growth Drivers.....II-32
State of Spinal Fusion Cages.....II-32
1$350
   Emerging Technologies and Techniques.....II-33
Non- Invasive Surgeries.....II-33
Universal Multilevel Fusions.....II-33
Motion-Sparing Technology- Leap Forward in Spinal Fusions.....II-33
1$100
   Artificial Nuclei.....II-34
Lumbar Artificial Discs Launch TimeLine.....II-34
Cervical Artificial Disc Launch Timeline.....II-34
Artificial Disc Competitive Landscape.....II-34
1$100
   Recent Acquisitions and Mergers in Artificial Disc Sector: 2002-2004.....II-35
Market Analysis.....II-35
E. Other Products.....II-35
1$100
   Bone Cement.....II-36
Mechanical Properties of Bone Cements.....II-36
Soft Goods Sector.....II-36
1$100
   Resorbables.....II-37
Bone Substitutes.....II-37
1$100
   Osteoinductive Agents/Bone Graft Factors:.....II-381$100
   Viscoelastics.....II-391$100
   Soft Tissue Repair and Replacement.....II-40
Tissue Engineering.....II-40
2$200
   Anatomy of the Industry.....II-42 1$100
   Table 5: Orthopedic Instrumentation Market Worldwide by Segment (2001, 2008 & 2012): Percentage Breakdown by Dollar Sales for Reconstructive Sector, Fracture Fixation, Arthroscopy, Spinal Products, and Other Products (includes corresponding Graph/Chart).....II-43
Increase in Age Spurs Demand.....II-43
Technology-Driven Market.....II-43
1$350
   Designing of Device: Complex Requirements.....II-44
Futuristic View of Designs.....II-44
1$100
   Consolidation - Resets Competition.....II-45
Mergers and Acquisitions in the Worldwide Orthopedics Industry: 1997-2008.....II-45
1$100
   M & A Activity: 1993 –2008 in Orthopedic Instrumentation Segment.....II-462$200
   Skull and Bones - Regional Overview.....II-48
The United States: Leading Orthopedics Market.....II-48
Japan: Growing At A Steady Pace.....II-48
Europe.....II-48
1$100
   Table 6: Orthopedic Instruments Market in Europe by Region: 2008 (includes corresponding Graph/Chart).....II-49
Asia-Pacific: Providing Glut of Opportunities.....II-49
Entry Barriers in the Asian Markets.....II-49
1$350
   Advancement in Power Surgical Products.....II-50
Competitive Factors Influencing Orthopedics Market.....II-50
Positive Factors.....II-50
Pricing and Cost Effectiveness of Products.....II-50
1$100
   Consumer Relationships.....II-51
Safety and Competency of Products.....II-51
Technological Advancements.....II-51
Product Innovation.....II-51
1$100
   Risk Factors.....II-52
Delays in Product Development.....II-52
Time Taken for Regulatory Approvals.....II-52
Competitive Analysis.....II-52
1$100
   Table 7: Leading Players in the Global Orthopedic Market (2007): Percentage Breakdown of Value Sales for Stryker, J&J, Zimmer, Medtronic, Synthes, Smith & Nephew, Biomet, and Others (includes corresponding Graph/Chart).....II-53
Reconstructive Sector.....II-53
1$350
   Table 8: Leading Players in the Global Reconstructive Implants Market (2007): Percentage Share Breakdown of Value Sales for Zimmer Holdings, DePuy Orthopedics, Stryker Corp, Biomet, Wright Medical Group, Exactech and Others (includes corresponding Graph/Chart).....II-54

Table 9: Leading Players in the Worldwide Hip & Knee Replacement Market (2008E): Percentage Share Breakdown of Revenues for Zimmer, J&J DePuy, Stryker, Smith & Nephew, Biomet, Wright Medical and Others (includes corresponding Graph/Chart).....II-54
Hip Implants.....II-54
1$350
   Table 10: Leading Players in the Global Hip Implants Market (2007 & 2008E): Percentage Share Breakdown of Revenues for Zimmer, DePuy, Stryker, Smith & Nephew, Biomet, Wright Medical, and Others (includes corresponding Graph/Chart).....II-55
Knee Implants.....II-55
1$350
