The Orthopedic M&A Market: Takeaways for 2021

The Orthopedic M&A Market: Takeaways for 2021
The COVID-19 pandemic did little to slow the orthopedic market's consolidation. We surveyed the orthopedic merger and acquisition market over the last six years to show why 2020 was a busy year and 2021 may be busier; why spine continues to dominate M&A transactions; and what has driven transactions so far in 2021. These charts, […]

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Medtronic to Acquire Medicrea

Medtronic to Acquire Medicrea
Medicrea announced that it entered into an agreement to be acquired by Medtronic at a price of €7 (USD $8.01) per share with a 2020 estimated close date.

OrthoPediatrics to Acquire ApiFix

OrthoPediatrics to Acquire ApiFix
OrthoPediatrics acquired ApiFix and its minimally invasive deformity correction system, MID-C, for non-fusion treatment of progressive adolescent idiopathic scoliosis.

Anika Therapeutics Takes Major Step in Strategic Transformation with Acquisition of Parcus Medical and Arthrosurface

Anika Therapeutics Takes Major Step in Strategic Transformation with Acquisition of Parcus Medical and Arthrosurface
With the acquisitions of Parcus Medical and Arthrosurface, Anika looks ready to complete a major step in its five-year strategic plan to become a leader in joint preservation and restoration.

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OrthoPediatrics Acquires Vilex, ExFix Technology

OrthoPediatrics acquired Vilex, with its Orthex Hexapod circular fixation technology and x-ray planning software, for USD $60MM. Vilex posted 2018 revenue of $11.8MM, mostly derived from U.S. sales.

M&A Recap: Three 2Q Announcements in Spine

Of the 20 OEM-related M&A announcements we've covered in 2019 thus far, seven have related to the spine market. Of those, three were announced in rapid succession within this quarter. Let's see who bought whom, and what they got: Medtronic/Titan Spine, Boston Scientific/Vertiflex and WishBone Medical/CSpine.

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Boston Scientific to Acquire Vertiflex

Boston Scientific entered into a definitive agreement to acquire Vertiflex, developer of the Superion® Indirect Decompression System. The transaction is slated to close in late 2Q19.

Axolotl Biologix Acquired by Private Equity Firm

Axolotl Biologix, a developer of regenerative medicine products, was acquired by a private equity firm. The company is preparing for FDA clinical trials of biologic products that have a range of applications in numerous segments, including orthopedics.

Burst of M&A Activity at the Close of 1Q19

As was shown last week at AAOS, companies are taking strides to connect their devices with technologies that support improved patient outcomes. That connection can come in the form of M&A activity - which certainly applies to transactions announced over the month of March in joint replacement.

Stryker Acquires OrthoSpace

Stryker acquired OrthoSpace, maker of the InSpace device to treat rotator cuff tears, in an all-cash transaction for an upfront payment of US $110MM and future milestone payments of up to an additional $110MM.

Smith & Nephew to Acquire Osiris

Smith & Nephew entered into an agreement to acquire Osiris Therapeutics, developer of regenerative medicine products including skin, bone graft and articular cartilage substitutes. The transaction is expected to close in 2Q19.

WishBone Medical Acquires Response Ortho

WishBone Medical acquired Response Ortho, a manufacturer of external and internal fixation and deformity correction products for the pediatric orthopaedic market.

Contract Manufacturer M&A: 2017-3Q18

Merger and acquisition activity is shaping the broader orthopedic supply chain base, with contract manufacturers of all sizes transforming in the last decade to keep pace with their scaling device company customers. We've identified three M&A trends in this portion of the market.

Spine Company M&A Picks Up in 3Q18

We've tracked 31 mergers and acquisitions in the spine space from 2017 through mid-September 2018...with eight of them happening in just the last four weeks. The global spine market comprises nearly 300 companies; players need broad portfolios or novel technologies to vie for market share today.

Stryker Acquiring K2M

Stryker entered into a definitive merger agreement to acquire K2M for ~US $1.4BB in cash. The transaction is slated to close in 4Q18. For 2017, K2M posted revenue of $249.3MM, +8.8% vs. 2016.

Wright Medical Acquiring Cartiva

Wright Medical is acquiring Cartiva, a manufacturer of the Synthetic Cartilage Implant to treat arthritis in the great toe, for US $435MM. The transaction is expected to close in 4Q18.

Integer to Divest Advanced Surgical and Orthopedics to MedPlast

Integer entered into an agreement to sell its Advanced Surgical and Orthopedics lines to MedPlast, a global services provider to the medical device industry, for US $600MM in cash. The transaction is expected to close in 3Q18.

Cadence to be Acquired by Kohlberg Private Equity Firm

Cadence, global provider of high-precision components and finished devices for orthopaedic and other markets, signed a definitive agreement to be acquired by private equity firm Kohlberg & Company.

NN, Inc. Acquiring Paragon Medical

NN entered into a definitive agreement to acquire Paragon Medical for US $375MM in cash. For 2017, Paragon posted revenue of $141.0MM. The transaction is slated to close during 2Q18.

