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U.S. Bone Void Fillers Market Size, Share & COVID-19 Impact Analysis, By Type (Demineralized Bone Matrix, Calcium Sulfate, Tri-calcium Phosphate, Bi-Phasic Calcium Phosphate, Hydroxyapatite, Silicates, and Others), By Form (Gel, Granules, Paste, Putty, and Others), By Application (Spinal Fusion, Joint Reconstruction, Foot & Ankle, and Others), By End-user (Hospitals and Ambulatory Surgical Centers, Specialty Clinics, and Others), and Forecast, 2022-2029

Region : USA | Format: PDF | Report ID: FBI106770



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The U.S. bone void fillers market size was valued at USD 1.17 billion in 2021. The market is projected to grow from USD 1.33 billion in 2022 to USD 2.06 billion by 2029, exhibiting a CAGR of 6.5% during the forecast period. The global COVID-19 pandemic has been unprecedented and staggering, with bone void fillers experiencing lower-than-anticipated demand across the U.S. compared to pre-pandemic levels. Based on our analysis, this market exhibited a decline of -8.9% in 2020 as compared to 2019. 

A bone void is a cavity in a bone that results from a failure of the bone’s self-healing process. Bone void fillers are the biological materials intended to fill gaps in bones or bony voids of the spine, pelvis, and extremities. Hydroxyapatite, calcium sulfate, and calcium phosphate are some of the major materials used for bone void filling.

The U.S. market is majorly driven by factors such as rising incidence of injuries and fractures related to the spine and the growing incidence of bone tumors & bone infections across the country. Moreover, the strong focus of manufacturers on the introduction of synthetic products due to various benefits associated with them is expected to contribute to the market growth during the forecast timeframe. 


COVID-19 had Negative Impact on the Market Growth due to Declining Patient Visits           

COVID-19 impeded the demand for bone void filling materials due to decreased patient volume. Key players operating in the market witnessed a considerable dip in their activities and earnings, largely due to the pandemic. The reallocation of healthcare resources, reducing number of patient visits, supply chain disruptions, and other key factors hampered the sales of bone void filling materials in the U.S., mainly during the first six months of 2020. Based on revenue, the market observed -8.9% dip in 2020.

For instance, Zimmer Biomet registered a decline of around -12.0% in total revenues generated in 2020 compared to 2019. The Sports Medicine, Extremities and Trauma (S.E.T.) segment that includes bone void fillers witnessed a decrease of -7.7% in 2020 as compared to 2019.

Meanwhile, in 2021, the patient volume bounced back in the U.S., owing to higher vaccination coverage among the general population, implementation of COVID-19 guidelines in public places, and travel restrictions. These factors prompted an increase in product demand. The revenues generated by Zimmer Biomet’s S.E.T. segment increased by 13.3% in 2021 as compared to 2020. Therefore, the resumption of services positively influenced the demand for bone void filling materials in 2021.


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Strong Investments in Antibiotic-eluting Bone Void Filling Materials to Boost the Market Growth

Total joint replacements, such as total knee replacement and total hip replacements, often require a revision in the patient’s lifetime as the prosthetic materials age. Factors, such as bone infections, aseptic loosening, and implant age, are increasing the rates of revision. The benefits provided by antibiotic eluting bone void fillers for revision surgeries are expected to boost the market.

  • For instance, antibiotic eluting products are used to fill defects created after debridement. These bone void filling products act as an effective local antibiotic release system to prevent and cure infections after total joint replacement surgeries. Moreover, they provide delivery of an antibiotic in a local targeted region for a longer time and allow the growth of new bones.

Additionally, the rising emphasis from leading companies on the launch of antibiotic eluting products is expected to accelerate the U.S. bone void fillers market growth during the forecast timeframe.

  • Specifically, in May 2022, the U.S. Food and Drug Administration (FDA) provided market authorization to BONESUPPORT AB for the company's antibiotic eluting product CERAMENT G for the indication of bone infection (osteomyelitis).

Such a strong focus of market players on launching antibiotic eluting products coupled with the benefits offered by these products in total joint replacement surgeries are expected to boost the market growth.


