Bone Void Fillers Market Size, Share & COVID-19 Impact Analysis, By Type (Demineralized Bone Matrix, Collagen Matrix, Calcium Sulfate, Tri-calcium Phosphate, and Others), By Form (Gel, Granules, Paste, Putty, and Others), By End-user (Hospital, Specialty Clinics, and Others), and Regional Forecast, 2022-2029

The global bone void fillers market size was valued at USD 2.88 billion in 2021. The market is projected to grow from USD 3.27 billion in 2022 to USD 4.98 billion by 2029, exhibiting a CAGR of 6.2% during the forecast period. The global COVID-19 pandemic has been unprecedented and staggering, with experiencing lower-than-anticipated demand across all regions compared to pre-pandemic levels. Based on our analysis, the global market exhibited a decline of -8.9% in 2020 as compared to 2019. 

Bone void fillers (BVF) are absorbable, biocompatible, bioactive, and osteoconductive biologic materials that are used to fill gaps and voids of the skeletal system such as the extremities, posterolateral spine, and pelvis. The biologic material provides stability and increases cell proliferation, resulting in the enhancement of bone regeneration for multiple types of orthopedic applications.

The bone void fillers market growth is attributed to the increasing prevalence of various bone diseases such as bone tumors and bone infections. Moreover, a growing geriatric population prone to fractures and bone injuries is anticipated to propel the demand for products to treat these injuries in the coming years. Furthermore, the growing demand for antibiotic eluting fillers for bone and the rising number of new product launches by market players are expected to boost the market growth during the forecast period.

In September 2021, Orthofix announced to launch Opus Mg set, a magnesium-based settable bone void filler for orthopedic procedures. Such a product launch is expected to increase the market revenue in the long term.

COVID-19 IMPACT

COVID-19 Negatively Impacted the Market Revenue Due to Canceled and Delayed Elective Surgeries

The emergence of COVID-19 has declined the demand for fillers used for bones due to cancellation and delayed elective orthopedic surgeries. Key market players recorded a significant decline in their revenues due to the COVID-19 pandemic. The restrictions imposed by the government, resulted in the declining number of surgeries, disruptions in supply chains, and other major parameters, impacted the sales of synthetic fillers, Demineralized Bone Matrix (DBM), and other fillers used in bone injuries, especially during the first half of 2020. In terms of revenue, the market witnessed a decline of 8.9% in 2020.

For instance, according to the study published by NCBI in June 2021, trauma surgeries decreased by 21.2% to 66.7% and elective orthopedic surgeries by 33.3% to 100%, while patient visits to these surgeries decreased by 37.7% to 74.2%.

The market players witnessed a significant decline in revenue generated during 2020. For instance, Zimmer Biomet recorded net sales of USD 7.03 billion in 2020. Net sales decreased by -12.0% compared to 2019 due to the deferral of elective surgical procedures from the COVID-19 pandemic.

However, in 2021, elective surgeries, such as orthopedic surgery and trauma surgery, started resuming as the regulations imposed by the government across various countries were relaxed. The patients and surgical volumes bounced back, owing to the factors such as strong guidelines and COVID-19 protocols in public places and dismissal of restrictions for travel. This led to the increased demand for fillers in 2021.

LATEST TRENDS

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Increasing Focus toward the Launch of Antibiotic Eluting Bone Void Fillers to Drive Market Growth

Clinical limitations such as bone infection during the procedures have increased the focus on the adoption of antibiotic eluting void fillers. The market players are focusing on increasing R&D activities and the subsequent launch of antibiotic eluting void fillers, which have also reduced bone infection during treatment.

BONESUPPORT AB has received approval for antibiotic eluting void fillers in the market, and it also has a significant number of pipeline products. Furthermore, the growing focus of market players on clinical trials to introduce products for the treatment of bone diseases is expected to fuel the market.

For instance, in June 2021, Elute, Inc. announced that the company received its first clinical trial authorization from the U.S. FDA to use its antibiotic eluting void filler product. This was the first FDA authorization to use EP Granules with Tobramycin in patients to treat bone infections.

 Such innovative product introductions are anticipated to fuel the growth of the market during the forecast period.

DRIVING FACTORS

Increasing Adoption of Synthetic BVF to Boost Market Growth

The increasing adoption of synthetic bone void fillers such as calcium sulfate and tri-calcium phosphate is expected to drive market growth. There are several advantages associated with these fillers, such as the less risk of morbidity, high sterility, and an infinite supply of these types of fillers instead of other sources of bone graft substitutes, leading to an increase in the demand during the forecast period.

Synthetic bone void fillers are composed of tri-calcium phosphate, which is an osteoconductive calcium phosphate and is considered to have the most similar chemical composition to human bone and is increasingly used as bone void fillers.

Key players such as BONESUPPORT AB and Biocomposites launched their products in the synthetic segment. These companies have experienced strong growth in recent years due to the increased adoption of their products. Recently, these companies have received approvals for their products and have been marketed across several countries in Europe.

