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U.S. Market for Orthopedic Biomaterials Published on July 2012

Report Summary The 2011 figures in the orthopedic biomaterials market show great promise for future performance of the orthopedic biomaterials market. To date there has been a multitude of products introduced to the market, with some becoming spectacular successes. Future growth for this market will be a result of continued improvements in product technology to meet the needs of patients as well as changes in healthcare reform and reimbursement. This comprehensive report covers a number of disciplines, including spinal surgery, sports medicine, tissue donation, and biotechnology. In each segment of this report, current market conditions are thoroughly examined and the behavior of each sub-segment over the forecast period is critically analyzed and cross-verified. The Orthopedic biomaterials market includes: - bone graft substitutes, - growth factors, - machined allografts, - hyaluronic acid viscosupplementation, - resorbable fixation devices, - tendon grafts, - cartilage repair, - platelet and bone marrow concentration, - orthopedic stem cells and - emerging technologies This report provides a comprehensive and detailed analysis of market revenues by device type, market forecasts through 2018, unit sales, average selling prices, market drivers and limiters and a detailed competitive analysis, including manufacturer market shares and product portfolios.

Table of Content U.S. Market for Orthopedic Biomaterials TABLE OF CONTENTS.I LIST OF FIGURESX LIST OF CHARTS.. XVI EXECUTIVE SUMMARY 1 1.1 U.S. MARKET FOR ORTHOPEDIC BIOMATERIALS 1 1.2 ORTHOPEDIC BIOMATERIAL MARKET GROWTH RATES.. 2 1.3 BONE GRAFT SUBSTITUTE USAGE PER INDICATION.. 3 1.4 MACHINED BONE ALLOGRAFT MARKET. 4 1.5 HYALURONIC ACID VISCOSUPPLEMENTATION MARKET 5 1.6 RESORBABLE FIXATION DEVICE MARKET . 6 1.7 TENDON GRAFT MARKET 7

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>> Get this Report Now by email! 1.8 CARTILAGE REPAIR MARKET 8 1.9 PLATELET AND BONE MARROW CONCENTRATION MARKET 9 1.10 ORTHOPEDIC STEM CELL MARKET .. 10 1.11 LEADING COMPETITORS . 11 RESEARCH METHODOLOGY 12 2.1 RESEARCH SCOPE . 12 2.2 IDATA'S 9-STEP METHODOLOGY . 12 Step 1: Project Initiation & Team Selection 13 Step 2: Prepare Data Systems and Perform Secondary Research 15 Step 3: Preparation for Interviews & Questionnaire Design . 16 Step 4: Performing Primary Research 17 Step 5: Research Analysis: Establishing Baseline Estimates . 19 Step 6: Market Forecast and Analysis 20 Step 7: Identify Strategic Opportunities 22 Step 8: Final Review and Market Release 23 Step 9: Customer Feedback and Market Monitoring.. 24 U.S. ORTHOPEDIC BIOMATERIALS MARKET OVERVIEW 25 3.1 INTRODUCTION .. 25 3.1.1 Growth Factors.. 26 3.1.2 Bone Graft Substitutes 26 3.1.3 Machined Bone Allografts 27 3.1.4 Hyaluronic Acid Viscosupplementation. 27 3.1.5 Resorbable Fixation Devices .. 28 3.1.6 Tendon Grafts . 28 3.1.7 Cartilage Repair 28 3.1.8 Platelet and Bone Marrow Concentration 29 3.1.9 Orthopedic Stem Cell Therapy 29 3.2 MARKET ANALYSIS AND FORECAST .. 30 3.2.1 Market by Segment 30 3.2.2 Trend Analysis 37 3.3 MARKET DRIVERS AND LIMITERS 41 3.3.1 Market Drivers 41 3.3.2 Market Limiters.. 42 3.4 COMPETITIVE ANALYSIS .. 44 3.4.1 Market Concentration. 49 3.5 MERGERS AND ACQUISITIONS 51 3.5.1.1 Osteotech Acquired Distributorship of Harvest Technologies System ..51 3.5.1.2 Regeneration Technologies Merged with Tutogen Medical Inc. ..51 3.5.1.3 NuVasive Acquired Osiris Therapeutics' Osteocel速 Product.51 3.5.1.4 NuVasive Acquired Cervitech.51 3.5.1.5 Biomet Acquired Cartilix..51 3.5.1.6 Alphatec Holdings Acquired Scient'x Groupe52 3.5.1.7 Anika Acquired Fidia Advanced Biopolymers52 3.5.1.8 Baxter International Acquired ApaTech52 3.5.1.9 Stryker Acquired Orthovita..52 3.5.1.10 Olympus Biotech Acquired OP-1TM from Stryker ..53 3.5.1.11 Histogenics Acquired ProChon Biotech .53 GROWTH FACTOR MARKET. 54

