MediPoint: Total Ankle Replacement - EU Analysis and Market Forecasts
NEW YORK, April 16, 2013 /PRNewswire/ -- Reportlinker.com announces that a new market research report is available in its catalogue:
MediPoint: Total Ankle Replacement - EU Analysis and Market Forecasts
MediPoint: Total Ankle Replacement - EU Analysis and Market Forecasts
Summary
Ankle arthritis is a severe and debilitating problem with notable increasing prevalence in both the developed and developing world. In a society constantly seeking out a modern lifestyle, sports-related injuries, trauma, aging, and obesity are contributing to an increased incidence of ankle arthritis. Total ankle replacement (TAR) enables implantation of prosthesis within the diseased native ankle joint to help patients maintain their ankles' range of motion. Promising results of newer generation prostheses revived interest in TAR and fueled further innovations in the prosthetic design. After decades of trial and error, TAR is now becoming a promising option for late-stage ankle arthritis patients as an alternative to ankle fusion, which has historically been presumed to be the gold-standard procedure. This report focuses on the TAR markets in EU, the EU5, Japan, Brazil, China and India. This report identifies unmet needs in the market, surgeon attitudes towards current TAR prostheses, and the future of TAR in the face of rapid technological advancement.
Early experience with TAR in Europe was met with unacceptable failure and complication rates in the 1980s, such that the procedure was largely abandoned. In the past decade, newer generations of TAR prostheses with a more anatomical replication of the ankle joint demonstrated some encouraging early and medium-term clinical results. Meanwhile, long-term results following successful early ankle fusion have brought to light somewhat disappointing long-term satisfaction rates. TAR is becoming an increasingly popular alternative to ankle fusion lately, as professional and commercial interest intensifies and long-term effectiveness becomes available. As more competitors enter the market and the indications of TAR have been suggested to expand to include younger patients and those with some hindfoot deformities, surgeon adoption will further increase and this industry will enjoy steady growth in coming years, especially in emerging markets.
Scope
- An overview of Ankle arthritis, which includes epidemiology, etiology, symptoms, diagnosis, pathology and treatment guidelines.
- Annualized EU TAR market revenue and future forecasts from 2009 to 2011, forecast for 7 years to 2018.
- Investigation of current and future market competition for TAR
- Insightful review of the key industry drivers, restraints and challenges as well as predicted impact of key events.
- Competitor assessment including device approval analysis and device sales forecasts.
- Marketed and pipeline product profiles covering efficiency, safety, clinical study details, device approvals, product positioning and device sales forecast.
- Analysis of unmet needs within the market and opportunities for future players.
- Technology trends evaluation to assess strength of pipeline.
- An overview of all devices in development including clinical study details, design and material selection considerations, efficacy reports, and device approval timelines.
- Company profiles including business description, financial overview and SWOT analysis.
- Coverage of key market players.
- Strategic assessment of the TAR device sector through market impact analysis, future market scenario and company analysis.
- Direct quotes from Key Opinion Leaders (KOL) as well as oncologists
Reasons to buy
- Understand the trends shaping and driving EU TAR Market.
- Realize device preferences of physicians who have performed the tests already.
- Access market sizing, forecasts and quantified growth opportunities in EU TAR Market through 2018.
- Quantify candidate patient populations to better design product pricing & launch plans.
- Drive revenues, formulate effective sales and marketing strategies and gain in-depth understanding of the competitive landscape.
- Perform benchmarking analysis of growth opportunities against currently marketed products.
- Assess competitiveness of products in market by understanding the strengths and weaknesses of current competition.
- Take a comprehensive look at the market's device pipeline and identify promising, paradigm-shifting products.
- Create an effective counter-strategy to gain a competitive advantage against those currently in the market.
- Organize your sales and marketing efforts by identifying the market categories and segments that present the best opportunities for growth.
- What's the next big thing in EU TAR market landscape? Identify, understand and capitalize.
