European Markets for Total Joint Replacement Products

Report overview from Medtech Insight - Published April 2008

EU medical markets: In 2007, European sales of total joint replacement products totaled approximately $2.9 billion. Over the forecast period covered by this report, sales of these products are expected to grow at a compound annual rate of 5.8%, reaching an estimated $4.3 billion in the year 2014. Learn more about these market opportunities.

This new report from Medtech Insight includes analyses of products, technologies, current and forecast markets, competitors, and opportunities in the European total joint replacement products market. These products are used for the treatment of painful and/or disabled joints due to traumatic fracture or disorders of the skeletal system such as arthritis and osteoporosis. Rheumatoid arthritis, the most common type of inflammatory arthritis, affects more than 3 million people in Europe. In 2006, the total annual economic impact of rheumatoid arthritis was estimated at EUR 42.0 billion in Western Europe and EUR 3.4 billion in Eastern Europe.

Orthopedic products covered in this report include total joint replacement systems for the hip, knee, shoulder, and elbow. Market forecasts are provided for total joint replacement products in Europe overall as well as for the individual countries of France, Germany, Italy, Spain, the United Kingdom, and the Benelux and Nordic countries. Forecasts are provided for both primary and revision total joint replacement products including cemented and cementless systems.

Other topics covered in this report include common bone and joint diseases that may lead to total joint replacement, as well as the healthcare policies of selected European countries.

To order reports or obtain information about special pre-publication offers from within the U.S., contact [email protected]. From outside the U.S., contact [email protected]. You can also call 1.949.219.0150 (or toll-free within the U.S. at 1.888.290.2225) or fax 1.949.219.0067.

European Markets for Total Joint Replacement Products
Report #A312 - April 2008
601 Pages – 374 Exhibits – 11 Key Company Profiles

TABLE OF CONTENTS

EXECUTIVE SUMMARY

i.    Clinical Overview

ii.   Total Joint Replacements, Procedure Volumes Forecast

a.   Total Hip Replacements

b.   Total Knee Replacements

c.   Total Shoulder Replacements

d.   Total Elbow Replacements

iii.   Total Joint Replacements, Combined Market Forecast

a.   Total Hip Replacement Product Sales

b.   Total Knee Replacement Product Sales

c.   Total Shoulder Replacement Product Sales

d.   Total Elbow Replacement Product Sales

iv.  Methodology

Exhibit ES-1:    Europe, Total Joint Replacement, Combined Procedure Volumes Forecast, 2004-2014

Exhibit ES-2:    Europe, Total Hip Replacement, Combined Procedure Volumes Forecast, by Country, 2004-2014

Exhibit ES-3:    Europe, Total Knee Replacement, Combined Procedure Volumes Forecast, by Country, 2004-2014

Exhibit ES-4:    Europe, Total Shoulder Replacement, Procedure Volumes Forecast, by Country, 2004-2014

Exhibit ES-5:    Europe, Total Elbow Replacement, Procedure Volumes Forecast, by Country, 2004-2014

Exhibit ES-6:    Europe, Total Joint Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit ES-7:    Europe, Total Hip Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit ES-8:    Europe, Total Knee Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit ES-9:    Europe, Total Shoulder Replacement Systems, Market Forecast, 2004-2014

Exhibit ES-10:  Europe, Total Elbow Replacement Systems, Market Forecast, 2004-2014