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>> Get this Report Now by email! 4.1 INTRODUCTION .. 54 4.1.1 Overview 54 4.1.2 BMP-2 (Medtronic).. 55 4.1.3 BMP-7 (Olympus Biomaterials) 55 4.1.4 Potential Complications 56 4.1.5 Reimbursement 57 4.1.6 Future Indications. 57 4.2 MARKET ANALYSIS AND FORECAST .. 59 4.3 MARKET DRIVERS AND LIMITERS 62 4.3.1 Market Drivers 62 4.3.2 Market Limiters.. 63 4.4 COMPETITIVE ANALYSIS .. 66 4.4.1 Leading Competitors 66 4.4.2 Potential Competitors . 67 BONE GRAFT SUBSTITUTE MARKET 69 5.1 INTRODUCTION .. 69 5.2 MARKET SEGMENTATION. 70 5.2.1 Indications 70 5.2.1.1 Spine 70 5.2.1.2 Trauma71 5.2.1.3 Extremities 71 5.2.2 Materials 71 5.2.2.1 Autografts .71 5.2.2.2 Standard Allografts..71 5.2.2.3 Demineralized Bone Matrix.71 5.2.2.4 Synthetics ..72 5.2.2.5 Xenografts.73 5.3 PROCEDURES 74 5.3.1 Total Procedures 74 5.3.2 Spinal Procedures. 75 5.4 UNITS PER PROCEDURE.. 78 5.5 MARKET OVERVIEW 80 5.5.1 Market by Material .. 80 5.5.2 Market by Indication 84 5.6 MARKET ANALYSIS AND FORECAST .. 89 5.6.1.1 Spinal Bone Graft Substitute Market ..91 5.6.1.2 Cervical Spinal Bone Graft Substitute Market ..93 5.6.1.3 Thoracolumbar Spinal Bone Graft Substitute Market 95 5.6.1.4 Trauma Bone Graft Substitute Market97 5.6.1.5 Large Joint Reconstruction Bone Graft Substitute Market..99 5.6.1.6 Foot Reconstruction Bone Graft Substitute Market..101 5.6.1.7 Craniomaxillofacial Bone Graft Substitute Market..103 5.6.1.8 Oncology Bone Graft Substitute Market.105 5.6.2 Bone Graft Substitute Market by Material. 107 5.6.2.1 Allograft..107 5.6.2.1.1 Total Allograft Market ..107 5.6.2.1.2 Spinal Allograft.111 5.6.2.1.2.1 Cervical Spinal Allograft. 111