   Table 11: Leading Players in the Global Knee Reconstruction Market (2007): Percentage Share Breakdown of Value Sales for Zimmer, Stryker, DePuy, Smith & Nephew, Biomet, Wright Medical and Others (includes corresponding Graph/Chart).....II-56
Extremities.....II-56
Table 12: Leading Players in World Market for Extremities (2005) – Percentage Share Breakdown of Dollar Sales by Company for DePuy, Zimmer, Stryker, Biomet, Smith & Nephew Orthopedics, and Others (includes corresponding Graph/Chart).....II-56
Fracture Fixation.....II-56
1$350
   Table 13: Leading Players in the Global Trauma & Craniomaxillofacial Market (2007): Percentage Breakdown of Value Sales for Synthes, Stryker, Smith & Nephew, J&J, Zimmer, Biomet, and Others (includes corresponding Graph/Chart).....II-57
Arthroscopy.....II-57
1$350
   Table 14: Leading Players in the Worldwide Arthroscopy Market (2007): Percentage Share Breakdown of Value Sales for Smith & Nephew, Arthrex, Mitek (J&J), Stryker, Linvatec, Arthrocare and Others (includes corresponding Graph/Chart).....II-58
Spinal Implants.....II-58
Table 15: Leading Players in the Worldwide Spinal Implants Market (2008E): Percentage Share Breakdown of Revenues for Medtronic/Kyphon, DePuy (J&J), Synthes, Stryker, Biomet, Zimmer and Others (includes corresponding Graph/Chart).....II-58

Table 16: Leading Players in the Global Orthobiologics Market (2006): Percentage Breakdown of Value Sales for Medtronic, Synthes, J&J, Stryker, Osteotech, and Others (includes corresponding Graph/Chart).....II-58
1$350
   Competitive Factors from End-Use Perspective.....II-59
Demographics Crucial Factor Driving Demand.....II-59
Hospitals: The Largest End-Use Industry.....II-59
1$100
   Physicians’ Offices/Clinics.....II-60
New Technology Adds to the Growth.....II-60
Home Health Care Market: A Fast Growing Segment.....II-60
1$100
   An Insight into the Distribution Network of Select Players.....II-61
BioMet, Inc......II-61
Medtronic Sofamor Danek.....II-61
1$100
   Synthes.....II-62
Zimmer Holdings, Inc.,.....II-62
1$100
   Wright Medical Introduces Titanium Knee Implant.....II-63
Medtronic Introduces NANOSTIM® Synthetic Bone Paste.....II-63
CONMED Unveils Medical Devices.....II-63
1$100
   DePuy Unveils Pinnacle Hip Solutions.....II-64
Smith & Nephew Introduces VERILAST™ Technology.....II-64
DePuy Expands Sigma® Knee Product Portfolio.....II-64
1$100
   Smith & Nephew Introduces R3™ Acetabular Cup System for Hip Replacement.....II-65
Smith & Nephew Launches Bioraptor 2.3 PK Suture Anchor.....II-65
RTI Introduces of Fresh-Stored OC Allografts.....II-65
Wright Medical Group Launches Profemur Xm Hip Stem.....II-65
ConforMIS Launches Patient-Specific Implant.....II-65
Stryker Introduces Triathlon PKR System in the US.....II-65
1$100
   Orthovita Launches New Bone Graft Substitute.....II-66
DePuy Launches ALPS for Orthopaedic Trauma.....II-66
DJO Surgical Gains FDA Approval to Market New X-alt.....II-66
Osteotech Obtains FDA Clearance for Plexur M Biocomposite.....II-66
1$100
   ConforMIS Wins CE Mark Approvals for Two Arthritis Products.....II-67
Smith & Nephew Unveils New High Definition Surgical Camera System.....II-67
Modern Plastics Announces New Medical Grade PMMA.....II-67
Wright Medical Introduces a New Biologic Grafting System.....II-67
1$100
   Wright Medical Unveils Hip Solutions Products.....II-68
Smith & Nephew Introduces Bi-Compartmental Knee System.....II-68
DePuy Introduces Computer Software for Assisting Surgery.....II-68
Medtronic Launches CD Horizon® Legacy™ Anterior Spinal System.....II-68
Depuy Orthopaedics Unveils New Coating for Biological Fixation.....II-68
1$100
   DePuy Introduces Delta Xtend™ Reverse Shoulder System.....II-69
DePuy Launches New System for Hip Fractures.....II-69
DePuy Introduces New Hip-Bearing System.....II-69
DePuy Introduces Pinnacle® Acetabular Cup System AltrX™.....II-69
