Stryker, Johnson & Johnson’s DePuy Synthes and Zimmer Biomet are the largest orthopedic device companies.With elective procedure numbers rebounding after the darkest days of the COVID-19 pandemic, sales at most of the world’s largest orthopedic device companies increased by double-digit percentages during their most recent fiscal years.
Here are the world’s 10 largest orthopedic device companies, ranked by ortho business revenue pulled from their most recent annual reports:
|Largest orthopedic device companies
|Annual revenue (% change)
|$17.1 billion (+19.2%)
|Johnson & Johnson – DePuy Synthes
|$8.6 billion (+10.6%)
|Locations: Raynham, Massachusetts.; West Chester, Pennsylvania; Warsaw, Indiana; Palm Beach Gardens, Florida
|Zimmer Biomet (minus ZimVie spinoff)
|$6.8 billion (+11.6%)
|Medtronic – Cranial & Spinal Technologies
|$4.5 billion (+3.9%)
|Locations: Memphis, Tennessee; Louisville, Colorado
|Smith+Nephew (Orthopaedics + Sports Medicine)
|$3.7 billion (+14.3%)
|Enovis (Formerly Colfax’s Medical Technology segment, including DJO)
|$1.4 billion (+27.3%)
|$1.1 billion (+8%)
|$958 million (+21.4%)
|ZimVie (Spine business)
|$540 million (+2.1%)
|$465 million (+14.2%)
And here is more about how the world’s biggest orthopedic companies are doing:
With a strong order book for capital equipment and implant sales momentum, Stryker (NYSE:SYK) recently boosted its revenue projections for 2022, predicting organic sales growth between 8% and 9% for the year. The world’s largest orthopedic device company, however, scaled back its earnings range amid the foreign currency exchange environment. Like most manufacturers, Stryker said its supply chain is presenting challenges, too.
“We continue to invest in R&D at a healthy ratio of sales, demonstrating our continued focus on new product pipelines,” CEO Kevin Lobo said during Stryker’s Q2 2022 earnings call on July 26. Company officials are also excited about the synergies that Stryker is already realizing from its $3.1 billion acquisition of Vocera Communications, a provider of digital care coordination and communication offerings including the hands-free Vocera Smartbadge.
At DeviceTalks Boston in May, four Stryker executives shared how the company thinks differently about medical product development and how health care providers and patients will ultimately use them.
2. Johnson & Johnson – DePuy Synthes
DePuy Synthes officials see the Johnson & Johnson (NYSE: JNJ) business better enabling the personalization of orthopedic surgery, creating better outcomes. That was a big takeaway when five J&J executives spoke about the shift toward digital at DeviceTalks Boston in May. “We’re not adopting technology just for technology’s sake. We’re adopting technology because it’s meeting clear, unmet needs,” said Rajit Kamal, worldwide president, sports medicine/shoulder reconstruction at DePuy Synthes.
Recent DePuy Synthes wins include the Inhance system receiving FDA clearance for total shoulder arthroplasty and adding the Cementless Fixed Bearing knee and Medial Stabilized knee to its Attune Knee portfolio. The company is betting it can compete in the ortho surgical robotics space with its Velys system, which could help reduce the physical burden of orthopedic surgery. Earlier this year, DePuy Synthes acquired Tennessee-based CrossRoads Extremity Systems and its range of procedure-specific, sterile-packed implants and instrumentation systems cleared for lower extremity indications.
3. Zimmer Biomet
Zimmer Biomet (NYSE:ZBH) has had a great deal of news over the past year. It spun off its dental and spine business as ZimVie in March. ZB has also introduced new ortho surgical offerings based on AI and mixed reality. They are also pioneering smart ortho device implants, being the first to offer smart knee implants.
In early August, Zimmer Biomet reported second-quarter results that handily beat the consensus forecast on Wall Street, upping its full-year forecast for 2022. A host of U.S. companies in medtech and other industries are reporting macroeconomic headwinds related to foreign exchange rates, inflation, supply chain challenges and more. ZB officials, however, appear to be making a bet that they can innovate their way out of rough economic seas. CEO Bryan Hanson pretty much said it during the company’s Q2 earnings call: “We believe our focus on innovation and the transformation of our business continues to position us well for long-term growth and continued delivery for our shareholders.”
4. Medtronic – Cranial & Spinal Technologies
In the spine space, Medtronic (NYSE:MDT) had record quarters with its Mazor robotics system and StealthStation navigation system, CEO Geoff Martha said during the medtech giant’s Q4 earnings call in May. “The ongoing launch of our Catalyft expandable titanium interbody system and the rollout of our enabling technologies continues to differentiate us in spine,” Martha said. Recent spine wins for Medtronic include FDA 510(k) clearance and breakthrough device designation for its LigaPASS 2.0 ligament augmentation system for spine surgery and FDA clearance of its UNiD spine analyzer v4.0 planning platform. On the flip side, the spine business was facing slowing distributor purchases in China ahead of a potential national volume-based tender as the Chinese government seeks to rein in healthcare costs.
The most recent earnings report from Smith+Nephew (NYSE: SNN) showed an overall loss in revenue, and its orthopedics business experienced a revenue decline of 1.1% in Q2, noting supply chain challenges and a new hip and knee volume-based procurement program in China. However, company officials say they have a strategy to grow the orthopedics business.
“Orthopedics continues to be held back by execution and supply chain challenges,” CEO Deepak Nath said in a recent earnings release. “In the last three months, I have reviewed the business and, together with the team, we have developed a comprehensive plan to drive better execution at pace.”
