STRATEGIC REPORT

EUROPEAN ORTHOPAEDIC

MARKET2016-2021

H I P , K N E E & S H O U L D E R

May 2017 – 15th Editionw w w. av i c e n n e . c om

AVICENNE’S

UNIQUE WARRANTY

If you are not 100% satisfied with our

report, send it back to us with a letter indicating

the reasons and we will refund you in full!PUBLISHED MAY 2017 • 15TH EDITION

Special focus on the Worldwide

orthopaedic market, player dynamics

and global market shares

NEW

OVER 25 YEARS OF STRATEGIC CONSULTANCY FOR THE MEDICAL DEVICE INDUSTRY

AVICENNE HAS BEEN INVOLVED IN THE MAIN EUROPEAN ORTHOPAEDIC DEALS OVER THE PAST 25 YEARS

STRATEGIC & COMMERCIAL DUE DILIGENCE: EXAMPLE OF MISSIONS

STRATEGIC MARKET RESEARCH, DIVERSIFICATION AND FINDING TARGETS FOR ACQUISITION: EXAMPLE OF MISSIONS

Foundation of AVICENNE

DePuy-Landanger

deal

CARLYLE-Marle deal

AXA PE - LIMA deal

Keensight- Menixdeal

APAX- Amplitude

dealLISI entering

Orthopaedics

Charlesbank- TECOMET

deal

1992

IMPLANTS:1rst edition

2005 2009 2012

20131997 2007 2011

2014

Implants:11th edition

2015

Conférence internationale pour l’innovationdes implants orthopédiques et des biomatériaux

2 0 1 5

TECRESAAP Biomaterials

2016

Biomaterials

International conference on innovation & solutionsfor orthopaedic implants and orthobiologics

• Product portfolio assessment• Competitive advantages of the company in Italy, Germany, Spain, Portugal,

USA, Australia, South Korea and Japan in terms of products, market shares, image, etc.

• Analysis of the company distribution channels• Manufacturing organization assessment• New products, Business Plan and forecasts• Analysis of the company’s management capabilities to sustain growth• Support in finding the new company CEO• R&D projects pipeline up to 2018• Working Capital benchmarking with competitors• Management case discussions & restatements by segment• Profitability assumptions and analyses• Report and arguments for the debt suppliers

• Size and Forecast of the global orthopaedic markets by country, by product, by competitor market shares

• Reimbursement procedures, trends and impact on the target business• Outsourcing strategies and trends of orthopaedic companies• Segmentation, sizing and dynamics of contract manufacturing by capabilities

and also the market share details of the top 20 contract manufacturing players

• Risks and opportunities of relocation of the implants to BRIC countries• Selection and understanding of criteria for OEMs to choose their Contract

Manufacturers• Understanding company differentiation & the keys to grow market share• Strategic & operational recommendations: Ways to maximize value

• Product portfolio assessment for AAP biomaterials & TECRES• Size and Forecast of the global orthopaedics cement market• In-house Manufacturing & outsourcing strategies of the orthopaedic companies• Segmentation, sizing and dynamics of Vertebroplasty cements & instruments• Understanding the competitive advantages of each company• Strategic & operational recommendations for the merger• Proposal for an appropriate communication strategy with the Industry

• Analysis of orthopaedics contract manufacturing by segment: Forging, casting, machining, coating, etc..

• Drivers and limiters for each segment and focus on several opportunities• Analysis of the dental implants market worldwide and opportunities in this

field• Contract manufacturer acquisition opportunities analysis in Europe and the

USA• Business Plan scenarios: presentation & restatements• Road map for 5 years

• Quarterly market shares tracking in 14 European countries for different spine products

• Perimeter: Stabilization, Dynamics, Orthobiologics & Vertebroplasty with 13 sub-segments in detail

• Tracking of devices sold by unit & value• Product portfolio assessment of the players• Forecasts and trends to identify the future high growth products:

detailed inside the report

• Selection of 15 to 30 acquisition targets with defined criteria: - Serving the Orthopaedics OEMs in various areas - Capabilities in innovation with strong R&D and quality departments - Prototype, metrology, testing, machining, cleanroom class III, packaging,

competencies- Financial perimeter: 10 M US$ - 100 MUS$ revenues, level of profitability, etc.

• Analysis of the risks, complications and obstacles • Final selection of the appropriate targets• Open channels of communication with the targets

> 100 M€ revenues

> 100 M US$ revenues

2012

2013

2016

2011

2007 to

2011

CONFIDENTIAL

2016

Italy

USA

WW

WW

Europe

WW

Strategic Due

Diligence for the

buyer (AXA PE, now Ardian)

Strategic advice to

the shareholder(CharlesBank

Capital)

Strategic Due Diligence for the buyers (TECRES & Keensight Capital)

Strategic advice to diversify inorthopaedics.Goal: To reach

100 M US$ in revenues in 5 years

Strategic market

research

Finding appropriate targets for acquisition

and strategic analysis of risks and

opportunities

Deal Date Area Mission Details

Deal Date Area Mission Details

OEM :Hip, knee,shoulder,trauma

Contractmanufacturing

Implants &Instruments

Merger of n°2 and n°3 of the ortho. cement to build the independent

worldwide leader

Strategic advicesto enter in

orthopaedics

Market shares tracking for 50 spine

products

Finding targets for acquisition

Implants

Hip

Knee

Spine

Extremities

Trauma

METHODOLOGY: WHY CHOOSE THIS REPORT?

