M&A

CARLSMED has merged with Precisive Surgical to provide an end-to-end personalized surgical workflow platform for spine deformity intervention.

Generex Biotechnology completed its acquisition of Pantheon Medical “ Foot & Ankle, as was announced in 1Q19.

Kuros Biosciences entered into an agreement whereby Surgical Specialties will distribute MagnetOs synthetic bone graft in Australia and New Zealand.

Celling Spine acquired all assets of Link Spine, and will develop spinal fusion hardware to complement its own orthobiologic product portfolio.

Acumed acquired the RASL System to treat scapholunate ligament injury from Radicle Orthopaedics.

Smith & Nephew agreed to acquire Atracsys, provider of optical tracking technology used in computer-assisted surgery.

Bioventus and MTF Biologics will collaborate to develop a next-generation placental tissue product for the treatment of knee osteoarthritis.

Astura Medical partnered with Academy Medical for contracting within the U.S. Department of Defense and Veterans Affairs for sales of spinal instrumentation and implants.

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.

Smith & Nephew completed its previously-announced acquisition of Brainlab's orthopaedic joint reconstruction business. 

Exactech purchased EPIC Extremity, designer of plates and screws for foot/ankle applications.

Spineway plans to acquire an equity stake in Integral Medical Solutions, a holding company that manages private hospitals in Latin America. 

HealthpointCapital acquired a controlling stake in CrossRoads Extremity Systems, developer of procedure-specific, sterile-packed implants and instrumentation for foot/ankle fixation.

Medtronic entered into a definitive agreement to acquire Titan Spine, a titanium spine interbody implant and surface technology company.

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.

WishBone Medical purchased CSpine, manufacturer of spine and orthopedic implants and instruments. 

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.

OrthoPediatrics entered into an agreement with CoorsTek Medical for rights to sublicense its Variable-Angle technology.

Smith & Nephew completed its acquisition of Osiris Therapeutics, which was announced in 1Q19.

Brainlab has acquired Medineering, a developer of application-specific robotic technologies. The move supports Brainlab's growing market reach into ambulatory surgery centers.

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.

CollPlant renewed its exclusive distribution agreement with Arthrex for VergenixSTR for use in soft tissue repair.

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 will acquire Brainlab's orthopedic joint reconstruction business, enabling both companies to accelerate R&D in digital surgery and augmented reality.

THINK Surgical and United Orthopedic Corporation will pursue reproducible outcomes in total knee replacements, pairing THINK's Active Robotic System and UNITED's U2 knee. 

Medacta and the Geisinger health system partnered to pilot a knee replacement lifetime guarantee, in which the pair will stand behind the full cost of care associated with surgeries over a patient's lifetime.

Exactech acquired XpandOrtho, a designer of soft tissue balancing instruments for knee replacement. 

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.

RTI Surgical completed its acquisition of Paradigm Spine, developer of the coflex® Interlaminar Stabilization® device.

Corin, a U.K. orthopedic company, enters the robotics market by acquiring U.S.-based OMNI.

Implanet entered into a U.S. private label distribution agreement with SeaSpine covering the Jazz® portfolio of spinal devices.

KICVentures seeks funding to prepare its portfolio companies, AxioMed and NanoFUSE Biologics, to be acquisition targets.

Trice Medical will acquire SegWAY Orthopaedics, provider of minimally invasive endoscopic systems to treat the extremities.

Orthofix Medical acquired Options Medical, a former distributor of OFIX Bone Growth Therapies.

Japanese manufacturer Kyocera acquired certain assets of U.S.-based Renovis Surgical Technologies, a manufacturer of 3D-printed implants.

SpineSource acquired the IP assets of two spinal implant systems from Kisco International, including the L-VARLOCK® expandable lumbar cage.

Generex Biotechnology entered into letters of intent to acquire Pantheon Medical “ Foot & Ankle, manufacturer of the FDA-cleared Balanced Plating System, and distributor Medisource Partners.

Integra LifeSciences entered into a license and development agreement with Consortium of Focused Orthopedists for a short stem and stemless shoulder.  