Table of Contents
1 Table of Contents 5
1.1 List of Tables 10
1.2 List of Figures 12
2 Introduction 14
2.1 Catalyst 14
3 Disease Overview 15
3.1 Anatomy and Physiology 15
3.2 Pathophysiology 16
3.2.1 Overview 16
3.2.2 Post-Traumatic Arthritis 17
3.2.3 Inflammatory Arthritis 18
3.2.4 Primary Osteoarthritis 19
3.2.5 Others 19
3.3 Clinical Presentation 20
3.3.1 Symptoms 20
3.3.2 Diagnosis 21
3.4 Clinical Outcomes 22
3.4.1 Overview 22
3.4.2 Conservative Treatments 23
3.4.3 Joint-Preserving Surgeries 24
3.4.4 Definitive Procedures 26
3.5 Epidemiology 30
3.5.1 Prevalence 30
3.5.2 Treatments 31
3.6 Economic Impact 32
3.6.1 Economic Impact in Europe 33
4 Competitive Assessment 34
4.1 Overview 34
4.2 Competitive Assessment 35
4.3 Two-Component Fixed-Bearing 36
4.3.1 Agility LP 36
4.3.2 Salto Talaris 39
4.3.3 INBONE II 41
4.4 Three-Component Mobile-Bearing 44
4.4.1 Scandinavian Total Ankle Replacement (STAR) 44
4.4.2 Mobility 46
4.4.3 Salto 48
4.4.4 HINTEGRA 50
4.4.5 BOX (Bologna-Oxford) 52
4.4.6 Zenith 54
4.4.7 CCI Evolution 56
5 Unmet Needs 58
5.1 Long-Term Follow-Up 59
5.2 Commitment to Medical Education 60
5.3 Advanced Biological Fixation 61
5.4 Minimal Bone Resection 63
5.4.1 Tibial Component 63
5.4.2 Talar Component 63
5.5 Mobile-Bearing versus Fixed-Bearing 64
5.6 Bespoke Instrumentation 66
5.7 Custom Prostheses 66
5.8 Revision Components 67
6 Pipeline Products 68
6.1 Overview 68
6.2 INBONE II Total Ankle with Calcaneal Stem Fixation 68
6.2.1 Overview 68
6.2.2 SWOT Analysis 69
6.3 Akilos Total Ankle System 70
6.3.1 Overview 70
6.3.2 SWOT Analysis 71
7 Industry Overview 72
7.1 Procedure Trends 72
7.2 Market Access 74
7.2.1 Regulatory Process 74
7.2.2 Adoption 74
7.3 Reimbursement Trends 76
7.4 Regulatory Issues/Recalls 79
7.4.1 Medical Device Alert for Biomet's Ankle Evolutive System (AES) used in the UK 79
7.5 Mergers & Acquisitions/Key Partnerships 79
8 Current and Future Players 81
8.1 Overview 81
8.2 Trends in Corporate Strategy 81
8.3 Company Profiles 82
8.3.1 DePuy Synthes 82
8.3.2 Tornier N.V. 84
8.3.3 Integra LifeSciences 86
8.3.4 Small Bone Innovation, Inc. 88
8.3.5 Wright Medical Group, Inc. 90
8.3.6 Corin Group 92
8.3.7 MatOrtho 94
8.3.8 Implants International 96
8.3.9 Other Companies 97
9 Market Drivers, Opportunities, and Barriers 98
9.1 Market Drivers 98
9.1.1 Superiority to Ankle Fusion 98
9.1.2 Rising Prevalence 99
9.1.3 Expanded Insurance Coverage 100
9.1.4 Availability of Long-Term Data 101
9.1.5 Increased Patient Awareness 101
9.1.6 Expected Launch of CE-Marked Devices 101
9.2 Opportunities 102
9.2.1 Expanded Indications 102
9.2.2 Advanced Biological Fixation Approaches 103
9.2.3 Revision TAR 103
9.2.4 Demand for Custom Prostheses 104
9.2.5 Demand for a Comprehensive Foot and Ankle Product Portfolio 104
9.2.6 Emerging Markets 105
9.3 Market Barriers 105
9.3.1 Preoperative Patient Selection 105
9.3.2 Long Learning Curve 106
9.3.3 Complications 107
9.3.4 Cost 107
9.3.5 Substitutes 108
10 Country Outlooks and Forecasts 109
10.1 Major Markets Overview 109
10.2 France 111