HIP, KNEE & SHOULDER DETAILED SEGMENTATION USED

SURVEY METHODOLOGY

OEM & Contract Manufacturer direct interviews with decision makers thanks to strong links with CEOs, R&D, Marketing, Sales...

Cross-checking of information thanks to our tried & tested operating models

OEM

Hip

Knee

Shoulder

IMPL

ANTS

ZIMMER STRYKER DEPUY SYNTHES

Vol Vol Vol

Y

Val Val ValRowth % %

DEPUY SYNTHES

AVIC

ENN

E SU

MM

ARY

Y a b c d e

Sour

ce 1

: con

tact

1

Sour

ce 1

: con

tact

2

Sour

ce 3

: mar

ketin

g

Sour

ce 4

: Pr

oduc

t Man

ager

Sour

ce 5

: Sa

les M

anag

er

…

Worldwide coverage

DEVELOPED COUNTRIES

BRICCOUNTRIES

DEVELOPING COUNTRIES

Latin America, Middle East, Asia

Western Europe+

25+ years of historical data on the Orthopaedics & Contract Manufacturing markets

Companies & continuous tracking

Highly detailed segmentation

Entire supply chain & all players: OEMs, Contract Manufacturers

All product types: implants, instruments, cases & trays, biologics, cements, ceramics

All manufacturing services: forging, casting, machining, coating, packaging, sterilization

Operating Models & Cross-checking of information

Implants Instruments Cases, trays Biologics

Contract Manufacturing

Fixations for Total hip

Cemented(Stem & cup are

cemented)

Metal / Polyethylene

Posterior stabilized

Metal / Polyethylene

Metal / Polyethylene

Hybrid(Stem is

cemented, cup is

cementless)

Bearings for Cemented

Total Knee

Bearings for Cementless

Bearings for Hybrid

Monobloc

Dual mobility cup

Standard With bipolar shell

HIP GENERAL SEGMENTATION

HIP SEGMENTATION BY FIXATIONS & BEARINGS

KNEE SEGMENTATION BY FIXATIONS & BEARINGS

Anterior approach

Postero/lateral approach

Total

Total Fixed

Fixed Mobile

Revision

Revision

Partial

HIP

KNEE Fixations for Total Knee

ResurfacingModular

Cemented Cementless Hybrid

Shorter stem & mini hip

Revision

Primary

Cementless(Stem & cup

are cementless)

Ceramic / Polyethylene

Cruciate retaining

Ceramic / Polyethylene

Ceramic / Polyethylene

Ceramic / Ceramic

Ceramic / Ceramic

Metal / Metal

Metal / Metal

Partial Mobile

CementedCemented

Total

Standard Reversed

Universal stems Revision Resurfacing

SHOULDER Mini shoulder

Partial

Cemented CementedCementless CementlessHybrid Hybrid

CementlessCementless

HybridHybrid

Unicondylar Femoro patelar

KNEE GENERAL SEGMENTATION

SHOULDER GENERAL SEGMENTATION

YOU WILL FIND IN THE REPORT:

GENERAL DATA ON COUNTRIES HEALTHCARE SYSTEMS

850 Pages – 1,550 Exhibits

Highly detailed segmentation: Total, Revision, Partial – Cemented, Cementless, Hybrid - All bearings, fixed, mobile - Standard, Reversed, etc.

5 main European countries analyzed in detail: Germany, UK, France, Italy, Spain

12 other countries, also analyzed to get accurate picture of entire European market: Belgium, Denmark, Finland, Sweden, Ireland, Netherlands, Austria, Luxembourg, Greece, Portugal, Switzerland & Norway

USA, China, South Korea, Australia, Japan: Hip & knee units and value in 2016 and 2021 forecast

Analysis of the drivers & limiters of the market, price pressure and regulatory trends

Comprehensive analysis of the key companies and their market share

KNEE

40+ companies analyzed plus market shares

detailed

SHOULDER

20+ companies

analyzed plus market shares detailed

HIP

50+ companies analyzed plus market shares detailed

DETAILS OF ALL SEGMENTS

MARKET SHARE PER COUNTRY, PER PLAYER AND FOR HIP,

KNEE & SHOULDER

2021 FORECASTS FOR ALL THE SEGMENTS & SUB-SEGMENTS

High growth productsD E TA I L E D I N R E P O RT

> Hip dual mobility,> Mini hip & Shorter hip stem,

> Anterior surgical hip approach,> Trabecular metal usage for hip,

knee & shoulder,> Mini shoulder stems

Download the detailed table of contents

www.avicenne.com

O R D E R F O R MEUROPEAN ORTHOPAEDIC MARKET

2016-2021H I P , K N E E & S H O U L D E R

Published May 2017 – 15th Edition

CUSTOMER INFORMATIONName: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Job title: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Company: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Email: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