1. EUROPEAN HEALTHCARE MARKETS

1.1 The European Union

1.1.1 A Common Currency

1.1.2 Regulatory Policies

1.1.3 Reimbursement

1.1.4 Healthcare Spending

1.2 Selected European National Healthcare Profiles

1.2.1 France

1.2.1.1 Healthcare Organization and Reform

1.2.1.2 Hospital Services

1.2.1.3 Medical Device Reimbursement

1.2.2 Germany

1.2.2.1 Healthcare Organization and Reform

1.2.2.2 Hospital Services

1.2.2.3 Medical Device Reimbursement

1.2.3 Italy

1.2.3.1 Healthcare Organization and Reform

1.2.3.2 Hospital Services

1.2.3.3 Medical Device Reimbursement

1.2.4 Spain

1.2.4.1 Healthcare Organization and Reform

1.2.4.2 Hospital Services

1.2.4.3 Medical Device Reimbursement

1.2.5 United Kingdom

1.2.5.1 Healthcare Organization and Reform

1.2.5.2 Hospital Services

1.2.5.3 Medical Device Reimbursement

1.2.6 Benelux Countries

1.2.6.1 Healthcare Organization and Reform

1.2.6.1.1 Belgium

1.2.6.1.2 Luxembourg

1.2.6.1.3 The Netherlands

1.2.6.2 Hospital Services

1.2.6.3 Medical Device Reimbursement

1.2.7 Nordic Countries

1.2.7.1 Healthcare Organization and Reform

1.2.7.1.1 Denmark

1.2.7.1.2 Finland

1.2.7.1.3 Norway

1.2.7.1.4 Sweden

1.2.7.2 Hospital Services

1.2.7.3 Medical Device Reimbursement

Exhibit 1-1:      European Union, Medical Devices Risk Classification System

Exhibit 1-2:      European Union Population Statistics Comparison for the Years 1996, 2006, and 2016

