Joint surgery looks to embrace more and more technologically advanced endeavors in an effort to give arthritis sufferers their freedom of movement back, states a new report by research and consulting firm GlobalData.
The report – MediPoint: Total Wrist Reconstruction – Global Analysis and Market Forecast – describes Total Wrist Replacement (TWR) and Total Wrist Fusion (TWF) as surgical solutions to persistent pain caused by degenerative osteoarthritis, traumatic and rheumatoid arthritis, and gout. The patient population is set to swell in the future, due to the globally aging population, but these medical devices need some perfecting before they are embraced by the masses.
TWF provides significant pain relief but at the expense of wrist motion, while in contrast, TWR focuses on preserving this motion and allowing patients the ability to continue with daily activities. TWF has historically been the more popular option, with much less risk of complications than TWR, which requires extensive bone resection. However, TWR has been gaining momentum as a choice for patients who want to retain more motion and have increased functional use of their hand.
Several types of implants are available, constructed from silicone, titanium and polyethylene, and recent improvements in TWR implant design has shown marked improvement, with issues of implants loosening and small bone perforation being resolved. Orthopedic surgeons have also called for TWR devices with alternative materials and coatings to give better biological fixation. Increasing popularity amongst patients and doctors will drive technology to improve further, as competition increases amongst current TWR players and new companies looking to enter the market.
Long-term clinical efficacy of TWR needs to be proven however, as the majority of TWR clinical trials so far have been only short-term studies, and failure rates and complication rates have been high beyond five years of implantation, making it a challenge for physicians to justify TWR procedures.
Finally, better surgical training is needed, as wrist surgery is very complex to perform, and physicians have stated that refined instrumentation is required to obtain more successful implantation. Joint replacement for the wrist is a complicated surgery with a high learning curve for the surgeon, yet still it is gradually being adopted in the U.S. more and more by orthopedic hand surgeons.
The TWR sales market across the United States, France, Germany, Italy, Spain, the United Kingdom, Japan, Brazil, China, and India was worth an estimated US$32.1m in 2012, and this value is predicted to grow at a compound annual growth rate (CAGR) of 6.08% to US$46.1m in 2018. The TWF market was estimated to be worth US$30.4m in 2012 across the same markets, estimated to reach more than US$33.7m in 2018 following growth at a CAGR of 1.67%.