Top 10 Orthopedic Device Firms

6. DJO Global

August 9, 2016

$1.1 Billion

Michael P. Mogul, President, CEO, and Director; Manager of DJOFL
Susan M. Crawford, Exec. VP, Chief Financial Officer, and Treasurer; Manager of DJOFL
Jeff Northern, Exec. VP, Global Quality and Operations
Steven Ingel, President, Global Bracing and Vascular
Stephen J. Murphy, President, International Commercial Business
Brady Shirley, President, DJO Surgical
Sharon Wolfington, President, Global Recovery Sciences


HEADQUARTERS:  Vista, Calif.

The CrossFit Games purport to find the “Fittest on Earth” by way of a remarkably strenuous test of the toughest athletes around the globe. According to CrossFit aficionados, the Ironman triathlons or the NFL “neglect to accurately test fitness.” Competitors in the CrossFit Games are rather challenged to perform a broad range of “functional movements,” the hallmark exercises of the CrossFit program, which require athletes to quickly move large loads long distances. Every CrossFit Games features a series of challenges completely unknown to competitors until directly before the competition—because apparently, lack of preparation permits a fair test of fitness.

About a week after its U.S. Food and Drug Administration clearance and launch last July, Compex Wireless USA, DJO Global’s latest wireless neuromuscular electronic stimulation (NMES) device, was featured at the 2015 CrossFit Games in Carson, Calif. The first-ever wireless NMES technology specifically designed to supercharge workouts and speed recovery, Compex Wireless USA elicits involuntary muscle contractions via electronic pulses to maximize muscular effort. Potential athletic benefits include increased muscle strength and density, larger muscle size, boosted speed, enhanced circulation, and speedier recovery times.

“Compex has been a key tool to enhance my performance since I started training,” said Josh Bridges, 2014 CrossFit Games competitor. “It allows me to activate all my muscle fibers, dig deeper, and ultimately get stronger for competition day. With the introduction of Wireless USA, I’m now able to have more freedom and increase the usage of NMES in my training.” Other notable athletes training the body electric include UFC fighter Chad Mendes, the NFL’s Steve Weatherford, and Ironman champion Andy Potts.

The company is no stranger to involvement in sports medicine; DJO’s DonJoy and DonJoy Performance brands have been integral to the performance of a number of famous athletes. You might remember New England Patriots quarterback Tom Brady’s season ending knee injury in 2008 as the result of a low tackle (which the NFL made a violation soon after that some call the “Tom Brady Rule.”) Three years later, Brady was hit in nearly the same manner, but this time wore a DonJoy Defiance knee brace, protecting him from another missed season.

“I’m glad I had a knee brace on. Those are scary, man, when you’ve been through those ones before. He got me in a good spot, and I’m glad the knee brace took the brunt of the force,” Brady said to WEEI sports radio following the near-injury. “Why I never wore a knee brace before, I have no idea. Why every quarterback doesn’t wear one on their left knee, I have no idea. It’s just so unprotected.”

San Francisco 49ers three-time Pro Bowl linebacker became the face of the DonJoy Performance DEFENDER line in June 2016. (Courtesy of DJO Global)
Other notable NFL athletes sporting DonJoy protective gear include recently retired Denver Broncos quarterback Peyton Manning, and three-time Pro Bowl San Francisco 49er’s linebacker NaVorro Bowman. Bowman recently became the face of DonJoy’s Defender line, following recovery from a torn MCL and ACL using the Donjoy A22 Knee Brace. “When I was unsure about recovery from knee injury in 2014, I put my trust in DonJoy to help me fully recover,” Bowman commented in June 2016. “As I go into the 2016 season, I know DonJoy Performance has me protected.”

Famous athlete advocates definitely kicked DonJoy products into the limelight, but star players are nothing without a team to support them. DonJoy represents just one portion of DJO’s largest moneymaker, its Bracing and Vascular segment. The division drew $526.3 million in sales in fiscal year 2015 (ended Dec. 31), accounting for 47.3 percent of the company’s total sales and 4.3 percent revenue bump from 2014. Total revenue followed suit and also experienced a rise in FY15, though didn’t quite perform as admirably as Bracing and Vascular—the $1.11 billion gained in 2015 was a 2.4 percent growth from the year prior.

