Robot assisted medial knee arthroplasty: orthopedic surgical robots are poised to take knee and hip surgery quality far beyond what has previously been available. The quality of knee arthroplasty is improved with robotic capability. All the advantages of surgical robots carry into the Stryker Mako orthopedic reconstruction surgical products. When the knee and hip surgical robots are used, patients have less bleeding, reduction of post-operative pain, fewer re-admissions to hospital and faster recovery. Robots support high-precision surgery. A clinic in Switzerland, La Source, has reported a reduction in the average days of hospitalization from 10 to 6. Surgical robots provide consistent reproducible precision. This capability is so significant for implant surgery that the robots are positioned to become the defacto standard of care for knee and hip surgery within five years. Any one getting a knee or hip replaced will demand clinician attention to quality of life, to maintenance of lifestyle provided by a robot when they have a joint replacement. As next generation systems, hip and knee robotic units provide a way to improve traditional orthopedic hip and knee replacement surgery. Total hip replacement surgery has evolved dramatically as advances in technology have brought improved surgical techniques. Surgical robots and robotic assist devices are a significant part of that advance. Once, the penetration achieves a 35% level, all orthopedic surgeons will demand that hospitals offer robotic orthopedic surgical capability because the outcomes are more predictable and better. If the hospital does not offer the robot, the surgeon will move to a more modern facility. Once some hospitals are offering superior outcomes, all hospitals must come up tot that standard, the good physicians will migrate to the good technology and the patients will follow. This market has exceeded the threshold of 100 paid successful installations, that is the watermark for strong technology growth. Knee and hip surgical robot procedures and robotically assisted surgeries have been impacted by the reduction in insurance payments. Payment reductions have forced hospitals to start acting as businesses. The cost of delivering care has become as much a factor as providing quality care when making decisions about patient improvement in condition. Cost-cutting has been made in the supply chain. Suppliers were examined closely for quality and cost. The number of suppliers is reduced to put pressure on the ones that remain. Those remaining are pressured to improve prices and efficiencies. Hospitals, physicians, and care providers have been financially incentivized to create accountable care organizations (ACOs). Coordinated patient care plans and value-based purchasing were rewarded. The med device buyer shifted from physicians to the ACOs and smart buying groups. Stryker has thrived in this cost efficient environment with a surgical robot that permits faster surgeries, more cost efficient surgeries. In addition, Stryker offers an integrated system. The ability to include a Mako total knee application with Stryker Triathlon total knee system is anticipated to increase market share for Stryker. Stryker market leading Triathlon total knee system is helped in the market by the robot simply by the improved surgical technique possible. Surgical robots are proving themselves in a variety of disciplines, lending credibility to the Stryker robotic initiative. According to Susan Eustis, lead author of the study, “Use of the robot with the orthopedic implant represents a key milestone in reconstructive surgery. Robots provide an opportunity to transform orthopedics. By furthering the growth of robotic-arm assisted surgery, patients can get better treatment. By enhancing the surgeon and patient experience is is likely that the entire orthopedics implant market will grow more rapidly than it would otherwise.” Stryker uses the Mako to perform partial knee resurfacing and is happy to add robotic capability to total knee resurfacing. Technology is enhancing a wide variety of procedures in many surgical specialties. Omni has had remarkable success with