1. Advanced Biologics (Ladera Ranch, Calif.). The company's OsteoAMP exploits growth factors within allograft tissue. A proprietary process utilizes the osteoinductivity of autografts and the osteoconductivity of allografts from the same donor to enhance growth factors to higher levels. OsteoAMP won first place in the regenerative technologies category in Best New Technology for 2009 hosted by Orthopedics This Week. OsseoGEN is the company's line of allograft-derived stem cell technology. The company's OsteoMEM, an ultra porous shape memory scaffold, is not currently available in the U.S. market. www.advancedbiologicscorp.com
2. Aesculap USA (Center Valley, Pa.). Aesculap, a division of the German company B. Braun Melsungen, provides implants for orthopedics, neurosurgery and spinal surgery as well as surgical sutures, sterile containers, motor & navigation systems and products for cardiology. The division also operates the Aesculap Academy, which actively exchanges knowledge and numerous continuing education programs. In May, Aesculap Implant Systems launched S4 Element Pedicle Screw System for use in spinal fusion procedures. In March, it launched the Spyder Minimally Invasive Spinal Retractor System for use in the lumbar spine with Aesculap's S4 Pedicle Screw System. www.aesculapimplantsystems.com
3. Alphatec Spine (Carlsbad, Calif.). The company develops products for older spine patients, ages 65 years and older, who have disorders such as osteoporosis, scoliosis and spondylolisthesis. Product lines include cervico-lumbar, thoraco-lumbar, interbody/VBR, biologics, minimally invasive solutions and vertebral compression fractures. In the Best New Technology awards hosted by Orthopedics This Week in Dec. 2009, Alphatech Spine won two first-place awards for its OsseoScrew Expandable Screw for lumbar care and for its Guided Lateral Interbody Fusion system for minimally invasive care. www.alphatecspine.com
4. Amedica Corp. (Salt Lake City). Amedica is a spinal and orthopedic implant and instrument maker focused on silicon nitride ceramic technologies. It has brought various spinal implant products to market and products under development include reconstructive hip and knee implants. In June, the company received a patent for its hip implant featuring a monoblock ceramic acetabular cup for use in articulating joints for total joint replacement. The cup, currently under development, will be used as an ultralow wear-bearing component for motion-preserving implants. In March, Amedica received a patent for its ceramic-on-ceramic bearings for articulating joints used for total joint replacement and spinal disc applications. www.amedicacorp.com
5. Arthrex (Naples, Fla.). Founded in 1981, Arthrex develops sports medicine products and educational services for orthopedic surgeons. The company has introduced more than 5,000 products for arthroscopic and minimally invasive orthopedic surgical procedures. Its TightRope product, originally designed for ankle surgery, is also being used for minimally invasive shoulder surgery. In March, the company acquired iBalance Medical of Boulder, Colo., maker of the IBalance HTO System, which uses an implant placed within the tibia to align the osteotomy in both the coronal and sagittal plane. In June, the company launched the its new 2.9 mm Bio-PushLock with a reduced size to allow more anchors to be implanted around the glenoid for improved fixation. www.arthrex.com
6. Arthrocare (Austin, Texas). Founded in 1993, Arthrocare offers Coblation technology using radio frequency energy to remove soft tissue from the body, used in arthroscopic procedures to repair joints. At its Costa Rica factory, ArthroCare also makes ligament-repair, spinal-stabilization, and wound-care products. Its SpineWand surgical devices use plasma disc decompression, a minimally invasive procedure for patients with symptoms associated with a contained disc herniation who have failed conservative care and are not yet candidates for major surgery. The AccuMeter manometer provides a precise digital read out that records opening and maximum disc pressures for each level and prints the information on a sheet of paper. The company reported a more than 4 percent increase in revenues in 2009. www.arthrocare.com
7. Aspen Medical Products (Irvine, Calif.). The company makes upper and lower spinal orthotics. It was formed in 2000, when International Healthcare Devices, the product development and marketing arm for Aspen Cervical Collars and CTOs, merged with Fiji Manufacturing. Aspen Medical's Symmetrically Adjustable Cervical Collar won first place for Best New Technology in the cervical care category for 2009, hosted by Orthopedics This Week. Other products include the Aspen "Low Profile" LSO, Summit LSO, Aspen Pediatric Cervical Collar, Contour TLSO, QuikDraw RAP and Vista Collar. www.aspenmp.com
8. Biomet (Warsaw, Ind.). Company products include reconstructive products for hips, knees and shoulders. It also makes bone cement systems, orthopedic support devices and operating room supplies. Through its EBI subsidiary, Biomet sells orthopedic fixation devices, electrical bone-growth stimulators, and bone grafting materials. And Biomet Microfixation markets implants and bone substitute material for craniomaxillofacial surgeries. Biomet is controlled by LVB Acquisition, owned by a group of private equity firms. www.biomet.com
9. ConforMIS Corp. (Burlington, Mass.). This company holds more than 250 patents and patent applications in imaging software, image processing, implant design, surgical techniques and instrumentation. But it has truly stood out for its patient-specific knee implants that have been shown to be a superior alternative to off-the-shelf knee implants. ConforMIS was a winner of the 2009 Medical Design Excellence Awards for its iUni and iDuo resurfacing implants. In April, ConforMIS received CE Mark certification to market its iUni G2 patient-specific knee replacement system in Europe. The iUni G2 is the only patient-specific unicompartmental knee resurfacing implant currently on the market. www.conformis.com
10. CONMED Corp. (Utica, N.Y.). About 60 percent of CONMED's revenues come from arthroscopy and powered surgical instruments for orthopedic surgery. Its arthroscopic products include reconstruction tools, scopes, implants, and fluid management systems. Brands include Linvatec and Hall Surgical. In Nov. 2009, its Linvatec arthroscopy unit released the Bullseye Anatomic Cruciate Reconstruction System, designed to precisely perform anatomic single bundle and double bundle cruciate reconstructions with a flexible and intuitive guide system. At the time, it also launched an expanded range of smaller sizes of Matryx Biocomposite interference screws for fixation of graft bundles. www.conmed.com
