Early trends/predictions for the orthopedics industry in the COVID era.

Below are some early trends/predictions that I am seeing in orthopedics.

Many of these trends have been occurring very slowly for years, but the COVID situation has accelerated everything. Examples: Some ortho companies were going out of business in a few years anyway; now it’s months. VR Surgical Training was a decade phenomenon; now it’s months. Big robot systems were going to be eclipsed by new small integrated ubiquitous systems in years; now it’s months. Remote work was trending for years; now it’s today. There has been a gradual pull towards virtual ortho meetings; now it’s here as the CCJR is going 100% online in May.

Think of the COVID as a disruption ACCELERATOR for the orthopedics industry.


  1. 25% of all orthopedic device companies are in trouble and may not survive the next 18 months.
  2. Cash-rich companies will acquire over-leveraged companies at bargain prices over the next four quarters. Look for many M&A closings in late 2020 and 2021.
  3. The IPO market will be closed for orthopedic companies over the next four quarters.
  4. For the next few quarters, 100% of orthopedic patients will be screened for COVID before surgery.  If positive they will be treated in a quarantined COVID section of the hospital. If negative they will be treated in a regular wing of the hospital. 
  5. Many Ortho device companies will rethink their OUS supply chains. Many will start programs to onshore or nearshore manufacturing, or at the very least, qualify new US suppliers as backups.
  6. Many Ortho device companies will hire people in interim leadership roles. Why hire a full time CFO when you need her only 2 days a week? Why carry an R&D team when the bulk of the development is finite? BTW, I can help you with interim hires. tiger@tigerbuford.com.
  7. Many Ortho device companies will become comfortable with certain roles working remotely forever. Remote work for many functions will become the default mode because of the benefits (productivity, great new tools, scheduling flexibility). Virtual meetings will replace international travel to meetings.
  8. There will be a lag time after hospitals/ASCs reschedule elective procedures. Many orthopedic patients will be scared to set foot in a hospital. Other potential patients will change their minds about their surgery and “live with the musculoskeletal issue” indefinitely. Here is the rebound prediction from the orthopedic community.
  9. For the rescheduling of patients who need elective surgeries, patients will be triaged based on severity of the musculoskeletal issue, age and level of COVID exposure in the community. Also, family may not be allowed in the hospital or ASCs during cases.
  10. Many orthopedic patients will prefer and seek-out surgery centers over hospitals for elective orthopedic procedures. For irrational reasons, many older patients will be scared of hospitals for some time. Many surgeons will also move procedures to ASCs if they have access.
  11. ASCs will continue to push back on complexity such as robotic systems and large capital purchases.
  12. Hospitals will begin to question the purchase of leasing of large complex robot surgical systems (Mako, Rosa, Stealth, Brainlab, Pulse, Orthotaxy, ExcelsiusGPS, Navio). COVID will mark the end of the “large” surgical robot 1.0 wars and the beginning of the surgical robot 2.0 movement (small, cheap, ubiquitous, seamless, automatically integrated).
  13. Health care providers will be incentivized to work through the backlog as fast as possible. Most have lost income. Once COVID is “contained“, many aggressive hospitals/ASCs will plan to perform orthopedic surgeries 24/7. Device companies should be prepared to provide service to certain hospitals customers 24/7. This will require an inventory strain on both implants and instrument trays to run 24/7 every day. Smart device companies will build inventory to properly service 24/7.
  14. ASCs, as well as certain hospitals, will prefer single-use disposables over instrumentation systems that require autoclave trays. Health care systems will look for orthopedic solutions that are less burdensome. Simpler tools will be in demand in order to turn over ORs faster.
  15. The distribution representation for device companies will have to learn how to supply product to hospitals with less human contact. I would call this “contactless service”. I don’t know what this looks like right now, but reps will NOT be bouncing around the hospital managing for inventory and moving from one OR to another.
  16. Hospitals/ASCs will insist that device companies “certify” that their implant boxes and packaging are COVID free with either additional outside packaging or they will quarantine the inventory for 48 hours which will stress the supply chain for the manufacturers. I think we will see new creative packaging solutions from device companies.
  17. Hospitals/ASCs will ask that device companies “certify” that sales reps are COVID free before they enter the hospital. Proactive device companies will educate their customers how they are keeping hospitals/ASCs safe.
  18. Hospital administrators will fight letting reps back in the OR and surgeons will be advocates for reps in the OR, especially for complex cases. Creative device companies will learn to provide “contact-less” surgery support. Avail offers the virtual rep solution with zero human contact (see Avail.io).
  19. There will be a stronger trend towards earlier discharges at hospitals.
  20. Telehealth will boom. There will be more patient consultations and more followup care via telemedicine because it works, barriers to telemedicine in the U.S. have largely fallen, and we have found that HIPAA compliance is doable.
  21. VR surgical training for residents and orthopedists will gain more traction (see Precision OS, Osso VR)
  22. Orthopedic wearables to track outcomes (in real-time and with less human interaction) will become more popular. (see TracPatch)
  23. Large international orthopedic medical meetings will be replaced with virtual meetings. Small regional meetings will return to in-person attendance (with distance) in late 2020.
  24. 95% of medical education will be delivered virtually.
  25. Device companies will transform their marketing efforts to drive sales leads in the world where there is little human touch between sales and surgeon customers. Send me a note and I can help you walk through your digital marketing strategy tiger@tigerbuford.com.