Rising Prevalence of Spinal Disorders and Bone Tumors to Drive the Market Growth

Spinal fusion is one of the most commonly performed spinal surgeries in the U.S. In spinal fusion, multiple vertebrae are fused together permanently to prevent movements between them. An increase in the number of spinal and orthopedic surgeries in the united states due to various bone fractures and sports injuries is driving the market growth.

  • For instance, according to the 2019 article by the National Center for Biotechnology Information, approximately 900,000 American adults undergo spine surgery annually. Of these surgeries, more than 75% of the spinal surgeries are performed in the U.S.

Moreover, a large number of bone void filling materials offered by the companies operating in the U.S. market target spine applications.

Thus, the presence of multiple bone void filling materials for spine applications, coupled with the rising prevalence of bone related diseases, is expected to drive the U.S. market growth over the projected period.

Introduction of Synthetic Bone Void Filling Materials to Contribute to the Market Growth

Synthetic products have several benefits over natural bone void filling materials. These benefits include little or no risk of contamination, a high success rate, and easy attainability and availability.

Such benefits associated with the synthetic products are increasing their demand from hospitals and ambulatory surgical centers in the U.S. Thus, due to the increased demand from these end-user settings, the manufactures are focusing on the introduction of synthetic products across the country.

  • For instance, in February 2022, Orthofix Medical Inc. launched a synthetic bioactive bone graft solution called Opus BA. This product is used for cervical and lumbar spine fusion procedures and can also be used to fill bone voids or gaps in the skeletal system that are not intrinsic to the stability of the bony structure. Such new launches of synthetic products are expected to drive the market in the coming years.


Alternatives such as Autograft and Allograft Transplantations for Bone Diseases to Limit the Market

Autograft and allograft transplantations are among the traditional treatments used for bone infections and bone void filling. Despite the increasing launches of synthetic products, a large population group in the U.S. still focuses on the utilization of allograft and autograft transplantations for their treatment.

  • For instance, according to information provided by RTI Surgical as an education service, in the U.S., approximately 1.75 million allografts are transplanted every year.

Moreover, several drawbacks associated with the use of synthetic bone void fillers, such as the inclusion of animal or marine-derived components, poor resorbability, and expensive cost, enable healthcare professionals to adopt traditional bone void filling treatments.

Such few disadvantages of synthetic products coupled with the presence of alternative options for treating bone infections are anticipated to limit the market to a certain extent.


By Type Analysis

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Soaring Popularity of Calcium Sulfate-based Bone Void Fillers among Orthopedic Surgeons to Boost the Segmental Growth

With respect to type, the market is categorized into tri-calcium phosphate, demineralized bone matrix, calcium sulfate, bi-phasic calcium phosphate, hydroxyapatite, silicates, and others.

The calcium sulfate segment accounted for a significant market share in 2021 and could grow at a considerable CAGR during the assessment period. The growth is largely due to factors such as rising adoption of bone void filling materials containing calcium sulfate by the spine and orthopedic surgeons and increasing launches of calcium sulfate-based products across the country.

  • To illustrate, in April 2019, orthopedic surgeons at Richmond University Medical Center performed the first surgery using InterSep, which is manufactured by Pacific Bioceramics and distributed exclusively by Exactech.

By Form Analysis

Increasing Research & Development Activities for Putty-based Products to Contribute to the Dominance of the Segment

In terms of form, the market is divided into gel, putty, paste, granules, and others. The putty segment accounted for the largest market share in 2021 and is estimated to grow at a substantial CAGR during the assessment period. The large share of this segment is due to orthopedic surgeons' increasing preference for putty-based bone void filling materials. Moreover, growing research and development activities for new products in putty form are expected to contribute to the dominance of the putty segment during the forecast period.

  • For instance, according to an article published by NCBI in November 2020, a clinical study was funded by the Department of Pharmaceutical Sciences, North Dakota State University, to evaluate the efficacy of an Antibiotic-Releasing Bone Void Filling (ABVF) putty for the treatment of osteomyelitis. Such funding for research & development of putty-based products drives the segmental growth.

By Application Analysis

Surging Number of Total Joint Replacement Procedures to Boost the Joint Reconstruction Segment

In terms of application, the market is segmented into joint reconstruction, spinal fusion, foot & ankle, and others.