11. Corin (Cirencester, U.K.). Corin makes reconstructive orthopedic devices used in joint replacement procedures. In addition to replacement ankles, hips, knees and spinal implants, it is developing computerized surgical systems for joint replacements and other procedures. Products include the Trinity advanced bearing acetabular system, the MiniHip, the Cormet advanced hip resurfacing system, Metafix, the Uniglide triple radius unicompartmental knee system, the Rotaglide total knee replacement, LARS, the Zenith total ankle replacement and Hip Fracture Management Solutions. Corin was founded in 1985 and went public in 2002. www.coringroup.com
12. Covidien (Loughlinstown, Ireland). In addition to producing many medical products not related to orthopedics or spine, the company makes DuraSeal Spine Sealant to stop cerebral spinal fluid leaks after surgery. DuraSeal was launched in Nov. 2009 and it won first place in the for biomaterials category for Best New Technology for 2009 hosted by Orthopedics This Week. The company separated from Tyco International and changed its name from Tyco Healthcare to Covidien, a $10 billion company. www.covidien.com
13. DFine (San Jose, Calif.). DFine's RF Kyphoplasty procedure with the StabiliT Vertebral Augmentation System, introduced in October 2008, uses site-specific cavity creation, controlled cement delivery and ultra-high viscosity bone cement. Radiofrequency energy is applied to energy-responsive bone cement to create an ultra-high viscosity cement, delivered into a cavity within the vertebra using a remote hand switch that limits the surgeon's exposure to radiation. Two recent studies in Germany showed radiofrequency kyphoplasty with StabiliT for vertebral compression fractures resulted in less cement leakage in patients than traditional vertebroplasty. www.dfineinc.com
14. DePuy (Warsaw, Ind.). DePuy, a division of Johnson & Johnson, includes DePuy Orthopaedics, DePuy Spine and DePuy Mitek. Its products are used for reconstructing damaged or diseased joints, caring for traumatic skeletal injuries, treating spinal disorders and deformity, and repairing injured soft tissue. DePuy's Confidence System, launched in 2008, provides directional high viscosity cement placement and allows for a longer working time than other systems. In May, DePuy launched two products. The Expedium Vertebral Body Derotation Set is for spinal alignment in patients with scoliosis. The Bristow-Latarjet Instability Shoulder System is an instrument set for open and arthroscopic Latarjet or Bristow procedures. www.depuy.com
15. Geistlich Surgery (Root Längenbold, Switzerland). Geistlich Surgery, a unit of Geistlich Pharma, sells products for cartilage regeneration, including natural matrix structures for long-term osteogenesis in orthopedic and trauma surgery and to treat spinal damage. It also makes natural biomaterials for sports medicine and orthopedics and provides therapy concepts for biological cartilage substitute solutions. Orthoss is a bone substitute made from the mineral part of bovine bone. It is structurally integrated into the surrounding bone and incorporated into the physiological remodeling process. www.geistlich.com
16. Eminent Spine (Georgetown, Texas). The company's motto is "Bad to the Bone." Co-founded in 2008 by Steve Courtney, MD, a Texas orthopedic spine surgeon, and David Freehill, an expert in manufacturing and product design, Eminent Spine makes bio-mechanically sound spinal implants. In 2009, it received FDA clearance for a full line of PEEK spacers and for its Fang anterior lumbar buttress plate. Market clearance for the Diamondback Pedicle Screw System with Boa Constrictor Crosslink and the King Cobra Anterior Cervical Plate is anticipated this year. www.eminentspine.com
17. Exactech (Gainesville, Fla.). Founded in 1985 by an orthopedic surgeon and a biomedical engineer, Exactech wants to make every day "a great day in the OR." Exactech provides orthopedic implant devices, related surgical instruments and biologic materials and services to hospitals and physicians. The company markets its products in more than 30 markets in Europe, Latin America, Asia and the Pacific. In May, it acquired Brighton Partners, the sole-source supplier of the direct compression molded polyethylene bearings used in Exactech's Optetrak knee replacement system. In Oct. 2009, the company reported total revenue for the third quarter increased 12 percent over the same period the year before. It reported a 24 percent gain for hip implants, a 4 percent gain for knee implants and 7 percent gain for biologic and spine. www.exac.com
18. Implants International (Cleveland, U.K.). The company sells products for arthroplasty, trauma and spinal implant sectors. Its orthopedic products include Spinal Plif/Alif Cages and End Plates, the CP Titanium-CSLP Plate System, Ultra Low Profile ACP Systems with Dual-Lok Screws, the Secure S3 System, metal-on-metal ACD systems, metal-on-metal posterior approach lumbar systems. Its manufacturing process uses 3-D computer-aided design, computer-aided manufacturing, backed up by a range of computer numerical control manufacturing machines. Inspection is controlled via a ZEISS CNC co-ordinate measuring machine and other non-contact optical devices, housed in a temperature and humidity controlled environment. www.implantsinternational.com
19. K2M (Leesburg, Va.). K2M makes spinal stabilization and minimally invasive systems for treatment of complex spinal pathologies and procedures. Products involve motion preservation, annular repair, and nucleus replacement. John Kostuik, MD, its chairman and co-founder, is former chief of spine surgery at Johns Hopkins University School of Medicine. The company is beginning to market its products in Germany, the UK and Japan. Its Serengeti minimally invasive retractor system earned a Medical Design Excellence Award in 2010. In Nov. 2009, K2M launched the Terra Nova Minimally Invasive Access System and the Serengeti Disposable Kit. Terra Nova, which involves a small incision and uses a muscle-splitting technique, is used in conjunction with Serengeti, which features a flexible polymer retractor for screw-based retraction. www.k2m.com
20. Kinamed (Camarillo, Calif.). Established in 1987, Kinamed sells implantables and instruments for orthopedics and neurosurgery. With about half of its sales abroad now, Kinamed has been seeing double-digit growth for the past three years. Several products are FDA-approved and the Gem total knee system is approved for investigational use. Kinamed makes the CarboJet carbon dioxide lavage system for cleaning and preparing bone surfaces; the SuperCable Iso-Elastic Cerclage system, a polymer-based cerclage system; and the KineMatch Patello-Femoral Replacement, a unicompartmental joint replacement for patients with isolated, end-stage patello-femoral disease. www.kinamed.com
21. Lanx (Broomfield, Colo.). Founded in 2003 and led by medical professionals and engineers, Lanx's devices and systems are used for anterior cervical discectomy fusion, anterior lumbar interbody fusion, deformity correction of the thoracolumbar spine, lumbar fracture fixation, lumbar fusion, posterior cervical fusion, posterior lumbar interbody fusion, posterolateral fusion, thoracic fracture fixation and transforaminal lumbar interbody fusion. Its Silverton Spinal Fixation System is for use in the thoracolumbar spine region. Other products include the Fortis Allograft Interbody Spacers, Silverton-D Deformity System, and the Snowcap Anterior Cervical Plate. Lanx had backing from several institutional investors, including Chicago Growth Partners, Goldman Sachs Private Equity Opportunities Fund, Noro-Moseley Partners and Oakwood Medical Investors. www.lanx.com
