MediPoint: Total Shoulder Replacement - South American Analysis and Market Forecasts

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MediPoint: Total Shoulder Replacement - South American Analysis and Market Forecasts
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MediPoint: Total Shoulder Replacement - South American Analysis and Market Forecasts

Summary

Compared with the more mature reconstruction markets, such as hip and knee replacements, shoulder reconstruction is developing as a specialty. Current market growth in shoulder reconstruction is mainly driven by total shoulder replacement (TSR), which comprises anatomic total and reverse total shoulder replacements. Although sluggish economic growth has hindered the large-joint replacement market in the United States and Europe, the global TSR market has seen a promising growth rate in the past few years. This healthy growth can be attributed to an increasing patient population, an improved surgeon adoption of reverse shoulder implants, as well as evolving insurance and reimbursement landscape.

GlobalData evaluated currently marketed TSR prostheses, identified the unmet needs in the market, and provided an understanding of surgeon perception of the latest advances within the shoulder community. Over the forecast period, despite the dampening effect of downward pricing pressure, the TSR market is expected to enjoy healthy growth, primarily driven by the trend of active aging, continuous medical education efforts from the supply side, the introduction of additional reverse shoulder implants and the FDA's approval of modern stemless designs. In particular, the market size of reverse TSR is expected to grow at a much faster pace compared with anatomic TSR.

This report focuses on TSR market in Brazil. GlobalData evaluated currently marketed TSR prostheses, identified the unmet needs in the market, and provided an understanding of surgeon perception of the latest advances within the shoulder community. An accelerated market expansion is expected in emerging countries including Brazil.

Scope

- An overview of arthritis, which includes epidemiology, etiology, symptoms, diagnosis, pathology and treatment guidelines.
- Annualized South American TSR market revenue and future forecasts from 2009 to 2011, forecast for 7 years to 2018.
- Investigation of current and future market competition for TSR
- 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 TSR sector through market impact analysis, future market scenario and company analysis.
- Direct quotes from Key Opinion Leaders (KOL) as well as Orthopedic Surgeon

Reasons to buy

- Understand the trends shaping and driving the South American TSR Market.
- Realize device preferences of physicians who have performed the tests already.
- Access market sizing, forecasts and quantified growth opportunities in the South American TSR 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 South American TSR market landscape? Identify, understand and capitalize.

