$855 Million 
Prior Fiscal: $786 Million
Percentage Change: +8.7%
R&D Expenditure: $40.8M
Best FY24 Quarter: Q4 $225M
Latest Quarter: Q2 $232M
No. of Employees: 4,078
Global Headquarters: Reykjavik, Iceland

The couple is frozen in time, forever locked in a partial embrace.

With their hands placed on each other’s naked backsides, the pair stare straight ahead, their gaze transfixed on a distant horizon. The statuesque duo is revered in their home city for both their cultural significance and lasting legacy.

While the man and woman bear no resemblance to their primitive state—tree trunks—their names pay homage to their roots: Ash (Askr) and Elm (Embla, though the etymology for this moniker is still debatable ).

Askr and Embla were the world’s first humans, according to Norse mythology. Brought to life by the mighty all-father god Odin (either on a beach or forest, accounts differ), and given human traits like speech, hearing, sight, mobility, and cognitive functioning by Odin’s two brothers, Askr and Embla were granted guardianship of the Earth. The gods tasked the pair with cultivating the land, tending to the forests and fields, and living in harmony with nature.

Considered a cornerstone of Norse mythology, Askr and Embla’s creation tale has deeply influenced Nordic beliefs and traditions. “The creation myth of Ask and Embla underscores people in Viking societies’ belief in the cyclical nature of existence,” a March 2024 article in The Viking Herald stated. “For them, life emerges from the elements and then returns to them in an eternal dance of renewal and transformation.”

One of the latest devotees of that dance was Icelandic bracing/support/prosthetics developer Össur, which established a new parent company last year named Embla. Össur created the new company to better reflect its 54-year evolution beyond its initial focus on prosthetics.

“In our journey to become a global provider of mobility solutions, we have been fortunate to add several individual brands to our portfolio that all greatly benefit from being part of a synergistic organization, servicing patients in need of prosthetics, neuro orthotics, and bracing/supports solutions,” President/CEO Sveinn Sölvason said. “The structure of our organization needs to reflect this evolution and therefore we are establishing Embla Medical as our parent entity. This structure will enable all our established brands to flourish within their respective markets while harvesting synergies and support from Embla Medical.”

The name change did not affect customers of the company’s subsidiaries. Embla Medical is now parent to product brands Össur, College Park, and FIOR & GENTZ, the latter of which joined the new firm’s ranks via acquisition just five weeks before its late February birth.

The deal gives Össur (now Embla Medical) admittance to the $500 million neuro orthotics market. Founded in 1997, FIOR & GENTZ provides functional lower limb neuro orthotic solutions; its components are specifically designed for people suffering from neurological conditions affecting their gait (i.e., stroke, multiple sclerosis, spinal cord injuries).

The enterprise value for FIOR & GENTZ is €100 million, with an additional contingent earnout of €10 million to €20 million, based on 2024-2026 sales performance.

FROM THE TOP: “The year was marked by several milestones, most notably the establishment of Embla Medical, beginning to unite our patient care business under the ForMotion brand, and the acquisition of Fior & Gentz, to name a few.”

—President and CEO Sveinn Sölvason

“The acquisition of FIOR & GENTZ is in line with our Growth’27 ambition and a strong strategic fit for Össur in addition to meeting our strategic objective to address chronic mobility challenges in a broader context,” Sölvason said upon the M&A announcement. “With FIOR & GENTZ’s sales largely generated in Germany today, there are commercial synergies in leveraging Össur’s global sales structure to serve a larger patient population…I am convinced that our combined efforts will benefit our customers and patients around the world.”

The companies’ combined efforts also benefited Embla Medical: The FIOR & GENTZ purchase boosted the (larger) firm’s 2024 reported growth rate by 3%, spawning record high sales of $855 million.

Much of that total came from the Prosthetics & Neuro Orthotics segment, which increased revenue 14% to $451 million, according to Embla Medical’s 2024 annual report. The company attributed the double-digit expansion rate to solid volume growth, product mix, and a strong overall performance in high-end solutions, the aforesaid driven by EMEA demand for bionic devices and high-end mechanical feet.

Augmenting that demand was the debut of several new bionics devices and mechanical feet. During Q2, Embla Medical initiated a limited market release of Icon, a user-friendly microprocessor-based knee solution featuring responsive sensors, a streamlined setup, and the intuitive Stride Studio app; and NAVii, a fully waterproof, sand-proof, corrosion-resistant bionic knee that incorporates a powerful actuator for improved stair and ramp descent support.

Likewise, Embla Medical supplemented its mechanical feet lineup with the Pro-Flex Terra Foot, a multi-blade prosthetic with a pre-compressed top blade. With a soft heel and quick adaptation to uneven grounds and slopes, the Pro-Flex foot’s design and high range of motion combines softness and power, enabling users to think beyond placing their next step.

“I am very proud of our ability to innovate while addressing real patient needs,” Sölvason noted in Embla Medical’s 2024 report.

That ability extended beyond lower limb prosthesis last year. The company also premiered the third generation of its Naked Prosthetics finger device portfolio, which feature expanded customization options including nine nature-inspired hues, five modern textures, and eight colored screws.

Besides launching new products, Embla Medical’s Prosthetics & Neuro Orthotics segment positioned itself for future growth last summer by gaining expanded U.S. Medicare coverage for advanced bionic prosthetics for less mobile K2 amputees. Medicare had previously restricted access to these knees to only high-active amputees classified as functional level K3 and K4. The expanded coverage took effect Sept. 1, 2024.

Coincidentally, Medicare’s expanded coverage decision was announced just 24 hours after Embla Medical revealed plans to unify its network of patient care facilities under a new common brand identity, ForMotion. The ForMotion brand is being introduced in phases, beginning in select regions in the United States, and will eventually encompass the entire network of global Orthotic & Prosthetic patient care facilities, currently operating under different brand names.

With its gradual rollout, the patient care brand unification had little effect on Embla Medical’s 2024 sales. Its Patient Care segment boosted proceeds 5% to $294 million, thanks to strong patient volume growth and positive mix effects, especially in the EMEA region.

