Sternal Closure Systems Market: Key To The Future of Healthcare Industry

What happens during sternotomy and sternal reconstructive surgical procedures? Why are surgeons required sternal closure systems?

Cardiac surgeons perform life-saving procedures like median sternotomy, hemisternotomy, and bilateral thoracosternotomy. Sternal closure systems enable the sternum to be fixed internally after a sternotomy or sternal farcture. Sternal closure systems are used to close the dissected sternum bone after critical procedures such as cardiac bypass surgery, acute traumatic heart surgery, and cardiac valve repair surgery.

What are sternal closure systems? What are the different types?

Overview: Sternal closures are intended for use in both stabilizing and repairing anterior chest wall fractures. The systems are used to stabilize the sternum following sternotomies and sternal reconstructive surgeries in order to encourage fusion. The median sternotomy is the most commonly used technique for cardiac procedures because it allows for quick and easy access to heart valves and arteries. Sternal closure products are primarily divided into two categories: closure devices and bone cement. Closure devices are classified into four product categories: wires, plates and screws, cables, and clips.  Wires are still the king of closure devices. Because of the ease of use, speed of use, low complication rate, and low cost of wires, sternal closure with wires has become the standard.

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What solutions/options are available for them?

The majority of companies offer two types of products: closure devices and bone cement.

Closure Devices: The following are some of the most important companies that provide closure devices.

Bone Cement: In orthopaedic surgery, bone cement is commonly used. During the regeneration or healing process, these products are used to provide adhesive support to sternal bones. For orthopaedic and trauma surgeries, various types of bone cement products are used. The most commonly used bone cements are calcium phosphate cement, glass polyalkenoate cement, and kryptonite bone cement. Kryptonite bone cement is the most commonly used bone cement for median sternotomy procedures, as it reduces post-surgical risks such as sternal dehiscence, deep wound infection, and chronic pain.

What is the current adoption rate, and why does it fluctuate?

Titanium is the most preferred material for sternal closure system manufacturers due to associated advantages over other alloys for medical device manufacturing, such as greater mechanical strength, radio-opaque nature, and high malleability. Titanium Sternal Fixation System (DePuy Synthes) and Sternal Closure System are two key products in the market (Medicon eG). Following titanium-based systems, stainless steel is the second most commonly used raw material for the manufacture of internal fixation devices due to its favorable mechanical properties, corrosion resistance, and cost-effectiveness when compared to other metallic raw materials. Stainless steel wires can occasionally damage and cut into the bone during chest and respiratory motion, increasing the risk of dehiscence. In the near future, however, procedural constraints will limit the optimal adoption of stainless steel-based sternal closure systems.

Polytheretherketone-based sternal closure systems will be adopted at a much higher rate in the future than titanium-based sternal closure systems and stainless steel-based sternal closure systems due to advantages such as excellent mechanical and chemical resistance, device stability at high temperatures, high tensile strength, lack of shadow effect during X-ray imaging, limited risk of allergic reactions, and increased availability of clinical evidence to support efficacy and safety.

DePuy Synthes, Zimmer Biomet, KLS Martin Group, B.Braun, and Stryker are the key companies in this market, accounting for the majority of the market share.

DePuy Synthes: DePuy Synthes has a strong presence in the US, Germany, and Canada and seeks to further enhance its geographical presence by strengthening its business operations in emerging markets like the Asia Pacific.

Zimmer Biomet: The company focuses on expanding its product portfolio in the market through acquisitions. In 2020, Zimmer Biomet Holdings, Inc. announced the acquisition of A&E Medical Corporation and its complete portfolio of sternal closure devices, including sternal sutures, cable systems, and rigid fixation.

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What does the future of sternal closure systems look like:

Increasing target patient population coupled with subsequent increase in the number of procedures is expected to drive up demand for sternotomy procedures used to diagnose and treat chronic obstructive pulmonary diseases, CVDs, and among others. The growing popularity of these procedures is expected to drive demand for sternal closure systems in the coming years.

According to the American Heart Association (AHA), cardiovascular diseases killed 18.6 million people in 2019, with the majority of deaths occurring in Eastern Europe and Central Asia. According to the AHA, by 2030, 40.5% of the SU population will have some form of CVD. Sternal closure is a required technique for certain surgical procedures such as cardiac bypass surgery, acute traumatic heart surgery, and cardiac valve repair surgery. Globally, 2 million median sternotomy procedures for heart surgery are performed each year. The increasing number of target surgical procedures and the increased adoption of novel products are expected to drive increased demand for sternal closure products in the near future.

The availability of reimbursement for surgical procedures has increased the number of surgeries, which is expected to help the sternal closure products market grow.

Medical reimbursement for critical surgeries is increasingly being offered by respective government authorities in developed countries (such as the US, Germany, Japan, and the UK). Increased reimbursements for sternal closure are expected to drive sternal closure product adoption among healthcare professionals in major healthcare markets in the near future.

Key Reimbursement Codes for Sternal Closures (As of 2021):

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