Orthopedics: Five Trends to Watch

Some observations from our recent interview with Kyle Rose. MedTech Strategist subscribers can view the full video interview here.

1. In hot-spot regions, the pressure continues on total joint and spine procedures, which are mostly elective, and also some complex cases and even trauma. Discussions at AAOS might shed light on the pandemic’s impact on long-term, ongoing trends, such as site of procedure shifts to outpatient care and adoption of enabling technologies, which refers to a portfolio of innovations including surgical navigation, robotics, imaging, smart implants and virtual reality.
2. The shift to outpatient settings for certain procedures continues as a long-term trend, but structural change at the healthcare system level has been extremely slow, despite accelerated interest due to COVID-19 and recent, dramatic CMS policy changes. Manufacturers are committed to investing more in their outpatient and ambulatory surgery center (ASC) strategies at a high level but still generate only a single-digit percentage of their total joint and spine sales (two high-volume surgeries) from this customer base.
3. Enabling technologies, after a fitful start, are gaining traction and have the potential to reshape the traditional orthopedics industry by impacting patient selection, product design, and procedure workflow. The goals are to improve reproducibility of complex procedural techniques to improve patient outcomes. Whether these technologies remain necessary value-adds for physicians or revenue generators for manufacturers remains to be seen.
4. Rose does not expect either AAOS or the upcoming National Association of Spine Specialists (NASS) annual meeting at the end of September to provide new scientific evidence of the efficacy of these technologies, for which data on outcomes impact remains spotty. “The ability to cleanly integrate all of these enabling technologies into the natural surgical workflow has potential to be very impactful,” he says. 
5. As successful as Stryker Corp.’s Mako robotic system has been in the total joint arthroplasty surgery, it has only penetrated a portion of the company’s existing customer base, so there is room for competition, especially since Zimmer, not Stryker, remains the largest orthopedics company. At the least, these competitors can introduce their robots to their own customers. Longer term, it remains to be seen whether robotic systems can move market share as the field gets more competitive.

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