As people worldwide increasingly participate in sports activities and physical sports, accidents consisting of sprains, fractures, and muscle tears have multiplied. According to ResearchAndMarkets, in America alone, about 30 million kids and teenagers take part in organized sports, and over 3.5 million injuries every 12 months cause members to miss a while from their sports activities.

Technological advancements in orthopedic implants and minimally invasive surgical strategies drive the global sports medicine market. These improvements provide specific, less invasive, quicker recovery alternatives, with advanced materials like titanium alloys improving implant durability. Minimally invasive processes like arthroscopy also reduce trauma and healing times, fueling demand.

“Some of the market drivers we see influencing the sports medicine landscape include advanced healing techniques including biological technologies that repair and regenerate soft tissue, a focus on joint preservation for increased longevity, the shift in site-of care from traditional hospital facilities to Ambulatory Surgical Centers (ASCs), and advancing the development of a solution to treat mild to moderate osteoarthritis and delaying interventional medicine,” said Christie Van Geffen, senior VP of global strategic marketing for Smith+Nephew.

The sports medicine market is classified based on its end-users, which include hospitals, ASCs, physiotherapy centers, and clinics. Hospitals are among the key players in the sports medicine market because of their role as primary care vendors for sports activities-related injuries.

ASCs are modern healthcare facilities that focus on providing same-day surgical care. They’ve transformed the outpatient experience for millions of Americans by offering a more convenient alternative to hospital-based outpatient procedures. According to the Ambulatory Surgery Center Association (ASCA), as of 2022 there were 2,233 Medicare-certified ASCs specialized in orthopedic surgery.

Companies operating in sports medicine technology have taken notice of this trend, aligning their business goals to meet the demand for same-day surgeries for sports-related injuries.

“One of the most prevalent market forces for which customers have sought assistance from Arthrex is the transition of surgical procedures from hospital inpatient settings to outpatient and ambulatory settings,” stated Jimmy Dascani, director of health care administrator relations at Arthrex. “As customers strive to differentiate themselves, optimize operations, achieve service line expansion, and enhance the overall patient experience, we anticipate that this trend will persist.”

Healthcare provider markets have also become increasingly consolidated over the past 30 years. Following a wave of consolidation in the early and mid-1990s, there were 1,573 hospital mergers from 1998 to 2017 and another 428 hospital and health system mergers announced from 2018 to 2023, according to KFF, an independent source for health policy research, polling, and news.

“The most significant market changes are not necessarily in technology but in the consolidation of physician practices through mergers, private equity, and hospital acquisitions,” said Michael McBrayer, senior VP of business development and professional relations at Enovis Bracing and Supports. “What we used to call the ‘practice’ of medicine is now the ‘business’ of medicine.”

“Products not only need to keep up with physician and patient demands, but also how they are managed in the practice,” Michael McBrayer went on. “Patients are becoming more consumer-minded with their healthcare choices, and changes to health insurance have made them more aware of their out-of-pocket costs.”

All-Star Technologies

Smith+Nephew fortified its sports medicine business by acquiring CartiHeal for $180 million in January 2024. The company developed AGILI-C, a technology that can regenerate cartilage in the knee.

The AGILI-C cartilage repair implant is a porous, biphasic biomaterial derived from naturally occurring calcium carbonate. It’s billed as an off-the-shelf, one-step treatment for osteochondral (bone and cartilage) lesions with a broader indication than existing treatments. Smith+Nephew reported in a 251-patient randomized controlled trial, that the implant delivered clinically meaningful improvements in pain, function, and quality of life compared to microfracture and/or debridement, the surgical standard of care. It’s indicated to treat a wide patient population, including those with lesions in knees with mild to moderate osteoarthritis, a previously unaddressed condition.

“These results were seen in patients with very broad indications, including patients up to 75 years old and with lesions up to 7cm²,” said Steven Moore, senior director of Smith+Nephew’s CartiHeal business. “This study also allows for CartiHeal AGILI-C’s indication in treating cartilage lesions in knees with the presence of mild to moderate osteoarthritis (KL 0-3), a previously unaddressed condition, as well as the ~700,000 patients that receive cartilage repair annually in the U.S. Patients treated with CARTIHEAL AGILI-C also saw statistically significant improvements regardless of lesion location in overall patient reported KOOS scores at 48-months post-operation when compared to patients treated with microfracture and/or debridement.”

Smith+Nephew also purchased Rotation Medical in 2018, adding the REGENETEN bioinductive implant to its lineup. The bioengineered scaffold composed of purified, type I collagen fibers its attached to tendons after, or instead of, a repair using sutures and suture anchors. REGENETEN is implanted arthroscopically through a small incision over the location of a rotator cuff tendon injury. 

