Avascular necrosis (AVN), which is also known as osteonecrosis, is defined as bone tissue death due to lack of blood supply. AVN affects weight-bearing joints such as hip and knee. It is associated with the usage of high-dose steroid medications and intake of heavy alcohol, mostly seen in males between 30 and 50 years of age than females. The symptoms of AVN include minimal early joint pain, increased joint pain as bone and joint begin to collapse, and limited range of motion due to pain. AVN is diagnosed by X-ray, CT or CAT scan, MRI, radionuclide bone scan, biopsy, and functional evaluation of the bone.
Market Overview
The global AVN market is expected to grow from $1.6 billion in 2021 to $2.2 billion by 2028, at a compound annual growth rate (CAGR) of 5.7%. Moreover, the market size was valued at $652.73 million in 2023 and is expected to reach $1,001.08 million by 2030, at a CAGR of 6.3%. Based on types, the market is segmented into trauma-related AVN and non-trauma related AVN. Some of the key market players include Stryker, Medtronic, Smith and Nephew, Ethicon, Sanofi, Bayer, Pfizer, Merck, Boehringer Ingelheim, Eli Lilly, Aurobindo Pharma, Integra Life Sciences, Zimmer Biomet, Wright Medical, and Grifols.
Comparison between traditional treatments and PerFuse System
Following are the key points for the AVN incidences:
- Insights of awareness and diagnosis: Advancements in diagnostic tools used in imaging technologies such as MRI and CT scans allow for more accurate detection of AVN.
- Risk factors: The usage of corticosteroids for different medical conditions has increased, contributing significantly to AVN cases. Generally, long-term therapy is required for conditions such as autoimmune disorders and chronic inflammatory diseases. Increasing alcohol consumption, especially among the younger population, is linked to AVN, as it can corrupt blood flow and bone health.
- Obesity and idle lifestyle: Weight gain contributes to increased stress on weight-bearing joints, which can intensify AVN. Moreover, an idle lifestyle leads to decreased physical activity, which can affect bone health.
- Trauma and injury: Sportspersons with the incidence of traumatic injuries are prone to AVN. Fractures and dislocations are significant risk factors for developing the condition.
- Chronic conditions: Diabetes, lupus, and certain cancers increase the risk of AVN due to compromised blood supply. Moreover, the prevalence of these chronic conditions is rising, leading to an increase in AVN cases.
- Aging population: Elderly adults are more prone to conditions such as corticosteroid use, diabetes, alcohol abuse, autoimmune disease, and radiation therapy that can lead to AVN with osteoporosis and hip fractures.
Technological Advancements
- Imaging technologies help in early and accurate diagnosis of AVN. MRI with high resolutions can detect bone marrow edema and changes in bone structure before symptoms occur. 3D imaging techniques demonstrate detailed visualizations of bone structures, helping surgeons plan more precise interventions.
- Biologics and regenerative medicine: Stem cell therapy includes the use of stem cells to promote bone regeneration and is gaining traction. Stem cells can be harvested from a patient’s bone marrow or adipose tissue and injected into the affected area to enhance healing.
- Platelet-Rich Plasma (PRP): PRP therapy involves platelet concentration from a patient’s blood and injection into the affected area to stimulate healing and tissue regeneration.
- Invasive surgical techniques: Minimally invasive arthroscopic procedures allow surgeons to access the joint with smaller incisions, reducing recovery time and complications. Techniques such as core decompression are helpful for minimizing trauma to surrounding tissues.
- PerFuse system: This innovative system delivers growth factors and stem cells directly to the affected bone, improving blood flow and promoting healing. Its minimally invasive nature and targeted approach offer significant advantages over traditional treatments. Moreover, bone grafting techniques, along with the use of allografts and synthetic materials, are improving outcomes in patients with AVN. These grafts can help restore structural integrity and enhance healing.
- Advanced biomaterials: Biomaterials are being developed to support bone regeneration.
Advancements in Minimally Invasive Procedures for AVN
Minimally invasive procedures offer advantages, such as shorter recovery time over traditional surgical methods, for patients as well as healthcare providers. With smaller incisions and less disruption to surrounding tissues, minimally invasive procedures typically carry a lower risk of complications, such as infection or excessive bleeding. Patients who undergo minimally invasive procedures often report postoperative pain reduction compared to traditional surgeries, which can lead to lower reliance on pain medications and speedy recovery. Various minimally invasive procedures can be performed on an outpatient basis, reducing the need for staying in the hospital. Moreover, they include regenerative techniques such as stem cell therapy and PRP injections, which aim to promote natural healing and bone regeneration, addressing the root causes of AVN. Nowadays, most individuals prefer medical procedures that perform speedy recovery and less discomfort. Studies and clinical trials demonstrate that minimally invasive techniques can yield comparable or superior outcomes to traditional surgical methods, reinforcing their increasing acceptance among medical physicians. Robotic-assisted surgeries and advanced imaging systems have developed the feasibility and effectiveness of minimally invasive procedures.
