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As earnings announcements roll in for the third quarter, we’ll update this article with public orthopedic companies’ reported results.
Before that, let’s quickly review the themes that emerged in 2023. Year-over-year sales are elevated, particularly in joint replacement, but tougher comps await in the back half. Supply chain and staffing challenges remain in play, but are improving. Orthopedic M&A activity is accelerating after a few down years, with spine deals leading the way. Finally, leadership changes at leading companies could lead to disruption and revised guidance ranges.
About the Data
You should definitely read this part.
The data below is based on reported sales from a subset of public orthopedic companies on a quarterly reporting schedule. Combined, these companies generated $37.2 billion in orthopedic sales for 2022, accounting for about two-thirds of the global market. I’m using this group as a proxy to measure quarterly market performance.
Orthopedic Market Data for Third Quarter 2023
The third quarter played out as expected, for the most part. Surgical volumes remain elevated but have fallen off the torrid growth pace of the first half. Enabling technology is playing a crucial role in joint replacement and spine sales, but the spine market is in a state of flux because of consolidation and leadership changes.
The market is set to finish 2023 a few percentage points above its historical average.
Where applicable, company names for the current quarter are linked to a more detailed article containing highlights and segment and regional sales data.
Orthopedic Market Segment Data
| Segment | 3Q23 | 3Q22 | $ Chg | % Chg |
|---|---|---|---|---|
| Joint Replacement | $3,751.4 | $3,528.3 | $223.1 | 6.3% |
| Knees | $1,815.0 | $1,691.2 | $123.8 | 7.3% |
| Hips | $1,398.1 | $1,349.3 | $48.8 | 3.6% |
| Extremities | $538.3 | $487.8 | $50.5 | 10.3% |
| Spine | $1,216.0 | $1,172.4 | $43.6 | 3.7% |
| Trauma | $1,682.3 | $1,570.7 | $111.7 | 7.1% |
| Sports Medicine | $1,015.4 | $949.5 | $65.9 | 6.9% |
| Orthobiologics | $414.5 | $422.5 | ($8.0) | (1.9%) |
| Enabling Technology | $222.4 | $193.6 | $28.8 | 14.9% |
| Other | $578.2 | $533.5 | $44.6 | 8.4% |
| Total | $8,880.2 | $8,370.4 | $509.7 | 6.1% |
| Segment | 9m23 | 9m22 | $ Chg | % Chg |
|---|---|---|---|---|
| Joint Replacement | $11,678.1 | $10,795.1 | $883.0 | 8.2% |
| Knees | $5,750.8 | $5,220.7 | $530.1 | 10.2% |
| Hips | $4,366.9 | $4,150.0 | $216.8 | 5.2% |
| Extremities | $1,560.5 | $1,424.3 | $136.1 | 9.6% |
| Spine | $3,886.8 | $3,663.7 | $223.1 | 6.1% |
| Trauma | $5,086.1 | $4,697.3 | $388.8 | 8.3% |
| Sports Medicine | $2,979.9 | $2,779.4 | $200.5 | 7.2% |
| Orthobiologics | $1,301.0 | $1,303.7 | ($2.7) | (0.2%) |
| Enabling Technology | $639.4 | $561.5 | $77.9 | 13.9% |
| Other | $1,666.7 | $1,593.9 | $72.8 | 4.6% |
| Total | $27,238.1 | $25,394.6 | $1,843.5 | 7.3% |
Orthopedic Company Data
| Company | 3Q23 | 3Q22 | $ Chg | % Chg |
|---|---|---|---|---|
| Anika Therapeutics | $38.4 | $36.3 | $2.1 | 5.7% |
| ATEC | $118.3 | $89.8 | $28.4 | 31.6% |
| Bioventus | $110.1 | $107.5 | $2.6 | 2.5% |
| CONMED | $124.7 | $118.6 | $6.1 | 5.1% |
| DePuy Synthes | $2,164.0 | $2,094.6 | $69.4 | 3.3% |
| Enovis | $163.7 | $143.7 | $20.0 | 13.9% |
| Globus Medical | $383.6 | $254.1 | $129.5 | 51% |
| NuVasive * | $188.3 | $295.3 | ($107.0) | (36.2%) |
| Orthofix | $184.0 | $114.0 | $70.0 | 61.4% |
| OrthoPediatrics | $40.0 | $35.0 | $5.0 | 14.4% |
