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We’ve wrapped up our coverage of orthopedic company earnings for the fourth quarter of 2023. The 17 orthopedic players sampled here grew 7.5% for the year, with above-market performance in most segments. Some themes from the quarter were healthy end markets, growing utilization of technology and volume-based procurement for sports medicine in China.
About the Data
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 Fourth Quarter 2023
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 | 4Q23 | 4Q22 | $ Chg | % Chg |
|---|---|---|---|---|
| Joint Replacement | $4,212.1 | $3,899.6 | $312.5 | 8% |
| Knees | $2,095.0 | $1,924.3 | $170.7 | 8.9% |
| Hips | $1,534.5 | $1,451.6 | $82.9 | 5.7% |
| Extremities | $582.6 | $523.7 | $59.0 | 11.3% |
| Spine | $1,323.3 | $1,177.0 | $146.3 | 12.4% |
| Trauma | $1,815.0 | $1,693.6 | $121.4 | 7.2% |
| Sports Medicine | $1,204.2 | $1,089.6 | $114.6 | 10.5% |
| Orthobiologics | $456.3 | $441.2 | $15.1 | 3.4% |
| Enabling Technology | $233.4 | $243.4 | ($10.0) | (4.1%) |
| Other | $632.2 | $587.0 | $45.2 | 7.7% |
| Total | $9,876.5 | $9,131.3 | $745.2 | 8.2% |
| Segment | FY23 | FY22 | $ Chg | % Chg |
|---|---|---|---|---|
| Joint Replacement | $15,890.3 | $14,694.7 | $1,195.6 | 8.1% |
| Knees | $7,845.8 | $7,145.0 | $700.8 | 9.8% |
| Hips | $5,901.3 | $5,601.6 | $299.7 | 5.4% |
| Extremities | $2,143.1 | $1,948.0 | $195.1 | 10% |
| Spine | $5,210.1 | $4,840.7 | $369.4 | 7.6% |
| Trauma | $6,901.1 | $6,391.0 | $510.2 | 8% |
| Sports Medicine | $4,184.1 | $3,868.9 | $315.2 | 8.1% |
| Orthobiologics | $1,757.3 | $1,744.9 | $12.4 | 0.7% |
| Enabling Technology | $872.8 | $804.8 | $67.9 | 8.4% |
| Other | $2,298.9 | $2,180.9 | $118.0 | 5.4% |
| Total | $37,114.5 | $34,525.9 | $2,588.6 | 7.5% |
Orthopedic Company Data
| Company | 4Q23 | 4Q22 | $ Chg | % Chg |
|---|---|---|---|---|
| Anika Therapeutics | $40.4 | $38.1 | $2.3 | 6% |
| ATEC | $105.9 | $74.0 | $32.0 | 43.2% |
| Bioventus | $119.0 | $104.8 | $14.2 | 13.5% |
| CONMED | $136.5 | $115.2 | $21.3 | 18.5% |
| DePuy Synthes | $2,267.9 | $2,146.5 | $121.4 | 5.7% |
| Enovis | $189.7 | $162.5 | $27.2 | 16.7% |
| Globus Medical | $616.5 | $274.5 | $342.0 | 124.6% |
| Orthofix | $200.4 | $122.2 | $78.2 | 64% |
| OrthoPediatrics | $37.6 | $31.0 | $6.6 | 21.4% |
| Paragon 28 | $60.6 | $51.5 | $9.1 | 17.6% |
| SI-BONE | $38.9 | $32.0 | $6.9 | 21.6% |
| Smith+Nephew | $992.3 | $938.6 | $53.7 | 5.7% |
| Stryker | $2,911.3 | $2,635.6 | $275.8 | 10.5% |
| Treace Medical | $62.2 | $49.8 | $12.4 | 25% |
| Vericel | $56.7 | $46.4 | $10.3 | 22.3% |
| Zimmer Biomet | $1,940.1 | $1,825.1 | $115.0 | 6.3% |
| ZimVie | $100.5 | $112.3 | ($11.9) | (10.6%) |
| Company | FY23 | FY22 | $ Chg | % Chg |
|---|---|---|---|---|
| Anika Therapeutics | $156.7 | $145.5 | $11.2 | 7.7% |
| ATEC | $450.2 | $318.9 | $131.4 | 41.2% |
| Bioventus | $454.1 | $440.2 | $13.9 | 3.2% |
| CONMED | $533.2 | $461.5 | $71.7 | 15.5% |
| DePuy Synthes | $8,941.6 | $8,586.2 | $355.4 | 4.1% |
| Enovis | $694.5 | $599.4 | $95.1 | 15.9% |
| Globus Medical | $1,568.5 | $1,022.8 | $545.6 | 53.3% |
| Orthofix | $746.6 | $460.7 | $285.9 | 62.1% |
| OrthoPediatrics | $148.7 | $122.3 | $26.4 | 21.6% |
| Paragon 28 | $216.4 | $181.4 | $35.0 | 19.3% |
