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Bone Graft Substitutes Market Size, Share & COVID-19 Impact Analysis, By Type (Autograft, Allograft, Demineralized Bone Matrix (DBM), Synthetic, and Xenograft), By Application (Spinal Fusion, Joint Reconstruction, Foot & Ankle, and Others), By End User (Hospitals, and Specialty Clinics), and Regional Forecast, 2020-2027

Region : Global | Format: PDF | Report ID: FBI103106



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The global bone graft substitutes market size was USD 3.18 billion in 2019. The global impact of COVID-19 has been unprecedented and staggering, with the global market witnessing a negative demand shock across all regions amid the pandemic. Based on our analysis, the market will exhibit a huge decline of -12.6% in 2020. The market is projected to grow from USD 2.78 billion in 2020 to USD 3.93 billion in 2027 at a CAGR of 5.1% in the 2020-2027 period. The sudden rise in CAGR is attributable to this market’s demand and growth, returning to pre-pandemic levels once the pandemic is over.

Bone grafting is a surgical procedure that restores a displaced bone with bone grafts or its substitutes to fix bone fractures that pose a significant health risk to the patient. Bone grafting is done for compound fractures and is majorly used in spinal fusion procedures. Physicians can use bone grafts to stabilize a corrected spinal deformity, prevent motion between two or more vertebral bodies, or repair spinal fractures. The bone graft doesn't fuse or heal the spine immediately, but it offers a scaffold or foundation for the patient's body to grow a new bone.

The increasing incidence of trauma cases worldwide is one of the major factors propelling the market growth. Moreover, the growing research and development activities, coupled with various nonprofit organizations sparing clinical research funds, is another significant factor adding impetus to the market growth.

Decreased Orthopedic Procedures due to the COVID-19 Pandemic to Exert a Negative Impact on the Global Market

In terms of the medical devices market, the COVID-19 pandemic has had a negative impact due to the significant volumes of cancellation or postponement of elective medical procedures, including elective orthopedic surgeries. Elective surgeries, including orthopedic surgeries, have witnessed a significant decline from the later stages of Q1 2020 till mid Q2 2020. Various regional and national governing agencies have laid down regulations that have led to the deferral of elective surgeries and reallocation of healthcare resources towards tackling the pandemic. This led to a decline in the number of patients undergoing elective or even moderately elective orthopedic surgeries. The withdrawal of lockdown regulations in most countries is expected to normalize the current scenario up to a certain extent by the end of 2020.

The major players such as DePuy Synthes, Zimmer Biomet, Stryker, Smith & Nephew, and Medtronic have witnessed a decline in their sales due to the coronavirus pandemic. For instance, Medtronic witnessed an overall decline of 26.0% in revenues in the fourth quarter, which ended in April 2020. Hence, the COVID-19 pandemic is expected to exert a negative impact on the global market.


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Increasing R&D Initiatives to Bolster Market Growth

One of the most prevalent trends in the global market is the strong ongoing R&D initiatives to develop novel product offerings. This increase in ongoing R&D is further bolstered because there is a high demand for efficient bone graft substitutes for bone associated incidents such as simple or complex fractures and trauma. Similarly, the increasing number of orthopedic surgical procedures such as spine surgeries are expected to lead to greater growth prospects for companies engaged in the R&D processes. This is primarily because an increasing number of orthopedic patients are demanding better treatment outcomes.

For instance, in February 2020, MTF Biologics, a global nonprofit organization engaged in the advancement of tissue and organ donation, transplantation, and research, awarded over USD 1.8 million in funding to 12 researchers across the nation through its 2019 Extramural Research Grants Program. Such initiatives are expected to lead to the development and subsequent product launches globally.


Rising Number of Orthopedic Surgeries to Drive Global Market

One of the foremost drivers of the global market is the increasing usage of the product for a wide range of orthopedic procedures. This is especially applicable as some of the critical application areas of these product offerings include spinal surgeries such as spinal fusion procedures for the treatment of complex fractures and the treatment and management of trauma cases. Bone graft substitutes serve as an optimum treatment strategy and are often considered indispensable, which has further led to the increasing demand for these product offerings.

A substantial increase in trauma cases globally has been noted, and such trauma cases can only be treated and managed effectively with the administration of these products. For instance, according to the Centers for Disease Control and Prevention (CDC), an estimated 40.0 million people were treated in an emergency department for injuries in 2017 in the U.S. These contributive factors have surged the demand for the product during the forecast period.

Surging Adoption of Synthetic Substitutes to Aid Market Growth

Another critical factor leading to the growth of the market during the forecast period is the increasing adoption of synthetic product types. Several advantages are associated with their adoption, such as the lesser risk of morbidity, high sterility, and infinite supply than other sources. Some other advantages of synthetic bone void fillers include decreased pain in the patients, reduced risks of complications, and avoidance of risks involved in injury to the donor site.

For example, tricalcium phosphate (beta-TCP) is an osteoconductive calcium phosphate and is considered to have a similar chemical composition to human bone and is increasingly used as a bone graft substitute. For instance, the Vitoss Synthetic Bone Graft product portfolio by Stryker is a prominent example of the synthetic bone graft substitute. Furthermore, synthetic bone void fillers have a wide range of application areas where they can be administered. This is expected to drive the market during the forecast period.


