U.S. Joint Spacer Systems Market Size, Share & COVID-19 Impact Analysis, By Procedure Type (Knee, Hip, and Shoulder), By End-user (Hospital and Ambulatory Surgical Centers), By Region (Northeast, Midwest, South, and West), and Forecast, 2022-2029

The U.S. joint spacer systems market size was valued at USD 33.2 million in 2021 and is projected to grow from USD 38.4 million in 2022 to USD 73.3 million by 2029, exhibiting a CAGR of 9.7% during the forecast period. Based on our analysis, the U.S. joint spacer systems market exhibited a decline of -52.3% in 2020 as compared to 2019. The global COVID-19 pandemic has been unprecedented and staggering, with joint spacer systems experiencing lower-than-anticipated demand across the country compared to pre-pandemic levels.

Joint spacer systems are preformed spacers or articulating spacers loaded with antibiotics and available in different sizes. These medical devices are composed of bone cement and are used to maintain interim joint motion to enhance functional status and improve patient satisfaction. These spacers are the products for surgical procedures for treating prosthetic joint infection in the two-stage revision.

The U.S. market growth of joint spacer systems is attributed to the increasing cases of prosthetic joint infection and growing orthopedic implantations in the country. Furthermore, the market players are emphasizing the introduction of new products, which is predicted to fuel the market growth during the forecast period.

COVID-19 IMPACT 

Postponements of PJI Treatment Negatively Impacted the Market During the Pandemic

The COVID-19 outbreak has negatively impacted the demand for joint spacer systems due to decreased patient volume for joint arthroplasty procedures. Postponements and rescheduling of orthopedic procedures, the decline in hospital admissions due to health concerns, and stringent guidelines by healthcare associations regulating the orthopedic practice were some of the reasons responsible for the decline in two-stage revisions. This decline has resulted in lower adoption of spacers during the pandemic.

For instance, according to an article published by Cureus in 2021, it was reported that there was around 22.8% decline in the number of orthopedic surgeries in the first year of the pandemic.

Some of the major players operating in the U.S. joint spacer systems market are situated outside the U.S., which has impacted the distribution of these systems during COVID-19. The overall impact of COVID-19 on these spacer systems declined in revenues by an estimated -52.5% in 2020.

However, by 2021, patient volumes for the treatment of prosthetic joint infection started increasing as the regulations imposed by the government of various countries were relaxed. Therefore, the resumption of services positively impacted the demand for preformed spacer systems in 2021.

LATEST TRENDS

Rising Joint Spacer Systems Launches to Augment Market Growth

Various benefits associated with joint spacers enhanced the demand for products in the market. For instance, it provides a highly-effective spectrum of activity against around 90% of clinically-relevant bacteria and significantly reduces surgical site infections in high-risk primary arthroplasty patients.

Moreover, till 2015, only one company named Tecres S.p.A. was operating in the market. However, after 2015, the launches of these spacers increased and contributed to the overall market growth in the past few years.

The increasing incidence of prosthetics joint infection coupled with a growing number of orthopedic implantations has stimulated the market players to focus on developing and introducing preformed joint spacers to provide better treatment for prosthetic joint infection.

The continuous growing focus of manufacturers on the launches of preformed joint spacers is driving the U.S. joint spacer systems market growth.

DRIVING FACTORS

Growing Incidence of Prosthetic Joint Infection (PJI) to Boost the Demand for Joint Spacer Systems

The increasing orthopedic implantation procedures for knee, hip, and shoulder have increased the rate of PJI infection across the country.

• For instance, according to the research study published by NCBI in March 2019, the rate of prosthetic joint infection typically ranges between 0.5% to 1.0% for hip and shoulder replacements and 0.5% to 2.0% for knee replacements.

The two-stage revision procedure is a standard procedure in the U.S. to treat PJI, which has increased with the growing cases of prosthetic joint infection in the country. Thus, with the increasing number of two-stage revision surgeries, the demand for joint spacers is expected to increase during the forecast period.

Furthermore, market players are also launching advanced products in the country, which is expected to propel the demand for these spacers during the forecast period.

