The human race may have inadvertently sealed its own fate. 

Human intelligence, long viewed as unmatched, may soon be outpaced by artificial intelligence (AI). The exact timing for this event—known in scientific circles as singularity—is still unknown, though there have been various guesstimates for its arrival, ranging from a few months (yes, 2026), to several decades.

OpenAI CEO Sam Altman is fairly confident for singularity’s arrival to occur in just four years. “I would certainly say by the end of this decade—by 2030—if we don’t have models that are extraordinarily capable and do things that we ourselves cannot do, I would be very surprised,” he predicted during an interview in Berlin earlier this fall. 

Microsoft founder Bill Gates shares Altman’s confidence in AI’s incredible opportunities. During a Tonight Show interview in February, the billionaire businessman and philanthropist told host Jimmy Fallon that humans would probably not be needed for “most things” within a decade. “There’ll be some things that we reserve ourselves [for] but in terms of making things and moving things and growing food, over time, those will be basically solved problems.”

AI has already gained a problem-solving head start in orthopedics, where the technology is spawning new tools for image analysis and diagnostics, predictive modeling, pre-operative planning, surgical assistance (robotics), and post-operative care/rehabilitation. AI allows surgeons to make necessary adjustments in real time during joint replacement procedures, improving implant placement accuracy and decreasing overall OR time.

As AI continues its upward trajectory in healthcare, Gates warns that its future development must be guided by humans. “I love the way that it’s driving innovation forward,” he told Fallon, “but I think it’s a little bit unknown—will we be able to shape it?”

A question for the ages.

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AI Acceleration

The chemistry was undeniable.

The three men sensed it immediately upon their first meeting—the unspoken rhythm that passed between them, quiet yet unmistakable and impossible to ignore. Gabriel Jones remembers feeling a strong sense of purpose in that moment, as if the trio’s meeting was not merely coincidence.

“When we connected, we felt a strong chemistry and the sense that we needed to build something together,” Jones told R&D World earlier this year. 

Indeed, it seemed the three men were fated to meet: Jones was focused on the future of brain therapies at the time; pediatric neurosurgeon Samuel Browd, M.D., was intent on leveraging augmented reality, virtual reality, and artificial intelligence to revolutionize surgical navigation; and electrical/computer engineering and computer science/engineering professor Joshua R. Smith, Ph.D., led the Sensor Systems Laboratory at the University of Washington, which conducts research on new sensor systems and devises power solutions and algorithms for enhanced performance.

Acting on their shared sense of calling, the trio began discussions about possibly replacing the surgical microscope. With the help of James Youngquest, a Ph.D. student at Smith’s Sensor Systems Lab, the foursome began building a prototype that would allow cameras to point directly into the brain.

In developing their prototype, however, the foursome soon realized their desire to bridge healthcare inequities stretched far beyond a better surgical microscope. Heeding advice from science fiction writer and futurist Arthur C. Clarke, Jones and his cohorts began envisioning advanced surgical solutions that elevate patient care standards.

“Arthur C. Clarke’s Law states, ‘The only way of discovering the limits of the possible is to venture a little way past them into the impossible,’” Jones recalled, “and applying this law, we realized we needed to go beyond the current.”

The quartet’s trek beyond the current spawned a company (Proprio) and an artificial intelligence (AI)-powered surgical guidance system that creates a 3D map of patient anatomy in real time. 

Proprio’s Paradigm system leverages light field imaging technology to produce high-definition, multi-modal anatomical images—without exposing patients to harmful radiation. Using collected data and pre-operative imaging like MRI and CT scans, Paradigm captures the full spectrum of live anatomical information—a significant departure from traditional systems that rely on static data “snapshots.” 

Since gaining U.S. Food and Drug Administration clearance in 2023, the Paradigm system has earned numerous awards and recognitions, including TIME magazine’s Best Inventions of 2025 and Fast Company’s 2025 World Changing Ideas Award, among others. Surgical teams have successfully placed hundreds of implants during complex procedures ranging from scoliosis to collapsed discs, and the company has formed a partnership with the Biedermann Group to integrate that company’s spinal implants with the Paradigm system.

Moreover, study data show that Paradigm reduces the time required for critical tasks such as implant placement by up to 50% compared to traditional navigation systems. And on average, the use of Paradigm resulted in a tenfold reduction in radiation-based imaging.