its robotic assist device. Joint stiffness and joint instability are eliminated with the use of the Omni device. The aging US population has supported demand, since the occurrence of health issues that require medical devices is higher in the elderly population. Buoyed by strong demand and sales, industry profit margins have increased considerably during the past five years. The aging of the population worldwide is anticipated to trigger further growth of these markets. Hospitals are adopting robotic surgical devices to improve their outcomes numbers. Hospitals are measured on outcomes, robots for surgery, when used by a trained physician are improving outcomes significantly. Hundreds of universities worldwide have research programs in robotics and many are awarding degrees in robotics. These “roboticists” are increasingly being hired by Global 2000 organizations to link mobile robots (mobile computers) into existing IT systems. Robot-assisted surgery gives the surgeon better control over the surgical instruments and a better view of the surgical site. Hip and knee orthopedic surgical robot device markets at $222 million in 2015 are anticipated to reach $5 billion by 2022 as next generation robotic devices, systems, and instruments are introduced to manage surgery. The complete report provides a comprehensive analysis including procedure numbers, units sold, market value, forecasts, as well as a detailed competitive market shares and analysis of major players’ success, challenges, and strategies in each segment and sub-segment. The reports cover markets for knee and hip robotic orthopedic surgery medical specialties and sub-specialties. WinterGreen Research is an independent research organization funded by the sale of market research studies all over the world and by the implementation of ROI models that are used to calculate the total cost of ownership of equipment, services, and software. The company has 35 distributors worldwide, including Global Information Info Shop, Market Research.com, Research and Markets, Bloomberg, and Thompson Financial. It conducts its business with integrity. WinterGreen Research is an independent research organization funded by the sale of market research studies all over the world and by the implementation of ROI models that are used to calculate the total cost of ownership of equipment, services, and software. The company has 35 distributors worldwide, including Global Information Info Shop, Market Research.com, Research and Markets, and Thompson Financial. 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Companies Profiled Market Leaders Stryker / Mako Omni Smith & Nephew Market Participants Johnson & Johnson / DePuy Synthes Shenzhen Advanced Institute Spinal Surgical Robot Smith & Nephew Stryker / Mako THINK Surgical Wright Medical Technology Zimmer Biomet Key Topics Joint Surgical Robotics Knee Surgical Robotics Hip Surgical Robotics Orthopedic Surgical Robotics Robotic surgery Smart Instruments Medical Devices Healthcare Robotics Enabling Technology Robotic-Assisted Minimally Invasive Surgery Robotic Surgical System Robotic Surgery Equipment Surgical Robot Applications Next Generation Robotic Surgery Flexible Robot Platform Minimally Invasive Surgery (MIS)
Table of Content KNEE AND HIP SURGICAL ROBOTS MARKET SHARES AND MARKET FORECASTS 13 Knee and Hip Surgical Robot Market Driving Forces 13 Knee and Hip Surgical Robot Market Shares 16 Knee and Hip Surgical Robot Forecasts 19 1. KNEE AND HIP SURGICAL ROBOTS MARKET DESCRIPTION AND MARKET DYNAMICS 22 1.1 Knee and Hip Surgical Robots Reduction In Payments 22 1.1.1 Med Device Industry 22 1.1.2 Stryker Positions to Assist Hospital Capital Investment in Knee and Hip Robotics 23 1.1.3 Stryker Flex Financial Provides Assistance in the Financing Of The Surgical System Purchase 24 1.2 Knee and Hip Surgery Three Dimension High-Definition Visualization with Robotic Arm 25 1.3 Osteoporosis Impact On Hip 25 2. KNEE AND HIP SURGICAL ROBOTS MARKET SHARES AND MARKET FORECASTS 28 2.1 Knee and Hip Surgical Robot Market Driving Forces 28 2.2 Knee and Hip Surgical Robot Market Shares 31 2.2.1 Orthopedic Surgical Robot Market