LimaCorporate and the Hospital for Special Surgery are co-founding an additive manufacturing 3D printing facility to create custom orthopaedic implants in a hospital setting. 

Medtronic completed its planned acquisition of Mazor Robotics in a transaction valued at US $1.7BB.

Smith & Nephew entered into an agreement to acquire Ceterix Orthopaedics, developer of NovoStitch®Pro Meniscal Repair, for up to US $105MM. The transaction is expected to close in early 2019.

WishBone Medical was granted a global, non-exclusive license for sale of a guided growth plating system to treat pediatric deformed limbs. Product launch is slated for 1Q19. 

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

ChoiceSpine, a manufacturer of devices and biologics used to treat complex spine disorders, was acquired by Altus Capital Partners.

Colfax entered into a definitive agreement to acquire DJO Global from Blackstone for US $3.15BB in cash. The transaction is expected to close in 1Q19. 

Innovasis entered into a private-label agreement with Stability Biologics that includes access to Physio® bone allograft. Product launch is expected by year-end.

Medacta invests in personalized medicine by acquiring start-up Balgrist CARD.

Implanet partnered with KICO Knee Innovation Company for distribution of the MADISON primary total knee.

CellRight Technologies, a Tissue Regenix company, entered into an agreement granting Arthrex distribution rights to its BioRinse bone portfolio in Europe.

Stryker closed the previously-announced $1.4BB acquisition of K2M.

WishBone Medical acquired Red Star, a contract manufacturer, to provide sterile packaging and plastic injection molded single-use instruments for the pediatric orthopaedic market.

RTI Surgical entered into a definitive agreement to acquire Paradigm Spine in a cash and stock transaction valued at up to US $300MM.

Stryker completed its previously-announced acquisition of Invuity, manufacturer of single-use, lighted visualization instruments.

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.

DePuy Synthes entered into an exclusive U.S. co-promotion agreement with Ortho Development for the KASM® Knee Articulating Spacer Mold.

Wright Medical completed its acquisition of Cartiva, developer of the Synthetic Cartilage Implant.

NuVasive Clinical Services was awarded a three-year, sole source supplier contract for Intraoperative Neuromonitoring with Premier, effective November 2018. 

NuVasive entered into a strategic partnership with Biedermann Technologies to integrate proprietary screw technology into NUVA's RELINE® portfolio, for 1H19 launch.

Corin signed a binding agreement to acquire Global Orthopaedic Technology, manufacturer of hip and knee replacement devices in Australia.

Amedica completed the sale of its spine business to CTL Medical, which is now exclusive owner of the metal and silicon nitride spine product portfolio.

Bioventus received ANVISA approval to market DUROLANE® single-injection in Brazil to treat hip osteoarthritis. Pfizer will serve as its exclusive distribution partner.

4WEB Medical entered into an exclusive partnership with Lattus Spine and TeDan Surgical Innovations to co-market a turnkey Total Lateral Solution, with retractor and implant.

Medtronic entered into a definitive agreement to acquire Mazor Robotics for US $1.64BB in cash in a transaction that is slated to close in January 2019. 

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.

Zavation acquired PanMed, a manufacturer of minimally invasive products used in the kyphoplasty and interventional radiology markets.

Globus Medical is acquiring Nemaris, developer of Surgimap® software used to preoperatively plan spine surgery. Terms were not disclosed.

IZI Medical is acquiring Benvenue Medical's vertebral augmentation systems portfolio, used for treatment of spinal fractures.

Johnson & Johnson Medical Devices is acquiring Emerging Implant Technologies, a manufacturer of 3D-printed titanium interbodies for spinal fusion.

Stryker entered into a definitive agreement to acquire instrument manufacturer Invuity for US $190MM in equity. The transaction is slated to close in 4Q18.

LimaCorporate is acquiring medical device software company TechMah Medical to complement its joint reconstruction implants with digital applications.

CTL Medical will acquire the commercial spine business of Amedica for US $10.0MM. The transaction is slated to close within 3Q18. 

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 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.