AVN Market Overview and Market Dynamics
The market revenue is determined by the primary and secondary data collection methods. The bottom-up approach was used to estimate the AVN market size. The rise in the geriatric population, the increasing number of knee replacements and hip surgeries, the surging use of diagnostic centers for trauma-related cases, and new product launches by the key players are among the key factors propelling the growth of the AVN market. The prevalence of AVN is surging among the population due to the increasing consumption of alcohol and tobacco, the growing number of drug approvals from regulatory bodies, and the increasing risk of several chronic diseases, including arthritis, diabetes, and HIV. Road accidents, traumatic injuries, and increasing incidence of Legg-Calve-Perthes disease (LCPD) in children are boosting the growth of the AVN market. In road accidents, due to vehicle crashes, individuals face major problems such as broken bones, dislocated hips, and interrupted blood flow, which leads to AVN. Traumatic injuries are caused when the blood supply to the femoral head is stopped due to the dislocation and fracture of the femoral head. Trauma injuries such as fractures to the neck of the talus are common, and they happen due to vehicle collisions, falls, sports injuries, natural disasters, and other physical injuries. Additionally, in children, AVN occurs mainly from cancer therapy. The LCPD is an AVN of the proximal femoral head, and it commonly occurs in children aged 4–10 years. As a result, the growing number of road accidents and traumatic injuries is fueling the growth of the AVN market. All the advanced techniques for the treatment of AVN are expected to influence the growth of the AVN market.
Market Restraints
The high cost of AVN treatments, several risk factors associated with the drug treatment, which includes NSAIDs, bisphosphonates, corticosteroids, pain management medications, etc., and the lack of knowledge about the symptoms of AVN among the population are some of the factors restraining the growth of the market. Moreover, the strict regulatory requirements and the availability of alternative treatments are restraining market growth.
AVN Market — Regional Insights
North America dominated the AVN market, with the largest revenue share in 2023, and is expected to continue its dominance over the forecast period. The growth of the regional market can be attributed to the presence of the major key players, the growing adoption of advanced treatment options, advanced healthcare infrastructure, and the increasing prevalence of avascular necrosis among individuals. Additionally, the increasing geriatric population, increasing prevalence of AVN, favorable reimbursement policies, growing awareness regarding AVN among the population, increasing healthcare spending, and the increasing number of inorganic growth strategies by key players are influencing the growth of the AVN market. Asia Pacific is expected to witness a significant growth rate for the AVN market over the forecast period. The presence of the large population, the increasing number of patients suffering from AVN, increasing government initiatives for promoting awareness about AVN, improvement in the healthcare infrastructure, rising healthcare expenditure, and increasing prevalence of bone disorders in developing economies such as India and China are among the major factors fueling the growth of the AVN market. The AVN market is projected to grow from $0.564 billion in 2024 to $0.881 billion by 2032, registering a CAGR of 5.72% over the forecast period (2024–2032).
AVN Market — Segment Analysis
Based on Disease type, the market is categorized into Traumatic AVN and Non-Traumatic AVN. The growth of the segment is driven by the increasing trauma injuries such as dislocation or fracture, usage of steroids and bisphosphates, and consumption of alcohol among the population. When traumatic AVN occurs, the blood supply to the head of the femur is simply disrupted, leading to AVN. AVN results in 15–50% of the fractures of the neck of the femur and 10–25% of the hip dislocations. Approximately 20% of the people who dislocate their hips cause AVN.
Based on Treatment type, the market is divided into Drug and Therapy. The Drug type is categorized into Nonsteroidal Anti-inflammatory Drugs, Osteoporosis Drugs, Cholesterol-lowering Drugs, Blood Thinners, and Others. The Nonsteroidal Anti-inflammatory Drugs segment is expected to have the highest growth rate in the market. Over-the-counter medications such as ibuprofen or naproxen sodium nonsteroidal anti-inflammatory drugs help to relieve pain associated with AVN. The Nonsteroidal anti-inflammatory drugs taper off steroids and offer a total hip replacement. It is used to manage the early symptoms of the disease. All the above-mentioned factors are propelling the growth of the Nonsteroidal Anti-inflammatory Drugs segment. The therapy type is categorized into electrical stimulation, rest, exercise, gene therapy, and surgery. The Electrical Stimulation segment is expected to witness significant growth over the forecast period. The growth of the segment is attributed to the benefits of the electrical simulation method. In electrical stimulation or electrical bone growth stimulation method, low-level electrical currents are used to promote bone healing and regeneration. The gene therapy and Surgery segment is expected to witness the fastest growth over the forecast period. Based on Diagnosis, the market is categorized into Imaging, Biopsy, Total, CT Scan and PET, and X-ray. The market for MRI is expected to grow significantly in the AVN market over the forecast period. MRI is the sensitive test for the diagnosis of AVN, and it is more sensitive than plain film radiography used for the detection of AVN. MRI creates 3D images of the bone and provides a detailed view of the bone.
