Orthopedic Enabling Technology Market Size and Share
Market Definition
Surgical planning, navigation technologies, robotics, patient monitoring and other digital tools used in orthopedics. Excludes sports medicine capital equipment.
April 2026
Mike Evers, Senior Market Analyst
Welcome to our overview of the orthopedic enabling technology market. This page builds upon the inaugural chapter covering enabling technology in our latest edition of THE ORTHOPAEDIC INDUSTRY ANNUAL REPORT®. It is a dynamic and rapidly changing segment as the industry learns how to best leverage technology.
The Market at a Glance
Enabling technology sales eclipsed $1.5 billion worldwide in 2025, accounting for about 2.5% of the global orthopedic market. Revenue doesn’t tell the entire story for the segment, given the prevalence of alternative placement methods like rentals and implant share arrangements. Priority has shifted from lump sum payments for capital equipment to reliable annuities and implant pull-through.
Market Forecast
Revenue growth from the expansion of players and offerings in the enabling technology space will be tempered by the trend toward volume-based placement arrangements. We estimate the market will grow 9.5% in 2026 as it exceeds $1.7 billion in global sales.
Exhibit 1: Worldwide Enabling Technology Sales by Year ($million)
Get More Orthopedic Market Data. Download the Orthopedic Companies Sales Matrix for our most complete and granular numbers. It contains worldwide orthopedic sales for 80 public and private companies by segment from 2016 through 2025.
Here are some of the enabling technology market dynamics we considered in our forecasts:
The Quest for Tech Supremacy. While enabling technology in general is a no-brainer, robotics is still a bit of an open question in terms of format and functionality. Robotics remains underpenetrated among surgeons. According to Zimmer Biomet, 80% of U.S. surgeons don’t use robotics. Internationally, the number is closer to 90%. If those surgeons haven’t adopted large-footprint robots by now, there’s a chance they may never do so. That’s why Zimmer Biomet believes the pathway to robotics leadership is through optionality. The company has assembled a wide array of technologies over the last several years to meet surgeons where they are, including a distribution agreement with THINK Surgical that integrates Zimmer Biomet technology into a customized TMINI handheld robotic solution for total knee arthroplasty Stryker also made an effort to increase surgeon adoption of robotic-assisted surgery with the introduction of the handheld Mako RPS (Robotic Power System) for total knee surgery. As more companies join the push to expand optionality, it could help drive future growth.
Robotics Expanding Beyond Joint and Spine. Joint replacement and spine are the largest segments in orthopedics, so it is no surprise that the bulk of technology development has focused there. However, we’re seeing an increased interest in enabling technology for sports medicine and trauma. Stryker said it is keeping an open mind on what form factor a sports medicine robot might take given the broad range of procedures, clinical opportunities and need to deliver on the workflow required in a minimally invasive environment. DePuy Synthes announced an AI-assisted version of VELYS to deliver intraoperative surgical guidance and fracture reduction assistance in trauma cases.
Healthy Demand in Hospitals and ASCs. Companies in the enabling technology space were bullish on the operating environment in 2025. Smith+Nephew said CORI had a record year for placements, along with continued acceleration of utilization. Zimmer Biomet said the fourth quarter of 2025 was its strongest for robotic placements in two years. Stryker said hospital balance sheets are strong, even leading to more outright Mako purchases in 2025 than has been typical over the past few years. Given that enabling technology demand remained strong even through the disruption after the pandemic, we expect the environment to remain favorable going forward.
Other Segment Reports
Sales by Region
The United States is at the forefront of the enabling technology market in terms of penetration and opportunity, with an estimated 5,000 hospitals and a growing number of outpatient sites. Stryker often says its target addressable market in the United States for the Mako robot is every operating room where knee and hip replacements (and eventually spine procedures and shoulder arthroplasties) are performed. While probably not feasible, it does underscore the tremendous runway remaining for robotic systems, let alone navigation technology.
Technology penetration is still in the early innings outside the United States but represents a compelling opportunity. The adoption curve in the United States could be a fairly accurate proxy for countries like Australia and Japan that have the financial means and appetite for advanced surgical tools. Countries with highly socialized medicine like France could be slower to adopt robotic and navigation platforms.
China is a unique case. Companies like Smith+Nephew are in wait-and-see mode to determine their long-term strategy in the country. Massive technology adoption could change the business case that was turned upside down by volume-based procurement. However, it seems likely that domestic Chinese companies like TINAVI and AK Medical will preferentially get their systems purchased and placed in that market.
