The end of Big Ortho dominance

There are few circumstances that have the potential to dislodge Big Ortho's dominant grip on our industry. 
Let me share one specific blind spot that could be the Achilles heal for Big Ortho.

Today - Big Orthos Competitive Advantage
The top 10 orthopedic companies today are: Stryker, DePuy-Synthes, ZB, S+N, MDT, Arthrex, DJO, NUVA, Wright Medical, OFIX. They control the world market... most of the implants, instruments, capital equipment and disposables. Life is good for Big Ortho companies as they manage millions of products worldwide on a daily basis.
So what do these top 10...