Ember Therapeutics plans to divest its OP-1 bone morphogenetic protein (BMP-7) portfolio to Viscogliosi Brothers. The transaction is slated to close by 4Q18.

KFx Medical entered into a license agreement with Zimmer Biomet to promote products and techniques for knotless double row rotator cuff repair.

NuVasive and Siemens Healthineers entered into a Spine Precision Partnership to integrate the Pulse surgical automation platform with Siemens' Cios Spin mobile 3D C-arm.

Fuse Medical acquired Maxim Surgical, a manufacturer of spinal fusion devices.

RTI Surgical and Aziyo Biologics signed an agreement for RTI's exclusive U.S. distribution of ViBone® cellular bone matrix.

BONESUPPORT entered into an agreement with MTF Biologics, gaining U.S. rights to distribute two demineralized bone matrices.

Bioventus entered into a definitive agreement to divest its next-gen bone morphogenetic protein development program to Viscogliosi Brothers. The transaction is slated to close in 3Q18.

Aziyo Biologics entered into an agreement to supply ViBone viable bone matrix for distribution with SurGenTec's GraftGun delivery system.

Insight Medical Systems and Onkos Surgical are entering a pilot project to explore use of the ARVIS augmented reality system in bone tumor surgery.

Medigus entered into a development agreement with A.M. Surgical to develop an integrated visualization device to complement Stratos, A.M. Surgical's product for endoscopic carpal tunnel release. 

Safe Orthopaedics entered into an exclusive commercialization and distribution agreement in Japan with KiSCO.

CoreLink has acquired Expanding Orthopedics, developer of the FLXfit line of expanding interbody devices. Terms were not disclosed.

Safe Orthopaedics will acquire the salesforce of U.K. distributor Qspine. 

BONESUPPORT entered into an agreement with Collagen Matrix on U.S. sales of bone graft substitute products through its own U.S. distribution network, beginning in 4Q18.

In™Tech Medical, a contract manufacturer for the orthopaedic industry, entered into a binding agreement to acquire Bradshaw Medical.

DePuy Synthes signed a definitive agreement to acquire the assets of Medical Enterprises Distribution, developer of the ME1000 Surgical Impactor for use in hip replacement. The transaction is slated to close in 2Q18.

Corin is to be acquired by a company backed by investment firm Permira for an undisclosed sum, in a transaction slated to close in early 3Q18.

DePuy Synthes entered into an exclusive agreement to promote Prosidyan's FIBERGRAFT® synthetic bone graft in spinal fusion, starting in 2Q18.

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, 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.

JRI Orthopaedics, manufacturer of hip and shoulder reconstruction devices, was acquired by AK Medical for £16.7MM (~US $23.7MM). 

Konica Minolta will distribute HydroCision's TenJet Percutaneous Tenotomy system to manage diseased tendon tissue under ultrasound.

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.

KFx Medical entered into a license agreement allowing Wright Medical Technology to promote products and techniques for knotless double row rotator cuff repair, as claimed in U.S. Patent No. 7,585,311.

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.

Alphatec Spine acquired SafeOp Surgical, provider of neuromonitoring technology, for an initial outlay of US $15MM, and also announced new leadership appointments. 

WishBone Medical entered into a license agreement with the Hospital for Special Surgery to develop a Pediatric Total Hip.

Onkos Surgical signed a 4-year agreement with 3D Systems to develop and advance patient-specific tools for use in tumor-related reconstruction in the pelvis and long bones.

CellRight Technologies signed a long-term, multi-year distribution agreement with Arthrex for CellRight's orthobiologic products for use in orthopaedic, spine and foot/ankle procedures.

WishBone Medical entered into a U.S. distribution agreement with Implanet addressing JAZZ spinal implants.

Leader Biomedical is acquiring International Orthopaedics, manufacturer of ICON total hip and hip resurfacing implants and instruments. 

Implanet and L&K Biomed finalized agreements for cross-distribution of spinal products in the U.S., Asia/Oceania and Europe. 

Bioventus and LifeLink Tissue Bank will co-develop bone allograft for spine and trauma applications. 

