The Big 4 Orthos sold $15B of total joint implants last year… so why aren’t the Big 4 Orthos focused on preventing revisions ?
I understand that revisions will always happen because of infections, loosening, continued pain, bad surgeries, dislocation…. but 15% is unacceptable.
The Big 4 are always working on the next implant thingy or the next surgical approach or a robot. Its like they consider the total joint industry as a “feature industry” or worse, a “fashion industry”, not a “let’s improve clinical outcomes” industry.
Why don’t they focus on minimizing the 15% revision rate each year ?
What am I missing here ?
In a article in BareBones titled, Joint Replacement Leaders Focus on Implant Improvements, Carolyn LaWell wrote that in 2023, Zimmer Biomet, Stryker, DePuy Synthes, and Smith+Nephew dominated nearly 70% of the global joint replacement market, which grew by 7.5% to $21.5 billion. These leading companies anticipate continued strong performance in 2024, driven by increased demand for procedures and the adoption of new implants and enabling technologies. Zimmer Biomet is set to launch the stemless Identity Shoulder System to cater to active patients, while Stryker’s Triathlon Hinge system simplifies knee revision surgeries by reducing procedural steps. DePuy Synthes focuses on patient-specific alignment with the ATTUNE Knee implant and the VELYS tech portfolio, aiming for reproducible, high-quality outcomes. Smith+Nephew’s AETOS Shoulder System, designed for both anatomic and reverse shoulder replacements, promises a streamlined OR workflow and bone preservation. These innovations underscore each company’s commitment to enhancing patient outcomes and maintaining market leadership.
REFERENCES from Tiger
Here are ten references that detail the annual revision rate of total joint replacements (hip and knee) in the US, compared to the total number of primary surgeries:
- American Joint Replacement Registry (AJRR) 2023 Annual Report – This report indicates that the AJRR, with over 3.1 million procedures, shows a steady increase in both primary and revision hip and knee arthroplasties. The data highlights that revision surgeries represent a smaller, but significant portion of the total procedures performed annually.
- American Joint Replacement Registry (AJRR) 2022 Annual Report – The 2022 report reveals a cumulative procedural volume growth of 14%, with primary surgeries significantly outnumbering revisions, but still providing critical insights into the percentage of revisions compared to primary surgeries.
- Proliance Orthopedic Associates: 2020 AJRR Results – This resource outlines that in 2019, primary hip replacements accounted for 80.5% of procedures, while revision hip replacements constituted 7.3%. Similar trends are noted for knee replacements.
- Evolving Etiologies and Rates of Revision Total Knee Arthroplasty: A 10-Year Institutional Report – This study provides detailed analysis of the causes and rates of revision knee arthroplasties over a decade, showing a substantial increase in revision rates relative to the number of primary procedures performed.
- Orthopedic Design Technology: AJRR 2023 Annual Report – This article discusses the AJRR findings, noting the percentage of revision surgeries within the broader context of all hip and knee arthroplasty procedures, and emphasizing trends in surgical outcomes and technological advancements.
- American Joint Replacement Registry Overview – This source offers an overview of the data collection and reporting processes, highlighting the annual percentage of revision surgeries compared to primary hip and knee replacements in the US.
- UNC Health Talk: Revision Surgery After Joint Replacement – This article explains the complexities and frequency of revision surgeries, suggesting that revisions, while less common than primary surgeries, represent a critical aspect of total joint replacement outcomes.
- Journal of Rheumatology: Future Projections of Total Joint Replacement – The study uses statistical models to project future trends, including the percentage of revision surgeries in comparison to primary hip and knee replacements, based on demographic changes and current data.
- Highlights of the 2021 AJRR Annual Report – This report highlights data from 2,244,587 primary and revision arthroplasties between 2012 and 2020, providing insights into the percentage of revision surgeries over time.
- Arthroplasty Today: AJRR Report Highlights – This resource summarizes key findings from AJRR reports, including the proportion of revision surgeries within the total number of hip and knee replacements performed annually.