Sternal Closure Systems Market Size, Share & Trends Analysis Report By Product (Closure Devices, Bone Cement), By Material (Stainless Steel, PEEK, Titanium), By Procedure And Segment Forecasts, 2019 - 2026

Industry Insights

The global sternal closure systems market size was estimated at USD 2.05 billion in 2018 and is expected to witness a CAGR of 5.4% during the forecast period. Expanding the base of the geriatric population undergoing open-heart surgery through median sternotomy is considered to be one of the primary growth stimulants for the market. Median sternotomy procedure has remained the most popular technique for cardiac exposure to date, owing to easy and quick access to heart valves and vessels. Sternotomy and sternal closure occur prior and post-cardiac surgery, respectively.

Furthermore, developing countries are focusing on investing in public healthcare infrastructure due to rising non-communicable disease burden and injuries. This is projected to increase the number of surgical procedures in developing regions as well. According to data published by the World Bank, in 2015, China's per capita healthcare expenditure was USD 425.6, accounting for 5.3% of GDP. Furthermore, Plan of Health China 2030 estimates that by 2020 healthcare spending is anticipated to account for 6.5% to 7% of its total GDP. Sedentary lifestyles, high smoking, and alcohol consumption, and an unhealthy diet are leading to an increase in the prevalence of cardiac diseases globally. This is resulting in a rise in surgical procedures, which in turn, is likely to fuel the adoption of sternal closure systems in surgeries over the coming years. According to a survey conducted by the Centers for Disease Control and Prevention, in 2016, 28.1 million adults in the U.S. were diagnosed with heart disease.

A rise in the number of surgical procedures globally has driven demand for surgical instruments leading to the growth of the market. According to OECD, the estimated surgical procedures in 2012, were around 399,952 in the U.K. which later increased to 491,604 by 2016. Furthermore, lack of exercise and poor nutrition increase the risk of heart diseases in the elderly population. Furthermore, the growing geriatric population, which is more susceptible to chronic CVDs, is leading to an increase in the number of cardiovascular surgical procedures, thereby boosting the demand for sternal closure systems globally.

Moreover, developing countries are focusing on investing in public healthcare infrastructure due to the rise in non-communicable disease burden and injuries will further increase the number of surgical procedures in developing regions as well. According to data published by the world bank, in 2015, China's per capita healthcare expenditure was USD 425.6 accounting for 5.3% of GDP. Furthermore, Plan of Health China 2030 estimates that by 2020 healthcare spending is expected to account for 6.5% to 7% of its total GDP.

Product Insights

Based on the product, the market is bifurcated into closure devices and bone cement. Closure devices represented the leading share in the market in 2018. Factors such as the launch of products coupled with rising per capita expenditure in developed as well as developing economies are key factors responsible for the dominant share of the segment. These devices have demonstrated benefits such as a decrease in postoperative complications and infections along with faster recovery time in comparison with bone cement. Moreover, rising efforts being taken by key players in the market to introduce new techniques and product lines are likely to further boost the segment growth shortly.

Key products in this segment include SternaLock Blu and SternaLock 360 by Zimmer Biomet; Sternal ZIPFIX System by DePuy Synthes; and Sternal Talon Implants by KLS Martin Group. Companies operating in the market are focusing on R&D to deliver advanced solutions. For instance, Orthofix Holdings, Inc., a U.S. based company engaged in R&D and marketing of orthopedic products, has invested USD 28.8 million and USD 29.7 million during FY 2017 and FY 2018, respectively. In January 2017, JACE Medical, LLC has launched pre-monoblock sternal plates in the U.S. These plates are used before the surgery and work as implant positioner.

Material Insights

Some of the materials used for sternal closure systems are titanium, PEEK, and stainless steel. Titanium material accounted for over 40.0% of the total market share in 2018. This dominance is due to the associated benefits such as corrosion-resistant, ability to effectively join human bones, and biocompatibility of titanium. Besides, non-ferromagnetic property, which allows patients with titanium implants to examine safely under Magnetic resonance imaging (MRI) scan, is further enhancing penetration of this material in the industry.

Furthermore, high efficacy, non-toxic nature of implant and stability of the titanium products, greater economic feasibility coupled with increased affordability for the use of advanced titanium clips and plates in developed as well as developing region, are projected to bolster the penetration of titanium-based sternal closure systems. The Polyether Ether Ketone (PEEK) segment is expected to grow at the highest rate over the forecast period owing to technological advancements, growing R&D investments by key players, and biocompatible properties of the material.