Johnson & Johnson will collaborate with Trinity College Dublin to open a 3D bioprinting research lab, initially focusing on orthopaedic-related projects.

Johnson & Johnson Medical Devices is acquiring Orthotaxy, developer of a robotic-assisted surgery solution in early-stage development for total and partial knee replacement.

Bioventus extended its agreement to exclusively distribute Seikagaku's SUPARTZ FX five-injection hyaluronic acid in the U.S. through May 2028.

Implanet entered into a U.S. distribution agreement with Aegis Spine, subsidiary of L&K Biomed, to complement Implanet's commercialization activity in the region.

The Arthroscopy Association of North America and VirtaMed signed an agreement to co-develop virtual reality arthroscopy simulation training.

RTI Surgical entered into an agreement to acquire Zyga Technology, developer of the SImmetry® Sacroiliac Joint Fusion system.

Histogenics entered into an agreement with MEDINET to develop and commercialize NeoCart® cartilage repair therapy in Japan.

Vericel initiated its Carticel/MACI distribution agreement with Innovative Cellular Therapeutics following a US $5.1MM upfront payment. 

Centinel Spine completed the acquisition of worldwide prodisc® total disc replacement assets from DePuy Synthes Products.

Wright Medical acquired IMASCAP, developer of the technology that drives BLUEPRINT™ 3D surgical planning software, for US $88.8MM in cash, stock and milestone payments.

Bodycad entered into an exclusive agreement with OrthoGrow for distribution of its unicompartmental knee in the European Union.

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.

Smith & Nephew completed its acquisition of Rotation Medical, developer of novel tissue regeneration technology for shoulder rotator cuff repair.

curasan entered into an exclusive agreement with Implantcast for distribution of CERASORB bone regeneration products in Austria, Germany and Switzerland.

OrthoPediatrics will market Bioretec's bioresorbable bone and soft tissue fixation implants under its own TorqLoc™ brand.

Xtant Medical entered the U.S. bone graft substitute market through a distribution agreement with curasan.

Arthrosurface acquired IP from WASAS pertaining to an acellular dermal stabilization allograft device that may address various orthopaedic therapeutic challenges.

K2M and Brainlab will partner to commercialize and co-market future navigated K2M spinal systems for open and MIS procedures.

Stryker acquired Vexim, developer of the SpineJack® expandable vertebral compression fracture implant, for ~US $191.0MM. The transaction is expected to close in 4Q17.

Sites Medical entered into an agreement to license OsteoSync™ Ti technology to Integrity Implants for its use in expandable interbody devices.

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

K2M acquired Cardinal Spine's cervical static corpectomy cage, to be branded as the PALO ALTO® system.

Smith & Nephew entered into a definitive agreement to acquire Rotation Medical for US $125MM in initial cash. The transaction is expected to close by year-end.

Corin acquired the large joint business unit of its distributor, MBA Belgium & Luxembourg. 

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

Bone Therapeutics signed an exclusive license agreement with Asahi Kasei to develop and commercialize PREOB® autologous bone cell therapy.

Centinel Spine entered into an agreement to purchase DePuy Synthes' worldwide prodisc artificial disc assets.

Artoss entered into a Defense Acquisition Purchasing Agreement with Owens & Minor for U.S. Department of Defense access to NanoBone bone graft.

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

ApiFix granted exclusive distribution rights to Joint Solutions Alliance for its scoliosis treatment in Canada.

Mazor Robotics entered Phase II of its strategic partnership with Medtronic, which will now take on exclusive global distribution of the Mazor X surgical assistance platform. 

OrthoPediatrics entered into an agreement for exclusive U.S. distribution of Mighty Oak Medical's FIREFLY® pedicle screw navigation guides in pediatric hospitals.

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.

DePuy Synthes entered into an exclusive U.S. agreement with JointPoint to co-market a surgical navigation platform for total hip replacement, beginning in 2H17.

Bone Biologics entered into an exclusive license agreement with UCLA for global application of NELL-1 protein in the treatment of osteoporosis and trauma, through a technology transfer. 

ConforMIS acquired the machining and polishing assets of its supplier, Broad Peak Manufacturing, for US $6.5MM.

