MediPoint: Knee Replacement - EU Analysis and Market Forecasts

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Jan 07, 2014, 08:25 ET

NEW YORK, Jan. 7, 2014 /PRNewswire/ -- Reportlinker.com announces that a new market research report is available in its catalogue:

MediPoint: Knee Replacement - EU Analysis and Market Forecasts
http://www.reportlinker.com/p01936454/MediPoint-Knee-Replacement---EU-Analysis-and-Market-Forecasts.html#utm_source=prnewswire&utm_medium=pr&utm_campaign=Orthopedic

Summary

The current knee replacement market is a crowded space, with an increasing number of companies offering a myriad of partial, primary/total, and revision prostheses to meet orthopedic surgeons' demands in the management of knee diseases, primarily osteoarthritis. Worldwide, the primary/total knee segment represents about 80–90% of the entire knee market, with the remainder being partial knee and revision knee. Overall, clinical data show that short- to medium-term survivorship is excellent after almost all common types of knee replacement, regardless of fixation, constraint, and bearing type. Future competition among vendors will be more likely to center on the instrumentation and the ancillary equipment, such as patient-specific instruments, navigation systems, and robotic systems.

Similarly, on the opposite side of the Atlantic, the expanding patient population for orthopedic surgical treatments, the widespread appreciation of the clinical efficacy of knee replacement, and the steady domestic supply of orthopedic devices in the European countries have all contributed to a stable increase in the procedure volume in the past decades. However, the recent European sovereign debt crisis is putting pressure on the 5EU countries (France, Germany, Italy, Spain, and UK) to put measures in place to prevent excessive healthcare budget deficits.

Scope

- An overview of hypertension, which includes epidemiology, etiology, symptoms, diagnosis, pathology and treatment guidelines.
- Annualized EU Knee replacement market revenue and future forecasts from 2009 to 2011, forecast for 7 years to 2018.
- Investigation of current and future market competition for Knee replacement
- Insightful review of the key industry drivers, restraints and challenges as well as predicted impact of key events.
- Competitor assessment including device approval analysis and device sales forecasts.
- Marketed and pipeline product profiles covering efficiency, safety, clinical study details, device approvals, product positioning and device sales forecast.
- Analysis of unmet needs within the market and opportunities for future players.
- Technology trends evaluation to assess strength of pipeline.
- An overview of all devices in development including clinical study details, design and material selection considerations, efficacy reports, and device approval timelines.
- Company profiles including business description, financial overview and SWOT analysis.
- Coverage of key market players.
- Strategic assessment of the Knee replacement sector through market impact analysis, future market scenario and company analysis.
- Direct quotes from Key Opinion Leaders (KOL) as well as cardiologists

Reasons to buy

- Understand the trends shaping and driving EU Knee replacement market.
- Realize device preferences of physicians who have performed the tests already.
- Access market sizing, forecasts and quantified growth opportunities in EU Knee replacement market through 2018.
- Quantify candidate patient populations to better design product pricing & launch plans.
- Drive revenues, formulate effective sales and marketing strategies and gain in-depth understanding of the competitive landscape.
- Perform benchmarking analysis of growth opportunities against currently marketed products.
- Assess competitiveness of products in market by understanding the strengths and weaknesses of current competition.
- Take a comprehensive look at the market's device pipeline and identify promising, paradigm-shifting products.
- Create an effective counter-strategy to gain a competitive advantage against those currently in the market.
- Organize your sales and marketing efforts by identifying the market categories and segments that present the best opportunities for growth.
- What's the next big thing in EU Knee replacement market landscape? Identify, understand and capitalize.
1 Table of Contents