Shares, Units and Dollars 36 2.2.2 Knee and Hip Surgical Robot Unit Analysis 37 2.2.3 Stryker MAKO Platform Expansion 40 2.2.4 Omni OMNIPlasty Total Knee Replacement Robotic Surgery 40 2.2.5 OMNI Life Science OMNIBoics 41 2.2.6 Smith & Nephew Navio 41 2.2.7 Think ROBODOC Surgical Assistant 42 2.2.8 Wright / Tornier 42 2.3 Surgical Robot and Surgical Assistive Robot Forecasts 43 2.3.1 Knee and Hip Surgical Robotic Procedures Forecasts 45 2.3.2 Hip and Knee Orthopedic Surgical Robot Market Segment Forecasts 56 2.3.3 Consequences of Mal-Positioning 56 2.4 Knee and Hip Surgical Robot Regional Analysis 57 3. KNEE AND HIP SURGICAL ROBOT PRODUCTS 60 3.1 Stryker Mako RIO® Robotic Arm 60 3.1.1 Stryker MAKOplasty ® Robotic Arm Hip Replacement Solution 62 3.1.2 Stryker MAKOplasty® Surgical Robotic Total Hip Arthroplasty 64 3.1.3 Stryker MAKO Surgical Knee Replacements 70 3.1.4 Stryker’s Mako Total Knee Application Receives FDA Clearance 72 3.1.5 Stryker Knee and Hip Surgical Robot Products Benefits 74 3.1.6 Stryker / Mako 75 3.2 Omni OMNIPlasty Robotic Surgery 79 3.2.1 OMNIPlasty Total Knee Replacement Procedure 79 3.2.2 OMNIBotic™ Surgery Provides Increased Accuracy 81 3.2.3 OMNIBotics Bone Morphing 82 3.2.4 OMNIBotics Virtual Implant Planning 83 3.2.5 Omni NanoBlock 84 3.3 Smith & Nephew Navio 85 4. KNEE AND HIP SURGICAL IMPLANT COMPANY DESCRIPTIONS 90 4.1 Orthopedic Implant Surgical Companies 90 4.2 DePuy Synthes / Johnson & Johnson 90 4.2.1 Depuy Knee Replacement System 91 4.3 Stryker® Knee Replacement System 91 4.4 Zimmer Biomet 92 4.5 Smith&Nephew 94 4.5.1 Smith & Nephew Knee Implant Systems 97 4.5.2 Smith & Nephew Hip Implant Systems 97 4.5.3 Smith & Nephew Bearing Surfaces 98 5. KNEE AND HIP SURGICAL COMPANY DESCRIPTIONS 99 5.1 Omni 99 5.2 Shenzhen Advanced Institute Spinal Surgical Robot 101 5.3 Smith & Nephew 102 5.3.1 Smith & Nephew Revenue 103 5.3.2 Smith & Nephew Navio 105 5.4 Stanmore 105 5.5 Stryker / MAKO Surgical 107 5.5.1 Stryker Business Segment Operations 108 5.5.2 Stryker Revenue 109 5.5.3 Stryker Hip Recall: $1.4 Billion Settlement 109 5.5.4 Stryker Revenue 110 5.5.5 Stryker Results Of Operations 113 5.5.6 Stryker Segment Orthopaedics 115 5.5.7 Stryker Regional Revenue Segment 116 5.5.8 Stryker Robots 117 5.5.9 Stryker / MAKO Surgical 122 5.5.10 Stryker / Mako 123 5.6 THINK Surgical 131 5.6.1 THINK Surgical TPLAN™ 3D Planning Workstation 132 5.6.2 THINK Surgical TCAT™ Computer Assisted Tool 135 5.6.3 Think Surgical 137 5.6.4 Think Surgical Robodoc 138 5.7 Wright Medical Technology 138 5.7.1 Wright Revenue 139 5.7.2 Wright Medical Group NV Revenue 139 5.7.3 Wright Medical Group N.V. Revenue for 2015 Third Quarter 141 5.7.4 Wright / Tornier 146 5.8 Zimmer Biomet 147
List of Table and Figures Figure ES-1 13 Stryker MAKO Surgical Robots 13 Table ES-2 14 Knee and Hip Surgical Robot Market Driving Forces 14 Table ES-3 15 Innovative Knee and Hip Surgical Robot Features 15 Figure ES-4 18 Orthopedic Surgical Robot and Robotic Surgical Assist Devices, Market Segments, Dollars, 2015 18 Figure ES-5 20 Orthopedic Surgical Robots and Surgical Assistive Robots Market Forecasts, Dollars, Worldwide, 2016-2022 20 Table 1-1 24 Stryker Positions to Assist Hospital Capital Investment in Orthopedic Surgical Robots 24 Figure 1-2 26 Osteoporosis Impact on Hip 26 Table 1-3 27 Causes of Knee and Hip Deterioration 27 Figure 2-1 28 Stryker MAKO Surgical Robots 28 Table 2-2 29 Knee and Hip Surgical Robot Market Driving Forces 29 Table 2-3 30 Innovative Knee and Hip Surgical Robot Features 30 Figure 2-4 33 Orthopedic Surgical Robot and Robotic Surgical Assist Devices, Market Segments, Dollars, 2015 33 Table 2-5 34 Orthopedic Surgical Robot and Surgical Robot Assist Devices Market Shares, Dollars, Worldwide, 2015 34 Table 2-6 36 Orthopedic Surgical Robot Market Shares, and Installed Systems Units and Dollars, Worldwide, 2015 36 Table 2-7 38 Orthopedic Surgical Robot and Surgical Robot Assist Market Shares, Units and Dollars of Shipments,Worldwide, 2015 38 Table 2-8 39 Medical Surgical Robot Joint Reconstruction and Joint Replacement Market Installed Systems, and Units and Dollars of Shipments, Worldwide, 2015 39 Figure 2-9 43 