10.2.1 France Market Analysis 111
10.3 Germany 112
10.3.1 Germany Market Analysis 112
10.4 Italy 114
10.4.1 Italy Market Analysis 114
10.5 Spain 115
10.5.1 Spain Analysis 115
10.6 UK 116
10.6.1 UK Market Analysis 116
11 Appendix 119
11.1 Abbreviations 119
11.2 Bibliography 120
11.3 Methodology 127
11.3.1 Coverage 127
11.3.2 Secondary Research 127
11.3.3 Primary Research 128
11.3.4 Forecasting Methodology 129
11.4 Physicians and Specialists Included in this Study 130
11.5 Physician Survey 130
11.6 About the Authors 131
11.6.1 Analysts 131
11.6.2 Global Head of Healthcare 132
11.7 About MediPoint 132
11.8 Contact Us 133
11.9 Disclaimer 133
List of Tables
Table 1: Common Clinical Symptoms of Ankle Arthritis 20
Table 2: Indications and Contraindications of TAR 29
Table 3: Direct and Indirect Costs of Arthritis 32
Table 4: Currently Marketed Total Ankle Replacement Implants 34
Table 5: Product Profile – Agility LP 37
Table 6: SWOT Analysis – Agility LP 38
Table 7: Product Profile – Salto Talaris 40
Table 8: SWOT Analysis – Salto Talaris 40
Table 9: Product Profile – INBONE II 42
Table 10: SWOT Analysis – INBONE II 43
Table 11: Product Profile – STAR 45
Table 12: SWOT Analysis – STAR 45
Table 13: Product Profile – Mobility 47
Table 14: SWOT Analysis – Mobility 47
Table 15: Product Profile – Salto 49
Table 16: SWOT Analysis – Salto 49
Table 17: Product Profile – HINTEGRA 51
Table 18: SWOT Analysis – HINTEGRA 51
Table 19: Product Profile – BOX 53
Table 20: SWOT Analysis – BOX 53
Table 21: Product Profile – Zenith 55
Table 22: SWOT Analysis – Zenith 55
Table 23: Product Profile – CCI Evolution 57
Table 24: SWOT Analysis – CCI Evolution 57
Table 25: Overall Unmet Needs – Current Level of Attainment and Importance (n=30) 58
Table 26: Coating Methods of Currently Marketed TAR Implants 61
Table 27: Product Profile – INBONE II Total Ankle with Calcaneal Stem Fixation 68
Table 28: SWOT Analysis of INBONE II Total Ankle with Calcaneal Stem Fixation 69
Table 29: Product Profile – Akilos 71
Table 30: SWOT Analysis – Akilos 71
Table 31: Company Profile – DePuy Synthes Companies 82
Table 32: DePuy's Total Ankle Replacement Portfolio Assessment, 2013 83
Table 33: DePuy's Foot and Ankle Business SWOT Analysis, 2013 83
Table 34: Company Profile – Tornier N.V. 84
Table 35: Tornier's Total Ankle Replacement Portfolio Assessment, 2013 84
Table 36: Tornier's Foot and Ankle Business SWOT Analysis, 2013 85
Table 37: Company Profile – Integra LifeSciences 86
Table 38: Integra's Total Ankle Replacement Portfolio Assessment, 2013 86
Table 39: Integra's Foot and Ankle Business SWOT Analysis, 2013 87
Table 40: Company Profile – Small Bone Innovations 88
Table 41: Portfolio Assessment – Small Bone Innovations, 2013 88
Table 42: SBi's Foot and Ankle Business SWOT Analysis, 2013 89
Table 43: Company Profile – Wright Medical Group 90
Table 44: Wright Medical's Total Ankle Replacement Portfolio Assessment, 2013 91
Table 45: Wright Medical's Foot and Ankle Business SWOT Analysis, 2013 91
Table 46: Company Profile – Corin Group 92
