Syndesmosis Implant Systems Market

Syndesmosis Implant Systems Market Outlook (2023 to 2033)

The Global revenue from the Syndesmosis Implant Systems Market was around US$ 83.5 Million in 2022, with the global market expected to grow at a CAGR of 7.9% to reach a valuation of around US$ 194.5 Million by the end of 2033.

As assessed by Persistence Market Research, titanium based plate implants held a market share of around 53.2% in the global market, in 2022. Overall, syndesmosis implant systems market sales account for around 1.2% of revenue share in the global sports medicine market, which was valued at around US$ 6.8 Billion in 2022.

Sales Analysis of Market from 2015 to 2022 Vs Market Outlook for 2023 to 2033

The Global Syndesmosis Implant Systems Market recorded a historic CAGR of 6.6% in the last 7 years from 2015 to 2022.

A syndesmosis is a joint between two bones that is connected by strong membrane and ligaments. An ankle sprain known as a syndesmotic ankle sprain (high ankle sprain) affects the ligaments connecting the distal tibia and fibula at their syndesmosis (a syndesmotic joint). The interosseous ligament (IOL), posterior-inferior tibiofibular ligament (PITFL), and anterior-inferior tibiofibular ligament (AITFL), and transverse tibiofibular ligament adhere to the distal tibiofibular syndesmosis (TTFL). Any ankle motion can result in syndesmotic damage. Extreme external rotation or talar dorsiflexion are the most frequent movements. In football, downhill skiing, and athletics, syndesmotic ankle sprains are frequent injuries.

Syndesmosis implant systems are expected to see profitable growth in the future as a result of product development, increased research and development activities, increased awareness about ankle syndesmosis, and increased investments in product innovation.

Several studies have been conducted to compare the cost-effectiveness of suture button fixation to syndesmotic screws.

• In 2017, the American Journal of Sports Medicine published an article comparing the cost-effectiveness of suture button fixation as compared to syndesmotic screws in ankle fractures with unstable supination-external rotation type 4 (SER IV). The study's findings revealed that suture button fixation is both more effective and less expensive.

Adoption of newly launched orthopedic implants has increased due to surgeons' readiness to perform technologically advanced surgeries, increased awareness of metal and absorbable implants, and the growing availability of customised therapies in the era of personalised medicine.

Surgeons are primarily concerned with improving patient outcomes and expediting recovery. Increased coverage for foot and ankle implants is also likely to encourage adoption and boost the chances of the surgeon recommending these implants.

How Can the Global Market Grow?

“Use of Titanium and Biodegradable Implants for Various Sport Injuries and Bone Disorders”

In recent years, the frequency of sports injuries has dramatically grown.

• According to a research by the American Academy of Orthopedic Surgeons (AAOS), 25% of sports injuries involve the lower extremities, such as the foot and ankle. Both professional and amateur athletes have experienced serious bone injuries.
• According to a study conducted by the School of Public Health, Physiotherapy and Population Science, University College Dublin, ankle sprain is one of the most common musculoskeletal injuries. Nearly 116 studies revealed that the incidence of ankle sprain was higher among women than in men. In sports category, ankle sprain incidence was higher in indoor/court sports.

Increase in the number of accidents and bone disorders such as joint pain, instability in the joint, bone loss, and infection are anticipated to spur demand for syndesmosis implant systems during the forecast period.

Use of titanium and biodegradable implants in fracture fixation has increased due to rising awareness of advantages of these implant materials among surgeons. Implants made of titanium are lightweight and maintain a steel-like level of strength. Using bioabsorbable implants has a number of benefits, including minimal risk of osteopenia, no irritation of soft tissue, and no need for a second procedure to remove the implants.

Ankle fractures and syndemostic injuries are most common among athletes and sportspersons. Early diagnosis and treatment of ankle injuries and sprains helps faster healing and reduces pain. Increase in number of health care providers focusing on optimal management of ankle injuries is expected to fuel the growth of the market

Key principle of surgical treatment of syndesmotic injuries is anatomic reduction of the ankle joint and establishment of correct tibia–fibula interval. Therefore, orthopedic surgeons focus on optimal management of sport injuries in order to reduce patient discomfort, proper fixation, and speedy recovery.

Can the Market Growth Be Affected in Any Way?