1 Table of Contents 6
1.1 List of Tables 12
1.2 List of Figures 18
2 Introduction 21
2.1 Catalyst 22
2.2 Related Reports 22
3 Disease Overview 23
3.1 Anatomy and Physiology 23
3.2 Pathophysiology 25
3.2.1 Overview 25
3.2.2 Primary Osteoarthritis 25
3.2.3 Rheumatoid Arthritis 26
3.2.4 Post-Traumatic Arthritis 27
3.2.5 Avascular Necrosis 27
3.3 Clinical Presentation 28
3.3.1 Diagnosis 28
3.4 Clinical Outcomes 29
3.4.1 Overview 29
3.4.2 Conservative Treatments 29
3.4.3 Joint-Preserving Treatments 31
3.4.4 Joint Replacement 33
3.5 Economic Impact 44
3.5.1 5EU 45
4 Industry Overview 46
4.1 Procedural Trends 46

4.1.1 5EU 46
4.2 Market Access 52
4.2.1 5EU 52
4.3 Regulatory Issues/Recalls 66
4.3.1 DePuy Orthopaedic's Diaphyseal Sleeve Components of the Limb Preservation System (LPS) 66
4.3.2 Stryker's ShapeMatch Cutting Guides 66
4.3.3 B. Braun's Columbus Total Knee System's Cementless Version 67
4.3.4 Smith & Nephew's Journey Uni Tibial Insert, Right Medial/Left Lateral 67
4.4 Mergers and Acquisitions/Key Partnerships 67
4.4.1 Stryker's Acquisition of MAKO Surgical 67
4.4.2 MicroPort Medical B.V.'s Acquisition of Wright Medical's OrthoRecon Business 68
4.4.3 Stryker's Extension of Co-Marketing Agreement with OrthoSensor 68
4.4.4 Blue Belt Technologies' Co-Marketing Agreement with DJO Surgical 68
4.4.5 Biomet and OrthoSensor Enter Into Co-Promotion Partnership 69
4.4.6 Italian Consortium 2IL Orthopaedics Acquires Corin Group 69
4.4.7 Smith & Nephew Acquires LifeModeler, Inc. (LMI) 69
4.5 Market Drivers, Opportunities, and Barriers 70
4.5.1 Market Drivers 70
4.5.2 Market Opportunities 75
4.5.3 Market Barriers 81
5 Competitive Assessment 86
5.1 Overview 86

5.2 Global Market Share 88
5.3 B. Braun 89
5.3.1 Primary Knee Replacement 89
5.3.2 Partial Knee Replacement 91
5.3.3 Revision Knee Replacement 92
5.3.4 SWOT Analysis 92
5.4 Biomet 93
5.4.1 Primary Knee Replacement 93
5.4.2 Partial Knee Replacement 96
5.4.3 Revision Knee Replacement 97
5.4.4 SWOT Analysis 98
5.5 DePuy Synthes 99
5.5.1 Primary Knee Replacement 99
5.5.2 Partial Knee Replacement 104
5.5.3 Revision Knee Replacement 105
5.5.4 SWOT Analysis 106
5.6 DJO Surgical 107
5.6.1 Primary Knee Replacement 107

5.6.2 Partial Knee Replacement 110
5.6.3 Revision Knee Replacement 110
5.6.4 SWOT Analysis 111
5.7 Exactech 112
5.7.1 Primary Knee Replacement 112
5.7.2 Partial Knee Replacement 113
5.7.3 Revision Knee Replacement 114
5.7.4 SWOT Analysis 114
5.8 Smith & Nephew 115
5.8.1 Primary Knee Replacement 115
5.8.2 Partial Knee Replacement 118
5.8.3 Revision Knee Replacement 118
5.8.4 SWOT Analysis 119
5.9 Stryker 120
5.9.1 Primary Knee Replacement 120
5.9.2 Partial Knee Replacement 123
5.9.3 Revision Knee Replacement 124
5.9.4 SWOT Analysis 125
5.10 Wright Medical (MicroPort) 126
5.10.1 Primary Knee Replacement 126
5.10.2 Revision Knee Replacement 128
5.10.3 SWOT Analysis 129
5.11 Zimmer 130
5.11.1 Primary Knee Replacement 130
5.11.2 Partial Knee Replacement 136
5.11.3 Revision Knee Replacement 136
5.11.4 SWOT Analysis 138
6 Unmet Needs 139
6.1 Availability of Long-Term Clinical Data 139
6.2 Complete Knee Platform 141
6.3 Need for Cost-Containment 143
6.4 Training for Computer Navigation Technologies 144
6.5 Continued Innovations in Instrumentation 146
6.6 Advanced Materials 147
6.7 Implants for Metal-Sensitive Patients 148
6.8 National Joint Registry 149
7 Pipeline Products 151