“Arthur C. Clarke states in his laws that ‘Any sufficiently advanced technology is indistinguishable from magic,’” Jones noted. “The magic behind Proprio’s Paradigm platform is that it makes surgery better, faster, and safer…”

Behind Paradigm’s surgical magic lies the power of AI. The technology has become more commonplace in the orthopedic industry as implant developers and manufacturers realize its potential to improve patient outcomes through pathological diagnoses, surgical guidance, continuous monitoring, and personalized care. An initial laggard, AI adoption in healthcare has surged in recent years, with the U.S. Food and Drug Administration (FDA) approving a record 235 AI-enabled products alone in 2024. Over the last 30 years, the agency has authorized more than 1,200 AI devices, although growth has been exponential since 2015.

The scale of such explosive growth is underscored by the vast number of active AI users. The inaugural NVIDIA State of AI in Healthcare and Life Sciences Report—released this past summer—found that two-thirds of industry professionals are actively using AI and another 31% are piloting or assessing AI initiatives.

Moreover, the breadth of use cases reflects the life sciences industry’s varied needs: Foundational models, for instance, are expediting drug discovery while generative and agentic AI is lending a hand to hospital administrators, and visual AI is augmenting medical imaging to provide quicker, more accurate diagnoses.

While AI has found its strongest foothold in medical imaging across healthcare, the technology’s orthopedic applications are concentrated largely in surgical navigation and preoperative planning systems.

Proprio’s Paradigm system, for example, earned its second FDA clearance in April, gaining authorization for intraoperative measurements. Paradigm now provides real-time visibility into surgical progress, continuously measuring and comparing results against preoperative plans. It alerts surgeons when objectives are met and uses live data to guide intraoperative decisions. According to Proprio, this capability can help reduce the need for revision surgeries and significantly improve patient outcomes. 

“We’ve been using navigation in spine surgery for a while, but what this technology allows us to do is precisely find the right angle without intraoperative radiation and navigate it,” Dr. Rick Bransford, a UW Medicine orthopedic surgeon at Harborview Medical Center, said upon Paradigm’s second FDA clearance. “The system can kind of tell us the trajectory and guidance to place screws with zero radiation. This is a big deal, as almost all other forms of navigation require some component of intraoperative radiation. This next generation will also allow us to measure real-time change in segmental alignment without intraoperative radiation. This means that not only can we ideally do a better job taking care of patients, but we can also better train our medical students, residents, fellows, and the next generation of surgeons.” 

Like Paradigm, Johnson & Johnson MedTech’s VIRTUGUIDE System reduces both operative time and surgical complexity. Released in the United States over the summer, the AI-powered VIRTUGUIDE is designed specifically to support Lapidus procedures, a type of bunion surgery that realigns the foot by joining two bones near the arch (the first metatarsal bone and the medial cuneiform). The system uses FDA-cleared pre-operative planning software, developed in collaboration with PeekMed, to assess each patient’s bunion and make personalized recommendations for the intended correction. 

Early VIRTUGUIDE users have estimated procedural time savings of at least 30 minutes compared to their previous technique, according to Johnson & Johnson MedTech.

“This milestone marks an important step forward, as VIRTUGUIDE becomes the latest addition to our portfolio of VELYS Enabling Tech solutions,” stated Oray Boston, worldwide president of Trauma, Extremities, Craniomaxillofacial, Animal Health, and Sports Medicine, Orthopaedics, Johnson & Johnson MedTech. “By automating surgical planning and tailoring instrumentation to each patient, the system helps reduce complexity in the operating room and helps surgeons achieve the intended correction.” 

New orthopedic and trauma planning software from mediCAD Hectec GmbH is chasing those same objectives. Combining AI, automation, and with a new user experience, mediCAD 8 aims to change the ways in which surgeons prepare and evaluate orthopedic and trauma procedures—accelerating planning and improving both accuracy and consistency.   

At the heart of mediCAD’s new release is mediCAD AI, a framework that uses advanced algorithms to automatically recognize anatomical landmarks and interpret medical images with considerable precision. The system detects key reference points across the hip, knee, and lower limb, supporting surgeons with data-driven accuracy from the first step of the planning process. Comparable studies show that detection in mediCAD 8 achieves an average deviation of less than 2 millimeters, ensuring precise alignment and reducing the need for manual corrections frequently required in earlier versions. 