Exhibit 2: Enabling Technology Sales by Region ($million)
| Region | 2025 | 2024 | $ Chg | % Chg |
|---|---|---|---|---|
| US | $1,213.4 | $1,107.8 | $105.6 | 9.5% |
| OUS | $342.2 | $314.3 | $28.0 | 8.9% |
| EMEA | $219.7 | $201.9 | $17.8 | 8.8% |
| APAC | $99.6 | $91.0 | $8.6 | 9.4% |
| ROW | $22.9 | $21.3 | $1.6 | 7.6% |
| Total | $1,555.7 | $1,422.0 | $133.6 | 9.4% |
Exhibit 3: Enabling Technology Market Share by Region ($million)
Top Companies
Five players had more than $100 million in enabling technology revenue in 2025, accounting for 68% of the market. It should be no surprise that these companies are the top players in joint replacement and spine as well, each with total orthopedic revenues of $2.9 billion or more. In recent years, we’ve seen more mid-tier players like Orthofix and ATEC expanding their technology offerings.
Exhibit 4: Top 10 Enabling Technology Players ($million)
| Company | 2025 | 2024 | $ Chg | % Chg |
|---|---|---|---|---|
| Stryker | $534.8 | $453.0 | $81.8 | 18% |
| Medtronic | $176.9 | $168.3 | $8.6 | 5.1% |
| Globus Medical | $141.0 | $154.0 | ($13.0) | (8.4%) |
| Smith+Nephew | $109.3 | $80.8 | $28.5 | 35.3% |
| Zimmer Biomet | $101.1 | $94.8 | $6.2 | 6.6% |
| ATEC | $77.0 | $66.7 | $10.3 | 15.5% |
| J&J MedTech | $76.4 | $71.1 | $5.3 | 7.4% |
| OrthAlign | $65.4 | $59.7 | $5.7 | 9.5% |
| Corin | $43.9 | $39.6 | $4.4 | 11% |
| THINK Surgical | $21.0 | $9.0 | $12.0 | 133.3% |
| All Others | $208.9 | $225.1 | ($16.2) | (7.2%) |
| Total | $1,555.7 | $1,422.0 | $133.6 | 9.4% |
Exhibit 5: Enabling Technology Market Share by Company ($millions)
Strong capital markets and accelerating utilization helped Stryker surpass 2 million Mako procedures during 2025. More than two-thirds of Stryker’s U.S. knee replacements and one-third of its U.S. hip replacements were performed using Mako. Globally, those numbers were 50% and 20%, respectively.
The CORI ecosystem has been a strong performer for Smith+Nephew as it begins to penetrate teaching institutions and ASCs, where 45% of CORIs were placed in the fourth quarter of 2025. Zimmer Biomet is leading the charge for optionality in technology ecosystems and made some waves with the acquisition of Monogram Orthopedics’ autonomous robotic system. Zimmer Biomet plans to roll out the autonomous system in early 2027 and is bullish on the potential demand from surgeons. The VEYLS Robotic-Assisted Solution for knee replacement surgery continues to be a winner for DePuy Synthes, especially internationally. The company also plans to launch an AI-assisted version for trauma procedures.
In spine, Medtronic extended its enabling technology lead over Globus Medical in 2025. Medtronic grew its install base over 10,000 and unveiled its next-generation AXiS system toward the end of the year. Globus Medical surpassed 110,000 robotic procedures in 2025 but faced elongated selling cycles for its capital products. The company said it intends to be more aggressive in placing robots in 2026. DePuy Synthes began rolling out VELYS Spine in mid-2025 but the system will likely take some time to turn around the company’s lagging spine sales.
Smaller companies have been active as well. French joint replacement player Amplitude Surgical collaborated with eCential Robotics to create the Andy robotic platform that gained CE Mark approval in late 2025. Cyber Surgery commenced the launch of ALAYA, reportedly the first CE-Marked Surgical Robotic Assistant for spine that offers an alternative to the limitations of conventional optical navigation technologies. THINK Surgical’s TMINI system surpassed 1,000 total knee replacement cases in mid-2025.
Important Developments in the Enabling Technology Market
Highly Active in M&A and Funding. As expected, digital assets have been more in demand for orthopedic M&A in recent years. From 2016 to 2020, 13% of transactions included digital assets. Since 2021, that percentage increased to 18%. Along with orthobiologics, digital was the only other category of M&A to accelerate since 2021. This trend is even more pronounced in the funding space, where the digital category has grown nearly 9% since 2021, jumping from 15% of funding announcements to 23%.