7.1 Overview 151
7.2 Biomet's Vanguard XP Total Knee System 151
7.3 Corentec's Lospa Total Knee System 152
7.4 NovoSource's NovoKnee 152
7.5 Pipeline Orthopedics' NEO PS Knee System 152
7.6 Bonovo Orthopedics' JMM Total Knee System 152
7.7 Corin Group's Unity Knee Systems 153
7.8 Kinamed's GEM Total Knee System 153
7.9 Emerge Medical 153
8 Current and Future Players 154
8.1 Trends in Corporate Strategy 154
8.2 Established Players 155
8.2.1 B. Braun 155
8.2.2 Biomet 157
8.2.3 Corin Group 160
8.2.4 DePuy Synthes 163
8.2.5 DJO Global 167
8.2.6 Exactech 169
8.2.7 Lima Corporate 172
8.2.8 Medacta 175
8.2.9 Smith & Nephew 177
8.2.10 Stryker 180
8.2.11 Waldemar LINK 184
8.2.12 Wright Medical Group (MicroPort) 186
8.2.13 Zimmer Holdings 189
8.2.14 Other Established Players 194
8.3 Emerging Players 195
8.3.1 Blue Belt Technologies 195
8.3.2 ConforMIS 197
8.3.3 MAKO Surgical 200
8.3.4 OmniLife science 202
8.3.5 Other Emerging Players 205
9 Market Outlooks 206
9.1 Overview 206
9.2 France 211
9.3 Germany 214

9.4 Italy 217
9.5 Spain 219
9.6 United Kingdom 221
10 Appendix 224
10.1 Abbreviations 224
10.2 Bibliography 227
10.3 Report Methodology 247
10.3.1 Overview 247
10.3.2 Coverage 247
10.3.3 Secondary Research 248
10.3.4 Forecasting Methodology 249
10.3.5 Primary Research - Key Opinion Leader Interviews 250
10.3.6 Expert Panel Validation 250
10.4 Physicians and Specialists Included in This Study 251
10.5 Physician Survey 253
10.6 About the Authors 254
10.6.1 Analysts 254
10.6.2 Bonnie Bain, Ph.D., Global Head of Healthcare 255
10.7 About MediPoint 256
10.8 About GlobalData 256
10.9 Disclaimer 256

1.1 List of Tables

Table 1: Risk Factors for Primary OA of the Knee 26
Table 2: Common Clinical Symptoms of Knee Arthritis 28
Table 3: Common Reasons for Failed Knee Implants 40
Table 4: Advantages of CAS 42
Table 5: Direct, Indirect, and Intangible Costs of Arthritis 44
Table 6: Differences Between US FDA Approval and EU CE-Marking 52
Table 7: Common Reasons for Revision After Total and Partial Knee Replacement 82
Table 8: Product Profile - Columbus Total Knee System 90
Table 9: Product Profile - e.motion Total Knee System 91
Table 10: Product Profile - univation Unicondylar Knee System 91
Table 11: Product Profile - B. Braun's Revision Knee Replacement Systems 92
Table 12: SWOT Analysis - B. Braun's Knee Portfolio 92
Table 13: Product Profile - Vanguard Complete Knee System 94
Table 14: List of Select Clinical Studies - Vanguard Complete Knee System 94
Table 15: Product Profile - AGC Total Knee System 95
Table 16: List of Select Clinical Studies - AGC Total Knee System 96
Table 17: Product Profile - Biomet's Partial Knee Replacement Systems 97
Table 18: Product Profile - Biomet's Revision Knee Replacement Systems 97
Table 19: Select Clinical Study - Biomet's Revision Knee Replacement Systems 98
Table 20: SWOT Analysis - Biomet's Knee Portfolio 98
Table 21: Product Profile - LCS Complete Knee Systems 100