22. Medtronic (Minneapolis). Medtronic controls more than half of the spine market, but the market is growing rapidly and future control is very much in flux, orthopedic surgeon John Cherf, MD, told Becker's Orthopedic & Spine Review last year. Medtronic's Spinal and Biologics business collaborates with surgeons and researchers to treat neurological, orthopedic and spinal conditions. Products include bone grafts, minimal-access spinal technologies and image-guided surgical navigation procedures. In 2007, it launched the CD Horizon Legacy Anterior Spinal System. In 2008, it acquired Restore Medical, which makes devices to treat sleep-disordered breathing. Its balloon kyphoplasty system leads the market for compression fracture treatment. In Dec. 2009, Medtronic launched the Sovereign Spinal System, an intervertebral body fusion device. www.medtronic.com
23. NuOrtho Surgical (Fall River, Mass.). Founded in Sept. 2008, NuOrtho is an early-stage medical device company, focusing on treating damaged tissue and preserving healthy tissue. NuOrtho has three main product platforms: soft tissue treatment, agent delivery and bone fusion. Its first product launch will be Ceruleau, a technology for knee cartilage that is a surgical probe designed to preserve joint cartilage during surgical treatment for articular knee cartilage. The company's nine patents involve tissue preservation. www.nuorthosurgical.com
24. NuVasive (San Diego). NuVasive's products cover spine surgery procedures, implants and instruments. Its principal product, the Maximum Access Surgery platform, involves a lateral approach, eXtreme Lateral Interbody Fusion, which spreads the psoas muscle instead of cutting it. The MAS platform uses a software algorithm enabling the surgeon to see the nerve's location in real time. After going public in 2009, NuVasive's total revenue rose 48 percent from 2008 and it is projecting annual sales of $500 million for 2010. In March, UnitedHealthcare and Aetna began to cover Xtreme, which they had previously classified as unproven technology. The company is developing the MAS-TLIF system, allowing surgeons to compress and distract bones of the spine through a 1.25-inch incision. In Oct. 2009, the company posted third-quarter sales of $94.9 million, up 41.8 percent from the same period the year before. www.nuvasive.com
25. OMNIlife Science (East Taunton, Mass.). Founded in 1999, this orthopedic device company offers modular hip stem technology and total knee replacement systems. It sells the Apex Modular Hip System, the Apex K1 Hip System, the Apex K2 Modular Hip System and the Apex Knee Reconstruction System. In June, Orthopaedic Synergy, the holding company for OMNIlife Science, completed its acquisition of Praxim, a French company that develops automated systems, software and instruments for total joint arthroplasty. OMNIlife Science plans to extend its hip and knee product offerings and introduce of new products to complement its current product portfolio. www.omnils.com
26. Orthalign (Aliso Viejo, Calif.). OrthAlign makes surgical navigation products for precise alignment. Its palm-sized KneeAlign system addresses tibial alignment in total knee arthroplasty. It is a disposable unit for one-time use at significantly lower cost than large console CAS and does not require a CT Scan, MRI or additional x-rays. In March, OrthAlign received market clearance from the FDA for the latest version of KneeAlign. www.orth-align.com
27. Orthofix (McKinney, Texas). The company's product offerings include internal systems to lengthen bone, plating systems to reconstruct a deformity, soft tissue management for rehabilitation and cold therapy for post-surgical pain management. In June, Orthofix's Breg sports medicine division won the 2010 CIO 100 award for its Vision Advanced Inventory Management software, which automates management of in-house inventories of orthopedic bracing and other products. In May, the company launched three sports medicine products: a lateral stabilizer with hinge, the Polar Care Kodiak Intelli-Flo Hip Pad and a neutral hand accessory. The company collaborates on R&D with the Musculoskeletal Transplant Foundation, the Orthopedic Research and Education Foundation, the University of Medicine and Dentistry of New Jersey and the National Osteoporosis Institute. www.orthofix.com
28. OrthoPro (Salt Lake City). Since 2003, OrthoPro has released several surgical foot and ankle products for podiatrists and orthopedic surgeons. Its first product was the Subtalar Spacer, a minimally invasive approach for flexible flatfoot deformity. It also makes the Cannulated Screw System for use in midfoot and forefoot surgeries, the Mini-Rail External Fixation Device and the Hemiarthroplasty Implant. Its Total Compression Plate System, released in 2010, has a variety of plate sizes and configurations. www.orthoprollc.com
29. Osseon Therapeutics (Santa Rosa, Calif.). This $14 million start-up company was launched by the University of Northern California. Osseon focuses on bone cement delivery devices and bone cement composite for treating symptomatic compression fractures of the vertebral spine. Its Osseoplasty 1.0, launched in Dec. 2008, features a curved delivery system that enables the physician to channel through the vertebral body, creating a void to house the injected bone cement. www.osseon.com
30. Pioneer Surgical Technology (Marquette, Mich.). The company's first product, the Songer Spinal Cable System, introduced in 1992, was designed to be superior to wire in ease of use, flexibility and strength. This surgeon-driven company in Michigan's isolated Upper Peninsula has expanded into orthobiologics and has exhanced its spinal implant offerings. Products include the Quantum Spinal Rodding System and nanOss Bioactive. During 2006, the company signed a distribution agreement with Regeneration Technologies and acquired Encelle, renamed Pioneer Surgical Orthobiologics, maker of E-Matrix, a sterile, injectable biopolymer for the repair of diseased or damaged tissue. www.pioneersurgical.com
31. RTI Biologics (Alacua, Fla.). RTI Biologics, formed by the 2008 merger of Regeneration Technologies and Tutogen Medical, provides allograft and xenograft implants for orthopedic and other specialty surgeries. In early 2010, the company launched one spinal implant and three implants for bone graft substitutes and general orthopedics. RTI makes BioSet demineralized bone matrix. In Oct. 2009, the company posted record revenues of $42.8 million for the third quarter, an 11 percent increase over the same period the year before. In the first quarter of 2010 revenues were up 2 percent over the prior-year period. www.rtix.com
