MediPoint: Total Shoulder Replacement – South American Analysis and Market Forecasts


Compared with the more mature reconstruction markets, such as hip and knee replacements, shoulder reconstruction is developing as a specialty. Current market growth in shoulder reconstruction is mainly driven by total shoulder replacement (TSR), which comprises anatomic total and reverse total shoulder replacements. Although sluggish economic growth has hindered the large-joint replacement market in the United States and Europe, the global TSR market has seen a promising growth rate in the past few years.This healthy growth can be attributed to an increasing patient population, an improved surgeon adoption of reverse shoulder implants, as well as evolving insurance and reimbursement landscape.

GlobalData evaluated currently marketed TSR prostheses, identified the unmet needs in the market, and provided an understanding of surgeon perception of the latest advances within the shoulder community. Over the forecast period, despite the dampening effect of downward pricing pressure, the TSR market is expected to enjoy healthy growth, primarily driven by the trend of active aging, continuous medical education efforts from the supply side, the introduction of additional reverse shoulder implants and the FDAs approval of modern stemless designs. In particular, the market size of reverse TSR is expected to grow at a much faster pace compared with anatomic TSR.

This report focuses on TSR market in Brazil. GlobalData evaluated currently marketed TSR prostheses, identified the unmet needs in the market, and provided an understanding of surgeon perception of the latest advances within the shoulder community. An accelerated market expansion is expected in emerging countries including Brazil.


-An overview of arthritis, which includes epidemiology, etiology, symptoms, diagnosis, pathology and treatment guidelines.

-Annualized South American TSR market revenue and future forecasts from 2009 to 2011, forecast for 7 years to 2018.

-Investigation of current and future market competition for TSR

-Insightful review of the key industry drivers, restraints and challenges as well as predicted impact of key events.

-Competitor assessment including device approval analysis and device sales forecasts.

-Marketed and pipeline product profiles covering efficiency, safety, clinical study details, device approvals, product positioning and device sales forecast.

-Analysis of unmet needs within the market and opportunities for future players.

-Technology trends evaluation to assess strength of pipeline.

-An overview of all devices in development including clinical study details, design and material selection considerations, efficacy reports, and device approval timelines.

-Company profiles including business description, financial overview and SWOT analysis.

-Coverage of key market players.

-Strategic assessment of the TSR sector through market impact analysis, future market scenario and company analysis.

-Direct quotes from Key Opinion Leaders (KOL) as well as Orthopedic Surgeon

Reasons to buy

-Understand the trends shaping and driving the South American TSR Market.

-Realize device preferences of physicians who have performed the tests already.

-Access market sizing, forecasts and quantified growth opportunities in the South American TSR market through 2018.

-Quantify candidate patient populations to better design product pricing & launch plans.

-Drive revenues, formulate effective sales and marketing strategies and gain in-depth understanding of the competitive landscape.

-Perform benchmarking analysis of growth opportunities against currently marketed products.

-Assess competitiveness of products in market by understanding the strengths and weaknesses of current competition.

-Take a comprehensive look at the markets device pipeline and identify promising, paradigm-shifting products.

-Create an effective counter-strategy to gain a competitive advantage against those currently in the market.

-Organize your sales and marketing efforts by identifying the market categories and segments that present the best opportunities for growth.

-Whats the next big thing in South American TSR market landscape? Identify, understand and capitalize.

1 Table of Contents

1 Table of Contents 7

1.1 List of Tables 13

1.2 List of Figures 21

2 Introduction 24

2.1 Catalyst 25

3 Disease Overview 26

3.1 Anatomy and Physiology 26

3.2 Pathophysiology 28

3.2.1 Overview 28

3.2.2 Primary Osteoarthritis 28

3.2.3 Rotator Cuff Tear Arthropathy 29

3.2.4 Post-Traumatic Arthritis 31

3.2.5 Proximal Humerus Fracture 31

3.2.6 Avascular Necrosis 33

3.2.7 Rheumatoid Arthritis 34

3.3 Clinical Presentation 35

3.3.1 Diagnosis 35

3.4 Clinical Outcomes 36

3.4.1 Overview 36

3.4.2 Conservative Treatments 36

3.4.3 Joint-Preserving Treatments 37

3.4.4 Joint Replacement 39

3.5 Epidemiology 50

3.5.1 Shoulder Arthritis 50

3.5.2 Proximal Humerus Fractures 51

3.6 Economic Impact 53

3.6.1 Shoulder Arthritis 53

3.6.2 Rotator Cuff Diseases 55

3.6.3 Proximal Humerus Fractures 55

3.6.4 Cost-Effectiveness of Total Shoulder Replacement 56

3.6.5 Cost-Effectiveness of Reverse Total Shoulder Replacement 56

4 Competitive Assessment 57

4.1 Overview 57

4.2 Global Market Share 61

4.3 Anatomic Total Shoulder Replacement 62

4.3.1 Univers II (Arthrex) 62

4.3.2 Comprehensive (Biomet) 64

4.3.3 Comprehensive Fracture (Biomet) 66

4.3.4 Global Advantage (DePuy Synthes) 69

4.3.5 Global Fx (DePuy Synthes) 73

4.3.6 Global AP (DePuy Synthes) 75

4.3.7 Global Unite (DePuy Synthes) 78

4.3.8 Turon (DJO Surgical) 80

4.3.9 Equinoxe (Exactech) 83

4.3.10 TITAN (Integra LifeSciences) 85

4.3.11 SMR (Lima Corporate) 87

4.3.12 Cofield 2 (Smith & Nephew) 90

4.3.13 Neer 3 (Smith & Nephew) 93

4.3.14 Promos Standard (Smith & Nephew) 96

4.3.15 Solar (Stryker) 98

4.3.16 ReUnion (Stryker) 100

4.3.17 Aequalis Primary (Tornier) 102

4.3.18 Aequalis Fracture (Tornier) 105

4.3.19 Affiniti (Tornier) 107

4.3.20 Aequalis Ascend (Tornier) 110

4.3.21 Bigliani/Flatow (Zimmer) 112

4.3.22 Anatomical (Zimmer) 115

4.3.23 Trabecular Metal (Zimmer) 117

4.4 Anatomic Stemless Total Shoulder Replacement 121

4.4.1 Eclipse (Arthrex) 121

4.4.2 T.E.S.S. (Total Evolutive Shoulder System) Anatomic (Biomet) 123

4.4.3 Comprehensive Nano (Biomet) 126

4.4.4 Simpliciti (Tornier) 128

4.4.5 InSpyre (Tornier) 131

4.4.6 Sidus (Zimmer) 133

4.5 Reverse Total Shoulder Replacement 136

4.5.1 Univers Revers (Arthrex) 136

4.5.2 T.E.S.S. (Total Evolutive Shoulder System) Reverse (Biomet) 138

4.5.3 Comprehensive Reverse (Biomet) 141

4.5.4 Delta Xtend (DePuy Synthes) 143

4.5.5 Reverse Shoulder Prosthesis (RSP) (DJO Surgical) 146

4.5.6 Equinoxe Reverse (Exactech) 149

4.5.7 SMR Reverse (Lima Corporate) 152

4.5.8 Promos Reverse (Smith & Nephew) 155

4.5.9 Aequalis Reversed II (Tornier) 157

4.5.10 Aequalis Reversed Fracture (Tornier) 160

4.5.11 Ascend Flex (Tornier) 162

4.5.12 Anatomical Reverse (Zimmer) 164