The 10 largest orthopedic device companies in the world
Stryker, Johnson & Johnson’s DePuy Synthes and Zimmer Biomet are the largest orthopedic device companies.
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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) | Headquarters | |
| 1 | Stryker | $17.1 billion (+19.2%) | Kalamazoo, Michigan |
| 2 | Johnson & Johnson – DePuy Synthes | $8.6 billion (+10.6%) | Locations: Raynham, Massachusetts.; West Chester, Pennsylvania; Warsaw, Indiana; Palm Beach Gardens, Florida |
| 3 | Zimmer Biomet (minus ZimVie spinoff) | $6.8 billion (+11.6%) | Warsaw, Indiana |
| 4 | Medtronic – Cranial & Spinal Technologies | $4.5 billion (+3.9%) | Locations: Memphis, Tennessee; Louisville, Colorado |
| 5 | Smith+Nephew – (Orthopaedics + Sports Medicine) | $3.7 billion (+14.3%) | London |
| 6 | Enovis (Formerly Colfax’s Medical Technology segment, including DJO) | $1.4 billion (+27.3%) | Wilmington, Delaware |
| 7 | NuVasive | $1.1 billion (+8%) | San Diego |
| 8 | Globus Medical | $958 million (+21.4%) | Audubon, Pennsylvania |
| 9 | ZimVie (Spine business) | $540 million (+2.1%) | Westminster, Colorado |
| 10 | Orthofix | $465 million (+14.2%) | Lewisville, Texas |
And here is more about how the world’s biggest orthopedic companies are doing:
1. Stryker
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. But in May, Senior Research Analyst Mike Matson at Needham & Co. downgraded ZBH shares because he thought inflationary pressure on Zimmer Biomet’s gross margin will carry into 2023, resulting in slow EPS growth until at least 2024. “In addition, ZBH has been losing share in its hip and knee business, and we’re not sure what will reverse this trend,” he said.
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.
5. Smith+Nephew
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.
6. Enovis
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.
7. NuVasive
NuVasive (Nasdaq:NUVA) is on track to grow its revenue more than 6% in fiscal 2022, and its orthopedic technology is expected to drive the growth.
The spine surgery tech company recently released data from a study of its Attrax Putty porous interbody implant and synthetic bone graft substitute and a porous titanium interbody implant, Modulus XLIF for lateral lumbar interbody fusions. Nuvasive said the fully porous architecture and 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) made headlines this year with the sudden resignation of CEO Dave Demski in April, and the company’s stock price still hasn’t recovered.
After Chief Commercial Officer Daniel Scavilla took over as CEO, the musculoskeletal repair device company reported sales of $230.5 million for the first quarter. Globus told investors at the time that it anticipates $1.025 billion in full-year revenue, which would be its first time crossing the billion-dollar mark.
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,” Scavilla said. 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)
Zimmer Biomet’s latest spinoff, ZimVie (NYSE:ZBH), became an independent public company on March 1, nearly 13 months after Zimmer Biomet announced the move.
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. The company anticipates $1 billion in combined revenue for 2022, relatively unchanged from 2021.
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.”
ZimVie will report financial results for its first full quarter as a standalone company on Aug. 10.
10. Orthofix
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.
Orthofix reported $106.4 million in sales for Q1, most of which was driven by the global orthopedics and spinal businesses. The company collectively grew its sales 2%, while spinal implants and global orthopedics grew 4.2% and 7.2%, respectively.
“In addition to the AccelStim device, we expect that our growth will be fueled by continued disciplined investments made across the business using our strong balance sheet, particularly in areas where we have a competitive advantage, with an eye towards accelerating profitable topline growth in 2023 and beyond,” CEO Jon Serbousek said when discussing Q1 results in May.
Orthofix expects between $475 million and $490 million in sales for fiscal year 2022, which would be a year-over-year increase of 2% to 5%. The company is scheduled to release its Q2 results on Aug. 5.
Managing Editor Jim Hammerand and Senior Editor Danielle Kirsh contributed to this story.