Orthopedic Enabling Technology Market Size and Share
Market Definition
Surgical planning, navigation technologies, robotics, patient monitoring and other digital tools used in orthopedics. Excludes sports medicine capital equipment.
April 2025
Mike Evers, Senior Market Analyst
Welcome to our overview of the orthopedic enabling technology market. This page builds upon the inaugural chapter covering enabling technology in our latest edition of THE ORTHOPAEDIC INDUSTRY ANNUAL REPORT®. It is a dynamic and rapidly changing segment as the industry learns how to best leverage technology.
The Market at a Glance
Enabling technology sales totaled over $1.4 billion in 2024, accounting for 2.3% of the orthopedic market.
Companies have grown increasingly flexible with their capital equipment strategies, including placing technology in accounts through outright sales and engaging in a host of volume-based agreements. As such, the segment’s importance can be masked by modest revenue performance.
Market Forecast
We expect more technologies to enter the market soon, but the trend away from outright sales will continue. We estimate 7.5% growth for enabling technology in 2025 as the segment reaches global revenue of $1.5 billion.
International markets, with a few exceptions like Australia, are a few years behind the United States in the adoption of enabling technology. There are economic and regulatory hurdles to clear, but those geographies could drive additional future growth in the segment.
Exhibit 1: Worldwide Enabling Technology Sales by Year ($millions)
Get More Orthopedic Market Data. Download the Orthopedic Companies Sales Matrix for our most complete and granular numbers. It contains worldwide orthopedic sales for 75 public and private companies by segment from 2016 through 2024.
Here are some of the enabling technology market dynamics we considered in our forecasts:
The New Basis for Competition. Technology is changing the competitive dynamics in orthopedics. Stryker changed the paradigm of joint replacement with its Mako robotic system. For years, Mako and cementless knees were a virtually unbeatable combination. Stryker’s competitors are just now starting to close the gap. The technology race between Medtronic and Globus Medical did the same thing in spine. Medtronic CEO Geoffrey Martha believes the very basis for competition is changing in spine due to enabling technology. He predicts it will filter out smaller companies and even knock large competitors out of segments.
Strong Appetite for Capital Products. Stryker, Globus Medical and Orthofix are among the companies that reported record quarters for technology placement at various points in 2024, indicating ongoing robust demand for these systems. However, sales no longer tell the entire story of capital technology demand with the increased focus on rentals, leases and volume agreements. Technology’s ability to drive implant pull-through allows companies to offer significant flexibility in deal terms and package arrangements.
Leveling the Playing Field. While technology use is well established in knee and hip replacement and spine, it could accelerate growth for smaller specialties and empower surgeons in less populated areas. The high number of total knee replacements performed every year means surgeons can get ample time to hone their technique, but the average ankle surgeon might complete five or six total ankle replacements per year. Likewise, the volume of shoulder replacement surgeries performed each year is much lower than large joints. The complexity of the shoulder and ankle make those anatomies prime candidates for technology assistance.
Sales by Region
The United States accounts for almost 80% of all enabling technology sales, but companies are beginning to see doors open for the segment in international markets.
Stryker cited Mako as a driver of its success outside the United States and said the robotic system has shown the ability to drive sales across the company’s entire portfolio. Likewise, the rapid globalization of Johnson & Johnson MedTech’s VEYLS robot was a key contributor to the company’s improved knee replacement performance in 2024.
Companies heavily impacted by volume-based procurement (VBP) price cuts in China are counting on a robotics boom in that country. Smith+Nephew’s joint replacement business operates at a loss in China. The company’s leadership said the uptake of robotics there will be an important consideration in whether or not it continues business in China.
Exhibit 2: Enabling Technology Sales by Region ($millions)
| Region | FY24 | FY23 | $ Chg | % Chg |
|---|---|---|---|---|
| US | $1,107.8 | $1,009.0 | $98.8 | 9.8% |
| OUS | $314.3 | $298.0 | $16.3 | 5.5% |
| EMEA | $201.9 | $189.5 | $12.4 | 6.6% |
| APAC | $91.0 | $88.9 | $2.1 | 2.4% |
| ROW | $21.3 | $19.6 | $1.7 | 8.8% |
| Total | $1,422.0 | $1,307.0 | $115.1 | 8.8% |
Exhibit 3: Enabling Technology Market Share by Region ($millions)
Top Companies
Enabling technology is the domain of orthopedics’ largest companies. The top six players in enabling technology control 75% of the market. Notably, each of these companies has total orthopedic annual revenues over $1 billion. The segment’s seventh largest player, ATEC, is on track to hit $1 billion in sales within the next few years.
