The Knee Market Begins to Bend for Start-Ups

The $4.6 billion worldwide market for knee arthroplasty is technologically mature, but it is underpenetrated today and it's still growing at a robust 14% annual rate. Furthermore, changes in demographics and patient expectations have created a large, unmet clinical need: the 50-something year old with unbearable knee pain. Today, that is the focus of a great deal of technological innovation-most of it incremental-on the part of large companies that seek to increase the longevity of devices with wear-resistant materials, and technologies that improve device fit, or the precision of placement and the accuracy of alignment of implants. But recently, and somewhat surprisingly, venture-backed start-ups have also begun to enter joint reconstruction with their own technological solutions. Four new companies believe they've staked out spaces ranging from operating alongside multi-billion dollar companies without facing crushing competition from them, to taking a more head-on competitive posture, and in each case, to make a clinical difference.