Biomet Introduces Two New Hip Stem Products.....II-69
1$100
   ArthroCare Introduces Opus® TwinLock™ Knotless Fixation System.....II-70
SBI Introduces Advanced RingFIX™ System and Forefoot Repair Set.....II-70
SBI Launches New Distal Radius Plating System.....II-70
Smith & Nephew Endoscopy Introduces New Lateral Hip Distractor.....II-70
1$100
   HydroCision Launches SpineJet® EndoResector.....II-71
Wright Medical Launches Latest Stature-Specific Knee Replacement.....II-71
Integra LifeSciences Introduces Uni-CP Compression Plate.....II-71
Wright Medical Introduces the CAROLINA™ Jones Fracture.....II-71
1$100
   Wright Medical Launches EVOLVE® PROLINE System.....II-72
SBi Launches Artelon® STT Spacer.....II-72
Amedica Gains FDA Approval for Valeo VBR Spinal Implant.....II-72
Amedica Obtains FDA Marketing Approval for Valeo Pedicle Screw System.....II-72
1$100
   Corin Group Obtains FDA for Cormet Resurfacing Hip Device.....II-73
Altiva Obtains FDA Approval for Altiva® Classic ACP.....II-73
SBI Obtains FDA Approval for Artelon CMC Spacer Arthro.....II-73
Smith & Nephew’s Knee Systems Receive FDA Approval.....II-73
Amedica Gains FDA Clearance for Valeo™ Cervical Plate System.....II-73
1$100
   Zimmer Obtains FDA Approval for Zimmer® NexGen® Knee.....II-74
Invibio Receives Approval to Market Implantable Spinal Implant in Japan.....II-74
BioMedical Obtains FDA Clearance for OSSpine Spinal Product.....II-74
Blackstone Medical Introduces New Spinal Fusion Product line.....II-74
1$100
   CONMED Linvatec Launches New Powered Surgical Instruments & Arthroscopy
  Products.....II-75
Smith & Nephew Introduces New JOURNEY BI-Cruciate Stabilized Knee System.....II-75
1$100
   Stryker Launches Triathlon Knee System for Women.....II-76
Wright Medical Unveils ODYSSEY™ Distal Cut First Instruments for MIS
  Procedures.....II-76
FDA Grants Approval for Marketing Smith & Nephew’s BHR System.....II-76
Smith & Nephew Unveils LEGION Revision Knee System with OXINIUM Material.....II-76
1$100
   Smith & Nephew Rolls Out TRIGEN* HFN.....II-77
Wright Medical Introduces New SUPER-FIX Acetabular System.....II-77
Cedara Introduces OrthoWorks Spine Analyzer.....II-77
1$100
   Arthrex Launches the Small Joint OATS Set.....II-78
OSH Launches Navitrack Navigation System.....II-78
Biomet Obtains FDA Clearance for ArComXL™.....II-78
Bonutti Receives FDA Approval.....II-78
1$100
   Smith & Nephew Unleashes PERI-LOC System.....II-79
Biomet’s C2a-Taper™ Acetabular System Approved by FDA.....II-79
Depuy Mitek Inc Launches Soft Tissue Tibial Fixation System.....II-79
Arthrex’s V-Tak for Bone Reconstruction.....II-79
Low Profile Plate and Screw Sets for Osteotomy.....II-79
Arthrex Introduces Conical and Reverse Cutting Needles for Soft Tissue Repairs.....II-79
1$100
   DePuy Orthopedics Introduces New Biologic Shoulder Implant.....II-80
DePuy Orthopaedics Introduces UnI-Compartmental Knee Implant.....II-80
DePuy Orthopaedics Introduces Agility™ Total Ankle System.....II-80
Biomet Develops First Spring-Enhanced, Stress- Sharing Orthopedic Implant.....II-80
1$100
   Eurosurgical Unveils Improved Versions of Zenith, Claris and SCS.....II-81
Biomet’s Meniscal Unicompartmental System in the US.....II-81
Biomet Develops First Spring-Enhanced, Stress-Sharing Orthopedic Implant.....II-81
1$100
   Synthes Receives FDA mark of Vertical Expandable Prosthetic Titanium Rib.....II-82
MBI Receives CE Approval.....II-82
Smith & Nephew’s Uncemented Porous Coated Knees.....II-82
1$100
   Smith & Nephew’s Bone Graft Substitute.....II-83
Stryker’s Revolutionary Ceramic-on-ceramic Hip Replacement in the US.....II-83
Wright Medical Receives FDA Clearance for LINEAGE.....II-83
Exactech Unveils Two New Products.....II-83