32. SI-Bone (Cupertino, Calif.). This company has been pioneering the use of a minimally invasive surgical device to treat the sacroiliac joint. Its iFuse Implant System allows for a less invasive approach than an open surgical procedure. This simpler approach reduces OR time to less than one hour, produces fewer complications and provides a stronger construct than other sacroiliac joint fixation systems. SI-Bone has been working with several well-known spine surgeons with experience in low back pathologies. In February, the company launched a smaller, 4.0 mm size of its iFuse Implant System. www.si-bone.com
33. Siemens Medical Solutions (Malvern, Pa.). Siemens Medical Solutions provides imaging modalities for orthopedic surgery and neurosurgery. Products include flexible mobile C-arms, navigation, surgery tables and ultrasound. The company is part of Siemens Healthcare, which provides medical imaging, laboratory diagnostics, medical information technology and hearing aids. www.medical.siemens.com
34. Small Bone Innovations (Morrisville, Pa.). Formed in 2004, Small Bone Innovations has been acquiring companies in the small bone and joint market. Its product portfolio includes more than 40 devices and instruments in arthroplasty, fixation, trauma and biologic solutions. The company has acquired Avanta, which specializes in hand, wrist and elbow arthroplasty and trauma products; Fixano, specializing in hand, wrist, elbow and shoulder arthroplasty and trauma products; Envision, an implant manufacturer; Actipore, a porous metal technology company; Artelon, involved in biologically active and biodegradable technology; and Xtremi-T, which focuses on resorbable trauma technology. www.totalsmallbone.com
35. Smith & Nephew (Memphis, Tenn.). The Smith & Nephew Orthopaedics division makes Oxinium Genesis II and Profix Knee Systems, TriGen Intramedullary Nails, Synergy and Echelon hip operation systems, and the Exogen Ultrasound Bone Healing System. Recent launches include Oxinium material for hip and knee implants, the Birmingham Hip, BHR Resurfacing and the Journey Deuce knee. Other products include the Emperion Modular Hip System, the Legion Revision Knee System and Synergy Primary Hip Systems. Smith & Nephew research focuses on bioresorbable polymers, tissue and cell engineering and non-invasive stimulation. In May, the company reported first quarter revenues were up 9 percent from the same period the year before. www.smith-nephew.com
36. Spinal Motion (Mountain View, Calif.). Founded in 2004, Spinal Motion makes artificial discs for use in the spine. The company has applied for premarket approval of its Kineflex Disc, for lumbar cases, and its Kineflex C Disc, total disc replacements for cervical cases that preserve motion. These are weight-bearing, modular implants consist of two keeled endplates and one semi-constrained, fully articulating cobalt chrome core. In Nov. 2009, Spinal Motion announced it had secured $27.4 million in Series D funding and reached 20 percent enrollment for a laterally placed lumbar artificial disc clinical study. www.spinal-motion.com
37. Spine Surgical Innovation (South Easton, Mass.). SSI designs and markets the Holmed Swivel Port System, which is intended for posterior or lateral lumbar surgery. The SSI product line is categorized into three key sections: lumbar, cervical and instruments. SSI's products include a line of dilator products, swivel tip rod forcepts and nerve hook retractors and bayonets. www.spinesurgicalinnovation.com
38. Stryker Corp. (Kalamazoo, Mich.). Stryker is a seasoned player covering all key applications, from hip, knee and upper extremity to spinal implants. Products include artificial joints, spinal rods and screws, artificial vertebral discs and bone cement. Its OP-1 is a biological product to grow bone. Stryker also makes video-assisted surgical systems for minimally invasive surgery. In April, the company announced it had made its one-millionth Exeter hip stem, developed by an orthopedic surgeon and an engineer 40 years ago to control aseptic loosening. In April, the company launched the iVAS inflatable vertebral augmentation system for vertebral compression fractures. In February, it released the Rejuvenate Modular Primary Hip System, designed to closely match the hip biomechanics of the patient. www.stryker.com
39. Tornier (Edina, Minn.). Tornier makes orthopedic devices such as the Aequalis line of shoulder arthroplasty prostheses and the Salto and Salto Talaris total ankle prostheses. It offers a portfolio of foot and hand products including the NexFix system for reconstructive foot surgery, the CoverLoc system for wrist fracture repair, the Piton shoulder anchor system and ArthroTunneler system for rotator cuff repair, and the Conexa tissue matrix for tendon and ligament repair. Tornier has collaborations with BioSurface Engineering Technologies, Bioretec and Tepha Medical Devices, providing access to non-metal technologies for unmet soft and hard tissue repair. In June, the company filed for a $205 million IPO. www.tornier-us.com
40. VertiFlex (San Clemente, Calif.). The company makes minimally invasive and motion-preserving spinal surgery technologies. Its Dynabolt Dynamic Stabilization System is a pedicle screw-based system to allow a full range of motion. The Superion Interspinous Spacer, still under clinical investigation, is for patients with moderate lumbar spinal stenosis. The Silverbolt MIS Screw System, introduced in 2007, serves as a surgery platform by supporting a mini-open approach through VertiFlex's Oracle Expandable Retractor. The Silverbolt MLR System percutaneously delivers two rods into a single screw for multilevel stabilization applications. The Octane Spinal Implant System uses an implant made from PEEK Optima and has radiographic markers to ensure accurate placement. The Mainframe Screw System is the foundation for the company's posterior spinal fixation systems. www.vertiflex.net
41. Wright Medical Technology (Arlington, Tenn.). Wright Medical Group makes surgical solutions for the foot and ankle market as well as hip and knee repair and reconstruction. The company recently launched the Xpansion Micrografting System for split-thickness skin grafting and Valor Hindfoot Fusion Nail for the treatment of skeletal deformity, late-stage arthritis or complications from diabetes. Other Wright products are the Charlotte family of reconstructive implants, Darco locked plating systems, Ortholoc polyaxial locking systems, the Bioarch subtalar implant, Side-Kick External Fixators, Cancello-Pure and Biofoam osteotomy wedge systems, Dart-Fire small screw systems, Graftjacket regenerative tissue matrix, and the Inbone total ankle replacement. www.wmt.com
42. Zimmer Holdings (Warsaw, Ind.). Globally, Zimmer controls 27 percent of the market for artificial knees, 21 percent of the market for artificial hips, 13 percent of the market for extremities, 5 percent of the market for trauma products and 3 percent of the market for spine. It makes the NexGen knee System, the bone-conserving Fitmore Stem, the Zimmer M/L Taper Hip Prosthesis with Kinectiv Modular Neck technology, the Zimmer Trabecular Metal Glenoid and the Zimmer Natural Nail System. In 2008, the company acquired Abbott Spine, maker of spine implants. In March, Zimmer launched a line of Zimmer Patient Specific Instruments, which use MRI technology and pre-operative planning tools to create customized cutting guides tailored to each patient's own anatomy. www.zimmer.com