Exhibit 1-3:      France, Selected National Healthcare Statistics

Exhibit 1-4:      Germany, Selected National Healthcare Statistics

Exhibit 1-5:      Italy, Selected National Healthcare Statistics

Exhibit 1-6:      Spain, Selected National Healthcare Statistics

Exhibit 1-7:      United Kingdom, Selected National Healthcare Statistics

Exhibit 1-8:      Belgium, Selected National Healthcare Statistics

Exhibit 1-9:      Luxembourg, Selected National Healthcare Statistics

Exhibit 1-10:    The Netherlands, Selected National Healthcare Statistics

Exhibit 1-11:    Denmark, Selected National Healthcare Statistics

Exhibit 1-12:    Finland, Selected National Healthcare Statistics

Exhibit 1-13:    Norway, Selected National Healthcare Statistics

Exhibit 1-14:    Sweden, Selected National Healthcare Statistics

2. CLINICAL OVERVIEW

2.1 Bone Structure and Function

2.1.1 Cellular Framework

2.1.1.1 Osteoblasts

2.1.1.2 Osteogenesis

2.1.1.3 Osteocytes

2.1.1.4 Osteoclasts

2.1.2 Collagen

2.1.3 Bone Marrow

2.1.4 Factors Affecting Bone Physiology

2.1.4.1 The Effect of Physical Stress on Bone Remodeling

2.1.4.2 Age and Gender

2.1.4.3 Physical Activity

2.1.4.4 Cigarette Smoking, Alcohol, and Caffeine

2.1.4.5 Nutritional Deficiencies

2.2 Ligaments and Tendons

2.3 Joint Structure and Function

2.3.1 Elbow

2.3.2 Knee

2.3.3 Hip 2-20

2.3.4 Shoulder

2.4 Diseases and Injuries Affecting Bone and Joint Tissue

2.4.1 Arthritis

2.4.1.1 Osteoarthritis

2.4.1.2 Rheumatoid Arthritis

2.4.1.2.1 Incidence and Prevalence of Rheumatoid Arthritis

2.4.1.3 Traumatic Arthritis

2.4.2 Osteoporosis

2.4.3 Synovial Osteochondromatosis

2.4.4 Osteochondritis Dissecans

2.4.5 Neuropathic Osteoarthropathy

2.4.6 Congenital Hip Dysplasia

2.4.7 Protrusio Acetabuli

2.4.8 Paget’s Disease

2.5 Biomaterials Used in Joint Implants

2.5.1 Metals

2.5.1.1 Cobalt Alloys

2.5.1.2 Stainless Steel Alloys

2.5.1.3 Titanium Alloys

2.5.2 Ceramics

2.5.3 Bioactive Glasses

2.5.4 Polymers

2.5.4.1 Carbon Fiber

2.5.4.2 Silicone Rubber

2.5.4.3 Polyethylene

2.5.4.3.1 Ultra-High Molecular Weight Polyethylene

2.5.4.3.2 Polytetrafluoroethylene

2.5.4.4 Polyurethane

Exhibit 2-1:      Anatomy of a Long Bone

Exhibit 2-2:      Structure of Bone

Exhibit 2-3:      The Bone Remodeling Cycle

Exhibit 2-4:      Structure of Hydroxyapatite

Exhibit 2-5:      Structure of Collagen

Exhibit 2-6:      Functions of Ligaments

Exhibit 2-7:      Types of Synovial Joints

Exhibit 2-8:      Anatomy of the Elbow

Exhibit 2-9:      Anatomy of the Knee

Exhibit 2-10:    Anatomy of the Hip

Exhibit 2-11:    Anatomy of the Shoulder:  The

Rotator Cuff

Exhibit 2-12:    Anatomy of the Shoulder:  The

Glenoid Cavity

Exhibit 2-13:    Prevalence and Incidence of Rheumatoid Arthritis in Selected European Countries

Exhibit 2-14:    Key Osteoporosis Statistics for Selected European Countries

3. EUROPEAN MARKETS FOR TOTAL HIP REPLACEMENT IMPLANTS

3.1 Overview

3.2 Structure of the Hip Joint

3.3 Types of Total Hip Replacement

3.3.1 Cemented Primary Total Hip Replacement

3.3.1.1 Cemented Stem Designs

3.3.1.2 Surface Finish

3.3.1.3 Stem Geometry

3.3.1.4 Cemented Acetabular Designs

3.3.2 Cementless Primary Total Hip Replacement

3.3.2.1 Cementless Femoral Stem Designs

3.3.2.1.1 Anatomic Cementless Femoral Fixation

3.3.2.1.2 Cylindrical or Rectangular Cementless Femoral Fixation

3.3.2.1.3 Tapered Cementless Femoral Fixation

3.3.2.1.4 Modular Cementless Femoral Stems

3.3.2.2 Cementless Acetabular Designs

3.3.2.3 Surface Coatings

3.3.3 Hybrid Total Hip Replacement

3.3.4 Revision Total Hip Replacement

3.3.5 Surface Hip Replacement

3.4 Selected Hip Replacement Systems

3.4.1 Cemented Hip Replacement Products

3.4.2 Cementless Hip Replacement Products

3.4.3 Revision Hip Replacement Products

3.5 Market Analysis

3.5.1 Procedure Volumes

3.5.2 Market Overview

3.5.2.1 Market Drivers

3.5.2.1.1 Incidence of Age-Related Musculoskeletal Disorders

3.5.2.1.2 Technological Advances

3.5.2.1.3 Growth in Specific Market Segments

3.5.2.1.4 Total Hip Replacement As A Preferred Alternative to Standard Fixation

3.5.2.1.5 Devaluation of the United States Dollar

3.5.2.2 Market Limiters

3.5.2.2.1 Cost-Containment Efforts

3.5.2.2.2 Competitive Pricing

3.5.2.2.3 Late Payments

3.5.3 Competitive Analysis

Exhibit 3-1:      The Hip Joint

Exhibit 3-2:      Cemented Versus Cementless Hip Replacement

Exhibit 3-3:      2008, Selected Cemented Hip Replacement Systems

Exhibit 3-4:      2008, Selected Cementless Hip Replacement Systems

Exhibit 3-5:      2008, Selected Revision Hip Replacement Systems

Exhibit 3-6:      Europe, Total Hip Replacement, Combined Procedure Volumes Forecast, 2004-2014

Exhibit 3-7:      Europe, Total Hip Replacement, Combined Procedure Volumes Forecast, by Country, 2004-2014

Exhibit 3-8:      Europe, Total Hip Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 3-9:      Europe, Total Hip Replacement Systems, Combined Market Forecast, by Country, 2004-2014

