MediPoint: Total Wrist Reconstruction - Global Analysis and Market Forecasts
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MediPoint: Total Wrist Reconstruction - Global Analysis and Market Forecasts
Summary- Wrist arthritis is a serious issue that affects a significant number of people and making it difficult to engage in many day to day activities. While it is most prevalent in the developed nations, it is a growing concern in the emerging markets as well. The primary indications that have caused wrist arthritis are osteoarthritis, rheumatoid arthritis and post-traumatic arthritis. More recently with the aging population, and high quality biologic medications available for rheumatoid arthritis, osteoarthritis and post-traumatic arthritis are the primary indications that get severe enough to be considered for surgical intervention.
There is also an expected increase in the incidence of wrist arthritis due to the rising aging population numbers. Total wrist fusion (TWF) and total wrist replacement (TWR) are two surgical procedures that are considered in patients with severe wrist arthritis. While TWR is a motion preserving procedure, TWF has been seen as the gold standard especially in younger patients due to the high revision and failure rate in TWR. Patient demand and desire to retain motion in their joints will drive innovation and the numerous unmet needs expressed by physicians. This report focuses on the TWR and TWF markets in the US, the EU5, Japan, Brazil, China and India. This report identifies unmet needs in the market, surgeon attitudes towards current TWR and TWF prostheses, and the future of the market in the midst of a rapidly growing small bone joint replacement segment.
Highlights
Key Questions Answered- Wrist arthritis prevalence is expected to increase during the forecast period. (Q).What is the cost of wrist arthritis? (Q).How will changing demographics and lifestyles affect the incidence of wrist arthritis? - Lack of long-term results and studies have hampered adoption of TWR implants and TWF is still used frequently. (Q).What will require shifts in surgeon attitudes towards wrist replacement in the treatment of late-stage wrist arthritis? - TWR is still slowly becoming more popular as an alternative to wrist fusion, as companies promote their products and patients demand technology that allows them to retain joint motion. (Q).What is the current perception and adoption of this technique in the major markets?- There is a limited pipeline and one product slated for release in the US in 2014 already marketed in the EU with additional plate products expected in 2013. (Q).What is the Scope for more wrist innovation and what are surgeons looking for in their products? (Q).What is the debate on fusion versus replacement?- Today approximately 3-5 TWR and 2-3 TWF prostheses have most market share throughout the world. Current prosthesis design less bone resection and are used for preserving joint motion. (Q).Which countries expect to see the most adoption and what are the hurdles? (Q).What are the unmet needs? (Q).How can device manufacturers differentiate themselves from the competition?
Reasons to buy- "What Physicians Think" quotes provide a unique insight into how healthcare professionals are reacting to events within the industry, and what their responses could mean for industry strategists. In this report you will understand the perceptions of leading Orthopedic Hand Surgeons from around the world. This information is essential for all strategic decision makers in every organization allowing them to act on high quality information.
