Orthopedic implants are one of the important segments of high-value medical consumables, with strict regulatory requirements for safety and effectiveness, and high market access threshold. At present, China's orthopaedic implant industry is in a rapid development stage, there are short boards in the upstream materials of the industry chain, high-end materials rely on imports, domestic enterprises need to speed up the breakthrough; midstream products, trauma implantable devices basically realized the domestic substitution, the future will be to improve the quality of the direction of the development of the spine and joints are mainly imported products occupy the market, the development of domestic products has a lot of space.

　　After years of development, orthopedic implants have emerged in the field of Dabo, Weigao, Akcome Medical, Chunli Medical and other high-quality local enterprises. In the future, with the improvement of the domestic orthopedic industry chain and the development of technology, domestic orthopedic implants will have more and more market power.

　　China's market development is favorable

　　Public data show that in 2018, the global orthopedic market size reached 51.2 billion U.S. dollars, basically maintaining a stable growth rate of about 3% in recent years. Europe, the United States, Japan and other developed economies in the field of orthopedic implants have a leading edge in technology, a higher degree of industrialization, and a more mature market. Among them, North America is the world's largest orthopaedic medical device market, accounting for more than half of the global market share; European market size ranked second in the world, but by the impact of fiscal austerity policies and price reduction pressure, growth is not strong, the market share has been reduced year by year; with the rapid development of China and India market, the Asia-Pacific region has become the fastest-growing global orthopaedic medical device regional market, market growth space is vast.

　　Public data show that in recent years, China's orthopedic implant market size is growing at a high rate, with sales revenue growing from 16.4 billion yuan in 2015 to 30.8 billion yuan in 2019, with a compound annual growth rate of 17.03%. The development of China's orthopedic medical device industry started in the 1980s. At present, the domestic orthopedic theory and clinical research has a certain foundation, but in terms of product research and development, production process and market development, it is still in the primary stage, and there is still a big gap compared with the international orthopedic giants. With foreign giants entering the country to seize the market, local enterprises are growing rapidly in the process of competition and learning with multinational enterprises, and the level of technology, process, research and development, and management have been greatly improved, and began to gradually break the competitive pattern of foreign giants dominance, and the market share of domestically produced orthopaedic implants has been increasing.In 2019, domestic enterprises accounted for 40% of the orthopaedic implant market in China .

　　Reconstructing the market pattern of segmentation

　　Orthopedic medical devices can be categorized into joints, spine, trauma, sports medicine, orthopedic repair materials and other segments. Among them, joints, spine and trauma are the most important segments, all of which are implantable orthopedic medical devices. In terms of the global orthopedic medical devices market, joint, spine and trauma orthopedic implants accounted for 37%, 18% and 14% of the market share, respectively, in 2018 (see Figure 1).

　　The domestic orthopedic medical device market pattern is different compared to the overall global market, and currently, the market share of trauma, spine, and joint implants is close to each other.In 2019, trauma, spine, and joints accounted for 29.8%, 28.23%, and 27.77%, respectively, of China's orthopedic medical device market (see Figure 2). This is mainly due to the late start of the domestic orthopedic implant application, the market penetration rate and the level of consumption of residents and other large gaps with the developed countries and regions, is still in the stage of industry restructuring. With the improvement of residents' medical expenditure capacity, the improvement of medical insurance system and the continuous improvement of clinical technology level, the proportion of each segment will gradually converge with the international mature market, and the proportion of joints and spine orthopedic medical devices will be further increased.

　　At present, the market penetration rate of domestic orthopedic implants is less than 5%, far lower than the 40% to 70% in the United States, and there is more room for development. According to relevant information, it is expected that from 2019 to 2024, the trauma implant market will grow at a compound annual growth rate of about 12%, the spine implant market will grow at a compound annual growth rate of about 14%, and the joint implant market will grow at a compound annual growth rate of about 15%, which means that among the three types of implants, the joint implant market will grow at the highest rate.

