Arthroscopic Burs & Procedures Market

Arthroscopic Procedure & Burs Market was worth of USD 54.0 billion in 2021 and it is expected to reach USD 82.7 billion at the end of 2028 with CAGR of 6.3%. 

Executive Summary of Arthroscopic Burs & Procedures Market

Covid-19 was quickly spread throughout several countries and regions, wreaking havoc on people's lives and the community as a whole. It originated as a human health issue and had since evolved into a major threat to global trade, commerce, and finance. The Covid-19 pandemic raised the relevance of government healthcare facilities, resulting in an increase in global healthcare spending. As a result, research facilities for arthroscopy burs have been reopened at full capacity.

Moreover, degenerative knee disease is a worldwide occurrence among the elderly that is becoming more common as the global geriatric population grows. Degenerative knee disease affects about 25% of adults over the age of 50, according to the World Health Organization. The pain is debilitating, and a knee replacement treatment is frequently the last and only option for relief. In the United States and other industrialized countries, arthroscopic knee surgery for degenerative knee disease is the most common orthopedic procedure. Due to the rising prevalence of sports injuries, particularly those sustained in contact sports, the demand for knee arthroscopy is expanding globally.

The introduction of arthroscopic surgery has revolutionized the diagnosis and treatment of a variety of joint problems. Manifold arthroscopic procedures & burs engineering companies are anticipated to implement go-to-market strategies, mergers & acquisitions, and new product launches to remain competitive and meet the escalating demand for medical drones. Johnson & Johnson, Arthrex Inc., Conmed Corporation, and many more are hugely contributing to producing different types of arthroscopic burs. For example; Zimmer Biomet innovated the Shaver System which is designed for cutting soft tissue and bone in arthroscopic procedures. In addition to this, CONMED's Edge Bipolar Arthroscopic RF System raised the bar for ablation performance. Apart from the aforementioned firms, many other companies are also investing their money in the arthroscopic procedure and burs market.

Arthroscopic Burs & Procedures Market Key Players:

• Johnson & Johnson
• Arthrex Inc
• Conmed Corporation
• Smith & Nephew
• Stryker Corporation
• Zimmer Biomet Holdings Inc.
• Richard Wolf
• Auxein Medical
• Others

Arthroscopic Burs & Procedures Market Segmentation:

By Type

• Knee Arthroscopy
• Shoulder-Elbow Arthroscopy
• Hip Arthroscopy
• Others

By Regional & Country Analysis:

• North America
• U.S.
• Canada
• Europe
• U.K.
• France
• Germany
• Italy
• Asia Pacific
• China
• Japan
• India
• Southeast Asia
• Latin America
• Brazil
• Mexico
• Middle East and Africa
• GCC
• Africa
• Rest of Middle East and Africa

 North America is expected to dominate the global arthroscopic procedures and burs market in terms of revenue in 2021. This is due to ongoing investments in arthroscopic procedures and burs by various market players. The Asia Pacific is the fastest growing region in arthroscopy due to the high incidence of musculoskeletal disorders, increasing aging population, and a robust medical device manufacturing sector.

Trends Of Arthroscopic Burs & Procedures Market

Constant changes in arthroscopic instruments and systems are in a state of change. Sustaining success is not easy. The new combined products are energizing the Ortho or with the speed and power of the rotating bur. Some of the major advancements in this market are: -

• High-Def Imaging: - 

  So far, surgical facility leaders have begun to see the many benefits of the quality they can afford through 4K imaging. With this technology, subtle differences in neighboring physiology can have a major impact on the surgery that users perform. The better the image, the easier it is for doctors to see and treat patients. The new arthroscopic imaging system has significantly improved surgical visualization.

• Knotless Suture Anchors: - 

  One of the most exciting things about arthroscopy today is that we are performing major surgeries in a less invasive manner. This is due to advances in the imaging system, but also to the technical advances in the implants used to perform these surgeries. An example of this progress is the knotless suture anchor. Suture anchors are small, usually, polymer or metal devices that are attached to sutures and inserted directly into the bone. They are commonly used to fix tendons and ligaments to bones. The latest knotless anchors work just like the knotted anchors, but they can be placed faster and more efficiently.