Orthofix Enters Agreement to Acquire Spinal Kinetics

Orthofix entered into a definitive agreement to acquire Spinal Kinetics for US $45MM in cash plus up to $60MM in potential milestone payments. The transaction is expected to close in 2Q18.

NuVasive Acquiring SafePassage Neuromonitoring Company

NuVasive entered into a definitive agreement to acquire SafePassage, provider of intra-op neurophysiological monitoring services. The company will join NUVA's Clinical Services business in a transaction slated to close in January 2018.

In’Tech Medical Acquires Pyxidis

In'Tech Medical acquired Pyxidis, a manufacturer of customized metal and plastic sterilization cases and trays for surgical Instruments.

Orthobiologics Activity Signals Collaborations and Clinical Data Essential for Company Growth

ORTHOWORLD estimates that global orthobiologic product sales account for ~10% of the orthopaedic market's revenue, overall. In 2016, that translated to just over $4.9 billion, an increase of 3% vs. 2015. For 2017 and into 2019, we're projecting similar growth.

NN, Inc. Acquires DRT Medical

NN, Inc. acquired DRT Medical, supplier of precision manufactured orthopaedic implants and instruments. Financial terms were not disclosed.

NuVasive Acquires Vertera Spine

NuVasive acquired Vertera Spine, developer of porous-PEEK-based spinal interbody fusion devices. Transaction terms were not disclosed.

Orthopaedic Supplier M&A Boosted by Private Equity Backing

Supplier companies have been involved in 17 of the 33 mergers and acquisitions that have closed in the orthopaedic space as of August 15, according to our tracking of activity. This activity comes in direct response to device company consolidation.

Tecomet Purchased by Charlesbank Capital Partners

Genstar Capital sold Tecomet, a global supplier of high-precision manufacturing solutions for orthopaedic implants, instruments and sterilization cases/trays, to Charlesbank Capital Partners.

Sussex Wire Acquires Marox

Sussex Wire, manufacturer of cold formed components for a variety of industries, acquired Marox, a manufacturer of orthopaedic implants and instruments.

Zimmer Biomet Product Highlights

Zimmer Biomet has publicly unveiled Signature Solutions, and is previewing a concept device that will support personalization and intelligent instrument technology through surgical robotics.

Implanet Enters Exclusive Distribution Partnerships in Australia and New Zealand

Implanet announced integration of its Jazz Claw device into the Australian Register of Therapeutic Goods and entry into an exclusive partnership with Device Technologies for product distribution in Australia and New Zealand.

Hospital M&A, Priorities Offer OEMs Strategic Direction

The U.S. hospital landscape steadily continues to be shaped by consolidation that is forced by competition, declining reimbursement and public and private payor cost and control measures. As these trends are expected to endure at least through the next decade, it's imperative that you understand what your hospital customer base will look like several years from now.

Vertebral Technologies Enters GPO Contract

Vertebral Technologies entered into a GPO contract to provide modular interbody fusion devices to member facilities of Resource Optimization & Innovation/ROi. 

Exactech Divests Assets to ChoiceSpine

Exactech has restructured its Spine & Biologics segment, divested its spine product assets to ChoiceSpine and announced restructuring charges related to ex-U.S. operations. Terms were not disclosed.

DePuy Synthes Agreement with Pacira Pharmaceuticals

DePuy Synthes entered into an exclusive agreement with Pacira Pharmaceuticals for U.S. co-promotion of EXPAREL® local analgesic across its joint reconstruction, spine, sports medicine and trauma businesses.

The Forgotten Phase of M&A: Mitigating Supply Chain Risks

The primary responsibility of the supply chain team post-M&A is the assurance of uninterrupted upstream and downstream product supply. These essential steps will assist you in identifying supply chain risk and developing a plan to minimize that risk.

OssDsign Secures New EU Distribution Partnerships

OssDsign entered into new commercial partnerships covering distribution of its products for cranial repair and facial bone reconstruction in Italy, Spain, Switzerland, Austria and The Netherlands.

AxioMed/DSM Extend Terms on Exclusive License Agreement

AxioMed modified terms of a previously-signed 15-year exclusive license agreement with DSM Biomedical, holder of the patent on polymer technology used in AxioMed's viscoelastic disc replacement. 

MedPlast Acquired by Strategic Investor, PE Firm

MedPlast, parent company of OrthoPlastics, was acquired by strategic investor Water Street Healthcare and JLL Partners, a middle-market private equity firm. Terms were not disclosed.

HD Surgical Acquires Assets from PAK Manufacturing

HD Surgical, a custom orthopaedic surgical instrument and implant manufacturer, recently acquired certain assets of PAK Manufacturing, a maker of custom and specialty handheld surgical instruments.

GE to Acquire Stake in Concept Laser

General Electric reached an agreement to acquire a 75% stake in Concept Laser, manufacturer of powder bed-based laser additive manufacturing machines, for 549MM (~US $599MM). 

M&A Close-up: 2016 Transactions Year to Date

Strategic transactions year to date in 2016 represent participants from OEMs, Suppliers, Distributors and Private Equity, with values ranging from $10 million to $1 billion.