Sulzer Orthopedics Launches Anatomical Shoulder.....II-83
1$100
   Sulzer Medica Launch the Knee Prosthesis Innex.....II-84
MedNet Locator Launches New Prosthesis System.....II-84
SaluMedica Develops Knee Cartilage Prosthesis from Hydrogel Biomaterial.....II-84
Linvatec Launches New Products.....II-84
Biomet to Unveil a Group of Reconstructive Products.....II-84
1$100
   Corin Medical- 2000 Launches Rotaglide 2000.....II-85
1$100
   Alternate-Bearing Materials in the Hip Implants Market.....II-86
Diamond-on-Diamond Technology.....II-86
Cementless Procedures Gain Ground.....II-86
1$100
   Trabecular Metal Technology.....II-87
Surface Modification Technology.....II-87
Novel Minimally Invasive Approaches.....II-87
Zimmer Launches Quad-Sparing Total Knee Replacement.....II-87
Spire’s Subsidiary Expands Ion Implantation Processing.....II-87
1$100
   Zimmer to Launch New Minimally Invasive Hip Procedure.....II-88
DePuy Introduces New MinI-Incision Technique in Hip Replacement.....II-88
1$100
   Wright Medical Takes Over INBONE Technologies.....II-89
Riverside Acquires Summit Medical.....II-89
UniPhar to Acquire Forth Medical and Northstar.....II-89
Regeneration Technologies and Tutogen Merge to Form RTI Biologics.....II-89
1$100
   Precimed Acquires DePuy Orthopaedics' Chaumont Plant.....II-90
SBI to Acquire Ankle Replacement Technology.....II-90
Symmetry Medical Acquires Orthopaedic Instrument Facility of DePuy.....II-90
Greatbatch Completes Acquisition of Precimed.....II-90
1$100
   Exactech Acquires Altiva.....II-91
Exactech to Acquire France Medica; Starts Direct Distribution in Japan.....II-91
Tornier and LifeCell Sign Distribution Agreement.....II-91
Osteotech Enters into Distribution Agreement with Harvest Technologies.....II-91
1$100
   Misonix Signs Distribution Deal with Aesculap.....II-92
Alynx Acquires MiMedx.....II-92
Alphatec Acquires Rights for Interbody/Vertebral Body Replacement Technology.....II-92
Exactech Inks License Deal for Cartilage Repair Technology.....II-92
1$100
   Biomet Ties Up with Massachusetts General Hospital for Clinical Studies.....II-93
Stryker Recalls Select Hip Products.....II-93
Biomet Merges with LVB Acquisition Merger Sub.....II-93
Cardinal Health Completes Acquisition of VIASYS Healthcare.....II-93
1$100
   Biomet Sports Medicine and Marc Tec Ink Licensing Agreement.....II-94
Zimmer Inks a Distribution Agreement with Regeneration Technologies.....II-94
1$100
   Sandvik Inks Agreement with Medtronic to Acquire Medtronic’s Plant.....II-95
Medtronic and Weigao to Establish Joint Venture in China .....II-95
HealthpointCapital Takes over Ideal Medical Products.....II-95
Covidien’s Subsidiary Takes Over Scandius Biomedical.....II-95
1$100
   Integra LifeSciences Takes over IsoTis.....II-96
DePuy Spine Completes Acquisition of Certain Disc-O-Tech Assets.....II-96
Wright Medical Acquires BIO-ARCH™ Subtalar Implant.....II-96
1$100
   UniPhar Merges Whelehan Surgical and Surgicare Divisions.....II-97
Orthofix International Completes Acquisition of InSWing™ Technology.....II-97
Sandvik Acquires Doncasters Medical Technologies.....II-97
Medtronic Completes Acquisition of Kyphon.....II-97
1$100
   Tornier Takes Over DVO Extremity Solutions & Nexa Orthopedics.....II-98
Medtronic Takes over O-arm Imaging from Breakaway Imaging.....II-98
Wright Medical Takes over Assets of R&R Medical.....II-98
1$100
   Wright Medical Acquires DARCO’s Reconstructive Foot Surgery Business.....II-99
Zimmer Holdings Acquires Endius.....II-99
Leis Medical and MedicineLodge Merge to Form iMDs.....II-99
Zimmer Takes Over ORTHOsoft.....II-99
1$100
   NuVasive Takes Over Radius Medical.....II-100
DJO Completes ReAble Merger.....II-100
Smith & Nephew Acquires Plus Orthopedics.....II-100
1$100