Table of Contents1 Table of Contents 61.1 List of Tables 131.2 List of Figures 152 Introduction 172.1 Catalyst 172.2 Related Reports 182.3 Upcoming Related Reports 183 Disease Overview 193.1 Anatomy and Physiology 193.2 Pathophysiology 203.2.1 Overview 203.2.2 Osteoarthritis 203.2.3 Rheumatoid Arthritis 213.2.4 Carpal Tunnel Syndrome 213.2.5 Others 213.3 Clinical Presentation 223.4 Clinical Outcomes 233.4.1 Overview 233.4.2 Conservative Therapy 243.4.3 Arthroscopic Debridement 243.4.4 Proximal Row Carpectomy 243.4.5 Total Wrist Fusion 253.4.6 Total Wrist Replacement 273.4.7 Wrist Fusion Versus Total Wrist Replacement 293.5 Epidemiology 303.6 Economic Impact 323.6.1 Economic Impact of Treating Arthritis 323.6.2 Cost Effectiveness of Orthopedic Implants 334 Competitive Assessment 344.1 Total Wrist Implant 344.1.1 Overview of Historical Designs 344.1.2 Current Designs 354.2 Total Wrist Fusion 484.2.1 Overview of Historical Designs 484.2.2 Current Designs 495 Unmet Needs 575.1 Long-Term Clinical Data 575.2 Limited Product Offerings 585.3 Failure and Revision Rate 595.4 Minimal Bone Resection and Other Complications 595.5 Lack of Pipeline Products 615.6 Need for Better Physician Training 616 Pipeline Products 636.1 Overview 637 Industry Overview 647.1 Procedure Volumes 647.1.1 US 667.1.2 Europe 687.1.3 Asia-Pacific 707.1.4 Brazil 727.2 Market Access 737.2.1 US 747.2.2 Europe 767.2.3 Asia-Pacific 777.2.4 Brazil 787.3 Reimbursement Trends 797.3.1 US 797.3.2 Europe 817.3.3 Japan 847.3.4 Brazil 847.3.5 China 857.3.6 India 867.4 Regulatory Issues/Recalls 877.5 Mergers & Acquisitions / Key Partnerships 878 Company Profiles 908.1 Small Bone Innovation Inc. 908.1.1 Overview 908.1.2 Portfolio Assessment 908.1.3 SWOT Analysis 918.2 Depuy Synthes International 918.2.1 Overview 918.2.2 Portfolio Assessment 918.2.3 SWOT Analysis 928.3 Integra LifeSciences Inc. 938.3.1 Overview 938.3.2 Portfolio Assessment 938.3.3 SWOT Analysis 938.4 Biomet Orthopedics 948.4.1 Overview 948.4.2 Portfolio Assessment 948.4.3 SWOT Analysis 958.5 Medartis AG 958.5.1 Overview 958.5.2 Portfolio Assessment 958.5.3 SWOT Analysis 968.6 Acumed 968.6.1 Overview 968.6.2 Portfolio Assessment 968.6.3 SWOT Analysis 978.7 Tornier N.V. 988.7.1 Overview 988.7.2 Portfolio Assessment 988.7.3 SWOT Analysis 998.8 Swemac Orthopaedics AB 998.8.1 Overview 998.8.2 Portfolio Assessment 998.8.3 SWOT Analysis 1008.9 Zimmer Holdings Inc. 1008.9.1 Overview 1008.9.2 Portfolio Assessment 1008.9.3 SWOT Analysis 1018.10 Skeletal Dynamics 1028.10.1 Overview 1028.10.2 Portfolio Assessment 1028.10.3 SWOT Analysis 1029 Market Drivers & Opportunities 1039.1 Market Drivers 1039.1.1 Rise in Osteoarthritis 1039.1.2 Aging 1039.1.3 Trauma 1039.1.4 Patient Demand and Awareness 1049.1.5 Availability of Long-Term Clinical Data 1049.1.6 Further Technological Advancement 1059.1.7 Corporate Promotions and Teaching Seminars 1059.2 Opportunities 1069.2.1 Expanding Aging and Arthritis Indication 1069.2.2 Revision Surgery 1069.2.3 Emerging Markets 1079.2.4 Capitalizing on Market Fragmentation 10710 Market Threats & Substitutes 10810.1 Market Threats 10810.1.1 Slow Technological Advancement 10810.1.2 Physician Perception and Learning Curve 10810.1.3 Complications 10910.1.4 Cost 10910.1.5 Lack of Long-Term Studies 11010.2 Substitutes 11010.2.1 Therapeutic Options and Fusion 11011 Country Outlooks & Forecasts 11111.1 Major Markets Overview 11111.2 US 11511.2.1 Overview 11511.2.2 US Market Analysis 11511.3 France 11711.3.1 Overview 