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Year in Review

2014: A Recap of Strategic Activities in Joint Replacement

Editor’s Note: This segment-specific article is excerpted from the full version, covering major market segments, appearing in ORTHOKNOW January 2015.

To begin 2015, let’s look back at what fueled growth in 2014 in joint replacement. Here, we present companies that have merged and emerged, products that launched, projects that received funding. (Please note, ORTHOKNOW July 2014 features a review of 1H14 funding activity.)

Lending perspective from your peers, this issue includes insights gathered at the 2014 Musculoskeletal New Ventures Conference, as well. See companion articles, “Business Development Execs Speak on M&A and Innovation” and “Industry Investments Stay Steady, Focus on Established Technologies.”

Start-ups, spin-outs and subsidiaries identified during 2014 included:

GEN2 Medical
Cleveland, Ohio, USA

  • Formed to import, manufacture and sell instruments and devices for use in all surgical specialties, with a primary focus on neurosurgery, orthopaedics and spine
  • Also partners with surgeon inventors to support more control over product development
  • Exclusive U.S. distributor of Rebstock spinal instruments from Germany

Andover, Massachusetts, USA

  • Launched by Smith & Nephew in the U.S. to offer hospitals the SYNERGY stem + REFLECTION CUP and the GENESIS II knee, clinically-proven primary joint replacement products that should address >80% of procedures and represent at least five to ten percent of the U.S. market
  • Includes technology to streamline supply chain and logistics, ensure automatic replenishment, etc., and technical support and training in lieu of a rep in the OR
  • Healthcare providers enter into a multi-year contract to purchase the instrument set and own the implant inventory, allowing implants to be offered at a substantial discount to U.S. average price

Irvine, California, USA

  • Established by United Orthopedic to market cost-effective hip and knee arthroplasty implants and instruments in the U.S.
  • Parent company headquartered in Taiwan

Closures, restructuring and rebranding announced in 2014 included:

  • Wright Direct: Rebranded as Implant Partners, a provider of cost-effective orthopaedic implants and services, selling directly to hospitals; wholly-owned subsidiary of MicroPort Orthopedics

M&A Activity in 2014:

ORTHOWORLD’s Merger & Acquisition database recorded 41 transactions in 2014. The table below captures select OEM activities with joint reconstruction applications; visit the M&A database to see all 41, including numerous deals among suppliers.

Also announced in 2014, and not yet closed:

  • Medtronic to acquire Covidien (slated for early 2015)
  • Wright Medical merging with Tornier (slated for 1H15)
  • Zimmer to acquire Biomet (slated for 1Q15)


Acquiring Company  Acquired Company
Cayenne Medical  TGS Knee Innovations/Mirror Partial Knee
Corin Optimized Ortho kinematic joint simulation software
MicroPort Orthopedics  Wright Medical's OrthoRecon business 
Stryker Small Bone Innovations extremities repair
Wright Medical  OrthoPro foot/ankle products
Wright Medical  Solana Surgical extremities repair

Fundings identified during 2H14 included:

Consensus Orthopedics raised $8MM of a planned $9MM round

  • To support general growth, new product launches, etc. of total knee and hip replacement devices

Nimbic Systems awarded a $1.5MM grant from the National Institutes of Health

  • To support a pivotal, multi-center clinical trial of the Air Barrier System for the prevention of implant infections in hip arthroplasty, spine fusion, acetabular reconstruction, etc.

OrthAlign completed a $15MM preferred series capital raise

  • To support 2015 launch of the OrthAlign Plus® hip arthroplasty navigation device, sales and marketing, international distributor expansion

Surgical Frontiers closed a $7MM fund

  • To invest in its incubator focused upon musculoskeletal surgical technology start-ups
  • Initial funding commitments have been made to 3 portfolio companies addressing foot/ankle, sports medicine and trauma

Product launches in 2014 included:

Cayenne Medical
Mirror™ Partial Knee

  • Uses patient’s own ligaments to balance knee as definitive bone cuts are made, thus balancing the knee throughout the entire range of motion
  • To offer the procedure, facilities do not need to acquire expensive equipment or incur additional costs tied to approaches that rely on software from CT or MRI imaging studies to create cutting guides for surgeons

DePuy Synthes Joint Reconstruction
ATTUNE® Rotating Platform Knee

  • Designed to improve conformity, stability throughout range of motion
  • Supports tibial insert to self-align and track with femoral component throughout range of motion

DJO Global
e+™ blended vitamin E polyethylene bearing for reverse shoulder

  • Marked 1st surgical use
  • Demonstrated 92% wear rate reduction while maintaining yield strength of conventional polyethylene
  • Reportedly the only company that offers blended vitamin E polyethylene throughout entire shoulder portfolio

ExactechGPS® Guided Personalized Surgery

  • Reportedly the 1st advanced surgical technology to offer truly real-time patient-specific approach to total knee arthroplasty
  • Includes instantaneous data and imaging
  • Supports range of soft tissue strategies, ligament balancing options, less invasive approaches and techniques

Smith & Nephew
JOURNEY™ II Cruciate Retaining Knee

  • Preserves the posterior cruciate ligament; applies PHYSIOLOGICAL MATCHING™ technology using LIFEMOD™ human simulation software to analyze and account for bone, ligament and muscle forces within the design of an implant
  • Made from VERILAST™ technology (proprietary OXINIUM alloy + highly cross-linked plastic liner)

Wright Medical
INFINITY® Total Ankle Replacement

  • Full U.S. commercial launch; also available on a limited basis in select ex-U.S. countries
  • Combines low-profile implant and seamless integration with PROPHECY® Pre-Operative Navigation Alignment Guides
  • Features talar resurfacing option for preservation of talar bone, and a tibia design compatible with the INBONE® II System
  • Talar component of INFINITY is interchangeable with the INBONE II, which may serve as a revision option

A portion of this article appeared in the December 2014 issue of BONEZONE®.

Sources: Company press releases, earnings calls, filings with the U.S. Securities and Exchange Commission, company web sites, articles in the public domain, etc.

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