Late Entrants Increase Competition. In joint replacement, the big four players have robust ecosystems of technology. However, we expect more companies to launch competing products. Globus Medical is nearing the long-awaited launch of their joint replacement robot, Corin’s system seems to have found a home at Arthrex, and Enovis intends to double down on technology, though it remains to be seen if that includes robotics. In spine, ATEC is set to enter the robotics arena with their Valence system. These systems and a host of others from smaller players underscore that evolution of technology in orthopedics from a near-monopoly among the largest players to a virtual “must-have” portfolio piece.
Market Share Moats. Medtronic has demonstrated that strategic success with enabling technology is best served by having a complete, differentiated ecosystem. Key accounts are increasingly upgrading not just one piece of technology but are instead adopting the entire Medtronic ecosystem. That level of investment by hospitals makes Medtronic very sticky in those accounts and creates a defensive moat around crucial implant market share. So, while more companies are entering the technology space, integrated ecosystems are still the domain of the largest companies in orthopedics given the resources they take to develop and deploy.
Navigation Market Getting Attention. Robotics often dominates the conversation about enabling technology, but more than 75 companies play in the navigation space. Companies like Enovis, Medacta, Advita and Orthofix continue to preach the benefits of preoperative planning and intraoperative navigation over large robotic systems. Standalone enabling technology companies like OrthAlign, Pixee Medical and Proprio are rolling out advanced technologies that they say are meeting an important market need. The systems that are able to offer streamlined operating room setup, faster registration and enhanced visualization are more likely to gain widespread adoption.
Advent of AI in Enabling Tech. “AI-assisted” has become the new buzz terminology in enabling technology, but orthopedics is just at the beginning stages of AI use and machine learning inside and outside of the operating room. AI will help further standardize care and scale personalization of procedures by automating the segmentation of scans, creating surgical plans and helping provide real-time intraoperative decision support.
Further Reading
Thanks for visiting! Need more insight on the enabling technology market? Questions and comments are always welcome. You can reach me by email. Until then, I’ve gathered a few posts about enabling technology from recent months. Enjoy!
Our overview of the orthopedic enabling technology includes up-to-date information on forecasted growth, the top companies and industry-driving trends.
Market Definition
Surgical planning, navigation technologies, robotics, patient monitoring and other digital tools used in orthopedics. Excludes sports medicine capital equipment.
April 2026
Mike Evers, Senior Market Analyst
Welcome to our overview of the orthopedic enabling technology market. This page builds upon the inaugural chapter covering enabling technology in our latest edition of THE ORTHOPAEDIC INDUSTRY ANNUAL REPORT®. It is a dynamic and rapidly changing segment as the industry learns how to best leverage technology.
The Market at a Glance
Enabling technology sales eclipsed $1.5 billion worldwide in 2025, accounting for about 2.5% of the global orthopedic market. Revenue doesn’t tell the entire story for the segment, given the prevalence of alternative placement methods like rentals and implant share arrangements. Priority has shifted from lump sum payments for capital equipment to reliable annuities and implant pull-through.
Market Forecast
Revenue growth from the expansion of players and offerings in the enabling technology space will be tempered by the trend toward volume-based placement arrangements. We estimate the market will grow 9.5% in 2026 as it exceeds $1.7 billion in global sales.
Exhibit 1: Worldwide Enabling Technology Sales by Year ($million)
Get More Orthopedic Market Data. Download the Orthopedic Companies Sales Matrix for our most complete and granular numbers. It contains worldwide orthopedic sales for 80 public and private companies by segment from 2016 through 2025.
Here are some of the enabling technology market dynamics we considered in our forecasts:
The Quest for Tech Supremacy. While enabling technology in general is a no-brainer, robotics is still a bit of an open question in terms of format and functionality. Robotics remains underpenetrated among surgeons. According to Zimmer Biomet, 80% of U.S. surgeons don’t use robotics. Internationally, the number is closer to 90%. If those surgeons haven’t adopted large-footprint robots by now, there’s a chance they may never do so. That’s why Zimmer Biomet believes the pathway to robotics leadership is through optionality. The company has assembled a wide array of technologies over the last several years to meet surgeons where they are, including a distribution agreement with THINK Surgical that integrates Zimmer Biomet technology into a customized TMINI handheld robotic solution for total knee arthroplasty Stryker also made an effort to increase surgeon adoption of robotic-assisted surgery with the introduction of the handheld Mako RPS (Robotic Power System) for total knee surgery. As more companies join the push to expand optionality, it could help drive future growth.