Bracing & Supports sales, however, barely budged from its 2023 totals, climbing just 1% to $148 million, the 2024 annual report shows. Although growth was solid in key product categories, challenging market dynamics in select product categories and markets inhibited substantial revenue increases.

$786 Million
Prior Fiscal: $719 Million
Percentage Change: +9.3%
R&D Expenditure: $38.1M
Best FY23 Quarter: Q4 $210M
Latest Quarter: Q1 $200M
No. of Employees: 3,999

It’s easy to misread Markus Rehm’s Game Day mug.

The Paralympic long jumper rarely smiles during his competitions, especially when there’s a world record at stake.

It’s not that Rehm doesn’t want to smile. He does.

It’s just…well, perfectionism stands in his way.

At the Tokyo Paralympic Games four years ago, for example, Rehm was the only athlete to jump over 8 meters (26.2 feet). He beat his nearest competitor—French Paralympian long jumper/sprinter Dimitri Pavade—by 79 centimeters (31.1 inches).

Yet there was no smile.

Rehm seemed similarly unfazed last spring after setting two consecutive world records in the men’s long jump T64 setting. The second record—8.72 meters—was just 23 centimeters short of the Olympic world record, 8.95 meters, attained by American Mike Powell in 1991.

Still no smile.

Rehm’s long leaps have gained him admission to an elite athletic club with few members. Olympics.com reports that only eight people in the entire world have jumped further distances than Rehm.

Surely such an achievement is worthy of a smirk, at least.

Alas, not in the least.

“Sometimes, it’s hard to explain because people look at me and think, ‘Why is he not happy?’ Well, it’s not because I’m not happy, but I know there’s more coming,” Rehm, a below-the-knee amputee for more than two decades, told Olympics.com. “If people watch me jumping or watch me competing and I jump, let’s say 8.15 at competition and they don’t see me smiling all over the place and being super happy, (it’s) because that’s usually the moment when I know there’s more left and that’s why I’m not so happy.”

True contentment could eventually find Rehm but it is highly unlikely unless (until?) he bests Powell’s 33-year-old long jump record. Rehm’s stone-faced days may be numbered though, as he continues to shatter Paralympic world records (14 and counting) and inches ever closer to Powell’s prime performance.

“I’m dreaming of this magic mark. 8.95 still stands for Mike Powell and for me, it’s always so far out of reach and slowly we’re getting closer,” Rehm mused to Olympics.com. “To be very honest, yeah, that’s the goal.”

Rehm is chasing that goal with the help of a prosthetic created specifically for long jumpers. Developed by Icelandic bracing/prosthetics manufacturer Össur with input from elite athletes, the Cheetah Xpanse sport foot was designed to facilitate a faster pace for the run-up and improved push-off, enabling athletes to achieve a maximum distance out of their jumps. The blade’s shape allows the foot to flex aggressively for a powerful energy return, with a long toe offering increased ground contact time before push-off, and a plantar-flexed pylon intended to support forward progression. The Cheetah Xpanse’s large carbon fiber blade is built to withstand the unique requirements of a heavier load—i.e., the moment an athlete lands from a jump, or is participating in other high-endurance sports.

Released in 2021, the Cheetah prosthetic line (also including the Cheetah Xcel and Cheetah Xceed) can absorb and return approximately 90% of the energy stored while the user is running. While this may sound like an impressive metric, the Cheetah’s energy return to an amputee athlete is still substantially less than that experienced by an able-bodied runner, whose biological limb may return as much as 241% of stored energy, clinical data indicate.

Nevertheless, the Cheetah prosthetic still facilitates some notable feats of natural physics. In Rehm’s case, the blade helps him reach a >35 kph running speed (before liftoff), convert from a horizontal to a vertical force that is equivalent to seven times his body weight, launch at a 60-degree angle, and attain a peak height of 1.6 meters (5.2 feet).

As Rehm, nicknamed the “Blade Jumper,” says in a Cheetah promotional video (still without smiling), “I don’t jump, I fly.”

Rehm’s flying jumps are somewhat emblematic of the pecuniary leap his prosthetic manufacturer experienced last year. Össur’s fiscal 2023 revenue bounded 9.3% to $786 million and gross profit sprang up 10.4% to $486 million, with the latter fueled by strong sales growth, a favorable product mix, and lower freight costs, the company’s annual report states. Gross profit, however, was hampered by higher unit manufacturing costs and longer reimbursement lag times.

EBITDA and net profit proved to be the true long jumpers, though: EBITDA (18% of sales) lurched forward 21.9% to $139 million, while net profit shot up 37.2% to $59 million.

Geographical and business segment sales posted solid gains as well in FY23. EMEA (Europe/Middle East/Africa) and APAC (Asia-Pacific) revenue each grew 10% (totaling $336 million and $65 million, respectively), while Americas sales climbed 8% to $384 million.

Össur’s business segments seemed unaffected by a new sales reporting system implemented last year (a third category was added). Prosthetics captured the lion’s share of revenue and growth, increasing sales 15% (13% organic) to $398 million on higher product volume and sales, price hikes, and solid demand for high-end solutions such as bionics and high-end mechanical feet.

Those same factors contributed to an 8% boost in Patient Care sales ($280 million), but only price increases and robust high-end solutions demand benefited Bracing & Supports revenue, which rose 2% (3% organic) to $147 million.

“Our strategy to provide more patients access to high-end solutions is evident in our bionic sales in 2023 being among the highest ratios of prosthetics sales we have ever had. This achievement fuels our commitment to the ongoing development of our innovative bionic solutions,” Össur President/CEO Sveinn Sölvason told shareholders at the start of the firm’s 2023 annual report. “As we reflect on the past year, we can be proud of our progress and unwavering commitment to improving people’s mobility.”

Össur bolstered that commitment last year with the launch of two new waterproof prosthetic feet. The low-profile Pro-Flex LP is designed to be fully resistant to both chlorine and saltwater; like previous versions of the product, it offers users a high degree of ankle motion and a smooth rollover to patients with longer residual limbs or low clearance for a prosthetic foot. The Pro-Flex LP also is available with a waterproof Unity, a sleeveless vacuum system that provides elevated vacuum in the socket using the energy created by the prosthetic foot’s natural motion.

