Even during Lent, New Orleans has a way of making everything feel bigger and badder—the crowds, the conversations, the ambitions, the French Quarter, and of course, Bourbon Street.

The American Academy of Orthopaedic Surgeons (AAOS) 2026 Annual Meeting was no different. From the moment the doors opened at the Ernest N. Morial Convention Center, it was clear this was not a meeting in maintenance mode. Given the disappointing attendance and engagement in previous post-pandemic AAOS events, this year’s meeting was refreshing. 

More than 600 exhibitors filled the exhibit hall, the Investment Forum attracted standing-room-only interest, and the sessions pulsed with an excitement about a genuine inflection point for the industry. Moreover, The Terminator—a.k.a., Zimmer Biomet Chief Movement Officer Arnold Schwarzenegger—rocked the house with his enthusiasm for orthopedic products and his message emphasizing the importance of maintaining an active lifestyle. 

Having attended numerous AAOS Annual Meetings, we arrived in New Orleans this year to take stock of the industry’s overall health and determine where it might be headed—commercially, strategically, and financially (examining active and engaged M&A projects). Our analysis revealed six trends that could potentially impact OEMs, contract manufacturers, investors, and the broader orthopedic ecosystem. A closer look at each of these themes follows. 

Trend One: The robotics entry fee. If there was a single dominant narrative at AAOS 2026 and perhaps the past few years, it was robotics, and the message was unmistakable: the technology is no longer a differentiator.

Stryker showcased a full portfolio expansion of its Mako SmartRobotics platform. Mako Shoulder, now fully commercialized, extends the ecosystem into primary reverse shoulder arthroplasty. Equally notable was the introduction of Mako RPS (Robotic Power System), a handheld robotic format for total knee procedures—deliberately designed for surgeons who prefer robotic precision without abandoning manual familiarity. This is a smart commercial move, as it lowers the adoption barrier and broadens the addressable market to fit the growing ASC market footprint requirements.

Not to be outdone, Zimmer Biomet Holdings Inc. (ZB) showcased its ROSA platform along with artificial intelligence (AI)-driven navigation tools and smart implant technology, while Smith+Nephew featured its CORI Surgical System as the centerpiece of a broader digital surgery ecosystem spanning pre-operative planning through post-operative data management.

Clearly, the robotics arms race is reshaping procurement dynamics across the industry. For contract manufacturers and component suppliers, this creates both opportunities and pressures. Systems like Mako and DePuy Synthes’ VELYS are reportedly driving a robotics market CAGR approaching 10%, which in turn will accelerate demand for high-precision components, advanced sensors, and integrated software capabilities. Companies that can credibly support robotic device manufacturing—from tolerancing to software integration—will increasingly be included in strategic supplier conversations.

Trend Two: Capital market communication. One of the most significant structural additions to AAOS 2026 was the Investment Forum, an event that enabled mid- and late-stage medtech companies to pitch their innovations to venture capital and private equity audiences; the presentations were followed by a high-level executive roundtable comprising the CEOs of Stryker, Smith+Nephew, DePuy Synthes, and ZB. Accordingly, the industry’s four largest players used the AAOS stage to communicate their strategic intent directly to the investment community.

For the M&A community, the Investment Forum sends several clear signals. First, the appetite for private orthopedic investment remains robust despite broader macro uncertainty. It also indicates that the major strategics are willing to publicly share their priorities, which is useful intelligence for anyone considering a transaction. And finally, it shows the line between clinical innovation and commercial strategy has never been thinner. Remember ZB’s $1.2 billion acquisition of Paragon 28 last year? Well, the company is now launching the procured innovation while continuing to look at additional investment opportunities. That’s savvy business strategy.

For smaller and mid-sized companies navigating their exit or partnership strategy, AAOS has evolved beyond a clinical showcase into a legitimate capital markets event—a meaningful development.

Trend Three: AI moves from buzzword to infrastructure. Whether companies could spell it or understand it, artificial intelligence was everywhere at AAOS 2026—literally and figuratively. The organization and U.S. Food and Drug Administration hosted a Town Hall meeting on the ways AI, digital health, and device innovation are transforming orthopedic surgery. Perhaps underscoring its cultural penetration, AI appeared in corporate marketing materials for everything—from pre-operative planning to post-market surveillance.