Table 22: List of Select Clinical Studies - LCS Complete Knee System 100
Table 23: Product Profile - Sigma Knee System 102
Table 24: List of Select Clinical Studies - Sigma Knee System 102
Table 25: Product Profile - Attune Knee System 103
Table 26: List of Select Clinical Studies - Attune Knee System 104
Table 27: Product Profile - Sigma HP Partial Knee System 104
Table 28: Product Profile - DePuy's Revision Knee Replacement Systems 105
Table 29: List of Select Clinical Studies - DePuy's Revision Knee Replacement Systems 106
Table 30: SWOT Analysis - DePuy's Knee Portfolio 106
Table 31: Product Profile - Movation Knee System 107
Table 32: Product Profile - 3D Knee System 108
Table 33: Product Profile - Foundation Knee System 109
Table 34: Product Profile - EPIK Knee System 110
Table 35: Product Profile - Foundation Revision Knee System 110
Table 36: SWOT Analysis - DJO's Knee Portfolio 111
Table 37: Product Profile - Optetrak Knee System 113
Table 38: Product Profile - Optetrak Unicondylar Knee System 113
Table 39: Product Profile - Optetrack Constrained Condylar (CC) Knee System 114
Table 40: SWOT Analysis - Exactech's Knee Portfolio 114
Table 41: Product Profile - LEGION Knee System 116
Table 42: List of Select Clinical Studies - GENESIS II Total Knee System 116
Table 43: Product Profile - JOURNEY Knee System 117
Table 44: List of Select Clinical Studies - JOURNEY Knee System 117
Table 45: Product Profile - Smith & Nephew's Partial Knee Replacement Systems 118
Table 46: Product Profile - Smith & Nephew's Revision Knee Systems 119
Table 47: SWOT Analysis - Smith & Nephew's Knee Portfolio 119
Table 48: Product Profile - Triathlon Total Knee System 121
Table 49: List of Select Clinical Studies - Triathlon Total Knee System 121
Table 50: Product Profile - Scorpio Knee System 122
Table 51: Product Profile - Stryker's Partial Knee Replacement Systems 123
Table 52: Product Profile - Stryker's Revision Knee Replacement Systems 124
Table 53: Select Clinical Study - Stryker's Revision Knee Replacement System 124
Table 54: SWOT Analysis - Stryker's Knee Portfolio 125
Table 55: Product Profile - Advance Knee System 127
Table 56: Product Profile - Evolution Medial-Pivot Knee System 128
Table 57: Product Profile - Wright Medical's Revision Knee Replacement Systems 128
Table 58: SWOT Analysis - Wright Medical's Knee Portfolio 129
Table 59: Product Profile - NexGen Knee System 131
Table 60: List of Select Clinical Studies - NexGen Knee System 132
Table 61: Product Profile - Gender Solutions Knee Systems 133
Table 62: List of Select Clinical Studies - Gender Solutions Knee System 133
Table 63: Product Profile - Persona Knee System 135
Table 64: List of Select Clinical Studies - Persona Knee System 135
Table 65: Product Profile - Zimmer's Partial Knee Replacement Systems 136