Certain Clinical Limitations to Hinder Market Growth

One of the strong restraining factors of the market is certain clinical limitations, such as the adverse reactions arising from the administration of these products. For instance, despite high risks such as infections and high morbidity associated with autogenous and allograft bone transplantations, it is still considered the gold standard in bone grafts across several regions. In certain cases, this may lead to the adoption of synthetic product types, leading to the restricted growth of the market in the forecast period.

Another factor restraining growth is the clinical limitations associated with certain types of bone graft substitutes. For instance, until recently, the synthetic product types only had osteoconductive properties and demonstrated a distinct absence of osteoinductive and osteogenic properties. Although recent product offerings have tried to mask the absence of osteoinductive and osteogenic properties, these factors are critical in limiting the growth of the market during the forecast period.


By Type Analysis

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Synthetic Segment to Grow at Faster Pace during 2020-2027

Based on type, the market includes autograft, allograft, demineralized bone matrix (DBM), synthetic, and xenograft.

The synthetic segment can be further segmented into polymer and ceramic. The ceramic segment can be further segmented into hydroxyapatite, beta TCP, and others. The synthetic segment held a dominant share of the market in 2019. The dominance is due to the greater adoption of this type due to advantages such as the lack of risk of infections, the infinite supply of raw material for the manufacturing of this type, and the increasing number of product launches in this segment.

The allograft and autograft segments were projected to account for the second and the third most dominant segment during the forecast period. However, they are anticipated to account for comparatively lower CAGRs due to the increasing transition of the patient population to bone graft substitutes free of biological composition.

The demineralized bone matrix (DBM) is anticipated to register a comparatively higher growth rate due to the presence of strong products such as Medtronic’s GRAFTON DBM.

The xenograft segment is anticipated to register the lowest growth rate due to the lack of high procedure volumes for this type of bone graft substitute.

By Application Analysis

Spinal Fusion Segment Accounted for the Highest Market Share in 2019

Based on application, the market is segmented into spinal fusion, joint reconstruction, foot & ankle, and others.

The spinal fusion segment is anticipated to dominate the market during the forecast period owing to the strong demand for these products in spinal fusion procedures.

The joint reconstruction segment is projected to be the second dominant segment due to the strong volume of hip and knee replacement procedures that used these product offerings.

Foot & ankle segment accounted for a lower share of the global market but is expected to register a comparatively higher CAGR due to the increasing usage of these graft substitutes to treat foot & ankle diseases or conditions.

By End User Analysis

Hospitals Segment Dominated the Market in 2019

On the basis of the end-user, the market can be segmented into hospitals and specialty clinics.

The hospital segment is anticipated to be the dominant segment of the global market during the forecast period because of the increasing number of patient’s dependent on these medical settings for various critical orthopedic procedures such as spinal fusion and joint reconstruction surgeries.

The specialty clinics segment is anticipated to record the highest CAGR. An increasing number of patient pools visit these settings for specialist and focused orthopedic care in both the developed and emerging regions.


North America Bone Graft Substitutes Market Size, 2019 (USD Billion)

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Based on the regions, the global market can be segmented into North America, Europe, Asia Pacific, Latin America, and the Middle East & Africa.

North America stood at USD 1.27 billion in 2019. The region is anticipated to dominate owing to the higher volume of orthopedic surgeries, coupled with the strong adoption of advanced bone graft substitutes such as the synthetic product offerings. Other contributing factors to the region’s dominance include new product launches, further bolstered by the high medical expenditure and the presence of prominent companies. For instance, according to the 2018 statistics published by Wolters Kluwer Health, Inc., elective lumbar fusion operations increased 62.3% by volume from 122,679 cases in 2004 to 199,140 in 2015 in the United States. These factors are anticipated to support the region’s growth in the forecast period.

Europe is anticipated to be the second most dominant market during the forecast period due to the adoption of technologically sophisticated bone graft substitutes, growing medical expenditure, and a strong volume of orthopedic surgeries in the region.

Asia Pacific is expected to register the highest CAGR during the forecast period. This is attributable to the presence of a strong potential patient population, increasing demand and adoption of advanced bone graft substitutes, and developing healthcare infrastructure in the region leading to the conduction of critical orthopedic surgeries in the region.

The other markets include Latin America and the Middle East & Africa, which registered a lower CAGR and market share during the forecast period. However, these regions may witness more robust growth prospects in the future due to the development of healthcare infrastructure, increasing healthcare expenditure, and the presence of key companies. Furthermore, greater awareness and demand from the general population for effective orthopedic procedures for better treatment outcomes is likely to favor market growth.


Advanced Product Portfolios of Medtronic, Stryker, and Zimmer Biomet to Lead to Their Dominance

The market is dominated by prominent players such as Medtronic, Zimmer Biomet, Stryker, and DePuy Synthes in terms of the competitive scenario. These companies have several technologically advanced diverse product portfolios, coupled with a broader geographical presence. Collectively, these companies are projected to account for the dominant share of the global market during the forecast period. Furthermore, these companies are engaged in constant new product launches in different application areas of orthopedics.