More important than marketing strategy, however, is the way AI is being embedded into the architecture of major products. ZB’s ROSA ecosystem, Smith+Nephew’s CORIOGRAPH pre-operative planning service, and Stryker’s Blueprint planning software all reflect a strategic pivot: the implant is no longer the product. The data-enabled surgical workflow is the product, and the implant is the revenue-generating component within it.

The industry’s embrace of AI has significant implications for the competitive landscape. Companies that master the data layer—connecting pre-operative planning, intraoperative guidance, and post-operative outcomes tracking—will create switching costs that reach beyond the implant itself. From an M&A perspective, continued acquisition activity is likely in software, AI, and digital health capabilities as the major OEMs race to complete their connected care ecosystems.

Trend Four: Tariffs are reinforcing an affinity for reshoring. While the exhibit hall was chock full of innovation, the conversations in the corridors reflected a more complex reality: tariffs and supply chain resilience are now a priority for virtually all OEMs and contract manufacturers.

While most OEMs are striving to adopt a supply chain strategy of “manufacture in the region for the region” (sold), companies are reassessing geographic production choices, investing in domestic supplier qualifications, and exploring innovative risk-sharing arrangements in their supply contracts. For U.S.-based contract manufacturers with advanced capabilities, this is a genuine window of opportunity. The companies that can demonstrate supply chain reliability alongside manufacturing precision will find themselves in a stronger negotiating position as OEMs seek to reduce their cross-border exposure.

Trend Five: The ASC migration. Two structural shifts were clearly present at AAOS 2026 that deserve attention beyond the robotics headlines. The migration of large-joint procedures to ambulatory surgical centers (ASCs) continues to reshape the commercial landscape. ASCs are projected to capture approximately 30% of U.S. large-joint procedures by 2029, driven by lower overhead, bundled payment alignment, and patient preference for outpatient settings. For device companies, this means packaging, instrumentation, and workflow need to be re-engineered for speed and efficiency. Smith+Nephew’s ASC suite showcased at AAOS—featuring an end-to-end solution for both de novo ASC development and facility modernization—perfectly reflects this market reality.

Trend Six: Orthobiologics are not to be ignored. Growing at a double-digit CAGR well above the broader market pace, this segment is benefiting from an AAOS-level spotlight through a dedicated Collaborative Symposium featuring evidence-based updates on novel therapies in partnership with the Biologics Association. The OrthoPitch winner, MY01, also demonstrated the expanding role of real-time biologic monitoring—i.e., using continuous pressure sensing and AI algorithms to transform compartment syndrome diagnosis. Taken together, biologics and data-enabled diagnostics represent a meaningful adjacent growth opportunity for the industry.

Undoubtedly, AAOS 2026 provided a clear picture of an industry operating with strategic confidence in a complex environment. The orthopedic device market’s value is estimated at $62 billion to $69 billion (globally) this year and is projected to swell to $78 billion to $100 billion by the early 2030s, driven by aging populations, rising procedure volumes, and the continued premiumization of surgical technology.

The competitive dynamics, however, are intensifying. The convergence of robotics, AI, digital health, and biologics is compressing the window between innovation and commoditization. Companies that move decisively—whether through organic R&D, strategic acquisition, or differentiated manufacturing partnerships—will define the market hierarchy of the next decade. Those that hesitate may find the gap difficult to close.

New Orleans delivered its usual dose of energy and optimism. But the more lasting impression from AAOS 2026 is that the orthopedic industry is not waiting for the future. The sector is building its future piece by piece, transaction by transaction, and platform by platform. Assuming they haven’t given up investing for Lent, the companies and investors paying close attention will be well-positioned to benefit.

MORE FROM THESE AUTHORS: Why Procedural Optimization and Additive Manufacturing Will Define Orthopedics in 2026

Florence Joffroy-Black, CM&AA, is a longtime marketing and M&A expert with significant experience in the medical technology industry, including working for multi-national corporations based in the United States, Germany, and Israel. She currently the CEO at MedWorld Advisors and can be reached at florencejblack@medworldadvisors.com.

Dave Sheppard, CM&AA, is a former medical technology Fortune 500 executive and is now focused on M&A as a managing partner at MedWorld Advisors. He can be reached at davesheppard@medworldadvisors.com.