• Advanced Suture Options: - 

  Suture options for repairing tissues are also improving and offering more choices for surgical scenarios. Some sutures change mechanical properties when exposed to fluid, which allows them to swell causing greater fixation to contact and strength. Similarly, some sutures are changing from a simple round piece of material-like thread to a broader (think broad tape) design, which lends itself to a bigger footprint and better force distribution when repairing tissues.

• Streamlined Scopes: - 

  Considering the devices that allow doctors to perform these minimally invasive procedures, there is a lot of curiosity this time around. angle-guided instruments for arthroscopy, especially in the hip scope, have made the procedure much easier. With this type of tool, more (angles) are fewer (slits). Due to the flexible nature of the device, doctors can get more angles through a single incision, reducing the total number of incisions on the patient. In the example of hip arthroscopy, flexible, angle-guided instruments can transform 4-to-5-incision surgery into a 2-to-3-incision procedure.

• Pump Flow Systems: - 

  Pump flow is the workhorse of arthroscopy. Unlike first-generation pumps that relied solely on gravity to add fluid, today's ""smart"" pumps are more efficient in regulating flow and preventing excess fluid from entering the surrounding tissues. The latest pumps have the ability to push fluid in and out of the joint and adjust the level automatically to balance. The arthroscopy pump system is an important part of making the arthroscopy procedure visible and appropriate.

New advances in technology improve the ability to perform minimally invasive arthroscopic procedures. There is no doubt that this trend will continue. And with the rapid development of technology in the field of arthroscopy, doctors are indebted to their patients for discovering all new technologies and developments to provide the best possible care.

In the last few years, knee arthroscopy and shoulder arthroscopy have seen a lot of advancement and some of these are trending, while some will be trending in the near future as mentioned below: -

Recent Advances and Future Trends in Knee Arthroscopy: -

      A) Ligament: -

• ACL: - ACL tears are the most common and controversial injury in orthopedic sports medicine. The latest trends in ACL surgery include ACL repair, individual ACL reconstruction, residual-sparing ACL reconstruction, use of reproductive aids to improve the biology of ACL graft lamentation, and early stabilization in patients with immature ACL deficiency. With the launch of the ACL Prevention Program, the role of bone morphology and hormones in the predisposition to ACL tears has increased over the years.
• ACL Repair: - Anatomic ACL can deliver excellent results with high rates in reconstructive games. However, this reconstructive approach has some shortcomings such as loss of proprioception, deformation of the graft site, surgeon error in tunnel placement, residual instability, and long process of graft revascularization and incorporation. Thus, although this approach initially failed, interest in ACL repair has re-emerged. Healing a torn ACL after repair provides an exciting opportunity to restore the stability of the knee with tissue that retains not only its original physiology but also the neurovascular supply.
• Antero-Lateral Ligament (ALL) and Lateral Extra-articular Tenodesis (LET): - The persistence of rotational instability after ACL reconstruction has led to increasing the interest in anthropocentric extra-articular stabilizing structures called ALLs. The ALL-expert group has published a consensus that all restructuring reduces internal rotation stability and pivot shifts after ACL restructuring. In addition to ACL reconstruction, all physical restructuring is advised in patients at high risk of ACL reconstruction, such as those under 20 years of age, athletes engaged in sports, and patients with general ligament relaxation. In patients with a Grade 3 pivot shift, the ACL is reconstructed, and all physical restructuring can be performed to reduce the chances of failure. The alternative to all reconstruction is the LET which basically consists of the central band of the iliotibial band under the LCL and is fixed on the tibia. One Level One study found that the addition of extra-articular processes reduces pivot shifts and improves the stability of ACL reconstruction, while subjective and objective qualities remain the same.
• A Posterior Cruciate Ligament (PCL): - PCL remains less controversial than ACL, and there is increased consensus on its surgical treatment. Various methods have been described for PCL reconstruction, including single- or double-bundle, TT, and tibial inlay techniques. Like ACL, there has been renewed interest in PCL repair, and recent studies have strengthened repair with suture tape. Looking forward to the long-term results and further developments in this area.
• Multiple Ligament Knee Injury and Knee Dislocations: - Knee dislocation presents a unique challenge with the management of soft-tissue envelopes, repair and/or ligament reconstruction, their timing, and technique. Although individual approaches to these complex injuries have been recommended, numerous studies have enabled consensus and algorithms for the management of these challenging injuries.