   Orchid Takes Over Three Orthopedic Instrument Companies.....II-101
Synthes Takes Over N Spine.....II-101
Avalign Technologies Acquires Nemcomed.....II-101
1$100
   Wright Medical and A.M. Surgical in Distribution and License Agreement.....II-102
Symmetry Medical and MAKO Surgical Enter into an Agreement.....II-102
Medtronic and Axon Enter into Agreement.....II-102
Wright Medical Shuts Down Facility in France.....II-102
1$100
   Portland Orthopaedics Retakes US Distribution.....II-103
Tornier and Bioretec in Partnership for Bioresorbable Surgical Devices.....II-103
Impulse Takes Over Clinical Support Services.....II-103
Alphatec Holdings Gains License for Vertebroplasty Technology System.....II-103
Smith & Nephew Signs Global Distribution Agreement with Teknimed.....II-103
1$100
   Corin Enters into Marketing and Distribution Deal with Stryker.....II-104
Biomet and Kensey Signs Marketing and Distribution Agreement.....II-104
BSN Medical Acquires FLA Orthopedics.....II-104
SimplexityMD Takes Over OrthoAccel Technologies.....II-104
Hanger Orthopedic Group Acquires Paris O&P Laboratory.....II-104
Smith & Nephew Recalls Knee Implants.....II-104
1$100
   Alphatec to Merge with Scient’X.....II-105
Endius and Quantum Form Strategic Alliance.....II-105
Biomet to Expand Indiana Facility.....II-105
DJ Orthopedics Acquires Newmed.....II-105
1$100
   FDA Clears Zimmer’s Gender Solutions Artificial Knee for Women.....II-106
Zimmer Acquires Surgical Instrument Technology from MedTech S.A.....II-106
dj Orthopedics Acquires Aircast.....II-106
FDA Approves Biomet’s Regenerex™ Acetabular System.....II-106
DePuy Mitek Takes Over FMS Operations.....II-106
1$100
   Medtronic Provides Research Grant to OTA.....II-107
Orthofix Restructures its International Business Operations.....II-107
Orthofix Acquires IMeS to Expand European Operations.....II-107
Encore Medical Enters into Multi-Year Collaboration Agreement with UCDHSC.....II-107
1$100
   Alphatec Spine Acquires All Assets of Cortek.....II-108
HealthpointCapital Takes Over Alphatec.....II-108
VIASYS Acquires Intermed Precision.....II-108
1$100
   RTI Amends Distribution Contracts with Medtronic and Exactech.....II-109
Zimmer Holdings Enters Into Agreement with Heraeus Kulzer.....II-109
Genzyme Corp. Acquires Verigen.....II-109
Nash Corporation Enters into Agreement with Orthovita, Inc.....II-109
1$100
   Biomet Acquires Interpore.....II-110
Synthes-Stratec Merger with Mathys Medizinaltechnik.....II-110
Tailwind Capital Acquires Aircast.....II-110
Conmed Forges Strategic Partnership with eTrauma.....II-110
DePuy Orthopaedics Launches New Trauma & Extremities Division.....II-110
1$100
   Synthes Acquires Gelifex .....II-111
Angiotech Acquires Neucoll.....II-111
Encore Takes Over Empi.....II-111
Arthrocare Acquires Opus Medical.....II-111
Orthologic Acquires CBI.....II-111
1$100
   Orthofix Signs Contract With Premier.....II-112
Angiotech Signs Sales and Distribution Agreement with Orthovita.....II-112
1$100
   Hanger Orthopedic Acquires Advanced Bio-Mechanics and Northern Virginia Orthotics &
  Prosthetics.....II-113
Zimmer Completes the Acquisition of Implex.....II-113
Smith & Nephew Acquires MMT.....II-113
1$100
   Exactech Acquires Total Shoulder System of Teknimed.....II-114
Zimmer Acquires Centerpulse.....II-114
Virtual Scopics Collaborates with Anderson Orthopaedic Research Institute.....II-114
Haemonetics Extends Agreement with Zimmer.....II-114
1$100
   DePuy Orthopaedics Establishes New Trauma & Extremities Group.....II-115
Orthofix Acquires Breg.....II-115
Symmetry Medical Merges with Mettis Orthopedic.....II-115
1$100
   Hanger Acquires Two US Orthopedic Firms.....II-116
Spire Biomedical Expands Orthopedic Surface Processing Facilities.....II-116