DePuy Synthes gained exclusive rights to co-market Medical Enterprises' ME1000™ Surgical Impactor for use in Total Hip Arthroplasty.

During 2Q17, Globus Medical acquired KB Medical, Switzerland-based developer of the AQrate™ Robotic Assistance system.

K2M acquired exclusive license to a portfolio of 17 issued and pending patents for expandable interbody technology.

SpineSource was awarded a contract to supply the U.S. Department of Defense with the L-Varlock® expandable lumbar cage.

OrthAlign announced first KneeAlign® total knee arthroplasties completed in Panama, alongside entrance into a distribution partnership with Ortosistemas.

Adhezion Biomedical entered into an exclusive U.S. distribution agreement with OsteoRemedies for FLORASEAL® Microbial Sealant. 

Tissue Regenix proposes to acquire CellRight Technologies for US $30MM, to offer products for bone and soft tissue regeneration.

ApiFix entered into an exclusive distribution agreement with Acuna-Fombona to market the ApiFix scoliosis system in Spain.

CTL Medical entered into an agreement to market G-21's bone cement, kyphoplasty and vertebroplasty products in the U.S.

K2M signed a long-term exclusive distribution agreement with Japan Medicalnext.

Ortho Development granted China Pioneer Pharma exclusive regional distribution rights for the Balanced Knee® system.

MedShape reached a definitive agreement for ConMed to acquire the ExoShape® ACL fixation system. 

DePuy Synthes acquires Sentio and its nerve localization technology for minimally invasive spine surgery.  

SpineGuard entered an exclusive distribution agreement with XinRong Medical for PediGuard® in China, Hong Kong and Macau. 

GE Additive and Stryker established an agreement to support Stryker's growth in additive manufacturing, covering new machines, materials and services. 

Cretex Companies acquired Quality Tech Services, supplier of outsourced packaging for the medical device industry.

Premier is now offering Bioventus' full surgical orthobiologics product portfolio to its U.S. membership, comprising 3,750 hospitals and >130,000 provider organizations. 

Aurora Spine's proprietary implant locking technology is available for out-licensing or private labeling opportunities.

SANUWAVE Health appointed LITHOMED to distribute the orthoPACE® shockwave therapy device in Taiwan.

Integra LifeSciences signed an agreement with aap Implantate to distribute the LOQTEQ® Distal Radius System in the U.S. 

Vericel entered into a 2-year renewable agreement with Orsini Pharmaceutical for distribution of Carticel® and MACI® in the U.S. and Puerto Rico. 

Zimmer Biomet entered into an agreement to license patents from Bonutti Research, supporting the development of the Rosa® robotic total knee application. 

Stryker entered into an agreement to distribute AlloSource biologic products in the U.S. for use in sports medicine procedures.

Seikagaku entered into a basic co-development and marketing collaboration with Ono Pharmaceutical in Japan for SI-613 for the treatment of osteoarthritis.

Xtant Medical (XTNT) entered into a licensing agreement with Sites Medical for use of OsteoSync™ Ti porous titanium scaffold technology with XTNT's spinal products.

DePuy Synthes was awarded a contract from the U.S. Department of Defense to supply up to US $260MM worth of orthopaedic products to global U.S. military medical facilities.

Vericel entered into a license agreement whereby Innovative Cellular Therapeutics will obtain exclusive rights to develop and distribute Carticel® and MACI® in Southeast Asia.

Cook Medical sold its vertebroplasty product line to IZI Medical Products. 

Vertebral Technologies partnered with Medikon for distribution of InterFuse® spinal fusion products in Turkey.

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

TITAN Metal Fabricators acquired select assets of Edge International, distributor of raw materials used in the manufacture of implants and instruments for the orthopaedic, spine and trauma markets.

aap Implantate entered into a distribution agreement for the LOQTEQ® Radius System with an unnamed, U.S.-based global medical technology company.

7D Surgical entered into exclusive partnerships with Surgical One and DB Surgical for U.S. distribution of its Machine-Vision Image Guided Surgery platform for spine procedures.