Such rising focus of the companies on introducing joint spacers and the growing incidence of prosthetic joint infections are expected to drive market growth in the coming years.

Increasing Number of Orthopedic Implantation Procedures to Propel the Market 

The growing number of orthopedic implantations has propelled the number of PJI cases, which has increased the demand for these systems for their treatment in the U.S.

• For instance, according to the American Academy of Orthopedic Surgeons study, the primary total knee replacement and primary total hip replacement numbers are projected to reach 1.28 million and 635,000 procedures by 2030, respectively. Such an increase in knee & hip implantations is expected to boost the demand for these spacer systems during the forecast period.

The companies’ increased focus on developing medical technology for preformed joint spacers to achieve a higher patient outcome is likely to improve the adoption of technologically advanced orthopedic implants. Moreover, fewer adverse effects related to post-implantation on the patient have increased the adoption of implants for orthopedic procedures.

The introduction of advanced spacers coupled with the increasing number of prosthetic joint infections is expected to contribute to the U.S. joint spacers market growth.

RESTRAINING FACTORS

Presence of Alternatives such as Surgeon-made Spacers Coupled with Adverse Effects Associated with Preformed Spacer Systems to Limit the Market Growth

Factors such as the presence of alternatives, such as surgeon-made spacers, and side effects associated with preformed spacer systems are anticipated to restrict the growth of the U.S. joint spacer systems market during the forecast timeframe.

Preformed joint spacers are the newly introduced product compared to surgeon-made spacers used in the two-stage revision arthroplasty. Moreover, surgeon-based spacers have easier availability across the country and have significant advantages in mobility, pain, bone loss, success, or re-infection rate than preformed spacers. Such advantages of surgeon-based spacers are expected to limit the adoption of these preformed spacer systems in the U.S.

Moreover, some adverse effects are associated with these devices such as relatively low-antibiotic dosage/elution and limitation on the type of antibiotic used.

Hence, better alternatives and drawbacks associated with preformed joint spacers are anticipated to limit the overall market growth during the forecast period.

SEGMENTATION

By Procedure Type Analysis 

Knee Segment to Lead Backed by Rising Prosthetic Joint Infection Incidences During Implantation Procedures

By procedure type, the market is segmented into knee, hip, and shoulder.

The knee segment was the largest segment in 2021 and is anticipated to register significant growth during the forecast period. The growth is attributed to the growing incidence of prosthetic joint infection, the presence of many spacers for knee procedures, and rising demand for the preformed joint spacer in prosthetic joint infection treatment.

The hip segment held a significant market share in 2021 and is anticipated to register lucrative growth during the forecast period. The strong market share of the segment is attributable to the increasing demand for the treatment of prosthetic joint infection coupled with growing two-stage revision hip procedures. Furthermore, the launch of an advanced hip joint spacer containing two antibiotic properties in the market is expected to contribute to the segmental growth during the forecast period.  

By End-user Analysis 

Hospital Segment to Dominate Backed by Increasing Medical Facilities

Based on end-user, the market is segmented into hospital and ambulatory surgical centers.

The hospital segment held the highest market share in 2021 and is anticipated to register substantial growth during the forecast period. The availability of advanced medical facilities in hospitals is propelling segmental growth. Also, an upsurge in the number of hospital visits by patients for the two-stage revision procedures for prosthetic joint infection treatment is driving the growth of this segment.

The ambulatory surgical centers segment is expected to grow at the highest CAGR due to the preferential shift among patients toward Ambulatory Surgery Centers (ASCs), the increasing number of ambulatory surgery centers, and the surge in hip and knee procedures performed in these settings.

• For instance, according to the annual report of the American Joint Replacement Registry, in October 2019, 367 hip and knee procedures were registered in ASCs, which witnessed an increase of 14.3% as compared to procedures registered in September 2019. This spike in hip and knee procedures in ASCs is expected to boost segmental growth.

REGIONAL INSIGHTS

Presence of a Large Number of Hospitals to Drive Device’s Demand from the South Region

Based on region, the market is segmented into Northeast, Midwest, South, and West.

