US orthopedic implant demand will grow 8.9 percent annually through 2012. Knees and hips will continue to claim most reconstructive joint replacements. New technologies and surgical techniques will boost demand for spinal implants. Orthobiologics will benefit from breakthroughs in biotechnology and nanotechnology.

This study analyzes the $14.3 billion US orthopedic implant industry. It presents historical demand data (1997, 2002 and 2007) and forecasts for 2012 and 2017 by product (e.g., knee replacements, hip replacements, shoulder implants, thoracolumbar implants, intervertebral spacers, hyaluronic acid, bone substitutes, bone growth factors, bone cement, trauma implants), and market.

The study also considers market environment factors, details industry structure, evaluates company market share and profiles 18 industry players, including Stryker, DePuy, Zimmer and Medtronic.

TABLE OF CONTENTS


SECTION                                                                        PAGE

                INTRODUCTION                                                   viii

          I.    EXECUTIVE SUMMARY                                                 1

         II.    MARKET ENVIRONMENT                                                4
                General                                                           4
                Macroeconomic Trends                                              5
                Demographic Patterns                                             10
                Health Care Trends                                               12
                    Health Insurance                                             13
                    Acute Conditions                                             16
                    Chronic Conditions                                           18
                    National Health Expenditures                                 21
                    Medical Providers                                            24
                      Acute Care Hospitals                                       25
                      Outpatient Facilities                                      26
                      Skilled Nursing Homes                                      27
                      Physicians                                                 27
                    Patient Activity                                             28
                      Acute Care Hospital Admissions                             29
                      Surgical Procedures                                        30
                      Outpatient Visits                                          30
                    Medical Product Markets                                      31
                Orthopedic Implant Market Overview                               33
                    Regulation                                                   34
                    Orthopedic Conditions                                        37
                      Mobility Impairments                                       39
                      Arthritis                                                  39
                      Osteopenia & Osteoporosis                                  40
                      Paget's Disease                                            41
                    Orthopedic Implant Procedures                                42
                    Orthopedic Implant Procedure Revenues                        44
                    Historical Demand Patterns                                   45
                    US Trade                                                     47
                International Markets                                            49

        III.    PRODUCTS                                                         53
                General                                                          53
                Product Overview                                                 55
                Reconstructive Joint Replacements                                57
                    Knee Replacement Implants                                    60
                      Types of Knee Replacements                                 62
                      Cemented Versus Cementless Implants                        65
                      Alternative Therapies                                      65
                      Producers                                                  66
                      Product Development                                        70
                    Hip Replacement Implants                                     72
                      Types of Hip Replacements                                  74
                      Alternative Therapies                                      77
                      Producers                                                  77
                    Shoulder Implants                                            83
                      Shoulder Anatomy                                           84
                      Types of Shoulder Replacements                             85
                      Producers                                                  86
                    Other Reconstructive Joint Replacements                      87
                      Elbow Replacements                                         88
                      Ankle Implants                                             89
                      All Other Reconstructive Joint Replacements                90
                Spinal Implants                                                  91
                    Spinal Conditions & Procedures                               94
                    Thoracolumbar Implants                                       97
                    Intervertebral Spacers                                      100
                      Non-Bone Intervertebral Spacers                           101
                      Machined Allograft Spacers                                103
                    Cervical Implants                                           104
                      Types of Cervical Implants                                105
                      Producers                                                 106
                    Other Spinal Implants                                       108
                      Motion Preservation Implants                              109
                      Electrical Stimulation Devices                            111
                Orthobiologics                                                  112
                    Hyaluronic Acid                                             114
                    Bone Substitutes                                            116
                      Types & Applications                                      116
                      Producers                                                 117
                    Bone Growth Factors                                         119
                    Bone Cement                                                 121
                    Tissue Implants                                             124
                Trauma Implants                                                 126
                    Internal Trauma Fixation Devices                            128
                      Types of Internal Fixation Devices                        129
                      Competing Products                                        130
                      Producers                                                 130
                    Craniomaxillofacial Fixation Devices                        131
                      Types of Craniomaxillofacial Implants                     131
                      Producers                                                 132
                    Implantable Trauma Stimulators                              134

         IV.    MARKETS                                                         137
                General                                                         137
                Hospitals                                                       138
                    Market Overview                                             139
                    Market Trends                                               139
                Outpatient Facilities                                           141
                Physicians' Offices                                             143
                Other Markets                                                   144

