Total Knee Replacement Market Size By Product (Primary Knee Replacement Systems, Revision Knee Replacement Systems, Partial Knee Replacement Systems), By Device Type (Three-compartmental Knee Implants, Bicompartmental Knee Implants, Unicompartmental Knee Implants), By Component (Femoral, Tibial, Patellar), By Implant Type (Fixed-Bearing Implants, Mobile-Bearing Implants, Medial Pivot Implants), By Design (Cruciate Retaining, Posterior Stabilized Design), By Surgery Type (Traditional Surgery Type, Technology Assisted Surgery Type) By Fixation Material (Cemented, Cementless, Hybrid), By Material (Metal-on-plastic, Ceramic-on-plastic, Ceramic-on-ceramic, Metal-on-metal), By Polyethylene Inserts (Conventional Polyethylene Inserts, Highly Cross-Linked Polyethylene Inserts, Antioxidant Polyethylene Inserts), By End-use (Hospitals, Ambulatory Surgical Centers), COVID19 Impact Analysis, Regional Outlook, Application Potential, Competitive Market Share & Forecast, 2021– 2027
Published Date: May 2021 | Report ID: GMI2804 | Authors: Sumant Ugalmugle, Rupali Swain
Total Knee Replacement Market size was valued at around USD 7.8 billion in 2020 and is expected to grow at a CAGR of over 6% from 2021 to 2027. The rising prevalence of osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis will offer several market growths opportunities.
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Additionally, knee arthroplasty has offered an opportunity for key players operating in the market that is mostly driven by the low satisfaction levels of patients receiving total knee replacement. Thus, to cater to this increasing need, manufacturers have started utilizing various biomaterials for increased strength. In addition to this, knee replacement procedures are high in demand owing to increasing success rates, technological advancements, and easy availability of durable and better-quality implants.
Total knee replacement system or total knee arthroplasty procedures are the most common orthopedic surgery that comprises replacing the articular surfaces of the knee joint with highly cross-linked polyethylene plastic and smooth metal. The total knee replacement surgery involves the removal of the end of the femur & lower leg bone and the replacement with artificial material. The patients suffering from severe knee joint ailments are associated with progressive pain and impaired function may be candidates for total knee replacement.
However, the high cost associated with the total knee replacement surgery may adversely affect the market expansion. Knee implants can make up 20% to 40% of the cost of a therapy, which makes a significant impact on the procedure margins, especially in today's capitated reimbursement environment. The industry growth can be hampered in emerging economies having relatively low-income levels due to high costs associated with total knee replacement procedures.
|Market Size in 2020:||USD 7,819.5 Million|
|Forecast Period:||2021 to 2027|
|Forecast Period 2021 to 2027 CAGR:||6.0%|
|2027 Value Projection:||USD 12,528.7 Million|
|Historical Data for:||2016 to 2020|
|No. of Pages:||966|
|Tables, Charts & Figures:||2,505|
|Segments covered:||Product, Device Type, Component, Implant Type, Design, Surgery Type, Fixation Material, Material, Polyethylene Inserts and End-use|
|Pitfalls & Challenges:|
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The utilization of advanced technology within the devices has increased the cost of the total knee replacement procedures that will be a restraining factor affecting the market value. However, the government in certain developing countries including India is undertaking several initiatives to reduce the prices of the procedures.
The emergence of the COVID-19 pandemic is an unprecedented public health concern and has negatively impacted the total knee replacement market. Preserving essential health care resources was prioritized in the wake of COVID-19, starting from mid-March 2020, wherein the surgeons were instructed to perform only the essential surgical operations. For instance, as per the Journal of Arthroplasty, an estimated 30,000 primary and 3,000 revision knee replacement surgeries were canceled every week in the early 2020.
These numbers showcase the profound impact of COVID-19 on knee replacement surgeries. However, intensive efforts are being undertaken by several healthcare authorities, hospitals, and surgeons to restore the flow of total knee arthroplasty procedures to pre-pandemic levels. ERAS programs (Enhanced Recovery after Surgery) have been developed to shorten hospital stay, morbidity, and surgical complications. Furthermore, with restoring the regular operating volume of surgeries, there will be significant patient inflow due to postponing and cancelation of surgeries earlier. Hence, such changes in surgical practices are poised to help in restoring the surgical volume post-COVID-19 pandemic.
Rising infection rates contributing to an increase in knee revisions will drive the total knee replacement market revenue
Increasing infection rates contributing to the rising knee revisions is one of the prime factors fuelling the market demand. Total knee replacement is classified into four main types such as type 1 (early post-operative), type 2 (late chronic), type 3 (acute hematogenous) and type 4 (positive intraoperative cultures but clinically unapparent infection). The rate of infections associated with total knee replacement has been increasing gradually over the years. For instance, according to the American Academy of Orthopedic Surgeons, serious complications such as infections occur in over 2% of patients. The infections most often occur in the wound site or around the prosthesis and happen during the hospital stay or after discharge of a patient.