The Proprio Foot, released to market in April 2023, also is waterproof and available with a waterproof Unity. This foot is an adaptive microprocessor-controlled ankle that improves safety by increasing toe clearance in swing phase and adapting to changing terrain. Coupled with recent speed and adaptation enhancements, Proprio Foot is now suitable for a wide range of patient profiles—from the active hiker to the community ambulator.

The Proprio Foot features a longer battery life, and an upgraded Össur Logic app that enables healthcare professionals to easily set up the prosthetic, adjust the functionality for each user, and access activity reports.

“The Össur organization is growing and evolving from what was once a niche product company to a holistic provider of mobility solutions and patient care,” Sölvason’s shareholder letter stated. “The patients in need of our mobility solutions are the driving force behind all we do.”

That driving force prompted Össur to open a new innovation center at its global headquarters in Reykjavik, Iceland, and provide clinical training to Ukrainian medical professionals on treating lower limb amputees.

In a unique collaboration between Össur and the Ukraine Protez Hub Foundation, 19 Ukrainian medical professionals of various disciplines gathered at the company’s academic facility in Köln, Germany, last fall for a week of comprehensive education and hands-on training in lower limb amputation and prosthetic rehabilitation. Several thought leaders in the field as well as orthopedic surgeons, prosthetists, physiotherapists, and other specialists provided the participants with a holistic program that covered surgical techniques, wound healing, assistive technology as a part of early and post-trauma rehabilitation, and gain training. Dr. Anton Johannesson from Össur and Antonina Kumka from Protez Hub curated the program in an effort to help advance Ukraine’s prosthetic profession.

“Össur has been diligently supporting Ukrainian medical professionals and amputees in need since the beginning of the war in February 2022,” Sölvason said, “and we are committed to contributing to the positive development of prosthetic care in the country.”

$719 Million
Prior Fiscal: $719 Million
Percentage Change: 0%
R&D Expenditure: $34M
Best FY22 Quarter: Q4 $191M
Latest Quarter: Q1 $181M
No. of Employees: 3,892

Patients with finger and partial hand loss are traditionally an underserved, yet growing population. To address this, in August 2022 Icelandic prosthetic and bracing company Össur purchased Naked Prosthetics, which provides durable, custom, and functional finger prostheses for finger and partial hand amputees.

Located in Olympia, Wash., Naked Prosthetics added about 70 employees to Össur’s workforce and strengthened its upper limb portfolio. In 2021, Naked Prosthetics claimed about $9 million in sales.

“Naked Prosthetics has developed functional and high-quality finger prostheses that complement our product portfolio and add an important range to our upper limb product offering,” Sveinn Sölvason, who took the company’s helm from Jon Sigurdsson on April 1, 2022, said in a company press release. “The acquisition strengthens our global market position, and we are pleased to welcome the employees of Naked Prosthetics to the Össur team.

“Össur’s global reach and expertise make them an obvious and welcome next step for Naked Prosthetics’ goal of getting more finger amputees back to work and doing what they love,” added Bob Thompson, CEO of Naked Prosthetics. “We are excited to join forces with the Össur team and continue to grow the partial-hand prosthetic market.”

The Icelandic company’s sales remained flat in its fiscal year 2022 at $719 million. The Americas captured $351 million last year, growing 4%. That was the only global region that celebrated growth—EMEA revenue dropped 3% to $306 million and APAC claimed the remaining $62 million, a 4% fall. $440 million of gross profit (61% of sales) was claimed in 2022, compared to 2021’s $455 million (65% of sales).

Prosthetics posted $440 million in sales—63% of Össur’s FY22 revenue—which represented a small, 1% bump over the year prior. Bionic products accounted for 21% of prosthetics component sales and performed strongly in Q4 2022, taking 25% of prosthetics components. This was mainly driven by Power Knee sales, according to the company’s FY22 annual report. The company stated that going into 2023, the demand for the first motor-powered prosthetic knee continues to surge.

The company’s most momentous product release came last February, in the form of the Power Knee. According to Össur, it’s the first actively powered microprocessor prosthetic knee for patients with above-knee amputation of limb difference. The motor-powered “smart prosthesis” uses algorithms to detect movement patterns, learns, and adjusts to the user’s speed and cadence in real-time. Power Knee creates motion via active powered assistance while distinguishing whether it’s walking on varying surface, inclines, or declines, as well as sitting or standing.

When ascending, the wearer can perform a more natural “step-over-step” pattern, and have more controlled resistance when descending ramps or stairs. According to the company, the Power Knee’s motor-powered energy encourages wearers’ symmetrical motion and conserves their own energy.

The company also expanded its prosthetic foot portfolio to include 20 waterproof feet, according to its most fiscal year annual report. Bracing and supports products claimed the remaining 37% of FY22 sales with $263 million—a 1% drop from FY21.

$719 Million
Prior Fiscal: $630 Million
Percentage Change: +14.1%
R&D Expenditure: $32M
Best FY21 Quarter: Q2 $190M
Latest Quarter: Q2 $181M
No. of Employees: 3,761

A happy golden anniversary to Össur! 2021 marked the 50th year since its founding in February 1971.

The prosthetics and orthotics company celebrated five decades in business with an announcement last February that the company would be carbon neutral for energy and fuel consumption, waste generation, business travel, transportation of goods, and electricity consumption of finished goods suppliers last year.

“We care about the environment and take our responsibility seriously. We have been actively working on establishing a good overview of the company’s carbon footprint and are proud to commemorate the company’s 50th anniversary by becoming carbon neutral,” said then-president and CEO Jon Sigurdsson. “As part of our larger commitment to sustainability, we are contributing to the UN Sustainable Development Goals and Climate Action is one of four UN Sustainable Development Goals we have chosen to focus on. The others are Good Health & Well-being, Gender Equality, and Responsible Consumption and Production.”

The company pledged commitment to their sustainability vision and continuing to actively reduce its carbon footprint, remaining carbon neutral beyond 2021.

Össur pocketed $719 million of revenue last year, rising 14.1% over the previous year. Currency movements positively affected sales growth by $20 million (about 3%), according to the company’s annual report. The company also completed several acquisitions of entities with full-year sales of about $26 million. However, supply chain cost increases stifled cost of goods sold negatively by $10 million for the year.