| Paragon 28 | $52.8 | $46.0 | $6.8 | 14.7% |
| SI-BONE | $34.0 | $26.4 | $7.6 | 28.7% |
| Smith+Nephew | $902.0 | $832.2 | $69.8 | 8.4% |
| Stryker | $2,446.8 | $2,267.7 | $179.1 | 7.9% |
| Treace Medical | $40.8 | $33.1 | $7.7 | 23.3% |
| Vericel | $37.6 | $31.0 | $6.6 | 21.2% |
| Zimmer Biomet | $1,753.6 | $1,669.8 | $83.8 | 5% |
| ZimVie | $97.6 | $108.2 | ($10.6) | (9.8%) |
| Company | 9m23 | 9m22 | $ Chg | % Chg |
|---|---|---|---|---|
| Anika Therapeutics | $116.3 | $107.4 | $8.9 | 8.3% |
| ATEC | $344.3 | $244.9 | $99.4 | 40.6% |
| Bioventus | $335.1 | $335.4 | ($0.3) | (0.1%) |
| CONMED | $396.7 | $346.3 | $50.4 | 14.5% |
| DePuy Synthes | $6,673.7 | $6,439.7 | $234.0 | 3.6% |
| Enovis | $504.8 | $436.9 | $67.9 | 15.5% |
| Globus Medical | $951.9 | $748.3 | $203.6 | 27.2% |
| NuVasive * | $813.7 | $896.5 | ($82.7) | (9.2%) |
| Orthofix | $546.2 | $338.5 | $207.7 | 61.4% |
| OrthoPediatrics | $111.1 | $91.3 | $19.8 | 21.7% |
| Paragon 28 | $155.8 | $129.9 | $26.0 | 20% |
| SI-BONE | $100.0 | $74.5 | $25.6 | 34.3% |
| Smith+Nephew | $2,755.3 | $2,610.9 | $144.4 | 5.5% |
| Stryker | $7,437.1 | $6,789.9 | $647.1 | 9.5% |
| Treace Medical | $124.9 | $92.1 | $32.8 | 35.7% |
| Vericel | $108.1 | $85.6 | $22.5 | 26.3% |
| Zimmer Biomet | $5,454.2 | $5,114.8 | $339.4 | 6.6% |
| ZimVie | $308.7 | $337.5 | ($28.8) | (8.5%) |
* NuVasive results are for January 2023 through August 2023. Sales after September 1 are attributed to Globus Medical.
Orthopedic Market Developments for Third Quarter 2023
As companies report, I’ll collect interesting developments here.
Elevated Volumes to Persist Through 2024
According to Johnson & Johnson CFO Joe Wolk, medtech volumes will remain higher than normal through 2024. This tracks with previous commentary from other large players like Stryker and Zimmer Biomet. DePuy Synthes’ results imply continued momentum in the joint replacement market, especially outside the U.S.
Johnson & Johnson to Restructure Orthopedic Business
DePuy Synthes’ parent company announced a two-year restructuring of its orthopedics business aimed at improving simplicity and profitability. The company plans to exit certain product lines and regions. The program will disrupt revenues by $250 million and cost between $700 million and $800 million.
Supply Chain Constraints Exacerbated by Acute Shortages
CONMED felt the pinch of lingering supply constraints on its legacy orthopedic products. It also cited acute, industry-wide shortages of a reagent used in sterile processing for tissue that is likely to persist into the first quarter of 2024.
GLP-1 Drugs Headwind or Tailwind?
Orthopedic companies tackled uncertainty around GLP-1 drugs head-on during their conference calls. The consensus is weight loss drugs will not significantly reduce demand for orthopedic procedures. Indeed, they could help more patients enter the surgical funnel by reducing BMI and increasing activity and, therefore, injuries.
Third Quarter Seasonality Back, And Then Some
Seasonality is mostly back to normal, but several companies like Treace Medical and Enovis noted the number of vacations and travel exceeded expectations for the third quarter of 2023.
As earnings announcements roll in for the third quarter, we'll update this article with public orthopedic companies' reported results.
Before that, let’s quickly review the themes that emerged in 2023. Year-over-year sales are elevated, particularly in joint replacement, but tougher comps await in the back half. Supply chain and staffing...