Table 66: Product Profile - Zimmer's Revision Knee Replacement Systems 137
Table 67: SWOT Analysis - Zimmer's Knee Portfolio 138
Table 68: Pipeline Products in the Global Knee Replacement Market, 2013 151
Table 69: Company Profile - B. Braun 155
Table 70: Portfolio Assessment - B. Braun 156
Table 71: SWOT Analysis - B. Braun 157
Table 72: Company Profile - Biomet 158
Table 73: Portfolio Assessment - Biomet 159
Table 74: SWOT Analysis - Biomet 160
Table 75: Company Profile - Corin Group 161
Table 76: Portfolio Assessment - Corin Group 162
Table 77: SWOT Analysis - Corin Group 162
Table 78: Company Profile - DePuy Synthes 163
Table 79: Portfolio Assessment - DePuy Synthes 165
Table 80: SWOT Analysis - DePuy Synthes 166
Table 81: Company Profile - DJO Global 167
Table 82: Portfolio Assessment - DJO Global 168
Table 83: SWOT Analysis - DJO Global 169
Table 84: Company Profile - Exactech 170
Table 85: Portfolio Assessment - Exactech 171
Table 86: SWOT Analysis - Exactech 172
Table 87: Company Profile - Lima Corporate 173
Table 88: Portfolio Assessment - Lima Corporate 173
Table 89: SWOT Analysis - Lima Corporate 174
Table 90: Company Profile - Medacta 175
Table 91: Portfolio Assessment - Medacta 176
Table 92: SWOT Analysis - Medacta 176
Table 93: Company Profile - Smith & Nephew 178
Table 94: Portfolio Assessment - Smith & Nephew 179
Table 95: SWOT Analysis - Smith & Nephew 180
Table 96: Company Profile - Stryker 181
Table 97: Portfolio Assessment - Stryker 183
Table 98: SWOT Analysis - Stryker 184
Table 99: Company Profile - Waldemar LINK 185
Table 100: Portfolio Assessment - Waldemar LINK 185
Table 101: SWOT Analysis - Waldemar LINK 186
Table 102: Company Profile - Wright Medical Group 187
Table 103: Portfolio Assessment - Wright Medical Group 188
Table 104: SWOT Analysis - Wright Medical Group 189
Table 105: Company Profile - Zimmer Holdings 190
Table 106: Portfolio Assessment - Zimmer Holdings 192
Table 107: SWOT Analysis - Zimmer Holdings 193
Table 108: Other Established Players in the Global Knee Replacement Market, 2013 194

Table 109: Company Profile - Blue Belt Technologies 195
Table 110: Portfolio Assessment - Blue Belt Technologies 196
Table 111: SWOT Analysis - Blue Belt Technologies 197
Table 112: Company Profile - ConforMIS 198
Table 113: Portfolio Assessment - ConforMIS 199
Table 114: SWOT Analysis - ConforMIS 199
Table 115: Company Profile - MAKO Surgical 200
Table 116: Portfolio Assessment - MAKO Surgical 201
Table 117: SWOT Analysis - MAKO Surgical 202
Table 118: Company Profile - OMNIlife science 203
Table 119: Portfolio Assessment - OMNIlife science 204
Table 120: SWOT Analysis - OMNIlife science 204
Table 121: Other Emerging Players in the Global Knee Replacement Market, 2013 205
Table 122: Knee Replacement Market Sales Forecast ($m) in 5EU, 2010-2019 206
Table 123: 5EU Primary Knee Replacement Market Sales Forecast ($m), 2010-2019 209
Table 124: 5EU Partial Knee Replacement Market Sales Forecast ($m), 2010-2019 210
Table 125: France Knee Replacement Market Sales Forecast ($m), 2010-2019 211
Table 126: Germany Knee Replacement Market Sales Forecast ($m), 2010-2019 214
Table 127: Italy Knee Replacement Market Sales Forecast ($m), 2010-2019 217
Table 128: Spain Knee Replacement Market Sales Forecast ($m), 2010-2019 219
Table 129: UK Knee Replacement Market Sales Forecast ($m), 2010-2019 221
Table 130: Abbreviations 224
Table 131: Physicians Surveyed, By Country 253