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>> Get this Report Now by email! 5.6.2.1.2.2 Thoracolumbar Spinal Allograft 112 5.6.2.1.3 Trauma Allograft .113 5.6.2.1.3.1 Non-Union Fracture Allograft Market. 113 5.6.2.1.3.2 Fresh-Fracture Allograft Market .. 114 5.6.2.1.4 Joint Reconstruction Allograft..115 5.6.2.1.4.1 Hip Reconstruction Allograft . 115 5.6.2.1.4.2 Knee Reconstruction Allograft . 116 5.6.2.1.5 Foot Reconstruction Allograft ..117 5.6.2.1.6 Craniomaxillofacial Allograft117 5.6.2.1.7 Oncology Allograft .118 5.6.2.2 Demineralized Bone Matrices .119 5.6.2.2.1 Total DBM Market..119 5.6.2.2.2 Spinal DBM 122 5.6.2.2.2.1 Cervical Spinal DBM. 122 5.6.2.2.2.2 Thoracolumbar Spinal DBM.. 123 5.6.2.2.3 Trauma DBM.124 5.6.2.2.3.1 Non-Union DBM 124 5.6.2.2.3.2 Fresh-Fracture DBM. 125 5.6.2.2.4 Joint Reconstruction DBM..126 5.6.2.2.4.1 Hip Reconstruction DBM. 126 5.6.2.2.4.2 Knee Reconstruction DBM. 127 5.6.2.2.5 Foot Reconstruction DBM ..128 5.6.2.2.6 Craniomaxillofacial DBM Market..128 5.6.2.2.7 Oncology DBM .129 5.6.2.3 Synthetic Bone Graft Substitute Market..130 5.6.2.3.1 Total Synthetic Market..130 5.6.2.3.2 Spinal Synthetic.133 5.6.2.3.2.1 Cervical Synthetic 133 5.6.2.3.2.2 Thoracolumbar Synthetic .. 134 5.6.2.3.3 Trauma Synthetic .135 5.6.2.3.3.1 Non-Union Fracture Synthetic.. 135 5.6.2.3.3.2 Fresh Fracture Synthetic. 136 5.6.2.3.4 Joint Reconstruction Synthetic..137 5.6.2.3.4.1 Hip Reconstruction Synthetic. 137 5.6.2.3.4.2 Knee Reconstruction Synthetic. 138 5.6.2.3.5 Foot Synthetic 139 5.6.2.3.6 Craniomaxillofacial Synthetic ..139 5.6.2.3.7 Oncology Synthetic .140 5.7 MARKET DRIVERS AND LIMITERS . 141 5.7.1 Market Drivers. 141 5.7.1.1 Standard Allograft Market.141 5.7.1.2 DBM Market .142 5.7.1.3 Synthetic Market .143 5.7.2 Market Limiters 144 5.7.2.1 Standard Allograft Market.144 5.7.2.2 DBM Market .145 5.7.2.3 Synthetic Market .145 5.8 COMPETITIVE ANALYSIS 147

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>> Get this Report Now by email! 5.8.1 Bone Graft Substitute Market .. 147 5.8.1.1 Allograft Market .150 5.8.1.2 DBM Market .152 5.8.1.3 Synthetic Bone Graft Substitute Market..154 ORTHOPEDIC STEM CELL MARKET.. 157 6.1 INTRODUCTION 157 6.2 MARKET OVERVIEW. 158 6.2.1 Lineage 158 6.2.1.1 Human Embryonic Stem Cells (hESC) 158 6.2.1.2 Mesenchymal Stem Cells (MSC).158 6.2.2 Legislation . 159 6.2.3 Other Therapeutic Applications.. 159 6.3 MARKET ANALYSIS AND FORECAST 160 6.3.1 Total Market . 160 6.3.1.1 Lumbar Spine Stem Cell Market.163 6.3.1.2 Cervical Spine Stem Cell Market165 6.4 MARKET DRIVERS AND LIMITERS . 167 6.4.1 Market Drivers. 167 6.4.2 Market Limiters 168 6.5 COMPETITIVE ANALYSIS 170 6.5.1 Leading Competitors. 170 6.5.2 Potential Competitors .. 171 MACHINED BONE ALLOGRAFT MARKET. 174 7.1 INTRODUCTION 174 7.1.1 Approaches 175 7.1.1.1 Anterior Lumbar Interbody Fusion (ALIF) ..175 7.1.1.2 Posterior Lumbar Interbody Fusion (PLIF).175 7.1.1.3 Transforaminal Lumbar Interbody Fusion (TLIF) 175 7.1.1.4 Extreme Lateral Interbody Fusion (XLIF).176 7.1.1.5 Cervical ..176 7.2 PROCEDURES. 177 7.3 MARKET OVERVIEW. 180 7.4 MARKET FORECAST AND ANALYSIS 182 7.4.1 ALIF Approach 185 7.4.2 PLIF Approach 188 7.4.3 TLIF Approach 191 7.4.4 Cervical Machined Bone Allografts.. 194 7.5 MARKET DRIVERS AND LIMITERS . 197 7.5.1 Market Drivers. 197 7.5.2 Market Limiters 198 7.6 COMPETITIVE ANALYSIS 200 PLATELET AND BONE MARROW ASPIRATE CONCENTRATION MARKET. 203 8.1 INTRODUCTION 203 8.1.1 Platelet Rich Plasma. 204 8.1.2 Bone Marrow Aspirate. 206 8.2 MARKET OVERVIEW. 207 8.3 MARKET ANALYSIS AND FORECAST 212 8.3.1 Total Platelet Concentration Market 215