DePuy Synthes acquired 3D printing technology from Tissue Regeneration Systems to offer patient-specific, bioresorbable implants for orthopaedic and CMF applications. 

Amendia acquired Spinal Elements, provider of implants, instruments and orthobiologics. Terms were not disclosed.

United Orthopedic acquired A-Spine Asia, developer of spinal fixation, osteoplasty and vertebral body replacement systems, for US $20.0MM. For 2016, A-Spine posted revenue of $11.3MM.

Audax Medical was granted an exclusive worldwide license from Northeastern University for a self-assembling, arginine-rich nanomolecule for development in tissue regeneration. 

DJO Global's Surgical Division partnered with IPG on delivery of its products to IPG's health plan clients and patients.

KFx Medical entered into a license agreement with ConMed addressing patents used in knotless double row rotator cuff repair.

K2M and LifeHealthcare entered into a new 5-year distribution agreement for K2M's spinal technologies in Australia and New Zealand.

OMNIlife science signed an agreement granting exclusive license to Global Orthopaedic Technology to manufacture and market the APEX™ Knee in Australia, New Zealand and South Africa.

Medovex entered into a distribution partnership with Technology Consult Berlin for its Denervex™ system in Germany.

IBS Investment Bank acquired a minority membership interest in The Progressive Orthopaedic Company.

Organogenesis is acquiring NuTech Medical, developer of amniotic products with application in soft tissue and bone regeneration.

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

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

Amend Surgical entered into an exclusive agreement with The University of Florida Research Foundation to license patents for the development of Biomimetic Bone.

BONESUPPORT extended its U.S. distribution agreement with Zimmer Biomet (ZBH), continuing ZBH's exclusive rights for CERAMENT BONE VOID FILLER.

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.

Misonix entered into an exclusive agreement with Weigao Orthopedic for distribution of the BoneScalpel in China, Hong Kong and Macau.

Vertebral Technologies appointed new distributors in Finland, Germany and Sweden to expand access to InterFuse® modular interbody fusion implants.

Shoulder Options seeks to divest its AFT™ Proximal Humerus Fracture, AFT Greater Tuberosity Fracture and CRP™ Cuff Repair plates.

Wenzel Spine acquired PrimaLOK™ SP Interspinous Fusion and PrimaLOK™ FF Facet Fixation systems from OsteoMed.

Proper implementation post-acquisition-close will allow your supply chain to deliver immediate and long-term value, and avoid integration delays and disruptions.

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.

Medacta acquired Vivamed, its Austrian distributor of 15 years.

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

Trice Medical entered into an agreement with Pacific Medical for multi-state distribution of the mi-eye 2™ in-office arthroscopic diagnostic tool in the U.S.

SpineSource entered into a long-term exclusive U.S. agreement to distribute Kisco International's L-Varlock® Expandable Lumbar Cage for vertebral interbody fusion.

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.

OsteoMed completed the acquisition of OT Medical's InstaFix™ shape memory staple systems. 

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 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.

Bovie Medical entered into a global sales channel partnership agreement with CONMED for its PlazXact™ Ablator, which will be marketed as the UltrAblator Bipolar® series effective in late 1Q17.

Bioventus selected MEDSERVICE to distribute DUROLANE® single-injection joint fluid in Russia. 

Orthocell entered into a research collaboration agreement with DePuy Synthes Products for the Ortho-ATI® stem cell treatment for tendon and ligament regeneration. 

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.

Medovex entered into an international distribution agreement with AlfaMed for distribution of its DenerveX™ System throughout Italy.

DePuy Synthes entered into an asset purchase and development agreement with Interventional Spine, addressing expandable fusion cages and a facet screw system for open and percutaneous spine surgery.

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. 

aap Implantate entered into a distribution contract for LOQTEQ® trauma products with an unnamed U.S. healthcare service provider.

Bioventus entered into an agreement with Galderma to bring DUROLANE knee osteoarthritis treatment to the U.S.

Amplitude Surgical acquired a 50% stake in industrial subcontractor SOFAB Orthopedie.

GE completed its agreements to acquire stakes in Arcam and Concept Laser.

