Trends in the US Orthopedic Trauma Device Market

The US orthopedic trauma device market has seen changing market dynamics in the last decade. New technologies for internal fixation prompting shifts in the internal vs external fixation discussion. With internal fixation seeing a new wave of devices in the plate and screw market. Through the new technologies, the market has seen expansion that is expected to be maintained over the reporting period. The population demographics also factor into the market growth through the aging population and the consistent role of accidental fractures.

As such the orthopedic trauma device market has an expected value of $4 billion dollars in 2024, rising at a compound annual growth rate (CAGR) of 2.6% over the next seven years.

Population Demographics

The patient pool for orthopedic trauma devices includes a wide variety of age groups and demographics. A rising portion of the demographic is aging resulting in higher risks for bone fractures. Further, the participation in risky behaviour and injuries from car accidents maintains the use of orthopedic trauma devices in all age groups. These population trends are supporting a consistent rise in procedures performed in both internal and external fixation.

The U.S. Census Bureau projects that the elderly population in the United States will increase by over 50% by 2035, to reach 78 million. This is in comparison to a mere 13% increase in the overall U.S. population. Now, for the first time in U.S. history, the elderly population is projected to outnumber the under-18 youth population, accounting for 21% of the population by 2030. As the U.S. population ages, the prevalence of fractures, particularly hip and lower extremity fractures, will increase dramatically. The cause of many of these fractures is due to osteoporosis. This will be a significant stimulus for the growth of the U.S. orthopedic trauma device market. 

Another factor in the population demographics that continues to fuel the orthopedic trauma device market is the consistent role of accidental fractures. These come from motor vehicle accidents and injuries sustained in risky behaviours. There is an estimated total of 18 million bone fractures annually in the U.S., with car accidents being the top cause of femur fractures. Fractures in the hand and feet typically occur early in life, more often in men and linked with recreational and occupational injuries.

New device technology

The number of people needing orthopedic trauma devices is one the rise. This has encouraged companies across a multitude of segments to invest in developing new materials and product designs to meet complex patient needs. Three areas of notable investment include bioabsorbable fixation devices, titanium devices and the rise of anatomical plates.

Bioabsorbable fixation devices in the orthopedic trauma space have not seen strong clinical adoption. One of the leading products in this space is BioComposite™ from Arthrex. It is a interference screw for use as a fixation device for bone-tendon (BTB or Achilles) and soft tissue grafts during ACL and PCL reconstruction procedures. Bioabsorbable fixation devices have gained a more favorable use in the sports medicine field. However, some companies are starting to develop new materials for bioabsorbable fixation that are expected to flip the market from a declining growth rate to one of expansion. These devices are still in early stages and may take years to get approved so for the next few years the declining market value may remain but will shift.

The majority of orthopedic trauma products sold in the U.S. are made with titanium instead of stainless steel. Stainless steel is often the more cost-effective material and has an established history of clinical performance. However, the costs associated with titanium manufacturing have decreased prompting companies to offer devices made of both materials. Some new clinical evidence suggests that titanium implants last longer and experience less degradation. All these factors have led to titanium devices cannibalizing various screw market shares from stainless steel.

The plate and screw market are a core feature of the orthopedic trauma device report. All internal fixation procedures use plate and screws, with the choice of using generic or anatomical plates. Generic plates are designed to be used across multiple parts of the body but in the last decade anatomical specific plates have dominated the market. with ten different specific plates included in this report including the clavicle, proximal humerus, elbow, distal radius, hand, proximal femur, distal femur, proximal tibia, distal tibia and foot. These anatomical specific devices have shown great clinical results, allowing for better patient healing and long-term joint health. 

Of the ten anatomical specific plate and screws in this report, the distal radius and the foot are the most commonly repaired; representing almost half of all fractures. As mentioned above as the fall rates rise alongside an aging population and reckless behaviors, these wrist and foot fractures will remain very common. So it comes as no surprise that every company in the market has anatomical plates designed for these bones. DePuy Synthes offers the variable angle LCP™ two-column volar distal radius plate while stryker has the VariAx^© 2 Distal Radius.

Market Dynamics

The orthopedic trauma device market is heavily fragmented with a multitude of companies having notable devices. However, the big four (DePuy Synthes, Stryker, Smith and Nephew and Zimmer Biomet) often acquire the smaller companies resulting a four-way lead for controlling the market. This is a heavily competitive environment which has led to pricing competition. 

As each company continues to develop new technologies (in the areas discussed above) the portfolios continue to expand. It is expected that all four companies will release titanium devices, DePuy Synthes notably just launched the new Volt plating system.

Conclusion

The orthopedic trauma device market has maintained steady expansion in device use across all age groups. As new devices and materials are developed better patient outcomes are fueling internal fixation procedures over the reporting period. Companies continue to thrive from this expansion with portfolio expansion and minor company acquisitions. These investments come as larger pools of the population demand fixation devices resulting from increasing reckless behavior and aging resulting in lower bone density.

About the Authors

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

Kamran Zamanian, Ph.D., is 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.