The importance of optionality and cohesive ecosystems will drive the largest players to seek out novel technologies from smaller companies. We saw this in 2024 with Zimmer Biomet’s acquisition of OrthoGrid’s navigation platform and in 2025 with Globus Medical’s acquisition of Nevro, a company that could inform future capabilities in the Excelsius ecosystem.
Exhibit 4: Enabling Technology Players Over $50 Million and All Others
| Company | FY24 | FY23 | $ Chg | % Chg |
|---|---|---|---|---|
| Stryker | $453.0 | $401.4 | $51.6 | 12.9% |
| Medtronic | $168.4 | $156.2 | $12.2 | 7.8% |
| Globus Medical | $154.0 | $144.9 | $9.1 | 6.3% |
| Smith+Nephew | $117.6 | $99.3 | $18.3 | 18.5% |
| Zimmer Biomet | $94.8 | $94.1 | $0.7 | 0.7% |
| J&J MedTech | $71.1 | $66.2 | $4.9 | 7.5% |
| ATEC | $66.7 | $59.1 | $7.6 | 12.9% |
| OrthAlign | $59.7 | $52.0 | $7.7 | 14.8% |
| All Others | $236.7 | $233.8 | $2.9 | 1.2% |
| Total | $1,422.0 | $1,307.0 | $115.1 | 8.8% |
Exhibit 5: Enabling Technology Market Share by Company ($millions)
The healthy demand and appetite for enabling technology capital equipment continued in 2024. Companies like Stryker, Globus Medical and Orthofix drove record quarters for placements during the year.
In the past, we’ve seen gaudy placement numbers that did little to elevate usage rates. However, technology utilization in orthopedic surgery saw meaningful growth in 2024 as well.
Stryker surpassed 1 million robotic knee procedures performed to date with Mako and the Triathalon knee. By mid-2024, Johnson & Johnson MedTech’s VELYS was in 20 countries and had been used in more than 70,000 procedures. About 25% of Smith+Nephew’s knee cases involved its CORI robot. Globus Medical’s robotic procedures grew 17% over the prior year and exceeded 94,000 since its Excelsius robotic system launch in 2017.
Important Developments in the Enabling Technology Market
Creating Optionality to Drive Adoption. When we spoke to THINK Surgical CEO Stuart Simpson in late 2023, he wanted the large device companies to see THINK as a partner rather than a competitor. Judging from Zimmer Biomet’s distribution agreement with THINK Surgical, top players may start considering open robotic platforms as part of their portfolio offering. Zimmer Biomet is engaged in a strategy shift aimed at adding breadth to its enabling technology portfolio, as it plans to launch multiple new ROSA robot applications and recently acquired OrthoGrid for its navigation technology.
It’s All About the Ecosystem. As the novelty of orthopedic robotics wears off, companies have invested in surrounding those systems with ways to deliver more and better information to surgeons. Hospitals and surgeons are increasingly looking for a partner to provide a comprehensive suite of planning, imaging, robotics, navigation and powered instruments. It is becoming increasingly important that these technologies work seamlessly with each other and a company’s implants.
Companies Generating International Growth. Increasing adoption of enabling technology outside the United States is driving significant joint replacement revenue for global players. Stryker called Mako the tip of the spear for its international sales, while Johnson & Johnson’s VELYS system is in 20 markets. The international success of VELYS helped the company turn around its knee franchise, which lagged its peers in growth. Open platform joint replacement and spine robotic systems are beginning to enter markets in Europe and China. These could lead to additional opportunities for small- and mid-size implant companies in those markets.
Further Reading
Thanks for visiting! Need more insight on the enabling technology market? Questions and comments are always welcome. You can reach me by email. Until then, I’ve gathered a few posts about enabling technology from recent months. Enjoy!
March 17, 2025
,
Carolyn LaWell
March 28, 2025
,
Carolyn LaWell
Our overview of the $1.4 billion orthopedic enabling technology includes up-to-date information on forecasted growth, the top companies and industry-driving trends.
