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While Zimmer Biomet remains the dominant player in the knee replacement market, its growth in the segment has plateaued in recent years. We expect the company to generate $2.7 billion in sales for 2022, the same amount it achieved in 2016.
Over that same period, Stryker’s knee replacement implant sales consistently grew in the mid-single-digits. Exhibit 1 shows reported sales for Zimmer Biomet and Stryker from 2016 through 2022 estimated close.
Exhibit 1: Zimmer Biomet and Stryker Reported Knee Replacement Sales: 2016-2022 ($Millions)
However, Zimmer Biomet’s renewed dedication to innovation made the company far more relevant in recent years. The company entered the U.S. robotic-assisted surgery market in 2019 with the FDA 510(k) clearance of its ROSA® Knee System, which later added clearances for hip replacement and partial knee replacement. ROSA created the foundation of the ZBEdge digital ecosystem, which benefits from around 70% of the company’s product development dollars. In 2021, the company debuted its Persona IQ smart implant.
Most recently, Zimmer Biomet gained FDA 510(k) clearance for its cementless implant, the Persona® OsseoTi® Keel Tibia. We had the opportunity to discuss the product with Jim Lancaster, President of Zimmer Biomet’s Global Reconstructive Business.
ORTHOWORLD: Let’s start with the Persona Knee System overall. What makes it such a compelling offering? Where does it outperform competitive systems?
Mr. Lancaster: The Persona Knee System offers personalized implants designed for optimal fit and function. The system is designed to include anatomically accurate components with finer sizing increments to help surgeons personalize the fit for each patient and restore the unique identity of every knee. Since its introduction in 2012, more than two million Persona Knees have been implanted globally.
What excites you most about the addition of the Persona OsseoTi Keel Tibia to Zimmer Biomet’s portfolio? What would you say is the product’s most significant technological advancement?
Mr. Lancaster: What’s most exciting about its addition is that it fortifies the well-established Persona Knee System portfolio. Our loyal base of Persona Knee surgeons will now have a truly comprehensive system to meet the diverse needs of each patient.
What sets the OsseoTi Keel Tibia apart from other cementless knee implant systems can be distilled down to three words: Stable. Versatile. Anatomic.
- Stable: We have a long history of porous designs that feature a long, central keel and additional spikes that promote stable initial fixation. The Persona OsseoTi Keel Tibia combines our proprietary OsseoTi Porous Metal Technology, which uses anatomical data in combination with 3D printing technology to build a structure that directly mimics the architecture of human cancellous bone. The combination of OsseoTi material and keel is designed to optimize initial mechanical fixation and long-term biological fixation.
- Versatile: One of the practical benefits of this new keeled tibia is that it is complemented with a cemented keel tibia implant that uses the same bone prep and instrumentation to give surgeons intraoperative freedom to choose a cementless or cemented solution, depending on the patient’s bone quality and clinical needs.
- Anatomic: The anatomic tibia allows for proper tibial rotation and optimal bone coverage from the clinically proven Persona Knee System.
Over the last few years, we’ve seen tremendous synergy between cementless knee solutions and robotics. What makes them such a great combination?
Mr. Lancaster: The general perception of the surgeons I speak to is that robotic surgery may add O.R. time due to registration of the robot. Removing the need to handle cement and wait for it to harden usually equates to quicker procedures. When a cementless total knee arthroplasty (TKA) is combined with robotic surgery, the procedure becomes close to time neutral.
To what extent have cementless implants penetrated the knee replacement market? How might that change in the next three to five years?
Mr. Lancaster: According to the 2022 American Joint Replacement Registry, cementless TKA has grown significantly over the past five years. In 2017, less than 5% of total knees in the registry were cementless. In 2021, over 15% of total knees were cementless.
Additionally, according to independent research, the global cementless TKA market size was USD $1.8 billion in 2021, and it is expected to reach around $14.7 billion by 2030. Market drivers include the predicted growth in the prevalence of arthritis in younger, active patients and growing awareness of the value of cementless procedures.
Commentary from Zimmer Biomet and its peers indicates that joint replacement procedure volume improved in 2022, at least in the U.S. Do you have the same read? What are your procedure volume expectations for the end of 2022 and early 2023?
Mr. Lancaster: As we shared in our 3Q earnings report, our strong performance was driven by knee procedure recovery across most regions, continued global traction of our Persona Knee System and a continual increase in ROSA procedure penetration and pull-through. Looking ahead, we expect the backlog of patients due to the pandemic and staffing shortages to work its way through the system, and that could provide a tailwind in 2023.
While Zimmer Biomet remains the dominant player in the knee replacement market, its growth in the segment has plateaued in recent years. We expect the company to generate $2.7 billion in sales for 2022, the same amount it achieved in 2016.
