1H16 M&A Recap: Big Players Make Moves

by Julie A. Vetalice on June 24, 2016

During 1H16, seven of the eight largest orthopaedic device companies confirmed or completed acquisitions or divestitures spanning nearly every orthopaedic market segment.

Most notably, Stryker and Zimmer Biomet both announced three orthopaedic-related acquisitions, with Zimmer Biomet boosting its spine, arthroscopy/soft tissue and general surgery portfolios, and Stryker continuing to expand its spine portfolio. DePuy Synthes picked up BioMedical Enterprises to enhance its small bone trauma portfolio, while Medtronic purchased Responsive Orthopedics in an effort to enter the hip and knee market in the U.S. From a general market perspective, Medtronic and Zimmer Biomet made plays to diversify their overall offerings, while DePuy Synthes and Stryker deepened their breadth of products in markets in which they already had strong footing.

Below is a list of M&A transactions closed during the first half of the year, including transaction terms where available and a short take on what was accomplished with each. (Please note, NuVasive’s acquisition of Biotronic NeuroNetwork and Zimmer Biomet’s purchase of LDR, though announced in 1H16, are not expected to close until 3Q16.)

A list of orthopaedic M&A dating back to 1993 can be found here.

Acquirer	Acquired	Transaction Details
CTL Medical	AccelSPINE	CTL Medical was founded by AccelSPINE management to serve as a device company; the entity develops custom instruments and implants to treat the cervical, thoracic and lumbar spine.
DePuy Synthes	BioMedical Enterprises	BME manufactures Nitinol orthopaedic implants for small bone fixation.
EQT private equity firm and Hansjörg Wyss	Lima Corporate majority ownership	Lima markets large joint primary/revision implants and a complete extremities portfolio, including fixation devices.
Exactech	Exactech Australia (distributor)	Provides direct regional distribution of orthopaedic implants, instruments and surgical technology.
Histogenics	NeoCart rights in Japan	Acquired development and distribution rights for the autologous cell therapy from its partner in Japan, Purpose Co.
In’Tech Medical	Ortho Solutions	The acquired company is a contract manufacturer of orthopaedic implants and instruments in Asia.
Joint Active Systems	DJO’s Empi Advance ROM line of dynamic bracing	Transaction complements JAS’ range of motion therapies and dynamic splints.
Keensight Capital private equity firm	aap Implantate Biomaterials	aap sold off its biomaterials unit for €36MM (~US $40.3MM), and will proceed as a pure-play trauma entity. Subsequently, Keensight and Tecres, a specialist in bone substitutes and bone cements, formed Demetra Holdings to manage Tecres and aap Biomaterials as separate entities.
Kohlberg & Company private equity firm	Amendia majority ownership	Kohlberg’s $1.6BB private equity fund will support Amendia’s growth initiatives in the spine segment.
Kuros Biosurgery	Cytos Biotechnology	Merged to form Kuros Biosciences and continue development of orthobiologic products to treat fractures and spinal stability.
LISI Medical	Alcoa Remmele	For €90MM (~US $102MM), acquired the provider of precision machining for orthopaedic and spinal implants, minimally invasive surgical components and devices.
Medtronic	Responsive Orthopedics	A start-up focused on low-cost hip and knee replacements, to support bundled payment programs for hospital customers.
MiMedx	Stability Biologics	$10MM in cash/stock to acquire human tissue products for surgical, spine and orthopaedic applications.
NuVasive	Ellipse Technologies	For $380MM in cash, with potential milestones, purchased magnetically-adjustable implant systems to treat early onset scoliosis and limb lengthening.
NuVasive	Mega Surgical (distributor)	Exclusive distributor in Brazil since 2008.
Smith & Nephew	Blue Belt Technologies	For $257MM, gained the Navio surgical robotic-assistance system with present application in unicondylar or partial knee replacement.
Smith & Nephew	Piramal’s BST CarGel assets	The cartilage repair product is cleared for use in most geographies (including Australia, Canada and most of the EU).
Stryker	SafeWire	Gained access to the Y-Wire guidewire and Tiger Jamshidi Needle for use in minimally invasive spine surgery.
Stryker	BD’s vertebral augmentations assets	Included AVAmax, AVAflex, AVAtex and AVAprep branded products.
Stryker	Stanmore Implants Worldwide	All-cash transaction for £35.6MM (~US $52MM) for patient-specific and off-the-shelf implant systems for limb salvage.
Thompson Street Capital Partners private equity firm	ISTO Technologies	Thompson Street plans to invest and acquire to support ISTO’s orthobiologic product development, salesforce and reach within spine and orthopaedics.
Zimmer Biomet	Cayenne Medical	Manufacturer of soft tissue repair and reconstruction products for knee, shoulder and extremities.
Zimmer Biomet	Compression Therapy Concepts	Provider of devices to prevent deep venous thrombosis following a variety of surgical procedures (including musculoskeletal).