  B) Meniscus: -

The importance of the meniscus for normal knee function has been greatly appreciated over the past decade. It is increasingly recognized that repairing, replacing, or regenerating an injured meniscus is important to prevent the progression of osteoarthritis. Meniscus preservation has been shown to improve clinical outcomes and delay wear and tear using a variety of techniques. The meniscal repair can be achieved with all-in-out, in-and-out techniques, and a variety of tools and equipment are available.

• Augmentation of Meniscus Repairs: - Sophisticated meniscus repair techniques have also reported failure rates of up to 24% and are related to a variety of factors, including tear patterns, vascular anatomy, age, and organ alignment. Simple augmentation techniques, including origination, rasping, and abrasion of the synovium, improve treatment in meningeal tears. Techniques such as fibrin clots and PRP used alone or with different scaffolds at the meniscus repair site have provided clear evidence in clinical studies. Further, high-level studies are needed to prove their usefulness. New methods include arthroscopic collagen sheath wrap and bone marrow aspirate injected complex tears and chitosan-PRP composite implants.
• Meniscal Substitution: - In some cases, repair of the meniscus is not possible, and complete segmental, subtotal, or meniscus damage may occur in patients. In such cases, prosthetic meniscus scaffolds for meniscus replacement and segmental defects in the form of allograft implants for subtotal or total meniscus damage are viable options. In all these cases, the patient should be between 16 and 50 years of age, with a BMI of

  C) Cartilage: -

Cartilage defects and injuries are a major challenge in regenerative medicine. Cartilage treatment strategies can be characterized as palliation (chondroplasty and debridement), repair (drilling and microfracture), or restoration (autologous chondrocyte implantation [ACI], osteochondral autograph transfer [OAT], and osteoclast).

• OATS and ACI: - OAT regenerates hyaline cartilage: It has its own disadvantages, most importantly it cannot be used in wounds larger than 3 cm2. The current generation of matrix ACI and fibrin ACI has the advantage of the three-dimensional culture of chondrocytes which reduces the chondrocyte isolation observed with previous generations of the technique. The main disadvantage of ACI is that it requires a two-stage process, and the new generation of this technique will be aimed at a one-stage allograft ACI.
• Scaffolds: - Scaffold-based cartilage regeneration may be applied for chondral or osteochondral defects. For chondral defects, the defect can be corrected in one or two stages. Scaffolds can be porcine collagen matrix, a variety of synthetic substrates such as polylactic acid and polyglycolic acid, or natural substrates such as hyaluronic acid, collagen derivatives, agarose, alginate, or fibrin glue. The single-stage procedure involves the use of scaffolds implanted with fragmented cartilage tissue obtained from healthy parts of the knee or bone marrow. Another approach, called autologous matrix-induced chondrogenesis (AMIC), uses the porcine collagen matrix to stabilize blood clots obtained from microfractures. “AMIC Plus” adds PRP for further biological stimulation. For osteochondral defects, scaffolding has been developed with two or three-layered structures and is currently under investigation. Similarly, 3D printed personalized scaffolds, nanofiber technology, and hydrogel are being examined and will be included in future cartilage repair. 4D scaffolding is also an interesting development. These arteries are made from biomaterials that will respond to external stimuli and modify accordingly.
• Orthobiologics in Focal Cartilage Defects: - Orthobiologists used in cartilage defects include amniotic membrane-derived mesenchymal stem cells (MSC), adipose-derived MSC, BMAC, PRP, and growth factors (BMP4 and BMP7). Human studies with scaffolds have shown complete defect filling in 80-100% of patients. Clinical improvement has been reported in 100% of patients by the age of 5 years, and second-degree arthroscopy has shown regeneration of near-normal hyaline cartilage.