For instance, Stryker has a diverse and technologically advanced product portfolio covering various application areas and different types of bone graft substitutes. Some prominent product offerings of Stryker include the Vitoss product portfolio, which has offerings such as Vitoss BBTrauma, Vitoss BA, Vitoss BA2X, and Vitoss BiModel.

Other important players in the global market include private companies such as SeaSpine, MTF Biologics, and Bioventus. These companies focus on new product launches to increase their market presence during the forecast period.


  • Medtronic (Dublin, Ireland)

  • DePuy Synthes Companies (Johnson & Johnson Services, Inc.) (New Brunswick, U.S.)

  • RTI Surgical Holdings, Inc. (Alachua, U.S.)

  • Stryker (Kalamazoo, U.S.)

  • Zimmer Biomet (Warsaw, U.S.)

  • Smith & Nephew plc (London, U.K.)

  • Wright Medical Group N.V. (Amsterdam, The Netherlands)

  • SeaSpine (Carlsbad, U.S.)

  • AlloSource (Centennial, U.S.)

  • Bioventus (Durham, U.S.)

  • MTF Biologics (Edison, U.S.)

  • Orthofix Holdings, Inc. (Lewisville, U.S.)

  • Exactech, Inc. (Gainesville, U.S.)

  • Aesculap, Inc. (B. Braun Company) (Tuttlingen, Germany)

  • Other Players


  • November 2020 – Stryker announced its acquisition of Wright Medical Group N.V., a medical device company focused on extremities and biologics. This acquisition further strengthens Stryker’s bone graft substitutes portfolio.

  • September 2019 – Isto Biologics announced the launch of Influx Demineralized Bone Matrix (DBM) Putty, which is expected to expand the company’s Influx portfolio.

  • February 2019 – Medtronic announced the launch of Grafton demineralized bone matrix in Japan for use in orthopedic procedures.


An Infographic Representation of Bone Graft Substitutes Market

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The global bone graft substitutes market research report provides a detailed analysis of the market. It focuses on key aspects such as recent industry developments such as mergers & acquisitions, insights on funding scenarios pertaining to research and development of bone grafts substitutes, product pricing analysis, industry background of the market, key industry trends, new product launches, and impact of COVID-19 on the global market. Besides this, the report offers insights into the market trends and highlights key industry dynamics. In addition to the aforementioned factors, the report encompasses several factors that have contributed to the growth of the global market over recent years.

Report Scope & Segmentation



Study Period


Base Year


Forecast Period


Historical Period



  Value (USD Billion)


  Type, Application, End-User, and Geography

By Type


  • Autograft

  • Allograft

  • Demineralized Bone Matrix (DBM)

  • Synthetic

    • Polymer

    • Ceramic

      • Hydroxyapatite

      • Beta TCP

      • Others

  • Xenograft

By Application


  • Spinal Fusion

  • Joint Reconstruction

  • Foot & Ankle

  • Others

By End User


  • Hospitals

  • Specialty Clinics

By Geography


  • North America

    • By Type

    • By Application

    • By End User

    • By Country

      • U.S.

        • By Type

      • Canada

        • By Type

  • Europe

    • By Type

    • By Application

    • By End User

    • By Country/ Sub-Region

      • UK

        • By Type

      • Germany

        • By Type

      • France

        • By Type

      • Italy

        • By Type

      • Spain

        • By Type

      • Scandinavia

        • By Type

      • Rest of Europe

        • By Type

  • Asia Pacific

    • By Type

    • By Application

    • By End User

    • By Country/ Sub-Region

      • Japan

        • By Type

      • China

        • By Type

      • India

        • By Type

      • Australia

        • By Type

      • South East Asia

        • By Type

      • Rest of Asia Pacific

        • By Type

  • Latin America

    • By Type

    • By Application

    • By End User

    • By Country/ Sub-Region

      • Brazil

        • By Type

      • Mexico

        • By Type

      • Rest of South America

        • By Type

  • The Middle East & Africa

    • By Type

    • By Application

    • By End User

    • By Country/ Sub-Region

      • South Africa

        • By Type

      • GCC Countries

        • By Type

      • Rest of Middle East & Africa

        • By Type

Frequently Asked Questions

Fortune Business Insights says that the global market size was USD 3.18 billion in 2019 and is projected to reach USD 3.93 billion by 2027.

In 2019, North America stood at USD 1.27 billion.

Registering a CAGR of 5.1%, the market will exhibit steady growth during the forecast period (2020-2027).

The synthetic segment is expected to be the leading segment in this market during the forecast period.

The increasing number of orthopedic surgeries, strong demand for technologically advanced products, and new product launches are major factors driving the growth of the market.

Medtronic, Zimmer Biomet, Stryker, and DePuy Synthes are some of the global market players.

North America dominated the market share in 2019.

Launch of technologically advanced companies, rising cases of orthopedic surgeries, and the increasing prevalence of bone associated conditions necessitating the need for effective product offerings are expected to drive the adoption.

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