1 Table of Contents
1 Table of Contents 7
1.1 List of Tables 13
1.2 List of Figures 21
2 Introduction 24
2.1 Catalyst 25
3 Disease Overview 26
3.1 Anatomy and Physiology 26
3.2 Pathophysiology 28
3.2.1 Overview 28
3.2.2 Primary Osteoarthritis 28
3.2.3 Rotator Cuff Tear Arthropathy 29
3.2.4 Post-Traumatic Arthritis 31
3.2.5 Proximal Humerus Fracture 31
3.2.6 Avascular Necrosis 33
3.2.7 Rheumatoid Arthritis 34
3.3 Clinical Presentation 35
3.3.1 Diagnosis 35
3.4 Clinical Outcomes 36
3.4.1 Overview 36
3.4.2 Conservative Treatments 36
3.4.3 Joint-Preserving Treatments 37
3.4.4 Joint Replacement 39
3.5 Epidemiology 50
3.5.1 Shoulder Arthritis 50
3.5.2 Proximal Humerus Fractures 51
3.6 Economic Impact 53
3.6.1 Shoulder Arthritis 53
3.6.2 Rotator Cuff Diseases 55
3.6.3 Proximal Humerus Fractures 55
3.6.4 Cost-Effectiveness of Total Shoulder Replacement 56
3.6.5 Cost-Effectiveness of Reverse Total Shoulder Replacement 56
4 Competitive Assessment 57
4.1 Overview 57
4.2 Global Market Share 61
4.3 Anatomic Total Shoulder Replacement 62
4.3.1 Univers II (Arthrex) 62
4.3.2 Comprehensive (Biomet) 64
4.3.3 Comprehensive Fracture (Biomet) 66
4.3.4 Global Advantage (DePuy Synthes) 69
4.3.5 Global Fx (DePuy Synthes) 73
4.3.6 Global AP (DePuy Synthes) 75
4.3.7 Global Unite (DePuy Synthes) 78
4.3.8 Turon (DJO Surgical) 80
4.3.9 Equinoxe (Exactech) 83
4.3.10 TITAN (Integra LifeSciences) 85
4.3.11 SMR (Lima Corporate) 87
4.3.12 Cofield 2 (Smith & Nephew) 90
4.3.13 Neer 3 (Smith & Nephew) 93
4.3.14 Promos Standard (Smith & Nephew) 96
4.3.15 Solar (Stryker) 98
4.3.16 ReUnion (Stryker) 100
4.3.17 Aequalis Primary (Tornier) 102
4.3.18 Aequalis Fracture (Tornier) 105
4.3.19 Affiniti (Tornier) 107
4.3.20 Aequalis Ascend (Tornier) 110
4.3.21 Bigliani/Flatow (Zimmer) 112
4.3.22 Anatomical (Zimmer) 115
4.3.23 Trabecular Metal (Zimmer) 117
4.4 Anatomic Stemless Total Shoulder Replacement 121
4.4.1 Eclipse (Arthrex) 121
4.4.2 T.E.S.S. (Total Evolutive Shoulder System) Anatomic (Biomet) 123
4.4.3 Comprehensive Nano (Biomet) 126
4.4.4 Simpliciti (Tornier) 128
4.4.5 InSpyre (Tornier) 131
4.4.6 Sidus (Zimmer) 133
4.5 Reverse Total Shoulder Replacement 136
4.5.1 Univers Revers (Arthrex) 136
4.5.2 T.E.S.S. (Total Evolutive Shoulder System) Reverse (Biomet) 138
4.5.3 Comprehensive Reverse (Biomet) 141
4.5.4 Delta Xtend (DePuy Synthes) 143
4.5.5 Reverse Shoulder Prosthesis (RSP) (DJO Surgical) 146
4.5.6 Equinoxe Reverse (Exactech) 149
4.5.7 SMR Reverse (Lima Corporate) 152
4.5.8 Promos Reverse (Smith & Nephew) 155
4.5.9 Aequalis Reversed II (Tornier) 157
4.5.10 Aequalis Reversed Fracture (Tornier) 160
4.5.11 Ascend Flex (Tornier) 162
4.5.12 Anatomical Reverse (Zimmer) 164
4.5.13 Trabecular Metal Reverse (Zimmer) 166
5 Unmet Needs 169
5.1 Durable Glenoid Components 169
5.2 Augmented Glenoid Components 172
5.3 Grammont-Style versus Frankle-Style 173
5.4 Addressing Complications of Reverse Shoulder Replacement 175