The role of organ restructuring is important as an adjunct to cartilage repair with upper tibial osteotomy. The rationale is to change the mechanical axis of the lower limb to transfer body weight to healthy articular cartilage. Numerous studies have shown that accurate improvement is the leading predictor of success.

A) Patellofemoral Joint: -

The management of patellofemoral joint pathology is challenging as a result of the unique and complex organization of static forces and the dynamic factors that contribute to its efficiency. The role of the medial patellofemoral ligament (MPFL) and its anatomy has been studied for many years. Recent studies have defined a more extensive medial attachment of the MPFL fanning and distal medial quadriceps tendon in the upper half of the patella. Hence, this structure is now called the medial patella-femoral complex. This joint has significant variability, 57.3% of this complex is attached to the patella and the rest is attached to the quadriceps tendon. Although the knee position is different during MPFL tensioning; biomechanical studies confirm that 2N tension at a knee 30-60 ° bend is best. Practically, at a 30-knee bend, stretching so that a lateral patellar translation of a square will be achieved, is the best way to ensure that the patella avoids excessive obstruction. Double-bundle grafts have been shown to reduce graft failure rates from 10.6% -26.9% in single bundle grafts to 4.5% -5.5% in double-bundle grafts. Patel has described several new techniques to avoid complications related to tunneling and suture anchors. MPFL repair may be indicated in young patients who are first displaced with patellar osteochondral fragmentation, which requires fixation, where a slightly different rupture from the patella or femur may be identified. Similarly, embryo embedding of MPFL in the knee may be sufficient where the bone regeneration process stabilizes the patella with a lax medial retinacular structure in the trachea.

B) Computer-Assisted Navigation in Knee Arthroscopic Surgery (CANS OR CAS): - 

Computer-assisted navigation was developed to improve the position of the tunnel in the ligament reconstruction of the knee and to enable accurate correction in the osteotomy around the knee. While there are conflicting reports on its usefulness, many studies support the use of navigation. The use of CANS in knee arthroscopic ligament surgery is limited, with additional aggression and complexity, with a huge increase in cost.

• Currently, it is used to study knee kinematics and in the following research applications:
• Comparing the effectiveness of different techniques of ACL reconstruction
• To evaluate the effectiveness and the need for extra-articular procedures
• Scientific tool for studying pivot shift test
• Pre- and post-operative results
• To personalize ACL reconstruction and in difficult iterative situations

C) Robotic and Image-Guided Knee Arthroscopy: - Knee arthroscopy is technically demanding. Current arthroscopes do not provide depth of vision, they are rigid, cannot easily negotiate curved spaces in the knee, and the field of vision is limited. All these factors, including human error, can lead to optimal results. Steerable robotic tools have additional freedoms, such as bending and rotating, which make it easier to reach and carry out the desired process. It will have sensors that will make it easy to locate and show the way to the desired location and plan the surgery. Furthermore, robotic devices require in-depth awareness to operate in space. Therefore, small stereoscopic cameras are being developed to get in-depth information. In addition to developing 3D / 4D ultrasound methods, they will help map the physiology of the soft tissue inside and outside the knee, allowing for ligament, meniscus, neurovascular structures, and tendon surgery.

The expansion of robotic technology will allow in the future to perform fully autonomous surgery under the supervision of specialists.