2. Aesculap USA (Center Valley, Pa.). Aesculap, a division of the German company B. Braun Melsungen, provides implants for orthopedics, neurosurgery and spinal surgery as well as surgical sutures, sterile containers, motor & navigation systems and products for cardiology. The division also operates the Aesculap Academy, which actively exchanges knowledge and numerous continuing education programs. In May, Aesculap Implant Systems launched S4 Element Pedicle Screw System for use in spinal fusion procedures. In March, it launched the Spyder Minimally Invasive Spinal Retractor System for use in the lumbar spine with Aesculap's S4 Pedicle Screw System. www.aesculapimplantsystems.com
3. Alphatec Spine (Carlsbad, Calif.). The company develops products for older spine patients, ages 65 years and older, who have disorders such as osteoporosis, scoliosis and spondylolisthesis. Product lines include cervico-lumbar, thoraco-lumbar, interbody/VBR, biologics, minimally invasive solutions and vertebral compression fractures. In the Best New Technology awards hosted by Orthopedics This Week in Dec. 2009, Alphatech Spine won two first-place awards for its OsseoScrew Expandable Screw for lumbar care and for its Guided Lateral Interbody Fusion system for minimally invasive care. www.alphatecspine.com
4. Amedica Corp. (Salt Lake City). Amedica is a spinal and orthopedic implant and instrument maker focused on silicon nitride ceramic technologies. It has brought various spinal implant products to market and products under development include reconstructive hip and knee implants. In June, the company received a patent for its hip implant featuring a monoblock ceramic acetabular cup for use in articulating joints for total joint replacement. The cup, currently under development, will be used as an ultralow wear-bearing component for motion-preserving implants. In March, Amedica received a patent for its ceramic-on-ceramic bearings for articulating joints used for total joint replacement and spinal disc applications. www.amedicacorp.com
5. Arthrex (Naples, Fla.). Founded in 1981, Arthrex develops sports medicine products and educational services for orthopedic surgeons. The company has introduced more than 5,000 products for arthroscopic and minimally invasive orthopedic surgical procedures. Its TightRope product, originally designed for ankle surgery, is also being used for minimally invasive shoulder surgery. In March, the company acquired iBalance Medical of Boulder, Colo., maker of the IBalance HTO System, which uses an implant placed within the tibia to align the osteotomy in both the coronal and sagittal plane. In June, the company launched the its new 2.9 mm Bio-PushLock with a reduced size to allow more anchors to be implanted around the glenoid for improved fixation. www.arthrex.com
6. Arthrocare (Austin, Texas). Founded in 1993, Arthrocare offers Coblation technology using radio frequency energy to remove soft tissue from the body, used in arthroscopic procedures to repair joints. At its Costa Rica factory, ArthroCare also makes ligament-repair, spinal-stabilization, and wound-care products. Its SpineWand surgical devices use plasma disc decompression, a minimally invasive procedure for patients with symptoms associated with a contained disc herniation who have failed conservative care and are not yet candidates for major surgery. The AccuMeter manometer provides a precise digital read out that records opening and maximum disc pressures for each level and prints the information on a sheet of paper. The company reported a more than 4 percent increase in revenues in 2009. www.arthrocare.com
7. Aspen Medical Products (Irvine, Calif.). The company makes upper and lower spinal orthotics. It was formed in 2000, when International Healthcare Devices, the product development and marketing arm for Aspen Cervical Collars and CTOs, merged with Fiji Manufacturing. Aspen Medical's Symmetrically Adjustable Cervical Collar won first place for Best New Technology in the cervical care category for 2009, hosted by Orthopedics This Week. Other products include the Aspen "Low Profile" LSO, Summit LSO, Aspen Pediatric Cervical Collar, Contour TLSO, QuikDraw RAP and Vista Collar. www.aspenmp.com
8. Biomet (Warsaw, Ind.). Company products include reconstructive products for hips, knees and shoulders. It also makes bone cement systems, orthopedic support devices and operating room supplies. Through its EBI subsidiary, Biomet sells orthopedic fixation devices, electrical bone-growth stimulators, and bone grafting materials. And Biomet Microfixation markets implants and bone substitute material for craniomaxillofacial surgeries. Biomet is controlled by LVB Acquisition, owned by a group of private equity firms. www.biomet.com
9. ConforMIS Corp. (Burlington, Mass.). This company holds more than 250 patents and patent applications in imaging software, image processing, implant design, surgical techniques and instrumentation. But it has truly stood out for its patient-specific knee implants that have been shown to be a superior alternative to off-the-shelf knee implants. ConforMIS was a winner of the 2009 Medical Design Excellence Awards for its iUni and iDuo resurfacing implants. In April, ConforMIS received CE Mark certification to market its iUni G2 patient-specific knee replacement system in Europe. The iUni G2 is the only patient-specific unicompartmental knee resurfacing implant currently on the market. www.conformis.com
10. CONMED Corp. (Utica, N.Y.). About 60 percent of CONMED's revenues come from arthroscopy and powered surgical instruments for orthopedic surgery. Its arthroscopic products include reconstruction tools, scopes, implants, and fluid management systems. Brands include Linvatec and Hall Surgical. In Nov. 2009, its Linvatec arthroscopy unit released the Bullseye Anatomic Cruciate Reconstruction System, designed to precisely perform anatomic single bundle and double bundle cruciate reconstructions with a flexible and intuitive guide system. At the time, it also launched an expanded range of smaller sizes of Matryx Biocomposite interference screws for fixation of graft bundles. www.conmed.com
11. Corin (Cirencester, U.K.). Corin makes reconstructive orthopedic devices used in joint replacement procedures. In addition to replacement ankles, hips, knees and spinal implants, it is developing computerized surgical systems for joint replacements and other procedures. Products include the Trinity advanced bearing acetabular system, the MiniHip, the Cormet advanced hip resurfacing system, Metafix, the Uniglide triple radius unicompartmental knee system, the Rotaglide total knee replacement, LARS, the Zenith total ankle replacement and Hip Fracture Management Solutions. Corin was founded in 1985 and went public in 2002. www.coringroup.com