Prosthetics sales accounted for about two-thirds (67%) of Össur’s revenue, generating $453 million last year and leaping 11% over the prior year’s tally. Bionic products captured 21% of the franchise’s sales last fiscal. Prosthetics sales stayed resilient throughout the pandemic, driven by the existing amputee population with maintenance, renewals, and upgrades of prosthetics.
Last May, the company launched three new models of the Cheetah sports prosthesis. Cheetah is engineered for athletes participating in athletics that involve sprinting, distance running, and long jumping.

Cheetah Xcel was designed for explosive, short-distance (100-200m) sprints with features that reduce running effort and facilitate increased speed. The carbon fiber blade has a more extreme curve and dynamic shape that allows the foot to flex for a powerful energy kick, and a long toe boosts push-off while a plantar-fixed pylon supports forward movement.

Cheetah Xceed was designed for athletes with single or double amputation who participate in long-distance running. A larger carbon blade enhances shock absorption and reduces running effort.

Cheetah Xpanse was engineered for long-jumping with input from elite athletes to have faster pace for the run-up and improved push-off. A dynamic shape helps the foot flex aggressively for powerful energy return and plantar-flexed pylon for forward progression. The large carbon fiber blade helps withstand a heavier load, like when the athlete lands or participates in other high-endurance sports.

The Xceed and Xcel models have the option to place the co-developed Nike SoleX interchangeable sole system atop the running blades. The Xpanse model features a next-gen Nike Spike Pad 2.0 for specialized traction.

Bracing & supports sales jumped 8% to $266 million last year. It lacked the strength of the prosthetics franchise because this business is driven by injuries, surgeries, and osteoarthritis (OA) prevalence—measures to control COVID’s spread impacted amateur sports and activity levels that resulted in fewer injuries. Elective surgery disruption also impacted the segment’s sales volume, and physicians’ limited access to patient slowed OA bracing sales as well.

Last April saw release of the Rebound post-op elbow brace, designed to optimize clinicians’ fitting experience. Össur claims it’s the lightest weight brace on the market. It provides both elbow immobilization and range-of-motion restriction, and a drop-lock hinge have range-of-motion stops that automatically lock-out. Four telescoping ergonomic paddles with contoured hinge struts help make the brace more comfortable.

The Rebound DUAL Recover brace stepped in a month later. The orthosis has a combined purpose of rehabilitation up to full regeneration and user-friendly, patient-oriented functions. Its intuitive handling and tool-free adjustable joints are included in a lightweight design as well.

The Rebound ACL brace hit the market in September. It dynamically reduces strain on the ACL when recovering from injury and provides comfortable load on the posterior thigh and anterior tibia. A dynamic tension system allows individual, adjustable settings based on anatomy and rehabilitation requirements. It features extension range-of-motion lockouts, posterior frame design, and open anterior. It also has the company’s “Blue is You” system of patient touch points and ActiveGrip liners with anti-migration strapping.

The week before Christmas, CEO Jon Sigurdsson proclaimed his retirement after a whopping 26 years leading Össur. CFO Sveinn Sölvason was appointed president and CEO of the company on April 1 of this year. Sölvason had been with the company since 2009 and CFO since 2013.

“I congratulate Sveinn on his appointment and look forward to working with him on the transition,” Sigurdsson expressed. “It has been an honor to lead Össur for the past 26 years. I have had the pleasure of working with a dedicated team of employees, customers and end-users alike, all of whom have made Össur the successful business it is today. I look forward to watching Össur continue to flourish in the years to come.”

$630 Million
Prior Fiscal: $686 Million
Percentage Change: -8.2%
No. of Employees: 4,000

Through a 20-year partnership, the Challenged Athletes Foundation (CAF) and Össur gave the gift of mobility to thousands of amputees. In October, five new high-profile celebrities and professional athletes received the firm’s running prosthetics.

Surprise moments included MLB’s Eric Byrnes and Kevin Millar, NFL’s Luke Kuechly, Professional Supercross Riders, and fitness supermodel-amputee Paola Antonini.

“For athletes with limb loss, participation in sports is not always possible due to the high cost of adaptive sports equipment not covered by medical insurance,” Travis Ricks, programs director for CAF and ambassador for Össur, said in an interview with KUSI News. “Our long-standing partnership between CAF and Össur has allowed individuals to regain their independence using running prosthetics, connecting with the community and getting instructional support for running and mobility.”

The $630 million Össur generated last year was an 8.2 percent revenue loss over the year prior. Prosthetics sales amounted to $372 million, declining by 7 percent. Bracing and supports proceeds fell 15 percent to reach $257 million. Sales of mechanical prosthetic products was stable in 2020 compared to 2019, while bionics sales shrank. Bracing and supports sales fell because the pandemic and associated lockdowns significantly impacted amateur sports and activity levels, resulting in fewer injuries. Elective surgeries like knee replacements were slowed as well, which also stifled demand for post-op bracing solutions. Osteoarthritis bracing proceeds were also affected due to limitations to physician access.

Last April, Össur won U.S. antitrust approval to buy College Park Industries on the condition it sold its Espire Elbow business, which U.K.-based Steeper Group acquired. According to a company spokesperson, the FTC approval was the last needed to close the deal—which occurred June 1 of last year.

Last May the company acquired design and visualization software for prosthetic and orthotic shape capture, design, and manufacture from privately held startup Standard Cyborg. Professionals can replace less efficient processes for socket-making with computer-aided design capabilities that use a tablet to capture 3D images and make modifications of the patient’s residual limb. The socket design can then be sent to Össur to create a custom socket.

“Before Standard Cyborg, design technologies for prosthetic sockets were unwieldy, time-consuming, and required expensive hardware,” Standard Cyborg CEO Jeff Huber told the press. “We are glad this technology has found a home in Össur, so that prosthetists will be able to help even more people with limb loss and limb difference,” he said.

A month later the company released several innovations for lower limb loss patients. The Balance Foot S lightweight, waterproof, fiberglass prosthetic foot features a wide sole blade and cushioning foam heel for smooth rollover and sit-to-stand movements. Balance Foot S Torsion is for low-active walkers looking for a lightweight, waterproof foot for everyday use. It has a torsion shock unit to assist with tuning movements, absorb shock, and restore lost rotational capabilities. The Iceross Seal-In X Locking textile silicone liner is compatible with all seal-rings and the Unity system, suitable for users of all abilities and activity levels.