Naitive Technologies and Surgical Theater are striving to improve surgical planning and accuracy through their respective AI-enhanced solutions.

Naitive Technologies’ bone health assessment tool, OsteoSight, enables clinicians to assess bone mineral density (BMD) using standard X-rays originally taken for other clinical reasons. Cleared by the FDA in September, OsteoSight analyzes routine hip and pelvic X-rays in patients aged 50 and older to opportunistically identify those at risk for low BMD.

Roughly a month after OsteoSight earned the FDA’s blessing, Surgical Theater secured its own 510(k) clearance for its spine platform. The authorization expands SyncAR Spine’s capabilities with advanced extended reality (XR) tools underpinned by AI algorithms. 

The platform aims to transform standard imaging (CT scans and MRIs) into an interactive surgical guide by integrating the images with the Medtronic StealthStation navigation system. SyncAR Spine includes such features as AI-assisted vertebra segmentation for planning, pre-surgical mapping of resections through advanced decompression planning, and segmental fusion technology to maintain the alignment of preoperative models with intraoperative imaging despite patient movement.

Notably, the platform enables surgeons to monitor real-time bone removal using voxel-level drill tracking. Additionally, the system provides intraoperative access to MRI data, offering detailed views of vessels, nerves, and pathology to enhance visual clarity during minimally invasive procedures.

“SyncAR Spine gives me the visibility of open surgery in a minimally invasive case. Having MRI data live in the OR, aligned seamlessly with navigation, is the greatest improvement in navigation since its inception nearly two decades ago,” said Dr. Greg Poulter, a renowned spine surgeon who performed the first SyncAR Spine procedure. “I can plan every detail in advance and then see that plan projected in real time during surgery, fully aligned with my workflow. That level of clarity changes how we operate.”

A magical change, no doubt.

Read more: bit.ly/47Owd5p

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Beauty in the Beast

The warning signs were all there.

They were simple and straightforward—void of guessing games, hidden agendas, and double entendres.

They were plain yet brash, looming unapologetically large like the pink stucco exterior of Mar-a-Lago or midtown Manhattan’s golden escalator. Missing such imposing signs would have been nearly impossible, since they replayed like a scratched record, and were about as subtle as a marching band in a library—much like their architect, President Donald J. Trump.  

During his 2024 run for the White House, Trump laid bare his domestic policy vision: securing borders, taming inflation, reducing taxes, strengthening public infrastructure, and overhauling foreign trade agreements. He toured the country, parroting only one word when discussing the latter goal’s strategy. 

Tariff.

Savannah, Ga., Sept. 24, 2024: “…the word tariff, properly used, is a beautiful word, one of the most beautiful words I’ve ever heard. It’s music to my ears.”

Chicago Economic Club, Oct. 15, 2024: “To me, the most beautiful word in the dictionary is tariff…it’s my favorite word. It needs a public relations firm to help it, but to me, it’s the most beautiful word in the dictionary.”

Auburn Hills, Mich., Oct. 18, 2024: “It’s the most beautiful word in the dictionary. You have other words that are damn nice like love. But I tell you, I think it’s more beautiful than love. The word tariff.”

Trump used his giddy affection for that word to craft an America-first trade policy that is as unpredictable as it is perplexing. At times, it seemed as if the president’s edicts were based more on the whims of a Magic 8 ball than on logic—tariff policies changed dramatically day to day, even hour to hour in the first few months of Trump’s second term. 

Amid the confusion were brief moments of clarity: a U.S.-U.K. deal in June, for example, reduced tariffs on British automobile and aerospace goods and concurrently lowered levies on American beef and ethanol. A handful of other agreements followed over the summer, arriving in bits and spurts between threats to holdouts and errant adversaries.

As the Trump administration played Deal or No Deal with America’s friends and foes, a bunch of business owners and lawyers were prepping for the good fight against tariffs. In April, five import companies and a dozen state attorneys general sued the Trump administration over tariffs, claiming the president exceeded his statutory authority by imposing levies under the International Emergency Economic Powers Act (IEEPA) without congressional approval. The plaintiffs also argued the tariffs caused them financial harm by driving up costs and disrupting their business operations.

The U.S. Justice Department claimed the IEEPA is written broadly; the authority to impose tariffs, the Trump administration contended, falls within the power the Act grants the president to “regulate” imports.

