In a daily letter from Canaccord Genuity this week, analysts were positive about the gradual improvement of business in orthopaedics but said that it would never be the same. “The days of lavish spending on surgeons and consulting agreements are a thing of the past, while struggling procedure volume growth combined with steady price degradation is the sign of the times,” analysts wrote. They noted that business should get better with the economy—but the question is when. “We expect medtech investors to play the waiting game for many of these stocks until consistent growth and subsequent leverage opportunity returns.”

The latest confusion surrounds joint reconstruction volumes, which analysts called “an enigma wrapped in a mystery wrapped in a puzzle.” Most recently, Biomet saw its sales fall in Q4 2011, right on the heels of the previous quarter’s flat U.S. sales. And the fallout from metal-on-metal hips has yet to be fully realized.

However, it’s not all bad news. Robotics manufacturer Mako Surgical and China-based Kanghui Medical could experience better-than-expected results. More on them later. --Maria Fontanazza