| SI-BONE | $138.9 | $106.4 | $32.5 | 30.5% |
| Smith+Nephew | $3,747.5 | $3,549.5 | $198.1 | 5.6% |
| Stryker | $10,348.4 | $9,425.5 | $922.9 | 9.8% |
| Treace Medical | $187.1 | $141.8 | $45.3 | 31.9% |
| Vericel | $164.8 | $132.0 | $32.8 | 24.9% |
| Zimmer Biomet | $7,394.3 | $6,939.9 | $454.4 | 6.5% |
| ZimVie | $409.2 | $449.8 | ($40.6) | (9%) |
Orthopedic Market Developments for Fourth Quarter 2023
As companies report, I’ll collect interesting developments here.
Very Healthy End Markets
The orthopedic market ended 2023 on a high note. Procedure demand, pricing dynamics and hospital capital budgets are all very healthy. There is a growing sense that the elevated market may not be as temporary as first thought. Changing patient demographics and behaviors combined with maturing orthopedic technology could change the market’s growth profile.
Stryker Shows Gains in Robotic Utilization
While Stryker has a significant lead in joint robotics, the company’s ability to drive usage rates bodes well for the overall orthopedic robot market. Exiting 2023, 60% of Stryker knees in the U.S. used Mako while 34% of Stryker U.S. hips used the system. Globally, those usage rates remained relatively high at 40% and 20% respectively.
Good News, Bad News for VBP
Over the next few quarters, the impact of price cuts to spine and trauma devices in China will anniversary. However, DePuy Synthes expects a national volume-based procurement tender on sports medicine products in 2024.
Globus Merger Creates Size and Reach to Compete in Spinal Robotics Race
Globus Medical said it expected and welcomed more competition in the spinal robotics market as DePuy Synthes and Stryker enter the space. The company said creating the size and reach to penetrate the market and compete against industry giants was part of the merger’s rationale. Globus expects more entrants into the robotics market and stressed the importance of driving innovation.
Enovis Anticipates Cross-Selling Opportunities
The company launched the EMPOWR Revision System in late 2022, unlocking access to about 20% of the knee market previously unserved by Enovis. The launch contributed to strong knee replacement sales growth in 2023, even through inventory constraints. However, 2024 brings a healthy supply state and and Lima’s 3D-printed trabecular titanium clip cones for more difficult cases, becoming one of the initial cross-selling opportunities from the acquisition.
Orthofix Remains Committed to Trauma Business
New CEO Massimo Calafiore ranked profitable growth as the company’s foremost priority but conceded the relative lack of profit coming from the trauma business. He called orthopedics “the DNA of this organization” and said the heavy skew toward a mature portion of the European market limits opportunities. However, Orthofix sees the U.S. trauma market, where it has very little share, as an enormous opportunity. As market share in the U.S. increases, so will the trauma segment’s profitability.
We've wrapped up our coverage of orthopedic company earnings for the fourth quarter of 2023. The 17 orthopedic players sampled here grew 7.5% for the year, with above-market performance in most segments. Some themes from the quarter were healthy end markets, growing utilization of technology and volume-based procurement for sports medicine in...