The existing standard of care for late chronic infection is a two-stage revision arthroplasty. It involves the removal of the implant and placement of an antibiotic-impregnated cement spacer. Additionally, a course of intravenous antibiotics is offered, and a delayed second-stage revision is conducted. Thus, the continuously increasing rate of post-surgical infections has significantly boosted the demand for total knee replacement procedures that in turn will uplift the product adoption rate.
Numerous benefits offered by primary knee replacement system will stimulate the industry expansion
Primary knee replacement systems segment dominated 83% of the total knee replacement market share in 2020 led by the multiple advantages such as improved mobility, high satisfaction rates, and pain relief among others. Primary knee replacement surgery uses implants made from ceramic, metal, or high-density polyethylene to replace a damaged knee joint. The total knee replacement procedures are successful and provide increased safety with high accuracy. The development of non-invasive surgical procedures that causes minimum pain and offer precise clinical outcomes will drive the demand for these devices.
Growing prevalence of tricompartmental arthritis will spur the business revenue with high product acceptance
The three-compartmental knee implants segment is expected to significantly expand at a 5.7% growth rate through 2027 impelled by the rising prevalence of severe tricompartmental knee osteoarthritis resulting in the increasing number of total knee arthroplasty procedures. Three-compartmental knee devices help in relieving pain while restoring the function of the knee post total knee surgery. Surgeons are significantly giving preference to these implants attributed to around 90% of people undergoing total knee surgery experience reduced pain levels and increases mobility. This high success rate further translates to increased product acceptance and augments patient retention.
Increasing preference for a femoral component in knee arthroplasty procedures will enhance the total knee replacement market growth
Femoral segment exceeded USD 3.9 billion in 2020 on account of the long-lasting results, decreased chances of osteolysis, and reproduces the anatomy of the distal femur. This component is available in several ceramic or metal options and is made up of cobalt-chromium alloys that are considered the most durable. The femoral component curves around the end of the femur so the kneecap can move up and down easily against the bone as the knee bends and straightens. In addition, it has an asymmetrical anterior flange identical to the patellar grove, which is convenient to prevent adjacent dislocation of the patella.
Rising demand for fixed-bearing implants will positively impact the industry revenue
Fixed-bearing implant segment in the total knee replacement market accounted for more than USD 5.6 billion in 2020 owing to the less expensive alternative, allows the patient to stretch the knee, and provides low contact stress. The clinical studies have demonstrated that fixed-bearing total knee arthroplasty shows a promising clinical success over time in relatively inactive elder people. The fixed bearing design shows excellent survival rates of up to 95% in a 10-year follow-up. Moreover, lower infection rate, no revisions, and reduced dislocations have positively influenced the product acceptance.
Benefits of posterior stabilized design in knee surgery will augment the product adoption
The total knee replacement market for posterior stabilized design segment valued at USD 3.9 billion in 2020 and is projected to witness 6.2% growth rate till 2027 propelled by the advantages posterior stabilized design offers that includes an improved range of motion and a more stable component interface. In the posterior stabilized design, the cruciate ligaments are removed and parts of the implant substitute for the posterior cruciate ligament. Furthermore, this design is technically less complex, avoids anterior translation in weight bearing conditions, and offers better flexion to the knees. Thus, player in the market focuses on developing such advanced implants in total knee arthroplasty with potential advantages comprising greater posterior femoral rollback and less polyethylene sliding wear.
High acceptance of traditional knee replacement surgery among physicians will fuel the market progression
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The traditional surgery type segment dominated more than 88% of the total knee replacement market share in 2020. This high segmental share is attributed to the process involving large incision that offers the surgeons a wide view to properly align the implant & bone and ensures durability & long life of the implant. For instance, around 70% to 80% of the knee replacement procedures are performed using the traditional approach. During this traditional knee arthroplasty surgery, the kneecap is turned over 180 degrees, providing the surgeon complete access to the point where the femur and tibia meet.
Growing advantages offered by cemented fixation in high survival rate of implant will accelerate the revenue growth
The total knee replacement market for cemented segment is expected to observe a 5.8% CAGR by 2027. The cemented fixation materials are generally used in patients with osteoporosis as it allows surgeons to attach prosthetic joint components to a moderately porous bone. Bone cement dries within 10 minutes of application that gives assurity to patients and surgeons regarding firm placement of prosthetics. The quick drying nature of the cement enables surgeons to immediately check the bond strength and is widely recommended for patients with osteoporosis. Moreover, the survival rate is up to 99% for cemented total knee arthroplasty procedures. Cementation provides an easier surgical technique that is useful for the delivery of local antibiotics and produces a barrier able to prevent the diffusion of wear particles, thereby fostering the segment growth in the coming years.
Technological advancements in metal-on-plastic knee replacement devices will result in the exponential product demand
The metal-on-plastic segment in the total knee replacement market accounted for more than USD 4.6 billion in 2020 owing to the cost-effective nature of these implants and a long track record for implant life span & safety. The most frequently used metals include titanium, cobalt-chromium, zirconium, and nickel. Metal-on-plastic implants feature a metal femoral component that rides on a polyethylene plastic spacer attached to the tibial component. Numerous advantages including technological developments and reduced post-surgical complications are enhancing its acceptance. Hence, it is the broadly used artificial knee component material preferred by surgeons due to its benefits.