Exhibit 3-10:    Europe, Cemented Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-11:    Europe, Cementless Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-12:    Europe, Revision Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-13:    France, Total Hip Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 3-14:    France, Cemented Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-15:    France, Cementless Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-16:    France, Revision Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-17:    Germany, Total Hip Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 3-18:    Germany, Cemented Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-19:    Germany, Cementless Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-20:    Germany, Revision Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-21:    Italy, Total Hip Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 3-22:    Italy, Cemented Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-23:    Italy, Cementless Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-24:    Italy, Revision Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-25:    Spain, Total Hip Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 3-26:    Spain, Cemented Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-27:    Spain, Cementless Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-28:    Spain, Revision Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-29:    United Kingdom, Total Hip Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 3-30:    United Kingdom, Cemented Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-31:    United Kingdom, Cementless Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-32:    United Kingdom, Revision Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-33:    Benelux Countries, Total Hip Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 3-34:    Benelux Countries, Cemented Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-35:    Benelux Countries, Cementless Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-36:    Benelux Countries, Revision Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-37:    Nordic Countries, Total Hip Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 3-38:    Nordic Countries, Cemented Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-39:    Nordic Countries, Cementless Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-40:    Nordic Countries, Revision Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-41:    Rest of Europe, Total Hip Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 3-42:    Rest of Europe, Cemented Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-43:    Rest of Europe, Cementless Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-44:    Rest of Europe, Revision Total Hip Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 3-45:    2007, Europe, Combined Total Hip Replacement Systems Market, Share by Supplier

Exhibit 3-46:    2007, Europe, Cemented Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-47:    2007, Europe, Cementless Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-48:    2007, Europe, Revision Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-49:    2007, France, Combined Total Hip Replacement Systems Market, Share by Supplier

Exhibit 3-50:    2007, France, Cemented Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-51:    2007, France, Cementless Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-52:    2007, France, Revision Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-53:    2007, Germany, Combined Total Hip Replacement Systems Market, Share by Supplier

Exhibit 3-54:    2007, Germany, Cemented Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-55:    2007, Germany, Cementless Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-56:    2007, Germany, Revision Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-57:    2007, Italy, Combined Total Hip Replacement Systems Market, Share by Supplier

Exhibit 3-58:    2007, Italy, Cemented Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-59:    2007, Italy, Cementless Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-60:    2007, Italy, Revision Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-61:    2007, Spain, Combined Total Hip Replacement Systems Market, Share by Supplier

Exhibit 3-62:    2007, Spain, Cemented Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-63:    2007, Spain, Cementless Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-64:    2007, Spain, Revision Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-65:    2007, United Kingdom, Combined Total Hip Replacement Systems Market, Share by Supplier

Exhibit 3-66:    2007, United Kingdom, Cemented Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-67:    2007, United Kingdom, Cementless Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-68:    2007, United Kingdom, Revision Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-69:    2007, Benelux Countries, Combined Total Hip Replacement Systems Market, Share by Supplier

Exhibit 3-70:    2007, Benelux Countries, Cemented Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-71:    2007, Benelux Countries, Cementless Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-72:    2007, Benelux Countries, Revision Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-73:    2007, Nordic Countries, Combined Total Hip Replacement Systems Market, Share by Supplier

Exhibit 3-74:    2007, Nordic Countries, Cemented Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-75:    2007, Nordic Countries, Cementless Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-76:    2007, Nordic Countries, Revision Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-77:    2007, Rest of Europe, Combined Total Hip Replacement Systems Market, Share by Supplier

Exhibit 3-78:    2007, Rest of Europe, Cemented Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-79:    2007, Rest of Europe, Cementless Total Hip Replacement Systems Market Segment, Share by Supplier

Exhibit 3-80:    2007, Rest of Europe, Revision Total Hip Replacement Systems Market Segment, Share by Supplier