12. Covidien (Loughlinstown, Ireland). In addition to producing many medical products not related to orthopedics or spine, the company makes DuraSeal Spine Sealant to stop cerebral spinal fluid leaks after surgery. DuraSeal was launched in Nov. 2009 and it won first place in the for biomaterials category for Best New Technology for 2009 hosted by Orthopedics This Week. The company separated from Tyco International and changed its name from Tyco Healthcare to Covidien, a $10 billion company. www.covidien.com
13. DFine (San Jose, Calif.). DFine's RF Kyphoplasty procedure with the StabiliT Vertebral Augmentation System, introduced in October 2008, uses site-specific cavity creation, controlled cement delivery and ultra-high viscosity bone cement. Radiofrequency energy is applied to energy-responsive bone cement to create an ultra-high viscosity cement, delivered into a cavity within the vertebra using a remote hand switch that limits the surgeon's exposure to radiation. Two recent studies in Germany showed radiofrequency kyphoplasty with StabiliT for vertebral compression fractures resulted in less cement leakage in patients than traditional vertebroplasty. www.dfineinc.com
14. DePuy (Warsaw, Ind.). DePuy, a division of Johnson & Johnson, includes DePuy Orthopaedics, DePuy Spine and DePuy Mitek. Its products are used for reconstructing damaged or diseased joints, caring for traumatic skeletal injuries, treating spinal disorders and deformity, and repairing injured soft tissue. DePuy's Confidence System, launched in 2008, provides directional high viscosity cement placement and allows for a longer working time than other systems. In May, DePuy launched two products. The Expedium Vertebral Body Derotation Set is for spinal alignment in patients with scoliosis. The Bristow-Latarjet Instability Shoulder System is an instrument set for open and arthroscopic Latarjet or Bristow procedures. www.depuy.com
15. Geistlich Surgery (Root Längenbold, Switzerland). Geistlich Surgery, a unit of Geistlich Pharma, sells products for cartilage regeneration, including natural matrix structures for long-term osteogenesis in orthopedic and trauma surgery and to treat spinal damage. It also makes natural biomaterials for sports medicine and orthopedics and provides therapy concepts for biological cartilage substitute solutions. Orthoss is a bone substitute made from the mineral part of bovine bone. It is structurally integrated into the surrounding bone and incorporated into the physiological remodeling process. www.geistlich.com
16. Eminent Spine (Georgetown, Texas). The company's motto is "Bad to the Bone." Co-founded in 2008 by Steve Courtney, MD, a Texas orthopedic spine surgeon, and David Freehill, an expert in manufacturing and product design, Eminent Spine makes bio-mechanically sound spinal implants. In 2009, it received FDA clearance for a full line of PEEK spacers and for its Fang anterior lumbar buttress plate. Market clearance for the Diamondback Pedicle Screw System with Boa Constrictor Crosslink and the King Cobra Anterior Cervical Plate is anticipated this year. www.eminentspine.com
17. Exactech (Gainesville, Fla.). Founded in 1985 by an orthopedic surgeon and a biomedical engineer, Exactech wants to make every day "a great day in the OR." Exactech provides orthopedic implant devices, related surgical instruments and biologic materials and services to hospitals and physicians. The company markets its products in more than 30 markets in Europe, Latin America, Asia and the Pacific. In May, it acquired Brighton Partners, the sole-source supplier of the direct compression molded polyethylene bearings used in Exactech's Optetrak knee replacement system. In Oct. 2009, the company reported total revenue for the third quarter increased 12 percent over the same period the year before. It reported a 24 percent gain for hip implants, a 4 percent gain for knee implants and 7 percent gain for biologic and spine. www.exac.com
18. Implants International (Cleveland, U.K.). The company sells products for arthroplasty, trauma and spinal implant sectors. Its orthopedic products include Spinal Plif/Alif Cages and End Plates, the CP Titanium-CSLP Plate System, Ultra Low Profile ACP Systems with Dual-Lok Screws, the Secure S3 System, metal-on-metal ACD systems, metal-on-metal posterior approach lumbar systems. Its manufacturing process uses 3-D computer-aided design, computer-aided manufacturing, backed up by a range of computer numerical control manufacturing machines. Inspection is controlled via a ZEISS CNC co-ordinate measuring machine and other non-contact optical devices, housed in a temperature and humidity controlled environment. www.implantsinternational.com
19. K2M (Leesburg, Va.). K2M makes spinal stabilization and minimally invasive systems for treatment of complex spinal pathologies and procedures. Products involve motion preservation, annular repair, and nucleus replacement. John Kostuik, MD, its chairman and co-founder, is former chief of spine surgery at Johns Hopkins University School of Medicine. The company is beginning to market its products in Germany, the UK and Japan. Its Serengeti minimally invasive retractor system earned a Medical Design Excellence Award in 2010. In Nov. 2009, K2M launched the Terra Nova Minimally Invasive Access System and the Serengeti Disposable Kit. Terra Nova, which involves a small incision and uses a muscle-splitting technique, is used in conjunction with Serengeti, which features a flexible polymer retractor for screw-based retraction. www.k2m.com
20. Kinamed (Camarillo, Calif.). Established in 1987, Kinamed sells implantables and instruments for orthopedics and neurosurgery. With about half of its sales abroad now, Kinamed has been seeing double-digit growth for the past three years. Several products are FDA-approved and the Gem total knee system is approved for investigational use. Kinamed makes the CarboJet carbon dioxide lavage system for cleaning and preparing bone surfaces; the SuperCable Iso-Elastic Cerclage system, a polymer-based cerclage system; and the KineMatch Patello-Femoral Replacement, a unicompartmental joint replacement for patients with isolated, end-stage patello-femoral disease. www.kinamed.com
21. Lanx (Broomfield, Colo.). Founded in 2003 and led by medical professionals and engineers, Lanx's devices and systems are used for anterior cervical discectomy fusion, anterior lumbar interbody fusion, deformity correction of the thoracolumbar spine, lumbar fracture fixation, lumbar fusion, posterior cervical fusion, posterior lumbar interbody fusion, posterolateral fusion, thoracic fracture fixation and transforaminal lumbar interbody fusion. Its Silverton Spinal Fixation System is for use in the thoracolumbar spine region. Other products include the Fortis Allograft Interbody Spacers, Silverton-D Deformity System, and the Snowcap Anterior Cervical Plate. Lanx had backing from several institutional investors, including Chicago Growth Partners, Goldman Sachs Private Equity Opportunities Fund, Noro-Moseley Partners and Oakwood Medical Investors. www.lanx.com