City/Country: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Phone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Fax: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Intra-community VAT Number (Mandatory for EU companies): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PAYMENTTotal € (from above): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Purchase order number (if applicable): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Accounting dept. address (if different than company address): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Date, Signature & Stamp

PRODUCT OPTIONSPlease select:

Full report (pdf) European orthopaedic Market 2016-2021 / Hip, Knee & Shoulder market report 5 main countries + Rest of Europe (12 countries) and all products (Hip & Knee & Shoulder) • 850 pages / 1,550+ exhibits • Single-user licence: 5,900 €

1 country report (pdf) Selected from Ger, UK, Fr, It, Sp or other country with all products - Please specify country: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 130 pages / 250+ exhibits • Single-user licence: 3,900 €

WAYS TO ORDER1 - E-mail the order form to a.madani@avicenne.com

2 - Fax the order form to +33-1-47 78 46 01

3 - Mail the order form to AVICENNE, Litwin Bldg, 10 rue Jean Jaurès, 92800 Puteaux La Défense, FRANCE

4 - Use Credit Card: Mastercard, Visa

Type of card: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Card number:

Expiration date:

Name of the cardholder: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Security number (3 digits on the back of your card)

For a corporate license, please contact us: a Corporate (or multi-user) license is needed for any organization in which more than one user in at least two different locations will access the report. Please add VAT for French companies.

STRATEGIC REPORT

EUROPEAN ORTHOPAEDIC

MARKET2016-2021

H I P , K N E E & S H O U L D E R

CLIENTS

EUROPEAN ORTHOPAEDIC MARKET 2016-2021

H I P , K N E E & S H O U L D E R

Published May 2017 – 15th Editionco

mpa

nies

Ort

hopae

dics manufacturers

Contract

Private Equities

& financial services Consulti

ng firm

s

Aesculap-B Braun, Amplitude, Aston Medical, Bioland, Biomet, Biomicron, Ceraver,

Cousin-Biotech, Dedienne, Depuy Synthes, Eurospine, Evolutis, FH, FX Solutions, Geistlich,

Help Ortho, Implanet, Implant Industries, Integra Life Sciences, Kisco International,

Lepine, Lima, Mathys, Medtronic, MBA, Medacta, Nexis, OST, Orthosoft, Ossacur,

Osteotech, Plus Ortho, Progenor, SEM, Seremm, Scient’x, Smith & Nephew, SME, SMI, Stryker

Corp, Stryker Limerick, Stryker Spine, Spineway, SGM-Codim, Stanmore Implants, Stryker,

Symbios, Tornier, Transtructure, Transysteme, Zimmer Biomet, Wright Tornier, X’Nov…

Apax Partners, Altor Equity Partners, AXA PE now Ardian, Argos Soditic, Banque Lazard, BIP

Investment Partners, Carlyle Group, Charlesbank Capital, Clayton Dubilier & Rice, Eurazeo,

European Capital, Goldman Sachs, Keensight Capital, LBO France, Permira, Piper Jaffray,

Pragma Capital, Rothschild Five Arrows, Simuval, Tikehau, Warburg Pincus, Zurmont Madison…

Autocam Medical, Avalign, Ceramtec, Cetim, EOS, Eurocoating, Finetubes, Forginal, Geoffroy, Greatbatch, HWG, In’tech Medical, Invibio, Ionbond, Jabil Medical, Jenoptik, Heptal, Komet, LISI Medical, Manoir Industries, Marle, Metal Craft & Riverside, Nowak, Oerlikon, One Ortho, Paragon Medical, PolymerExpert, Projection Plasma System, Sandvik, Stainless, Somepic, Symmetry Medical, Tecomet, Terolab Surface Medical, Vaccucast, VSMPO Tirus, Wichard, Willemin Macodel…

Arthur D. Little, AT Kearney, Bain, Boston Consulting Group, KPMG Strategy, LEK Consulting, McKinsey & Company, OC&C Strategy, Oliver Wyman, Roland Berger…

The 2016 and 12th edition of IMPLANTS attracted more than 200 international decision-makers for a full day of presentations, tutorials and business networking. The speakers highlighted how innovation and new manufacturing techniques are evolving and impacting the future landscape. IMPLANTS has become a “must attend” event on the orthopaedics industry calendar.

www.implants-event.com

International conference on innovationfor orthopaedic implants and orthobiologics

20 1 7

Created and chaired by

June 7th, 2017 - Paris - 13rd edition