Every year, my colleagues and I generate reports on the leading revenue-producing firms for both MPO and ODT. As we do so, we make observations and predictions based on what we discover as we write and read these reports. While I enjoy sharing these insights with my peers, the reports are not the place for such commentary. Hence, I maintain this space each year to share my thoughts. That said, the following are not in any specific order of importance. They are just things that came to mind as I wrote and reviewed this year’s entries.

First, wasn’t spine considered a growth segment not that long ago? It seemed like a favorable business in which to be involved. Yet, Stryker is splitting off from its spine unit. This follows Zimmer Biomet, which did the same not that long ago. Were the expectations too great? Is the technology too different from other orthopedic segments such that synergies aren’t realized?

However, J&J still maintains spine as a focus through its Velys Spine robotic surgical solution, developed in tandem with eCential Robotics. Although, as noted in the report, the segment has not performed all that well over the years and Velys could be the new hope for an enhanced revenue stream or a final effort to revitalize the business. 

Regarding robotic systems, have the smaller, disruptive firms made an impact on the future of these solutions? Zimmer Biomet provides its full-sized, traditional robot—the ROSA—and, more recently, worked with THINK Surgical to be able to provide a wireless handheld option—the TMINI. Will other leading firms follow suit, addressing the more space-restricted needs of the ASC environment by marketing a handheld robotic offering as well as their larger system?

Speaking of the Velys Spine system, this technology represents a clearer trend in orthopedics. Digital and data-based solutions have fully enveloped the sector. Perhaps the transformation is so dramatic because orthopedics was the least digital-centric (or smart) clinical sector in healthcare, so the rapid “catching up” process we’ve witnessed over the last several years (even surpassing some clinical areas) has been quite exciting and noteworthy. 

Personally, I find the technology transformation taking place within the industry incredibly interesting. While numerous forces are driving the changes, the emphasis and reliance on more data-based systems is fascinating. The fact orthopedics was viewed as an art by more than a few professionals is, frankly, frightening to me. It’s no wonder (and unfortunate) how much disparity there was between success and failure in procedures, even those performed by the same surgeon. The patient case is always unique, but the fact that preference, experience, and tendencies played such a significant role in surgeries was concerning. Of course, skill is going to vary between individuals, but the greater reliance on technologies that enable repeatability, consistency, accuracy, and safety, regardless of preference, is a welcome change for the sector. 

Elsewhere, rumors of Medtronic separating from spine have yet to be realized, but they are spinning out diabetes. In fact, many in the medtech space seem to be exploring the option of the spin-out. It’s not something impacting the orthopedic sector much yet (Stryker/ZB Spine being one of the obvious exceptions; Zimmer Biomet/ZimVie being another, although in that case, it dissolved quickly as the spine portion became Highridge Medical while the dental piece is to be acquired). Will be interesting to see if the spinout continues to be a popular strategy for medtech and if it takes place more in orthopedics (and/or if spine continues to be split off from companies). 

With this in mind, keep an eye on Globus and Enovis following their major acquisitions of NuVasive and LimaCorporate, respectively. At minimum, each may spin out, divest, or sell a portion of the business they brought in if company leaders deem it doesn’t align exactly with their desired core focus. 

Meanwhile, Arthrex seems to be embracing a holistic strategy in terms of addressing certain orthopedic issues. Not only are they putting out technologies for surgeons, but they are also creating patient-facing online resources for those with questions about a procedure. They even have information being peer-reviewed for at least one such site—OrthoPedia Patient. Wisely, the company also links to its “Find a Doctor” resource, where prospective patients can identify a surgeon who utilizes Arthrex solutions. It’s a great way of driving business—educating patients on their condition and then offering someone to help resolve it.

While the ODT list doesn’t have nearly the number of changes we see on MPO’s top 30 list, we did get a new name this year, even if it was a familiar face. Össur was joined with a couple of other organizations to form Embla Medical, the #9 list resident. 

What stood out to you in the 2025 reports? Let me know! (View the Top 10 reports here)

Sean Fenske, Editor-in-Chief

sfenske@rodmanmedia.com