11711.3.2 France Market Analysis 11711.4 Germany 11811.4.1 Overview 11811.4.2 Germany Market Analysis 11811.5 Italy 12011.5.1 Overview 12011.5.2 Italy Market Analysis 12011.6 Spain 12111.6.1 Overview 12111.6.2 Spain Market Analysis 12111.7 UK 12211.7.1 Overview 12211.7.2 UK Market Analysis 12211.8 Japan 12411.8.1 Overview 12411.8.2 Japan Market Analysis 12411.9 Brazil 12511.9.1 Overview 12511.9.2 Brazil Market Analysis 12511.10 China 12611.10.1 Overview 12611.10.2 China Market Analysis 12611.11 India 12811.11.1 Overview 12811.11.2 India Market Analysis 12812 Appendix 13012.1 Abbreviations 13012.2 Bibliography 13112.3 Report Methodology 13712.3.1 Overview 13712.3.2 Coverage 13712.3.3 Secondary Research 13712.3.4 Forecasting Methodology 13812.3.5 Primary Research - Key Opinion Leader Interviews 13912.3.6 Primary Research - Physician Survey 13912.3.7 Expert Panel Validation 13912.4 Physicians and Specialists Included in this Study 14012.4.1 Dr. Philippe Bellemère 14012.4.2 Dr. Vikas Gupta, MBBS, MS 14012.4.3 William H. Seitz, Jr., MD 14012.4.4 Robert M. Szabo, MD, MPH 14012.4.5 David Warwick, MD, BM, DIMC, FRCS (Orth) 14012.5 About the Authors 14112.5.1 Analysts 14112.5.2 Global Head of Healthcare 14212.6 About MediPoint 14212.7 About GlobalData 14212.8 Contact Us 14312.9 Disclaimer 143
List of TablesTable 1: Clinical Symptoms and Descriptions 22Table 2: Advantages and Disadvantages of Wrist Fusion and Total Wrist Replacement 30Table 3: Direct and Indirect Costs of Arthritis 32Table 4: Universal 2 Total Wrist Implant System (Integra LifeSciences Inc.) 36Table 5: SWOT Universal 2 Total Wrist Implant System 37Table 6: ReMotion Total Wrist (Small Bone Innovations, Inc.) 38Table 7: SWOT ReMotion Total Wrist 38Table 8: Maestro Total Wrist System (Biomet Orthopedics) 40Table 9: SWOT Maestro Total Wrist System 40Table 10: Tornier Resurfacing Capitate Pyrocarbon Implant 42Table 11: SWOT:Tornier Resurfacing Capitate Pyrocarbon Wrist Implant 42Table 12: Motec Wrist Joint Prosthesis (Swemac Orthopaedics AB) 44Table 13: SWOT Motec Wrist Joint Prosthesis 45Table 14: MWP III Total Wrist Prosthesis (Zimmer Inc.) 47Table 15: SWOT MWP III Total Wrist Prosthesis 47Table 16: LCP Wrist Fusion Set (DePuy Synthes, Johnson & Johnson Co.) 51Table 17: SWOT LCP Wrist Fusion Set 51Table 18: Integra Total Wrist Fusion System (Integra LifeSciences Inc.) 52Table 19: SWOT Integra Total Wrist Fusion System 53Table 20: Arthrodesis System 2.0/2.3, 2.5 APTUS Wrist (Medartis AG) 54Table 21: SWOT Arthrodesis System 2.0/2.3, 2.5 APTUS Wrist 54Table 22: Arthrodesis System 2.0/2.3, 2.5 APTUS Wrist (Medartis AG) 55Table 23: SWOT Implate Wrist Arthrodesis Nail 56Table 24: Complications and Risks for TWR and TWF 60Table 25: Product Components and Costs 73Table 26: Regulatory Differences Between the US and EU 76Table 27: Reimbursements Associated with TWR 80Table 28: Medicare Payment Trend for Wrist Procedures,1992-2004 80Table 29: Company Profile - Small Bone Innovation Inc. 90Table 30: SWOT Analysis - Small Bone Innovations Inc. 91Table 31: Company Profile - Depuy Synthes International 92Table 32: SWOT Analysis - Depuy Synthes International 92Table 33: Company Profile - Integra LifeSciences Inc. 93Table 34: SWOT Analysis - Integra LifeSciences Inc. 93Table 35: Company Profile - Biomet Orthopedics 94Table 36: SWOT Analysis - Biomet Orthopedics 95Table 37: Company Profile - Medartis AG 95Table 38: SWOT Analysis - Medartis AG 96Table 39: Company Profile - Acumed LLC 97Table 40: SWOT Analysis - Acumed LLC 97Table 41: Company Profile - Tornier N.V. 