Over that same period, Stryker’s knee replacement implant sales consistently grew in the...
While Zimmer Biomet remains the dominant player in the knee replacement market, its growth in the segment has plateaued in recent years. We expect the company to generate $2.7 billion in sales for 2022, the same amount it achieved in 2016.
Over that same period, Stryker’s knee replacement implant sales consistently grew in the mid-single-digits. Exhibit 1 shows reported sales for Zimmer Biomet and Stryker from 2016 through 2022 estimated close.
Exhibit 1: Zimmer Biomet and Stryker Reported Knee Replacement Sales: 2016-2022 ($Millions)
However, Zimmer Biomet’s renewed dedication to innovation made the company far more relevant in recent years. The company entered the U.S. robotic-assisted surgery market in 2019 with the FDA 510(k) clearance of its ROSA® Knee System, which later added clearances for hip replacement and partial knee replacement. ROSA created the foundation of the ZBEdge digital ecosystem, which benefits from around 70% of the company’s product development dollars. In 2021, the company debuted its Persona IQ smart implant.
Most recently, Zimmer Biomet gained FDA 510(k) clearance for its cementless implant, the Persona® OsseoTi® Keel Tibia. We had the opportunity to discuss the product with Jim Lancaster, President of Zimmer Biomet’s Global Reconstructive Business.
ORTHOWORLD: Let’s start with the Persona Knee System overall. What makes it such a compelling offering? Where does it outperform competitive systems?
Mr. Lancaster: The Persona Knee System offers personalized implants designed for optimal fit and function. The system is designed to include anatomically accurate components with finer sizing increments to help surgeons personalize the fit for each patient and restore the unique identity of every knee. Since its introduction in 2012, more than two million Persona Knees have been implanted globally.
What excites you most about the addition of the Persona OsseoTi Keel Tibia to Zimmer Biomet’s portfolio? What would you say is the product’s most significant technological advancement?
Mr. Lancaster: What’s most exciting about its addition is that it fortifies the well-established Persona Knee System portfolio. Our loyal base of Persona Knee surgeons will now have a truly comprehensive system to meet the diverse needs of each patient.
What sets the OsseoTi Keel Tibia apart from other cementless knee implant systems can be distilled down to three words: Stable. Versatile. Anatomic.
- Stable: We have a long history of porous designs that feature a long, central keel and additional spikes that promote stable initial fixation. The Persona OsseoTi Keel Tibia combines our proprietary OsseoTi Porous Metal Technology, which uses anatomical data in combination with 3D printing technology to build a structure that directly mimics the architecture of human cancellous bone. The combination of OsseoTi material and keel is designed to optimize initial mechanical fixation and long-term biological fixation.
- Versatile: One of the practical benefits of this new keeled tibia is that it is complemented with a cemented keel tibia implant that uses the same bone prep and instrumentation to give surgeons intraoperative freedom to choose a cementless or cemented solution, depending on the patient’s bone quality and clinical needs.
- Anatomic: The anatomic tibia allows for proper tibial rotation and optimal bone coverage from the clinically proven Persona Knee System.
Over the last few years, we’ve seen tremendous synergy between cementless knee solutions and robotics. What makes them such a great combination?
Mr. Lancaster: The general perception of the surgeons I speak to is that robotic surgery may add O.R. time due to registration of the robot. Removing the need to handle cement and wait for it to harden usually equates to quicker procedures. When a cementless total knee arthroplasty (TKA) is combined with robotic surgery, the procedure becomes close to time neutral.
To what extent have cementless implants penetrated the knee replacement market? How might that change in the next three to five years?
Mr. Lancaster: According to the 2022 American Joint Replacement Registry, cementless TKA has grown significantly over the past five years. In 2017, less than 5% of total knees in the registry were cementless. In 2021, over 15% of total knees were cementless.
Additionally, according to independent research, the global cementless TKA market size was USD $1.8 billion in 2021, and it is expected to reach around $14.7 billion by 2030. Market drivers include the predicted growth in the prevalence of arthritis in younger, active patients and growing awareness of the value of cementless procedures.
Commentary from Zimmer Biomet and its peers indicates that joint replacement procedure volume improved in 2022, at least in the U.S. Do you have the same read? What are your procedure volume expectations for the end of 2022 and early 2023?
Mr. Lancaster: As we shared in our 3Q earnings report, our strong performance was driven by knee procedure recovery across most regions, continued global traction of our Persona Knee System and a continual increase in ROSA procedure penetration and pull-through. Looking ahead, we expect the backlog of patients due to the pandemic and staffing shortages to work its way through the system, and that could provide a tailwind in 2023.
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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.