Federal judges in two separate rulings disagreed with that logic, as did an Appeals court. “The statute bestows significant authority on the President to undertake a number of actions in response to a declared national emergency, but none of these actions explicitly include the power to impose tariffs, duties, or the like, or the power to tax,” the Appeals court decision stated. “It seems unlikely that Congress intended, in enacting IEEPA, to depart from its past practice and grant the President unlimited authority to impose tariffs.”

The Trump administration, not surprisingly, appealed the courts’ rulings to the U.S. Supreme Court, which agreed to hear oral arguments on Nov. 5. The tariffs remain in effect until the high court decides the case.

Predictably, the Appeals court ruling did not sit well with Trump. Within hours of the Aug. 29 decision, he posted on TruthSocial that “tariffs are the best tool to help workers and support companies that produce great MADE IN AMERICA products. If these Tariffs ever went away, it would be a total disaster for the country…”

But a relief for businesses. Trump’s renewed embrace of tariffs has been a persistent headache for Corporate America since it resurfaced during the 2024 presidential campaign. Although their full impact remains unclear, the whiplash-type decisions about and ongoing uncertainty over tariffs has left many companies anxious about the financial fallout.

Anxiety levels among medtech firms were considerably higher this year as manufacturers grappled with tariff-related supply chain disruptions, reduced investment in innovation, higher manufacturing expenses (with some devices experiencing cost increases of $2,000-$8,000), and potential profit margin erosion.

Initially panicked by the potential earnings-suppressing consequences, OEMs predicted significant tariff charges but subsequently adjusted them lower. Johnson & Johnson and Boston Scientific Corp., for example, both halved their expectations (to roughly $200 million and $100 million respectively), while Stryker Corp. reduced its initial $200 million estimate by $75 million. Similarly, Medtronic downgraded its original $200 million-$300 million guess to $185 million; Zimmer Biomet Holdings Inc. lowered its forecast by $20 million to $40 million; and Smith+Nephew expected to sacrifice $15 million to $20 million to tariffs.

As Zimmer Biomet Executive Vice President/Chief Financial Officer Suketu (Suky) Upadhyay told Goldman Sachs conference participants in June, “The situations continues to remain fluid and dynamic.”

And unpredictable. The revised tariff charges could spike as quickly as they fell if medtech products are pulled into Trump’s tariff maelstrom. Medical technologies have historically been subjected to low tariffs or tax exemptions, thanks largely to the humanitarian need for healthcare solutions. Medtech industry leaders lobbied for such leniency as Trump began shaping his tariff policy, reminding lawmakers of medical technology’s essential role in delivering quality healthcare to patients.

In May, AdvaMed President/CEO Scott Whitaker warned a U.S. Senate finance committee that Trump’s tariff policies could put medical innovation at risk, increase costs, and complicate the medtech supply chain. He urged the committee members to consider a “zero-for-zero” reciprocal tariff policy on medical products. 

Rather than consider such an option, however, the Trump administration initiated national security investigations into imports of medical devices, industrial machinery, and robotics—a move that could possibly end medtech tax-exempt status. 

Launched Sept. 2 under Section 232 of the Trade Expansion Act of 1962, the probes aim to assess whether higher tariff rates are warranted for various medical products such as N95 respirators, syringes, surgical masks, coronary stents, heart valves, hearing aids, robotic and non-robotic prosthetics, blood glucose monitors, orthopedic appliances, electromedical apparatus (CT scanners, magnetic resonance machines), electrosurgical apparatus, X-ray/other radiation equipment, and MRI machines.

The investigation—publicly disclosed more than three weeks after its launch—will analyze current and projected demand for PPE, medical consumables, and medical devices; and whether domestic production can adequately meet that demand. The U.S. Commerce Department also is examining the role foreign supply chains play in meeting U.S. demand for medical devices and equipment, and the concentration of U.S. imports of PPE, devices, and equipment as well as associated risks.

The investigation prompted another red alert from Whitaker, who attributed medtech’s strong job growth over the past six years—three times the average rate for manufacturing—to “sound tax policies.”

“…U.S. medtech manufacturing is strong and lower tariffs will fuel more manufacturing and job growth in the U.S.,” Whitaker noted, “which means greater access to lifesaving technologies and lower costs to American hospitals and patients.”

In that regard, tariffs (or a lack thereof) could indeed be a beautiful word.  