98Table 42: SWOT Analysis - Tornier N.V. 99Table 43: Company Profile - Swemac Orthopaedics AB 100Table 44: SWOT Analysis - Swemac Orthopaedics AB 100Table 45: Company Profile - Zimmer Holdings Inc. 101Table 46: SWOT Analysis - Zimmer Holdings, Inc. 101Table 47: Company Profile - Skeletal Dynamics LLC 102Table 48: SWOT Analysis - Skeletal Dynamics LLC 102Table 49: Global Sales ($m) Forecast for TWF and TWR, 2009-2018 111Table 50: US Sales ($m) Forecast for TWF and TWR, 2009-2018 116Table 51: France Sales ($m) Forecast for TWF and TWR, 2009-2018 117Table 52: Germany Sales ($m) Forecast for TWF and TWR, 2009-2018 119Table 53: Italy Sales ($m) Forecast for TWF and TWR, 2009-2018 120Table 54: Spain Sales ($m) Forecast for TWF and TWR, 2009-2018 121Table 55: UK Sales ($m) Forecast for TWF and TWR, 2009-2018 123Table 56: Japan Sales ($m) Forecast for TWF and TWR, 2009-2018 124Table 57: Brazil Sales ($m) Forecast for TWF and TWR, 2009-2018 125Table 58: China Sales ($m) Forecast for TWF and TWR, 2009-2018 127Table 59: India Sales ($m) Forecast for TWF and TWR, 2009-2018 128
1.2 List of FiguresFigure 1: Anatomy of the Wrist 19Figure 2: Treatment Paradigm for Wrist Arthritis 23Figure 3: Wrist Arthrodesis with a Fusion Plate 26Figure 4: Total Wrist Arthroplasty 28Figure 5: Population with Wrist Arthritis in Major Markets, 2009-2018 31Figure 6: Disease Segments of Wrist Arthritis 32Figure 7: Global Market Share of TWR Implants 34Figure 8: Universal 2 Total Wrist Implant System (Integra LifeSciences Inc.) 36Figure 9: ReMotion Total Wrist (Small Bone Innovations, Inc.) 37Figure 10: Maestro Total Wrist System (Biomet Orthopedics) 39Figure 11: Tornier Resurfacing Capitate Pyrocarbon Implant 41Figure 12: Motec Wrist Joint Prosthesis (Swemac Orthopaedics AB) 44Figure 13: MWP III Total Wrist Prosthesis (Zimmer Inc.) 46Figure 14: Global Market Share of TWF Implants 48Figure 15: LCP Wrist Fusion Set (DePuy Synthes, Johnson & Johnson Co.) 50Figure 16: Integra Total Wrist Fusion System (Integra LifeSciences Inc.) 52Figure 17: Arthrodesis System 2.0/2.3, 2.5 APTUS Wrist (Medartis AG) 53Figure 18: Implate Wrist Arthrodesis Nail (Skeletal Dynamics LLC) 55Figure 19: Importance of Safety of Arthrodesis and Arthroplasty Implants 60Figure 20: US Arthrodesis and Arthroplasty Procedure Volumes (2009-2018) 67Figure 21: Europe Arthrodesis and Arthroplasty Procedure Volumes (2009-2018) 69Figure 22: Asia-Pacific Arthrodesis and Arthroplasty Procedure Volumes (2009-2018) 71Figure 23: Brazil Arthrodesis and Arthroplasty Procedure Volumes (2009-2018) 72Figure 24: Medicare Payment Trend for Wrist Procedures, 1992-2004 81Figure 25: Global Sales ($m) Forecast for TWR and TWF, 2009-2018 112Figure 26: TWR Revenue by Major Market, 2009 and 2018 113Figure 27: TWF Revenue by Major Market, 2009 and 2018 114Figure 28: US TWR and TWF Market, 2009-2018 116Figure 29: France TWR and TWF Market, 2009-2018 118Figure 30: Germany TWR and TWF Market, 2009-2018 119Figure 31: Italy TWR and TWF Market, 2009-2018 120Figure 32: Spain TWR and TWF Market, 2009-2018 121Figure 33: UK TWR and TWF Market, 2009-2018 123Figure 34: Japan TWR and TWF Market, 2009-2018 124Figure 35: Brazil TWR and TWF Market, 2009-2018 126Figure 36: China TWR and TWF Market, 2009-2018 127Figure 37: India TWR and TWF Market, 2009-2018 129
Companies Mentioned Small Bone Innovation Inc.Depuy Synthes InternationalIntegra LifeSciences Inc.Biomet OrthopedicsMedartis AGAcumedTornier N.V.Swemac Orthopaedics ABZimmer Holdings Inc.Skeletal Dynamics
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