Rising usage of highly cross-linked polyethylene inserts will spur the total knee replacement market demand
The highly cross-linked polyethylene inserts segment is slated to witness around 6% CAGR through 2027. These polyethylene inserts feature a polymer with increased cross-linking that improves the stability of the material and therefore offers increased strength. The highly cross-linked polyethylene inserts reduce the risk of osteolysis associated with conventional inserts and reduce the need for revision surgery. According to the recently published article, these inserts have a high success rate in knee replacement surgery and provides improved clinical outcomes. Additionally, cross-linked polyethylene inserts reduce the chances of bone degeneration as compared to the other inserts, thereby promoting the product demand during the forecast timeline.
Increasing hospitalizations with severe knee arthritis and osteoporosis will uplift the industry value
Hospitals segment is projected to exceed USD 9.9 billion by 2027. Availability of advanced technologies and presence of trained professionals in hospitals will increase the preference for surgeries being carried out in hospitals. Furthermore, intensive post-surgery care provided in hospitals will increase the patient inclination towards these healthcare settings. Therefore, growing hospital admissions with knee arthritis and demand for joint replacement procedures along with the availability of highly trained professionals impels the demand for knee implants in these facilities.
High acceptance of technologically advanced implants in the North America region will offer unprecedented growth opportunities
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U.S. total knee replacement market market is anticipated to expand at 4.8% CAGR through 2027 led by the several factors including increased government spending on healthcare and medical devices along with the presence of established manufacturers. According to data provided by the Agency for Healthcare Research and Quality, in the U.S., over 754,000 knee replacements were performed in 2017. In the U.S., knee arthroplasty surgeries are commonly performed in elderly people, but it’s also become popular in middle age owing to the availability of high-quality surgical devices and painless procedures.
Germany region dominated the Europe market and accounted for USD 370 million in 2020. The high revenue share is credited to the growing geriatric base coupled with the rising prevalence of diseases such as osteoporosis and arthritis. In 2017, Germany was among the countries with the highest rates for knee replacement. Osteoarthritis is the most prevalent chronic joint disease and people aged 65 or older suffer from some or the other form of OA.
Notable industry players are focusing on a new product launch that will boost the market growth
Some of the major companies operating in the market are Amplitude Ortho (Amplitude Surgical), B Braun Melsungen AG, ConforMIS Inc., Corin Group, Johnson & Johnson (Depuy Synthes), DJO Global, Exactech Inc., Mathys Ltd Bettlach, Medacta International, Waldemar LINK, and Zimmer Biomet among others. These leading participants are implementing advanced technologies to cater to the large unmet needs of the consumers.
Recent industry developments:
- In July 2020, Corin Group received the U.S. FDA approval for OMNIBotics software update, enabling the option to incorporate Unity Knee, total knee implants with robotic-assisted surgery in the U.S. This approval helped the company to strengthen its product portfolio in the U.S.
- In October 2019, DePuy Synthes announced the launch of the ATTUNE Cementless Knee in selected marketplace across the globe. ATTUNE Cementless Knee provides better stability and features novel cementless technology. This launch helped the company to introduce innovative products, further offering a competitive edge.
Total knee replacement market research report includes an in-depth coverage of the industry with estimates & forecast in terms of revenue in USD and volume in Units from 2016 to 2027, for the following segments:
Market, By Product, 2016 - 2027 (USD Million and Units)
- Primary Knee Replacement Systems
- Revision Knee Replacement Systems
- Partial Knee Replacement Systems
Market, By Device Type, 2016 - 2027 (USD Million and Units)
- Three-compartmental Knee Implants
- Bicompartmental Knee Implants
- Unicompartmental Knee Implants
Market, By Component, 2016 - 2027 (USD Million and Units)
Market, By Implant Type, 2016 - 2027 (USD Million and Units)
- Fixed-bearing Implants
- Mobile-bearing Implants
- Medial Pivot Implants
Market, By Design, 2016 - 2027 (USD Million and Units)
- Posterior Stabilized Design
- Cruciate Retaining
Market, By Surgery Type, 2016 - 2027 (USD Million and Units)
- Traditional Surgery Type
- Technology Assisted Surgery Type
Market, By Fixation Material, 2016 - 2027 (USD Million and Units)
Market, By Material, 2016 - 2027 (USD Million and Units)
Market, By Polyethylene Inserts, 2016 - 2027 (USD Million and Units)
- Conventional Polyethylene Inserts
- Highly Cross-Linked Polyethylene Inserts
- Antioxidant Polyethylene Inserts
Market, By End-Use, 2016 - 2027 (USD Million and Units)
- Ambulatory Surgery Centers
The above information is provided for the following regions and countries:
- North America
- Czech Republic
- Asia Pacific
- South Korea
- New Zealand
- Latin America
- Middle East & Africa
- South Africa
- Saudi Arabia
Frequently Asked Questions (FAQ) :