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>> Get this Report Now by email! 8.3.1.1 Spinal Platelet Concentration Market .218 8.3.1.2 Extremity and Sports Medicine Platelet Concentration Market.220 8.3.2 Total Bone Marrow Aspirate Concentration Market 222 8.4 MARKET DRIVERS AND LIMITERS . 224 8.4.1 Market Drivers. 224 8.4.2 Market Limiters 225 8.5 COMPETITIVE ANALYSIS 227 TENDON GRAFT MARKET 231 9.1 INTRODUCTION 231 9.1.1 Repair Methods 231 9.1.1.1 Bone-Patellar Tendon-Bone (BTB) Graft, ACL/PCL Surgery 231 9.1.1.2 Soft Tissue Grafts231 9.1.1.3 Allograft Tendons ..232 9.1.1.4 Ligament and Tendon Synthetic Grafts ..232 9.2 PROCEDURES. 234 9.3 MARKET FORECAST AND ANALYSIS 235 9.4 MARKET DRIVERS AND LIMITERS . 237 9.4.1 Market Drivers. 237 9.4.2 Market Limiters 238 9.5 COMPETITIVE ANALYSIS 239 CARTILAGE REPAIR MARKET. 242 10.1 INTRODUCTION . 242 10.1.1 Methods for Cartilage Repair 242 10.2 PROCEDURES.. 244 10.3 MARKET ANALYSIS AND FORECAST . 245 10.3.1 Cartilage Repair Market.. 245 10.3.2 Autologous Chondrocyte Implantation Market. 247 10.3.3 Osteochondral Allograft Market.. 249 10.3.4 Meniscal Graft Market.. 251 10.4 MARKET DRIVERS AND LIMITERS .. 253 10.4.1 Market Drivers.. 253 10.4.2 Market Limiters. 253 10.5 COMPETITIVE ANALYSIS . 255 10.5.1 Leading Competitors.. 255 10.5.2 Emerging Competitors.. 256 HYALURONIC ACID VISCOSUPPLEMENTATION MARKET .. 259 11.1 INTRODUCTION . 259 11.1.1 Benefits of Viscosupplementation 260 11.1.2 Synovial Fluid 260 11.1.3 Product Types 261 11.1.3.1 Single-Injection Products 261 11.1.3.2 Three-Injection Cycle Products 261 11.1.3.3 Three/Five-Injection Cycle Products.262 11.1.4 Reimbursement.. 262 11.2 MARKET OVERVIEW.. 263 11.3 MARKET ANALYSIS AND FORECAST . 268 11.3.1 Total Market .. 268 11.3.1.1 Single-Injection Hyaluronic Acid Viscosupplementation Market271

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>> Get this Report Now by email! 11.3.1.2 Three-Injection Cycle Hyaluronic Acid Viscosupplementation Market ..274 11.3.1.3 Five-Injection Cycle Hyaluronic Acid Viscosupplementation Market .277 11.4 MARKET DRIVERS AND LIMITERS .. 280 11.4.1 Market Drivers.. 280 11.4.2 Market Limiters. 281 11.5 COMPETITIVE ANALYSIS . 283 RESORBABLE FIXATION MARKET.. 287 12.1 INTRODUCTION . 287 12.1.1 Materials.. 287 12.1.2 Disadvantages Compared to Metal Fixation. 288 12.1.3 Indications and Product Descriptions .. 288 12.1.3.1 Shoulder Fixation 288 12.1.3.2 Knee Reconstruction..289 12.2 MARKET OVERVIEW.. 291 12.3 MARKET ANALYSIS AND FORECAST . 295 12.3.1 Resorbable Fixation Market .. 295 12.3.2 ACL/PCL Resorbable Fixation Market 297 12.3.2.1 Femoral Fixation .297 12.3.2.2 Tibia Fixation Market301 12.3.3 Meniscal Resorbable Fixation Market.. 304 12.3.4 Rotator Cuff Resorbable Fixation Market .. 308 12.3.5 Labrum Repair Market . 311 12.4 MARKET DRIVERS AND LIMITERS .. 314 12.4.1 Market Drivers.. 314 12.4.1.1 Shoulder Fixation 314 12.4.1.2 Knee Fixation.314 12.4.2 Market Limiters. 315 12.4.2.1 Shoulder Fixation 315 12.4.2.2 Knee Fixation.316 12.5 COMPETITIVE ANALYSIS . 318 12.5.1 Leading Competitors.. 318 12.5.2 Other Notable Competitors. 319 ABBREVIATIONS 322

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