In 2021, the joint reconstruction segment accounted for a considerable share of the market and is likely to grow at a moderate growth rate during the assessment period. An increasing number of total joint replacement procedures, such as knee and hip replacements, across the U.S. contributes to the segmental share.

  • According to the June 2020 article by the American Academy of Orthopedic Surgeons, more than 450,000 hip replacements are done each year in the U.S. Such a large number of hip replacements is likely to surge the demand for bone void filling materials, thereby fueling the segmental growth. 

By End-user Analysis

Large Patient Footfall in Hospitals and Ambulatory Surgical Centers to Drive the Segment

Based on end-user, the market is divided into specialty clinics, hospitals and ambulatory surgical centers, and others.

The hospitals and ambulatory surgical centers segment dominated the market in 2021 and is anticipated to lead from the front during the forecast period. The dominance of this segment is attributed to factors such as increasing number of patient admissions and a surge in the number of spinal surgeries in these end-user settings. Moreover, a significant number of hospitals and ambulatory surgical centers in the U.S. attracts a large patient pool for spinal and orthopedic surgeries, which, in turn, drives the segmental growth.


Companies with Robust Product Portfolio of Bone Void Fillers to Strengthen the Market Growth

Stryker, Zimmer Biomet, and Medtronic plc are some key companies operating in the U.S. bone void fillers market.

In 2021, Stryker and Zimmer Biomet accounted for the largest shares in the market. The large share of these companies is due to their diversified product portfolio. Moreover, focus of their bone void filling materials on the spine application area is also one of the reasons for their dominance in the market.

Other small and medium-sized companies, including BONESUPPORT AB, Biocomposites Ltd, and Collagen Matrix, Inc. are focusing on gaining their shares in the market through various strategies such as new product launches and investments in research & development of novel bone void filling materials.

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



  • July 2021 – Arthrex, Inc. announced an exclusive partnership with Celularity Inc. to distribute and commercialize biomaterial products of Celularity Inc. for sports medicine and orthopedic surgery.

  • December 2020 – Collagen Matrix, Inc., acquired Sunstar’s GUIDOR synthetic bone graft & membrane portfolio.   

  • March 2019 BONESUPPORT AB announced the launch of BONIFY, a demineralized bone matrix (DBM) product line, thereby expanding in the U.S. market. BONIFY aims to complement the company’s proprietary technology platform CERAMENT.

  • October 2018 – BONESUPPORT AB announced that it has started selling its CERAMENT Bone Void Filler (BVF) directly in the U.S. via the company’s own new network of distributors.

  • May 2018 – DePuy Synthes entered into an exclusive agreement with Prosidyan for the promotion of FIBERGRAFT family of products, a product line of synthetic bone grafts substitutes in the U.S


An Infographic Representation of U.S. Bone Void Fillers Market

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The U.S. bone void fillers market research report provides a detailed competitive landscape. It focuses on market size analysis of different product types. Additionally, it includes the key industry developments such as partnerships, mergers, and acquisitions. Furthermore, the report covers company profiles of key market players, market growth opportunities, and the impact of COVID-19 on the market. The report consists of quantitative and qualitative data contributing to the market's growth.

Report Scope & Segmentation



Study Period


Base Year


Estimated Year


Forecast Period


Historical Period



Value (USD Billion)

By Type

  • Demineralized Bone Matrix

  • Calcium Sulfate

  • Tri-calcium Phosphate

  • Bi-Phasic Calcium Phosphate

  • Hydroxyapatite

  • Silicates

  • Others

By Form

  • Gel

  • Granules

  • Paste

  • Putty

  • Others

By Application

  • Spinal Fusion

  • Joint Reconstruction

  • Foot & Ankle

  • Others

By End-user

  • Hospitals and Ambulatory Surgical Centers

  • Specialty Clinics

  • Others

Frequently Asked Questions

Fortune Business Insights says that the U.S. market stood at USD 1.17 billion in 2021 and is projected to reach USD 2.06 billion by 2029.

The market is expected to exhibit a CAGR of 6.5% during the forecast period (2022-2029).

The putty segment is set to lead the market by form.

The key factors driving the market are rising prevalence of spinal disorders and bone tumors and increasing launches of synthetic bone void fillers by the market players.

Zimmer Biomet, Stryker, and Medtronic are the top players in the market.

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