A new, streamlined version of the firm’s Empower program rolled out last July. The smartphone app provides comprehensive practice management solutions for durable medical equipment (DME), prosthetic and orthotic suppliers, and orthotic and prosthetic practices. It touts inventory management, paperless dispensing, tracking, and replenishment through barcode scanning and PAR level notifications. Empower also allows timely, secure, and trackable DME product shipments to patients nationwide.

In August the firm established Össur Japan G.K. in Tokyo, which was operational from Jan. 1 of this year. The company continued working with Pacific Supply Co. Ltd., the firm’s exclusive prosthetics distributor in Japan since 1999.

$686 Million
Prior Fiscal: $613 Million
Percentage Change: +11.9%
No. of Employees: 3,382

The Alfred Mann Foundation’s (AMF) implanted myoelectric sensor (IMES) system are implanted in muscles that directly control a bionic prosthetic limb’s desired movement. The implants sense a tiny electrical charge in muscle tissue and wirelessly send information to a prosthetic limb when the user intends to make specific movements. The result is a bionic limb that responds virtually the same way a sound arm, hand, or leg would.

The world’s first-in-man cases to evaluate AMF’s IMES technology were conducted in 2014 on upper-limb amputees from the U.S. military using i-Limb bionic prosthetic hands produced by Iceland-based prosthetics and bracing firm Össur. A year later, two Icelandic lower-limb amputees with IMES units implanted into residual muscle tissue demonstrated the ability to control their Össur leg prostheses with their intentions.

The IMES system served as a bridge between the amputee users’ neuro-muscular system and artificial limbs, so the learning process took place subconsciously and continuously. The system has also been used successfully in a pilot study to control an entire bionic arm in amputees who had undergone targeted muscle re-innervation surgery. And last November, Össur and AMF signed a milestone agreement that allows Össur to further develop and license AMF’s IMES system as both organizations continue to explore the potential of mind-controlled prosthetic technologies.

“We are eager to further explore how the user-experience will evolve when amputees use our advanced bionic prosthetic solutions along with this advanced sensor technology,” said Jón Sigurdsson, president and CEO of Össur. “This agreement is another demonstration of our company’s continuing commitment to ongoing research and development in the field of advanced prosthetics, to help more people enjoy a life without limitations. Our bionic products are truly ready to step into the future,” he said.

Össur celebrated its 20-year anniversary as a publicly listed company with further success, growing fiscal 2019 sales 5 percent to $686 million. According to Sigurdsson, the firm launched over 25 products and a number of incremental updates within both its prosthetic and bracing & supports businesses. Strong revenue growth was mainly driven by excellent prosthetic segment performance and high-end solutions in both businesses. Favorable product mix changes and savings from ongoing efficiency initiatives also boosted profitability.

Össur’s prosthetics sales swelled beyond estimated market growth, rising 7 percent to reach $378 million. High-end carbon fiber mechanical feet products and bionics continued their strong sales globally. Bionics made up 23 percent of prosthetics component sales; main market EMEA growth was healthy, as was APAC growth in emerging markets. Americas sales flourished apart from lower than expected U.S. sales to “a certain customer in the fourth quarter of the year,” according to the firm’s fiscal 2019 annual report.

The company bolstered its prosthetics business last February by purchasing powered ankle technology from privately held engineering firm SpringActive Inc., which specializes in computer controlled prosthetic devices and industrial exo-systems. SpringActive’s technology enables users to run and walk on all terrains with a range of motion that is intended to allow balance and performance of natural ankle positions. According to Sigurdsson, the purchase was aimed at strengthening the company’s R&D activities and product innovation, and did not have an impact on the firm’s financial guidance for 2019.

Global provider of lower and upper limb prostheses and supporting services College Park Industries, whose 2018 sales totaled $22 million, was bought last July. College Park will remain independent and continue to serve its customer base according to Össur, who hopes to support College Park’s focus on the lower active population and further strengthen established presence in the upper limb arena. The acquisition did not affect financial guidance for the year, according to the company.

“College Park has created a strong brand presence over the past decades, recognized for its quality products and stellar service,” Sigurdsson told the press. “It has also made important strides towards technology upgrade in the upper limb arena, an area where Össur hopes to support further development. We believe the joint efforts of the two brands will benefit our customers’ experience worldwide, all the while focusing on delivering the best solution for the end-user.”

The first new prosthetics launch was the new Proprio Foot last January. It is the latest generation of the world’s first bionic ankle with enhanced capabilities to reduce the risk of stumbles and falls. It also automatically detects terrain, adjusting the ankle position on the fly. The new model adapts to varied terrain 60 percent faster than the previous one, according to the company. It also boosts toeoff power 44 percent with a 23 percent increase in range of motion over the previous Proprio Foot. An upgraded Össur Logic app allows professional easy setup, adjusted functionality for each user, and access to valuable activity reports.

Last year also saw the release of i-Limb Wrist, a powered wrist rotator for the firm’s i-Limb hands. When used with the i-Limb Quantum, i-Limb Wrist offers transradial level absence patients simultaneous rotation upon grip selection. It supports conventional control options, including co-contraction and high/low. A proprietary SMART control algorithm and embedded encoder calibrates i-Limb Wrist to each wearer’s unique muscle activities.

Bracing and supports proceeds rose a slight 3 percent over the prior year, coming to rest at $308 million. The Rebound and Unloader franchises mainly provoked this segment’s growth in all market regions. There were solid gains in the APAC, EMEA, and Americas markets, but a competitive market environment in the U.S. and France somewhat offset them.

The Formfit Pro Knee Quest and Formfit Pro Knee Flite compression knee sleeves hit the shelves last July. Both feature custom MotionTech 3D knit construction for medical grade compression, breathability, moisture wicking, and a skintight fit. Formfit Pro Knee Quest helps realign the patella for conditions like Chondromalacia Patella (runner’s knee), mild strains and sprains, knee pain, and instability. The most lightweight compressive knee sleeve in the firm’s portfolio, Formfit Pro Knee Flite is designed to help with mild knee instability.