Robotics Expanding Beyond Joint and Spine. Joint replacement and spine are the largest segments in orthopedics, so it is no surprise that the bulk of technology development has focused there. However, we’re seeing an increased interest in enabling technology for sports medicine and trauma. Stryker said it is keeping an open mind on what form factor a sports medicine robot might take given the broad range of procedures, clinical opportunities and need to deliver on the workflow required in a minimally invasive environment. DePuy Synthes announced an AI-assisted version of VELYS to deliver intraoperative surgical guidance and fracture reduction assistance in trauma cases.
Healthy Demand in Hospitals and ASCs. Companies in the enabling technology space were bullish on the operating environment in 2025. Smith+Nephew said CORI had a record year for placements, along with continued acceleration of utilization. Zimmer Biomet said the fourth quarter of 2025 was its strongest for robotic placements in two years. Stryker said hospital balance sheets are strong, even leading to more outright Mako purchases in 2025 than has been typical over the past few years. Given that enabling technology demand remained strong even through the disruption after the pandemic, we expect the environment to remain favorable going forward.
Other Segment Reports
Sales by Region
The United States is at the forefront of the enabling technology market in terms of penetration and opportunity, with an estimated 5,000 hospitals and a growing number of outpatient sites. Stryker often says its target addressable market in the United States for the Mako robot is every operating room where knee and hip replacements (and eventually spine procedures and shoulder arthroplasties) are performed. While probably not feasible, it does underscore the tremendous runway remaining for robotic systems, let alone navigation technology.
Technology penetration is still in the early innings outside the United States but represents a compelling opportunity. The adoption curve in the United States could be a fairly accurate proxy for countries like Australia and Japan that have the financial means and appetite for advanced surgical tools. Countries with highly socialized medicine like France could be slower to adopt robotic and navigation platforms.
China is a unique case. Companies like Smith+Nephew are in wait-and-see mode to determine their long-term strategy in the country. Massive technology adoption could change the business case that was turned upside down by volume-based procurement. However, it seems likely that domestic Chinese companies like TINAVI and AK Medical will preferentially get their systems purchased and placed in that market.
Exhibit 2: Enabling Technology Sales by Region ($million)
| Region | 2025 | 2024 | $ Chg | % Chg |
|---|---|---|---|---|
| US | $1,213.4 | $1,107.8 | $105.6 | 9.5% |
| OUS | $342.2 | $314.3 | $28.0 | 8.9% |
| EMEA | $219.7 | $201.9 | $17.8 | 8.8% |
| APAC | $99.6 | $91.0 | $8.6 | 9.4% |
| ROW | $22.9 | $21.3 | $1.6 | 7.6% |
| Total | $1,555.7 | $1,422.0 | $133.6 | 9.4% |
Exhibit 3: Enabling Technology Market Share by Region ($million)
Top Companies
Five players had more than $100 million in enabling technology revenue in 2025, accounting for 68% of the market. It should be no surprise that these companies are the top players in joint replacement and spine as well, each with total orthopedic revenues of $2.9 billion or more. In recent years, we’ve seen more mid-tier players like Orthofix and ATEC expanding their technology offerings.
Exhibit 4: Top 10 Enabling Technology Players ($million)
| Company | 2025 | 2024 | $ Chg | % Chg |
|---|---|---|---|---|
| Stryker | $534.8 | $453.0 | $81.8 | 18% |
| Medtronic | $176.9 | $168.3 | $8.6 | 5.1% |
| Globus Medical | $141.0 | $154.0 | ($13.0) | (8.4%) |
| Smith+Nephew | $109.3 | $80.8 | $28.5 | 35.3% |
| Zimmer Biomet | $101.1 | $94.8 | $6.2 | 6.6% |
| ATEC | $77.0 | $66.7 | $10.3 | 15.5% |
| J&J MedTech | $76.4 | $71.1 | $5.3 | 7.4% |
| OrthAlign | $65.4 | $59.7 | $5.7 | 9.5% |
| Corin | $43.9 | $39.6 | $4.4 | 11% |
| THINK Surgical | $21.0 | $9.0 | $12.0 | 133.3% |
| All Others | $208.9 | $225.1 | ($16.2) | (7.2%) |
| Total | $1,555.7 | $1,422.0 | $133.6 | 9.4% |
Exhibit 5: Enabling Technology Market Share by Company ($millions)
Strong capital markets and accelerating utilization helped Stryker surpass 2 million Mako procedures during 2025. More than two-thirds of Stryker’s U.S. knee replacements and one-third of its U.S. hip replacements were performed using Mako. Globally, those numbers were 50% and 20%, respectively.