For instance, in 2020, BONESUPPORT AB received the U.S. Food and Drug Administration (FDA) approval for CERAMENT BVF to use as a void filler for bone.

Such product launches are expected to drive the growth of the market over the forecast period.

Growing Burden of Bone Diseases & Other Bone Related Incidents to Drive Market Growth

The increasing prevalence of bone-related diseases such as bone tumors and osteomyelitis is driving the growth of the market. Additionally, other types of trauma, bone lesions, and bone fractures also require the administration of bone void fillers.

For instance, according to the American Cancer Society, Inc, the estimated number of diagnosed cases of primary bone cancer will be 3,910 in 2022, which is expected to fuel the product demand in the forecast timeframe.

The major application area of these fillers is in treating chronic osteomyelitis. This disease is a clinical challenge for orthopedic surgeons. However, using void filler with antibiotic properties is safe, reliable, and effective in treating contamination.

Such a high incidence of bone-related diseases is expected to boost the market growth in the coming years.

RESTRAINING FACTORS

Under Penetration and Certain Clinical Limitations of Bone Void Fillers to Limit Market Growth

The growing clinical limitations and under penetration of bone void filling material led to a reduction in their adoption. This reduced adoption is due to the high risks associated with them that include adverse tissue reaction, incomplete bone formation or lack of bone formation, infection of the soft tissue and bone, and breakage of the fillers with or without particulate formation.

The growing risks associated with these fillers have led to product recalls by the U.S. FDA, which negatively impact the brand image and position of the market players.  

• For instance, in February 2021, the U.S FDA announced the recall of Skeletal Kinetics, Llc's OSTEOVATION RMX 10CC. The U.S. FDA stated that the product kits did not maintain their setting characteristics for the labeled shelf-life duration.

According to various researchers, autogenous and allograft bone transplantation is still a commonly performed procedure, thereby limiting the adoption of these fillers. Moreover, the invasive nature of these fillers could limit their adoption across the globe.

SEGMENTATION

By Type Analysis

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Rising Adoption of Calcium Sulfate to Fuel the Segment

Based on type, the market can be segmented into the demineralized bone matrix, collagen matrix, calcium sulfate, tri-calcium phosphate, and others.

The demineralized bone matrix segment held the highest bone void fillers market share in 2021 and is expected to continue its dominance during the forecast timeframe. The segmental growth is attributed to the strong presence of demineralized bone matrix in the product portfolio of market players. Moreover, factors such as abundant donor sources, reduction of complications associated with autograft, and short recovery time are expected to fuel the segmental growth during the forecast period.  

The calcium sulfate segment is expected to expand at the highest CAGR during the 2022-2029 period. The growth is attributed to its antibiotic properties, leading to better results observed by users in lower-extremity osteomyelitis treatment. Moreover, the increasing number of product launches and adoption of synthetic void fillers such as calcium sulfate is expected to drive the segment during the forecast period.

• For instance, in April 2019, Exactech announced that it has conducted its first successful surgery using InterSep, manufactured by Pacific Bioceramics. InterSep is a synthetic calcium sulfate bone void filler that is used for the complete resorption and replacement of bone during healing.

By Form Analysis

Increasing Product Launches to Drive the Putty Segment

Based on form, the global market can be segmented into gel, granules, paste, putty, and others.

The putty segment held the highest market share in 2021 and is projected to expand at the highest CAGR during the forecast timeframe. The rising prevalence of bone diseases is expected to increase the demand for demineralized bone matrix in the putty form, especially in developing countries that are more dependent on DBM as compared to other bone void fillers. Furthermore, the new product launches by the market players are expected to fuel the segmental growth in the long run.

• For instance, in 2019, in Japan, Medtronic Plc announced the launch of Japan's First DBM Bone Grafting product for spine and orthopedic procedures, called the Grafton DBM, which is present in the putty form.

The paste segment is expected to expand at a substantial growth rate during the bone void fillers market forecast period. The high preference and continuously increasing adoption of the paste form is due to its advantages such as better biocompatibility and osteoconductivity than other forms. Furthermore, the growing research studies to enhance the benefits of paste fillers are expected to boost their demand during the forecast timeframe.

• For instance, in February 2020, a clinical investigation was initiated by BBS-Bioactive Bone Substitutes at the clinical centers in Finland and Poland. In this study, ARTEBONE paste was used as a bone void filler for infusions of the ankle and subtalar joints. The paste form showed no safety concerns or product-related complications. It reduced the known risks and morbidity associated with synthetic bone growth factor products.

Such positive results from research studies are expected to increase the adoption of paste form during the forecast period.