Abbott Acquires Orthopedics Market through the Acquisition of Spinal Concepts.....II-116
DePuy Acquires Link Spine Group.....II-116
Synthes-Stratec and Spine Solutions, Inc......II-116
Conmed Acquires Bionx Implants.....II-116
1$100
   Year 2002 in Review.....II-1172$200
   Major M&A and Divestments in 1999- 2001.....II-119
1$100
   Acumed LLC (US).....II-120
Arthrex, Inc (US).....II-120
Biomet, Inc. (US).....II-120
1$100
   Conmed Corp. (US).....II-1211$100
   DJO Surgical (US).....II-122
Exactech, Inc. (US).....II-122
1$100
   Innomed, Inc. (US).....II-123
Johnson & Johnson (US).....II-123
DePuy Inc. (US).....II-123
1$100
   Medtronic Sofamor Danek, Inc. (US).....II-124
Orthofix International N.V. (The Netherlands).....II-124
1$100
   Smith and Nephew Plc (UK).....II-125
Stryker Corp., (US).....II-125
1$100
   Synthes, Inc. (Switzerland).....II-1261$100
   Wright Medical Technology, Inc. (US).....II-127
Zimmer Holdings, Inc. (US).....II-127
2$200
   Table 17: World Recent Past, Current & Future Analysis for Orthopedic Instrumentation by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 2001 through 2010 (includes corresponding Graph/Chart).....II-1291$350
   Table 18: World Long-term Projections for Orthopedic Instrumentation by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America & Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 2011 through 2015 (includes corresponding Graph/Chart).....II-1301$350
   Table 19: World Historic Review for Orthopedic Instrumentation by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 1991 through 2000 (includes corresponding Graph/Chart).....II-1311$350
   Table 20: World 15-Year Perspective for Orthopedic Instrumentation by Geographic Region – Percentage Breakdown of Dollar Sales for US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets for Years 1998, 2008 & 2012 (includes corresponding Graph/Chart).....II-1321$350
   By Segment.....II-133
Table 21: World Recent Past, Current & Future Analysis for Reconstructive Sector by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 2001 through 2010 (includes corresponding Graph/Chart).....II-133
1$350
   Table 22: World Long-term Projections for Reconstructive Sector by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 2011 through 2015 (includes corresponding Graph/Chart).....II-1341$350
   Table 23: World Historic Review for Reconstructive Sector by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 1991 through 2000 (includes corresponding Graph/Chart).....II-1351$350
   Table 24: World 15-Year Perspective for Reconstructive Sector by Geographic Region – Percentage Breakdown of Dollar Sales for US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets for Years 1998, 2008 & 2012 (includes corresponding Graph/Chart).....II-1361$350
   Table 25: World Recent Past, Current & Future Analysis for Reconstructive Sector by Product Segment - Hip Implants, Knee Implants and Extremities Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 2001 through 2010 (includes corresponding Graph/Chart).....II-137

Table 26: World Long-term Projections for Reconstructive Sector by Product Segment - Hip Implants, Knee Implants and Extremities Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 2011 through 2015 (includes corresponding Graph/Chart).....II-137
1$350
   Table 27: World Historic Review for Reconstructive Sector by Product Segment - Hip Implants, Knee Implants and Extremities Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 1991 through 2000 (includes corresponding Graph/Chart).....II-138

Table 28: World 15-Year Perspective for Reconstructive Sector by Product Segment – Percentage Breakdown of Dollar Sales for Hip Implants, Knee Implants and Extremities Markets for Years 1998, 2008 & 2012 (includes corresponding Graph/Chart).....II-138