Read more: bit.ly/4ovoQqG

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Robot Rally

It was the wheelchair, without a doubt.

That was the deciding factor.

Deborah Bettencourt’s failing knees had long been teaching her the hard lessons of limitation: a cane or walker for mobility assistance and decreased activity levels. She had learned to live with her limitations, to a degree, but she drew the line at the wheelchair.

“That’s not me,” she recounted in an online video. 

The “me” Bettencourt longed to reclaim was the lively wife, mother, pet mom, and grandmother who enjoyed long walks and delighted in playfully teasing her grandchildren. “I wanted to do something that would change my life for the better,” she said.

That something ultimately was bilateral total knee arthroplasty, assisted by THINK Surgical Inc.’s TMINI Miniature Robotic System. Designed to enable accurate implant placement, the miniature handheld wireless solution integrates into the OR with overhead active tracking, allowing for unrestricted patient access. The CT-based 3D surgical planning and the TMINI PRO Workflow allow for intraoperative adjustments to help fine-tune implant positioning and stability. 

Fashioned as an open implant robotic solution to empower surgeon choice, the TMINI System is marketed through development/distribution agreements THINK Surgical has forged with more than a half-dozen companies. Since receiving initial U.S. Food and Drug Administration (FDA) clearance in May 2023, the TMINI System has been authorized for use with implants from nine manufacturers and has helped repair 1,000 degenerative knees.

“Approximately one-third of cases performed so far were completed on the exclusive Zimmer Biomet TMINI Platform using the Persona Knee,” THINK Surgical President/CEO Stuart Simpson noted in a May company announcement of the 1,000-implant milestone. “The pace at which this…milestone has been achieved is evidence that there is a strong demand for our miniature, handheld robotic technology in combination with our partners’ implants.”

Strong indeed: Over six months this year, the TMINI System made its clinical debut with knee implants from four different manufacturers. THINK Surgical leaders say the steady rollout of first-use cases underscores the benefits of open-implant systems—chiefly greater bargaining power for surgeons and hospitals, and a wider range of implant options.

“With the growing demand for total joint replacements, surgical teams need to operate with even greater efficiency. Introducing a large, cumbersome robot comes with challenges as to which ORs can be used, how the OR is set up, the introduction of ‘no-go’ zones for tracking, which can interrupt OR workflow, staff satisfaction, and then speed of room turnover,” THINK Surgical Chief Growth Officer Nick Margree explained. “Moving a large robot from room to room can be a time-limiting step that prevents an efficient surgical day. Robot companies will struggle if they continue to try the ‘big box’ designs and do not have a compelling answer for improving efficiency.”

Maybe so, but the market seems diverse enough (for now) to support a wide range of players. Size and “no-go” zone concerns, for example, did not prevent Stryker Corp. from releasing the fourth generation of its Mako robotic system this past spring. 

A single system with integrated technologies and applications for total hip, total knee, partial knee, and spine procedures, Mako 4 expands on the brand’s established Total Hip offering to include a first-to-market robotic hip revision capability. That new competence streamlines workflow and enhances surgeon confidence in complex procedures with new proficiencies—including augment and screw planning, intraoperative screw trajectory guidance, and compatibility with Stryker’s revision hip implant portfolio. Mako 4 also integrates the company’s fourth-generation Q Guidance System, which is built on more than 20 years of experience developing guidance technologies. 

“Since Stryker introduced Mako SmartRobotics, it has evolved across procedures and specialties, and we don’t see this trend slowing down,” said Keith Evans, vice president and general manager of Stryker’s Mako and Enabling Technologies business. “Working in close partnership with our customers, we are regularly collecting insights and feedback to support the development of new and enhanced clinical applications and indications. As the technology advances, we are driven to help our customers address unmet patient needs across specialties. Stryker’s mission, as always, is to keep driving innovation forward.”

That mission, however, was not exclusive to Stryker this year.  

Austin, Texas-based Monogram Technologies championed innovation with its mBôS TKA System for total knee replacements and mPress 3D-printed press-fit implants, both of which received FDA 510(k) clearance in mid-March.   The artificial intelligence (AI)-powered mBôs robotic arm leverages CT scans to pre-plan bone cuts and define instrument boundaries, minimizing the risk of damage to the joint’s soft tissue.