The plan includes initiatives such as driving operational benefits in orthopedics and transforming the business. Smith+Nephew also recently invested in its orthopedics business by building a new $100 million manufacturing facility in Malaysia.
Enovis (NYSE:ENOV) — the parent company of DJO Global — completed acquisitions and spinoffs this year to strengthen its position in the orthopedic device industry.
In May, the company acquired assets of Outcome-Based Technologies‘ hip and knee bracing portfolio, adding the Excyabir hip brace and CryoKnee knee braces to its DonJoy bracing brand.
Enovis also completed the acquisition of Insight Medical and its FDA-cleared Arvis augmented reality platform for hip and knee replacement surgery earlier this month.
In early August, the company reported Q2 results that beat The Street on earnings but missed on revenue. It joined the host of medtech companies scaling back earnings projections for the year amid macroeconomic headwinds.
NuVasive (Nasdaq:NUVA) remains on track to grow its revenue more than 6% in fiscal 2022, and its orthopedic technology is expected to drive the growth. However, the company reduced its EPS guidance in early August amid the macroeconomic pressures that many device companies presently face.
Early this year, NuVasive announced that its Attrax Putty had received FDA 510(k) clearance for expanded indications in thoracolumbar interbody spine surgery. NuVasive officials say the Attrax Putty is the first synthetic bone graft with U.S. FDA indications for thoracolumbar interbody fusion. The company also describes Attrax as a relatively inexpensive biologic option. The spine surgery tech company in July released some positive data around Attrax and Modulus XLIF, a porous titanium interbody implant, when it came to lateral lumbar interbody fusions. Nuvasive said the fully porous architecture provided a favorable environment for bone in-growth and supported a less invasive XLIF procedure that was clinically and economically beneficial.
In April, NuVasive reported successful data that demonstrated significantly greater success rates with its Simplify disc at the 24-month follow-up compared to anterior cervical discectomy and fusion when used for two-level cervical total disc replacement. The implant allows for enhanced visualization through MRI postoperatively compared to alternative devices.
8. Globus Medical
Globus Medical (NYSE:GMED) during its second quarter delivered on a needed rebound after a Q1 earnings miss and a surprise CEO transition, said BTIG analyst Ryan Zimmerman as he kept his Buy rating on GMED shares. “To some extent, investors are flying blind in terms of where GMED is heading longer-term strategically (and how it reaccelerates core spine), but at the same time, we expect GMED to drive growth through competitive rep hires, pull through from Enabling Technology, and new product introductions; all of which are expected to pick-up as we move into FY23.”
Globus Medical reaffirmed its full-year 2022 guidance of $1.025 billion in net sales and non-GAAP EPS of $2.10.
The company reached another milestone in its business earlier this year with the first shipments of its Excelsius3D imaging system. Globus Medical announced the first procedures using the system in May. The mobile X-ray system is designed for 2D fluoroscopy, 2D digital radiography and 3D imaging of adult and pediatric patients. When combined with its ExcelsiusGPS, the image-guided robotic navigation improves implant placement accuracy.
Early feedback was “extremely positive,” CEO Dan Scavilla said in May. He called the imaging system “an excellent example of Globus Medical’s innovation engine, which will drive momentum and provide a platform for continued growth as we progress in 2022 and beyond.”
9. ZimVie (spine business)
ZimVie reported $540 million worth of spine sales for calendar year 2021, while the spinoff’s other business — dental — did $469 million for the year.
CEO Vafa Jamali earlier this year said there are opportunities for growth in the spine space, but the efforts could take years to accomplish. Two examples of the growth opportunity are cervical disc replacement and pediatric scoliosis treatments.
The former Medtronic executive also set his sights on “some operational issues to fix within our spine business,” saying ZimVie would exit several countries where the business has been unprofitable.
“That opens up a ton of management time and energy. It just frees us up. … We’re doing a lot of work with our inventory and how we manage our sets. So this really gives us a chance to sort of stabilize and then to grow from there.” Jamali said. “We’re going to have a year of resetting and sorting out all these pieces. And then you’ll see us accelerate on some of the more innovation-focused areas and goals.”
Facing greater than anticipated foreign exchange headwinds, ZimVie announced during its Q2 earnings report that it is reducing its full-year revenue forecast to $915 to $930 million versus prior guidance of $1 billion.
Orthofix (Nasdaq:OFIX) named Kimberley Elting as its global orthopedics business president in April. Eluting was previously chief legal and development officer and held other leadership roles in the areas of regulatory and quality, business development and corporate communications at the orthopedic implant purveyor.
In May, Orthofix said it received FDA premarket approval (PMA) for its AccelStim bone healing therapy device. In July, the company announced a licensing partnership with LimaCorporate to combine the limb-lengthening technology of Orthofix’s Fitbone intramedullary nail system with LimaCorporate’s proprietary, patient-specific, 3D-printed pelvic fixation device. The company most recently launched its Virtuos Lyograft autograft substitute and marked the first clinical use.
The company in early August lowered its financial outlook for the year. It now anticipates fiscal 2022 net sales to be in the range of $455 million to $465 million, down from its previous outlook of $475 million to $490 million.
Said CEO Jon Serbousek: “We had solid operational execution, despite the challenges that macro headwinds continue to present, including continued hospital staffing shortages, complex spine procedure softness, and patients deferring care due to economic pressures. In addition, currency fluctuations during the quarter dampened reported revenue results.”
Managing Editor Jim Hammerand and Senior Editor Danielle Kirsh contributed to this story. This story originally ran on July 28, 2022. Updated Aug. 9 and 10 with news from Q2 earnings reports.