AVN Market — Competitive Landscape
The global AVN market includes several key players at country, regional, and global levels. Wright Medical Group Inc., Bone Therapeutics SA, Medtronic Logo, Teva Pharmaceuticals Industries Ltd., DR. Reddy’s Laboratories Ltd., Solara Active Pharma Sciences Limited, Bayer AG, and ALkem Labs are among the key players in the market. These key players have adopted several strategies, including pricing investments, partnerships, expansion of the product portfolio, mergers & acquisitions, collaboration and agreements, joint ventures, and geographical expansion for the enhancement of the AVN market. The companies conducted research & development activities related to bone diseases. Bone Therapeutics SA develops ALLOB, an innovative allogeneic product, which currently targets a bone indication and offers the possibility of extending the product portfolio to other bone defects. The competitive landscape includes approved country-specific and pipeline therapies. Any asset/product-specific designation or review, such as Orphan Drug Designation, Fast Track, Priority Review, Breakthrough Therapy Designation, Rare Pediatric Disease Designation, and Accelerated Approval, are tracked and supplemented with analyst commentary.
Competitive Analysis
Competitors in the market are leveraging their competitive benefits to enhance their growth. Moreover, they are persistently trying to establish leading market positions through new policies and strategies. The key trends and players have established a positive tone for development. The experienced management in the companies functioning in the market is creating business models that can bring about a productive phase of development. The competitors in the market are trying to succeed commercially by ensuring demand and supply are in balance.
AVN Market Scope
AVN Market, by region: North America (US, Canada, and Mexico), Europe (UK, France, Germany, Italy, Spain, Sweden, Austria, and the Rest of Europe), Asia Pacific (China, South Korea, Japan, India, Australia, Indonesia, Malaysia, Vietnam, Taiwan, Bangladesh, Pakistan, and the Rest of APAC), South America (Brazil, Argentina, and the Rest of South America), and Middle East & Africa (South Africa, GCC, Egypt, Nigeria, and the Rest of ME&A)
Key Players in the AVN market include Bone Therapeutics SA; Wright Medical Group Inc; Medtronic Logo; Teva Pharmaceuticals Industries Ltd.; DR. Reddys Laboratories Ltd.; Solara Active Pharma Sciences Limited.; Bayer AG; ALkem labs; Novartis AG; GSK; Pfizer, Inc; Integra LifeSciences; Eli Lilly and Company; Medtronic Plc; Bristol Myers Squibb-Myers Squibb; Merck KGaA; Zimmer Biomet Holdings; Sanofi SA; Smith & Nephew Plc; Integra LifeSciences Corporation; Stryker Corporation; Boehringer Ingelheim; Zimmer Biom; Johnson & Johnson et; and Baxter. The rise in the percentage of individuals with incomes, the increasing number of business experts, and the enormous increase in population are the key factors driving the growth of the market.
Conclusion
The conclusion highlights the number of key aspects that describe the present landscape and future market potential. The increasing prevalence of AVN is attributed to factors such as trauma, the usage of long-term corticosteroids, and heavy alcohol consumption. Significant advancements in treatment modalities such as regenerative medicine (stem cell therapy and PRP) are gaining traction to promote the healing and restoration of blood flow to the affected areas. Core decompression and biologics demonstrated less invasive options to traditional surgery, reducing recovery time and improving patient satisfaction. These are helpful not only in the treatment efficacy but also in broadening the treatment options available to physicians and patients. Differences in diagnostic practices across regions can lead to delays in treatment, patient outcomes, and overall market growth. Several clinical studies are required to develop the long-term efficacy of newer treatment options, which is crucial for gaining regulatory approval and market acceptance. Collaborations among pharmaceutical companies, research institutions, and healthcare providers can enhance the development and commercialization of new treatments. The market analysis of AVN provides a dynamic landscape characterized by increasing incidence rates, novel treatment advancements, and a growing emphasis on patient care. Although challenges such as cost and diagnostic variability exist, the offers for growth through innovation, collaboration, and education are significant. Stakeholders in this space are focusing on raising improvements in care and capitalizing on the evolving landscape of the market.
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