5.5 Bone-Sparing Stemless Designs: Pros and Cons 177
5.6 Revision Systems 180
5.7 Long-Term Follow-Up 181
5.8 Patient Awareness in Emerging Markets 182
6 Pipeline Products 183
6.1 Overview 183
6.2 aSpire Total Shoulder Replacement System (Shoulder Options) 184
6.2.1 Overview 184
6.2.2 SWOT Analysis 185
6.3 Luna Stemless Humeral Prosthesis (Shoulder Options) 186
6.3.1 Overview 186
6.3.2 SWOT Analysis 188
6.4 AFT Proximal Humerus Fracture Prosthesis (Shoulder Options) 189
6.4.1 Overview 189
6.4.2 SWOT Analysis 190
6.5 Others 191
6.5.1 Stryker's Reverse Shoulder Implant 191
6.5.2 Tornier's Patient-Specific Image-Driven Glenoid Replacement Device 191
6.5.3 Integra's Reverse Shoulder Implant 191
6.5.4 Integra's PYROHEMI 191
7 Industry Overview 192
7.1 Procedure Trends 192
7.1.1 South America 192
7.2 Market Access 193
7.2.1 Regulation 193
7.2.2 Adoption 194
7.3 Reimbursement Trends 195
7.4 Regulatory Issues/Recalls 196
7.4.1 Lima Corporate's SMR Anatomic Polyethylene Liner 196
7.5 Mergers & Acquisitions/Key Partnerships 197
7.5.1 Integra LifeSciences Acquires Ascension Orthopedics 197
8 Current and Future Players 198
8.1 Trends in Corporate Strategy 198
8.2 Company Profiles 199
8.2.1 DePuy Synthes 199
8.2.2 Tornier N.V. 203
8.2.3 Biomet 207
8.2.4 Zimmer Holdings 211
8.2.5 Exactech 215
8.2.6 Smith & Nephew 218
8.2.7 Stryker 221
8.2.8 DJO Global 224
8.2.9 Arthrex 227
8.2.10 Lima Corporate S.p.a. 229
8.2.11 Integra LifeSciences 231
8.2.12 Mathys Ltd Bettlach 234
8.2.13 Wright Medical Group 236
8.2.14 Other Companies 239
9 Market Drivers & Opportunities 240
9.1 Market Drivers 240
9.1.1 Rising Prevalence of Shoulder Diseases 240
9.1.2 Expanded Indications of Reverse Shoulder Replacement 241
9.1.3 Increased Patient Awareness 242
9.1.4 Availability of Long-Term Clinical Data 243
9.1.5 Corporate Promotions and Medical Education 244
9.1.6 Expected Launch of New Devices in the US 244
9.2 Opportunities 245
9.2.1 Pyrocarbon 245
9.2.2 Revision Instrumentation 246
9.2.3 Demand for a Comprehensive Shoulder Reconstruction Portfolio 246
9.2.4 Computer-Assisted Navigation 247
9.2.5 Procedure-Specific Patient Education Platform 248
9.2.6 Emerging Markets 248
9.3 Market Barriers 249
9.3.1 Postoperative Complications 249
9.3.2 Steep Learning Curve 250
9.3.3 Cost 251
9.3.4 Reimbursement 252
9.3.5 Substitutes 252
10 Country Outlooks & Forecasts 254
10.1 Brazil 254
11 Appendix 256
11.1 Abbreviations 256
11.2 Bibliography 257
11.3 Report Methodology 274
11.3.1 Overview 274
11.3.2 Coverage 274
11.3.3 Secondary Research 275
11.3.4 Forecasting Methodology 275
11.3.5 Primary Research – Key Opinion Leader Interviews 277
11.3.6 Expert Panel Validation 277
11.4 Physicians and Specialists Included in this Study 278
11.5 About the Authors 280
11.5.1 Analysts 280
11.5.2 Bonnie Bain, Ph.D., Global Head of Healthcare 281
11.6 About MediPoint 282
11.7 About GlobalData 282
11.8 Disclaimer 282