Market Definition
Surgical planning, navigation technologies, robotics, patient monitoring and other digital tools used in orthopedics. Excludes sports medicine capital equipment.
April 2025
Mike Evers, Senior Market Analyst
Welcome to our overview of the orthopedic enabling technology market. This page builds upon the inaugural chapter covering enabling technology in our latest edition of THE ORTHOPAEDIC INDUSTRY ANNUAL REPORT®. It is a dynamic and rapidly changing segment as the industry learns how to best leverage technology.
The Market at a Glance
Enabling technology sales totaled over $1.4 billion in 2024, accounting for 2.3% of the orthopedic market.
Companies have grown increasingly flexible with their capital equipment strategies, including placing technology in accounts through outright sales and engaging in a host of volume-based agreements. As such, the segment’s importance can be masked by modest revenue performance.
Market Forecast
We expect more technologies to enter the market soon, but the trend away from outright sales will continue. We estimate 7.5% growth for enabling technology in 2025 as the segment reaches global revenue of $1.5 billion.
International markets, with a few exceptions like Australia, are a few years behind the United States in the adoption of enabling technology. There are economic and regulatory hurdles to clear, but those geographies could drive additional future growth in the segment.
Exhibit 1: Worldwide Enabling Technology Sales by Year ($millions)
Get More Orthopedic Market Data. Download the Orthopedic Companies Sales Matrix for our most complete and granular numbers. It contains worldwide orthopedic sales for 75 public and private companies by segment from 2016 through 2024.
Here are some of the enabling technology market dynamics we considered in our forecasts:
The New Basis for Competition. Technology is changing the competitive dynamics in orthopedics. Stryker changed the paradigm of joint replacement with its Mako robotic system. For years, Mako and cementless knees were a virtually unbeatable combination. Stryker’s competitors are just now starting to close the gap. The technology race between Medtronic and Globus Medical did the same thing in spine. Medtronic CEO Geoffrey Martha believes the very basis for competition is changing in spine due to enabling technology. He predicts it will filter out smaller companies and even knock large competitors out of segments.
Strong Appetite for Capital Products. Stryker, Globus Medical and Orthofix are among the companies that reported record quarters for technology placement at various points in 2024, indicating ongoing robust demand for these systems. However, sales no longer tell the entire story of capital technology demand with the increased focus on rentals, leases and volume agreements. Technology’s ability to drive implant pull-through allows companies to offer significant flexibility in deal terms and package arrangements.
Leveling the Playing Field. While technology use is well established in knee and hip replacement and spine, it could accelerate growth for smaller specialties and empower surgeons in less populated areas. The high number of total knee replacements performed every year means surgeons can get ample time to hone their technique, but the average ankle surgeon might complete five or six total ankle replacements per year. Likewise, the volume of shoulder replacement surgeries performed each year is much lower than large joints. The complexity of the shoulder and ankle make those anatomies prime candidates for technology assistance.
Sales by Region
The United States accounts for almost 80% of all enabling technology sales, but companies are beginning to see doors open for the segment in international markets.
Stryker cited Mako as a driver of its success outside the United States and said the robotic system has shown the ability to drive sales across the company’s entire portfolio. Likewise, the rapid globalization of Johnson & Johnson MedTech’s VEYLS robot was a key contributor to the company’s improved knee replacement performance in 2024.
Companies heavily impacted by volume-based procurement (VBP) price cuts in China are counting on a robotics boom in that country. Smith+Nephew’s joint replacement business operates at a loss in China. The company’s leadership said the uptake of robotics there will be an important consideration in whether or not it continues business in China.
Exhibit 2: Enabling Technology Sales by Region ($millions)
| Region | FY24 | FY23 | $ Chg | % Chg |
|---|---|---|---|---|
| US | $1,107.8 | $1,009.0 | $98.8 | 9.8% |
| OUS | $314.3 | $298.0 | $16.3 | 5.5% |
| EMEA | $201.9 | $189.5 | $12.4 | 6.6% |
| APAC | $91.0 | $88.9 | $2.1 | 2.4% |
| ROW | $21.3 | $19.6 | $1.7 | 8.8% |
| Total | $1,422.0 | $1,307.0 | $115.1 | 8.8% |
Exhibit 3: Enabling Technology Market Share by Region ($millions)
Top Companies
Enabling technology is the domain of orthopedics’ largest companies. The top six players in enabling technology control 75% of the market. Notably, each of these companies has total orthopedic annual revenues over $1 billion. The segment’s seventh largest player, ATEC, is on track to hit $1 billion in sales within the next few years.