4. EUROPEAN MARKETS FOR TOTAL KNEE REPLACEMENT IMPLANTS

4.1 Overview

4.1.1 Structure of the Knee Joint

4.1.2 Disorders Requiring Knee Replacement Surgery

4.2 Knee Implant Designs and Materials

4.2.1 Cemented, Cementless, and Hybrid Fixation

4.2.2 Fixed Bearing Implants

4.2.3 Mobile Bearing Implants

4.3 History of Knee Replacement Technology

4.4 Selected Total Knee Replacement Products

4.4.1 Primary Total Knee Replacement Products

4.4.2 Revision Total Knee Replacement Products

4.5 Market Analysis

4.5.1 Procedure Volumes

4.5.2 Market Overview

4.5.2.1 Market Drivers

4.5.2.1.1 Incidence of Age-Related Musculoskeletal Problems

4.5.2.1.2 Growth in Specific Market Segments

4.5.2.1.3 Technological Advances

4.5.2.1.4 Devaluation of the United States Dollar

4.5.2.2 Market Limiters

4.5.2.2.1 National Cost-Containment Measures

4.5.2.2.2 Cost-Containment Measures by Manufacturers

4.5.3 Competitive Analysis

Exhibit 4-1:      Anatomy of the Knee Joint:  Lateral View

Exhibit 4-2:      Anatomy of the Knee Joint:  Anterior View

Exhibit 4-3:      2008, Selected Primary Knee Replacement Systems

Exhibit 4-4:      2008, Selected Revision Knee Replacement Systems

Exhibit 4-5:      Europe, Total Knee Replacement, Combined Procedure Volumes Forecast, 2004-2014

Exhibit 4-6:      Europe, Total Knee Replacement, Combined Procedure Volumes Forecast, by Country, 2004-2014

Exhibit 4-7:      Europe, Total Knee Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 4-8:      Europe, Total Knee Replacement Systems, Combined Market Forecast, by Country, 2004-2014

Exhibit 4-9:      Europe, Cemented Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-10:    Europe, Cementless Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-11:    Europe, Revision Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-12:    France, Total Knee Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 4-13:    France, Cemented Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-14:    France, Cementless Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-15:    France, Revision Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-16:    Germany, Total Knee Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 4-17:    Germany, Cemented Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-18:    Germany, Cementless Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-19:    Germany, Revision Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-20:    Italy, Total Knee Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 4-21:    Italy, Cemented Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-22:    Italy, Cementless Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-23:    Italy, Revision Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-24:    Spain, Total Knee Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 4-25:    Spain, Cemented Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-26:    Spain, Cementless Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-27:    Spain, Revision Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-28:    United Kingdom, Total Knee Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 4-29:    United Kingdom, Cemented Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-30:    United Kingdom, Cementless Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-31:    United Kingdom, Revision Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-32:    Benelux Countries, Total Knee Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 4-33:    Benelux Countries, Cemented Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-34:    Benelux Countries, Cementless Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-35:    Benelux Countries, Revision Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-36:    Nordic Countries, Total Knee Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 4-37:    Nordic Countries, Cemented Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-38:    Nordic Countries, Cementless Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-39:    Nordic Countries, Revision Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-40:    Rest of Europe, Total Knee Replacement Systems, Combined Market Forecast, 2004-2014

Exhibit 4-41:    Rest of Europe, Cemented Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-42:    Rest of Europe, Cementless Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-43:    Rest of Europe, Revision Total Knee Replacement Systems Segment, Market Forecast, 2004-2014

Exhibit 4-44:    2007, Europe, Combined Total Knee Replacement Systems Market, Share by Supplier

Exhibit 4-45:    2007, Europe, Cemented Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-46:    2007, Europe, Cementless Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-47:    2007, Europe, Revision Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-48:    2007, France, Combined Total Knee Replacement Systems Market, Share by Supplier

Exhibit 4-49:    2007, France, Cemented Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-50:    2007, France, Cementless Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-51:    2007, France, Revision Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-52:    2007, Germany, Combined Total Knee Replacement Systems Market, Share by Supplier

Exhibit 4-53:    2007, Germany, Cemented Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-54:    2007, Germany, Cementless Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-55:    2007, Germany, Revision Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-56:    2007, Italy, Combined Total Knee Replacement Systems Market, Share by Supplier