1.1 List of Tables

Table 1: Walch Classification of Glenoid Wear Associated with Primary Osteoarthritis 29
Table 2: Clinical Symptoms and Descriptions 35
Table 3: Major Indications and Contraindications for Humeral Head Resurfacing 40
Table 4: Major Indications and Contraindications for Stemmed Partial Shoulder Replacement 43
Table 5: Major Indications and Contraindications for Anatomic Total Shoulder Replacement 46
Table 6: Major Indications and Contraindications for Anatomic Total Shoulder Replacement 49
Table 7: Shoulder Arthritis Prevalence in Brazil (2013–2019) 50
Table 8: Proximal Humerus Fracture Prevalence in Brazil (2013–2019) 52
Table 9: Direct and Indirect Costs of Arthritis 54
Table 10: Currently Marketed Anatomic Total Shoulder Replacement Implants 59
Table 11: Currently Marketed Anatomic Stemless Shoulder Replacement Implants 60
Table 12: Currently Marketed Reverse Total Shoulder Replacement Implants 60
Table 13: Product Profile – Univers II 63
Table 14: SWOT Analysis – Univers II 64
Table 15: Product Profile – Comprehensive 65
Table 16: SWOT Analysis – Comprehensive 66
Table 17: Product Profile – Comprehensive Fracture 67
Table 18: List of Clinical Studies – Comprehensive Fracture 68
Table 19: SWOT Analysis – Comprehensive Fracture 68
Table 20: Product Profile – Global Advantage 71
Table 21: List of Clinical Studies – Global Anchor Peg Glenoid 72
Table 22: SWOT Analysis – Global Advantage 72
Table 23: Product Profile – Global Fx 74
Table 24: SWOT Analysis – Global Fx 75
Table 25: Product Profile – Global AP 76
Table 26: List of Clinical Studies – Global AP 77
Table 27: SWOT Analysis – Global AP 77
Table 28: Product Profile – Global Unite 79
Table 29: SWOT Analysis – Global Unite 80
Table 30: Product Profile – Turon 82
Table 31: SWOT Analysis – Turon 82
Table 32: Product Profile – Equinoxe 84
Table 33: SWOT Analysis – Equinoxe 85
Table 34: Product Profile – TITAN 86
Table 35: SWOT Analysis – TITAN 87
Table 36: Product Profile – SMR 88
Table 37: List of Clinical Studies – SMR 89
Table 38: SWOT Analysis – SMR 89
Table 39: Product Profile – Cofield 2 91
Table 40: List of Clinical Studies – Cofield 2 91
Table 41: SWOT Analysis – Cofield 2 92
Table 42: Product Profile – Neer 3 94
Table 43: SWOT Analysis – Neer 3 95
Table 44: Product Profile – Promos Standard 97
Table 45: List of Clinical Studies – Promos Standard 97
Table 46: SWOT Analysis – Promos Standard 98
Table 47: Product Profile – Solar 99
Table 48: SWOT Analysis – Solar 100
Table 49: Product Profile – ReUnion 101
Table 50: SWOT Analysis – ReUnion 101
Table 51: Product Profile – Aequalis Primary 103
Table 52: List of Clinical Studies – Aequalis Primary 104
Table 53: SWOT Analysis – Aequalis Primary 104
Table 54: Product Profile – Aequalis Fracture 106
Table 55: List of Clinical Studies – Aequalis Fracture 106
Table 56: SWOT Analysis – Aequalis Fracture 107
Table 57: Product Profile – Affiniti 109
Table 58: List of Clinical Studies – Affiniti 109
Table 59: SWOT Analysis – Affiniti 110
Table 60: Product Profile – Aequalis Ascend 111
Table 61: SWOT Analysis – Aequalis Ascend 112
Table 62: Product Profile – Bigliani/Flatow 113
Table 63: List of Clinical Studies – Bigliani/Flatow 114
Table 64: SWOT Analysis – Bigliani/Flatow 114
Table 65: Product Profile – Anatomical 116
Table 66: SWOT Analysis – Anatomical 117
Table 67: Product Profile – Trabecular Metal 119
Table 68: List of Clinical Studies – Trabecular Metal 119
Table 69: SWOT Analysis – Trabecular Metal 120
Table 70: Product Profile – Eclipse 122
Table 71: List of Clinical Studies – Eclipse 122
Table 72: SWOT Analysis – Eclipse 123
Table 73: Product Profile – T.E.S.S. Anatomic 124
Table 74: List of Clinical Studies – T.E.S.S. Anatomic 125
Table 75: SWOT Analysis – T.E.S.S. Anatomic 126
Table 76: Product Profile – Comprehensive Nano 127
Table 77: SWOT Analysis – Compressive Nano 128
Table 78: Product Profile – Simpliciti 129
Table 79: List of Clinical Studies – Simpliciti 130
Table 80: SWOT Analysis – Simpliciti 130
Table 81: Product Profile – InSpyre 132
Table 82: SWOT Analysis – InSpyre 132
Table 83: Product Profile – Sidus 134
Table 84: List of Clinical Studies – Sidus 134
Table 85: SWOT Analysis – Sidus 135
Table 86: Product Profile – Univers Revers 137
Table 87: List of Clinical Studies – Univers Revers 137
Table 88: SWOT Analysis – Univers Reverse 138
Table 89: Product Profile – T.E.S.S. Reverse 139
