Let’s explore the dominant forces shaping the future of knee implants and how they impact manufacturing strategies.
Dominant Market Forces for Knee Implants
Patient Expectations
The patient demographic for knee replacements is changing. The typical knee replacement recipient is no longer just the advanced-age, low-demand patient. Today’s patients are younger, more active and better informed compared to 10 years ago. Because of this, they seek out options that will result in a better procedure experience, minimize surgical complication and deliver a longer-lasting prosthesis to maintain their active lifestyles.
The Shift to ASCs
More and more knee replacement procedures are moving to the ASC environment, which is driving the need for cost effective and innovative options.
Robotics
OEMs are no longer just selling total knee constructs—they are selling complete knee platforms, and the integration of robotics has become a critical driver of this strategy. Robotic platforms like Stryker’s Mako, J&J’s Velys and Zimmer Biomet’s Rosa are shaping how surgeons approach knee replacements. It’s not just about the implant anymore; it’s about the technology ecosystem that surrounds it.
Cementless Implants
ASCs and robotics are also driving the adoption rates of cementless knee implants. While cementless is the standard for primary hip implants, only about 20% of primary knee replacements are cementless, and the adoption rate is growing rapidly—some OEMs predict cementless options could represent 50% of their knee implant sales within a few years.
To compete in the market, having a cementless knee option is becoming more of a necessity for OEMs.
Alternatives to CoCr
We’re seeing a strong push toward alternatives to cobalt chrome for patients with metal sensitivities. Titanium more bio-compatible than CoCr, and is emerging as the primary solution, but it introduces its own challenges—such as the need for improved bearing surfaces. Legacy technologies like titanium nitride coatings and other surface-hardening innovations are addressing these issues while companies are searching for new and more promising solutions to extend wear-properties and implant life.
Orchid has developed our own solution to the bearing surface challenges of titanium knee implants. Our ALTITUDE® ceramic coating provides a thick, wear-resistant surface that outperforms anything currently on the market.
Solutions for Osseointegration
Cementless implant adoption aligns with Orchid’s expertise in advanced bone in-growth surfaces and manufacturing technologies. Our manufacturing strategies are designed to provide our customers with diverse, high-performing options for osseointegration.
Traditionally, we’ve offered sintered coatings—both spherical and asymmetrical—because they provide excellent bone in-growth properties. We also provide thick titanium plasma spray (TPS) coatings for our customers interested in on-growth properties. These cementless surfaces we have developed have evolved based on years of clinical success and have been adopted by many OEMs.
And now, we’ve leveraged 3D printing to develop customizable lattice structures with exceptional porosity and strength.
These structures not only mimic market-leading bone in-growth surfaces but also allow us to collaborate closely with OEMs to tailor the design and material properties to their exact needs. It’s a blend of innovation and collaboration.
Our approach to osseointegration combines tradition and innovation to meet diverse OEM needs.
- Sintered Coatings: These coatings—both spherical and asymmetrical—have long been a gold standard for bone in-growth, offering exceptional performance backed by years of clinical success.
- Thick TPS Coatings: For OEMs prioritizing on-growth properties, our TPS coatings deliver excellent outcomes.
- 3D-Printed Lattice Structures: Leveraging additive manufacturing, we’ve developed customizable, porous structures that mimic market-leading designs. These innovations allow us to collaborate with OEMs to tailor material properties and designs, ensuring optimal performance.
Advancing Manufacturing for Cementless Implants
As a contract manufacturer, OEMs are looking to us to help them reduce costs in their supply chain while they add new products to their portfolios. If 3D printing is supported through a robust and well-planned infrastructure, it is a great option to reduce costs. Traditional manufacturing involves separate steps: forming (often via casting), applying a bone in-growth coating, and finishing. 3D printing combines the forming and bone in-growth surface creation into a single step, streamlining the process and reducing costs.
While many companies use 3D printing to produce smaller volumes or patient-matched implants, we’ve built our platform to produce tibial baseplates and femoral components efficiently at industrial scales, including machining and finishing operations. This allows us to meet the growing demand for cementless implants in a cost-effective and scalable way.
Cementless titanium knee implants are clearly the way of the future, and we believe that 3D printing is the most economical and scalable way of delivering the next generation of knee implants.
Global Strategies for the Future
OEMs should also be considering which options help their ability to play in global markets in the future. How can they ensure global supply and compliance to different government regulations across the globe? For example, European government initiatives require that OEMs outline strategies to minimize their carbon footprint – will their supply chains for new knee products create limitations or opportunities when selling into these markets? This is another case for simplification and minimal footprint, which 3D printing lends itself well to.
A New Era for Knee Implants
The shift toward cementless titanium knee implants is one of the most exciting changes the industry has seen in years.
This isn’t just a technological upgrade—it’s a patient-centered evolution. Cementless options are particularly impactful for metal-sensitive, and younger and high-demand patients, offering solutions that could last a lifetime.
At the same time, cemented options will remain relevant for certain cases, so OEMs will need to balance both offerings in their portfolios.
What’s fascinating is how this trend is forcing the industry to innovate, and now they can leverage new manufacturing technologies to improve osseointegration, enable the use of more biocompatible materials, and strengthen their global market position.