About the size of a postage stamp, the implant is completely resorbed within six months. Over those six months, the REGENETEN implant is replaced by a new layer of tendon-like tissue, thickening the tendon and helping it to heal.

“Since acquiring the REGENETEN Implant in 2018, we have invested millions into globalization and research, resulting in a mountain of clinical evidence including recent randomized controlled trials demonstrating significantly improved outcomes with the REGENETEN implant versus standard techniques for repairing rotator cuff tendons,” said Kieran Lenehan, senior global market manager of Smith+Nephew’s Shoulder Repair business.

Arthrex’s NanoNeedle Scope imaging technology was launched with the aim of revolutionizing diagnosis and surgical treatment. The highly portable visualization system lets surgeons perform minimally invasive arthroscopy in the operating room, procedure room, or diagnostically in the physician’s office.

NanoNeedle is touted as an alternative to MRI imaging and second-look arthroscopy. Its advanced technology includes 1.0-mm imaging sensors, LED lighting, image management, and OR integration, with intuitive tablet control. Arthrex said it’s designed for a dynamic, true, needle-like feel for precise control in all joint spaces using chip-on-tip technology without a traditional camera head.

“Given the recent IV fluid shortage, surgeons are also optimizing potential saline savings by utilizing the Arthrex NanoNeedle Scope and the DualWave™ arthroscopy pump, which enhances fluid efficiency by reducing the amount of saline used in the joint space while simultaneously minimizing incision size and scarring,” said Dascani.

Enovis’ MotionMD software platform was developed in response to patients being more consumer-minded with healthcare choices. The HITRUST certified, software-as-a-service (SaaS) platform was designed to automate inventory management and compliant form completion, while boosting the patient experience.

MotionMD offers robust insights into the financial performance of a customer’s durable medical equipment (DME) program. Actionable data and financial dashboards with current and historic metrics can help to make smarter business decisions, Enovis said.

“More than 9 million claims have been processed through MotionMD and it’s integrated with over 60 EMR vendors,” said Michael McBrayer. “Moreover, because of the ever-growing debt related to healthcare costs, price transparency is key to allowing patients to make knowledgeable decisions and healthcare facilities to provide best-in-class patient experiences and run profitable businesses. Enovis’ VeriPro system provides real-time insurance verification, so patients know which out-of-pocket expenses they’re responsible for.”

Miach Orthopaedics reconstructed the paradigm for anterior crucial ligament (ACL) repair in 2021, rolling out its BEAR (Bridge Enhanced ACL Repair) implant in the U.S. ACL tears are one of the most common sports injuries of the knee. It’s marketed as the first medical technology to clinically demonstrate it can enable healing of a torn ACL.

“The BEAR Implant took more than 20 years to develop from concept to FDA approval,” said Patrick McBrayer, president and CEO of Miach Orthopaedics. “The BEAR technology was pioneered by Martha Murray, M.D., at the Boston Children’s Hospital Department of Orthopaedic Surgery, with initial research funding provided by the NFL Players Association, Boston Children’s Hospital, and the National Institutes of Health. Dr. Murray’s life work was to figure out how ACLs could be healed after one of her friends tore their ACL and described how it would be replaced during surgery. Before the development of the BEAR Implant, the biology behind why the ACL cannot heal on its own was not known.”

The BEAR Implant has several benefits over ACL reconstruction, according to Miach. First, it retains the knee’s normal anatomy and function. The company also said it results in faster muscle strength recovery and has better patient satisfaction with readiness to return to sports. 

The BEAR Implant also doesn’t require a graft, removing the need for a second wound site to heal and worries about donor graft quality or disease risk.

“The purpose of this implant is to allow the ACL fibers to grow and reattach the ligament back to the bone using normal healing properties,” said Sean McMillan, D.O., FAOAO, FAAOS, FAANA, chief of Orthopedics: Virtua Willingboro, Camden N.J., campuses for the Virtua Health System. “The implant helps protect the healing process and is resorbed by the body in approximately six weeks. Once the ligament has been healed back to the bone, it continues to mature and get stronger each month, allowing for return to function and sports for our patients similar to an ACL reconstruction—without the need for harvesting tendons to perform the procedure.”

Miach began the 250-patient BEAR III postmarket study in 2022. Patients in the study will be followed for 10 years. In 2023, the company began the Bridge Registry Post-Market Study, which will analyze real-world evidence in up to 750 patients. Primary outcomes that are being tracked include knee function and feeling.