“Product Recall in Foot and Ankle Market and Complications Associated With Implants”

Products recalls due to manufacturing errors, side effects, damage to bones, or infection affect the sales of the foot and ankle implants. Regulatory authorities such as the Food and Drug Administration have issued product recalls for a number of arthroplasty device manufacturers. There were some voluntary recalls by product manufacturers as well.

• In March 2018, Zimmer Biomet recalled Ziptight ankle syndesmosis fixation device, a titanium implant. The company initiated the recall as the product was packaged without the tip protectors. 885 units of Ziptight device were recalled. Therefore, product recalls affect a company’s brand image as well as nets sales.

Syndesmosis implants could lead to various complications and the patient might have to remove the implant in another surgery. This leads to economic burden and over-utilization of health care resources.

• A study published by the National Center for Biotechnology Information concluded that out of 102 cases of traumatic ankle syndesmotic stabilization, nearly eight patients had to remove the implant due to painful aseptic osteolysis surrounding the implant, failed stabilization of the syndesmosis, and steomyelitis surrounding the implant.

Country-wise Insights

Why is the United States Market Booming?

“Technologically Advanced Syndesmosis Implant Systems”

The United States will account for around 39.6% of the global market in 2022.

The United States is expected to account for a major share of the global market because of increasing awareness among people about orthopedic conditions and their subsequent surgeries in this region.

• According to published article on epidemiology of ankle and foot fractures in the Journal of Foot and Ankle Surgery in 2014, reported total foot and ankle fractures/dislocations were 280,933 in the United States as per the National Trauma Data Bank data set. Among this data ankle fracture was common and about 20% fractures were open from that data set.

The increase in population coupled with per capita expenditure on healthcare also offers significant opportunities for growth in this regional segment. Other factors such as technological advancement had led to the development of new implants, which are lighter and stronger, enhancing their reliability.

• For instance, the FIBULINK® Syndesmosis Repair System was introduced by Johnson & Johnson in October 2020. This implant's precision screw fixation and flexible suture are among its outstanding features. This fixation approach solves suture button designs' drawbacks, such as their inability to control tension and medial soft-tissue disturbance.

Will the Germany Be a Lucrative Market for Syndesmosis Implant Systems?

“Prevalence of Disease Related Ankle Osteoarthritis and Increased Demand of Advanced Syndesmosis Implants”

The German market held around 6.9% market share of the global market in 2022. Germany is emerging as a promising market for orthopaedic products due to factors such as an ageing population base and increased demand for medical devices among senior citizens in this region. Rising awareness about various types of disorders and associated with ankle osteoarthritis has also contributed to the growth of this regional market.

• According to a study on ankle-foot surgery that was published in the journal of Foot and Ankle Surgical in 2021, between 2008 and 2018, Germany's surgery volume climbed by 39.5%, yet the country's population only grew by 0.9%. The number of first metatarsophalangeal joint (MTPJ) and ankle arthrodesis procedures increased whereas total ankle replacement and first MTPJ arthroplasty procedures declined by 48% and 39%, respectively.

The key players are also focusing on creating cutting-edge syndesmosis implants.

• For instance, the German company Arthrex's TightRope XP implant device incorporates a special delivery mechanism that allows the implant to be inserted without having to draw a needle through the medial skin.

How is China Emerging as a Prominent Market?

“Syndesmosis Injuries Related to Certain Diseases Increase the Demand for Syndesmosis Implant Systems”

China held a market share of about 5.4% of the global market in 2022.

There is significant potential for market expansion due to factors such as increased awareness of various disorders associated ankle and foot problems like osteoarthritis, osteoporosis and surgeries required to treat them, which has resulted in an increase in population base with surgery demands.

• According to published article on the osteoarthritis in the journal of Emergency Medicine International in 2022, as per Ministry of China Arthritis Prevention degenerative osteoarthropathy or proliferative arthritis survey shows the Chinese 60 years aged population is over 100 million and among them expected osteoarthritis patients are more than 50 million. Whereas, according osteoporosis study in China, published in the Journal of Bone and Mineral Research in 2019, osteoporosis is estimated to affect 49.3 million women and 10.9 million men overall.

Ankle fracture and syndesmotic stabilisation are linked to osteoarthritis an osteoporosis.