As earnings announcements roll in for the third quarter, we’ll update this article with public orthopedic companies’ reported results.
Before that, let’s quickly review the themes that emerged in 2023. Year-over-year sales are elevated, particularly in joint replacement, but tougher comps await in the back half. Supply chain and staffing challenges remain in play, but are improving. Orthopedic M&A activity is accelerating after a few down years, with spine deals leading the way. Finally, leadership changes at leading companies could lead to disruption and revised guidance ranges.
About the Data
You should definitely read this part.
The data below is based on reported sales from a subset of public orthopedic companies on a quarterly reporting schedule. Combined, these companies generated $37.2 billion in orthopedic sales for 2022, accounting for about two-thirds of the global market. I’m using this group as a proxy to measure quarterly market performance.
Orthopedic Market Data for Third Quarter 2023
The third quarter played out as expected, for the most part. Surgical volumes remain elevated but have fallen off the torrid growth pace of the first half. Enabling technology is playing a crucial role in joint replacement and spine sales, but the spine market is in a state of flux because of consolidation and leadership changes.
The market is set to finish 2023 a few percentage points above its historical average.
Where applicable, company names for the current quarter are linked to a more detailed article containing highlights and segment and regional sales data.
Orthopedic Market Segment Data
| Segment | 3Q23 | 3Q22 | $ Chg | % Chg |
|---|---|---|---|---|
| Joint Replacement | $3,751.4 | $3,528.3 | $223.1 | 6.3% |
| Knees | $1,815.0 | $1,691.2 | $123.8 | 7.3% |
| Hips | $1,398.1 | $1,349.3 | $48.8 | 3.6% |
| Extremities | $538.3 | $487.8 | $50.5 | 10.3% |
| Spine | $1,216.0 | $1,172.4 | $43.6 | 3.7% |
| Trauma | $1,682.3 | $1,570.7 | $111.7 | 7.1% |
| Sports Medicine | $1,015.4 | $949.5 | $65.9 | 6.9% |
| Orthobiologics | $414.5 | $422.5 | ($8.0) | (1.9%) |
| Enabling Technology | $222.4 | $193.6 | $28.8 | 14.9% |
| Other | $578.2 | $533.5 | $44.6 | 8.4% |
| Total | $8,880.2 | $8,370.4 | $509.7 | 6.1% |
| Segment | 9m23 | 9m22 | $ Chg | % Chg |
|---|---|---|---|---|
| Joint Replacement | $11,678.1 | $10,795.1 | $883.0 | 8.2% |
| Knees | $5,750.8 | $5,220.7 | $530.1 | 10.2% |
| Hips | $4,366.9 | $4,150.0 | $216.8 | 5.2% |
| Extremities | $1,560.5 | $1,424.3 | $136.1 | 9.6% |
| Spine | $3,886.8 | $3,663.7 | $223.1 | 6.1% |
| Trauma | $5,086.1 | $4,697.3 | $388.8 | 8.3% |
| Sports Medicine | $2,979.9 | $2,779.4 | $200.5 | 7.2% |
| Orthobiologics | $1,301.0 | $1,303.7 | ($2.7) | (0.2%) |
| Enabling Technology | $639.4 | $561.5 | $77.9 | 13.9% |
| Other | $1,666.7 | $1,593.9 | $72.8 | 4.6% |
| Total | $27,238.1 | $25,394.6 | $1,843.5 | 7.3% |
Orthopedic Company Data
| Company | 3Q23 | 3Q22 | $ Chg | % Chg |
|---|---|---|---|---|
| Anika Therapeutics | $38.4 | $36.3 | $2.1 | 5.7% |
| ATEC | $118.3 | $89.8 | $28.4 | 31.6% |
| Bioventus | $110.1 | $107.5 | $2.6 | 2.5% |
| CONMED | $124.7 | $118.6 | $6.1 | 5.1% |
| DePuy Synthes | $2,164.0 | $2,094.6 | $69.4 | 3.3% |
| Enovis | $163.7 | $143.7 | $20.0 | 13.9% |
| Globus Medical | $383.6 | $254.1 | $129.5 | 51% |
| NuVasive * | $188.3 | $295.3 | ($107.0) | (36.2%) |
| Orthofix | $184.0 | $114.0 | $70.0 | 61.4% |
| OrthoPediatrics | $40.0 | $35.0 | $5.0 | 14.4% |
