The worldwide joint-replacement implants market is expected to hit $20bn by 2022, according to a new report from Meddevicetracker. The growth is driven by the rising number of elderly patients, whose natural joints have been damaged by arthritis, and the rising prevalence of chronic diseases, such as obesity and diabetes, and sport-related injuries. But a look at the market and the three largest segments – shoulder, knee and hip replacements – show that new technological advancements and improved surgical techniques are increasingly making joint replacement surgeries an option for younger people as well. Here's an overview and key insights from two orthopedic surgeons on the current market and key growth drivers and limiters.

With hip and knee joint markets still registering slow to modest growth, orthopedic companies looking to add bulk to their bottom line through mergers and acquisitions have pursued two distinct directions – the extremities and emerging markets.

The European orthopedic implants and trauma products market consists of hip, knee, shoulder, and small joint reconstruction and replacements; fracture fixation and bone growth stimulation; bone graft substitutes and growth factors; and bone cements segments. "European Markets for Orthopedic Implants and Trauma Products", a report published in October 2004 by Windhover/Medtech Insight, surveys and forecasts these markets in France, Germany, Italy, Spain, and the UK. Within these countries there is considerable potential for new and innovative technologies such as bone graft substitutes and the use of resorbable implants in trauma. However, medical-based evidence must show added value and improvement in a patient's quality of life before such innovations will be broadly accepted. Meeting health care regulatory authorities' compliance criteria while not burdening health care payers with dramatic increases in reimbursement budgets is viewed as a major driving factor within Europe.

Zimmer's acquisition of Implex Corp. for slightly greater than $100 million is, in some respects, the natural culmination of a standing alliance between the two companies. But it's also interesting for the way in which it seems to embrace all of orthopedics' hot spots. Building on Implex's innovative Hedrocel biomaterial, Zimmer has already developed hip, knee, and shoulder implants, as well as trauma products, out of the collaboration, and has announced that seven development projects are underway. At the same time, this is also clearly a spine play: Implex had developed a line of spine products out of its material, which have already begun to be implanted in Europe and the US, and Zimmer said in announcing the deal that it intends to expand that spine business by incorporating it into Zimmer's own spine division.