Trends in the Global Large Joint Reconstruction Market

The global large joint reconstruction market includes the hip replacement market, knee replacement market, and the bone cement market. Devices included throughout the expanded report include total joint replacements by bearing type (fixed and mobile devices) as well as materials used (including metal, HCPE, and ceramic). Rising interest in fine-tuning devices within these new sub-segments is driven by more patients requiring joint replacements for longer portions of their lives. Further fueling expansion is the role for AI and robotics within performing joint replacement surgeries around the globe.

It is forecasted that the global large joint reconstruction market will see a compounded annual growth rate (CAGR) of 3.3% over the forecast period. It is expected to reach a market value of $25.7 billion dollars by the year 2030.

Expanding Patient Pool

According to the United Nations (UN), the process of population aging is most advanced in Europe and in North America, where approximately 25% of the population were 60 years old or over in 2017. By 2050, older persons are expected to account for 35% of the population in Europe, and by 2070, this number is expected to exceed 50%. Globally, Western Europe has the top five oldest populations. As the number of people over the age of 60 in a population increases, the risk of large joint fractures also rises. 

In addition to aging, the shift towards a rising number of people partaking in risky behaviors that lead to traumatic fractures of the hip and knee. This is expanding the patient pool for large joint reconstruction procedures to increasingly younger people across the globe. Given the standard lifespan of a joint replacement is 15 years, as these younger patients require revisions and new replacements in their later years this is continuing the demographic expansion of the joint replacement procedure and, by extension, market. This is most notable for cases of partial hip and knee replacements later being redone as total hip and knee replacements.

Shifting Patient Needs

As the number of people receiving large joint replacements rises, the individual procedural needs are changing too. This is reflected in approaches taken and devices selected. The largest variance can be found within the knee replacement segment, but hip replacements are seeing changes as well.

Bearings can be fixed (that is, physically clipped into the plate inserted at the top of the shinbone). Or they can be mobile, where they have the freedom to move within the joint. There is strong variance regionally on the more popular approach, but globally speaking fixed devices are the preferred approach in knee replacements. The main reason for this is the reconstruction’s durability is better with the fixed bearings in older populations. However, as younger people face the need for a knee replacement mobile devices are considered the better option for the demographic, shifting the approach split over the forecast period.

Another area of variance in performing knee replacements is the role of the posterior cruciate ligament. In a cruciate-retaining knee implant, the surgeon chooses to keep the posterior cruciate ligament intact to give the knee support. Across the globe, the general preference is to sacrifice the ligament as there remains limited clinical evidence supporting the aid of retaining it. Unlike the bearing type, this is not altered by specific age demographics resulting in more stability over the forecast period. This trend may shift depending on the clinical evidence that gets published in the next five years.

Hip replacements are seeing shifts within one main area, that is the materials used within total hip replacement devices. The emergence of the new generation of HCPE (Highly cross-linked polyethylene) has resulted in the combination, with metal and ceramic being the most popular, the former remaining the most commonly used material in total hip replacements across the globe. In its 30 years of use in joint arthroplasties, HCPE has risen in popularity (as shown in Figure 2), and its continued innovation is one of the main areas of product development.

Rising Number of Virtual Assists

Investment within the large joint replacement market is being seen within the devices themselves as well as the tools used in performing the replacements. Globally there are a handful of leading companies within the large joint reconstruction market, with a heavy presence of minor regional competitors. Throughout the all competitors is an interest in continually developing better materials for the expanding product lines. A select number of companies have developed AI and robotic systems to assist in the reconstruction procedures. 

Within the realm of incorporating AI and robotics into joint reconstruction Stryker and Zimmer Biomet are the global leaders. Stryker developed the Mako SmartRobotics™ and was the first company to have an approved robotic system approved for knee replacements. The company has continued to invest in the line with the launch of the Mako Total Knee 2.0 in early 2023. Also competing within the robotics realm is DePuy Synthes. The FDA cleared DePuy Synthes robotic surgery system (The Velys digital joint reconstruction system) for total knee replacement, which is also used for hip and shoulder replacements.

Zimmer Biomet follows a similar path within AI assistant programs through enhancements to its ZBEdge Dynamic Intelligence platform for hip and knee replacements. The use of AI has seen less competition enter the space, but that is unlikely to stay the case over the coming years. Microport and Osso VR have worked together to bring virtual reality training to the procedure, entering the space the Zimmer Biomet has held a temporary lead in.

Holding steady with investment across both global leaders mentioned above and small regional companies is the expansion of joint replacement devices. DePuy Synthes has maintained its Attune line for knee replacement devices, spanning total replacements to revisions. Other companies, notably, Stryker, Zimmer Biomet, and Smith and Nephew, have continued to maintain their lines as well. 

Conclusion

The global large joint replacement market is seeing expansion across multiple plains over the reporting period. As more patients receive replacements in a larger variety of devices and technologies used, this market will continue to see interest from an array of companies. 

Emily Gilbert is a research analyst at iData Research. She develops and composes syndicated research projects regarding the medical device industry, publishing the US, EU, and global Interventional Cardiology series as well as the US, EU, and global cardiac surgery series.

Kamran Zamanian, Ph.D., is the CEO and founding partner of iData Research. He has spent over 20 years working in the market research industry with a dedication to the study of medical devices used in the health of patients all over the globe.