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Treace Medical Concepts, Xtant Medical and BONESUPPORT make up about 7% of the $62 billion orthopedic market. These companies have revenues roughly in the $100 million to $200 million range and, through the first quarter, each is set up for a strong 2025.
Below is an overview of each company’s position, its sales performance over the last 18 months and a selection of recent developments.
Treace Medical Concepts
Treace Medical is the last pure-play foot-and-ankle company remaining among orthopedics’ mid-tier players. The company generated over $209 million in sales during 2024, but also faced changing surgeon preferences and competitive pressures.
“The market environment and competitive landscape are quickly evolving,” said Treace Medical Founder and CEO John Treace in mid-2024. “We’re seeing increased use and surgeon adoption of MIS osteotomy solutions. At the same time, we’re facing even more competition from knockoffs of our Lapiplasty products. These dynamics are creating incremental headwinds to our Lapiplasty growth.”
Since then, the company has taken steps to address competitive headwinds and broaden its presence in the bunion market. Treace’s R&D engine is running “open throttle” to make the company the one-stop shop for bunion systems, which will drive top-line growth into 2026 and beyond.
Last 18 Months Sales Performance
Recent Developments
- December 2024 – Treace Medical further expanded its reach into the metatarsal osteotomy segment with the limited market release of the Percuplasty Percutaneous 3D Bunion Correction System and Procedure.
- November 2024 – The company entered the metatarsal osteotomy segment with its Nanoplasty 3D Minimally Invasive Bunion Correction System and Procedure. The segment represents the largest area of the bunion market, accounting for 70% of the estimated 450,000 annual procedures in the U.S.
- October 2024 – Treace filed suit against Stryker for patent infringement and unfair competition. Treace alleged infringement of nine patents related to its Lapiplasty 3D Bunion Correction technology.
2025 Outlook
For the full year, Treace expects sales between $224 million and $230 million, representing growth between 7% and 10% over 2024.
Xtant Medical
Xtant Medical overhauled its business and brought on new management between 2019 and 2021. The company followed that with a series of acquisitions including assets from Surgalign and nanOss. After generating under $65 million in 2019, Xtant drove sales over $117 million in 2024.
“We will continue to emphasize biologics because it’s who we are and what we do,” said Xtant Medical CEO Sean Browne. “But we will find market-buster devices like Coflex, technologies that distributors want to carry because no other company has anything like it. As a smaller hardware company, we need to show what makes us unique and adds value for distributors, surgeons and patients.”
In a spine market where cobbled-together acquisitions can often lead to a loss of identity, Xtant has a clear vision and path forward for its portfolio.
Last 18 Months Sales Performance
Recent Developments
- May 2025 – After an 18-month process, the company reached full vertical integration of its previously outsourced biologics products. Xtant said it is now the most diversified, vertically integrated biologics company in the market.
- May 2025 – Xtant launched OsteoFactor Pro, a naturally occurring cocktail of allogeneic growth factors engineered to improve bone healing. OsteoFactor Pro is an off-the-shelf, ready-to-use solution that integrates seamlessly with synthetic, allograft or autograft scaffolds.
- April 2025 – The company launched Trivium, a premium, next-generation demineralized bone matrix allograft designed to elevate the standard of care in bone grafting procedures.
2025 Outlook
Xtant Medical expects 2025 total revenue between $127 million and $131 million, representing 8% to 11% growth over 2024. The company does not anticipate the need to raise additional capital currently.
BONESUPPORT
The company’s CERAMENT technology platform gives it an array of innovative, injectable bio-ceramic bone graft substitutes that have the capability of eluting drugs. BONESUPPORT’s revenue has leapt up more than 50% annually since 2021. The company generated just under $82 million in 2024.
The U.S. market has been key in unlocking another level of growth for BONESUPPORT. Sales of drug-eluting versions of CERAMENT grew over 100% in 2024 and hit 92% growth in the first quarter of 2025.
“It has now been ten quarters since we launched CERAMENT G in the U.S.,” said BONESUPPORT CEO Emil Billbäck. “We see a steady and accelerating trend, despite a go-stop-go dynamic in the implementation at new, primarily larger, hospitals. Market penetration is further driven by physicians seeing positive six- and twelve-month follow-up results for patients treated with CERAMENT G and sharing these good results with colleagues at their own and neighboring hospitals.”
Last 18 Months Sales Performance
Recent Developments
- September 2024 – BONESUPPPORT’s SOLARIO study met primary end points. Top-line results from the study show that patients with orthopedic infections, who were surgically treated with antibiotic-eluting bone substitute materials such as CERAMENT G and CERAMENT V, achieved equally good infection prevention with a short systemic antibiotic course of no more than seven days, compared to the previous standard treatment that extends over at least four weeks.
- March 2024 – The company gained 510(k) approval to market CERAMENT for spinal interbody fusion.
- October 2023 – CERAMENT V received Breakthrough Device designation for bone infection from FDA. CERAMENT V is an injectable synthetic bone void filler comprising 40% hydroxyapatite, 60% calcium sulfate and the antibiotic vancomycin hydrochloride.
2025 Outlook
The company grew nearly 54% in the first quarter of 2025, driven by significant strength in drug-eluting CERAMENT in both the United States and Europe. For the full year, the company’s objective is sales growth of over 40% in constant currency rates.
Treace Medical Concepts, Xtant Medical and BONESUPPORT make up about 7% of the $62 billion orthopedic market. These companies have revenues roughly in the $100 million to $200 million range and, through the first quarter, each is set up for a strong 2025.