“I’ve used nearly every robotic system on the market, and I truly believe the Monogram mBôS has the potential to be the best. It’s slick. The precision, efficiency, versatility, and safety considerations set it apart from anything I’ve seen,” Monogram Technologies Founder/Chief Medical Officer Dr. Douglas Unis said in announcing the FDA clearance. “I’m…confident that surgeons will recognize the impact of this system.” 

Zimmer Biomet recognized the impact, too, and consequently purchased Monogram Technologies in July for $177 million. The orthopedic device behemoth is incorporating the mBôS TKA System into its Rosa robotics platform.

ChoiceSpine and Sino-European MicroRobotics (Shanghai) Co. Ltd. (SEMR) pushed the boundaries of spinal robotics innovation over the summer with their respective solutions. ChoiceSpine—in partnership with eCential Robotics—launched a new app for surgical use on the eCential Op.n robotic and navigation platform, while SEMR debuted its first miniature spinal surgical robot in China.

SEMR’s Intelligent SpinePecker uses Interventional Systems’ Micromate robotic technology in a palm-sized robotic arm that weighs just 1.63 kg (3.6 pounds). Housed in a mobile console with a 0.32m2 footprint, the system takes less than 10 minutes to set up. The Intelligent SpinePecker boasts a positioning accuracy of 0.2mm and aims to streamline surgical procedures.

IMPLANET, TINAVI Medical, and Cyber Surgery contributed to advancements in spinal robotics as well. IMPLANET and TINAVI inked a distribution agreement in September for the TiRobot spine surgery system, an autonomous cobot that is not fixed to an operating table, giving surgeons the flexibility to make continuous adjustments during the procedure based on surgical needs and patient movements. It offers an automated guidance system and can be used to address most spinal pathologies.

Cyber Surgery, meanwhile, premiered its Alaya surgical robotic assistant in Europe in early October. The Spanish firm claims Alaya is the first spine surgery robot to use Kinematic Navigation Technology, a patented solution intended to overcome conventional optical navigation limitations.

Unlike optical navigation, which relies on cameras and line-of-sight calibration, Kinematic Navigation uses motion-based tracking that remains stable throughout surgery. Alaya reportedly provides continuous navigation, reduces radiation exposure for both patients and surgeons, and shortens setup time. The technology also has a smaller OR footprint, allowing for easier hospital workflow integration. 

Designed for minimally invasive spine surgery, Alaya aims to help reduce reduce bleeding and infection risks, shorten recovery times, and empower surgeons with more precision and efficiency.

Almost as precise and efficient as a robot, no doubt.

Read more: bit.ly/43hMKNI

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Discerning Dealmaking

Call it Paradise Lost.

Or better yet, an Eden never realized. 

Lost to the ages were such technological triumphs as traffic-busting hovercraft, ballistic rocket passenger travel (capable of reaching any point on Earth in 40 minutes), and robotic household choremasters. Other faded visions included medical marvels like remedies for blindness, deafness, memory loss, mental impairment, grouchiness, laziness, etc., as well as the elimination of all bacterial and viral disease.

It certainly sounded like—and could have been—a modern-day shangri-la, had all those life-enhancing enchantments panned out.

But the visions were just that: imagined futures—predictions rather than realities—of life in the year 2000. The prophecies came from a group of futurists nearly six decades ago, compiled in a TIME magazine essay that dubbed their prophecies “a remarkable vision.” 

“…the futurists predict an era of almost limitless change,” the magazine stated in its Feb. 25, 1966, essay. “With remarkable confidence, and in considerable detail, they present a view of man not only in total control of his environment but of his own brain and his own evolution.” 

Granted, most of the divinations within the essay were pure pipe dreams—climate control (no global warming!), desert rains, independently wealthy Americans, steak-flavored kelp, and a smog-free Los Angeles—but a few were right on target: planes nearing speed of sound velocities; a 6 billion world population milestone (off by only 162 million); artificial hearts; and electronic information retrieval, with “contents of libraries and other forms of information or education…stored in a computer and…instantly obtainable at home by dialing a code.”   

Although it concedes America’s enduring fascination with the future, the TIME piece also acknowledges the inherent challenges in predicting it. “Forecasting is an art that still has few textbooks,” the magazine noted. “Its basic tool is extrapolation from yesterday and today. As John McHale, executive director of World Resources Inventory puts it: ‘The future of the future is in the present.’”

