Sean Fenske, Editor-in-Chief08.15.18
In my Letter last issue, I was wondering about what had happened to the promise of smart implants. The combination of sensors, connectivity, IoT, and miniaturization could be leveraged to enhance the level of orthopedic care provided to patients requiring joint replacements. As I had come to discover, efforts are ongoing, but in reviewing this year’s Top Companies reports, those same technologies are being utilized in another way for a much different effort—surgical robotics. And unlike smart implants, surgical robotics are becoming pervasive within the industry at a rapid pace, especially in orthopedics.
Surgical robotics have become so prominent, in fact, that six of the top 10 companies featured in this year’s reports can be tied to them (including all of the top five firms) either through internal development, acquisition, or partnership. And unlike the father of today’s surgical robotic offerings—the da Vinci surgical system—these solutions have been developed for the express purpose of orthopedic procedures (with one likely exception).
Although not the first to market, Stryker (page 31) was one of the loudest about its robotic offering, placing significant promotional energy behind its Mako surgical system. The robotic-arm assisted technology can be used in partial knee, total hip, and total knee procedures. According to the company, it has reduced overall readmission costs by 66 percent.
Johnson & Johnson (specifically Ethicon Endo-Surgery) partnered with Alphabet’s (Google) Verily to form Verb Surgical (whose ultimate robotic output could be the aforementioned exception). The new entity has been pushing the concept of Surgery 4.0, or digital surgery, which the company states is a combination of robotics, visualization, advanced instrumentation, data analytics, and connectivity. While the surgical challenges the Verb system will address remains to be seen, one valuable differentiator between it and the da Vinci system could be to tackle orthopedics. Further, given J&J’s connection to DePuy (page 36), it’s not out of the realm of possibility.
Meanwhile, a little quieter about its robotic offering, Zimmer Biomet (page 48) will undoubtedly be glad to finally bring the Rosa system to surgeons soon. Acquired when it bought Medtech SA, Rosa was expected to be launched in 2018, but has yet to make its commercial debut (as of this writing).
Navio from Smith and Nephew (page 52) employs a unique handheld design for both partial and total knee replacement procedures. The handpiece is used to accurately remove bone identified in the surgeon’s patient-specific plan. A variety of the company’s knee systems can be used in conjunction with the Navio.
Rounding out the top five is Medtronic (page 56). Although the company doesn’t have a robotic surgical system of its own for the orthopedic space, it has made significant investments in Mazor Robotics, developer of the Mazor X technology, which is indicated for spine procedures. Medtronic has also secured distribution rights for the third-generation system, which has been employed for over 1,000 surgeries in more than 50 hospitals within the United States.
The sixth member of the orthopedics robotics club is Globus Medical (page 68). Its Excelsius GPS system only gained FDA clearance in August 2017, but was already notching its first spine surgeries months later in October.
Meanwhile, this year’s list got a bit of a shake-up in terms of membership. Integra’s orthopedic portion has seen divestitures in recent years, ultimately resulting in net sales from that segment dropping below the next company on the list. As such, Össur (page 70) sits at #10 this year. Perhaps not wanting to feel left out from the robotics theme established by its orthopedic device peers, Össur has tackled the subject from a different angle. The firm provides robotic/bionic prosthetics for amputees. In addition, the company develops powered exoskeletons, which rely upon much of the same type of technologies driving the prosthetic solutions.
I hope you enjoy diving into this year’s company reports and gain valuable insights on the performance of these 10 firms. I expect you will find other trends and similarities between them yourself. Perhaps the next technology trend will be unveiled to you based on what you see in the reports ahead of any company announcements. At the very least, I hope the information helps with your own business planning or allows you to identify customer prospects who are focusing on orthopedic segments for which you are developing new innovations.
Surgical robotics have become so prominent, in fact, that six of the top 10 companies featured in this year’s reports can be tied to them (including all of the top five firms) either through internal development, acquisition, or partnership. And unlike the father of today’s surgical robotic offerings—the da Vinci surgical system—these solutions have been developed for the express purpose of orthopedic procedures (with one likely exception).
Although not the first to market, Stryker (page 31) was one of the loudest about its robotic offering, placing significant promotional energy behind its Mako surgical system. The robotic-arm assisted technology can be used in partial knee, total hip, and total knee procedures. According to the company, it has reduced overall readmission costs by 66 percent.
Johnson & Johnson (specifically Ethicon Endo-Surgery) partnered with Alphabet’s (Google) Verily to form Verb Surgical (whose ultimate robotic output could be the aforementioned exception). The new entity has been pushing the concept of Surgery 4.0, or digital surgery, which the company states is a combination of robotics, visualization, advanced instrumentation, data analytics, and connectivity. While the surgical challenges the Verb system will address remains to be seen, one valuable differentiator between it and the da Vinci system could be to tackle orthopedics. Further, given J&J’s connection to DePuy (page 36), it’s not out of the realm of possibility.
Meanwhile, a little quieter about its robotic offering, Zimmer Biomet (page 48) will undoubtedly be glad to finally bring the Rosa system to surgeons soon. Acquired when it bought Medtech SA, Rosa was expected to be launched in 2018, but has yet to make its commercial debut (as of this writing).
Navio from Smith and Nephew (page 52) employs a unique handheld design for both partial and total knee replacement procedures. The handpiece is used to accurately remove bone identified in the surgeon’s patient-specific plan. A variety of the company’s knee systems can be used in conjunction with the Navio.
Rounding out the top five is Medtronic (page 56). Although the company doesn’t have a robotic surgical system of its own for the orthopedic space, it has made significant investments in Mazor Robotics, developer of the Mazor X technology, which is indicated for spine procedures. Medtronic has also secured distribution rights for the third-generation system, which has been employed for over 1,000 surgeries in more than 50 hospitals within the United States.
The sixth member of the orthopedics robotics club is Globus Medical (page 68). Its Excelsius GPS system only gained FDA clearance in August 2017, but was already notching its first spine surgeries months later in October.
Meanwhile, this year’s list got a bit of a shake-up in terms of membership. Integra’s orthopedic portion has seen divestitures in recent years, ultimately resulting in net sales from that segment dropping below the next company on the list. As such, Össur (page 70) sits at #10 this year. Perhaps not wanting to feel left out from the robotics theme established by its orthopedic device peers, Össur has tackled the subject from a different angle. The firm provides robotic/bionic prosthetics for amputees. In addition, the company develops powered exoskeletons, which rely upon much of the same type of technologies driving the prosthetic solutions.
I hope you enjoy diving into this year’s company reports and gain valuable insights on the performance of these 10 firms. I expect you will find other trends and similarities between them yourself. Perhaps the next technology trend will be unveiled to you based on what you see in the reports ahead of any company announcements. At the very least, I hope the information helps with your own business planning or allows you to identify customer prospects who are focusing on orthopedic segments for which you are developing new innovations.