The U.S. bracing and supports market includes knee bracing and supports, ankle bracing and supports, spinal orthotic devices, back soft goods, upper extremity bracing, soft goods, and pain management products such as cold therapy and pain infusion pumps. These markets are expected to experience slow to moderate growth as a result of an aging U.S. population, increasing prevalence of obesity and osteoarthritis, and the increasing use of braces in the prevention of sporting injuries. The spinal orthotic devices segment is growing at a particularly fast rate due to the strong correlation between an aging population and the incidence of lower back problems requiring support devices. The pain management market is also expected to grow quickly, in large part due to the increase in cold therapy sales. Some contributors to the increase in cold therapy sales include the fact that cold therapy aid in the compliance for braces, as well as high average selling prices with low reimbursement rates.

 

Braces and supports play an important adjunctive role for many knee patients, despite effective treatment via drug therapy or surgery. Changes in average selling prices (ASP) and the competitive landscape of this market have lead to growth in several different U.S. market segments including the bracing and support markets for knees and ankles. Other initiatives that have also altered the market include cost containment efforts put forward by the U.S. healthcare system and the increasing popularity of high tech or multiuse braces due to factors such as the aging population.

The ankle bracing and supports market includes rigid ankle braces such as ankle stirrups and trainer braces; and ankle supports including semirigid supports, lace-ups, and elastic and neoprene supports. Growth will be driven by the increasing use of ankle braces for prophylaxis to treat injuries and for postoperative support. The increasing prevalence of sports injuries and obesity will have a positive effect on this market.

 

Prices are declining in all ankle support markets, as well as in the rigid stirrup market. Most competitors in this specific segment price their products lower than DJO’s well-known premium devices in order to compete effectively. As sales of these competing products grow, the total ASP is expected to decline. Prices are also expected to decrease as healthcare facilities seek less-expensive stirrups with all the same benefits of existing designs as a result of increasing cost constraints.   

Unit sales of spinal orthotic devices are increasing as a result of an aging population, a corresponding growth in the number of spinal surgeries and rising interest in conservative treatment options. This market includes cervical, thoracolumbosacral (TLSO), lumbosacral (LSO), lumbar (LO) and sacral (SO) orthoses in both prefabricated and custom formats. The number of spinal surgeries performed each year is also increasing as a result of technological advancements, including major improvements of minimally invasive surgical techniques. The total spinal orthotic devices market is expected to grow at a compound annual growth rate of more than 6% through 2018. However, the demand for custom devices is growing at a slower pace due to higher prices—prices that are prohibitive for many patients.

The pain management market consists of cold therapy devices and infusion pumps. The aging population wants a greater degree of main control, and this demand is contributing to the market’s rapid growth. In 2011, the largest segment of the pain infusion pump market was the single-use ambulatory pump segment, which represented more than 68% of the total market. Market growth will be driven by increased ASPs and unit sales in the ambulatory infusion pump segments due to new technological innovations that increase medication safety, such as the development of single-use devices which are ideal for administering single or combination drugs in alternate and home care settings where the purchase of larger and more expensive infusion pumps may not be an economical choice.

 

Unit sales of traditional cold therapy devices also grew last year, while sales of powered devices increased significantly. Growth will be driven by the increased use of both traditional and powered cold therapy units as a result of improved patient compliance when the products are prescribed as an adjunct therapy to orthopaedic bracing, as well as for postoperative and post-injury pain relief.

 

Both segments are expected to experience growth over the forecast period. The powered cold therapy market is anticipated to grow faster than the traditional market because of the convenience and ease of use of powered devices. 

In 2011, DJO was the leading competitor in the U.S. bracing and supports market and was a dominant player in every major segment analyzed within a report by iData Research (Vancouver). DJO offers knee bracing solutions under the Aircast, DonJoy, and ProCare lines, and cold therapy solutions under the Aircast, DonJoy, and Chattanooga lines. Other notable competitors include Aspen, the market leader in the spinal orthotic devices segment, and Ergodyne, the largest competitor in the occupational bracing segment. The dramatic effect of the company’s Aspen cervical collars on patient care is well documented. From 1999 to 2011, Aspen has expanded into the thoracolumbar and sacral spine markets, bringing more than a dozen products to market.

The U.S. orthopaedic bracing and support market will experience change in the next few years with respect to evolving demand and innovation in many different market segments. The knee bracing and supports segmentis expected to play a large role in the market until there is a shift towards spinal orthotics and cold therapy devices in the overall growth of the market. The pain management market is also anticipated to grow at an accelerated rate, offering another opportunity for advancement of the orthopaedic bracing and support market in the United States.