Exhibit 4-57:    2007, Italy, Cemented Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-58:    2007, Italy, Cementless Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-59:    2007, Italy, Revision Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-60:    2007, Spain, Combined Total Knee Replacement Systems Market, Share by Supplier

Exhibit 4-61:    2007, Spain, Cemented Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-62:    2007, Spain, Cementless Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-63:    2007, Spain, Revision Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-64:    2007, United Kingdom, Combined Total Knee Replacement Systems Market, Share by Supplier

Exhibit 4-65:    2007, United Kingdom, Cemented Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-66:    2007, United Kingdom, Cementless Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-67:    2007, United Kingdom, Revision Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-68:    2007, Benelux Countries, Combined Total Knee Replacement Systems Market, Share by Supplier

Exhibit 4-69:    2007, Benelux Countries, Cemented Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-70:    2007, Benelux Countries, Cementless Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-71:    2007, Benelux Countries, Revision Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-72:    2007, Nordic Countries, Combined Total Knee Replacement Systems Market, Share by Supplier

Exhibit 4-73:    2007, Nordic Countries, Cemented Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-74:    2007, Nordic Countries, Cementless Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-75:    2007, Nordic Countries, Revision Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-76:    2007, Rest of Europe, Combined Total Knee Replacement Systems Market, Share by Supplier

Exhibit 4-77:    2007, Rest of Europe, Cemented Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-78:    2007, Rest of Europe, Cementless Total Knee Replacement Systems Market Segment, Share by Supplier

Exhibit 4-79:    2007, Rest of Europe, Revision Total Knee Replacement Systems Market Segment, Share by Supplier

5. EUROPEAN MARKETS FOR TOTAL SHOULDER AND ELBOW REPLACEMENT IMPLANTS

5.1 Shoulder Arthroplasty Overview

5.1.1 Structure of the Shoulder Joint

5.1.2 Disorders Requiring Shoulder Replacement Surgery

5.2 Types of Shoulder Replacement Procedures

5.2.1 Total Shoulder Arthroplasty

5.2.2 Hemiarthroplasty

5.2.3 Reverse Shoulder Arthroplasty

5.2.4 Revision Shoulder Arthroplasty

5.3 History of Shoulder Replacement Technology

5.4 Selected Shoulder Replacement Products

5.5 Shoulder Implant Products Market Analysis

5.5.1 Procedure Volumes

5.5.2 Market Overview

5.5.2.1 Market Drivers

5.5.2.1.1 Technological Advances

5.5.2.1.2 Aging Populations and Increasing Preference to Treat Musculoskeletal Injuries with Total Joint Replacement

5.5.2.2 Market Limiters

5.5.2.2.1 Limited Number of Facilities for Total Shoulder Replacement

5.5.2.2.2 Limited Market Opportunities

5.5.3 Competitive Analysis

5.6 Elbow Arthroplasty Overview

5.6.1 Structure of the Elbow Joint

5.6.2 Disorders Requiring Elbow Replacement Surgery

5.6.3 Types of Elbow Implants

5.7 History of Elbow Replacement Technology

5.8 Selected Elbow Replacement Products

5.9 Elbow Implant Products Market Analysis

5.9.1 Procedure Volumes

5.9.2 Market Overview

5.9.2.1 Market Drivers

5.9.2.1.1 Incidence of Age Related Musculoskeletal Disorders

5.9.2.1.2 New Market Opportunities

5.9.2.1.3 Technological Developments and Surgeon Education

5.9.2.2 Market Limiters

5.9.2.2.1 Development of Alternative Therapies

5.9.3 Competitive Analysis

Exhibit 5-1:      The Shoulder Joint; Shoulder Replacement Prosthesis

Exhibit 5-2:      2008, Selected Total Shoulder Replacement Systems

Exhibit 5-3:      Europe, Total Shoulder Replacement, Combined Procedure Volumes Forecast, 2004-2014

Exhibit 5-4:      Europe, Total Shoulder Replacement, Procedure Volumes Forecast, by Country, 2004-2014