1.2 List of Figures
Figure 1: Schematic Diagram of Knee Anatomy 23
Figure 2: Unicompartmental Knee Replacement 34
Figure 3: Patellofemoral Knee Replacement 36
Figure 4: Bicompartmental Knee Replacement 37
Figure 5: CR and PS Designs 38
Figure 6: Knee Replacement Procedure Volume, 5EU, 2010-2019 48
Figure 7: Partial Knee Replacement Procedure Volume, 5EU, 2010-2019 49
Figure 8: Primary Knee Replacement Procedure Volume, 5EU, 2010-2019 50
Figure 9: Revision Knee Replacement Procedure Volume, 5EU, 2010-2019 51
Figure 10: Adoption Trend for Total Knee Implants in the 5EU, Fixed-Bearing vs. Mobile-Bearing, 2011-2015 56
Figure 11: Adoption Trend for Total Knee Implants in the 5EU, Cruciate Retaining vs. Cruciate Sacrificing, 2011-2015 57
Figure 12: Adoption Trend for Revision Knee Implants in the 5EU, 2011-2015 58
Figure 13: Adoption Trend for Computer-Assisted Technologies in the 5EU, 2012 59
Figure 14: Global Knee Replacement Market, Competitive Landscape by Sales Revenue, 2012 88
Figure 15: Columbus Total Knee System 89
Figure 16: e.motion Total Knee System 90
Figure 17: Vanguard Complete Knee System 93
Figure 18: AGC Total Knee System 95
Figure 19: LCS Complete Knee System 99
Figure 20: Sigma Knee System 101
Figure 21: Attune Knee System 103
Figure 22: Movation Knee System 107
Figure 23: 3D Knee System 108
Figure 24: Foundation Knee System 109

Figure 25: Optetrak Logic Knee System 112
Figure 26: GENESIS II Total Knee System 115
Figure 27: Journey Knee System 117
Figure 28: Triathlon Total Knee System 120
Figure 29: Scorpio Knee System 122
Figure 30: Advance Knee System 126
Figure 31: Evolution Medial-Pivot Knee System 127
Figure 32: NexGen Knee System 130
Figure 33: Gender Solutions' NexGen High-Flex Knee 133
Figure 34: Persona Knee System 134
Figure 35: Level of Impact of the Availability of Long-Term Clinical Data Upon Decision-Making (n=103) 140
Figure 36: Level of Impact of a Complete Knee System Upon Decision-Making (n=103) 141
Figure 37: Knee Replacement Market Sales Forecast ($m) in 5EU, 2010-2019 207
Figure 38: 5EU Knee Replacement Market by Country, 2012 and 2019 208
Figure 39: Global Primary Knee Replacement Market Sales Forecast ($m) in the 10MM, 2010-2019 209
Figure 40: 5EU Partial Knee Replacement Market Sales Forecast ($m), 2010-2019 210
Figure 41: France Knee Replacement Market Sales Forecast ($m), 2010-2019 212
Figure 42: France Primary Knee Replacement Market Segmentation by Type, 2012 and 2019 213
Figure 43: Germany Knee Replacement Market Sales Forecast ($m), 2010-2019 215
Figure 44: Germany Primary Knee Replacement Market Segmentation by Type, 2012 and 2019 216
Figure 45: Italy Knee Replacement Market Sales Forecast ($m), 2010-2019 217
Figure 46: Italy Primary Knee Replacement Market Segmentation by Type, 2012 and 2019 218
Figure 47: Spain Knee Replacement Market Sales Forecast ($m), 2010-2019 219
Figure 48: Spain Primary Knee Replacement Market Segmentation by Type, 2012 and 2019 220
Figure 49: UK Knee Replacement Market Sales Forecast ($m), 2010-2019 221
Figure 50: UK Primary Knee Replacement Market Segmentation by Type, 2012 and 2019 222
Figure 51: UK Primary Knee Replacement Competitive Landscape, 2011 223
Figure 52: UK Partial Knee Replacement Competitive Landscape, 2011 223