Össur introduced the Unloader One X knee brace last September. Its biomechanical properties provide pain relief and functional improvements for those suffering from unicompartmental knee osteoarthritis and degenerative meniscal tears. A patented three-point leverage system and dual DFS straps biomechanically unload the affected knee compartment to reduce pain. Lightweight and breathable soft-edge shells conform to each patient’s leg anatomy, and soft single-seamed straps eliminate bulk at the back of the knee and minimize chafing.

The Miami J Cervical Collar for gross cervical spine immobilization and Miami TLSO advanced spinal compression support system for gross spinal immobilization up to T7 also debuted last September. Miami J offers the widest range of height adjustability in the market according to the company, and a patented locking mechanism encourages patient compliance. The pre-assembled Miami TLSO brace offers three configurations in one. It can be worn in over the shoulder or underarm configuration, with obvious quick release buckles for quick donning and doffing.

AT A GLANCE
$613 Million
Prior Fiscal: $569 Million
Percentage Change: +7.7%
No. of Employees: 3,000
Global Headquarters: Reykjavik, Iceland

Sarah Reinertsen’s wish has finally come true.

It took a while—43 years to be exact (give or take a few turns of the calendar)—but the paratriathlete’s long-evasive aspiration has at last materialized.

Reinertsen has only ever wished for equality—not just for herself but for all disabled folk. She’s endured injustices for most of her life, having been exposed to the dark side of human nature at a very early age.

Reinertsen was born with proximal femoral focal deficiency (PFFD), an uncommon yet complex birth defect in which the upper femur is either malformed or missing, causing one leg to be shorter than the other. The condition affects roughly one in every 200,000 children. PFFD treatments vary depending on the patient; in Reinertsen’s case, the remedy was an above-the-knee leg amputation at age 7. Doctors told Reinertsen she would walk (with a prosthesis, of course), but never again run.

The biases began soon after the surgery, manifesting themselves most blatantly in sports. Reinertsen still remembers the shunning she endured on the soccer field—rather than being permitted to join other children in practice drills, the coaches assigned Reinertsen the monotonous task of kicking a ball against a wall. Alone.

The inequities only grew worse with the onset of puberty. “I often got made fun of,” Reinertsen recounted to USA Today last fall. “Kids would say mean things to me and pick on me, sometimes my leg would squeak or make noise and they would make fun of that.”

Reinertsen, ironically, found refuge from the verbal assaults in the same arena that was most exclusive. “Being the only kid in my school that wore a prosthetic leg made my teenage years very hard in trying to find a way to feel good in my body,” the motivational speaker and author told refinery29.com in a Q&A post last summer. “Sports has been the vehicle that has allowed me to embrace my body, flaws and all. I used to sort of resent my prosthetic leg and having a stump but now I’m proud of that. I realized if I hadn’t lost my leg, I wouldn’t have found this other half of myself.”

In celebrating her physical flaws, Reinertsen found the courage and determination to seek the equality that constantly eluded her. She chose to pursue that parity through running.

Inspired by Jim MacLaren—once the world’s fastest amputee triathlete—Reinertsen began competing in, and winning, marathons. At age 13, she broke the 100-meter world track record for female amputees. At 23, Reinertsen was the first above-the-knee amputee to ever finish the Seven Sisters 12-Mile Trail Run, considered the most challenging race in the Northeast. Then in 1999, she was the gold medalist in the ISOD (International Sports Organisation for Disabled) 100-meter, 200-meter, and 400-meter contests.

Reinertsen made history in the mid-2000s when she entered and completed (respectively, in consecutive years) the Ironman World Championship in Kona, Hawaii. No female leg amputee had ever before participated in the 140-mile race.

Reinertsen secured another date with history last winter upon completing the 777 World Marathon Challenge, a grueling contest that requires participants to run seven marathons on seven continents within seven days. She was the first amputee to ever enter and complete the event.

Eight months after running around the world (literally), Reinertsen returned to the Pineapple State to participate in her third Ironman World Championship (2018). She completed it 24 minutes faster than her 2005 finish, despite the various disadvantages she faced as an amputee (no kicking power for swimming, no extra force generation for biking, more overall energy required). Reinertsen, however, was more than willing to endure those challenges for the opportunity to fulfill her lifelong dream: be treated like everyone else.

“Most golfers don’t get to play with Tiger Woods,” Reinertsen said of the iconic triathlon event on Hawaii’s Big Island. “In Ironman, whether you are a professional, or an age grouper, or whoever, you are all in the same world championship. The caveat is that the rules don’t get changed, whoever you are.”

Translation: Everyone is treated as equals.

To qualify for that equal treatment, Reinertsen employed the latest technology from Össur, an Icelandic developer and manufacturer of non-invasive orthopedic equipment (bracing/support products, compression therapy, and prosthetics). For running, Reinertsen uses the Össur Flex-Run with Nike Sole and the Össur Total Knee 2100; the former product evolved from a collaboration between the two companies and features a longer toe lever for better energy return, while the latter innovation has a three-phase hydraulic swing control, a geometric locking system, adjustable stance flexion, and a 30-mm (13/16-inch) pylon adaptability.

For cycling, Reinertsen uses a prosthetic leg with a built-in biking cleat, and her everyday setup of choice is the Össur Total Knee 2100 combined with the Össur Vari-Flex XC foot and Össur Iceross 3 mm and 6 mm liners.

Reinertsen credits Össur’s prosthetics with helping improve her overall performance at last year’s Ironman World Championship, though she insists her physical prowess is mostly responsible for the feat.

“Having a coach to encourage me and create my plan with intention and with my goals in mind—I needed that more than anything,” Reinertsen said in response to an Equinox Furthermore Magazine question about besting her 2005 Ironman finish time. “…another thing was investing in equipment. I made a lot of changes with my gear, like adding electronic shifters to my bike and using Össur cycling and running legs with updated designs for racing and speed. The prosthetic tech definitely helps, but I don’t want to give it too much credit. I’m still the engine. I power the hinge through every revolution on the bike and every stride on the run.”