1$350
   Table 29: World Recent Past, Current & Future Analysis for Fracture Fixation by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 2001 through 2010 (includes corresponding Graph/Chart).....II-1391$350
   Table 30: World Long-term Projections for Fracture Fixation by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America & Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 2011 through 2015 (includes corresponding Graph/Chart).....II-1401$350
   Table 31: World Historic Review for Fracture Fixation by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 1991 through 2000 (includes corresponding Graph/Chart).....II-1411$350
   Table 32: World 15-Year Perspective for Fracture Fixation by Geographic Region – Percentage Breakdown of Dollar Sales for US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets for Years 1998, 2008 & 2012 (includes corresponding Graph/Chart).....II-1421$350
   Table 33: World Recent Past, Current & Future Analysis for Arthroscopy/ Soft Tissue by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 2001 through 2010 (includes corresponding Graph/Chart).....II-1431$350
   Table 34: World Long-term Projections for Arthroscopy/ Soft Tissue Products by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America & Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 2011 through 2015 (includes corresponding Graph/Chart).....II-1441$350
   Table 35: World Historic Review for Arthroscopy by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 1991 through 2000 (includes corresponding Graph/Chart).....II-1451$350
   Table 36: World 15-Year Perspective for Arthroscopy by Geographic Region – Percentage Breakdown of Dollar Sales for US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets for Years 1998, 2008 & 2012 (includes corresponding Graph/Chart).....II-1461$350
   Table 37: World Recent Past, Current & Future Analysis for Spinal Products by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 2001 through 2010 (includes corresponding Graph/Chart).....II-1471$350
   Table 38: World Long-term Projections for Spinal Products by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 2011 through 2015 (includes corresponding Graph/Chart).....II-1481$350
   Table 39: World Historic Review for Spinal Products by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 1991 through 2000 (includes corresponding Graph/Chart).....II-1491$350
   Table 40: World 15-Year Perspective for Spinal Products by Geographic Region – Percentage Breakdown of Dollar Sales for US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets for Years 1998, 2008 & 2012 (includes corresponding Graph/Chart).....II-1501$350
   Table 41: World Recent Past, Current & Future Analysis for Other Products by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 2001 through 2010 (includes corresponding Graph/Chart).....II-1511$350
   Table 42: World Long-term Projections for Other Orthopedic Instrumentation Products by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 2011 through 2015 (includes corresponding Graph/Chart).....II-1521$350
   Table 43: World Historic Review for Other Products by Geographic Region – US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets Independently Analyzed with Annual Sales Figures in US$ Million for Years 1991 through 2000 (includes corresponding Graph/Chart).....II-1531$350
   Table 44: World 15-Year Perspective for Other Products by Geographic Region – Percentage Breakdown of Dollar Sales for US, Canada, Japan, Europe, Asia-Pacific (excluding Japan), Latin America and Rest of World Markets for Years 1998, 2008 & 2012 (includes corresponding Graph/Chart).....II-1541$350
   A. Market Analysis.....III-1
Outlook.....III-1