The South region held a dominant share in 2021. The region's growth is attributable to the availability of superior healthcare quality in the region and the presence of a large number of hospitals in the region. Furthermore, the presence of one of the market players in this region is contributing to the dominant share of the region, among others.

• For instance, OsteoRemedies, LLC is situated in Tennessee, a state in the South region. The presence of this company in the region is anticipated to increase the distribution of the joint spacer due to the growing surgeries of total joint replacement in the South region.

The Midwest region is expected to be the second dominant region during the forecast period. Some factors contributing to the segment's growth include the growing incidence of prosthetic joint infection and the increasing focus of market players on introducing drugs in the region, which are expected to increase the demand for these joint spacers in the region during the forecast period.

KEY INDUSTRY PLAYERS

Diversified Joint Spacer Systems Offerings by Market Players to Fuel Market Growth

The market is highly consolidated in nature. There are only three key players operating in the U.S., Tecres S.p.A., OsteoRemedies, LLC, and Heraeus Holding.

Tecres S.p.A. is the dominant player in the U.S. The company’s products, such as InterSpace Knee, InterSpace Hip, and InterSpace Shoulder, are the first preformed spacers in the market. These joint spacers have been in the market for many years and have continued to perform well even with the introduction of products. The company's highest share is due to its robust product portfolio of preformed spacer systems and strong footprints in the U.S. market with an established distribution network.

OsteoRemedies, LLC, and Heraeus Holding are other players in the market. The growth of these companies is due to their constant focus on geographical expansions and new product development with advanced features. Moreover, the growing focus on introducing new joint spacers is expected to strengthen their market shares during the forecast timeframe.

List of Key Companies Profiled:

• Tecres S.p.A. (Italy)


• OsteoRemedies, LLC (U.S.)


• Heraeus Holding (Germany)

KEY INDUSTRY DEVELOPMENTS:

• October 2019: Heraeus Holding received approval from the U.S. FDA for COPAL exchange G Knee & Hip Spacers.


•  November 2018: OsteoRemedies, LLC announced the launch of the REMEDY SPECTRUM GV Hip Spacer System and SPECTRUM GV Bone Cement to provide broad-spectrum treatment options with both Gentamicin and Vancomycin.


•  October 2022:  Life Spine announced that it received clearance from the U.S. FDA to market the GHOST 3D-Printed Titanium Spacer System. The device is has a 3D-printed titanium interbody and listed on the company’s interbody portfolio to include PEEK, titanium, and now 3D-printed titanium spacers for treating spinal disorders. The new implants have integrated porous structures within the endplate surfaces, which helped in the surgical treatment of spinal. It also provides the solution for ALIF PLIF and lateral procedures. The large graft windows of these systems allow for packing bone grafting material. This system has a wide variety of posterior fixation, including NAUTILUS Spinal Fixation System, AVATAR Percutaneous Screw System ARx Spinal Fixation System, and CENTERLINE Midline Screw System. These advancements in the spacer systems provide opportunities for companies, such as Zimmer Biomet, to develop and introduce devices in developed regions such as North America.

REPORT COVERAGE 

The research report provides a detailed competitive landscape. It focuses on key aspects such as recent developments in the market and average pricing of joint spacer systems by key players. Additionally, it includes insights on the number of orthopedic implant procedures (hip, knee, and shoulder), the number of infected orthopedic implant procedures (hip, knee, and shoulder), and the U.S. market (in volume). Moreover, it covers the analysis of different segments, company profiles of key market players, and the impact of COVID-19 on the market. The report also encompasses an overview of technological developments and the U.S healthcare.

Report Scope & Segmentation 

ATTRIBUTE	DETAILS
Study Period	2018-2029
Base Year	2021
Estimated Year	2022
Forecast Period	2022-2029
Historical Period	2018-2020
Unit	Value (USD million)
Segmentation	By Procedure Type, End-user, and Region
By Procedure Type	Knee Hip Shoulder
By End-user	Hospital Ambulatory Surgical Centers
By Region	Northeast Midwest South West