“In addition, early studies showed the potential of the BEAR Implant to reduce osteoarthritis, a common side effect that can occur 10-15 years after traditional ACL reconstruction,” said Patrick McBrayer. “Miach is conducting ongoing clinical studies to assess long-term results and benefits. Healing the ACL instead of replacing it is already improving the lives of athletes, people with physical jobs, and other active individuals who unexpectedly tear their ACLs.”

There’s No ‘I’ in Team

The Arthrex Surgery Center Innovation program, known as “ASC X,” was developed with ambulatory surgery centers in mind. The program aims to differentiate customers’ ASCs via a partnership with Arthrex to develop minimally invasive products, procedures, and technologies to allow broad adoption of same-day, outpatient surgeries.

Arthrex announced “Studio X” in August 2023 as the latest addition to the company’s global headquarters. The company said the goal of ASC X and Studio X is to work with healthcare administrators to anticipate and prepare for emerging technologies when planning and executing growth strategies, so the newest products and procedures can be seamlessly integrated.

“In our one-of-a-kind 24,000-square-foot media production facility at our Naples, Fla., global headquarters campus, the Arthrex ASC X team delivers a customized planning and design experience for ambulatory surgery centers (ASCs) in an immersive 3D environment,” said Dascani. “Customers can render blueprints, test fit spaces, and fly through various designs to create highly efficient and patient-centric outpatient facilities.”

Smith+Nephew began a different caliber of partnership in early 2024, linking with the UFC (Ultimate Fighting Championship). The company became the mixed martial arts (MMA) organization’s Preferred Sports Medicine Technology partner—MMA is recognized as one of the most popular and rapidly growing sports in the world, the company said.

“Through this partnership, we are able to promote the repair, regeneration, and recovery work in tandem with UFC and their Performance Institutes and use their massive global reach to help educate and inform athletes, healthcare professionals, and fans about the latest advanced technologies available to them for treating common MMA injuries,” said Beau Baker, vice president of commercial marketing for Smith+Nephew’s U.S. Sports Medicine business. “Smith+Nephew’s purpose is ‘Life Unlimited’ and through this partnership we endeavor to help athletes return to doing what they love to do—get back in the game and compete at the highest level.”

The company also revealed it will be co-sponsoring a first-of-its kind medical education event with UFC in Las Vegas, Nev., on Feb. 20-21, 2025. The event will feature panel discussions and lectures to develop skills and knowledge about treating sports medicine shoulder, hip, knee, foot and ankle, trauma, and ENT pathologies in combat sports athletes. Attendees will work alongside leading experts on current trends and techniques in combat sports medicine as well.

Providing the Assist

As with any ultra-specialized market like sports medicine, orthopedic device makers may draft manufacturing partners who have the requisite expertise. These special team players keep a close eye on the market’s trend to optimize their manufacturing game plan.

“As surgeries become more and more minimally invasive, there is a growing need for articulated shafts across different segments from IM reamers in trauma surgery, to flexible acetabular drills in hip surgery, to flexible TLIF inserters in spinal surgery,” said Jason Ratcliffe, general manager of Lenkbar, an Intech company. Intech specializes in manufacturing of complex orthopedic medical devices.

Intech acquired Florida-based Lenkbar in September 2023. The merger with the cutting tool expert advanced Intech’s minimally invasive surgery, cutting tools, and sports medicine offerings with flexible drills and power shaver/blades as well as manufacturing capabilities. The acquisition also included cutting tools with a dedicated cutter, grinders, and recognized experts that support customers by dialing in cutting geometry for an optimal cut that will improve tool life.

“It also includes laser cutting with a combo Swiss/laser cutter that produces for precision flexible shafts, plastic injection molding partners to provide end-to-end solutions (single-use suture anchors, etc.), and ISO 7 cleanroom packaging of goods,” said Ratcliffe.

Welcoming Lenkbar into the fold brought its FlexMetric technology, which Intech said improves manufacturing of next-generation surgical shafts. It’s billed as “the strongest flexible shaft in the orthopedic industry,” facilitating surgical drilling, reaming, punching, and screwing around corners and hard-to-reach areas.

“The technology maintains access and control by creating a true non-wobble arc, and while most flexible shafts in the market are either made out of nitinol or spiral cut, they both have their limits,” said Ratcliffe. “Spiral cut coil isn’t intended to apply forces bi-directionally, whereas FlexMetric’s patented “fighting dovetail” geometry allows passage of stronger torque both clockwise and counter-clockwise and is well fitted for irrigation.”

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