During 1H16, seven of the eight largest orthopaedic device companies confirmed or completed acquisitions or divestitures spanning nearly every orthopaedic market segment.

Most notably, Stryker and Zimmer Biomet both announced three orthopaedic-related acquisitions, with Zimmer Biomet boosting its spine, arthroscopy/soft tissue and general...

During 1H16, seven of the eight largest orthopaedic device companies confirmed or completed acquisitions or divestitures spanning nearly every orthopaedic market segment.

A list of orthopaedic M&A dating back to 1993 can be found here.

Acquirer	Acquired	Transaction Details
CTL Medical	AccelSPINE	CTL Medical was founded by AccelSPINE management to serve as a device company; the entity develops custom instruments and implants to treat the cervical, thoracic and lumbar spine.
DePuy Synthes	BioMedical Enterprises	BME manufactures Nitinol orthopaedic implants for small bone fixation.
EQT private equity firm and Hansjörg Wyss	Lima Corporate majority ownership	Lima markets large joint primary/revision implants and a complete extremities portfolio, including fixation devices.
Exactech	Exactech Australia (distributor)	Provides direct regional distribution of orthopaedic implants, instruments and surgical technology.
Histogenics	NeoCart rights in Japan	Acquired development and distribution rights for the autologous cell therapy from its partner in Japan, Purpose Co.
In’Tech Medical	Ortho Solutions	The acquired company is a contract manufacturer of orthopaedic implants and instruments in Asia.
Joint Active Systems	DJO’s Empi Advance ROM line of dynamic bracing	Transaction complements JAS’ range of motion therapies and dynamic splints.
Keensight Capital private equity firm	aap Implantate Biomaterials	aap sold off its biomaterials unit for €36MM (~US $40.3MM), and will proceed as a pure-play trauma entity. Subsequently, Keensight and Tecres, a specialist in bone substitutes and bone cements, formed Demetra Holdings to manage Tecres and aap Biomaterials as separate entities.
Kohlberg & Company private equity firm	Amendia majority ownership	Kohlberg’s $1.6BB private equity fund will support Amendia’s growth initiatives in the spine segment.
Kuros Biosurgery	Cytos Biotechnology	Merged to form Kuros Biosciences and continue development of orthobiologic products to treat fractures and spinal stability.
LISI Medical	Alcoa Remmele	For €90MM (~US $102MM), acquired the provider of precision machining for orthopaedic and spinal implants, minimally invasive surgical components and devices.
Medtronic	Responsive Orthopedics	A start-up focused on low-cost hip and knee replacements, to support bundled payment programs for hospital customers.
MiMedx	Stability Biologics	$10MM in cash/stock to acquire human tissue products for surgical, spine and orthopaedic applications.
NuVasive	Ellipse Technologies	For $380MM in cash, with potential milestones, purchased magnetically-adjustable implant systems to treat early onset scoliosis and limb lengthening.
NuVasive	Mega Surgical (distributor)	Exclusive distributor in Brazil since 2008.
Smith & Nephew	Blue Belt Technologies	For $257MM, gained the Navio surgical robotic-assistance system with present application in unicondylar or partial knee replacement.
Smith & Nephew	Piramal’s BST CarGel assets	The cartilage repair product is cleared for use in most geographies (including Australia, Canada and most of the EU).
Stryker	SafeWire	Gained access to the Y-Wire guidewire and Tiger Jamshidi Needle for use in minimally invasive spine surgery.
Stryker	BD’s vertebral augmentations assets	Included AVAmax, AVAflex, AVAtex and AVAprep branded products.
Stryker	Stanmore Implants Worldwide	All-cash transaction for £35.6MM (~US $52MM) for patient-specific and off-the-shelf implant systems for limb salvage.
Thompson Street Capital Partners private equity firm	ISTO Technologies	Thompson Street plans to invest and acquire to support ISTO’s orthobiologic product development, salesforce and reach within spine and orthopaedics.
Zimmer Biomet	Cayenne Medical	Manufacturer of soft tissue repair and reconstruction products for knee, shoulder and extremities.
Zimmer Biomet	Compression Therapy Concepts	Provider of devices to prevent deep venous thrombosis following a variety of surgical procedures (including musculoskeletal).