22. Medtronic (Minneapolis). Medtronic controls more than half of the spine market, but the market is growing rapidly and future control is very much in flux, orthopedic surgeon John Cherf, MD, told Becker's Orthopedic & Spine Review last year. Medtronic's Spinal and Biologics business collaborates with surgeons and researchers to treat neurological, orthopedic and spinal conditions. Products include bone grafts, minimal-access spinal technologies and image-guided surgical navigation procedures. In 2007, it launched the CD Horizon Legacy Anterior Spinal System. In 2008, it acquired Restore Medical, which makes devices to treat sleep-disordered breathing. Its balloon kyphoplasty system leads the market for compression fracture treatment. In Dec. 2009, Medtronic launched the Sovereign Spinal System, an intervertebral body fusion device. www.medtronic.com
23. NuOrtho Surgical (Fall River, Mass.). Founded in Sept. 2008, NuOrtho is an early-stage medical device company, focusing on treating damaged tissue and preserving healthy tissue. NuOrtho has three main product platforms: soft tissue treatment, agent delivery and bone fusion. Its first product launch will be Ceruleau, a technology for knee cartilage that is a surgical probe designed to preserve joint cartilage during surgical treatment for articular knee cartilage. The company's nine patents involve tissue preservation. www.nuorthosurgical.com
24. NuVasive (San Diego). NuVasive's products cover spine surgery procedures, implants and instruments. Its principal product, the Maximum Access Surgery platform, involves a lateral approach, eXtreme Lateral Interbody Fusion, which spreads the psoas muscle instead of cutting it. The MAS platform uses a software algorithm enabling the surgeon to see the nerve's location in real time. After going public in 2009, NuVasive's total revenue rose 48 percent from 2008 and it is projecting annual sales of $500 million for 2010. In March, UnitedHealthcare and Aetna began to cover Xtreme, which they had previously classified as unproven technology. The company is developing the MAS-TLIF system, allowing surgeons to compress and distract bones of the spine through a 1.25-inch incision. In Oct. 2009, the company posted third-quarter sales of $94.9 million, up 41.8 percent from the same period the year before. www.nuvasive.com
25. OMNIlife Science (East Taunton, Mass.). Founded in 1999, this orthopedic device company offers modular hip stem technology and total knee replacement systems. It sells the Apex Modular Hip System, the Apex K1 Hip System, the Apex K2 Modular Hip System and the Apex Knee Reconstruction System. In June, Orthopaedic Synergy, the holding company for OMNIlife Science, completed its acquisition of Praxim, a French company that develops automated systems, software and instruments for total joint arthroplasty. OMNIlife Science plans to extend its hip and knee product offerings and introduce of new products to complement its current product portfolio. www.omnils.com
26. Orthalign (Aliso Viejo, Calif.). OrthAlign makes surgical navigation products for precise alignment. Its palm-sized KneeAlign system addresses tibial alignment in total knee arthroplasty. It is a disposable unit for one-time use at significantly lower cost than large console CAS and does not require a CT Scan, MRI or additional x-rays. In March, OrthAlign received market clearance from the FDA for the latest version of KneeAlign. www.orth-align.com
27. Orthofix (McKinney, Texas). The company's product offerings include internal systems to lengthen bone, plating systems to reconstruct a deformity, soft tissue management for rehabilitation and cold therapy for post-surgical pain management. In June, Orthofix's Breg sports medicine division won the 2010 CIO 100 award for its Vision Advanced Inventory Management software, which automates management of in-house inventories of orthopedic bracing and other products. In May, the company launched three sports medicine products: a lateral stabilizer with hinge, the Polar Care Kodiak Intelli-Flo Hip Pad and a neutral hand accessory. The company collaborates on R&D with the Musculoskeletal Transplant Foundation, the Orthopedic Research and Education Foundation, the University of Medicine and Dentistry of New Jersey and the National Osteoporosis Institute. www.orthofix.com
28. OrthoPro (Salt Lake City). Since 2003, OrthoPro has released several surgical foot and ankle products for podiatrists and orthopedic surgeons. Its first product was the Subtalar Spacer, a minimally invasive approach for flexible flatfoot deformity. It also makes the Cannulated Screw System for use in midfoot and forefoot surgeries, the Mini-Rail External Fixation Device and the Hemiarthroplasty Implant. Its Total Compression Plate System, released in 2010, has a variety of plate sizes and configurations. www.orthoprollc.com
29. Osseon Therapeutics (Santa Rosa, Calif.). This $14 million start-up company was launched by the University of Northern California. Osseon focuses on bone cement delivery devices and bone cement composite for treating symptomatic compression fractures of the vertebral spine. Its Osseoplasty 1.0, launched in Dec. 2008, features a curved delivery system that enables the physician to channel through the vertebral body, creating a void to house the injected bone cement. www.osseon.com
30. Pioneer Surgical Technology (Marquette, Mich.). The company's first product, the Songer Spinal Cable System, introduced in 1992, was designed to be superior to wire in ease of use, flexibility and strength. This surgeon-driven company in Michigan's isolated Upper Peninsula has expanded into orthobiologics and has exhanced its spinal implant offerings. Products include the Quantum Spinal Rodding System and nanOss Bioactive. During 2006, the company signed a distribution agreement with Regeneration Technologies and acquired Encelle, renamed Pioneer Surgical Orthobiologics, maker of E-Matrix, a sterile, injectable biopolymer for the repair of diseased or damaged tissue. www.pioneersurgical.com
31. RTI Biologics (Alacua, Fla.). RTI Biologics, formed by the 2008 merger of Regeneration Technologies and Tutogen Medical, provides allograft and xenograft implants for orthopedic and other specialty surgeries. In early 2010, the company launched one spinal implant and three implants for bone graft substitutes and general orthopedics. RTI makes BioSet demineralized bone matrix. In Oct. 2009, the company posted record revenues of $42.8 million for the third quarter, an 11 percent increase over the same period the year before. In the first quarter of 2010 revenues were up 2 percent over the prior-year period. www.rtix.com
32. SI-Bone (Cupertino, Calif.). This company has been pioneering the use of a minimally invasive surgical device to treat the sacroiliac joint. Its iFuse Implant System allows for a less invasive approach than an open surgical procedure. This simpler approach reduces OR time to less than one hour, produces fewer complications and provides a stronger construct than other sacroiliac joint fixation systems. SI-Bone has been working with several well-known spine surgeons with experience in low back pathologies. In February, the company launched a smaller, 4.0 mm size of its iFuse Implant System. www.si-bone.com