Maybe so, but Össur must be doing something right: The company has grown 20 percent annually since its 1999 stock exchange listing, and sales have surged 27 percent since 2015. In each of its last three fiscal years, Össur’s revenue jumped an average 8.27 percent, and its gross profit margin has hovered around 63 percent.

“We at Össur are dedicated to improving people’s mobility and witnessing the users of our products push their boundaries to reach new heights,” president and CEO Jon Sigurdsson told shareholders in the company’s 2018 annual report. “This fuels our passion and commitment to the orthopedic industry. People living with limb loss are gracing the covers of magazines, featured in global brand campaigns, and eliminating the stigma often associated with limb difference. We could not be prouder to be a part of this movement.”

Indeed, that pride has helped fuel the company’s ingenuity throughout its 48-year history, producing such innovations as bionic limbs, carbon fiber composites, and custom prosthetics.

Össur’s inventive streak continued last year with the release of 25 new products, including the Pro-Flex LP Align, the Rebound Post-Op Knee, the bionic PROPRIO FOOT, and the Formfit Pro Knee OA.

The Össur Pro-Flex LP Align prosthetic foot features heel height adjustability, enabling users to change from sneakers to heels as desired throughout the day. The product, according to the company, is the first prosthetic of its kind, as lower limb amputees have historically had to sacrifice the functionality of their prosthesis for heel height.

Össur’s Rebound Post-Op Knee brace is made for patients requiring controlled range of motion for various knee-related issues such as ligament or meniscal repairs, tibial plateau fractures, patellar tendon or osteochondral repairs, condylar fractures, knee sprains/strains, and high tibial osteotomy. Thirty percent lighter than other commercially available braces, the Rebound Post-Op Knee features ergonomic paddles and contouring struts that hug the patient’s anatomy and promote comfort. It also capitalizes on innovations incorporated in other Össur products, including an Anti-Migration System wrap and quick-fit buckle system to ensure secure suspension.

The Rebound brace aims to provide controlled knee range-of-motion (10-120 degrees), provides additional support via a secure drop-lock feature, and offers optional lockout clips to limit patient self-adjustments. The product’s design entails Smart-Fit packaging and a numbered frame with quick-fit gripping buckles for easy fitting. The brace is available in universal adult and pediatric models as well as specific left- and right-contoured configurations when a more anatomical fit is required. A button enables the telescoping frame to be sized from 18.5 inches to 27 inches in the adult models, and 15 inches to 21 inches in the pediatric version.

The PROPRIO FOOT makes use of a motor-powered microprocessor-controlled ankle to adjust the user’s foot position, thereby enabling the product to address variations in terrain better than other prosthetic feet, according to Össur. The PROPRIO FOOT provides a stable foot placement on stairs and inclined surfaces while reducing the risk of trips and falls by lifting the toe in every step.

Össur launched its Formfit Pro Knee OA in May 2018 in partnership with Iceland’s national soccer team. The first product to be introduced in the Össur Formfit Pro range, the Pro Knee is designed to unload the knee compartment and enhance proprioception for early or mild osteoarthritis as well as other knee conditions.

Patients, however, were not the sole beneficiaries of Össur’s new product introductions last year. The neophytes also benefitted the company’s bottom line, boosting 2018 sales 7.7 percent to $612.8 million and expanding gross profit 9 percent to $386.8 million, the annual report states. Net profit mushroomed 38.4 percent to $79.8 million, and earnings per share swelled 40 percent to 18.8 cents.

Growth was equally as robust in Össur’s Prosthetics segment, which accounts for 52 percent of the company’s total revenue. Fiscal 2018 proceeds rose 7 percent to $316 million due largely to strong sales gains in the Pro-Flex LP Align, bionic PROPRIO FOOT, bionic RHEO KNEE, and Touch Bionic upper limb solutions portfolios.

Bracing and supports, which accounts for 48 percent of Össur’s annual sales, increased revenue 2 percent last year to $296 million. Unloader One solutions and the Rebound Post-Op Knee mainly drove sales, though growth was somewhat curbed by a competitive EMEA market for compression therapy products. Asia-Pacific sales were particularly strong in Australia, China, and Japan.

$569 Million
NUMBER OF EMPLOYEES: 2,948

The Isklar Norseman Xtreme Triathlon is one of the most brutal events in international triathlon competition. Contenders begin the grueling race with a nearly four-kilometer swim in the icy waters off Norway. They then bike over five mountain passes, traversing 180 kilometers of rugged terrain littered with demanding climbs and breakneck descents. A 42.2-kilometer run through rocky, mountainous terrain completes the triathlon, including scaling 1,700 meters up the aptly named “Zombie Hill.” The finish line is located 6,178 feet above sea level at the summit of Norway’s Mount Gaustatoppen. Surely a near-impossible feat for even the fittest, most daring athletes.

Team Össur member Mohamed (Mo) Lahna, however, was able to complete the course in 15 hours, 52 minutes, and 45 seconds last year. This placed him 156th in competition, ranking him among the elite finishers. Mo was also the first amputee in the contest’s history to complete the course.

Born with proximal femoral focal deficiency in the right leg, Mo was essentially left without a femur. His lower leg pretty much begins at the hip, rendering him truly “one-legged” when it comes to cycling or running. Equipped with Össur’s Flex-Run—a prosthetic foot engineered for running and cycling—he was also able to earn a bronze medal for his home country of Morocco in the paratriathlon’s debut at the Rio 2016 Paralympic Games.

Össur’s Flex-Run prosthesis features a long toe lever and efficient energy return, and a partnership with Nike furnished the foot with top-of-the-line traction and sole technologies. With Flex-Run, Transfemoral and Transtibial users can participate in high impact activities like recreational jogging, trail running, distance running, and—if you have Mo’s mettle—triathlons.

“It’s not every day you get a shot at making the first-ever triathlon event in the Paralympics, so I wanted to make it count,” Mo said in an interview with the Challenged Athletes Foundation. “Going to the 2016 Rio Paralympics was an unbelievable experience and after all the sacrifice my family and I had made, I knew I couldn’t go home empty handed. I am so proud to have stood on the podium, earning my Bronze medal that day.”