Procedure Insights

The median sternotomy procedures dominated the procedure segment of the global sternal closure systems market with around 50.0% of share in 2018. Median sternotomies are frequently performed osteotomies worldwide, as the procedure provides easy access to the heart, lungs, and surrounding structures during heart valve replacement surgery and coronary artery bypass surgery. Median sternotomies also reduce post-operative infections and complications thereby further increasing its demand globally.

The growing geriatric population, prone to develop chronic cardiac disorders such as CVDs is anticipated to fuel demand for median sternotomy procedures. The geriatric population worldwide is anticipated to double in near future. According to a report by the United Nations Department of Economic and Social Affairs (2015), the number of people aged over 60 years is expected to grow by 56% from 2015 to 2030. The geriatric population was 901 million in 2015 and anticipated to reach 2.1 billion by 2050.

Regional Insights

North America accounted for a dominant share of the global sternal closure systems market. Rising collaborative efforts commenced by key players to improve their product offerings and ensure high-quality standards is further anticipated to boost the demand for systems across the region. For instance, in August 2017, A&E Medical Corporation acquired RTI Surgical’s Cardiothoracic Closure business. RTI Surgical’s Cardiothoracic Closure business offers cable-based plate products such as Tritium SPC System. Moreover, the major share for North America can also be attributed to the high cardiac disease burden in this region. For instance, according to the study conducted by the CDC, around 28.1 million people in the U.S. have diagnosed with heart-related disorders such as cardiac arrest and valvular heart disease. Also, favorable reimbursement regulations are expected to further fuel the growth of the market. As per the revised wound closure Medicare reimbursement coding guide, sternal closure procedures are reimbursed under 216, 217, 218, 219, 220, 221, 228, and 229 MS-DRG codes from 2018.

On the other hand, Asia Pacific is expected to grow at a lucrative CAGR over the coming years as key players are increasing their geographical presence in the region and focusing on the commercialization of their product at a relatively affordable price. For instance, in June 2016, the KLS Martin Group started its operations in Chennai, India in an attempt to seize the growing opportunity. Moreover, growing healthcare expenditure and infrastructure facilities coupled with growing awareness about cardiac diseases and treatment availability will further fuel growth in the region.

Sternal Closure Systems Market Share Insight

Johnson & Johnson, Zimmer Biomet, B. Braun Melsungen AG, Orthofix Holdings, Inc. are some of the key players in the global market focusing on high R&D investment to deliver technically advanced product portfolio. For instance, Orthofix Holdings, Inc, a U.S. based company, which delivers CONSTRUX Mini PEEK Spacer System in the U.S. As a percentage of revenue, the company invested USD 29.7 million i.e. around 7.0% of its total revenue in research and development during FY 2017. Moreover, in 2017, the company has introduced 20 new products in the orthopedics, sternal closure, biologics, and spine fixation markets.

Merger and acquisition and product portfolio expansion are key strategies adopted by the industry players. For instance, in June 2017, DePuy Synthes, a subsidiary of Johnson and Johnson has acquired Innovative Surgical Solutions, LLC, a Michigan, U.S. based company. The acquisition was in a view to strengthen the company’s spine care solution product portfolio.

Report Scope

Segments Covered in the report

This report forecasts revenue growth at global, regional & country levels and provides an analysis of the industry trends in each of the sub-segments from 2015 to 2026. For this study, Grand View Research has segmented the global sternal closure systems market report based on product, material, procedure, and region:  

• Product Outlook (Revenue, USD Million, 2015 - 2026)

  • Closure Devices

    • Sternal Closure Wires

    • Sternal Closure Plates and Screws

    • Sternal Closure Clips

    • Sternal Closure Cables

  • Bone Cement

• Material Outlook (Revenue, USD Million, 2015 - 2026)

  • Titanium

  • Polyether Ether Ketone (PEEK)

  • Stainless Steel

  • Others

• Procedure Outlook (Revenue, USD Million, 2015 - 2026)

  • Median Sternotomy

  • Hemisternotomy

  • Bilateral Thoracosternotomy

  • Others

• Regional Outlook (Revenue, USD Million, 2015 - 2026)

  • North America 

    • The U.S.

    • Canada

  • Europe 

    • U.K.

    • Germany

    • France

    • Italy

    • Spain

  • Asia Pacific 

    • Japan

    • China

    • India

  • Latin America 

    • Brazil

    • Mexico

    • Argentina

    • Colombia

  • Middle East & Africa

    • South Africa

    • Saudi Arabia

    • UAE