United States – The Largest Orthopedics Market.....III-1
An Overview of the US Orthopedic Healthcare System.....III-1
1$75
   Table 45: US Orthopedics Market (2006): Percentage Share Breakdown of Number of Physician Visits for Back, Knee, Neck, Lower Back, Hip, and Small Bone and Joint (includes corresponding Graph/Chart).....III-2

Table 46: Musculoskeletal Procedures Performed in US Hospitals (2004): Mean Duration of Hospitalization (in Days) (includes corresponding Graph/Chart).....III-2
1$200
   Table 47: Rate of Procedures (Per 10,000 Individuals) for Knee Arthroplasty, Hip Replacement, and Spinal Fusion: Breakdown by Age Group (includes corresponding Graph/Chart).....III-3
Trends & Issues.....III-3
Aging Population & Obesity Drive Demand for Orthopedic Procedures.....III-3
Table 48: Primary Hip and Knee Replacement Procedures in the US (2005): Percentage Breakdown by Age Group (includes corresponding Graph/Chart).....III-3
1$200
   Technological Developments Promote Growth.....III-4
Biomaterials Market – Keeping Pace with Changing Times.....III-4
Orthopedic Soft Tissue Allograft Market in the US.....III-4
1$75
   Rising Incidence of Arthritis Aids Growth in Implant Procedures.....III-5
Orthopedic Implants Market in the US.....III-5
Wear Debris-A Major Concern.....III-5
1$75
   Reimbursement Scenario.....III-6
CMS Implements MS-DRG System.....III-6
3$225
   Reimbursement for Trauma Procedures.....III-9
Table 49: Medicare Reimbursement Codes for Leading Trauma Procedures in US (includes corresponding Graph/Chart).....III-9
1$200
   Table 50: Percentage Change in Medicare Reimbursement Rates (2000-2005) (includes corresponding Graph/Chart).....III-10
Reconstructive Market: An Overview.....III-10
Large Joint Reconstructive Implants Market – An Overview.....III-10
1$200
   Aging Population Demographics.....III-11
Table 51: Percentage of Population in terms of Age Groups in the US (includes corresponding Graph/Chart).....III-11
1$200
   Table 52: US Population in the Over 45 Years Age Group (2006-2008) (includes corresponding Graph/Chart).....III-12
Arthritis: Stats.....III-12
Joint Replacement Procedures – Improving Technologies & Materials.....III-12
Knee Implants Market.....III-12
1$200
   Knee Implant Pricing Scenario.....III-13
Table 53: Knee Implants Market in the US (2004): Percentage Breakdown by Dollar Sales for Implant Type - Cemented Femoral, Cemented Tibial, Cementless Femoral, Cementless Tibial and Polyethylene Liner (includes corresponding Graph/Chart).....III-13
1$200
   Table 54: Knee Replacements in the US (1998-2008): Number of Procedures (in Thousands) and Average Duration of Hospitalization for Total, and Revision Knee Replacement Procedures (includes corresponding Graph/Chart).....III-14
Historic Note:.....III-14
Hip Implants Market.....III-14
1$200
   New Materials Emerge as Polyethylene Alternatives.....III-15 1$75
   Table 55: Hip Replacements in the US (1998-2005): Number of Procedures (in Thousands) and Average Duration of Hospitalization for Total, Partial and Revision Procedures (includes corresponding Graph/Chart).....III-16
Shift from Cemented to Press-Fit Procedures.....III-16
Cost Containment for Implants.....III-16
1$200
   Fracture Fixation Market.....III-17
Table 56: Number of Inpatient Fracture Repair Procedures in the US (2006): Percentage Breakdown by Anatomical Site for Femur, Tibia/Fibula, Radius/Ulna, Humerus, Face, Ankle/Foot, Others (includes corresponding Graph/Chart).....III-17
Shift Towards LCPs Drive Growth.....III-17
Arthroscopy Market.....III-17
1$200
   New Technologies Fuel Arthroscopy Market.....III-18
Spinal Implants Market.....III-18
1$75
   Troubled Backs.....III-19
Spinal Procedures in US Witness Substantial Growth.....III-19
1$75