Exhibit 5-5:      Europe, Total Shoulder Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-6:      Europe, Total Shoulder Replacement Systems, Market Forecast, by Country, 2004-2014

Exhibit 5-7:      France, Total Shoulder Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-8:      Germany, Total Shoulder Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-9:      Italy, Total Shoulder Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-10:    Spain, Total Shoulder Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-11:    United Kingdom, Total Shoulder Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-12:    Benelux Countries, Total Shoulder Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-13:    Nordic Countries, Total Shoulder Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-14:    Rest of Europe, Total Shoulder Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-15:    2007, Europe, Total Shoulder Replacement Systems Market, Share by Supplier

Exhibit 5-16:    2007, France, Total Shoulder Replacement Systems Market, Share by Supplier

Exhibit 5-17:    2007, Germany, Total Shoulder Replacement Systems Market, Share by Supplier

Exhibit 5-18:    2007, Italy, Total Shoulder Replacement Systems Market, Share by Supplier

Exhibit 5-19:    2007, Spain, Total Shoulder Replacement Systems Market, Share by Supplier

Exhibit 5-20:    2007, United Kingdom, Total Shoulder Replacement Systems Market, Share by Supplier

Exhibit 5-21:    2007, Benelux Countries, Total Shoulder Replacement Systems Market, Share by Supplier

Exhibit 5-22:    2007, Nordic Countries, Total Shoulder Replacement Systems Market, Share by Supplier

Exhibit 5-23:    2007, Rest of Europe, Total Shoulder Replacement Systems Market, Share by Supplier

Exhibit 5-24:    2008, Selected Elbow Replacement Systems

Exhibit 5-25:    Europe, Total Elbow Replacement, Procedure Volumes Forecast, 2004-2014

Exhibit 5-26:    Europe, Total Elbow Replacement, Procedure Volumes Forecast, by Country, 2004-2014

Exhibit 5-27:    Europe, Total Elbow Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-28:    Europe, Total Elbow Replacement Systems, Market Forecast, by Country, 2004-2014

Exhibit 5-29:    France, Total Elbow Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-30:    Germany, Total Elbow Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-31:    Italy, Total Elbow Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-32:    Spain, Total Elbow Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-33:    United Kingdom, Total Elbow Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-34:    Benelux Countries, Total Elbow Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-35:    Nordic Countries, Total Elbow Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-36:    Rest of Europe, Total Elbow Replacement Systems, Market Forecast, 2004-2014

Exhibit 5-37:    2007, Europe, Total Elbow Replacement Systems Market, Share by Supplier

Exhibit 5-38:    2007, France, Total Elbow Replacement Systems Market, Share by Supplier

Exhibit 5-39:    2007, Germany, Total Elbow Replacement Systems Market, Share by Supplier

Exhibit 5-40:    2007, Italy, Total Elbow Replacement Systems Market Share by Supplier

Exhibit 5-41:    2007, Spain, Total Elbow Replacement Systems Market, Share by Supplier

Exhibit 5-42:    2007, United Kingdom, Total Elbow Replacement Systems Market, Share by Supplier

Exhibit 5-43:    2007, Benelux Countries, Total Elbow Replacement Systems Market, Share by Supplier

Exhibit 5-44:    2007, Nordic Countries, Total Elbow Replacement Systems Market, Share by Supplier

Exhibit 5-45:    2007, Rest of Europe, Total Elbow Replacement Systems Market, Share by Supplier

6. COMPANY PROFILES

6.1       Aesculap AG & Company KG/B. Braun Melsungen AG

6.2       Biomet, Inc./LVB Acquisition, Inc.

6.3       Corin Group PLC

6.4       DePuy, Inc./Johnson & Johnson

6.5       Groupe Lépine SA

6.6       Waldemar Link GmbH & Company KG

6.7       Smith & Nephew PLC

6.8       Stryker Corporation

6.9       Tornier SA

6.10     Wright Medical Technology, Inc./Wright Medical Group, Inc

6.11     Zimmer Holdings, Inc.

APPENDIX: COMPANY LISTING