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High Demand for Total Ankle Replacement Procedures

By HospiMedica International staff writers
Posted on 15 Apr 2013
Total Ankle Replacements (TARs) are gradually becoming a mainstream solution to painful and debilitating trauma within the medical devices industry. These are the latest findings of GlobalData (London, United Kingdom), an international business intelligence provider.

Ankle arthritis can be a result of aging, obesity, sports injuries, and trauma. After decades of trial and error TAR is becoming a viable alternative to the gold-standard treatment option for end-stage ankle arthritis patients, ankle fusion, which had a risk of complications including malalignment, stress fractures, continued pain, and arthritis developing in adjacent joints. TARs provide late-stage ankle arthritis patients with fast pain relief and range of motion in the ankle, allowing individuals to restart recreational activities more quickly.

The United States is currently leading the way with almost 5,000 TARs performed every year, and European markets are not far behind. Expanded middle-income groups, increased public awareness of modern medical technology, and a trend of active aging have resulted in an unprecedented demand for orthopedic devices, and huge opportunities exist in emerging markets such as China, India, and Brazil, where TAR is currently regarded as a niche procedure. Increasing numbers of surgeon training programs on TAR surgical techniques suggest that demand is rising as accelerated urbanization and economic growth is leading to growing obese and elderly populations, triggering the TAR patient population in emerging nations to increase at a faster rate than elsewhere.

Orthopedic surgeons have also called for enhanced biological fixation materials to improve the osseointegration rate and strength of bone-prosthetic bonding. Additional clinical data would enable the study of long-term efficacies of TAR compared with ankle fusion, as the risks of postoperative complications of TAR, such as bone resorption, contact stress, and migration, are known to increase with time.

Extensive bone loss has plagued previous generations of TAR devices, and current products aim to minimize resection of bone to promote implant stability. However, new designs evolving from updated design philosophies require less bone resection, leaving stronger bone to secure the prosthesis, and these advances in implant design hold promise for improved outcomes in the future. However, the price tag of approximately USD 9,500 is limiting the adoption of TAR prostheses in developing countries.

“China, India, and Brazil will be experiencing a rapid market growth in the coming years, but their market value in 2018 may still be rather low compared with that generated from the developed countries,” concluded GlobalData analyst Linda Tian.

GlobalData values the global TAR market across the US, France, Germany, Italy, Spain, the UK, Japan, Brazil, China, and India at USD 100.9 million in 2011, and predicts further expansion at a compound annual growth rate (CAGR) of 15.3% to reach USD 273.2 million by 2018.

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