OrthoMend Research acquired from Temple University researchers an exclusive license to develop novel absorbable bone fixation and regenerative repair technologies for commercial use.

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.

Cerapedics was awarded a group purchasing agreement with Premier addressing i-FACTOR™ Peptide Enhanced Bone Graft.

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.

Konica Minolta Healthcare partnered with Mindray to develop portable musculoskeletal ultrasound devices.

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). 

Zimmer Biomet acquired RespondWell® telerehabilitation technology, designed to provide personalized, clinician-supervised post-surgical physical therapy in a patient's home.

NuVasive is introducing an Integrated Global Alignment™ platform that is expanded to support cervical alignment. Further, the company acquired LessRay software technology from SafeRay Spine.

Spinal Elements and Mighty Oak Medical will co-market the FIREFLY® surgical guidance system, comprising patient-matched bone models and intra-op pedicle screw guides created via 3D printing.

Wright Medical completed the sale of Tornier's hip/knee business to Corin for 29.7MM in cash (~US $32.3MM). 

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.

Avoid disruptions in customer service and financial performance by reviewing the people, processes and supporting systems of upstream and downstream supply chains.

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.

Zimmer Biomet entered into an exclusive agreement to globally distribute Nextremity Solutions' foot and ankle deformity correction products.

Isto Technologies acquired Arteriocyte Medical Systems, forming Isto Biologics. The new entity will offer evidence-based solutions for spine and orthopaedic applications. Terms were not disclosed.

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

InterMed Resources entered into an agreement to distribute Z-Medical's MIS Z-Pedicle Screw to HealthTrust's ~1,600 acute care facilities in the U.S.

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

Alpha Source has transitioned to be the services and exclusive parts provider for GE Healthcare's bone mineral densitometry products in the U.S. 

The Musculoskeletal Transplant Foundation is now sole tissue provider for Spineology's allograft product lines, including the newly-launched Incite™ Cortical Fiber bone graft.

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. 

Amplitude Surgical acquired the remaining 40% interest in Unimplant, its distribution subsidiary in Brazil.

Zimmer Biomet acquired Clinical Graphics, a specialist in 3D range-of-motion simulation technology for hip conditions requiring early intervention.

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.

In2Bones SAS has merged with In2Bones USA, its largest distributor, to form i2b, a global company serving the upper and lower extremities orthopaedic markets.

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.

GE plans to acquire Arcam and SLM Solutions, suppliers of additive manufacturing equipment, for US $1.4BB in cash.

Globus Medical completed its acquisition of the international operations and distribution channels of Alphatec Spine for US $80.0MM in cash. 

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.

SeaSpine entered into a definitive agreement to acquire NLT Spine, developer of minimally invasive surgery devices. SeaSpine's commercial launch of the first NLT product is expected in 1H17.

Zimmer Biomet acquired CD Diagnostics, developer of immunoassays and biomarker testing to inform treatment decisions. Financial terms were not disclosed.

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.

JRI Orthopaedics acquired Sheffield Medical Products, designer of the AEON cemented total hip. 

Globus Medical entered into an agreement to acquire the ex-U.S. operations and distribution channels of Alphatec (ATEC) for US $80.0MM in cash. ATEC posted 2015 ex-U.S. revenue of $70.7MM.

Zimmer Biomet announced its plans to acquire Medtech, provider of surgical systems including the ROSA™ Spine robotic-assistive device for minimally invasive surgery.

Wright Medical received a binding offer under which Corin Orthopaedics would acquire Wright's hip/knee business for 29.7MM in cash (~US $33MM). The proposed transaction is expected to close by early 4Q16.

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.

NuVasive completed its previously-announced acquisition of Biotronic NeuroNetwork, which is now part of the NuVasive Clinical Services division.

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 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 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.

NuVasive (NUVA) entered into a definitive agreement to acquire Biotronic NeuroNetwork, a U.S. provider of intraoperative neurophysiological monitoring services, for US $98MM in cash. 

Mazor Robotics entered into strategic agreements with Medtronic for equity investment and for co-development/potential global distribution of certain Mazor products. 