We’ve wrapped up our coverage of orthopedic company earnings for the fourth quarter of 2023. The 17 orthopedic players sampled here grew 7.5% for the year, with above-market performance in most segments. Some themes from the quarter were healthy end markets, growing utilization of technology and volume-based procurement for sports medicine in China.
About the Data
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 Fourth Quarter 2023
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 | 4Q23 | 4Q22 | $ Chg | % Chg |
|---|---|---|---|---|
| Joint Replacement | $4,212.1 | $3,899.6 | $312.5 | 8% |
| Knees | $2,095.0 | $1,924.3 | $170.7 | 8.9% |
| Hips | $1,534.5 | $1,451.6 | $82.9 | 5.7% |
| Extremities | $582.6 | $523.7 | $59.0 | 11.3% |
| Spine | $1,323.3 | $1,177.0 | $146.3 | 12.4% |
| Trauma | $1,815.0 | $1,693.6 | $121.4 | 7.2% |
| Sports Medicine | $1,204.2 | $1,089.6 | $114.6 | 10.5% |
| Orthobiologics | $456.3 | $441.2 | $15.1 | 3.4% |
| Enabling Technology | $233.4 | $243.4 | ($10.0) | (4.1%) |
| Other | $632.2 | $587.0 | $45.2 | 7.7% |
| Total | $9,876.5 | $9,131.3 | $745.2 | 8.2% |
| Segment | FY23 | FY22 | $ Chg | % Chg |
|---|---|---|---|---|
| Joint Replacement | $15,890.3 | $14,694.7 | $1,195.6 | 8.1% |
| Knees | $7,845.8 | $7,145.0 | $700.8 | 9.8% |
| Hips | $5,901.3 | $5,601.6 | $299.7 | 5.4% |
| Extremities | $2,143.1 | $1,948.0 | $195.1 | 10% |
| Spine | $5,210.1 | $4,840.7 | $369.4 | 7.6% |
| Trauma | $6,901.1 | $6,391.0 | $510.2 | 8% |
| Sports Medicine | $4,184.1 | $3,868.9 | $315.2 | 8.1% |
| Orthobiologics | $1,757.3 | $1,744.9 | $12.4 | 0.7% |
| Enabling Technology | $872.8 | $804.8 | $67.9 | 8.4% |
| Other | $2,298.9 | $2,180.9 | $118.0 | 5.4% |
| Total | $37,114.5 | $34,525.9 | $2,588.6 | 7.5% |
Orthopedic Company Data
| Company | 4Q23 | 4Q22 | $ Chg | % Chg |
|---|---|---|---|---|
| Anika Therapeutics | $40.4 | $38.1 | $2.3 | 6% |
| ATEC | $105.9 | $74.0 | $32.0 | 43.2% |
| Bioventus | $119.0 | $104.8 | $14.2 | 13.5% |
| CONMED | $136.5 | $115.2 | $21.3 | 18.5% |
| DePuy Synthes | $2,267.9 | $2,146.5 | $121.4 | 5.7% |
| Enovis | $189.7 | $162.5 | $27.2 | 16.7% |
| Globus Medical | $616.5 | $274.5 | $342.0 | 124.6% |
| Orthofix | $200.4 | $122.2 | $78.2 | 64% |
| OrthoPediatrics | $37.6 | $31.0 | $6.6 | 21.4% |
| Paragon 28 | $60.6 | $51.5 | $9.1 | 17.6% |
| SI-BONE | $38.9 | $32.0 | $6.9 | 21.6% |
| Smith+Nephew | $992.3 | $938.6 | $53.7 | 5.7% |
| Stryker | $2,911.3 | $2,635.6 | $275.8 | 10.5% |
| Treace Medical | $62.2 | $49.8 | $12.4 | 25% |
| Vericel | $56.7 | $46.4 | $10.3 | 22.3% |
| Zimmer Biomet | $1,940.1 | $1,825.1 | $115.0 | 6.3% |
| ZimVie | $100.5 | $112.3 | ($11.9) | (10.6%) |
| Company | FY23 | FY22 | $ Chg | % Chg |
|---|---|---|---|---|
| Anika Therapeutics | $156.7 | $145.5 | $11.2 | 7.7% |
| ATEC | $450.2 | $318.9 | $131.4 | 41.2% |
| Bioventus | $454.1 | $440.2 | $13.9 | 3.2% |
| CONMED | $533.2 | $461.5 | $71.7 | 15.5% |
| DePuy Synthes | $8,941.6 | $8,586.2 | $355.4 | 4.1% |
| Enovis | $694.5 | $599.4 | $95.1 | 15.9% |
| Globus Medical | $1,568.5 | $1,022.8 | $545.6 | 53.3% |
| Orthofix | $746.6 | $460.7 | $285.9 | 62.1% |
| OrthoPediatrics | $148.7 | $122.3 | $26.4 | 21.6% |