Orthopedic Surgical Robots and Surgical Assistive Robot Market Forecasts, Dollars, Worldwide, 2016-2022 43 Table 2-10 44 Orthopedic Surgical Robot and Assistive Surgical Robot Market Segment Forecasts, Dollars, Worldwide, 2016-2022 44 Table 2-11 46 Hip, Knee, and Other Orthopedic Surgical Implant Market Segment Forecasts Units, Dollars, and Dollars per Unit, United States and Worldwide, 2016-2022 46 Table 2-12 47 Knee Orthopedic Surgical Implant Market Segment Forecasts, Units, Dollars, and Dollars per Unit, United States and Worldwide, 2016-2022 47 Table 2-13 48 Hip Orthopedic Surgical Implant Market Segment Forecasts, Units, Dollars, and Dollars per Unit, United States and Worldwide, 2016-2022 48 Table 2-14 49 Other Orthopedic Surgical Implant Market Segment Forecasts, Units, Dollars, and Dollars per Unit, United States and Worldwide, 2016-2022 49 Table 2-15 50 Hip, Knee, and Other Orthopedic Surgical Implant Market Segment Forecasts Dollars, Worldwide, 2016-2022 50 Figure 2-16 51 Knee Implants Market Forecasts, Dollars, Worldwide, 2016-2022 51 Figure 2-17 52 Hip Implants Market Forecasts, Dollars, Worldwide, 2016-2022 52 Figure 2-18 53 Other Implants Market Forecasts, Dollars, Worldwide, 2016-2022 53 Figure 2-19 54 Orthopedic Implants Market Forecasts, Dollars, Worldwide, 2016-2022 54 Table 2-20 58 Orthopedic Surgical Robot Regional Market Segments, Dollars, 2015 58 Table 2-21 59 Orthopedic Surgical Robot Regional Market Segments, Dollars, 2015 59 Figure 3-1 61 Stryker Mako Advanced RIO® Robotic Arm 61 Figure 3-2 62 Stryker MAKOplasty ® Robotic Arm Solution 62 Figure 3-3 63 Stryker MAKOplasty Hip Arthroplasty 63 Figure 3-4 64 Stryker MAKOplasty Hip Arthroplasty 64 Table 3-5 65 Stryker MAKOplasty® Surgical Robotic Total Hip Arthroplasty Features 65 Figure 3-6 66 Stryker Hip Joint Kinematics 66 Figure 3-7 67 Stryker RIO Robotic Arm Interactive Orthopedic System 67 Figure 3-8 68 Stryker MAKOplasty 68 Figure 3-9 69 Stryker Mako RESTORIS Hip System Components 69 Table 3-10 Stryker Mako Diverse Family of RESTORIS® Hip Implant Systems 70 Figure 3-11 71 MAKO Surgical Maker Of Robots To Assist In Knee Replacements 71 Figure 3-12 73 Stryker Mako Robotic Stations for Surgery Planning and Bone Cutting 73 Figure 3-13 74 Stryker Knee and Hip Surgical Robot For Bone Cutting 74 Figure 3-14 75 Stryker Knee Surgical Robot Precision Cutter Decreases Need For Bone Resurfacing 75 Figure 3-15 77 Stryker Mako Surgical Preoperative and Post Operative Knee Surgery Images 77 Table 3-16 78 Stryker Mako Surgical Robot Knee Arthroplasty Benefits 78 Figure 3-17 80 Omni OMNIBotics Station 80 Figure 3-18 81 OMNI Life Science OMNIBoics 81 Figure 3-19 82 OMNIBotic Procedure Bone Morphing 82 Figure 3-20 83 OMNIBotics Bone Morphing Femur Planning Technology 83 Figure 3-21 84 Omni NanoBlock 84 Figure 3-22 85 Smith & Nephew Navio Surgical System 85 Figure 3-23 86 Smith & Nephew NAVIO Surgical Partial Knee Robotic Assist System 86 Table 3-24 87 Smith & Nephew Navio Assisted Robotic Surgery Benefits 87 Table 3-25 88 NAVIO Robotics Unicondylar Knee Replacement Functions 88 Table 4-1 93 Zimmer Biomet Musculoskeletal Healthcare Offerings 93 Figure 4-2 94 Smith & Nephew Product Line 94 Figure 5-1 100 Omni OMNIBotics Station 100 Figure 5-2 102 Smith & Nephew Laser Surgical Instrument 102 Figure 5-3 106 Stanmore Bone Implant Hydroxyappatite Collars 106 Figure 5-4 118 Stryker Joint Implants 118 Figure 5-5 119 Stryker Patient Specific Pre-Operative Planning 119 Figure 5-6 120 Stryker Patient Specific Pre-Operative Planning 120 Table 5-7 120 Stryker Better Fit Orthopedics 120 Table 5-8 121 Stryker Osteoarthritis Affects Compartments Of The Knee 121 Figure 5-9 122 Stryker / MAKO Surgical RIO Robotic Arm Interactive System 122 Figure 5-10 129 MAKO Surgical Restoris 129 Figure 5-11 132 THINK Surgical TPLAN™ 3D Planning Workstation 132 Figure 5-12 133 Think Surgical TSolution 510K Clearance 133 Figure 5-113 133 THINK Surgical TPLAN™ Workstation 133 Figure 5-14 135 THINK Surgical TCAT™ Computer Assisted Tool 135 Figure 5-15 137 Think Surgical Planning 137 Figure 5-16 138 Think SurgicalRobodoc 138
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