By End-user Analysis

Surge in the Orthopedic Surgeries in Hospitals to Drive the Segmental Growth

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

The hospitals segment is expected to dominate the global market during the forecast period. The growth is attributed to the rising number of hospitals in developed and developing countries. Moreover, a large patient pool visiting hospitals for treatment coupled with the increasing number of orthopedic procedures being conducted in hospital facilities are expected to contribute to the segmental growth during the analysis timeframe.   

• For instance, according to the annual statistics summary published by CIHI, in 2020, 63,496 hip replacement procedures were performed in Canada, which represented 2.4% increase compared to 2019.

The specialty clinics segment is anticipated to account for a substantial market share during the forecast period. The segmental growth is attributed to the number of specialty clinics providing orthopedic treatments and increased investment by governments and other organizations. Moreover, the treatment and management of bone voids require specialized care, and thus, the adoption of these fillers across specialty clinics is expected to increase in the coming years.  

The others segment (which includes medical institutions, ASCs, and trauma centers) is expected to grow at moderate CAGR due to the increasing demand for same-day surgical care.

REGIONAL INSIGHTS

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On the basis of region, the global market can be segmented into North America, Europe, Asia Pacific, Latin America, and the Middle East & Africa.

North America dominated the market, accounting for USD 1.35 billion in 2021 and is expected to continue its dominance during the forecast timeframe. The rapid adoption of synthetic void fillers which involve different material types such as tri-calcium phosphate and calcium sulfate and the increasing launch of advanced products by market players are expected to drive market growth in the region. Moreover, an increasing number of patients suffering from bone diseases, rising bone surgeries, and a strong presence of key market players in the region are anticipated to drive the market growth across North America.

Europe held the second-highest market share in 2021 and is anticipated to expand at a substantial CAGR during the forecast period. The growth is attributed to the presence of strong and emerging market players such as Biocomposites and BONESUPPORT AB. Moreover, the approval of products used for the management and treatment of bone voids is expected to fuel the market growth in Europe.

• For instance, in April 2020, BONESUPPORT AB announced that their product offering of STIMULAN received a new CE Mark from the European Union to mix antibiotics such as vancomycin, gentamicin, and tobramycin in void fillers. It can be used as a treatment option in the management of infected bone and soft tissue.

Asia Pacific is expected to expand at the highest CAGR during the forecast period. The highest CAGR of the region is attributed to the increasing arthroplasty and trauma surgeries and the growing geriatric population. Moreover, increasing product launches by the market players coupled with the growing awareness related to the treatment of bone voids are expected to drive market growth during the forecast timeframe.

Latin America and the Middle East &Africa are expected to expand at a comparatively lower CAGR during the forecast period. The growth is attributed to increasing healthcare expenditures, growing elective orthopedic surgeries, and increasing focus of market players to launch products in these regions during the projected timeframe.

KEY INDUSTRY PLAYERS

Companies with a Strong Product Portfolio to Hold Largest Market Share

Zimmer Biomet, Stryker, and DePuy Synthes Companies are prominent players in the market and accounted for a significant market share in 2021. The market share of these companies is attributed to factors such as a strong product portfolio focused on the application area of the spine, which is the largest application area of bone void fillers. Furthermore, the introduction of new products and acquisitions of other companies are the major factors anticipated to strengthen the position of these companies in the market.

• For instance, in November 2020, Stryker acquired Wright Medical to strengthen the company’s biologics portfolio, including bone void fillers.

Other companies operating in the market include Biocomposites Ltd, BONESUPPORT AB, Collagen Matrix, Inc., and other regional players. These companies are focusing on various strategic developments such as mergers & acquisitions, new product launches with advanced features, and expansion across untapped markets.

LIST OF KEY COMPANIES PROFILED:

• BONESUPPORT AB (Sweden)


• Biocomposites (U.K.)


• Collagen Matrix, Inc (U.S.)


• Zimmer Biomet (U.S.)


• Stryker (U.S.)


• Arthrex, Inc. (U.S.)


• DePuy Synthes (U.S.)


• Graftys (France)

KEY INDUSTRY DEVELOPMENTS:

• January 2022: BONESUPPORT AB announced a distribution agreement with OrthoPediatrics Corp. to distribute CERAMENT BONE VOID FILLER to pediatric hospitals within the U.S.


• December 2020: Collagen Matrix, Inc. announced the acquisition of Sunstar’s Degradable Solutions division, including its GUIDOR family of bone graft substitutes.

REPORT COVERAGE

An Infographic Representation of Bone Void Fillers Market

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The research report provides a detailed competitive landscape. It focuses on key aspects such as new product launches in the market. Additionally, it includes an overview of guidelines for the fillers, indication, site of placement of bone void filling material, and key industry developments such as mergers, partnerships, and acquisitions. Moreover, it covers regional analysis of different segments, company profiles of key market players, and the impact of COVID-19 on the market. Besides this, the report provides epidemiology of bone tumors. The report also encompasses qualitative and quantitative insights that contribute to the growth of the market.

Report Scope & Segmentation