Below is an overview of each company’s position, its sales performance over the last 18...
Treace Medical Concepts, Xtant Medical and BONESUPPORT make up about 7% of the $62 billion orthopedic market. These companies have revenues roughly in the $100 million to $200 million range and, through the first quarter, each is set up for a strong 2025.
Below is an overview of each company’s position, its sales performance over the last 18 months and a selection of recent developments.
Treace Medical Concepts
Treace Medical is the last pure-play foot-and-ankle company remaining among orthopedics’ mid-tier players. The company generated over $209 million in sales during 2024, but also faced changing surgeon preferences and competitive pressures.
“The market environment and competitive landscape are quickly evolving,” said Treace Medical Founder and CEO John Treace in mid-2024. “We’re seeing increased use and surgeon adoption of MIS osteotomy solutions. At the same time, we’re facing even more competition from knockoffs of our Lapiplasty products. These dynamics are creating incremental headwinds to our Lapiplasty growth.”
Since then, the company has taken steps to address competitive headwinds and broaden its presence in the bunion market. Treace’s R&D engine is running “open throttle” to make the company the one-stop shop for bunion systems, which will drive top-line growth into 2026 and beyond.
Last 18 Months Sales Performance
Recent Developments
- December 2024 – Treace Medical further expanded its reach into the metatarsal osteotomy segment with the limited market release of the Percuplasty Percutaneous 3D Bunion Correction System and Procedure.
- November 2024 – The company entered the metatarsal osteotomy segment with its Nanoplasty 3D Minimally Invasive Bunion Correction System and Procedure. The segment represents the largest area of the bunion market, accounting for 70% of the estimated 450,000 annual procedures in the U.S.
- October 2024 – Treace filed suit against Stryker for patent infringement and unfair competition. Treace alleged infringement of nine patents related to its Lapiplasty 3D Bunion Correction technology.
2025 Outlook
For the full year, Treace expects sales between $224 million and $230 million, representing growth between 7% and 10% over 2024.
Xtant Medical
Xtant Medical overhauled its business and brought on new management between 2019 and 2021. The company followed that with a series of acquisitions including assets from Surgalign and nanOss. After generating under $65 million in 2019, Xtant drove sales over $117 million in 2024.
“We will continue to emphasize biologics because it’s who we are and what we do,” said Xtant Medical CEO Sean Browne. “But we will find market-buster devices like Coflex, technologies that distributors want to carry because no other company has anything like it. As a smaller hardware company, we need to show what makes us unique and adds value for distributors, surgeons and patients.”
In a spine market where cobbled-together acquisitions can often lead to a loss of identity, Xtant has a clear vision and path forward for its portfolio.
Last 18 Months Sales Performance
Recent Developments
- May 2025 – After an 18-month process, the company reached full vertical integration of its previously outsourced biologics products. Xtant said it is now the most diversified, vertically integrated biologics company in the market.
- May 2025 – Xtant launched OsteoFactor Pro, a naturally occurring cocktail of allogeneic growth factors engineered to improve bone healing. OsteoFactor Pro is an off-the-shelf, ready-to-use solution that integrates seamlessly with synthetic, allograft or autograft scaffolds.
- April 2025 – The company launched Trivium, a premium, next-generation demineralized bone matrix allograft designed to elevate the standard of care in bone grafting procedures.
2025 Outlook
Xtant Medical expects 2025 total revenue between $127 million and $131 million, representing 8% to 11% growth over 2024. The company does not anticipate the need to raise additional capital currently.
BONESUPPORT
The company’s CERAMENT technology platform gives it an array of innovative, injectable bio-ceramic bone graft substitutes that have the capability of eluting drugs. BONESUPPORT’s revenue has leapt up more than 50% annually since 2021. The company generated just under $82 million in 2024.
The U.S. market has been key in unlocking another level of growth for BONESUPPORT. Sales of drug-eluting versions of CERAMENT grew over 100% in 2024 and hit 92% growth in the first quarter of 2025.
“It has now been ten quarters since we launched CERAMENT G in the U.S.,” said BONESUPPORT CEO Emil Billbäck. “We see a steady and accelerating trend, despite a go-stop-go dynamic in the implementation at new, primarily larger, hospitals. Market penetration is further driven by physicians seeing positive six- and twelve-month follow-up results for patients treated with CERAMENT G and sharing these good results with colleagues at their own and neighboring hospitals.”
Last 18 Months Sales Performance
Recent Developments
- September 2024 – BONESUPPPORT’s SOLARIO study met primary end points. Top-line results from the study show that patients with orthopedic infections, who were surgically treated with antibiotic-eluting bone substitute materials such as CERAMENT G and CERAMENT V, achieved equally good infection prevention with a short systemic antibiotic course of no more than seven days, compared to the previous standard treatment that extends over at least four weeks.
- March 2024 – The company gained 510(k) approval to market CERAMENT for spinal interbody fusion.
- October 2023 – CERAMENT V received Breakthrough Device designation for bone infection from FDA. CERAMENT V is an injectable synthetic bone void filler comprising 40% hydroxyapatite, 60% calcium sulfate and the antibiotic vancomycin hydrochloride.
2025 Outlook
The company grew nearly 54% in the first quarter of 2025, driven by significant strength in drug-eluting CERAMENT in both the United States and Europe. For the full year, the company’s objective is sales growth of over 40% in constant currency rates.
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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.