That would explain the high failure rate among prognosticators. Consider, for example, the gloomy predictions earlier this year about the U.S. economy—Torsten Slok, a top economist at New York-based Apollo Global Management, presaged a 90% chance of America entering a “voluntary trade reset recession,” while former New York Federal Reserve Bank President Bill Dudley chose stagflation as the best-case scenario for the U.S. economy, and HS Dent Investment Management Founder Harry Dent predicted a global stock market crash of catastrophic proportions.

These wildly inaccurate predictions are somewhat forgivable, however, considering they were grounded in McHale’s logic—having been formulated in the present, shortly after President Donald J. Trump set his tariff merry-go-round in motion.

The future of the future is in the present.

That same leniency should then be granted to medtech analysts who expected a resurgence in M&A activity this year. Although the industry’s overall financing trend was up 17%, courtesy of a $5.3 billion spike in debt financing, merger and acquisition activity was down in the 12 months ended June 30, 2025, compared to the previous year, concluded EY’s Pulse of the MedTech Industry Report 2025. 

“The number of deals were really down over the prior 10-year average,” EY Global MedTech Leader John Babitt noted in a media briefing earlier this fall. “I think we only saw about 36 deals in the first half of 2025, and that’s trending below the average trend. We have seen a number of larger small cap and mid-cap med techs be taken out…one other comment on the financing front was that we did see the IPO market open. There have been about five medtech IPOs over the last year. They’ve performed relatively well. There seems to be more of an appetite to continue do IPOs.”

There’s a healthy appetite for venture capital, too. The EY analysis calculated an $8.7 billion total for VC financing in 2024-25, which was just 5% below its record-breaking 2020-21 peak and up 13% on the five-year average. The increase defied a decline in the number of financing rounds. In the 12 months ended June 30, 2025, there were 237 VC financing rounds, a 47% decline from the previous year, and only 28% of the VC deal volume recorded at the industry’s peak in 2020-21.    

The discrepancy between VC deal value and volume reflects a rise in average VC round size to $37 million in 2024-25, which represents a 126% increase on the average financing round in 2023-24, itself a record at the time, the EY report states. Compared to the five-year mean, the average VC funding round in 2024-25 was up 221%, driven by major fundraising from a smaller number of companies.

The EY report found a shared pattern between VC investors and medtech firms looking to make deals—both players were willing to allocate capital this past year, but were selective about the target of their funding. “Companies are paying high prices for highly sought-after products and platforms, but are making fewer deals overall,” the report stated.

Among this year’s selective shoppers was Zimmer Biomet Holdings Inc., which bolstered its market share in the fast-growing foot and ankle arena through its $1.2 billion deal for Paragon 28.

“…the industry is shifting toward fewer, bigger deals,” EY’s analysis noted. “Where companies are willing to acquire, they are focused on late-stage deals for assets that are already close to achieving profitability.”

Or assets with high growth potential. Such prospects prompted ARCHIMED’s $730 million takeover of Zimvie in October; industry analysts say the move reflects private equity’s shift toward high-growth healthcare niches like dental implants.

Assets that complement companies’ core competencies are attractive as well. Hence the motivation behind Stryker Corp.’s $4.9 billion acquisition of Inari Medical (neurovascular portfolio augmentation); Highridge Medical’s pickup of multiple spinal surgery product lines (the FlareHawk and Toro expandable interbody fusion systems, as well as the LineSider pedicle screw system), Zimmer Biomet’s $177 million tender for Monogram Technologies Inc. (mBôS TKA System), Globus Medical Inc.’s $250 million proffer for Nevro Corp. (neuromodulation platform), and Medtronic’s purchase of nano surface technology from Nanovis.

Acquisitions, however, were not the only way medtech companies strengthened their core competencies this year. Stryker and Johnson & Johnson MedTech bolstered their existing capabilities by paring down their offerings—the former sold its spine business to Viscogliosi Brothers, while the latter announced its intention to shed its $9.2 billion orthopedics division (DePuy Synthes).

“The planned separation reflects our commitment to portfolio optimization and value creation,” Johnson & Johnson Chairman/CEO Joaquin Duato said in a news release announcing the planned separation. “We are confident our Orthopaedics business will be better positioned to improve top-line growth and operating margins as a standalone business.”

Some breakups are for the best.

Read more: bit.ly/440F2Yy