The CORI ecosystem has been a strong performer for Smith+Nephew as it begins to penetrate teaching institutions and ASCs, where 45% of CORIs were placed in the fourth quarter of 2025. Zimmer Biomet is leading the charge for optionality in technology ecosystems and made some waves with the acquisition of Monogram Orthopedics’ autonomous robotic system. Zimmer Biomet plans to roll out the autonomous system in early 2027 and is bullish on the potential demand from surgeons. The VEYLS Robotic-Assisted Solution for knee replacement surgery continues to be a winner for DePuy Synthes, especially internationally. The company also plans to launch an AI-assisted version for trauma procedures.
In spine, Medtronic extended its enabling technology lead over Globus Medical in 2025. Medtronic grew its install base over 10,000 and unveiled its next-generation AXiS system toward the end of the year. Globus Medical surpassed 110,000 robotic procedures in 2025 but faced elongated selling cycles for its capital products. The company said it intends to be more aggressive in placing robots in 2026. DePuy Synthes began rolling out VELYS Spine in mid-2025 but the system will likely take some time to turn around the company’s lagging spine sales.
Smaller companies have been active as well. French joint replacement player Amplitude Surgical collaborated with eCential Robotics to create the Andy robotic platform that gained CE Mark approval in late 2025. Cyber Surgery commenced the launch of ALAYA, reportedly the first CE-Marked Surgical Robotic Assistant for spine that offers an alternative to the limitations of conventional optical navigation technologies. THINK Surgical’s TMINI system surpassed 1,000 total knee replacement cases in mid-2025.
Important Developments in the Enabling Technology Market
Highly Active in M&A and Funding. As expected, digital assets have been more in demand for orthopedic M&A in recent years. From 2016 to 2020, 13% of transactions included digital assets. Since 2021, that percentage increased to 18%. Along with orthobiologics, digital was the only other category of M&A to accelerate since 2021. This trend is even more pronounced in the funding space, where the digital category has grown nearly 9% since 2021, jumping from 15% of funding announcements to 23%.
Late Entrants Increase Competition. In joint replacement, the big four players have robust ecosystems of technology. However, we expect more companies to launch competing products. Globus Medical is nearing the long-awaited launch of their joint replacement robot, Corin’s system seems to have found a home at Arthrex, and Enovis intends to double down on technology, though it remains to be seen if that includes robotics. In spine, ATEC is set to enter the robotics arena with their Valence system. These systems and a host of others from smaller players underscore that evolution of technology in orthopedics from a near-monopoly among the largest players to a virtual “must-have” portfolio piece.
Market Share Moats. Medtronic has demonstrated that strategic success with enabling technology is best served by having a complete, differentiated ecosystem. Key accounts are increasingly upgrading not just one piece of technology but are instead adopting the entire Medtronic ecosystem. That level of investment by hospitals makes Medtronic very sticky in those accounts and creates a defensive moat around crucial implant market share. So, while more companies are entering the technology space, integrated ecosystems are still the domain of the largest companies in orthopedics given the resources they take to develop and deploy.
Navigation Market Getting Attention. Robotics often dominates the conversation about enabling technology, but more than 75 companies play in the navigation space. Companies like Enovis, Medacta, Advita and Orthofix continue to preach the benefits of preoperative planning and intraoperative navigation over large robotic systems. Standalone enabling technology companies like OrthAlign, Pixee Medical and Proprio are rolling out advanced technologies that they say are meeting an important market need. The systems that are able to offer streamlined operating room setup, faster registration and enhanced visualization are more likely to gain widespread adoption.
Advent of AI in Enabling Tech. “AI-assisted” has become the new buzz terminology in enabling technology, but orthopedics is just at the beginning stages of AI use and machine learning inside and outside of the operating room. AI will help further standardize care and scale personalization of procedures by automating the segmentation of scans, creating surgical plans and helping provide real-time intraoperative decision support.
Further Reading
Thanks for visiting! Need more insight on the enabling technology market? Questions and comments are always welcome. You can reach me by email. Until then, I’ve gathered a few posts about enabling technology from recent months. Enjoy!
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