Japanese Markets for Large-Joint Reconstructive Implants 2010

The market for large-joint reconstructive implants in Japan has exhibited steady growth for many years. Despite a dip in procedure volume expansion as a result of the 2008 financial crisis, strong growth is expected to resume as the economy recovers and patients decide to stop delaying needed surgeries. Revenue increases in this market will continue to be driven by the aging Japanese population, as well as by substantial efforts by manufacturers to educate patients on the benefits of large-joint replacement as they try to dispel the cultural opposition to invasive surgery that is common in Japan. The factor most significantly curtailing this market is the Japanese government's effort to reduce health care costs by reducing reimbursement levels for reconstructive implants on a biennial basis, which forces manufacturers to continually lower selling prices. Perhaps the most intriguing trend in this market is the effect of unique Japanese bone morphology. Surgeons have found that current hip resurfacing implants and unicondylar knee implants are poorly suited to the common Japanese conditions of hip dysplasia and bowleggedness. With the largest proportion of people over 65 in the world, Japan will continue to be a source of steady revenues in the large-joint reconstructive implant market over the forecast period.

Questions Answered in This Report:

• In the US, more knee implant procedures are carried out per year than hip implant procedures; in Japan, the opposite is true. This is due in part to Japanese bone morphology and a cultural aversion to invasive surgery. How will each segment of the Japanese reconstructive hip implant market be affected by these factors? What impact does this have on the competitive landscape in the market? What considerations must be taken into account by international competitors intending to enter this market?
• Premium-priced cementless knee implants are growing in popularity in the US and Europe due to surgeon confidence and perceived superior performance. To what extent will product approval regulations impede this trend in Japan over the forecast period? What impact will this innovation have on the Japanese reconstructive knee implant market as a whole? How will the market for cementless knee implants grow relative to the cemented and hybrid knee implant segments?
• As a result of Japanese cultural practices, preserving joint mobility is an important factor in selecting large-joint reconstructive implants and procedures. What is the potential for the large and rapidly expanding mobile-bearing knee implant segment? To what extent will differences in offered joint mobility among hip implants affect their unit sales? How are competitors capitalizing on the unique needs of the Japanese population?
• The Japanese Ministry of Health, Labour and Welfare (MHLW) is engaged in ongoing efforts to curtail health care costs. What effect will the MHLW's foreign reference pricing policy have on unit prices in this market? When and how will reimbursement cuts for orthopedic implants be applied? How severely will these developments be compounded by cost consciousness among privatized Japanese hospitals?

Scope:
Regions covered: Japan
Procedure segmentation: Our analysis uses the following breakdown of procedures:

• Hip reconstruction
• Partial
• Primary total hip arthroplasty (THA)
• Revision
• Resurfacing
• Knee reconstruction
• Primary total knee arthroplasty (TKA)
• Unicondylar
• Revision

Market segmentation: Our analysis uses the following breakdown of the market:

• Hip implants
• Partial (bipolar, unipolar, and one-piece)
• Primary THA (cementless, cemented, and hybrid)
• Revision
• Resurfacing (total resurfacing and hemiresurfacing)
• Knee implants
• Primary TKA by fixation type (cemented, cementless, and hybrid) and bearing type (fixed bearing and mobile bearing)
• Unicondylar
• Revision

Market forecast features: Based on primary research with industry professionals, we use our proprietary forecasting model to provide an in-depth examination of current and future trends in procedure volumes, unit sales, average selling prices, and market values over a 7-year period (2008-2014).

Competitive analysis: We provide a detailed analysis of the competitive landscape in the market, as well as market shares and qualitative discussions of the leading competitors in each market segment.