The global orthopaedic market is valued at approximately US$29 billion. Under the influence of orthobiology and nanotechnology, there is scope for significant growth, as long as there are sufficient practitioners to perform the procedures.
The bone and joint decade
Musculoskeletal disorders are the most common cause of chronic long-term pain for millions of patients worldwide. The World Health Organisation (WHO) declared 2000–2010 the Bone and Joint Decade in an effort to improve the health-related quality of life for people with musculoskeletal conditions. Associated initiatives helped to increase awareness of chronic musculoskeletal conditions and their possible treatments. As a whole, this effort has led to an increase in patient demand and, consequently, industry revenue.
In 2009, the global orthopaedic devices market was estimated to be worth US$29 billion. Orthobiologics is one of the fastest growing sectors within this market. There is ample scope for investment in research to develop products that eventually will revolutionise the treatment of musculo-skeletal disorders.
The joint reconstruction and replacement sector is historically driven by significant demand. For example, approximately 364,000 hip and knee arthroplasty procedures were performed in Germany in 2008; 60% of those were hip arthroplasties and 40% were knee procedures.
Spinal surgery has been generating high revenues and it continues to increase. The market for trauma fixation and braces and supports has grown steadily over the years despite an absence of innovation. Steady growth also characterises the market for arthroscopic devices, driven by the impact of minimally invasive surgeries across Europe.
Areas of concern
Growth is as dependent on the ability to provide care as it is on demand. In Europe, osteoporosis costs national treasuries around €3.5 billion a year in hospital healthcare alone. In addition, bone and joint disorders result in indirect costs. Swedish economists have calculated the cost to society of illnesses related to musculo-skeletal disorders to be the highest in Europe, surpassing even the combined costs associated with neurological and mental illnesses.
More than 100 million European citizens suffer from arthritis or rheumatism, according to data from the WHO’s Bone and Joint Decade programme. A growing patient population, however, is competing for the attention of a smaller pool of practitioners. As patients are shuffled onto waiting lists, the condition may worsen and require a greater outlay of resources than would have been necessary if he or she had received timely and appropriate care.
The British Orthopaedic Association suggests that the number of orthopaedic consultants in the United Kingdom be increased from the current one per 25,000 patients to one for every 15,000 patients by 2020. Yet, the most recent available data report that there is one consultant for every 28,127 patients, which is well above the recommended norm. This has, in turn, swelled waiting lists, which can aggravate the nature of the problem and increase the burden on healthcare expenditures, as noted above.
Looking to the future
Innovation is the key to success, but it is not limited just to products. Innovation has helped to identify novel ways to improve treatments and to increase cost efficiencies.
One recent innovation is the development of low-wear materials that extend implant life. In hip replacement surgery, the development of cementless implants coated with hydroxyapatite (HA), a mineral that stimulates the formation of new bones, was a major milestone.
In concert with the advent of more durable and comfortable orthopaedic devices, procedural improvements also have benefited the industry. Surgical procedures, for example, have become less invasive and less costly to society. According to a study by Coon et al cited on the Eucomed website1, minimally invasive surgical (MIS) procedures cost approximately 26% less than conventional surgical procedures. Not surprisingly, MIS orthopaedic procedures are a growing trend.
Looking ahead, nanotechnology may have a huge impact on the orthopaedic industry. Nanomaterials have been called the next generation of orthopaedic implant materials, because of their surface properties that promote bone growth. Similarly, nanotubes—the building blocks of nanostructures that are lighter in weight but nearly 100 times stronger than steel—can improve the physical property of the implant. Several nanotech-related research programmes are underway in the drug-delivery arena that can revolutionise the orthopaedic industry, as well.
Bone and joint disease is physically painful for patients and economically painful for health services around the world. Industry experts estimate that 20% of all visits to outpatient facilities involve musculoskeletal conditions. It is extremely important both to diagnose the disorders and treat them appropriately to avoid paying more significant costs arising from complications. Recognising this would benefit patients and drive market growth.
is an Industry Analyst at Frost & Sullivan, 7th Floor, Karumuttu Center, 498 Anna Salai,
Nandanam, Chennai 600035, India
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