The importance of optionality and cohesive ecosystems will drive the largest players to seek out novel technologies from smaller companies. We saw this in 2024 with Zimmer Biomet’s acquisition of OrthoGrid’s navigation platform and in 2025 with Globus Medical’s acquisition of Nevro, a company that could inform future capabilities in the Excelsius ecosystem.
Exhibit 4: Enabling Technology Players Over $50 Million and All Others
| Company | FY24 | FY23 | $ Chg | % Chg |
|---|---|---|---|---|
| Stryker | $453.0 | $401.4 | $51.6 | 12.9% |
| Medtronic | $168.4 | $156.2 | $12.2 | 7.8% |
| Globus Medical | $154.0 | $144.9 | $9.1 | 6.3% |
| Smith+Nephew | $117.6 | $99.3 | $18.3 | 18.5% |
| Zimmer Biomet | $94.8 | $94.1 | $0.7 | 0.7% |
| J&J MedTech | $71.1 | $66.2 | $4.9 | 7.5% |
| ATEC | $66.7 | $59.1 | $7.6 | 12.9% |
| OrthAlign | $59.7 | $52.0 | $7.7 | 14.8% |
| All Others | $236.7 | $233.8 | $2.9 | 1.2% |
| Total | $1,422.0 | $1,307.0 | $115.1 | 8.8% |
Exhibit 5: Enabling Technology Market Share by Company ($millions)
The healthy demand and appetite for enabling technology capital equipment continued in 2024. Companies like Stryker, Globus Medical and Orthofix drove record quarters for placements during the year.
In the past, we’ve seen gaudy placement numbers that did little to elevate usage rates. However, technology utilization in orthopedic surgery saw meaningful growth in 2024 as well.
Stryker surpassed 1 million robotic knee procedures performed to date with Mako and the Triathalon knee. By mid-2024, Johnson & Johnson MedTech’s VELYS was in 20 countries and had been used in more than 70,000 procedures. About 25% of Smith+Nephew’s knee cases involved its CORI robot. Globus Medical’s robotic procedures grew 17% over the prior year and exceeded 94,000 since its Excelsius robotic system launch in 2017.
Important Developments in the Enabling Technology Market
Creating Optionality to Drive Adoption. When we spoke to THINK Surgical CEO Stuart Simpson in late 2023, he wanted the large device companies to see THINK as a partner rather than a competitor. Judging from Zimmer Biomet’s distribution agreement with THINK Surgical, top players may start considering open robotic platforms as part of their portfolio offering. Zimmer Biomet is engaged in a strategy shift aimed at adding breadth to its enabling technology portfolio, as it plans to launch multiple new ROSA robot applications and recently acquired OrthoGrid for its navigation technology.
It’s All About the Ecosystem. As the novelty of orthopedic robotics wears off, companies have invested in surrounding those systems with ways to deliver more and better information to surgeons. Hospitals and surgeons are increasingly looking for a partner to provide a comprehensive suite of planning, imaging, robotics, navigation and powered instruments. It is becoming increasingly important that these technologies work seamlessly with each other and a company’s implants.
Companies Generating International Growth. Increasing adoption of enabling technology outside the United States is driving significant joint replacement revenue for global players. Stryker called Mako the tip of the spear for its international sales, while Johnson & Johnson’s VELYS system is in 20 markets. The international success of VELYS helped the company turn around its knee franchise, which lagged its peers in growth. Open platform joint replacement and spine robotic systems are beginning to enter markets in Europe and China. These could lead to additional opportunities for small- and mid-size implant companies in those markets.
Further Reading
Thanks for visiting! Need more insight on the enabling technology market? Questions and comments are always welcome. You can reach me by email. Until then, I’ve gathered a few posts about enabling technology from recent months. Enjoy!
March 17, 2025
,
Carolyn LaWell
March 28, 2025
,
Carolyn LaWell
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