With $285 million in global fiscal 2017 sales (ended Dec. 31), prosthetics make up almost precisely half of Iceland-based Össur’s $569 million total revenue. The portfolio ranges from technologies to support less active people struggling to maintain mobility to those that enable especially active people to participate in high-impact athletics or endeavors. The company’s artificial limbs and related products for amputees are composed of a broad array of mechanical lower extremity prosthetics, as well as bionic solutions—microprocessor controlled knees, hands, and feet.

Össur’s $569 million of 2017 revenue—a respectable 9 percent bump over the prior year—and the prosthetics segment especially rests on the increasing economic value of prosthetics. The company believes with an aging population emerging that seeks to be more active, the population of elderly amputees is forecasted to follow similar trends.

“Still relatively few elderly amputees receive a prosthetic solution and even fewer a bionic solution,” CEO John Sigurdsson proclaimed in his letter to shareholders in the company’s 2017 annual report. “This is despite recent studies clearly demonstrating the economic benefit of bionic solutions and their proven capability to improve the quality of life for amputees. It is therefore not economical to withhold bionics from patients. This is an area where Össur aims to support industry developments in the future by providing effective, powered, intelligent, and energy-efficient prosthetic solutions for low active amputees.”

The RHEO KNEE, a microprocessor-controlled prosthetic knee boasting advanced features like auto adaptive real-time stance and swing control, dependable swing initiation on all surfaces, and automatic stumble recovery, was the key growth driver in both the EMEA and Americas regions. Over 30 new prosthetic products were introduced to the market in 2017, including new versions of the RHEO KNEE.

One such version surfaced with last February’s launch of RHEO KNEE XC. The knee was engineered to have a quick learning curve in the rehab setting via features that make it easier for everyday users—easy walking, automatic cycling recognition, stepping over objects, leg-over-leg stair ascent, and jogging. Rather than the traditional hydraulic systems, RHEO KNEE XC utilizes magnetorheological fluid, a smart fluid that changes viscosity when subjected to a magnetic field. This equips it with stumble recovery, activity recognition, and obstacle avoidance. It also comes with the firm’s Logic software, which lets clinicians adjust user functionality and access activity reports, and supplies the user with a library of exercises in both the rehab and home settings.

Össur released two mechanical feet within its Pro-Flex line last September. Launched in 2016, the Pro-Flex foot combines a 93 percent increase in peak ankle power with an 82 percent increase in range of ankle motion to reduce sound-side loads by 11 percent, compared to a conventional energy storing and return foot.

Pro-Flex XC Torsion and Pro-Flex LP Torsion, as their names suggest, augment the artificial foot with torsion capabilities. According to a 2016 study in Prosthetics and Orthotics International, prosthetic feet with torsion help prevent movement between the socket and residual limb, reducing shear stress on the residual limb. Additionally, a strong coupling between limb and socket gives the user more control over their prosthesis, which improves comfort and residual limb health.

Össur also reinforced its prosthetics business through two acquisitions made in 2016 that were successfully integrated last year. Buying U.K.-based Touch Bionics entered the firm into the upper limb prosthetic market. The first company to develop an electrically powered prosthetic hand with five independently powered fingers, Touch Bionics added electric prosthetic hands and fingers as well as passive silicone prostheses closely matching the wearer’s natural appearance to Össur’s portfolio. The firm completed its integration of German mechanical lower limb prosthetic components maker Medi Prosthetics last January. Thanks to the addition of Medi Prosthetics, customers in the United States and Canada will have access to a broader range of prosthetic knees and legs, as well as liners and sleeves.

The other half of Össur’s business—bracing and supports—deals in products to stabilize joints and improve healing for those recovering from fractures, ligament injuries, or an operation, as well as bracing for osteoarthritis (OA) patients. With $285 million in fiscal 2017 proceeds, the segment rose a slight 2 percent over the prior year. Growth was chiefly provoked by strong Unloader One sales in the EMEA region. However, performance was negatively impacted in the Americas due to a sales decline in Össur’s distribution companies. The operational challenges, according to the company, were due to internal restructuring efforts. Those distribution companies account for about 8 percent of global bracing and supports sales.

The Miami LSO (lumbar sacral orthosis) brace hit the market last September. It utilizes a unique double pulley system with powerful leverage, as well as a length-adjustable pulley cord for tailored placement and compression. Miami LSO is meant for patients requiring gross immobilization of the trunk in the lumbar region due to stable non-displaced spinal fractures; spinal stenosis; herniated disks and degenerative spinal pathologies; spondylolysis; and spondylolisthesis. Clinicians can select either universal posterior panels for Miami LSO or take a modular, customized approach addressing comfort and clinical necessity.

Össur pioneered OA bracing by launching the Unloader brace almost three decades ago. Intended for those suffering from mild to moderate knee OA or degenerative meniscal tear pain, it has proven instrumental in reducing pain, improving function, and decreasing the use of pain medication.

The Unloader One Lite brace was released last October. It is ideal for younger, more physically active patients beginning to experience early knee OA and degenerative meniscal tear symptoms. Unloader One Lite features a lower-profile design, weighing six ounces less than the classic Unloader One brace. It is the first unloading brace clinically proven to be effective for degenerative meniscal tears, a pre-OA condition. In order to reduce pain and improve function, it provides unloading—reduced stress—for the affected compartment.

Last October, Össur and Comau, a subsidiary of Fiat Chrysler Automobiles involved in the industrial automation field, initiated a joint venture to claim a majority share of BioRobotics Institute spinoff Iuvo. Founded in 2015, Iuvo’s objective is to create wearable, intelligent, and active tools for a better quality of life. The venture’s main initial priority is to research, develop, and eventually commercialize robotic exoskeletons that can improve both quality of life for industrial and service workers as well as patients needing improved mobility.

“This joint venture represents a key step toward the creation of wearable robotic exoskeletons that can enhance human mobility and quality of life,” Comau CEO Mauro Fenzi told Robotics and Automation News. “By uniting the know-how and enabling technologies of the various partners, we are in a unique position to extend the use of robotics beyond manufacturing and toward a truly progressive global reality. I believe the differentiating factor of a project like IUVO is the combination of Comau’s automation skills and Össur’s extensive experience in bionics and bracing to enable the production of products, such as the exoskeletons, and to be able to demonstrate the benefits of robotics.”