　　Joint implants are mainly used in the treatment of osteoarthritis, femoral head necrosis, rheumatoid arthritis and other diseases. A study published in the Chinese Journal of Orthopaedics shows that the incidence of osteoarthritis increases with age, and the prevalence of primary osteoarthritis in people over 60 years old in China has reached 62%. This means that osteoarthritis is a common disease in the elderly population. With the aging of China's population, the demand for joint-based orthopedic implants will increase significantly. Compared with spine and trauma, joint orthopedic implants track better.

　　Part of the domestic products to realize the breakthrough

　　Orthopaedic implant industry chain upstream for the production of raw materials, China's relevant industrial base is relatively weak; midstream for the production of implants, domestic enterprises have realized breakthrough in some segments.

　　The development of orthopedic implants is inseparable from the upstream disciplines of medicine, physiology, material science, chemistry and other industrial chain to improve the level of technology, the product of the upstream raw material requirements are high, the material needs to have a good safety, high strength, biocompatibility, mechanical properties close to the bone and other characteristics. With the development of technology, orthopaedic implant materials have gradually developed from steel, iron, copper, etc. to metal alloys, ceramics, polymers and resorbable materials, etc., with continuous updating. At present, the materials used mainly include medical metal materials (such as stainless steel, metal alloys, medical titanium, etc.) and medical biomaterials (such as inorganic non-metallic materials, polymer materials, etc.). At this stage, the market for orthopedic implantable devices is still dominated by metal materials.

　　In terms of R&D direction, bioresorbable materials are the focus of orthopedic implant materials at this stage. In recent years, bioresorbable materials have been rapidly developed in orthopedic implant applications, and are now mainly used in the manufacture of joints in non-weight-bearing areas, small joints, metacarpal phalanges, external ankles and other parts of the joint. Among them, the most applied orthopedic bioresorbable materials are composite biodegradable internal fixation materials, PLLA/PGA copolymer and so on.

　　Domestic orthopedic implant raw materials industry concentration needs to be improved, the temporary lack of leading enterprises, high-end core materials are still mainly imported, such as artificial joint production raw materials bioceramics, intervertebral fusion area production raw materials, such as polyether ether ketone. Domestic raw materials business to the production of general metal alloys or provide metal surface treatment processing, with less core competitiveness of enterprises.

　　Data show that China's existing orthopaedic implant midstream product manufacturers about 350, mainly in Beijing, Jiangsu, Shanghai, Guangdong and other economically developed regions, the industry has a certain degree of agglomeration.

　　Domestic orthopaedic implant manufacturers, business involved in trauma implants accounted for about 70% of the enterprises, the competition is more adequate, the product localization rate is higher. 2019, the localization rate of trauma orthopaedic implants to reach more than 60%, basically to achieve domestic substitution. Trauma orthopedic implants industry concentration is low - the highest market share of enterprises for Johnson & Johnson, its market share is only 14.2%; domestic trauma orthopedic implants leading enterprises Dabo medical market share is only 7.8%. Because of the technical threshold of trauma products compared to joints and spinal products is low, the industry is more involved in the enterprise, with the national and local orthopaedic consumables procurement policy to promote the implementation of the industry's low level of technology, weak competitiveness of the enterprise will face elimination or consolidation, the industry is expected to increase the degree of concentration.

　　In 2019, the localization rate of spinal products was 40.2%, and the market was mainly occupied by foreign brands. Among them, two foreign giant enterprises, Johnson & Johnson and Medtronic, occupy more than half of the market; domestic enterprise Weigao Orthopaedics is the leading domestic spinal orthopaedic implant enterprise, with a market share of 7.9%.

　　Relevant data show that as of the end of January 2021, joint orthopedic implants local production enterprises totaled nearly 100, mainly distributed in Beijing and Shanghai. Compared with trauma and spine orthopedic implants, joint products have the lowest degree of localization, with a localization rate of 27.5% in 2019. Public information shows that in 2019, the top five companies in China's joint-type orthopedic implants market were Jiemai Bangmei, Johnson & Johnson, Akcome Medical, Chunli Medical and Link Orthopedics. Among them, local enterprises Akcome Medical and Chunli Medical have already realized breakthrough in the competition, and are the leading domestic enterprises of joint-type implant products at this stage, with promising development prospects.