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ORTHOWORLD® estimates that orthopedic market sales will grow 4.3% in 2025 to a worldwide total of $64.6 billion. Many of the companies that impacted the market’s growth remain on our must-watch list as we turn the page to 2026 and look forward to tracking the progress of the industry’s most intriguing players.
Maxx Orthopedics
Maxx Orthopedics continues to build momentum through a steady stream of product launches and collaboration with THINK Surgical.
In 2025, the company received FDA 510(k) clearance for the Libertas Bipolar Hip System, further expanding its Libertas Hip Portfolio which now includes tapered, mini-tapered, coated, collared, non-collared, and cemented stems.
The company also received FDA clearance for the asymmetrical Porous Tibial Baseplate for the Freedom Total Knee. With the introduction of the 3D-printed baseplate, the Freedom Total Knee System now offers a cementless tibiofemoral solution.
In April, THINK Surgical completed the first clinical use of the Freedom Total Knee implant with the TMINI Miniature Robotic System. FDA clearance now allows both the Freedom Total and Titan Knee systems to be used with TMINI, positioning Maxx as a player in the robotic knee replacement segment.
Maxx is also addressing O.R. efficiency with its QRS instrumentation system, which significantly reduces tray count for total knee arthroplasty as hospitals and ASCs prioritize streamlined solutions that improve surgical workflows and reduce instrument reprocessing burdens.
The company also performed the first surgery with its PEEK-OPTIMA femoral component as part of its FDA Investigational Device Exemption clinical study. Maxx’s recent pace of innovation suggests that the company is far from done heading into 2026.
Shoulder Innovations
Shoulder Innovations is emerging as one of the most interesting growth stories in the upper extremity space. The newly-public company expects full-year revenue of $45 to $46 million, representing growth of more than 30%.
A key differentiator for the company is its focus on developing solutions that promote efficiency in the ASC setting.
CEO Rob Ball has made streamlined instrumentation a core strategic pillar, with the goal of enabling total and reverse shoulder procedures using just two instrument trays. For ASCs constrained by reprocessing capacity, that reduction can mean the difference between performing one procedure per day and completing several.
Shoulder Innovations is also pushing into robotics. The company announced a partnership with Interventional Systems to develop a portable, shoulder-specific micro-robotic solution that’s designed to integrate with its ProVoyance platform.
The unit is intended to be mobile, cost-efficient and well-suited to ASC environments, addressing many of the barriers that have slowed robotic adoption in shoulder replacement surgery.
In November, Shoulder Innovations announced the full commercial launch of the InSet 70 for the I-Series humeral stem product line. With continued product line expansion, the company is positioned to capitalize on the growing shoulder replacement and ASC markets.
Medacta
Medacta is quietly becoming one of the strongest mid-tier companies in orthopedics. The company is on track to exceed $800 million in revenue in 2025, supported by a compound annual growth rate of roughly 14% since 2017.
Its success has been driven by an integrated digital ecosystem that combines implant designs with enabling technologies. In hips, Medacta’s anterior approach has complemented its kinematic alignment strategy in knees, particularly in the U.S., where service-driven selling encourages surgeons to standardize across joints.
Platforms such as NextAR and MySpine have differentiated the company from mid-tier competitors while accelerating growth in shoulder and spine at rates well above market averages.
Looking ahead, sports medicine may be Medacta’s next fuel for significant growth. The acquisition of Parcus Medical expands the company’s sports medicine coverage and provides a proven innovation engine in the segment to expand access to ASCs.
Medacta’s expansion in the ASC market is expected to create a pull-through effect across its joint replacement portfolio, especially in the U.S.
VB Spine
A year ago, Stryker announced the divestiture of its U.S. spinal implants business to Viscogliosi Brothers. The deal created VB Spine, a privately-held company that entered play at the top of the spine market.
The agreement also included a binding offer to acquire Stryker’s spine implant business in France, with additional international markets expected to transition over time. That strategy moved forward this month with VB Spine’s acquisition of Stryker’s spine implant manufacturing facility in Cestas, France.
VB Spine’s implants will be exclusively compatible with Stryker’s Mako Spine robot and Copilot technologies, creating a separation between implant manufacturing and robotic platforms. Whether this hybrid model can rival the fully integrated strategies favored by most large OEMs will be one of the most closely-watched experiments in spine over the next several years.
Led by industry veterans with deep commercial relationships, VB Spine is positioned as a surgeon-focused organization with the scale to compete immediately in the spine market in which digital ecosystems, not implant-only business models, are key to competing among the biggest players.
It will be interesting to see how the company’s first full year of existence plays out.