Recent Advances and Future Trends in Shoulder Arthroscopy

There has been significant development in shoulder arthroscopy in the last decade. Fundamental science studies have provided important insights into the failure mechanisms of pathoanatomic and surgical procedures for general disabling injuries. Some of the Major Trends in the Shoulder Arthroscopy Procedures: -

Advances in arthroscopy have had a positive effect on three major shoulder problems: anterior instability, rotator cuff tears, and osteoarthritis.

       a) Anterior Glenohumeral Instability: - 

1. A pattern change in arthroscopic management of shoulder instability has occurred since the concept of critical defects of the glenohumeral bone was introduced. Recent clinical and biomechanical studies have reported a high failure rate of arthroscopic repair with “subcritical” bone loss ranging from 13.5% to 17%, and biomechanical studies have reinterpreted severe damage as 15% of the largest anteroposterior width of the glenoid is perpendicular. Cadaveric analysis of sequential changes in glenoid geometry with progressive bone loss indicates that significant changes in the glenoid region and arc length occur between 10% and 20% of the glenoid width, and significant changes in the glenoid version (retrograde to reflex) are observed. Glenoid bone loss greater than 20-30%. This analysis is supported by biomechanical data showing less stability with glenoid bone loss as small as 2 mm (7.5%) of glenoid width. Bone restoration is recommended when there is bone loss and especially for defects consistent with the upper-lower axis of the glenoid. The overall evidence is conducive to three major surgical procedures in anterior instability: arthroscopic bankart repairs combined with remplissage procedure, open bone grafting procedures, and arthroscopic bone grafting procedures.

• Emerging Frontiers in Shoulder Arthroscopy-

• Endoscopic Extra-Articular Procedures: - Shoulder ""endoscopy"" is a new and emerging frontier in arthroscopy and involves surgical procedures in the extra-articular areas of the shoulder. The procedures are technically challenging and potential iatrogenic complications are possible.
• Endoscopic Proximal Humeral Plate Removal: - Implant removal after proximal humerus fracture fixation can be performed endoscopically and combined with arthrosis. These techniques involve endoscopic dissection in the subdeltoid and upper arm area and have many advantages over conventional open removal implants.
• Scapulothoracic Endoscopy: - Scapulothoracic endoscopy and canaloplasty can be performed using a new two-portal technique that uses intraoperative landmarks for accurate orientation. Arthroscopic management of snapping scapula syndrome results in an improvement in the range of pain, cramps, and movements in most patients; However, most patients experience residual symptoms. Low pre-operative mental state scores, long duration of symptoms, and high age were associated with poor outcomes.
• Office-Based Needle Arthroscopy; - In-office needle arthroscopy is a new minimally invasive diagnostic procedure that allows the patient to actively participate in the diagnostic process and avoids the need for advanced imaging. The technology has been developed for use during surgery and single-portal rotator cuff and labral repair.

Thus, arthroscopic procedures and techniques are evolving rapidly, and current evidence suggests future roles for joint protection and restoration procedures. Arthroscopic techniques such as replacements are safe and durable and are likely to be commonly used to address large Hill-Sax injuries with minimal loss of glenoid bone. Arthroscopic bone grafting has shown technical and consequential benefits; However, the technique is limited by the acute learning curve, and the rate of complications remains unaffected by the surgical experience. Bio inductive scaffolds have the potential to increase the healing rate of repaired tendons and further clinical evaluation is required to evaluate their usefulness. SCR appears to be a solution to prevent prosthetic replacement in irreversible rotator cuff tears; however, graft thickness is important to achieve the desired results of the original process. assembling and repairing potentially non-filling rotator cuff tears with a combination of biceps autographs for augmentation is an attractive and cost-effective option, and this combination has the advantage of saving cuffs and excellent capsules. Finally, joint protection procedures for GHOA have stood the test of time and are likely to be adopted and further evaluated.

Analyst Comment, “With more sophisticated technology and immense investments in the arthroscopy will result in promising growth for the global arthroscopic procedures and burs market is projected to reach USD 82.7 Billion in 2028”.