Table 90: List of Clinical Studies – T.E.S.S. Reverse 140
Table 91: SWOT Analysis – T.E.S.S. Reverse 140
Table 92: Product Profile – Comprehensive Reverse 142
Table 93: SWOT Analysis – Comprehensive Reverse 143
Table 94: Product Profile – Delta Xtend 144
Table 95: List of Clinical Studies – Delta Xtend 145
Table 96: SWOT Analysis – Delta Xtend 145
Table 97: Product Profile – Reverse Shoulder Prosthesis (RSP) 147
Table 98: List of Clinical Studies – Reverse Shoulder Prosthesis (RSP) 148
Table 99: SWOT Analysis – Reverse Shoulder Prosthesis (RSP) 149
Table 100: Product Profile – Equinoxe Reverse 150
Table 101: List of Clinical Studies – Equinoxe Reverse 151
Table 102: SWOT Analysis – Equinoxe Reverse 151
Table 103: Product Profile – SMR Reverse 153
Table 104: List of Clinical Studies – SMR Reverse 154
Table 105: SWOT Analysis – SMR Reverse 154
Table 106: Product Profile – Promos Reverse 156
Table 107: List of Clinical Studies – Promos Reverse 156
Table 108: SWOT Analysis – Promos Reverse 157
Table 109: Product Profile – Aequalis Reversed II 158
Table 110: List of Clinical Studies – Aequalis Reversed II 159
Table 111: SWOT Analysis – Aequalis Reversed II 159
Table 112: Product Profile – Aequalis Reversed Fracture 161
Table 113: List of Clinical Studies – Aequalis Reversed Fracture 161
Table 114: SWOT Analysis – Aequalis Reversed Fracture 162
Table 115: Product Profile – Ascend Flex 163
Table 116: SWOT Analysis – Ascend Flex 164
Table 117: Product Profile – Anatomical Reverse 165
Table 118: SWOT Analysis – Anatomical Reverse 166
Table 119: Product Profile – Trabecular Metal Reverse 167
Table 120: List of Clinical Studies – Trabecular Metal Reverse 168
Table 121: SWOT Analysis – Trabecular Metal Reverse 168
Table 122: Currently Marketed Grammont-Style and Frankle-Style Reverse Shoulder Implants 174
Table 123: Major Pipeline Products in Total Shoulder Replacement Market, 2013 183
Table 124: Product Profile – aSpire 184
Table 125: SWOT Analysis – aSpire 185
Table 126: Product Profile – Luna 187
Table 127: SWOT Analysis – Luna 188
Table 128: Product Profile – AFT 189
Table 129: SWOT Analysis – AFT 190
Table 130: Company Profile – DePuy Synthes 199
Table 131: DePuy Synthes' Shoulder Portfolio Assessment, 2013 201
Table 132: DePuy Synthes' SWOT Analysis, 2013 202
Table 133: Company Profile – Tornier N.V. 203
Table 134: Tornier's Shoulder Portfolio Assessment, 2013 205
Table 135: Tornier's SWOT Analysis, 2013 206
Table 136: Company Profile – Biomet 207
Table 137: Biomet's Shoulder Portfolio Assessment, 2013 209
Table 138: Biomet's SWOT Analysis, 2013 210
Table 139: Company Profile – Zimmer Holdings 212
Table 140: Zimmer Holdings' Shoulder Portfolio Assessment, 2013 213
Table 141: Zimmer Holdings' SWOT Analysis, 2013 214
Table 142: Company Profile – Exactech 215
Table 143: Exactech's Shoulder Portfolio Assessment, 2013 216
Table 144: Exactech's SWOT Analysis, 2013 217
Table 145: Company Profile – Smith & Nephew 219
Table 146: Smith & Nephew's Shoulder Portfolio Assessment, 2013 220
Table 147: Smith & Nephew's SWOT Analysis, 2013 220
Table 148: Company Profile – Stryker 221
Table 149: Stryker's Shoulder Portfolio Assessment, 2013 222
Table 150: Stryker's SWOT Analysis, 2013 223
Table 151: Company Profile – DJO Global 224
Table 152: DJO Global's Shoulder Portfolio Assessment, 2013 225
Table 153: DJO Global's SWOT Analysis, 2013 226
Table 154: Company Profile – Arthrex 227
Table 155: Arthrex's Shoulder Portfolio Assessment, 2013 228
Table 156: Arthrex's SWOT Analysis, 2013 228
Table 157: Company Profile – Lima Corporate S.p.a. 229
Table 158: Lima Corporate S.p.a.'s Shoulder Portfolio Assessment, 2013 230
Table 159: Lima Corporate S.p.a.'s SWOT Analysis, 2013 230
Table 160: Company Profile – Integra LifeSciences 231
Table 161: Integra LifeSciences' Shoulder Portfolio Assessment, 2013 232
Table 162: Integra LifeSciences' SWOT Analysis, 2013 233
Table 163: Company Profile – Mathys Ltd Bettlach 234
Table 164: Mathys Ltd Bettlach's Shoulder Portfolio Assessment, 2013 234
Table 165: Mathys Ltd Bettlach's SWOT Analysis, 2013 235
Table 166: Company Profile – Wright Medical Group 237
Table 167: Wright Medical Group's Shoulder Portfolio Assessment, 2013 237
Table 168: Wright Medical Group's SWOT Analysis, 2013 238
Table 169: Other Companies in the Global Shoulder Replacement Market, 2013 239
Table 170: Sales Forecasts for TSR in Brazil (2012–2019) 254