Orthofix
Orthofix continues to execute a multi-pronged strategy across spine, trauma and bone growth therapies. Â Orthofix reported that throughout 2025, its U.S. spine performance was strengthened by continued adoption of 7D FLASH navigation.
The company is preparing for the full launch of its VIRATA Spinal Fixation System in the second half of 2026. VIRATA integrates with the 7D FLASH navigation and is expected to drive further market share gains with proprietary screws and instruments.
Orthofix’s trauma business is also evolving. The company has shifted focus to the U.S. market where it has achieved five consecutive quarters of double-digit growth. Bone growth therapies continue to benefit from cross-selling and access to multiple call points.
With guidance centered around $812 million in 2025 revenue, Orthofix appears well positioned to soon enter the $1 billion tier of orthopedic companies.
Anika Therapeutics
Anika Therapeutics enters 2026 at an inflection point. Its HYALOFAST scaffold — a resorbable, hyaluronic acid-based regenerative implant that’s designed to treat focal cartilage defects — has been commercially available internationally for over a decade. In the U.S., however, HYALOFAST faces a higher regulatory bar as a device/biologic combination product that requires premarket approval (PMA).
Although Anika’s 200-patient pivotal study failed to meet its co-primary endpoints versus microfracture at two years, the company remains confident in the broader clinical and real-world data package. Anika submitted the final PMA module in November 2025 and expects regulatory clarity later this year, a decision that will significantly impact its cartilage repair strategy in the U.S.
The company also announced a leadership transition this month, with Steve Griffin set to assume the role of President and CEO. He’ll replace Cheryl Blanchard, who moves to Executive Chair. How Anika navigates the regulatory uncertainty and leadership change will be closely watched.
ATEC
ATEC’s rise has been one of the most impressive success stories in spine. Since beginning its turnaround in 2018, the company has delivered an eight-year CAGR of 32%. In 3Q25 alone, ATEC reported that it grew its surgeon base by 26%, a rate that has significantly outpaced its competitors.
ATEC is expanding in the lateral, cervical and deformity spine markets while building a technology ecosystem that includes navigation and the expected launch of the Valence robotic system.
With raised guidance of $760 million in revenues for 2025 and a clear path toward $1 billion by 2027, ATEC is positioning itself as the largest pure-play spine company in the industry.
Advita Ortho
Advita Ortho officially launched as a global company following Exactech’s asset sale late last year, bringing with it a broad portfolio that includes shoulder, hip, knee and ankle systems, as well as joint balancing and navigation technologies.
Under CEO Aurelio Sahagun, Advita inherits plenty of product development experience and ownership of key product data, engineering expertise and manufacturing capabilities.
The company plans to manufacture implants internally while building an integrated technology platform powered by data, AI and machine learning.
With established brands such as Equinoxe Shoulder, Alteon Hip, Truliant Knee and Active Intelligence surgical technologies, Advita enters the year with experienced leadership and an opportunity to innovate quickly.
Carlsmed
Carlsmed is emerging as a leader in personalized spine surgery. In 3Q25, the company nearly doubled revenue year-over-year, driven by increasing surgeon adoption of its aprevo personalized spine platform.
The commercial launch of aprevo Cervical in early 2026, supported by CMS NTAP reimbursement, significantly expands Carlsmed’s customer base. More than 370,000 cervical fusions are performed annually in the U.S., providing Carlsmed with a significant growth opportunity.
By combining personalized surgical planning with 3D-printed implants, Carlsmed aims to address misalignment concerns and reduce the need for revision surgery.
Carlsmed’s 2025 revenue guidance approached $50 million, representing growth between 80% and 84% from the previous year and making the company’s trajectory worth tracking in 2026.
restor3d
restor3d continues to advance personalized solutions across multiple joints. In 2025, the company completed its first clinical cases with the iTotal Identity CR 3DP Porous Cementless Total Knee, the only fully personalized and cementless knee system cleared by FDA.
The company’s priorities for 2026 include growth of its Veritas Reverse Total Shoulder, iTotal Identity 3DP Porous Cementless Total Knee, Kinos Modular Stem Total Ankle and Velora 3DP Porous Acetabular System.
Strategic investment from Partners Group, along with additional capital from existing investors, will help drive restor3d’s growth. With more than 520 surgeon partners across 740 hospitals and multiple new product launches planned this year, restor3d has positioned itself as a leader in scalable personalized surgery.
Did we miss any important or innovative companies that are worth monitoring in the months ahead? Please reach out to let us know or to share your thoughts on important industry trends that should be on our radar.
