Held March 6–10 in New Orleans, Louisiana, the American Academy of Orthopaedic Surgeons (AAOS) 2018 Annual Meeting was a rich landscape of novel products and technologies, innovative research into emerging market segments, and conversation about physician best practices.
The use of stem cell therapies and opioids for orthopedic patients were hot topics at this year’s conference. Research into the use of stem cell therapies for knee osteoarthritis (OA) patients was published showing that the number of US clinics and centers offering direct-to-patient stem cell treatments is increasing, despite a lack of solid evidence in favor of the biological treatment. The elderly portion of the US population is growing, and with it the number of knee OA patients. These patients are increasingly focused on maintaining active lifestyles and avoiding major surgery, causing the markets for treatments that would prolong the time to knee replacement procedures to grow.
Stem cell therapies are gaining traction
Stem cell therapies are gaining more traction as a potential therapy for knee OA patients, with excitement from both patients and physicians. However, the study presented at AAOS shows that while clinics and healthcare providers are jumping at the opportunity for more procedures and increased revenue, the existing stem cell treatments are not yet at a point where they should be touted in the life-changing manner that is currently being advertised.
Research into the use of opioids in orthopedic patients was also presented at the conference. The ongoing opioid crisis in the US is receiving increased attention from the media and the public, in turn drawing greater attention from healthcare providers. Two studies conducted at the Rothman Institute at Thomas Jefferson University in hand surgery patients presented alternative approaches to opioid prescription. The studies indicated that not only did pre-operative counseling cause a significant decrease in the use of opioids among hand surgery patients, but patients who were given non-opioid pain relievers following hand surgery had similar pain support to those treated with opioids. These studies speak to a larger, national conversation that goes beyond the orthopedics market, and highlights the importance of seeking alternative approaches to pain management in order to best serve patients.
Activity on the industry side included companies taking the opportunity to spotlight new product launches. Many of the announced products were hip and knee implants, as companies seek to update and expand their joint replacement portfolios to cover the entire continuum of care, from initial joint replacement to revision.
GlobalData estimates the combined US hip and knee replacement markets were valued at $7.1B in 2017; although these markets are mature and expect to undergo only moderate growth over the next five years, the demand for hip and knee replacements will continue to increase as the population ages, and the markets will remain among the most lucrative orthopedic segments. Therefore, companies are continuing to invest in features and attributes that will set novel implants apart, including improved material technology to enhance bony integration, increasingly personalized implant components, superior retention of patient anatomy, and increased compatibility with robotic surgical systems and preoperative planning software.
Many of the hip and knee devices launched at AAOS exemplified the aforementioned attributes.
DePuy Synthes revealed the US launch of the ATTUNE Revision Knee System, which complements the ATTUNE Primary Knee System to cover the continuum of knee replacement care.
Corin announced the launch of the Trinity Dual Mobility System for hips, designed for use with Corin’s Optimized Position System (OPS) preoperative planning technology, and the Unity Knee with EquiBalance instrumentation for soft tissue preservation. Smith and Nephew announced the full commercial release of the JOURNEY II XR implant, a bi-cruciate retaining total knee system, in the US and Japan. Stryker revealed the commercial launch of the Trident II Acetabular System, which uses the company’s proprietary AMagine 3D printing technology, and Medacta launched the MOTO Medial Partial Knee and the MasterLoc LAT PLUS, a part of the MasterLoc Hip System.
New arrivals on the market
Finally, global spine device manufacturer Globus Medical announced its entry into the trauma fixation market. GlobalData estimates the trauma fixation market is the third largest orthopedic market globally, and that it will maintain this position through 2025. Globus’ announcement was accompanied by the presentation of 11 new FDA-approved trauma products, including intramedullary (IM) nails, compression screws, plating systems, cannulated screws, and external fixators.
The trauma market is fairly mature and consolidated, with five multinationals holding nearly 80% of the global market in 2017. GlobalData expects Globus will utilize a strong portfolio and brand recognition in the spine markets to gain share in the global trauma market, although increasingly competitive pricing worldwide and cheaper “me-too” products in emerging markets from local manufacturers are important barriers to be overcome.