The market pattern of knee surgery has changed, and the rise of medical robots?


The market pattern of knee surgery has changed, and the rise of medical robots?

Image credit: BSIP Getty Images

OFweekrobotThe world’s top medical technology companies are turning to Robots to help with complex knee surgery, hoping to change the surgical condition that has always left patients unsatisfied, leading to faster procedures and better surgical results.

Demand for artificial joint replacements is growing rapidly due to the wear and tear of the knees and hips of “baby boomers”. But in the past 15 years, no company has been able to deliver the technological advances to gain significant market share.

So now the US company Stryker and the UK company Smith & Nephew believe that is about to change because robots have created such an opportunity for them.

The use of medical robots will mean less trauma and faster recovery for patients, although they will still need to prove themselves in eventual clinical studies whose results will not be reported for several years.

Fares Haddad, a consultant surgeon at University College London Hospital, is the first person in the UK to use a new medical robot and has made an impressive impression. Still, he thinks healthcare solution providers need decisive data to justify their $1 million investment in each robot.

He said: “The main reason for using a Robotic system is to increase the accuracy and be able to hit very accurate lesions that vary from patient to patient. It is particularly useful in the knee, which tends to be more difficult to perform than the hip. , and when we want to be able to replace a patient’s knee, they are often not satisfied.”

Industry surveys show that the satisfaction rate of knee surgery is only about 65%, while the hip can reach 95%.

Different types of robots, which vary in cost and complexity, are used to assist surgeons with precise image guidance of bone cutting and artificial joint implantation.

The famous medical robot

Orthopedic companies hope to emulate Intuitive Surgical’s successful model. Intuitive Surgical was an early pioneer in the use of medical robots in hospitals and has now installed more than 4,000 da Vinci robots around the world to perform procedures including prostatectomy, hernia repair and hysterectomy. .

In addition to selling to big Western markets, they also hope to expand the use of robots in emerging markets such as India and China, where private hospitals have a reputation for high-tech systems that would be the biggest marketing advantage.

Stryker is leading the way with its $1.63 billion MAKO robotic arm, which it acquired in 2013 for $1.63 billion, a platform that can pioneer a new class of robotic-assisted total knee surgery by determining optimal positioning and then helping with bone cutting.

The market pattern of knee surgery has changed, and the rise of medical robots?

Mako Robotic-Arm (Source: Stryker)

But Stryker has a smaller competitor, Smith & Nephew, which launched a cheaper product called Navio last month in the US for total knee replacements. The UK-based company bought the company behind Navio for $275 million in 2016.

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The market pattern of knee surgery has changed, and the rise of medical robots?

The NAVIO (Source: Smith & Nephew)

Both companies are now able to perform total knee replacements, which also represent the vast majority of knee surgeries that can be performed, so the real competition has begun.

MAKO, which uses only Stryker’s joints and implants, costs about $1 million to install, while Navio, which doesn’t have as many features and isn’t fully tied to Smith & Nephew’s products, costs less than MAKO’s half of .

Both companies believe their robots will help them capture a larger market share in the orthopedics market, which has been divided among the four major players for more than a decade.

In fact, Smith & Nephew CEO Olivier Bohuon said it was his firm’s most significant strategic investment in more than a decade.

“We’re basically going hand in hand with Stryker right now, and I believe whether it’s Stryker or us, because we have robots, we’re going to have a bigger market share,” he said in an interview.

cost-benefit issue

Meanwhile, Stryker expects its MAKO system to provide market share gains from the end of 2017.

Katherine Owen, Stryker’s head of strategy, said at an investment conference in June: “With our exit this year, expect to start seeing evidence of our market share in knee joints. We use MAKO in knee joints. The goal in the market is to capture a few hundred basis points of market share. As for what the time frame looks like, we don’t have a concrete plan yet.”

The market pattern of knee surgery has changed, and the rise of medical robots?

Zimmer Biomet and Johnson & Johnson are the other two big players in the orthopedics market, and while both are a step behind the robotics race, both plan to enter the field in different ways.

Johnson & Johnson is developing surgical robotics with Verily, the life sciences arm of Alphabet, the mother of Google, while Zimmer last year acquired a majority stake in Medtech, a French neurosurgery specialist.

Analysts at Morgan Stanley believe that no knee or hip implant has dominated in recent years, a sign that robots have the potential to disrupt the market for artificial joints that are supposed to be commoditized.

And Smith & Nephew’s Bohuon believes that robots give the company an opportunity to regain its position in the market, even though Smith & Nephew currently ranks fourth in reconstructive surgery.

He estimates that robot-assisted surgery could account for 20 to 40 percent of knee surgeries.

However, this again largely depends on how the adversary’s system accumulates.

The semi-automatic osteotomy offered by MAKO could win in the long run, but Navio offers a cheaper option and still far outpaces either of the other two manufacturers, analysts at Jefferies said.

Haddad, an orthopaedic surgeon who has experimented with both products, said such a machine is so extraordinary that medical systems need to evaluate its cost-effectiveness based on the results of clinical trials.

“I think the clinical benefit will be very clear, but whether that justifies the upfront cost is still a big question,” he said.

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