1.2 List of Figures

Figure 1: Schematic Diagram of Shoulder Anatomy 26
Figure 2: Schematic Diagram of Rotator Cuff 27
Figure 3: Wide Spectrum of Disease Seen in Rotator Cuff Tear Arthropathy 30
Figure 4: Neer Classification of Proximal Humerus Fractures 32
Figure 5: Four-Part and Three-Part Proximal Humerus Fractures 33
Figure 6: An Example of Humeral Head Resurfacing 40
Figure 7: An Example of Stemmed Partial Shoulder Replacement 43
Figure 8: An Example of Anatomic Total Shoulder Replacement 46
Figure 9: An Example of Reverse Total Shoulder Replacement 47
Figure 10: Shoulder Arthritis Prevalence in Brazil 51
Figure 11: Proximal Humerus Fracture Prevalence in Brazil 52
Figure 12: TSR Global Market Share (2013) 61
Figure 13: Product Image – Univers II 62
Figure 14: Product Image – Univers Glenoid Components 63
Figure 15: Product Image – Comprehensive 65
Figure 16: Product Image – Comprehensive Fracture 67
Figure 17: Product Image – Global Advantage 70
Figure 18: Product Image – Global Steptech Anchor Peg Glenoid 70
Figure 19: Product Image – Global Fx 73
Figure 20: Product Image – Global AP 76
Figure 21: Product Image – Global Unite 78
Figure 22: Product Image – Turon 81
Figure 23: Product Image – Equinoxe Primary 83
Figure 24: Product Image – Equinoxe Fracture 84
Figure 25: Product Image – TITAN 86
Figure 26: Product Image – SMR (Anatomic and Fracture) 88
Figure 27: Product Image – Cofield 2 90
Figure 28: Product Image – Neer 3 94
Figure 29: Product Image – Promos Standard 96
Figure 30: Product Image – Solar 99
Figure 31: Product Image – ReUnion 100
Figure 32: Product Image – Aequalis Primary 102
Figure 33: Product Image – Aequalis Fracture 105
Figure 34: Product Image – Affiniti 108
Figure 35: Product Image – Cortiloc Glenoid 108
Figure 36: Product Image – Aequalis Ascend 111
Figure 37: Product Image – Bigliani/Flatow 113
Figure 38: Product Image – Anatomical Primary 115
Figure 39: Product Image – Anatomical Fracture 116
Figure 40: Product Image – Trabecular Metal 118
Figure 41: Product Image – Eclipse 121
Figure 42: Product Image – T.E.S.S. Anatomic 124
Figure 43: Product Image – Comprehensive Nano 127
Figure 44: Product Image – Simpliciti 129
Figure 45: Product Image – InSpyre 131
Figure 46: Product Image – Sidus 133
Figure 47: Product Image – Univers Revers 136
Figure 48: Product Image – T.E.S.S. Reverse 138
Figure 49: Product Image – Comprehensive Reverse 142
Figure 50: Product Image – Delta Xtend 144
Figure 51: Product Image – Reverse Shoulder Prosthesis (RSP) 146
Figure 52: Product Image – RSP Monoblock 147
Figure 53: Product Image – Equinoxe Reverse 150
Figure 54: Product Image – SMR Reverse and SMR Reverse HP 152
Figure 55: Product Image – Promos Reverse 155
Figure 56: Product Image – Aequalis Reversed II 158
Figure 57: Product Image – Aequalis Reversed Fracture 160
Figure 58: Product Image – Ascend Flex 163
Figure 59: Product Image – Anatomical Reverse 165
Figure 60: Product Image – Trabecular Metal Reverse 167
Figure 61: Product Image – aSpire 184
Figure 62: Product Image – Luna 186
Figure 63: Product Image – Luna Anchored 187
Figure 64: Product Image – AFT 189
Figure 65: Shoulder Replacement Procedure Volume in Brazil (2010–2019) 192
Figure 66: Anatomic and Reverse Total Shoulder Replacement Procedure Volume in Brazil (2010–2019) 193
Figure 67: Adoption Trend of Shoulder Replacement in Brazil, 2013 and 2019 194
Figure 68: Sales Forecasts for TSR Market in Brazil (2010–2019) 255

Companies Mentioned

DePuy Synthes
Tornier N.V.
Biomet
Zimmer Holdings
Exactech
Smith & Nephew
Stryker
DJO Global
Arthrex
Lima Corporate S.p.a.
Integra LifeSciences
Mathys Ltd Bettlach
Wright Medical Group