Table 47: Corin Group's Total Ankle Replacement Portfolio Assessment, 2013 92
Table 48: Corin Group's Foot and Ankle Business SWOT Analysis, 2013 93
Table 49: Company Profile - MatOrtho 94
Table 50: MatOrtho's Total Ankle Replacement Portfolio Assessment, 2013 94
Table 51: MatOrtho's Orthopedic Devices Business SWOT Analysis, 2013 95
Table 52: Company Profiles – Implants International 96
Table 53: Implants International's Total Ankle Replacement Portfolio Assessment, 2013 96
Table 54: Implants International's Orthopedic Devices Business SWOT Analysis, 2013 97
Table 55: Portfolio Assessment – Other Players in Total Ankle Replacement Market, 2013 97
Table 56: Advantages and Disadvantages of Ankle Fusion and Total Ankle Replacement 98
Table 57: Sales Forecasts for EU5 TAR Markets (2009–2018) 109
Table 58: Sales Forecasts for TAR in France (2009–2018) 111
Table 59: Sales Forecasts for TAR in Germany, 2009–2018 112
Table 60: Sales Forecasts for TAR in Italy (2009–2018) 114
Table 61: Sales Forecasts for TAR in Spain (2009–2018) 115
Table 62: Sales Forecasts for TAR in the UK (2009–2018) 116
Table 63: Abbreviations 119
Table 64: Physicians Surveyed, By Country 130
List of Figures
Figure 1: Schematic Diagram of Ankle Anatomy 15
Figure 2: Ankle Arthritis Subtypes 16
Figure 3: Causes of Post-Traumatic Ankle Arthritis 17
Figure 4: Staged Treatment Approach of Ankle Arthritis 22
Figure 5: An Example of Ankle Distraction Arthroplasty 25
Figure 6: An Example of Ankle Fusion 26
Figure 7: An Example of a Total Ankle Replacement Implant 28
Figure 8: EU5 Population with Ankle Arthritis (2009–2018) 30
Figure 9: Treatment Modalities of Ankle Arthritis in Developed Countries 31
Figure 10: Estimated Costs of Ankle Arthritis, 2009–2018 33
Figure 11: Product Image – Agility LP 37
Figure 12: Product Image – Salto Talaris 39
Figure 13: Product Image – INBONE II 42
Figure 14: Product Image – STAR 44
Figure 15: Product Image – Mobility 46
Figure 16: Product Image – Salto 48
Figure 17: Product Image – HINTEGRA 50
Figure 18: Product Image – BOX 52
Figure 19: Product Image – Zenith 54
Figure 20: Product Image – CCI Evolution 56
Figure 21: Product Image – Akilos 70
Figure 22: TAR Procedure Volume in Europe (2009–2018) 72
Figure 23: Sales Forecast for EU5 TAR Market (2009–2018) 109
Figure 24: Five Market Sales for TAR by Region (2011–2018) 110
Figure 25: Sales Forecasts for TAR in France (2009–2018) 111
Figure 26: Sales Forecasts for TAR in Germany (2009–2018) 113
Figure 27: Sales Forecasts for TAR in Italy (2009–2018) 114
Figure 28: Sales Forecasts for TAR in Spain (2009–2018) 115
Figure 29: Sales Forecasts for TAR in the UK (2009–2018) 117
Figure 30: TAR Market Share in the UK (2011) 118
Companies Mentioned
DePuy Synthes
Tornier N.V.
Integra LifeSciences
Small Bone Innovation, Inc.
Wright Medical Group, Inc.
Corin Group
MatOrtho
Implants International
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Orthopedic Industry: MediPoint: Total Ankle Replacement - EU Analysis and Market Forecasts
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