DJO cited an account acquisition within its OfficeCare channel—which maintains an inventory of soft goods and other products at healthcare facilities—as the main cause for growth in its Bracing and Vascular Business. But halfway through FY15 DJO launched its DonJoy Performance line in retail, making the company’s sports medicine products available to consumers for the first time. The new offering definitely had a say in sales growth, and should continue the trend. The product line-up includes:
  • Bionic—bilateral polycentric hinges that fully stabilize the respective joint against lateral forces
  • Webtech—a silicone web surrounding and suspending the knee joint for pain management, shock dampening, and structural alignment
  • Trizone—compression and bracing combined in one sleeve, targeting the knee, calf, and elbow
  • Proform—provides compression, mild joint support, improved heat retention, and increased circulation/oxygenation
  • Defender Skin—an adhesive “second skin” to defend against cuts, scrapes, turf burns, and bruising
DJO’s Recovery Sciences segment develops products for pain management, rehabilitation, and physical therapy. Continued slow market conditions affecting Chattanooga rehabilitation, coupled with a shift in bone growth stimulation products from reimbursement to direct customers, caused the division to fall 0.8 percent, with 2015 sales of $156.2 million. Retail sales of the Compex electrostimulation devices, led by Compex Wireless USA’s release in mid-2015, compensated for part of that decline. Further, DJO ceased the manufacture, sale, and distribution of products from its Empi business (comprising of TENS devices for pain relief, and other electrotherapy and orthopedic products) as well as related domestic insurance billing operations. A difficult regulatory and compliance landscape, as well as decreasing reimbursement rates, led to the decision to discontinue the business. The termination brought about a $157.6 million loss in 2015, due to asset impairment charges, net income from Empi operations, severance, and other termination costs.

DJO Surgical manufactures and markets products within the company’s Surgical Implant division, which consists of knee, hip, shoulder, and elbow implants, as well as bone cement. In June 2015, DJO Surgical’s subsidiary Encore Medical L.P. acquired a number of bone cement product lines from Zimmer Biomet, including the Biomet Cobalt Bone Cement, Optivac Cement Mixing Accessories, SoftPac Pouch, and Discovery Elbow system. The purchase strengthened DJO Surgical’s position in the U.S. market—the business garnered $134.8 million in 2015, skyrocketing 34.7 percent from the previous year.

The sales bump can’t be entirely attributed to bone cement sales fortified by the acquisition of Zimmer Biomet’s product lines, however. DJO Surgical also introduced two landmark products during the year, both within its knee products portfolio. During the 2015 meeting of the American Academy of Orthopedic Surgeons, DJO Surgical unveiled the Exprt Precision System for highly proficient revision knee surgeons. The system’s compact design reduces turn times, minimizes waste, and contains implant design technology, with a cost of about 40-70 percent less than comparable systems. “The Exprt approach leads to efficient operations that save both time and money, while providing excellent early results,” C. Lowry Barnes, M.D., chairman of Orthopaedics at the University of Arkansas for Medical Sciences, said in a DJO press release. “My operating team especially appreciates the fact that only two pans of instruments are opened. I believe that I can speak for the entire Exprt design team when I say that we have met our goals in offering a high-value, high-quality revision knee system for the accomplished surgeon.”

Further strengthening the DJO Surgical’s knee portfolio was the launch of the EMPOWR 3D Knee in November 2015. It retains the articular surface design of the original 3D Knee, which has demonstrated success in giving patients stability, durability, strength, and range of motion. “Randomized trials show this robust design provides the same clinical results whether or not the posterior cruciate ligament is retained,” said Dr. Scott Banks, co-designer of the 3DKnee and professor of Mechanical & Aerospace Engineering at the University of Florida. “The design retains all these functional benefits in a system that is designed to optimally fit patients’ anatomy while giving surgeons more intraoperative flexibility and efficiency.”

These businesses (Bracing and Vascular, Recovery Sciences, and Surgical Implant) represent DJO Global’s U.S. revenue, which together drew $817.3 million in 2015 revenue and accounted for 73.4 percent of total sales. The company’s International sales took a hit in 2015 with sales of $296.3 million, dropping 8.9 percent from the previous year. Despite stronger performance in the German and Spanish markets, the changes in foreign exchange rates negatively impacted international revenue by $46.8 million, resulting in an overall loss.