          V.    INDUSTRY STRUCTURE                                              146
                General                                                         146
                Market Share                                                    148
                Competitive Strategies                                          150
                Mergers & Acquisitions                                          154
                Licensing & Related Agreements                                  156
                Research & Development                                          159
                Marketing & Distribution                                        161
                Manufacturing Activities                                        163
                Company Profiles                                                164
                    Abbott Laboratories                                         165
                    Altiva Corporation, see Exactech
                    Biomet Incorporated                                         167
                    Blackstone Medical, see Orthofix International
                    Cook Group Incorporated                                     176
                    DePuy Incorporated, see Johnson & Johnson
                    DJO Incorporated                                            177
                    Exactech Incorporated                                       179
                    Genzyme Corporation                                         183
                    Johnson & Johnson                                           185
                    Kyphon Incorporated, see Medtronic
                    Medtronic Incorporated                                      194
                    Orthofix International NV                                   196
                    Orthovita Incorporated                                      199
                    Osteotech Incorporated                                      200
                    Pioneer Surgical Technology Incorporated                    202
                    RTI Biologics Incorporated                                  204
                    Smith & Nephew plc                                          207
                    Stryker Corporation                                         212
                    Synthes Incorporated                                        218
                    Tutogen Medical Incorporated, see RTI Biologics
                    Wright Medical Group Incorporated                           221
                    Zimmer Holdings Incorporated                                228


                                 LIST OF TABLES
                                        
TABLE NUMBER                                                                   PAGE

                SECTION I -- EXECUTIVE SUMMARY
                Summary Table                                                     3

                SECTION II -- MARKET ENVIRONMENT
           1    Macroeconomic Indicators                                         10
           2    Population by Age Group                                          12
           3    Health Insurance Coverage of the US Population, 1997-2007        16
           4    Acute Conditions by Type                                         18
           5    Chronic Conditions by Type                                       20
           6    National Health Expenditures by Type & Source                    23
           7    Medical Providers by Type                                        25
           8    Patient Activity by Type                                         29
           9    Medical Product Demand by Group                                  33
          10    Orthopedic Conditions by Type                                    38
          11    Orthopedic Implant Procedures by Type                            43
          12    Orthopedic Implant Procedure Revenues                            45
          13    Orthopedic Implant Market, 1997-2007                             47
          14    US Trade in Orthopedic Implants                                  49
          15    World Orthopedic Implant Demand by Region                        52

                SECTION III -- PRODUCTS
           1    Orthopedic Implant Demand by Product Group                       55
           2    Reconstructive Joint Replacement Demand by Product Group         59
           3    Reconstructive Knee Replacement Demand by Type                   61
           4    Reconstructive Hip Replacement Demand by Type                    74
           5    Reconstructive Shoulder Replacement Demand by Type               84
           6    Other Reconstructive Joint Replacement Demand by Type            88
           7    Spinal Implant Demand by Product Group                           93
           8    Thoracolumbar Implant Demand by Application                     100
           9    Intervertebral Spacer Demand by Type                            101
          10    Cervical Implant Demand by Application                          105
          11    Other Spinal Implant Demand by Product Group                    109
          12    Orthobiologic Demand by Product Group                           113
          13    Hyaluronic Acid Demand                                          115
          14    Bone Substitute Demand                                          116
          15    Bone Growth Factor Demand                                       121
          16    Bone Cement Demand                                              124
          17    Tissue Implant Demand                                           126
          18    Trauma Implant Demand by Product Group                          127
          19    Internal Trauma Fixation Device Demand by Application           129
          20    Craniomaxillofacial Fixation Device Demand                      131
          21    Implantable Trauma Stimulator Demand                            136

                SECTION IV -- MARKETS
           1    Orthopedic Implant Demand by Market                             137
           2    Hospital Orthopedic Implant Demand by Product Group             138
           3    Outpatient Market Orthopedic Implant Demand                     143
           4    Physicians' Office Orthopedic Implant Demand                    144
           5    Other Markets Orthopedic Implant Demand                         145

                SECTION V -- INDUSTRY STRUCTURE
           1    US Orthopedic Implant Sales by Company, 2007                    147
           2    Selected Acquisitions & Divestitures                            155
           3    Selected Cooperative Agreements                                 158

                                 LIST OF CHARTS
                                        
CHART NUMBER                                                                   PAGE

                SECTION II -- MARKET ENVIRONMENT
           1    Orthopedic Conditions by Type, 2007                              38
           2    Orthopedic Implant Procedures by Type, 2007                      44

                SECTION III -- PRODUCTS
           1    Orthopedic Implant Demand by Product Group, 2007                 57
           2    Reconstructive Joint Replacement Demand
                    by Product Group, 2007                                       60
           3    Spinal Implant Demand by Product Group, 2007                     93
           4    Orthobiologic Demand by Product Group, 2007                     114
           5    Trauma Implant Demand by Product Group, 2007                    128

                SECTION V -- INDUSTRY STRUCTURE
           1    Orthopedic Implant Market Share, 2007                           149