| Paragon 28 | $52.8 | $46.0 | $6.8 | 14.7% |
| SI-BONE | $34.0 | $26.4 | $7.6 | 28.7% |
| Smith+Nephew | $902.0 | $832.2 | $69.8 | 8.4% |
| Stryker | $2,446.8 | $2,267.7 | $179.1 | 7.9% |
| Treace Medical | $40.8 | $33.1 | $7.7 | 23.3% |
| Vericel | $37.6 | $31.0 | $6.6 | 21.2% |
| Zimmer Biomet | $1,753.6 | $1,669.8 | $83.8 | 5% |
| ZimVie | $97.6 | $108.2 | ($10.6) | (9.8%) |
| Company | 9m23 | 9m22 | $ Chg | % Chg |
|---|---|---|---|---|
| Anika Therapeutics | $116.3 | $107.4 | $8.9 | 8.3% |
| ATEC | $344.3 | $244.9 | $99.4 | 40.6% |
| Bioventus | $335.1 | $335.4 | ($0.3) | (0.1%) |
| CONMED | $396.7 | $346.3 | $50.4 | 14.5% |
| DePuy Synthes | $6,673.7 | $6,439.7 | $234.0 | 3.6% |
| Enovis | $504.8 | $436.9 | $67.9 | 15.5% |
| Globus Medical | $951.9 | $748.3 | $203.6 | 27.2% |
| NuVasive * | $813.7 | $896.5 | ($82.7) | (9.2%) |
| Orthofix | $546.2 | $338.5 | $207.7 | 61.4% |
| OrthoPediatrics | $111.1 | $91.3 | $19.8 | 21.7% |
| Paragon 28 | $155.8 | $129.9 | $26.0 | 20% |
| SI-BONE | $100.0 | $74.5 | $25.6 | 34.3% |
| Smith+Nephew | $2,755.3 | $2,610.9 | $144.4 | 5.5% |
| Stryker | $7,437.1 | $6,789.9 | $647.1 | 9.5% |
| Treace Medical | $124.9 | $92.1 | $32.8 | 35.7% |
| Vericel | $108.1 | $85.6 | $22.5 | 26.3% |
| Zimmer Biomet | $5,454.2 | $5,114.8 | $339.4 | 6.6% |
| ZimVie | $308.7 | $337.5 | ($28.8) | (8.5%) |
* NuVasive results are for January 2023 through August 2023. Sales after September 1 are attributed to Globus Medical.
Orthopedic Market Developments for Third Quarter 2023
As companies report, I’ll collect interesting developments here.
Elevated Volumes to Persist Through 2024
According to Johnson & Johnson CFO Joe Wolk, medtech volumes will remain higher than normal through 2024. This tracks with previous commentary from other large players like Stryker and Zimmer Biomet. DePuy Synthes’ results imply continued momentum in the joint replacement market, especially outside the U.S.
Johnson & Johnson to Restructure Orthopedic Business
DePuy Synthes’ parent company announced a two-year restructuring of its orthopedics business aimed at improving simplicity and profitability. The company plans to exit certain product lines and regions. The program will disrupt revenues by $250 million and cost between $700 million and $800 million.
Supply Chain Constraints Exacerbated by Acute Shortages
CONMED felt the pinch of lingering supply constraints on its legacy orthopedic products. It also cited acute, industry-wide shortages of a reagent used in sterile processing for tissue that is likely to persist into the first quarter of 2024.
GLP-1 Drugs Headwind or Tailwind?
Orthopedic companies tackled uncertainty around GLP-1 drugs head-on during their conference calls. The consensus is weight loss drugs will not significantly reduce demand for orthopedic procedures. Indeed, they could help more patients enter the surgical funnel by reducing BMI and increasing activity and, therefore, injuries.
Third Quarter Seasonality Back, And Then Some
Seasonality is mostly back to normal, but several companies like Treace Medical and Enovis noted the number of vacations and travel exceeded expectations for the third quarter of 2023.
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ME
Mike Evers is a Senior Market Analyst and writer with over 15 years of experience in the medical industry, spanning cardiac rhythm management, ER coding and billing, and orthopedics. He joined ORTHOWORLD in 2018, where he provides market analysis and editorial coverage.
