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Below we’ll take a dive into the performance of select companies for sales outside of the United States. According to our estimates, about a third of all orthopedic sales occur outside the U.S. However, several waves of disruption have made it harder to get a read on the health of these markets.
We’ve selected a handful of sizable companies that provide some granularity in geographic sales performance, including Stryker, J&J MedTech, Zimmer Biomet, Medacta, Medartis, Orthofix and CONMED.
Few Surprises Among Orthopedics’ Top 3
J&J MedTech and Zimmer Biomet have traditionally had a far larger global orthopedic footprint than Stryker. However, Stryker has meaningfully closed that gap, especially since the pandemic. From 2016 to 2024, J&J MedTech’s OUS CAGR is -0.8% while Zimmer Biomet’s is 1.5%. Stryker’s 6.1% CAGR has been driven by the international expansion of Mako, the acquisition of Wright Medical and a more robust hip offering of late.
Top 3 Orthopedic Players OUS Sales
Stryker OUS Sales by Segment
“I would tell you that the biggest opportunity, frankly, is increasing the penetration of products we already have in our portfolio internationally and especially acquisitions that primarily have U.S. revenue, taking those acquisitions to the international markets,” said Stryker CEO Kevin Lobo.
Medacta and Medartis Driving Substantial Growth in EMEA
Medacta consistently drives some of the best growth numbers in orthopedics for companies operating from a larger revenue base ($685 million in 2024). While 2020 hammered most companies in the industry, it served as an inflection point for growth for Medacta because of the steps it took to secure its supply chain and continuity of operations.
Medacta Sales by Region
Medartis continued its strong EMEA performance in the first half of 2025, aided by strong demand for KeriMedical products. The UK, Spain and France drove strong growth while distributor sales grew double digits in the Middle East.
Medartis Sales by Region
Orthofix Shifts Strategy on OUS Offerings
For years, Orthofix’s trauma business primarily operated in mature European markets. But those markets couldn’t provide much growth, as Orthofix’s trauma business generated a CAGR of 2.5% from 2017 to 2024.
The company has shifted its trauma priorities to the U.S. market where it is building a strong foundation, albeit from a small base, over the last few quarters. Additionally, Orthofix picked up SeaSpine’s OUS business during the merger between the companies (about $33 million in 2022).
Orthofix OUS Sales by Segment
Regionally, Orthofix has managed nice growth in EMEA (7.5% CAGR) that even weathered the pandemic with only minor impacts. Distributor sales across regions, categorized as Other, grew 5.6% and saw an influx from the SeaSpine integration. Brazil has remained challenging for the company.
Orthofix OUS Sales by Region
Orthofix Direct European Sales
EMEA Becomes CONMED’s Second Largest Market
In 2016, EMEA was CONMED’s smallest regional market, accounting for 13% of the company’s total orthopedic sales. By the end of 2024, EMEA had grown to become the company’s second-largest market and represented 24% of orthopedic sales. EMEA’s CAGR during that period was 11.1%, far outpacing other regions and the company’s overall growth.
CONMED Orthopedic Sales by Region
Takeaways
Admittedly, we’ve cherry-picked companies that report details on geographic sales. But among those companies, EMEA stood out as a unique opportunity despite challenges like EU MDR and the variety of dynamics in each country’s market. Interestingly, the COVID drop didn’t seem as severe in EMEA for the companies we surveyed.
We expect companies with a foothold in EMEA to remain priority targets for M&A as larger companies seek to expand into profitable markets, as well as further market share gains through enabling technology and cross-selling.
Below we’ll take a dive into the performance of select companies for sales outside of the United States. According to our estimates, about a third of all orthopedic sales occur outside the U.S. However, several waves of disruption have made it harder to get a read on the health of these markets.
We’ve selected a handful of sizable companies...
Below we’ll take a dive into the performance of select companies for sales outside of the United States. According to our estimates, about a third of all orthopedic sales occur outside the U.S. However, several waves of disruption have made it harder to get a read on the health of these markets.
We’ve selected a handful of sizable companies that provide some granularity in geographic sales performance, including Stryker, J&J MedTech, Zimmer Biomet, Medacta, Medartis, Orthofix and CONMED.
Few Surprises Among Orthopedics’ Top 3
J&J MedTech and Zimmer Biomet have traditionally had a far larger global orthopedic footprint than Stryker. However, Stryker has meaningfully closed that gap, especially since the pandemic. From 2016 to 2024, J&J MedTech’s OUS CAGR is -0.8% while Zimmer Biomet’s is 1.5%. Stryker’s 6.1% CAGR has been driven by the international expansion of Mako, the acquisition of Wright Medical and a more robust hip offering of late.
Top 3 Orthopedic Players OUS Sales
Stryker OUS Sales by Segment
“I would tell you that the biggest opportunity, frankly, is increasing the penetration of products we already have in our portfolio internationally and especially acquisitions that primarily have U.S. revenue, taking those acquisitions to the international markets,” said Stryker CEO Kevin Lobo.
Medacta and Medartis Driving Substantial Growth in EMEA
Medacta consistently drives some of the best growth numbers in orthopedics for companies operating from a larger revenue base ($685 million in 2024). While 2020 hammered most companies in the industry, it served as an inflection point for growth for Medacta because of the steps it took to secure its supply chain and continuity of operations.
Medacta Sales by Region
Medartis continued its strong EMEA performance in the first half of 2025, aided by strong demand for KeriMedical products. The UK, Spain and France drove strong growth while distributor sales grew double digits in the Middle East.
Medartis Sales by Region
Orthofix Shifts Strategy on OUS Offerings
For years, Orthofix’s trauma business primarily operated in mature European markets. But those markets couldn’t provide much growth, as Orthofix’s trauma business generated a CAGR of 2.5% from 2017 to 2024.
The company has shifted its trauma priorities to the U.S. market where it is building a strong foundation, albeit from a small base, over the last few quarters. Additionally, Orthofix picked up SeaSpine’s OUS business during the merger between the companies (about $33 million in 2022).
Orthofix OUS Sales by Segment
Regionally, Orthofix has managed nice growth in EMEA (7.5% CAGR) that even weathered the pandemic with only minor impacts. Distributor sales across regions, categorized as Other, grew 5.6% and saw an influx from the SeaSpine integration. Brazil has remained challenging for the company.
Orthofix OUS Sales by Region
Orthofix Direct European Sales
EMEA Becomes CONMED’s Second Largest Market
In 2016, EMEA was CONMED’s smallest regional market, accounting for 13% of the company’s total orthopedic sales. By the end of 2024, EMEA had grown to become the company’s second-largest market and represented 24% of orthopedic sales. EMEA’s CAGR during that period was 11.1%, far outpacing other regions and the company’s overall growth.
CONMED Orthopedic Sales by Region
Takeaways
Admittedly, we’ve cherry-picked companies that report details on geographic sales. But among those companies, EMEA stood out as a unique opportunity despite challenges like EU MDR and the variety of dynamics in each country’s market. Interestingly, the COVID drop didn’t seem as severe in EMEA for the companies we surveyed.
We expect companies with a foothold in EMEA to remain priority targets for M&A as larger companies seek to expand into profitable markets, as well as further market share gains through enabling technology and cross-selling.
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Mike Evers is a Senior Market Analyst and writer with over 15 years of experience in the medical industry, spanning cardiac rhythm management, ER coding and billing, and orthopedics. He joined ORTHOWORLD in 2018, where he provides market analysis and editorial coverage.