33. Siemens Medical Solutions (Malvern, Pa.). Siemens Medical Solutions provides imaging modalities for orthopedic surgery and neurosurgery. Products include flexible mobile C-arms, navigation, surgery tables and ultrasound. The company is part of Siemens Healthcare, which provides medical imaging, laboratory diagnostics, medical information technology and hearing aids. www.medical.siemens.com
34. Small Bone Innovations (Morrisville, Pa.). Formed in 2004, Small Bone Innovations has been acquiring companies in the small bone and joint market. Its product portfolio includes more than 40 devices and instruments in arthroplasty, fixation, trauma and biologic solutions. The company has acquired Avanta, which specializes in hand, wrist and elbow arthroplasty and trauma products; Fixano, specializing in hand, wrist, elbow and shoulder arthroplasty and trauma products; Envision, an implant manufacturer; Actipore, a porous metal technology company; Artelon, involved in biologically active and biodegradable technology; and Xtremi-T, which focuses on resorbable trauma technology. www.totalsmallbone.com
35. Smith & Nephew (Memphis, Tenn.). The Smith & Nephew Orthopaedics division makes Oxinium Genesis II and Profix Knee Systems, TriGen Intramedullary Nails, Synergy and Echelon hip operation systems, and the Exogen Ultrasound Bone Healing System. Recent launches include Oxinium material for hip and knee implants, the Birmingham Hip, BHR Resurfacing and the Journey Deuce knee. Other products include the Emperion Modular Hip System, the Legion Revision Knee System and Synergy Primary Hip Systems. Smith & Nephew research focuses on bioresorbable polymers, tissue and cell engineering and non-invasive stimulation. In May, the company reported first quarter revenues were up 9 percent from the same period the year before. www.smith-nephew.com
36. Spinal Motion (Mountain View, Calif.). Founded in 2004, Spinal Motion makes artificial discs for use in the spine. The company has applied for premarket approval of its Kineflex Disc, for lumbar cases, and its Kineflex C Disc, total disc replacements for cervical cases that preserve motion. These are weight-bearing, modular implants consist of two keeled endplates and one semi-constrained, fully articulating cobalt chrome core. In Nov. 2009, Spinal Motion announced it had secured $27.4 million in Series D funding and reached 20 percent enrollment for a laterally placed lumbar artificial disc clinical study. www.spinal-motion.com
37. Spine Surgical Innovation (South Easton, Mass.). SSI designs and markets the Holmed Swivel Port System, which is intended for posterior or lateral lumbar surgery. The SSI product line is categorized into three key sections: lumbar, cervical and instruments. SSI's products include a line of dilator products, swivel tip rod forcepts and nerve hook retractors and bayonets. www.spinesurgicalinnovation.com
38. Stryker Corp. (Kalamazoo, Mich.). Stryker is a seasoned player covering all key applications, from hip, knee and upper extremity to spinal implants. Products include artificial joints, spinal rods and screws, artificial vertebral discs and bone cement. Its OP-1 is a biological product to grow bone. Stryker also makes video-assisted surgical systems for minimally invasive surgery. In April, the company announced it had made its one-millionth Exeter hip stem, developed by an orthopedic surgeon and an engineer 40 years ago to control aseptic loosening. In April, the company launched the iVAS inflatable vertebral augmentation system for vertebral compression fractures. In February, it released the Rejuvenate Modular Primary Hip System, designed to closely match the hip biomechanics of the patient. www.stryker.com
39. Tornier (Edina, Minn.). Tornier makes orthopedic devices such as the Aequalis line of shoulder arthroplasty prostheses and the Salto and Salto Talaris total ankle prostheses. It offers a portfolio of foot and hand products including the NexFix system for reconstructive foot surgery, the CoverLoc system for wrist fracture repair, the Piton shoulder anchor system and ArthroTunneler system for rotator cuff repair, and the Conexa tissue matrix for tendon and ligament repair. Tornier has collaborations with BioSurface Engineering Technologies, Bioretec and Tepha Medical Devices, providing access to non-metal technologies for unmet soft and hard tissue repair. In June, the company filed for a $205 million IPO. www.tornier-us.com
40. VertiFlex (San Clemente, Calif.). The company makes minimally invasive and motion-preserving spinal surgery technologies. Its Dynabolt Dynamic Stabilization System is a pedicle screw-based system to allow a full range of motion. The Superion Interspinous Spacer, still under clinical investigation, is for patients with moderate lumbar spinal stenosis. The Silverbolt MIS Screw System, introduced in 2007, serves as a surgery platform by supporting a mini-open approach through VertiFlex's Oracle Expandable Retractor. The Silverbolt MLR System percutaneously delivers two rods into a single screw for multilevel stabilization applications. The Octane Spinal Implant System uses an implant made from PEEK Optima and has radiographic markers to ensure accurate placement. The Mainframe Screw System is the foundation for the company's posterior spinal fixation systems. www.vertiflex.net
41. Wright Medical Technology (Arlington, Tenn.). Wright Medical Group makes surgical solutions for the foot and ankle market as well as hip and knee repair and reconstruction. The company recently launched the Xpansion Micrografting System for split-thickness skin grafting and Valor Hindfoot Fusion Nail for the treatment of skeletal deformity, late-stage arthritis or complications from diabetes. Other Wright products are the Charlotte family of reconstructive implants, Darco locked plating systems, Ortholoc polyaxial locking systems, the Bioarch subtalar implant, Side-Kick External Fixators, Cancello-Pure and Biofoam osteotomy wedge systems, Dart-Fire small screw systems, Graftjacket regenerative tissue matrix, and the Inbone total ankle replacement. www.wmt.com
42. Zimmer Holdings (Warsaw, Ind.). Globally, Zimmer controls 27 percent of the market for artificial knees, 21 percent of the market for artificial hips, 13 percent of the market for extremities, 5 percent of the market for trauma products and 3 percent of the market for spine. It makes the NexGen knee System, the bone-conserving Fitmore Stem, the Zimmer M/L Taper Hip Prosthesis with Kinectiv Modular Neck technology, the Zimmer Trabecular Metal Glenoid and the Zimmer Natural Nail System. In 2008, the company acquired Abbott Spine, maker of spine implants. In March, Zimmer launched a line of Zimmer Patient Specific Instruments, which use MRI technology and pre-operative planning tools to create customized cutting guides tailored to each patient's own anatomy. www.zimmer.com