Novastep signed an agreement with Vivex Biomedical to launch bioSTART® Tissue Repair products, offering amniotic membranes and liquid to support foot and ankle procedures in the U.S.

Zimmer Biomet closed its previously-announced acquisition of Cayenne Medical, a manufacturer of soft tissue repair and reconstruction products for the knee, shoulder and extremities.

Demetra Holding has formed with investment from Tecres and Keensight, which acquired aap Implantate's biomaterials assets. 

aap Implantate completed the sale of its aapBiomaterials subsidiary. The buyer is Keensight Capital.

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

Histogenics acquired development and commercialization rights to NeoCart® for the Japanese market from its partner, Purpose Co. NeoCart autologous cell therapy is designed to treat knee cartilage defects. 

Private equity firm Kohlberg & Company has acquired majority ownership of Amendia, and will support its growth initiatives from a US $1.6BB private equity fund.

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.

Zimmer Biomet entered into a definitive agreement to acquire Cayenne Medical within 2Q16. Terms of the transaction were not disclosed.

BD sold its vertebral augmentation assets, including all AVAmax®, AVAflex®, AVAtex® and AVAprep® branded products, to Stryker. Financial terms were not disclosed.

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. 

Stryker Spine acquired SafeWire's product portfolio, including the Y-Wire guidewire and Tiger Jamshidi Needle for use in minimally invasive spine surgery. 

Vivex Biomedical and Arthrex signed a new multi-year agreement expanding the breadth of Vivex's products for Arthrex's distribution.

aap Implantate sold its biomaterials unit to an undisclosed private equity firm for 36MM (~US $40.3MM). Upon closing, aap will proceed as a pure-play trauma entity.

In'Tech Medical acquired Ortho Solutions, a contract manufacturer of orthopaedic implants and instruments in Asia. 

Intellijoint Surgical entered into a strategic partnership with Corin for Australia distribution of the intellijoint HIP™, to complement Corin's Optimized Positioning System™ technology.

OrthoSensor entered into a partnership with IM-Tech to support R&D collaboration, manufacturing and investments in electronics technology in the global commercialization of the VERASENSE™ sensor.

NuVasive entered into a definitive agreement to acquire Mega Surgical, its exclusive distributor in Brazil. The transaction is expected to close within 1Q16.

Joint Active Systems signed a non-binding letter of intent to acquire the Empi® Advance® ROM line of dynamic braces.

EOS imaging entered into a co-promotion agreement whereby Stryker's European Spine business will promote EOS imaging's platform to existing and prospective customers in the U.K.

Lima Corporate entered into an Innovation Alliance Agreement with the Hospital for Special Surgery. New product co-developments include a Trabecular Titanium total elbow and an advanced acetabular cup. 

EQT, a global private equity group, with Hansjörg Wyss as co-investor, has completed acquisition of the majority of shares of Lima Corporate. 

LifeNet Health and Arthrex signed a new long-term agreement to provide allograft implants and instrumentation to surgeons and explore new applications, such as opportunities in cartilage repair.

Invibio Knee partnered with Maxx Orthopedics to develop a PEEK-OPTIMA®-based femoral knee replacement. 

Bone Therapeutics extended its collaboration with Kasios to combine ALLOB® bone cell therapy with a 3D-printed synthetic cage intended to support the spinal fusion process.

Exactech acquired Exactech Australia, an independent importer and distributor of Exactech's orthopaedic implants, instrumentation and surgical technology.

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

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.

EOS imaging partnered with Spinologics to co-develop biomechanical spine surgery simulation tools for integration with EOS imaging's cloud-based, 3D planning software. 

Kuros Biosurgery closed its previously-announced transaction merging Kuros with Cytos Biotechnology, to form Kuros Biosciences.

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.

Smith & Nephew acquired BST-CarGel® cartilage repair product and IP assets from Piramal. Transaction terms were not disclosed. 

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.

Smith+Nephew completed its acquisition of Blue Belt Technologies, developer of the Navio surgical robotics-assistance system for unicondylar knee replacement.

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.