| Paragon 28 | $216.4 | $181.4 | $35.0 | 19.3% |
| SI-BONE | $138.9 | $106.4 | $32.5 | 30.5% |
| Smith+Nephew | $3,747.5 | $3,549.5 | $198.1 | 5.6% |
| Stryker | $10,348.4 | $9,425.5 | $922.9 | 9.8% |
| Treace Medical | $187.1 | $141.8 | $45.3 | 31.9% |
| Vericel | $164.8 | $132.0 | $32.8 | 24.9% |
| Zimmer Biomet | $7,394.3 | $6,939.9 | $454.4 | 6.5% |
| ZimVie | $409.2 | $449.8 | ($40.6) | (9%) |
Orthopedic Market Developments for Fourth Quarter 2023
As companies report, I’ll collect interesting developments here.
Very Healthy End Markets
The orthopedic market ended 2023 on a high note. Procedure demand, pricing dynamics and hospital capital budgets are all very healthy. There is a growing sense that the elevated market may not be as temporary as first thought. Changing patient demographics and behaviors combined with maturing orthopedic technology could change the market’s growth profile.
Stryker Shows Gains in Robotic Utilization
While Stryker has a significant lead in joint robotics, the company’s ability to drive usage rates bodes well for the overall orthopedic robot market. Exiting 2023, 60% of Stryker knees in the U.S. used Mako while 34% of Stryker U.S. hips used the system. Globally, those usage rates remained relatively high at 40% and 20% respectively.
Good News, Bad News for VBP
Over the next few quarters, the impact of price cuts to spine and trauma devices in China will anniversary. However, DePuy Synthes expects a national volume-based procurement tender on sports medicine products in 2024.
Globus Merger Creates Size and Reach to Compete in Spinal Robotics Race
Globus Medical said it expected and welcomed more competition in the spinal robotics market as DePuy Synthes and Stryker enter the space. The company said creating the size and reach to penetrate the market and compete against industry giants was part of the merger’s rationale. Globus expects more entrants into the robotics market and stressed the importance of driving innovation.
Enovis Anticipates Cross-Selling Opportunities
The company launched the EMPOWR Revision System in late 2022, unlocking access to about 20% of the knee market previously unserved by Enovis. The launch contributed to strong knee replacement sales growth in 2023, even through inventory constraints. However, 2024 brings a healthy supply state and and Lima’s 3D-printed trabecular titanium clip cones for more difficult cases, becoming one of the initial cross-selling opportunities from the acquisition.
Orthofix Remains Committed to Trauma Business
New CEO Massimo Calafiore ranked profitable growth as the company’s foremost priority but conceded the relative lack of profit coming from the trauma business. He called orthopedics “the DNA of this organization” and said the heavy skew toward a mature portion of the European market limits opportunities. However, Orthofix sees the U.S. trauma market, where it has very little share, as an enormous opportunity. As market share in the U.S. increases, so will the trauma segment’s profitability.
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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.