• As per published article on ankle fracture with relation of secondary osteoarthritis in Foot and Ankle Surgery journal in 2019, the ankle fractures accounts for around 9% among all fractures. Unstable tibiofibular syndesmotic injuries with ankle fracture chances increased by 10 to15% in osteoarthritis cases.
• One more published article of post-traumatic osteoarthritis of the ankle in International Orthopaedics journal in 2012, revealed the presence of Malleolar fractures in patients with advanced or end-stage ankle osteoarthritis at a rate of 37 to 53%.

Category-wise Insights

Which Product is Driving Demand within the Global Market?

“Advantages Offered by Titanium-Based Plate Implants”

Titanium-based plate implants segment held value share of around 53.2% of the global market in 2022 due to advantages of titanium plates like good hard-tissue compatibility and corrosion resistance.

The other advantages offered by titanium, such as high biocompatibility, rigidity, strength, greater strain-bearing capacity. It is also non-magnetic, non-allergic, and non-radio-opaque, and it adheres to the bone easily without any additional coating.

• According to a 2020 iScience journal article on titanium for orthopaedic applications, titanium plates enhance biocompatibility and reduce the growth of microbiofilms, infections of prosthetic joints, and aseptic loosening.

Which Application Segment Drives Demand for Syndesmosis Implant Systems?

Growing cases of Ankle Fractures due to High Impact Sports Injuries”

Ankle fracture demands for greater utilization of syndesmosis implant systems thereby contributing market share of around 54.5% in 2022 globally.

A broken ankle is most often the result of an ankle twisting, but it can also be the result of a direct injury to the ankle. Common causes of broken ankle are car accidents, missteps, and falls, etc.

High-impact sports such as gymnastics and football, improper technique in using sport equipment, stress fracture due to increased activity level, obesity, decreased bone density (osteoporosis) can cause ankle injuries, walking around in a cluttered area, and smoking can all increase the risk of osteoporosis and d smoking can all increase the risk of osteoporosis and eventually lead to ankle bone injuries.

• According to the published article on low bone mass in the Frontiers in Endocrinology journal in 2022, globally, disability-adjusted life-years (DALYs) and deaths numbers ascribed to low bone mineral density (LBMD) increased from 8,588,936 and 207,367 in 1990 to 16,647,466 and 437,884 in 2019 with a raise of 93.82% and 111.16%, respectively.

Which End User Segment is Helping to Expand the Global Market?

“Reduced Medical Stay and Cost offered by Ambulatory Settings”

Ambulatory Settings end user held around 52.0% share of the global market in 2022.

Ambulatory Settings are places where patients can receive surgical care without having to spend the night in the hospital. Outpatient surgeries are less stressful than inpatient surgery which are suitable for operations like knee or ankle replacement surgery.

Ambulatory settings are also popular due to lower cost of care by 45 to 60% less than hospital stays. Patients can receive better pre- and post-operative care in such a setting quickly, and the location is generally convenient. Patient is not required to stay in the hospital for several hours or days while recovering.

Competition Landscape

The key players are adopting key strategies to launch technologically advanced products, and partnership for manufacturing as well as distribution. The key players are also financially investing in the research and development for continuous innovation and advancement of products to survive in the competition.

A few examples of products strategically launched by the key players:

• In April 2022, Paragon 28, Inc. designed and launched 1R3ACT Stabilization System for the recovery of acute and chronic syndesmotic injuries. The Gorilla Pilon Plating System, Gorilla Ankle Fracture Plating System, R3LEASE Stabilization System, and Mini-Monster Screw System are among the ankle fracture and syndesmotic products offered by Paragon 28 that have been strengthened by the addition of the R3ACT Stabilization System.
• In November 2022, Zimmer Biomet, Inc. declared that the Persona OsseoTi Keel Tibia for obtained FDA 510(k) clearance for cementless knee replacement. This device provides stable initial and biological fixation in addition to the benefits of the Persona knee system, which have been clinically demonstrated.

Similarly, the team at Persistence Market Research has tracked recent developments related to companies in the syndesmosis implant systems market, which are available in the full report.

Companies Covered in Syndesmosis Implant Systems Market

• Zimmer Biomet
• Arthrex, Inc.
• Smith & Nephew
• Wright Medical Group N.V.
• Exactech, Inc.
• Acumed LLC (Colson Associates, Inc.)
• Inion Oy
• Mortise Medical (Surgical Frontiers)
• Paragon 28, Inc.