Extremity orthopedic implants — the shoulder arthroplasty, elbow, wrist, ankle, and foot and toe implant systems representing the growing market beyond hip and knee replacement — are experiencing above-average growth as aging populations' extremity pathology volume grows and surgical technique refinement expands appropriate indications, with the Orthopedic Implants Market reflecting extremities as the highest-growth orthopedic implant market segment.

Reverse total shoulder arthroplasty growth — the reverse shoulder implant design providing shoulder function through deltoid muscle-driven mechanics in patients with massive rotator cuff tears and glenohumeral arthritis who would not benefit from anatomic total shoulder — has expanded shoulder replacement indications dramatically. Reverse shoulder arthroplasty now representing over sixty percent of total shoulder arthroplasty volume in many practices demonstrates the indication expansion that this design has enabled. DePuy Synthes Delta Xtend, Stryker Restore RSA, Zimmer Biomet RSP, and Exactech Equinoxe compete in this fast-growing shoulder implant market.

Total ankle replacement resurgence — the third-generation total ankle replacement designs (STAR, Inbone, Infinity, Zenith) providing improved outcomes compared to failed first-generation designs that converted to fusion — have renewed interest in ankle arthroplasty as an alternative to ankle fusion for end-stage ankle arthritis. Foot and ankle specialists adopting total ankle replacement offer motion-preserving arthritis treatment that the large end-stage ankle arthritis population is increasingly aware of as an alternative to fusion.

Shoulder instability and rotator cuff repair implants — suture anchors, augmentation patches, and superior capsule reconstruction implants for the vast rotator cuff and shoulder instability market — represent the soft tissue repair implant market that complements arthroplasty in shoulder surgery volume. Arthrex, Smith+Nephew, and Stryker compete vigorously in the shoulder soft tissue repair market that represents the highest volume shoulder surgical implant category.

Do you think total ankle replacement will achieve adoption rates approaching total hip replacement within the next decade as implant designs improve and surgeon experience broadens?

FAQ

What is reverse total shoulder arthroplasty? Reverse shoulder arthroplasty flips the normal ball-and-socket relationship: the ball (glenosphere) is attached to the glenoid (shoulder socket) and the socket (polyethylene cup) attaches to the humerus; this design shifts the center of rotation, lengthening the deltoid muscle's lever arm to enable shoulder elevation using only the deltoid when the rotator cuff is absent or non-functional; FDA-cleared for rotator cuff tear arthropathy, failed anatomic shoulder replacement, and some complex fractures; represents sixty-plus percent of shoulder arthroplasty volume in the US.

What are third-generation total ankle replacement systems? Third-generation total ankle replacement systems include STAR (Scandinavian Total Ankle Replacement — Stryker), Inbone/Infinity (Wright Medical/Stryker), Zenith (Corin), Vantage (Exactech), and Salto Talaris (Tornier/Stryker); design improvements include better bone preparation instrumentation, improved implant geometry for motion and stability balance, and cementless fixation with porous ingrowth; survivorship of ten to fifteen years is achievable in appropriate patients; ankle replacement offers motion preservation versus the functional limitations of ankle fusion.

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