Postmarket Surveillance and M&A

Data collection is paramount to the success of any orthopaedic device. What happens to the much-coveted postmarket data/initiative during and after a merger or acquisition? We posed this question to Vicki Anastasi, Vice President & Global Head, Medical Devices & Diagnostics Research with ICON plc.

Richard Wolf Opens Subsidiary, RIWOspine

Richard Wolf established a RIWOspine subsidiary in Germany to market devices for minimally invasive and endoscopic spine surgery and pain therapy. 

Tecomet Acquires Mountainside Medical

Tecomet acquired Mountainside Medical, a manufacturer of instruments for minimally invasive surgery and orthopaedic/neurosurgical implants and instruments.

Tinavi Medical to Distribute Spineway Devices in China

Spineway signed a 5-year agreement with TINAVI Medical for distribution of spinal implants and instruments in China. TINAVI's TiRobot™ is reported to be the only surgical robot capable of addressing surgery on all spinal regions. 

Stryker to Acquire Instratek

Stryker entered into a definitive agreement to acquire Instratek, provider of implants and minimally invasive soft tissue recession instrumentation for foot, ankle and upper extremity procedures.

SpineVision Acquired by Norgine Ventures

Norgine Ventures entered into a definitive agreement to acquire SpineVision. The partnership will support SpineVision's research and development for commercialization of products combining dynamic stabilization and a minimally invasive, percutaneous approach, such as Flex+2 and LUMIS.

Ferring Acquires Rights to Seikagaku Treatment for Herniated Disc

Ferring Pharmaceuticals acquired exclusive development and commercialization rights to Seikagaku's SI-6603 injectable condoliase, a potential treatment for lumbar disc herniation, for up to US $95.0MM in upfront cash plus milestone payments.

Biomedical Structures Acquired by Confluent Medical Technologies

Biomedical Structures, manufacturer of biomedical textile implants with application in orthopaedics, was acquired by Confluent Medical Technologies, a contract manufacturer of Nitinol components and kyphoplasty balloons. Terms were not disclosed.

Merit Medical Acquires DFINE

Merit Medical Systems, manufacturer of proprietary disposable devices used primarily in cardiology, radiology and endoscopy, acquired DFINE in a merger transaction for ~US $97.5MM in cash.

1H16 M&A Recap: Big Players Make Moves

During 1H16, seven of the eight largest orthopaedic device companies confirmed or completed acquisitions or divestitures spanning nearly every orthopaedic market segment. Here we present a full list of M&A transactions from the first half of the year.

Zimmer Biomet Acquiring LDR

Zimmer Biomet entered into a definitive agreement to acquire LDR for US $37/share in cash, for a transaction valued at ~$1.0BB with an expected 3Q16 close.

Medtronic Acquires Responsive Orthopedics

Medtronic acquired Responsive Orthopedics, a start-up focused on sales of low-cost hip and knee replacements. A primary knee is slated for commercial U.S. availability within 1H17, followed by a primary hip in 1H18.

DePuy Synthes/JNJ Acquiring BioMedical Enterprises

DePuy Orthopaedics has acquired BioMedical Enterprises, a manufacturer of Nitinol orthopaedic implants for small bone fixation to treat bunions, hammertoes, hand/wrist deformities, etc.

Stryker Acquires Stanmore Implants

Stryker acquired Stanmore Implants Worldwide in an all-cash transaction for £35.6MM (~US $52MM). Stanmore Implants' portfolio comprises patient-specific and off-the-shelf implant systems for limb salvage.

LISI Medical to Acquire Alcoa Remmele

LISI Medical, a contract manufacturer, signed an agreement to acquire Alcoa Remmele for 90MM (~US $102MM). The transaction is expected to close in 2Q16. Remmele posted 2015 revenue of $70MM. 

CTL Acquires AccelSPINE

CTL Medical, a medical device manufacturing and services company, signed a definitive agreement to acquire AccelSPINE.

Bioventus Boosts Orthobiologics Business with Acquisitions

Bioventus spent most of 2015 building an infrastructure to expand its surgical business. With trecent acqusitions, a sales and distribution plan in place and future plans for inorganic and organic growth, Bioventus executives now say that the company is positioning itself as an orthobiologics leader.

MiMedx Closes Acquisition of Stability Biologics

MiMedx completed its acquisition of Stability Biologics, provider of human tissue products serving the surgical, spine and orthopaedic sectors. Stability Biologics will operate as a wholly-owned subsidiary of MiMedx.

MiMedx to Acquire Stability Biologics

MiMedx signed a definitive agreement to acquire Stability Biologics for US $10MM in cash and stock. Stability Biologics provides human tissue products for the surgical, spine and orthopaedic industries. The transaction is expected to close in early 1Q16.

NuVasive to Acquire Ellipse Technologies

NuVasive entered into a definitive agreement to acquire Ellipse Technologies for US $380MM in cash, with a potential $30MM milestone payable in 2017. The transaction is slated to close in mid-1Q16. Ellipse posted 2015 revenue of ~$40MM, +54% vs. 2014.